How do I know my hearing aids are working like they should?

Over the past year, the hearing instrument test box has quickly become one of my most-used pieces of equipment. Electroacoustic analysis (EAA) is a relatively quick test, and it provides so much data about how the hearing aids are working.

Often, EAA can pick up on a hearing aid problem when the patient has been suspecting that their hearing loss had worsened. 

Why is electroacoustic analysis (EAA) important? 

While EAA is only regularly completed by a small fraction of hearing healthcare providers, it is the only way a provider can know for sure that a hearing aid is working as it did when brand new. 

EAA can verify that the hearing aid hasn’t gotten weak, the frequency range is as big as it should be, there’s no distortion in the sound quality, it’s not noisy, the directional microphones are working, and the batteries aren’t draining faster than normal. 

Because Alabama Hearing Associates is one of the few practices that always measures EAA, we often work with hearing aid manufacturers to troubleshoot glitches in their fitting software—the manufacturers are able to rely on our results since we do the appropriate testing, giving them valuable data to fix any issues that may arise.  

Without verifying that the hearing aid is working correctly from the start, all of the other steps in the hearing aid fitting process are useless. 

EAA

What are the steps of EAA? 

In this section, I’m going to discuss the nitty-gritty of EAA; for those interested in the technical details (such as our engineers and audiophiles), the process is outlined below. If this isn’t your cup of tea, feel free to skip to the next section.  

  1. Preparing the devices:  
    1. Unless the hearing aids are new, the first step is to completely dry out the devices using the Redux and clean the hearing aids, replacing any parts that may be affected by regular wear and tear. 
    2. Then we use putty to create a very tight seal between the hearing aid and the equipment. 
    3. Next, we program hearing aids to a test level. This will deactivate any noise reduction and feedback suppression. Depending on the strength of the hearing aid, we may also have to deactivate the safety settings or volume limiter.  
  2. Running the hearing aids at their loudest setting: 
    1. We then run a tone sweep at 90 decibels (dB) and 50 dB from 200 Hz through 8000 Hz (very low pitched to very high pitched) to measure the loudest the hearing aid gets and the average volume at 3 specific frequencies. 
  3. Then we change the hearing aid setting to a medium volume and do a third and final tone sweep at 60 dB. With this, we measure the following: 
    1. Frequency range—at what pitches are the hearing aids amplifying? If the frequency range is less than it should be, it usually indicates the hearing aids are weak, and the patient may confuse this with their hearing getting worse. 
    2. Distortion—typically, if distortion is high, it’s the fault of the speaker (also known as a receiver). 
    3. Battery drain—while this cannot be measured on most rechargeable hearing aids, it can be very helpful diagnostic information if a patient is reporting that batteries need to be changed/charged more frequently than expected. 
  4. Lastly, we program the devices to the patient’s settings and measure the following: 
    1. Directionality—if the hearing aid has at least two microphones, we verify that in a noisy setting, the front microphone is more emphasized than the back microphone; with older hearing aids, it’s not an uncommon problem for the emphasis to get switched.  
    2. Gain—this is only done after hearing aid fitting and adjustment. The sound signal is the same as real-ear measurement, and this can be helpful for comparison between annual hearing aid checks if a patient drops off their hearing aid for troubleshooting. 

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When should EAA be completed? 

EAA should be completed at least once a year. At Alabama Hearing Associates, it is completed on all new hearing aids before a fitting, whenever hearing aids come back from repair (to ensure they were repaired correctly and not damaged in transit), at annual hearing aid checks, when a new patient is “adopted,” before the warranty expires to ensure they don’t need to be sent in one last time, during a drop off repair and recovery to verify repair was successful, and as troubleshooting to rule out the hearing aid malfunctioning if a patient is concerned their hearing may have changed.   

If you would like to schedule an appointment to have your hearing aids evaluated, please call us at 256-319-4327 or submit a contact request, and one of our helpful team members will call you back shortly. 

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Dr. Susan Sheehy

Dr. Sheehy earned her bachelor’s and master’s degrees in audiology at the University of Alabama before beginning her career as a clinical audiologist in Huntsville. In 2005, she received her doctorate in audiology from Salus University. Dr. Sheehy is one of a specialized subset of audiologists certified in tinnitus retraining therapy (TRT). By appointment from the governor, she has served as a member and chairperson of the Alabama Board of Examiners in Speech-Language Pathology and Audiology.
    Basic Hearing Test

    A basic hearing test begins with an air conduction test. You will be seated in a soundproof booth and single-use, foam earphones will be inserted into your ear canals. The Audiologist will ask you to push a button or raise your hand when you barely hear a series of beeps (tones) presented at various frequencies (pitches) to obtain your air conduction thresholds.

    To determine whether your hearing loss is a conductive (mechanical) loss, sensorineural (permanent) loss or combination of the two, we perform a bone conduction test.  

