Hi all. I have recently changed from domes to custom moulds but, I am still noticing that I am not able to understand speech clearly, despite the audiologist saying that speech clarity should be improved as I did tell him that I want to be able to hear speech properly and block background noise which he also did and I have the app on my phone to do that. I can hear high frequency sounds like the microwave, washing machine beeping etc but I am still finding that I am asking people to repeat themselves several times and their voices sound staticky and distorted, but without my hearing aids, I can SOMETIMES make out what they are saying (If I am upstairs and my husband is downstairs for example), whereas I would not be able to with my hearing aids in. I am quite worried that my word recognition score is really bad⌠what is the point me wearing them I still cannot understand what people are saying? As that is mainly why I want to, to be able to talk to others without repetitively asking them to repeat 2 or 3 times. As most of you know, NHS does not do it WRS but I have read on here how important it is. How do I test to see how bad it is? I am betting absolutely terrible⌠if I see the audiologist it will be the 4th adjustment and I am still not satisfied.
You donât say what brand and model of HAâs youâre wearing. That might help other folks here make suggestions. Also, if you know what fitting algorithm the audi used, thatâs useful information.
YMMV, but I prefer the NAL-NL2 fitting algorithm, for example, over ReSoundâs proprietary Audiogram+ algorithm because NAL-NL2 amplifies high frequencies more, and that helps me to hear and understand what my very soft-spoken wife is saying.
Similarly, ReSoundâs smartphone app has a settings button available called Speech Clarity. Tapping that will increase mid-tone and treble amplification and decrease bass slightly. I find that helpful to better hear speech sounds in situations where a person has a gravelly or raspy voice, or there is a lot of background noise in the environment.
So perhaps whatever model of HAâs youâre wearing, there are similar fitting adjustments or different fitting algorithms you could try to see if you can get better results. As you say, for your hearing loss, maybe, unfortunately, you are at the limits of what can be done. I donât know much about frequency lowering but looking at your audiogram and the profundity of your high-frequency loss, I wonder if you are a candidate for frequency lowering, whereby the hearing aid reproduces the very high-frequency sounds that might be ~impossible for you to hear at their original frequencies and instead shifts them for you to hear at a lower frequency. And the frequencies you can hear get shifted down a bit to make room in the range of frequencies you can hear for downshifted, otherwise inaudible high frequencies (sorry if this is an unclear, terribly long-winded explanation!).
What Iâm about to say is pure conjecture, so keep that in mind. Iâm guessing youâre getting a lot of gain to high frequencies that you canât make use of. You can hear the microwave, but it doesnât help with speech because your brain canât make use of it. All I can suggest is returning to the audiologist and sharing the problems youâre having.
Have you happened to get word understanding test done? At what db?
Testing before molds and after might tell you something.
Seems I remember you saying you went many years with hearing loss and didnât wear hearing aids. This can really affect word understanding if it goes too long. But you just might get some word understanding back with properly fit ads that are worn everyday.
In my experience it can take some time for the brain to learn how to interpret sounds. If the audiologist thinks the HAs are adjusted correctly, I would keep using them,
As much as possible, I would concentrate on speech in quiet environments to give the brain a chance to learn how to interpret the sounds.
@craftycrocheter: Who performed your hearing test? I ask because I canât recall seeing such perfect symmetry between left and right ears since I joined the Forum, a scant 2 years ago.
Check out my audiogram. 
Mine were almost identical until my left ear tanked a couple years ago. Weird. Happens I guess - or close enough.
Are these your new hearing aids, or are they still your old ones with new moulds?
@joanhawsey: Iâd agree with that, but I still donât consider either of you to be as close as @codgergeek. Itâs not important, anyway - just makes me wonder wher NHS doesnât âcookâ some results they may have had âgo astrayâ. Thassall.
Why would they do that?
They arenât particularly on the clock - assessments have long enough allocated time slots. All the audiometry is PC based and written back through medical DB like Audit Base. Thereâs no profit motivation to worsen or skew the results and the staff are fully trained. Also thereâs large soundproof rooms on tap.
The NHS might lack the budget to buy and fit top end product in the form factor that people would find most cosmetically appealing, plus thereâs some long waiting times kicking around, but suggesting that theyâd deliberately manipulate a test is just bonkers.
Thereâs likely to be some issues with the downward spread of masking from your fitting.
This is one of those occasions when fitting âto targetâ simply doesnât provide the best results due to the 5000x sensitivity difference between the the high and low frequencies.
If you have a look at the search function, you might find something about the management of steeply sloping losses like yours. The options are broadly:
1, Seal up the ears, make the output very punchy in the HF, cue distortion, poor resolution,
feedback, auditory fatigue etc.
