Hearing Aid Technology Settings and Speech-in-Noise Difficulties

Hearing aids are the primary method to manage hearing loss. However, there are limited recommendations for when and how to set advanced hearing aid features. The purpose of this study is to describe how hearing aid features are utilized in clinically fit devices and to evaluate the relationship between the fitted hearing aid feature and the Quick Speech-in-Noise Test (QuickSIN).

Data from two laboratories were evaluated retrospectively, resulting in 107 bilateral hearing aid participants who obtained their hearing aids at clinics in their communities. Ages ranged from 60 to 93 years. Degree of speech-in-noise difficulty was evaluated using the QuickSIN (mild, moderate, or severe). Settings for directionality, digital noise reduction (DNR), and hearing assistive technology (HAT) use were documented. Directionality was categorized as omnidirectional, fixed (full-time directional), or adaptive (adjusts automatically based on noise source). DNR was recorded as either on or off. HAT use was recorded as either yes or no.

QuickSIN scores ranged from -1.5 to 25 dB SNR loss (M = 7). A moderate correlation was determined for QuickSIN scores and pure-tone averages. Adaptive directionality was used most often, most participants had DNR turned on, and HAT use was low. The biggest contributions to the Chi-square test for directionality and degrees of speech-in-noise difficulty together were fixed/severe, fixed/moderate, and adaptive/mild.

In this clinical sample, there was limited HAT use and advanced features are not set in a way that is consistent with speech-in-noise abilities. It is likely that patients fit with noise management that is not suited to their listening abilities are experiencing increased difficulties in challenging listening environments that could potentially be mitigated with alternative management. Evidence-based research on prefitting measures of speech in noise to help inform patient-centered clinical decisions is needed.