Speech Comprehension Score 95%, But Moderate to Severe Hearing Loss-Do I Need HAs?


My audiologist told me that my audiogram (shown in my profile) indicates moderate to severe hearing loss. Yet my speech comprehension scores are 95% which I am told is good.

But I do experience some difficulty hearing television, understanding people with soft voices, or when people don’t face me and speak with me.

I was fitted with the Oticon OPN 1 late October. The return deadline is quickly approaching. Wearing them has been a mixed bag. I hear background sound much better, no problem with TV, hear my wife’s voice clearly now and don’t have to ask her to repeat occasionally.

Problems have been any kind of environment with background noise. It is actually more difficult to hear people in a city street (I live in New York City) with the hearing aid than without one. Same applies to a bus or restaurant. Difficulty hearing groups of people outside.

This is a big issue for me as I am a real estate broker and meet people outside to show them property.

I very much enjoy hearing more in my environment.

Are these sort of trade offs typical of hearing aids? These are my first ones. Or can I expect more if the hearing aids are adjusted? Also, will my ability to filter out background noise improve over time? I have only had these about 6 weeks. In the last month I have been wearing them 14 hours a day. The Oticons have a great reputation. But is there an alternative brand that would work better in aloud urban environment?

Really, my question is, with my level of hearing loss do I really need HAs? If I do, is there a better brand than Oticon where I could hear people clearly in a city environment?




That would be the clincher for me right there. Others might feel differently.

Speech-in-noise is probably the number one challenge for hearing aid wearers, although I can’t say I’ve noticed anyone saying it was worse than without the aids.

I’m going to copy and paste my response to another member who recently asked the exact same question.

Really only you can decide that. Make sure any hearing aids you try have a guaranteed return policy if you decide they’re not for you. Some providers offer a 100% money back guarantee, others will charge a restocking fee, usually somewhere around $200-300.
Try the hearing aids, see how much they help you, then decide how much that is worth to you. Value is determined not by your audiogram, but by your income and desires.

My opinion is, of the major brands, there really isn’t one that’s better than the others. But there may be one that’s better for you than the others. I would keep trying different brands until you find the one that works for you. It’s kind of like test driving cars.

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Are you sure you have a fitter that knows what they are doing with the OPN software



To me the biggy is that you can now understand your wife. Regarding the 95% speech comprehension score. It is indeed good, but it just indicates that you can benefit from amplification. It is done at a certain level of amplification. Regarding keeping the Oticons. How willing is your hearing aid fitter to work with you. How does he or she respond when you share problems you’re having? I think your fitter will be more important than what hearing aid you choose.

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Thanks for your feedback.

My hearing aid provider does there best. But the adjustments seem ad hoc. I would think there is an objective way to adjust the hearing aid with differing levels of background noise and keep adjusting the HAs until the best results are achieved.

I don’t think it is too much to ask to see improvement listening to people in a noisy outside environment, but I am new to hearing aids and understand there are limitations.

My audiologist has offered to arrange meeting with the Oticon tech, maybe that would be a good idea. But it shows me maybe he isn’t that knowledgeable.



Message @Volusiano. I’ll bet he can help you out with the OPN1



I hope so!!! I invested in the Mercedes Benz/Ferrari of hearing aids. Being able to hear people speak on the street isn’t asking for the moon.

But we will see. I will go back to my audi for further adjustment.



There are others just as good. Find the best one for you.



I live in NYC which is obviously very loud. Do you Do you think other brands would perform better in a noisy environment?



You need to check them for yourself. All of the top of line aids are great but different folks find some better for them. I’m trialing the Evoke 440 and really like them. Others like the Quattro. Others can’t wait to get the new Marvels.



The audi I’m working with now performed an interesting test with me. He put me in sound booth with head phones on. I would hear a female voice speak a short sentence. I had to repeat the sentence. Each time, background noise was increased, until eventually I could not understand her anymore. He performed the test with no aids, my old aids, then the new ones. Then he made some adjustments and performed the test again. Perhaps you could talk to your audi about performing such a test, especially with the factory rep there.



