By Lolly Wigall
I really like being an audiologist. I enjoy helping people hear well. I appreciate the technological changes that have taken place over my many years working as an audiologist.
I like doing hearing tests and explaining the test results to patients and their families. I especially like selling and fitting hearing aids. I really enjoy the listening part. I appreciate hearing stories from patients about their mis-hearings and their mis-adventures with their hearing loss and hearing aids. I find great satisfaction in finding the correct product for each person and then fine-tuning it to their needs and wants.
Changing Technology: Analog to Digital
In the 40 years since I earned my master’s degree in audiology, the technology our profession uses has changed enormously. The most dramatic change occurred in the 1990s when the era of digital hearing aids began.
At first these came with volume controls. But, gradually, as manufacturers made more sophisticated software, the hearing aids were supposed to react to the environments by themselves, so volume controls were eliminated. More recently, manufacturers have started to include volume controls in many digital hearing aids to give the wearer more control.
Digital hearing aids were primarily designed for people with sensorineural hearing losses ranging from mild-to-moderate to severe, and most such patients were able to hear and understand speech well with them. Digital hearing aids have become Bluetooth-compatible. When a person wears two hearing aids, the aids communicate with each other.
Fitting Profound Hearing Losses
Years ago, patients with profound hearing loss used body-worn hearing aids with cords that attached to receivers attached to custom molds. The cords came in different lengths depending on how the person used the aid. There were unilateral cords, and Y-cords.
As other hearing aids got smaller, so did power aids, which allowed even people with profound hearing loss to wear behind-the-ear hearing aids.
Even after digital aids became standard for most people, many power hearing aids were still analog. People with profound hearing loss were used to the sharp, clear sound of analog signal processing. And, with their profound hearing loss, they didn’t need subtle, sophisticated signal processing; they needed loudness and clarity.
Nevertheless, a few years ago manufacturers decided to stop making analog hearing aids. They were able to build more powerful receivers that, laboratory testing showed, should make the hearing aids “strong enough” to accommodate even profound loss.
However, because the hearing aids were digital, the sound seemed very different to a wearer accustomed to analog devices.
“Linear” Fit Processing Often Not Good Enough
Interestingly, many manufacturers now have a “linear” fit in their most powerful hearing aids. This linear processing is supposed to resemble an analog hearing aid. But, I can tell you, many of my patients have not found this to be satisfactory. I have at least five clients who are trying to replace their old analog hearing aids with the latest digital devices, but they are not happy. They are not hearing well in noisy places, and they are not hearing environmental sound cues as well as they did with their analog aids.
I understand that these are only anecdotal reports, and are not scientifically tested. However, they are very real to my patients. I have tried several manufacturers and their linear settings. I have called for programming help from the individual companies, hoping that I may be doing something that is inconsistent with their philosophy of programming.
I am sure I am not alone in my quest for fitting my patients with profound hearing loss. I am open to suggestions. Please help me help my patients!