Kneepoint and compression

Hi all:
One question. From my limited research, if you set the kneepoint low, the compression will be low, is that right? If so, which hearing aid in the market that I can set the kneepoint so that the compression will be that much. From my experience with digital hearing aid(Beltone), the sound is comfortable but too low tone. I guess if I can adjust the kneepoint say to 50, the compression will be less and I can hear better speech due to higher gain( less compression). Do you think it will work?


Yes. In my hearing aids I have the ability to adjust the kneepoint and compression ratio channel by channel (hearsource). I have set the kneepoint up to 55 dB prior to the compression kicking in. Originally the kneepoint was set at 45 dB and sounds sounded somewhat dull to me. After I raised the kneepoint up to 55 dB normal conversation sounded more natural to me. I think you are on the right track. Good Luck.

Hi David:
Can you tell me your hearing loss and which hearing aid you use.
My loss is 40db in the low frequencies, curve downwards to 70db in the highs


Yes, I am in the 20 to 30 range out to about 1000 hz and then I drop off to 60/65 dB from 4000 hz to 8000. I use an open fit hearing aid from a company called hearsource, they call it Freestyle. But it’s just an open fit hearing aid in a small bte case. I catch alot of flack around here but I like that I can do the fine tuning myself.

Hi David:
I never buy hearing aid on line. Do they make the ear mode for you? What is the trial period and the refund policy?


Well I’m sure the trial / refund policy can be found on their website ( I do wear the open fit version and it just came with an open tip. Actually I think it came with an assortment of different tips of varying sizes and characteristics.

As far as getting molds made for your ears, I’m sure any ENT Doc’s office or audie would make/sell you a custom mold.

David, I know you said in the other thread that they help you remotely but
how do you know when they’re adjusted right; you can just hear good?

I ask because the pricing and programming capability sound enticing for
these online aids. I’m just not sure I would adjust mine correctly. I doubt
I would be happy with the prescribed/preset setting for my hearing curve.
I’d be somewhat afraid that I would set something too high or incorrectly
and that my hearing (while adequate) would not be ideal.

Who does a real ear measurment to determine that the aids are working
and correcting as expected for speech?

real ear is design to find out exactly what you are receving at eardrum level… The amount of gain you need to compensate for your hearing loss
is determine by your audiogram, age, etc etc… The fitting software determine and programs that… But what the fitting software does not know much the instrument is actually doing…

So real ear is the only way to see what is actually happend @ the eardrum level… Picture this, when you order glasses from the optician, he gets them back from the lab and he uses a lensmeter to check that the prescription and the glasses match… Does this make sense?

Quite right XBuiler, but the hearing aid fitting (manufacturer’s) software does know what the aid is capable of and uses averages to determine the fitting. The problem with the average setting (first fit) is that is suits only a very small percentage of people’s hearing loss well. Most people’s ears are not average. When REM is done we measure what the natural ear canal resonance is (the ear canal boosts certain frequencies more than others due to canal shape, size consistency etc.), when you place something in this ear canal space you have to accurately compensate for what you take away (by using some of this space to fit the hearing aid which can be at different depths, have different venting etc.) and then correct for the hearing loss at the same time. Any hearing aid, even if set too softly will create an impression of working and may sound quite nice, but WILL NOT neccesarily give you the correction needed to correct for intelligibility without the help of REM. This can lead to a number of issues as a hearing aid does not fix your hearing, it compensates for the specific damage to your ear, stimulating the brain with the corrected information (We hear with the Brain not just the ear). Your brain then, over time, learns to make sense of this corrected information and forms new neural connections based on this correction as long as you use the aids consistently (which is why people wearing their aids more thend to do much better than people who don’t). If this has not been done properly, you may run a risk of forming new neural connections based on incorrect sounds and not find much benefit in the long run (or may not be able to accept a properly fitted aid in the future as easily), once the honeymoon period (1st 3 months or so) has passed. If the hearing aid is then set correctly at a later date the brain has to retrain to gain the missed info (this ability tof the brain to form new connections (neural plasticity) gets worse as we get older -which is why someone who addresses their hearing loss earlier tends to do better than someone who addresses it much later). There is also a slight risk of sensory deprivation if the aid does not compensate for the sound it takes away from the natural ear canal resonance, meaning the hearing aid actually makes you hear certain areas sounds WORSE with the hearing aid than without. This is turn may switch of some of the neural connections you had before using the hearing aid. So fitting your own aids or not having REM or other verifications done at fitting can be risky not only for this reason, but a few others not mentioned here.

What is this real ear measurment? I don’t think I quite understand lol…Is it a test the audie does?

Hi Jenny,

Yes it is one of the tests the audi should do when fitting the devices. In severe and particualrly profound hearing loss cases the computer (which does REM) might not be able to calculate a target for your loss or the measurement tube that needs to be palced in your ear at the same time as the aid, may cause feedback and then the audi will use other measures such as RECD aor speech testing to verify the fitting. So as long as they do more than just first fit on the hearing aid software you should be fine. From what you have been saying about your audi, I’m sure she will do the right thing.

I am sure she will too :slight_smile: I am not worried about her at all!

I just like to know as much as I can about the whole process. I think I know what you are talking about now. I think I remember it from the last time I got new aids…which was only two months ago haha

In order to do so, you need to buy an equipment, usually a HI analizer and a real ear equipment… I normally run a performance test when I receive the instrument from the Manf. And the REM with the client @ the time of the fitting…

I must sadly admit, only like 30 or 40% do perform the test consisitently

I googled it after that. My audie did it when I got my last hearing aids. I remember it now. She never explained it though…then again I never asked lol

then your audi is among the few…