    For this test, a head band is place on the bone behind one of the ears to obtain your bone conduction thresholds. This process provides a different form of sound transmission using vibration, which bypasses the eardrum and the middle ear bones and directly stimulates the auditory nerve. When you hear the beeps/tones, you will push a button or raise your hand.

    If bone conduction thresholds are better than air conduction thresholds (through the foam inserts), you have a conductive hearing loss. This suggests a problem with the mechanical structures (moving parts) of the ears.

    Conductive hearing loss is often a medically treatable condition for which we will provide you with a referral to an Ear, Nose and Throat (ENT) physician. However, if bone and air conduction thresholds match, it indicates a sensorineural hearing loss (permanent), and the treatment will likely involve hearing aids.

    ALL INCLUSIVE PLAN

    $6,790

    Comprehensive 5-Year treatment plan with premium technology

    If you want premium “out of this world” technology and the highest level of service and expert support, our All-Inclusive treatment plan is the right investment for you.

    The All-Inclusive treatment plan offers long-term value for your on-the-go lifestyle, providing everything you need to connect with family and friends for years to come.

    Includes:

    • Stellar hearing devices from top manufacturer (rechargeable option available)

    • Wireless accessory included at no charge

    • Comprehensive Annual Visit including hearing assessment, hearing device adjustment, and 19-Point preventative maintenance valutaion

    • Bi-annual hearing aid software update and reprogramming

    • Same day diagnosis and in-office repair during weekdays for devices dropped off before 3:00 p.m.

    • 5-Year full-service repair warranty

    • Unlimited remote hearing aid adjustments

    • 100% moisture removal by Redux and cleaning

    • Hearing aid supplies (stock receivers, batteries, domes and filters)

    • $1000 contribution towards purchase of upgraded technology within 48 months

    • 3-Year replacement warranty for loss or damage (no deductible)

    • Dedicated team of hearing care experts at your service

    • Unlimited teleaudiology appointments

    • Access to our “speed of light” repair specialists

    Schedule Appointment

    Choose Your Level of Technology

    A Comprehensive12-Step Functional Hearing Assessment

    If you struggle to understand conversations in social situations, restaurants, or other noisy environments, you do not need to schedule a basic hearing test. You certainly don’t need to schedule a “free” hearing screening or online hearing test.

    You need to schedule a “Connect 365” Functional Hearing Assessment at Alabama Hearing Associates!

    Hearing Technology with a Methodical Plan

    Our community understands better than most what can be achieved when you combine technology with human intelligence and persistence. It is much the same with hearing technology.

    The latest hearing aid technology is incredibly powerful, offering stellar sound quality and performance. Wireless connections allow phone calls, music and television to stream directly to your hearing aids for exceptional clarity.

    But hearing aids do not fit and program themselves! For best outcomes, you also need the human touch and expertise provided by our Doctors of Audiology.

    How do I know my new hearing aids are working properly?

    Without verifying that the hearing aid is working correctly from the start, all of the other steps in the hearing aid fitting process are useless. The most sensitive quality control measure is something called Electroacoustic Analysis. We complete EAA on every new set of hearing aids, before delivery of repaired devices, and on an annual basis.

    What Is Real-Ear Measurement?

    Real-ear measurement (REM) is how an audiologist knows that hearing aids are working the way they should in each patient’s ears.

    Ears are as unique as a fingerprint. Because of this, every ear will collect sounds differently.

    Even if I had two patients with the exact same hearing loss and hearing aids, there’s almost no chance the hearing aids would be programmed the same way.

    Orientation, Counseling, and Follow-up

    Dr. Cliff (the creator of the Best Practice Pro Network) said it best:

    “Having a detailed orientation can dramatically improve how much success you have with hearing treatment.  Counseling & Follow-up care can also ensure that you have success for years to come.  Regular visits to a hearing care provider who spends the time to discuss treatment related information and who will maintain your devices is extremely important.”

    During the orientation, your provider will give you the tools you need to be a successful hearing aid user. Everyone has different learning styles and we want to make sure whatever works best for you is what’s used. After the 75 day adjustment period, routine checkups are necessary to maintain the hearing aids and to ensure optimal hearing healthcare. 

    Real World Adjustments

    Your hearing loss didn't occur overnight, so it will take some time to adjust to the hearing aids. Your patience and persistence will be well worth it.

    Wireless Connections

    Most hearing aids automatically come with wireless streaming from smartphones and it has been a lifesaver for those that are working remotely and spending hours on teleconferences. As for other wireless accessories, the two most popular solutions are a small microphone used in less-than-ideal listening environments and a TV streamer that streams the TV’s sound directly into your ears—which can be a lifesaver when watching British TV shows or during football season. If your audiologist believes they would be beneficial for you, they will discuss your options and demonstrate the device in the office.

    Assessing Outcomes

    To ensure the most success with your hearing devices, we measure the benefits of amplification at the end of your adjustment period—some of the surveys and tests included in the “Connect 365” Functional Hearing Assessment will be repeated to evaluate progress, quality of life, and patient satisfaction with the hearing aids.