The greatest joy that our profession brings us is to help people hear well. People come to the office hearing poorly. They leave hearing better. They leave happy. And they leave us with a deep sense of accomplishment and satisfaction.
Today I want to add another tool to your toolbox. It a hearing aid feature you use everyday—the multi-program capacity of digital hearing aids. I want to tell you how I use “listening programs” to improve hearing.
The idea is simple. Create an “experimental listening program” and have the patient compare this “experimental program” to their basic hearing aid settings.
FIRST, SOME BASICS
We create the default (basic) program (the amplified sound) in a hearing aid when we enter the patient’s audiometric thresholds into the computer and select “first fit.” Afterwards, we use this program as the reference point from which we generate other listening programs, such as Noise Reduction, Music, and Telephone.
It is important to remember that the hearing aid industry has spent many years testing different formulas in an attempt to find the most successful listening program. Manufacturers quickly learned that attempts to give patients “maximum hearing” were fraught with problems. Said simply, too much amplification is quickly rejected; too little amplification is not.
The basic listening program is focused on making amplification comfortable and acceptable. It does not attempt to provide the best hearing possible.
Now, I want to make this next point very carefully; it is a critical concept. Think about all the “listening programs” you have available on your software. These include universal, noise reduction, music, telephone, etc. But, there is not a choice called “maximum listening.” That’s because the dangers of giving a patient too much amplification far outweigh the negative aspects of giving the patient too little amplification.
It would be nice if our fitting software offered 40 or 50 choices of listening programs, rather than 8 to 12. It would also be nice to have a program called “Superhuman hearing.” There are times when hard-of-hearing people need to hear extremely well, e.g., a teacher in a large classroom, a lawyer in a courtroom. When you have a patient with a special need, I recommend you develop an “experimental listening program” and have the patient try it.
MAXIMUM HEARING
In my next blog post, I will discuss the specifics of creating a maximum hearing listening-program. Most universal (default) hearing programs provide limited amplification in the lower frequencies. When appropriate, I add 10-20 dB of gain in this frequency region.
Please, do not misunderstand me. I am not suggesting you stop using the basic or universal program as the patient’s default program. This program is needed most of the time. It avoids problems such as too much noise and the upward spread of masking.
But if your patient is, for example, a teacher who works in a large classroom, this person needs very good hearing from a distance of 30 to 40 feet. In this case I would anticipate that the teacher would stay in P-1 (the Universal program) when talking to the class, then switch to P-4 (maximum hearing) during the question and answer period in the class.
I will develop the concept of maximum hearing in the next several articles.
