An audiologist is the hearing health-care professional who will perform an evaluation to determine the degree and type of your hearing loss. Based on the results of this evaluation, the audiologist will make a recommendation for the management of your hearing loss—either a medical evaluation by an ear, nose, and throat (ENT) physician or a hearing aid fitting.
If hearing aids are recommended, they will be customized by an audiologist to fit your ears and hearing loss. Modern hearing aids have automatic processing inside of the computer chip which can change the delivery of the sound based on the environment that you are in. Hearing aids can also have user controls, where you can change the volume and settings through buttons on the device or through a smartphone application. Hearing aids can stream sound from cell phones, allowing you to hear phone calls, music, or podcasts through your devices, or can stream dialogue from the television, so you can hear the TV in your hearing aids.
There are a variety of accessories and options to choose with hearing aids, and the audiologist is the hearing healthcare professional who will discuss these options with you to help narrow down which choices may be best for your lifestyle.
Styles of Hearing Aids
The choices of hearing aid styles and features are based on several factors, including the type and degree of your hearing loss, your individual needs (such as communication requirements, lifestyle, and manual dexterity), and your medical and audiological history. Hearing aid styles may be broadly classified as “behind-the-ear” and “in-the-ear.”
- Behind-the-ear (BTE) hearing aids are designed to fit most ears but may require some customization of the earpiece to fit securely. Most of the hearing aid sits on top of the ear, with a thin wire or tube that sits in the ear canal. BTE hearing aids include receiver-in-the-aid (RITA) devices and receiver-in-the-canal (RIC) devices. A RIC style may be preferred for some, as it tends to be smaller, which a RITA style may be more durable for people who are prone to moisture in their ears.
- In-the-ear (ITE) hearing aids are custom-molded to the shape of your ear. The entire hearing aid sits inside of the ear canal and bowl of the ear. Custom ITE hearing aids come in various sizes, depending on your needs and interests in certain features, like directional microphones, which help with conversations in noisy places, or cell phone streaming. Custom hearing aids may be particularly of interest for people who have vision or dexterity weaknesses, as they are sometimes easier to manipulate and insert into the ear.
Several features are available to improve the hearing aid experience. Some of the most common include:
- Directional microphones to enhance speech understanding in noise
- Noise management to improve listening comfort in noisy situations
- Feedback cancellation to alleviate the annoyance of whistling and buzzing
- Streaming programs to access sound from phones and other audio sources
One or Two Hearing Aids
When a person has hearing loss in both ears that can be helped with hearing aids, research has shown that two hearing aids provide superior benefits for sound quality1, understanding words in quiet2, and noisy places3. Research has also shown that when both ears are hearing aids candidates, but only one hearing aid is used, the other ear’s word understanding ability may deteriorate more than the fitted ear over time. Your audiologist will inform you if you are a candidate for one or two hearing aids4.
After your hearing aids have been selected, they must be fit appropriately. Hearing aids will be programmed to amplify sounds so they can be heard at specific levels and they also must be comfortable and secure in the ear. Hearing aids are programmed to a prescriptive level using real-ear measurements and can be adjusted with computer software in the audiologist’s office.
Sometimes, additional fine-tuning is necessary after you try your hearing aids out in your own day-to-day life, so a daily journal can help track your questions and concerns. It can take a few visits to the audiologist’s office to fine-tune your hearing aids for your lifestyle, so be sure to make an appointment if concerns arise. It is important to communicate with your audiologist to ensure you are satisfied with your hearing aid experience. Depending on your hearing loss and communication needs, other accessories may be recommended to improve your listening experience.
Maintenance and Insurance
Your audiologist will review with you the details of payment, including insurance coverage or financing options, as well as warranties for repair or loss, service recommendations, and trial policies.
As with all electronics, hearing aids require maintenance and care. It is important to handle the hearing aids carefully and keep the hearing aids dry and clean. Your audiologist will teach you proper daily care to maintain your hearing aids effectively and provide you with a hearing aid user manual for review. Proper care and maintenance can reduce the need for repair.
Expectations and Outcomes
Research has shown that hearing loss treated with hearing aids may decrease fatigue5 and improve quality of life6. More recently, hearing aid use was represented as a major factor protecting from cognitive decline, with a lower incidence of dementia in those using hearing aids7.
Even with the best hearing aid technology though, it is important to maintain realistic expectations, as hearing aids cannot fix all communication concerns. To improve your hearing aid outcomes, it is important to use good communication strategies. To hear better, try turning down any extra background noise, like the television, or try choosing a seat in a restaurant that is away from the noise. Also, always make sure you are face-to-face and in the same room as the person you are talking to.
When you get new hearing aids, you will be re-introduced to a world of sound, and it takes time to adjust. Your audiologist will discuss hearing aid techniques, communication strategies, and other assistive technologies to alleviate difficulties in these situations.
If you have difficulty hearing, schedule a hearing evaluation with an audiologist near you.
- Balfour, P.B. & Hawkins, D.B., (1992). Amplification and aural rehabilitation, Ear and Hearing: October 1992. p 331-339.
- McKenzie, A.R. & Rice, C.G. (1990). Binaural hearing aids for high-frequency hearing loss, British Journal of Audiology, 24:5, 329-334, DOI: 10.3109/03005369009076573
- Naidoo, S.V. & Hawkins, D B. (1997). Monaural/binaural preferences: Effect of hearing aid circuit on speech intelligibility and sound quality, J Am Acad Audiol, 8: 188-202.
- Silman, S., Gelfand, S.A., & Silverman, C.A. (1984). Effects of monaural versus binaural hearing aids. JAcoust Soc Am, 76 :1357-1362.
- Hornsby, B.W.Y. (2013). The effects of hearing aid use on listening effort and mental fatigue associated with sustained speech processing demands. Ear Hear. 2013;34:523–534.
- Chisolm, T.H., Johnson, C.E., Danhauer, J.L., Portz, L.J.P., Abrams, H.B., Lesner, S., McCarthy, P.A., & Newman, C.W. (2007). A systematic review of health-related quality of life and hearing aids: Final report of the American Academy of Audiology Task Force on the health-related quality of life benefits of amplification in adults. J Am Acad Audiol 18:151–183.
- Ouvrard, C., Meillon C., Rullier, L. &, Dartigues J.F. Death, depression, disability, and dementia associated with self-reported hearing problems: a 25-year study. J Gerontol A Biol Sci Med Sci. 2018; 73: 1383-1389.