08_Intro to prescriptive targets and fitting Flashcards

1
Q

What is a prescription?

A

A mathematical formula, sometimes implemented in the software, that recommends the decibel levels that should come out of the hearing aid

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2
Q

What is the difference between the REUR and REAR called?

A

Gain

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3
Q

What are the 3 major concepts regarding hearing aid output?

A

1) loudness normalization requires more overall gain for soft sounds and less gain for loud sounds (compression)
2) modern HAs can adjust gain quickly, in real time, and in many channels
3) HAs shape the output of speech to account for the shape of the hearing loss and the falling spectrum of speech (frequency shaping)

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4
Q

Name two things targets help us provide.

A
  • good speech intelligibility in quiet, by providing enough frequency shaping to ensure access to many/all sounds in speech
  • comfortable, acceptable loudness
  • reasonable subjective outcomes (good benefit)
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5
Q

The use of published prescriptions is typically considered part of _______

A

Evidence-based practice

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6
Q

Where are “generic” HA prescriptions developed? Are they specific to certain makes and models of HA?

A

Developed in research labs.
Not specific to any make or model of HA (typically do not recommend a specific profile of signal processing)
Revised over time based on research

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7
Q

Name 3 families of generic prescriptions that are active, and one feature about each

A

DSL - developed in Canada, originally for paediatrics

  • adult version available
  • current version DSLv5

NAL - from Australia

  • current version NAL-NL2
  • typically for older adults c/ hearing loss

Camfit - from English

  • current version Camfit-HF
  • has targets to 10 kHz
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8
Q

What might not be present in all prescriptions?

A
  • formula may not be adjusted for linear vs non-linear signal processing
  • formula may not adjust itself to provide more gain and output for children who are acquiring language, or corrections for pediatric EAMs or ax methods
  • formula may not include targets for the extended high frequencies
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9
Q

What are “propietary” prescriptions?

A

Prescriptions developed by individual manufacturers for use with their HAs

  • based on in-house studies, feedback from partnered clinics, and theoretical principles
  • intended to provide good initial fitting
  • typically associated c/ recommended signal processing profile (default setting for NR, programs, etc)
  • combined set of default settings and signal processing sometimes gets proprietary name (FirstFit, Autofit, etc)
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10
Q

How can generic and proprietary prescriptions be used together?

A

Can usually select an HA prescription together with default signal processing
- e.g. generic prescription for speech in quiet + proprietary default signal processing

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11
Q

Which prescription includes corrections for input level, adults vs children, and quiet vs noisy situations?

A

DSL

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12
Q

Which prescription includes corrections for input level, adults vs children, and tonal vs non-tonal languages?

A

NAL

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13
Q

Name 2 reasons why the HA instrument type is important to include when working with fitting software?

A
  • keep accurate record
  • set the system for active vs stored equalization at the ref mic
  • set the correct mic location effects if using test box verification
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14
Q

When do you select test box vs on ear mode for fitting software?

A
  • on ear if it is on the patient

- test box if you wish the system to use MLEs and RECDs to enable coupler-based testing with corrections

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15
Q

How does the HL transducer affect targets?

A

Different audiometric transducers use different procedures for the HL to SPL transform, to choosing the right menu item ensures the correct transform is used

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16
Q

What is the BCT for in the fitting software?

A

If your patient has an ABG and you choose a rx that has corrections for conductive hearing loss

17
Q

What is the binaural option good for on the fitting software?

A

If your are fitting binaurally and choose an rx that applies a binaural loudness correction
- also good for records

18
Q

Typical fits are within ___ dB of targets

A

5

19
Q

The steeper the loss, the ______ it is to fit to targets across a broad range of frequencies

A

Harder

20
Q

The smoothness of the fit ____ (is/is not) important

A

Is

21
Q

Is loudness balance between ears important?

A

Yes