How to know if your Audiologist is programming correctly?


I’ve had hearing aids for 7 years and am on trial with Phonak Audeo B-90:10. It seems I’m always in the office for programming adjustments for both. How do you know if your Audiologist is educated enough?
Are some Audiologist better programmers than others?

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The more complicated the aids the more possibilities for the fittings

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Hum, I think you may be right.



Did they perform Real Ear Measurements ? That has always seemed to put the fitting right on target for me.

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Yes, they did the REM. I’m not concerned with fitting mine are good. I’m concerned with programming and wondering if all Audiologist program well or some not. Thanks



Weighing in with my own 35 years’ worth of experience wearing AND having HAs adjusted: you’ll know your audi is competent enough when YOU no longer have to go in for adjustments.

No kidding. That’s where this buck stops. REMs and initial set-up programs are fine, but your own ears are going to tell you when things sound natural - and the HA is actually helping you hear - not adding noise and confusion to your listening.

It’s critical to get with an audi who understands your background, history, listening preferences and usage. That kind of knowledge builds over many years of interaction.

Also, being able to articulate precisely what’s NOT working or a nuance of change you’d like to try is critical. It’s true that each HA has its own software for the audi to master, but there are at least some commonalities across manufacturers in terms of hearing in noisy places, listening to music with no suppression of dynamic range, etc.,



Gosh, that makes sense. I do think it’s important to explain to the audi in understandably words what is not working in terms of adjustments and that has been a little hard for me to try to define in words so he can understand what I’m trying to explain.
But I’m learning. Thank you 1Bluejay



The bottom line: How well you can hear and understand speech in the real world. How well you hear and understand speech in a quiet office is easy.

I have an audiologist I see in Orange Park, FL more than 1000 miles away from my current duty station. He is a scientific artist. He measure sound pressure levels and real ear measurements. But, he adjusts the HAs to my needs and real world experience.

I see a young audiologist here where I live. She has all of the bells and whistles and matches the display to the graphs perfectly. When I attend meetings in conference rooms or real world locations and it is terrible. She is not an artist.

When you find an audiologist that can make your aids sing, don’t look back.




Oh my, yes I will tell my audio make my hearing aids sing. I’m laughing, but it’s true. Thank you Jlgreer1



it is so true. You do not always get what you pay for. When you find a professional who will listen to you and program appropriately, stay with them. There are some true magicians out there when it comes to hearing aids. There are also a number of “wanna be’s”. The “magicians” are magical, the wanna be’s are more common.



When I say “fitting” I am referring to programming not physical fit. Real Ear Measurement is when a microphone is inserted into the ear canal along with your hearing aid. This measures the actual output of the aids to insure they are producing the levels that the software calls for.



Oh, that makes sense. I’ll have to ask next week about this when I go to audi. Thank you for clarifying.



You seem to be distinguishing between fitting, which you define as getting the gain vs frequency right, and programming, which I guess would be setting all the bells and whistles?

If so, I think it is really hard to know how correctly the fitting to the prescription curve is done. When a REM test is done you have to face the REM speaker and not move your head around. Really hard to see what the fitter is actually doing. In the end you can talk to them about it, but have to trust they know what they are doing.

Setting all the bells and whistles correctly is a little easier to monitor, as you can look over their shoulder. The best way is to download the programming software for your specific hearing aids, and go through the software to see what can be set. I suspect that is the major shortcoming of programming hearing aids. Often the user has not much idea what the fitter can do. And I suspect often the fitter may not know what all the bells and whistles do, and how they can be set. Once you look at some software you will find out how complicated it is, and how many things can be set and adjusted. Each program can be setup differently so if you have in effect 12 different programs to set up, as each ear can be different.

Last multiply that issue times all the different hearing aids that fitters have to set up, and that the software is constantly changing. It is not hard to see how a fitter can pick a favourite HA and steer users into buying it, because it is the one they are the most familiar with.

Short answer? It is not easy!



I’ve had 4 hearing aids over the last 15 years (the latest being KS8) and this is my perception. (1) Basic fitting of modern hearing aids has become pretty mechanical – the fitting computer uses your hearing-test-results to match gain vs frequency based on pre-programmed algorithms, and REM is used after the aids are programmed (and fitted to your ear) to make sure the aids are doing what they are programmed to do. Any competent audiologist should be able to do this process satisfactorily. (2) Different manufacturers use different algorithms within their hearing aids and these provide different hearing experiences. It’s really good to be able to “try before buy” if that is available to you. Because your brain is such an important part of the system, however, you need to wear an aid for at least a couple of weeks to get a real indication of what they will do for you. (3) The audiologist is very important to getting a good experience – especially for a new user. The audi will select features that fit the client (I’m an experienced techie and have 6 programs installed and use them all, but my wife doesn’t want to deal with any of that so she just uses the “automatic” program), will help the client get through the the acclimatization period (a little hand-holding is very important to a new user), and will try to help deal with any issues that remain after acclimatization (this is the hardest part – success depends on the client’s ability to articulate the issue as as well as the experience and skill of the audiologist); I’ve never had good luck with this process (never found any magicians, never had much patience with the trial & error needed for fine tuning my aids) .



I have had 5 pairs of hearing aids over 15 years with me paying for the first pair, which was a total disaster. The other 4 pair including the new ones I have now have been provided by the VA, as my hearing loss is military service related. What I have learned is that regardless what anyone says that the VA Audis know their business. They do care about you the patient and they do listen. Oh, yes you have to have a lot of patience and you have to go in for the appointments knowing what adjustments you need. I never go to my appointment without notes on what I am experiencing and what I believe I need. I also give my Audis the upmost respect, and in return I get the respect that I feel I should get. I have also learned to never be bashful about what I prefer. I never demand but ask politely.

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That’s a pretty darn good explanation. It’s not easy.
So many ways to tune these hearing aids and each patient has different hearing issues with different needs. It is challenging.

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My VA experience matches yours to a tee.

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