Hearing Aid Selection Flashcards
Who will benefit from hearing aids?
People with similar audiograms may experience varying levels of benefit from hearing aids due to factors beyond threshold measurements, such as frequency discrimination, temporal elements, and central processing.
Can benefit be predicted from the audiogram?
- Relying solely on pure tone loss as an indicator of hearing aid benefit is unreliable.
- Dillon (2001) suggests using audiograms as a starting point for further inquiry.
- For those with hearing losses between normal and severe, audiograms should guide further questioning.
- Discussing patients’ needs and current aid benefits is crucial for selecting appropriate aids, features, and settings.
What is the audiologist’s role regarding patient motivation and expectations regarding hearing aids?
volves understanding the patient’s needs, motivations, and expectations, assisting them in deciding whether to try hearing aids, and determining if one or two aids are suitable for them.
What is the impact of gradual hearing loss, and why might individuals with mild losses initially fail to recognize their impairment?
- Gradual hearing loss, often caused by factors like presbycusis or noise-induced damage, typically starts with deterioration in high frequencies, affecting speech intelligibility while overall speech loudness may remain unchanged.
- Individuals with mild hearing loss may not realize their impairment initially, attributing difficulties to external factors such as others speaking quietly or mumbling.
what does the patients expectation of what a hearing aid will do for them significantly affect?
- Their acceptance of a trial of a hearing aid –
- Their acceptance of the aid following a trial
- It is VITAL that patients have realistic expectations of what amplification can achieve.
what are some common reasons for wanting hearing aids?
- Can’t hear the TV/radio/music or the phone/doorbell ringing
- Can’t hear in work, social situations or on the phone
- Relative, friend or work colleague has persuaded the patient to try them
- Client realises they are struggling to hear – often embarrassment motivates people to seek help for their loss
- A friend with hearing loss has benefitted from wearing hearing aids
and recommended them
Which ears should not be fitted with a hearing aid?
1- Medical contra-indications, such as chronic outer or middle ear infections
2- Very narrow dynamic range, where uncomfortable loudness levels (ULL) are close to the threshold
3- Normal hearing
4- Profound losses that may not benefit from aiding due to poor thresholds or discrimination.
When should hearing aids be provided unilaterally or bilaterally?
Bilateral provision should be the default option for hearing loss in both ears, unless there are clear contraindications, including patient preference.
when is a unilateral fitting more appropriate?
- The patient is unable to handle two aids (e.g., very poor dexterity)
- The patient does not want two aids
- The patient has diplacusis (difference in pitch perception between the two ears)
- One ear has much poorer speech discrimination than the other.
If unilateral provision is necessary, which ear should be fitted with a hearing aid?
*The decision balances three factors:
- Aiding the better ear maximizes the total range of audible sounds.
- Aiding the worse ear enhances the range of sounds audible in both ears, supporting better binaural hearing.
- Higher sound quality is likely from the better ear.
*Additionally, consider the audiometric configuration:
- Determine if one ear has a pattern of loss that is easier to fit than the other.
what are the benefits of binaural amplification?
Improved localization (e.g., for conversations in groups)
Better speech discrimination in noise (e.g., a busy office)
What is the 50dB HL Guide for fitting an asymmetrical hearing loss unilaterally?
The 50dB HL Guide suggests fitting the ear with thresholds closest to 50dB HL.
What factors affect the choice of hearing aid?
*Type of Loss:
- Air Conduction vs. Bone Conduction aid
*Air Conduction:
-BTE (Behind-The-Ear) vs. ITE (In-The-Ear) vs. ITC (In-The-Canal) vs. CIC (Completely-In-Canal)
- For BTE, consider the type of earmould:
- Open fitting, RIC (Receiver-In-Canal), or earmould acoustic modifications
*Specialist Aid Needed:
- CROS (Contralateral Routing of Signals) / Bi-CROS
- Spectacle aid
- Frequency compression aid
*Bone Conduction:
- BC (Bone Conduction) aid or BAHA (Bone Anchored Hearing Aid)
*Power of Hearing Aid Required:
- Based on the severity of the hearing loss
what lifestyle hearing aid features are needed?
– Extra programs for different listening situations (e.g. background noise, listening to the TV or music, etc)
– Loop/FM systems required?
– Bluetooth connection for use with mobile phone?
What audiological hearing aid features are needed?
– Compression
– Multiple frequency bands for better fit of audiogram
– Noise reduction
– Feedback suppression
