Clinical Practice

Greater individualization in hearing aid recommendations

“What hearing aid is right for me?” It is a question asked to audiologists by new hearing aid users every day.

“What hearing aid is right for me?” — It is a question asked to audiologists by new hearing aid users every day. Thinking back on my days as a clinical audiologist, I remember how difficult this question could be to answer. I always wanted to take into consideration important things like personal preference, budget, and activity level. However, individualization was something I was always trying to incorporate more and more into my hearing aid recommendations. This desire, further spurred by my undergraduate degree and interest in Psychology, has followed me throughout my career as a clinical audiologist and now research audiologist.

The culmination of my experiences both clinically and with our population of research participants has taught me that each individual has priorities and expectations when it comes to hearing aid use. When considering these priorities, and although there are always exceptions, three main “profiles” for hearing aid users have emerged: Those who prioritize speech performance, those who prioritize comfort, and those who prefer an “unprocessed” sound. These three domains may align with a higher or lower hearing aid technology level recommendation.

Those who embody the “speech performance above all else” profile, are usually very active, communicative individuals that want any and every feature enabled to suppress noise, and emphasize speech. These individuals most closely align with recommendations for higher levels of technology due to their active lifestyles, but also their desire for more sound cleaning and features to help with speech understanding.

Those who follow the “comfort” profile find satisfaction with hearing aids if they never reach an uncomfortable loudness level, if sounds are never “startling,” and if background noise is never “obnoxious.” These hearing aid users would also align with a recommendation for a higher level of technology, due to the availability of features related to comfort, transient sound suppression, and noise reduction.

Finally, the third “profile” comprises a portion of the hearing aid population that tend to be long-term hearing aid users. These individuals can have congenital hearing loss, and oftentimes extensive experience with linear amplification. These hearing aid users tend to value a preservation of sound relationships, in that they want to hear loud sounds as loud, and soft sounds as soft. It is these individuals, although they may be active in lifestyle, that may prefer the “unprocessed” sound quality of a lower level of technology, due to less sound cleaning and less adaptation to the surrounding environment.

The profiles presented here illustrate just a first step towards greater individualization in hearing aid recommendations. Activity level is certainly an important consideration, but priorities and expectations should also be taken into account. The features of a high technology level hearing aid will offer better performance, particularly those with challenging listening demands, but technology level cannot be considered in isolation. The benchmark for “success” with hearing aids changes through the eyes of each individual.

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