QuickSIN is what that was. Speech In Noise



I think based on your audiogram, it looks like you have enough loss in the high frequencies to warrant needing hearing aids, despite your high word recognition score.

My guess on the reason you have more difficulty with background noise with the OPN 1 on than off outside in the streets is because you’ve been used to your high frequency hearing loss, which basically and inadvertently acts as a background noise filter for you. Your low and mid frequency hearing is still good enough that it helps you still be able to hear and understand people in noisy places OK. Your high frequency loss had been giving you that “comfort” that you’ve gotten used to, and now hearing all those high frequency sounds again seems like it has upset your old way of unaided hearing, and making you feel overwhelmed when outside and hearing too much now. It becomes a distraction and takes away your ability to focus on what you want to hear.

It’s just something that takes getting used to. Some people take 1 month to adjust, others need 2 or 3 months. You’re already 6 weeks into it so I guess you’re of the later type.

Also there’s also a matter of expectation. Improving listening to people in noisy outdoors can mean different things. If you expect the OPN to give you the serenity that you’ve been used to when you’re outside and you’re only going to hear people talking but nothing else, then that would be a wrong expectation from the OPN. It’s not what it’s designed to do. If you expect to hear everything outside, but when you earnestly try to tune out what you don’t want to hear to focus on what you want to hear, and expect to be able to understand what’s being said, then that would be the right expectation in line with what the OPN is designed to help you with. Along with that expectation should also come with some patience, give it enough time for your brain to readjust to all this new stuff that you’re now hearing.

If you decide to stick with the OPN, I’d suggest the following if not done already. First, have your provider adjust the noise reduction values in your Genie 2 OpenSound Navigator setting to maximum for both Simple and Complex listening environments. See screen shot 1 below where both the Simple setting is at -3db and the Complex setting is at -9dB.

Next, for soft spoken speech, go to the Fine Tuning section and set the Soft Sound Perception to the rightmost value. It can’t hurt and can only help for soft spoken people. See screen shot #2.

Next, copy the program P1 with all the settings mentioned above to P2, then add Speech Rescue to program 2 (see screenshot # 3). I recommend using the 2.4 Configuration with the High Frequency Bands turned ON. This way, you can toggle between P1 and P2 to see if Speech Rescue is helpful for your speech understanding in noise or not.

Finally, go to the Program Manager and add the Speech in Noise program to P3. While you’re there, might as well add Music to P4 as well. See screenshot #4 below. You can try the Speech in Noise program in P3 if you want to see whether it’s different from the default P1 program or not. Generally if you already have P1’s noise reduction set to max values like recommended above, there should be little difference except that P3 may sound a little louder. Also if P3 has the OpenSound - Transition set to High, it will give help with auditory focus faster than P1 if this is set to medium in P1. You can also set it to High in P1 as well if you want, in which case it will make the difference between P1 and P3 even smaller. But at least now you have different programs to see if one is more helpful than the other or not.

Of course you can’t do all this and must ask your provider to do it for you. But now you’ve made several adjustments that I think is the most you can do to improve the issue you have with hearing people outdoors:

  1. Have the right expectation and good attitude about accepting the noise and give your brain time to adjust and learn how to tune out the noise and focus on the speech.

  2. Set the noise reduction values to maximum in P1 to get the most help for speech in P1.

  3. Improve the soft sound perception as best as you can in case there are soft spoken people you need to listen to in noisy places.

  4. Have the Speech Rescue option turned on in P2 so that you can toggle back and forth between P1 and P2 to see if the Speech Rescue option is helpful for you or not. If yes, use P2 most of the times, or later have your provider add it to P1 so you can use P2 for something else. You can also add it to P3 later if you think that the Speech in Noise program in P3 is more helpful than P1 for noisy places.

If after all this, and with the right expectation and attitude toward giving time for your brain to adjust and learn to tune things in and out, and you still have a problem, then maybe the OPN is not right for you can you can try many of the other brands’ newer models that have recently come out. The OPN may work out well for some and not others. It’s not for everyone. But I think with your level of hearing loss (which is not that bad), there’s a good chance of success for you with the OPN as long as you have the right settings and the right expectation and the right attitude to give it enough time for you to adjust to it.

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