By Lata A. Krishnan and Jennifer M. Simpson
This article is a part of the November/December 2018, Volume 30, Number 6, Audiology Today issue.
Hearing aid dispensing has been included in the scope of practice of audiologists in the United States since at least 1978, when the Executive Board of the American Speech-Language-Hearing Association (ASHA) recommended a change in the Code of Ethics that would permit audiologists to engage in the sale of hearing aids.
Surveys of audiology practice over the years indicate that the proportion of audiologists who dispense hearing aids has increased from 47 percent in 1985 (Martin and Sides, 1985) to 68 percent in 1989 (Martin and Morris, 1989), 80 percent in 1994 (Martin et al, 1994), and 83 percent in 1998 (Martin et al, 1998).
With advances in technology, hearing aid selection methodology has evolved over the years from comparative procedures (e.g., Carhart, 1946; Jerger and Hayes, 1976) to the prescriptive methods commonly in current use (e.g., Keidser et al, 2011; Scollie et al, 2005). Similarly, procedures for the verification of hearing aid fittings evolved from coupler and functional gain measurements (e.g., Hawkins and Haskell, 1982) to the use of real-ear measurements (REM) (e.g., Ringdahl, Leijon, and Linden, 1984).
There is a significant body of literature on the value of using real-ear measurements in conjunction with a prescriptive method to verify and optimize hearing aid fittings, as summarized in the document on Hearing Aids for Adults (ASHA) and the best practice guidelines from the American Academy of Audiology (Academy), which state that “prescribed gain (output) from a validated prescriptive method should be verified using a probe-microphone approach that is referenced to ear canal SPL” (Academy, 2006, p. 26).
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