- Pick the usable LF, use a bit of frequency compression/transposition, amplify more gently and accept you probably have a dead-spot around 6-8Khz anyway. Your results are possibly from adjacent hair cell stimulation. Accept the gain doesnât hit the target above 2KHz and set the response the same as the 2KHz across all of the upper frequencies to avoid feedback and other gain artefacts. Provide you with a usable/accessible volume control and noise management programming to access more power as needed.
@jUm_bongo: I do wish that youâd take the trouble to read my posts carefully before you go off.
What Iâm suggesting is that a beleaguered employee who - because of the tremendous pressure theyâre under due to constraints of resources and time - were to accidentally lose data for one ear might remember that this patient was symmetrical in their loss, and simply plug the data they did have into the blanks for the other ear, considering them to be the best proxy for the lost data.
No intentional manipulation of the data beyond that necessary to cover some unfortunate employeeâs ass was suggested or implied.
You literally said they could âcookâ some results; thatâs a colloquialism for manipulation.
Nobodyâs gone off on one. Youâve made another completely unsupported claim (this time) about the veracity of hearing tests in an organisation youâve got limited or no experience of.
My original point stands: NHS Hearing services, might be criminally underfunded by our current government, but why would the well qualified, experienced and equipped staff âcookâ a result thatâs of no benefit to them, the patient, the supervising ENT consultant or the delivery of hearing aids within the system?
I donât work with or for them; if youâd questioned the veracity if a particular bit of test kit, a weakness in the 4KHz response of the B-71 bone-conduction transducer or something in the prescribed practice of the BAA, you could have made sone form of argument. Otherwise like I said, itâs a pointless and spurious thing to suggest.
I am sorry to jump into the discussion, but if that were the case, and you were hearing far more decent environmental sounds than speech while having HAs fitted as maximum gain in-put on high frequencies, in your experience, in which direction should a new regulation move? Why would such regulation hinder speech recognition?
Thatâs interesting, Iâd like to read some more about thisâŚ
Hereâs a quote from Um bongo, an experienced audiologist from (edit) Wales.
My loss is a little similar to yours. What Um bongo says is what has been most helpful to me.
For sure I have dead zones, due to the genetics of the loss. I use less amplification on the highs. I use a some frequency compression (via Phonakâs algorithms for SoundRecover 2). And I use earmolds that are either more open (for quieter environments where noise isnât an issue) or 2mm vented ones (for noiser places where noise would make it harder to understand speech). My Roger pen helps a lot for zoom business meetings (less in person, unfortunately). I use captions, Live Transcribe, and other visual guidance as well. To me seeing is an important part of how I gain speech comprehension in some settings. I hope this is helpful to you and good luck!
@buiononsense:,This is a very simplistic account of my experience with speech lowering.
My audiologist at the time that I first took delivery of my More1 hearing aids, told me that because of my hearing deficiency in the very high frequencies, my brain was not receiving any valuable information from those frequencies above 4-5k Hz. So he suggested that I turn on the speech lowering feature of my More hearing aids.
I took his advice, and I canât really describe what I heard: it seemed to be âfullerâ, but on the other hand, my word comprehension diminished.
After trying speech lowering for a couple of months (Addendum::and by âtryingâ, I mean returning for adjustments and tweaks when it wasnât working for me), I went back to my audiologist and asked him to turn that feature off, meaning that I was now receiving input from the high frequencies that I couldnât hear before. With the additional input, even though I was not able to perceive the high frequencies, my brain must have been able to make use of the imperceptible information it was receiving way up there, because my word comprehension improved dramatically.
So the audiologist and I both concluded that, even though I was unable to perceive, or hear these very high frequencies, my brain must be receiving some useful information therefrom, based on my improvement in comprehension . My wife said she noticed a big improvement, too.
So, I realize that this is a very simplistic story - I have no science to back up what Iâm telling you, nor do I need to have it because itâs just an account of my subjective experience. But I would say, do not discount what your brain may be receiving from those very high frequencies that you canât perceive as tones. It may be more significant than you think.
To me what Um bongo said clarifies a lot of this, but if youâve got more questions, do chime in.
Regarding the brain not being able to make use of it. There can be multiple reasons. The highs can be so loud that they mask (drown out) the lower frequency sounds so the brain ends up getting less info even though it got the highs. If brain hasnât been getting high frequency speech information for some time, it loses the ability to make sense of it. Sometimes the sound is distorted because the cochlear region that deals with a specific frequency is damaged and another nearby region that still works is getting stimulated. This stuff can be complicated. My suggestions are to read and ask questions (or on the other hand, find a good audiologist or hearing aid specialist and donât worry about it! :>)