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. 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.