Setup Program

Hearing Aids
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I have a semi-annual session with my hearing instrument specialist.

Phonak Audeo Paradise P90R’s that are over 3 years old. The replacement hearing aids and charger have helped me out. Power Receivers are good too. The new waxguards helpe a lot.

My issue is understanding words in noise. Frankly the hearing aids just aren’t good enough.

I see notice on hearing tracker that NL2 has been replaced.

The article is disturbing to me.

NL2 was 15 years old. (No wonder we have problems!)

My question–What’s the best programming for setup?

quoting from the announcement:

" NAL-NL3 and New Modules Introduced for More Precise and Personalized Hearing Aid Fittings

The National Acoustic Laboratories (NAL) has unveiled its first update in 15 years to the world’s most-used prescriptive hearing aid fitting tool, along with new modules that should enhance individualized hearing care.

Written by

Karl Strom

Published onMar 27, 2025

NAL-NL3 and New Modules Introduced for More Precise and Personalized Hearing Aid Fittings

NAL-NL3, a new hearing aid prescriptive fitting formula that addresses unique patient needs, was unveiled by Australia’s National Acoustic Laboratories (NAL) on Thursday at the American Academy of Audiology (AAA) Annual Convention in New Orleans. Its forerunner, NAL-NL2, was introduced about 15 years ago, and is the most widely used prescriptive hearing aid fitting formula, incorporated in software used by audiologists and hearing aid specialists worldwide. Prescriptive hearing aid fitting formulas recommend target amplification levels based on a person’s hearing loss to optimize speech audibility and comfort.

NAL Director Brent Edwards, PhD, and Head of Audiology Science Pádraig Kitterick, PhD, introduced NAL-NL3 to audiologists at the AAA Convention. Many of these professionals have spent their entire careers using NAL’s formulas. NAL also announced a series of modules made for two special patient groups: people seeking better hearing in noise, and people who say they have trouble hearing but are diagnosed with hearing thresholds within “normal limits,” a problem that may affect as many as 26 million Americans.

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“Consumers want solutions that are best for them, not just a generic solution that is ‘kind of okay’ for everyone,” Edwards told HearingTracker. “They need personalized solutions, and they want a better understanding of what their needs are by the healthcare professional so they can receive solutions that are unique to their challenges when hearing. NAL-NL3 and the new tools we’re introducing today encourage audiologists and hearing care providers to take a more individualized approach when fitting hearing aids.”

NAL Director Brent Edwards, PhD.

NAL Director Brent Edwards, PhD.

One standout feature of all NAL fitting formulas is their extensive use of normative data—the large number of subjects involved in NAL’s research and data collection, which helps establish a more accurate and reliable baseline for individual and group results. The NAL-NL1 and NL2 fitting formulas used audiological data from studies involving about 300 and 1,000 participants, respectively, while NAL-NL3 uses a database of millions of fittings analyzed with neural networks (AI). It was also drawn from over 1,500 real-ear measurements (REM) and real-world feedback through ecological momentary assessment (EMA) on user’s phones, real-time feedback via smartphones about how the hearing aid was performing in specific listening situations.

All of this should result in NAL-NL3 providing more precise and improved prescriptive targets, says Edwards. “There’s nothing really wrong with NAL-NL2, and when I became director of NAL, it was not high on my list for revisions. It works well,” he explains. “However, we’ve learned a lot more in the past 15 years, and technology has changed substantially. NAL-NL3 is a more precise and improved prescription over NL2, based on millions of fittings. We’ve also ensured that things like reverse slope and mixed hearing losses [where NL2 was lagging] have been accounted for.”

Along with refinements to the previous NAL-NL2 fitting formula, NAL is also releasing new modules that focus on the specific needs of individuals. The first two modules released by NAL are:

  • Minimal Hearing Loss (MHL) Module: A new solution for fitting hearing aids to people with speech understanding difficulties but who have normal audiograms or minimal hearing loss (below 25 dB PTA, commonly thought to be “normal hearing”).
  • Noise Module: A new solution for improving comfort when listening in noise without compromising speech understanding. For example, a hearing provider could designate this as a separate program in hearing aids that users can turn to when encountering noisy, challenging listening situations.

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Edwards says other future modules might focus on improving music listening, extended high-frequency fittings, and profound hearing losses. NAL is actively seeking feedback from hearing care professionals and consumers on what types of future modules might be useful.

