HAT Awareness: Efficiency May Be the Key to Increased Use

By John Greer Clark and Brittany Gilb

This article is a part of the March/April 2019, Volume 31, Number 2, Audiology Today issue.

As audiologists are well aware, even the highest levels of hearing aid technology fit to best practice standards (Academy, 2006; ASHA, 2006) fail to meet the daily listening demands of many patients with hearing loss (Lesner, 2003; Laplante-Levesque et al, 2013). Indeed, as Table 1 reveals, the degree of hearing deficit remaining post-hearing aid fitting can be substantial.

Hearing assistance technologies (HATs)—also known as assistive listening devices (ALDs), designed to improve speech understanding, enhance the reception of auditory media, or heighten the awareness of environmental sounds or warning signals—have been around for many years, and their value in addressing specific listening needs can be substantial. A full review of these device types and their uses can be found in a variety of audiology texts (e.g., Atcherson et al, 2015; Montano and Spitzer, 2014; Tye-Murray, 2014).

Most patients unfortunately do not hear of HATs from their audiologists (Clark et al, 2017; Stika et al, 2002), and their use among adults frequently remains low (Aberdeen and Fereiro, 2014; Hartley et al, 2010). As Atcherson and his colleagues (2015) note, it is indeed unfortunate when hearing loss remediation ends in the fitting of hearing aids or cochlear implantation without further consideration of the limitations of these devices and the further assistance available.

HATs also have been shown to be beneficial to those whose hearing loss has not progressed to a degree warranting amplification. In addition, some form of hearing assistance may be beneficial for the estimated 26 million U.S. adults who have normal hearing thresholds on routine audiometrics in the presence of expressed hearing difficulties (Beck et al, 2018).