Fitting a hearing aid why don't they

I have a bone to pick, why is it when you get you hearing aid fitted that you are in a quiet room, one on one and then when you leave to go into the “real world” it sound awful. Why don’t audio’s have a cd with today’s noises playing when you are getting adjusted and you have a better idea to how you are hearing things. Is this too much to ask for???

Good question.

As I have posted many times, most professionals are trained to make a pure tone audiogram and let the manufacturers software automatically do the first fit adjustments. And tweak from there.

This works fairly well for those patients with uncomplicated mild/moderate loss. Often though those with severe/profound and or complicated loss can expect to have to make many trips back for re-fitting.

This is because pure tone audiometry is far from accurate for high losses. False patient responses are inevitable.

And try to find a professional whose office has the equipment to duplicate real life ambience. LOL. Ed

the 1st fitting I could not hear my car running and among other things and after the 1st fitting I told her to take a break and I would be right back and then I can tell her what I am hearing or not hearing. but sometimes if time avaiable to do this.

I know with Phonak, I program my HA’s myself via Target and I have used iPFG for my Naida’s, you can play background noise during each fitting, both have a media player… Having said that, I have yet to come across an Audi, private or NHS whom ever use this!

Cheers Kev.

After making adjustments, my audi always makes me leave the sound room and go for a walk around the building or outside for a few minutes, to hear real world sounds. Then we work on tweaks based on what I heard.

Seems like a good practice to me.

It is my biggest gripe. My Audie adjust the aids then says “How does that sound?”…yeh right …how does it sound in a sound proof room. Then sends me on my merry way. As soon as I have taken one step out of her door I know that they are not right and that I will have to make another appointment to have them adjusted. Why doesn’t Phonak, Siemens etc. come up with a hearing aid that is programmable by both the Audie and the person wearing them. I need the expert help of my Audie but I also know that I would be hearing a whole lot better if I could make a few tweaks myself.
Sue has not stepped down off her box. Sorry it is one of the many things with my hearing aids that are very frustrating.

Next time tell your Audi that you want to go outside for a while to see how they sound or you want two appointments on the same day, one for the 1st adjustment and then you want to see "How it sounds in the real world; then you want the 2nd appointment several hours later to fix what needs to be fixed.

Hi, I’m new to the forum (but not new to hearing aids) I was fitted with Phonak Audeo S yesterday and as always the Audi (and I’ve seen lots, NHS and private) says to me “how does that sound” then stares at me in silence in a silent room, i’ve read on some posts about Audis with surround sound systems and an array of speakers to simulate noisy rooms, does anyone know of anybody in the UK that does this?

The party noise sound file in my fitting software is probably the most used file on my computer! Can’t think of a good reason why other audiologists wouldn’t take advantage of it. I also like to have a friend or family member at fitting appointments so the person has a familiar voice to listen to.

Good ones do. I work for a company that fits Starkey, and Starkey even have samples of dozens of sounds built in to their fitting software. Background noises, social events, restaurants, play grounds, crowds, etc.

This software is free to all hearing professionals who fit Starkey based products.

But you are correct, if you don’t have access to this, you should use your initiative and download some kind of background noise generator or buy one. Or if you can’t do that, take a walk with the patient outside into the real world.

Absolutely. Aids should be fitted with nirmal every day background sounds.

But this takes time to do. Ed

Cafeteria noise is the one I use from the Med-Rx CD.

Will not let a client out of the door unless they can hear me over the noise with their aid in. I’ll also get the spouse to ask a couple of random questions while the noise is playing to make sure they are understanding everything.

I simply take my clients to an Italian cafe to try out the aids.

Real world, not CDs.

That’s nothing. I fly my patients first class to Las Vegas where I put them up at a suite in the Venetian. The next evening we go to the Rain at the Palms where all the kids go, and I whisper to them over cocktails in the VIP lounge. If they can’t hear me from 50 feet away, I buy them a new car.

Now of course, they only get that on the premium line of aids. :rolleyes:

What’s your phone number I think I will make an appointment :slight_smile: Love the sound of a trip to Las Vegas especially when I live in Oz.

So that’s why you sell so many Wi Series! :smiley:

Admittedly, I’m using software that’s kind of out-of-date (Aventa 2.95 – for Resound aids) but it surprises me that there are no “real-world” sound files that make sense for work or the classroom. The party sound files are the most help, but they really aren’t like a light-industry setting (my work) or discussion carried on politely and at reasonable levels, but in a peaky, overly bright acoustic environment (the classroom).

Resound has quite elaborate instructions for setting up just such a facility, and Aventa has tons of sound files (although like I say with some limitation) for this use. I’m thinking that, one, it would cost a lot of money to set up the specified listening room, and two, fitting sessions would take three or four times as long.

Caveat: I’m an untrained HA user who programs his own aids.

Ho Ho!

Luckily the Italian cafe is only 100 metres away, so it’s just as quick to go there as to set up an artificial environment.

(My practice is in the middle of the English countryside surrounded by fields, so I 'm not sure why anyone would set up an Italian cafe here … but whilst they are there I’ll use their facilities!)

Umbongo hit the nail right on the head when he suggested getting the spouse to ask a couple of questions. How about having a good argument too! That would trial any hearing aid!
Seriously though, I always ask my Audio if I can step outside for a couple of minutes. First thing you hear is the ‘clip-clop’ of womens high heels. Next is tyre noise from cars. Kids and babies come next. It takes just a moment to evaluate the settings. I then enjoy upsetting my Audi with a request for an adjustment. Get them working I say!

LR same


I use a five speaker surround system with subwoofer set up in my fitting room. I try to use different types of noise including “hall full of people speaking” and cocktail party noise. The system can be calibrated to produce this noise to a level of 70-75 db. I then sit it front of the patient from 3 to 4 ft. away and demonstrate the noise/directional programs and make adjustments accordingly. It is easy to set up and operate and very effective. Of course depending on the level of hearing loss and discrimination scores of the individuals sometimes they do not do as well as they would like even after making adjustments. At least you can set their expectations before they leave the office.

Most clinicians (in my experience) do not have this type of set up in their clinics. Excuses vary : Costs too much to install and set up, It adds too much time to the fittings and follow up appointments, It’s not “real”, etc., etc…Too bad, it seems to be quite effective from our clients point of view. Combine this type of adjustment for noise programs and set up the hearing aids with REM/speech mapping (in quiet) and you can actually save a lot of time with follow ups and adjustments.