Walden et al (2009) notes that hearing aids certainly improve the quality of life and provide benefit for people with hearing impairment. However, only a relatively small proportion of people with hearing loss (less than 25 percent) choose to wear amplification. Among the impediments that contribute to the lack of hearing aid acceptance by hearing-impaired people are cost, stigma, and the perceived limits of amplification to help in challenging situations. The authors refer to Kochkin's work (2007) that stated patients must recognize and accept the communication problems secondary to their hearing loss as prerequisites to amplification acceptance. Thus, the primary "ingredient" with regard to successful hearing aid fittings is the patient's belief he/she will benefit from amplification.
Walden et al developed and administered the Everyday Listening Assessment (ELA) to increase non-users' expectations and motivation to use amplification. The ELA requires about 20 minutes to complete and consists of common, everyday listening sound samples presented at unaided (no gain) loudness levels and at two amplified levels (mild or moderate gain) from which the patient indicates their preference. The ELA listening task involves 21 carefully selected sound samples presented to each ear, for a total of 42 presentations and a touch screen is used to capture the patient responses.
Forty-eight adults (42 males and 6 females) participated in the validation study (mean age 61 years). None of the participants had previously worn hearing aids and the participants represented a cross section of hearing ability, from normal to severe.
The authors note that results from the validation study suggest ELA ratings are generally predictive of clinical decisions with regard to amplification candidacy. The ELA may be very useful for patients experiencing ambivalence with regard to treatment options. Walden, Walden, Summers and Grant note the ELA only offers non-prescriptive single channel WDRC amplification, and as such, it is not custom programmed to the specific hearing loss and does not contain advanced circuitry (directionality, noise suppression, multichannel compression etc). Thus, the full benefit of amplification is not facilitated via the ELA. However, the ELA was helpful for some participants who were not convinced of the significance of their hearing loss, and was helpful for some who were pessimistic with regard to whether amplification would be beneficial.
For More Information, References, and Recommendations
Walden TC, Walden BE, Summers V, Grant KW. (2009) A Naturalistic Approach to Assessing Hearing Aid Candidacy and Motivating Hearing Aid Use. Journal of the American Academy of Audiology. (20)10:607-620.