I’ve encountered a few people recently who are wearing poorly fit hearing aids. The people I’m thinking of have a style that’s become very popular in recent years. It’s called open fit. These are behind-the-ear style with a thin tube that directs sound into the ear or a wire that goes to a speaker in the ear.
The tubes or wires vary in length. Selection of the right length is important because a short wire may direct the sound up against the wall of the ear canal and a long wire will not look right and may allow the aid to fall off the ear. The inevitable outcome is that the client is not getting proper amplification.
This leads me to the question of how providers and clients are evaluating performance. If the sound is directed toward the wall of the ear canal, the client may be getting some benefit but certainly not the full amount. If there is no tool to evaluate benefit, the client may say, “Yeah, it’s a little better” and both the client and the dispenser accept that as the best that can be done.
The profession of audiology is way past (or should be past) the simple question “How does it sound?” I use a questionnaire called the Client Oriented Scale of Improvement for subjective assessment. This gives the client a semi-structured tool with which to explore the listening situations where he has the most trouble and develop listening goals he would like to reach. I can use the information developed with this form to help him select the proper technology to meet his goals. After he uses the technology for a couple of weeks we can go back and look at his goals and determine whether we have attained them to his satisfaction.
The dispenser who selects a short wire should find the problem with a visual inspection of the speaker in the ear canal. Obviously some do not. If a visual inspection doesn’t reveal the problem, the use of Real Ear or Visible Speech measures will. This is a measurement that a dispenser (audiologist or hearing aid specialist) should use routinely to ensure that the sounds provided by the hearing aid are appropriate. Consumer Reports, in their June 09 article on hearing aids, said this measurement is a “must have.” Please see the embedded YouTube from Consumer Reports. It is a little dated, but their advice on Real Ear is right on.
You don’t have to put up with poor hearing aid performance. Find an audiologist who will sit down and take the time to find out who you are and where your listening problems lie. Then you’ll be on the road to better performance.