Posted on Feb 21, 2020

Real Ear Measurement: Eliminating the Guesswork from Hearing Aid Fittings

In this installment, we’d like to discuss a procedure which illuminates the ongoing efforts of Alabama Hearing Associates to implement the highest standards of excellence toward the goal of better hearing: Real Ear Measurement. This term (also referred to as REM) refers to the gold standard used to determine if a hearing aid user is receiving the precise level of amplification needed at every frequency to achieve the best hearing improvement possible. Enjoying the maximum benefits of one’s hearing aids can depend greatly on the use of the real-ear measurement system as part of the initial fitting process.

Due to ear canal anatomical individuality, every ear perceives sound differently. Despite this fact, hearing aid manufacturers themselves do not consider the unique shape of one’s ear canal. Instead, the manufacturer provides their “best fit” by utilizing a patient’s audiogram, without any significant additional information. This usually causes the patient’s newly-fitted hearing aid to be under-amplified and/or over-amplified.

During a real-ear measurement, a thin probe microphone is inserted into the ear canal alongside the hearing aid. The provider matches the output of the hearing aid to the “targets” of the patient’s hearing loss, giving a patient a proper, accurate prescription. The most significant improvement of a provider’s REM-enhanced fitting over a manufacturer’s best fit is typically an increase of gain in the high frequencies, which translates to better speech understanding and clarity.

A recent survey performed by the Hearing Review indicates that currently only 34% of audiologists surveyed across the United States perform real-ear measurements, despite the fact that hearing aid fittings using REMs lead to superior outcomes and enhanced benefits, both in quiet and noisy environments. At Alabama Hearing Associates, we employ the real-ear measurement system as part of our commitment to providing superior cutting-edge, evidence-based care, insuring that our patients enjoy the best hearing healthcare possible!



  • “Thank You, Thank You, Thank You!!!! In two visits you’ve brought my hearing levels close to perfect for me. Not exactly sure how, but the last session settings have me hearing the television at a near normal volume level without using the 4th ‘outdoor’ setting (which works perfectly as well). The fitting is comfortable, without any slippage of device or feedback. After nearly 4 years, I finally feel like the devices are worthwhile.”

  • “Dr. Jan Liles at Alabama Hearing Associates has demonstrated integrity, professional competence, patience, and a true interest in improving my ability to hear. She was candid from the beginning, acknowledging that I have a very difficult hearing loss and will never hear as I did before. She has gone the extra mile in attempting to improve my hearing, trying four different hearing aids over a period of several months, patiently listening to my observations about each one, and helping me to chose the hearing aid best suited for me. After the selection, she continues to work dilligently with me to make sure that I receive the maximum benefit from my hearing aids.”

  • “Progressive hearing loss has made it necessary for me to wear first one, now two hearing aids, since the mid-1980’s. During the past twenty years I have lived in various places from a small island 3,500 miles southwest of Hawaii, to New Mexico, to Colorado, and finally to Huntsville, Alabama. This has given me experience with a wide range of approaches to audiology. Dr. Susan Sheehy and Dr. Jan Liles are way ahead of others I’ve worked with. Their competence in and use of the fast-evolving hearing aid technology gives them a broad range of options to chose from. This competence backs up their determination to find the best hearing solution for each patient.”

  • “The audiologists at Alabama Hearing Associates are the most caring and helpful people I have had the privilege of knowing. From the very first day that I stepped into their office, their only concern was to help me. They wanted to be sure that the hearing aids I purchased were the right ones for me and that I would be happy with them. Unlike the previous company I purchased hearing aids from (which I can’t wear because they were not right for me), they did not try to sell me the most expensive aids. Their only concern was for me and my satisfaction with the hearing aids.”

  • “For the past 10 years I have had progressive hearing loss, and have worked with audiologists in Birmingham and Huntsville without success. Then Dr. Jan Liles came into my life and it all changed. She is knowledgeable, professional, caring, and compassionate. Dr. Liles immediately identified my needs and took time to make me a vital part of all decisions regarding the hearing aids that best suited my hearing loss. Dr. Liles has given me the ability to hear and understand what my grandchildren are saying and that is a very special gift! I am indebted to Dr. Liles and Dr. Sheehy for having the foresight to see the need in our community for their professional services.”

  • “I have worn hearing aids since I was nine years old. Until I met Jan and Susan at Alabama Hearing Associates, I had never dealt with such professional, caring, patient, and compassionate people. They have really helped me and I will be forever grateful to them!”

  • “I am extremely happy with the care I have received at Alabama Hearing Associates. I was impressed from the very beginning with the ability of Dr. Liles and Dr. Sheehy to be very professional and yet still relate to me on a personal level. I immediately felt comfortable and confident that I had chosen the right people to meet my hearing needs”