Use of a loudness model for hearing aid fitting: III. A general method for deriving initial fittings for hearing aids...

A model for predicting loudness for people with cochlear hearing loss is applied to the problem of the initial fitting of multi-channel fast-acting compression hearing aids. The fitting is based entirely on the pure tone audiogram, and does not require measures of loudness growth. One constraint is always applied: the specific loudness pattern evoked by speech of a moderate level (65 dB SPL) should be reasonably flat (equal loudness per critical band), and the overall loudness should be similar to that evoked in a normal listener by 65-dB speech. This is achieved using the 'Cambridge' formula. For hearing aids where the compression threshold in each channel can be set to a very low value, an additional constraint is used: speech with an overall level of 45 dB SPL should be audible over its entire dynamic range in all frequency channels from 500 Hz up to about 4 kHz. For hearing aids where the compression thresholds cannot be set to very low values, a different additional constraint is used: the specific loudness pattern evoked by speech of a high level (85 dB SPL, and with the spectral characteristics of shouted speech) should be reasonably flat, and the overall loudness should be similar to that evoked in a normal listener by 85-dB speech. For both cases, compression ratios are limited to values below 3. For each of these two cases, we show how to derive compression ratios and gains, and for the first case, compression thresholds, for each channel. The derivations apply to systems with any number of channels. A computer program implementing the derivations is described. The program also calculates target insertion gains at the centre frequency of each channel for input levels of 50, 65 and 80 dB SPL, and target gains at the eardrum measured relative to the level at the reference microphone of a probe microphone system.