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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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Usability and Performance of the Apple Over-the-Counter Hearing Aid Feature.

Megan Kruger1,2, Vinaya Manchaiah1,2,3,4,5, De Wet Swanepoel1,2,3

  • 1Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.

American Journal of Audiology
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The Apple Over-the-Counter Hearing Aid Feature (OTC-HAF) demonstrates high usability and user satisfaction for mild-to-moderate hearing loss. However, it showed limited accuracy in audiogram import and no significant speech-in-noise benefit.

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Area of Science:

  • Audiology
  • Health Technology
  • Human-Computer Interaction

Background:

  • The proliferation of direct-to-consumer hearing health technologies necessitates independent evaluation.
  • Apple's Over-the-Counter Hearing Aid Feature (OTC-HAF) represents a significant entry into this market.

Purpose of the Study:

  • To conduct the first independent evaluation of the Apple OTC-HAF.
  • To assess the usability and laboratory performance of the OTC-HAF in adults with self-perceived mild-to-moderate hearing loss.

Main Methods:

  • A cross-sectional study involving 25 digitally literate iPhone users (ages 20-72).
  • Participants independently used AirPods Pro 2 to complete the Apple Hearing Test and activate the OTC-HAF.
  • Usability and performance outcomes were assessed immediately post-setup using standardized questionnaires and objective measures.

Main Results:

  • High usability scores (mHealth App Usability Questionnaire: 6.7/7) and user satisfaction were reported.
  • Audiogram import accuracy was limited (71-73% within 5 dB).
  • No significant speech-in-noise benefit was observed (0.1 dB SNR), and real-ear measurements showed gain below prescriptive targets.

Conclusions:

  • The Apple OTC-HAF offers high usability and satisfaction for tech-savvy users.
  • Performance limitations include audiogram import accuracy and audibility benefit.
  • Further research is needed on broader applicability, long-term effects, and user support strategies.