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Trends in hearing aid fitting

The hearing aid fitting landscape is changing, and likewise the trends we see in hearing aid fitting.

In some parts of the world, the established private sector is under pressure from over-the-counter (OTC) hearing aids and personal sound amplification products (PSAPs). Countries with large public sectors are under pressure to cut costs and to increase capacity necessitated by demographic shifts. Finally, the developing world is facing the bottleneck of a shortage of trained audiologists.

Automated testing and personalized hearing aid fitting

In part, the two latter challenges could be solved by automated testing. If user-operated hearing testing – for example of puretone thresholds for air and bone conduction – could be made available in ways that were robust and trustworthy, precious time could be freed up. Depending on the setting, the time saved could be used to either increase the capacity of the system, or to allow audiologists to devote more of their time to their areas of specialty: advanced diagnostics, personalized hearing aid fitting and counseling.

Regarding the first challenge, we should expect that the technological gap from OTC instruments and PSAPs to medical-grade hearing aids will diminish. However, while technology is important in providing the foundation and the opportunities for a successful hearing aid fitting, what really makes the difference is the careful personalized fitting of the hearing aid and counseling the client about how to use the aid effectively.

High-frequency measurements

One example is real-ear measurement (REM). REM has been around since the 1980s, basically using the same technology ever since. In the meantime, however, the audio bandwidth of premium hearing aids has increased dramatically from 5 to 10 kHz. This poses a challenge for traditional REM technology, as its reliability lessens for frequencies above 5 kHz. Moreover, the high-frequency range is where the individual variability in, for example, real-ear-to-coupler difference (RECD) is the greatest, indicating an unmet potential for individual compensation. To address this, Interacoustics is engaged in researching a paradigm shift in REM technology that will allow reliable measurements throughout the entire bandwidth of modern hearing aids. In addition, the new technology will reduce the importance of correctly placing the measurement probe. This is expected to be warmly welcomed by clinical audiologists.

Spectro-temporal modulation (STM) test

Another example is the spectro-temporal modulation (STM) test. The STM test is actively researched by IRU together with partners at the Technical University of Denmark and Oticon A/S. The promise of STM is to be a simple, fast and language-independent proxy for complicated speech-in-noise testing. Such a test has potential use in the selection of hearing aids for the individual client, the adjustment of signal processing features such as noise reduction and beamforming, and it may also assist in managing the client’s expectations about life with hearing aids.

Up for similar reads on hearing aid fitting? Then head to our fitting magazine!

About the author

Søren Laugesen holds a Ph.D. in Acoustics and Signal Processing from the Technical University of Denmark. Søren has more than 23 years of experience within acoustics research, currently serving as a Senior Research Engineer at the Interacoustics Research Unit (IRU), following a 19 year stay at the Eriksholm Research Centre as a Research Engineer. Søren has more than 50 publications under his belt.
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