NAL-NL3 is a new improved version of the world's most popular hearing aid fitting formula, reflecting knowledge gained from the last 15 years and millions of hearing aid fittings. The new Noise and Minimal Loss modules are the first in a series that will address unique hearing aid fitting challenges."

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"Swiss Chalet Test Paradise P90R’s

Last night we went to a newly renovated Swiss Chalet in Oakville. Upper Middle Rd. It’s much nicer than it used to be. Even had a Robot dispensing meals, and taking back stuff when meals were finished. The meal was really good; I’m comparing this Chalet Suisse to the one near me in Heartland Mississauga.
We were a group of 5
I couldn’t hear the person right across the table from me. And that’s not far.
I couldn’t hear the person right beside me, on my left. Shoulder to shoulder.
3 Sisters. 2 men. I am the only shy one, likely to talk quietly.

Yes. I took out my phone and used the APP.
I checked every single program. None was acceptable. I turned up the volume from the REM value. Two clicks. Pretty simple test. Hearing aid score is 2-1/2 out of 10.

I stuck index fingers in each ear. The closed domes are doing a good job; volume didn’t change.

I had my hearing tested 6 months ago. I have a F/U appointment in several days."

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Is NL3 Available now?

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Thanks for sharing, I’d definitely like to try it, if only I could find it in the software, obviously coming soon…

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That’s from this site.

I’m between a rock and a hard place.

Last night had dinner at a noisy restaurant. My Phonak Audeo Paradise P90R’s were trash.
I couldn’t hear the person right next to me.
I couldn’t hear the person across from me.
I rate the Phonak Audeo Paradise P90R’s I have at a 2-1/2 out of 10

Last time I saw my Hearing Instrument Specialist I forgot to get the Pro Fitting Report from him.

I see him for a 6 month checkup on in 3 days. I’m 78 and on a fixed income. Im very grateful that i have workman’s compensation and they will replace my hearing aids in about 2 years. EXCEPt they don’t supply top model. And they won’t let me top-up (pay the difference) to get a better model of hearing aid.

I was really hoping that the brand-new fitting setup program was going to be used.

If he can provide the DSL v5.0 setup I’ll see how that works. I always ask him to boost volume and crank up mid and high frequencies.

If I was rich and famous I’d try a different make of top model hearing aids.

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Believe me, your already “rich and famous” right here on hearingtracker.

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I feel like a noob. I’ve read so much (had real trouble finding things that are pertinent with modern hearing aids.)
I’ve watched so many youtube videos. (learned lots reading here. My dispensing audi had me in open domes! He ordered my hearing aids and showed them to me…without trial, and without discussing what I needed.)
I found a hearing aid practioner who took me in even though I have workman’s compensation, and he couldn’t sell me hearing aids for 3-1/2 years. And he erased all my programs and cooked my hearing test, and did a quick fit. Said my hearing was better.)

I think there are fatal flaws in how our “medical equipment” hearing aids are sold.

If I’m rich & famous it’s because of people like yourself that contribute so much to noobs like myself.

Thanks for what you do.

(I was a ski instructor for 35 years, my second job 6 days a week.) I taught at a community college for two summers.

Hardest thing I’ve ever done is buy my second pair of Phonaks. And my third pair of phonaks. I expected to be able to hear.

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Have you thought about trying Oticon? Costco has the Philips 9050 which I understand is much better in noise than the Paradise. I have owned both the Paradise and the Lumity and they are both terrible in noise and I doubt that a different setup protocol is going to change that since they still have the same hardware and internal computer. The Philips 9050 or the Rexton Reach from Costco are both reported to be better in noise than the older Phonaks and are much less costly than the newer Phonak Infinio Sphere. In addition you have a reasonable period to try them. If you are able to try the NL3, let us know. I would love to be proven wrong.

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@raylock1

Thanks! I have a workman’s compensation claim
They provide new hearing aids every 5 years, or more.
They used to provide only a few makes. And they don’t provide the best models.
My dispensing audi did something right. He got me hearing aids early! And he got me top model. (I couldn’t hear behind me…and had almost been hit from behind on construction sites.)

I feel badly I haven’t figured out how to put that in a signature line.

