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Ask the Audiologist: Why Do I Need a Hearing Aid Fitting?



It seems like you can buy hearing amplification devices anywhere—online, mail order, and even at your neighborhood pharmacy via over-the-counter (OTC) devices. With so many products readily available, you might assume you can just put the devices in your ears and hear clearly and comfortably.

Or consider this scenario: Your neighbor’s friend purchased top-of-the-line hearing aids before he passed away. Since these are such fancy hearing aids, surely if you bring them to a hearing care professional, they’ll be able to fit those aids to your specific hearing loss, right?

These situations neglect to account for the fact that your degree of hearing loss, personal preferences, and lifestyle all play a role in determining the type of hearing aids that are best for you, and the unique way they need to be fit. The fitting process is critical in determining whether you will ultimately be happy with your hearing aids.

Hearing loss is complicated

With so much emphasis on technology, it’s easy to overlook the critical importance of the fitting process. If you can’t see well, the fanciest glasses are useless if they’re not customized to your vision needs. The same applies to hearing aids. The only difference is that hearing loss is in many ways even more complex than vision loss.

When hearing loss occurs, the degree of loss is usually different for different pitches. To quantify hearing loss, an audiogram is needed to establish at which loudness level a person begins to hear different pitches (frequencies) of sound. Everyone’s audiogram is different. One person can hear low frequency sounds normally but have a moderate hearing loss for higher frequency sounds. Another can have a moderate hearing loss throughout the different frequencies.

Beyond hearing simple sounds, there is also the matter of interpreting these sounds into meaningful speech or events occurring in the environment. Regardless of how well a person can hear different pitches of sound, the brain’s ability to interpret these sounds into intelligible speech differs. Two people with the exact same degree of hearing loss as shown on the audiogram may have different abilities to understand speech. Therefore, hearing aids should not only restore sounds, but also facilitate speech understanding.

How people prefer to hear their world is also different. Some prefer a quieter soundscape to focus on speech, while others prefer not to miss out on all the sounds in the environment. These preferences change as you move from one listening situation to another.

There’s also the physical aspect. Hearing aids need to fit comfortably above or inside the ear for extended periods. They need to be acceptable in terms of size and appearance, and easy to handle and maintain if you have any dexterity or vision limitations. Of course, the price tag matters too.

Finding the perfect fit

The various kinds of hearing aids fulfill patient demands differently, so choosing one that best matches your needs and preferences requires a professional’s expertise. Once chosen, the features and settings in the device need to be customized to create the optimum listening experience. Therefore, one person’s perfect hearing aids may not work for you.

Selecting and customizing hearing aids during the fitting process is critical in determining your ultimate satisfaction with your hearing aids. This important step is largely missing in OTC amplification devices, which is one of the reasons why these devices so far have a significantly higher rejection rate than hearing aids prescribed and fit by hearing care professionals. Ultimately, if you’re not fitted properly, you might be unsatisfied with your hearing aids at best, or further damage your hearing at worst.