Hearing Aid Fitting & Adjustment Flashcards

Which real-ear measurement verifies that the hearing aid output matches the prescribed target at the eardrum?

Answer: Real-ear insertion gain (REIG)

REIG is the difference between REAR and REUR, directly showing how much gain the hearing aid adds at the eardrum compared to the prescribed target.

A patient reports their hearing aid whistles when they cup their hand near their ear. What is the most likely cause?

Answer: Feedback due to acoustic leakage

Feedback occurs when amplified sound leaks out of the ear canal and re-enters the microphone, creating an oscillation loop.

When fitting a child with a hearing aid, why is the RECD (real-ear-to-coupler difference) especially important?

Answer: Children's ear canals produce more gain than a 2-cc coupler predicts

Smaller ear canals create higher SPL than a standard 2-cc coupler, so RECD corrects coupler-based targets to accurately represent real-ear levels in children.

Which fitting formula is specifically designed for children and incorporates loudness normalization?

Answer: DSL v5.0

Desired Sensation Level (DSL) v5.0 was developed to normalize loudness for children across the speech spectrum and includes pediatric-specific targets.

A patient with a precipitous high-frequency hearing loss complains that amplified speech sounds 'tinny.' What adjustment should you consider first?

Answer: Reduce high-frequency gain

Reducing high-frequency gain lowers the perceived brightness/tinny quality that results from over-amplification of high frequencies relative to lows.

What is the purpose of the 'first-fit' or manufacturer's default program at the initial hearing aid fitting?

Answer: To serve as a starting point based on audiogram before real-ear verification

The first-fit uses the audiogram and fitting formula to generate an initial gain prescription that will be refined with real-ear measurements and patient feedback.

A patient's real-ear measurement shows gain 10 dB above the NAL-NL2 target in the 2000 Hz region. What is the appropriate clinical action?

Answer: Reduce gain in the 2000 Hz channel to match the target

When measured gain exceeds the prescriptive target, the clinician should reduce gain in that frequency channel to prevent over-amplification and potential discomfort.