I truly appreciate your comment about Paradise and Lumity.
I’ve had 3 sets of Phonaks in about 20? years.I’ve read a lot about Oticon here.
I want my hearing aids to work.
The Phonaks still don’t. They’re >3 years old. Warranty is over. two more years to go.
I’d love to try Oticon

I’ll ask about NL3 on Thursday. And I’ll try the juvenile program if I can.
And Neville, I shall ask if I would be better served using some kind of insert…not closed domes. (But I did try my Power Domes and had sound quality problems. Went back to the closed domes that Hearing Well Matters did REM with…and understood more with the prescription domes.

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Dave, FYI, when you wish to flag a member for a response it’s best to use the @ symbol, which will alert them, so: @Neville I shall ask if I would be better served using some kind of insert
I think @raylock1 gave you a very good suggestion re Costco, and the Philips 9050.I know you rely on workmans comp, but you may have to go the other route, and try a different brand, and audi.

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Good suggestions. I’m on a fixed income. I’m trying really hard to get my Paradice P90’s working.

I’m almost desperate to buy Sony EarPods and give them a try.

Thanks for helping
Dave

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@flashb1024

Neville has been really helpful. He has suggested inserts to me a number of times.

My Widex in the ear hearing aid was my first one. It was remade twice. It hurt so much! I used it for 10 years.

I see many people talking about taking a number of visits to get inserts to work.

I’ve promised him I’ll raise the subject with my hearing aid specialist.

I was kind of hiding I’ve been stubborn and not taken his advice yet. I believe it’s time companies solve problems like their darn waxguards.

I’m a heart patient too. I think the medicine I’m taking has caused hearing loss.

Thanks for your suggestion

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I finally made the leap to moulds.
I definitely can tell the difference.
I wore closed domes for years.
I cannot feel the moulds in my ears.

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Thanks! I promised

@Neville

I would raise the insert suggestion to my provider. Just a couple of days.

I drive a long way to get there. I’m amazed he took me on as a customer.

He can’t make money helping me because of my workman’s compensation claim.

And he sells mainly resound hearing aids.

DaveL

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He’ll be fine.

It’s hard for me to know whether there’s a problem with the hearing aids, or whether they are optimized but you have a significant speech in noise deficit. Swiss Chalet is a restaurant with lots of hard, echoy surfaces that a lot of individuals with moderately severe hearing loss would find challenging.

I suspect custom tips will benefit you, but yes they’d have to be comfortable. Given your past experience open jaw or moving jaw mold may be better. But it’s possible your hearing aids are already doing the best they can, in which case you may be better off asking WSIB for a Roger On to use in noise situations. Although I think they still make you jump through the hoop of using the partner microphone first and having that not meet your needs. To request a partner microphone, your clinician will need an updated test with speech in noise measures (quickSIN) as well as a description of all the different situations where you are still struggling to hear, which you could help him out with by bringing a list.

NL3 may have been released but we don’t have it in hand yet. That is, the REM machines will need to be updated to have the prescriptive targets. Interesting to see that they’ve come out with targets for people with normal hearing. Noise targets are not unexpected, DSL came out with noise targets a few years ago. I’ll be interested to compare and contrast when I get access to NL3.

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I’m surprised. I thought DSL 5.0 was introduced about 20 years ago. I didn’t know about later changes.

I had the impression made with a closed jaw and a continuously open jaw several minutes ago. In that case, the earmold manufacturer make something “in-between”?

Do you feel the difference only in noisy situations, or in quiet situations as well?

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Both.
Things just seem clearer.
Closed domes do not block out all sound.
I have a transistor radio I listen to.
I could have my hearing aids on and hear the radio with them on wearing ear phones.
I cannot hear the radio with the moulds.
I wear Starkey Edge AI.
At my son’s wedding I used Edge AI mode with the domes.
It was the best I ever heard in noise.
Recently I went to a very noisy restaurant.
This time I had the moulds.
I did not use the Edge AI mode. I could clearly hear at the table.
Even people across the table.
Everything was being filtered by the aids.

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Great! What diameter of vent for your loss?

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Oh, BAHA softband targets came out earlier this year, and BAHA implanted targets a bit before that with the bone simulator. DSL came out in the early 90s I think, and updated to 5.0 in the mid aughts. I expect it to continue to evolve over time. I don’t know whether the use of datamining for NL2 will engender a response from DSL or not–the developers are more colleagues than competitors.

I suspect. . . not. I could be wrong. Is it still a handmade lab? Or are they modelling it digitally and printing it? One might imagine that they could look at the open jaw mold and carve the closed mold a bit based on that, but I don’t think they actually DO.

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