Related Experiment Video
Updated: Feb 26, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
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.
Purpose:
This study provides the first independent evaluation of the Apple Over-the-Counter Hearing Aid Feature (OTC-HAF), examining its usability and laboratory performance among adults with self-perceived mild-to-moderate hearing loss.
Method:
A cross-sectional evaluation was conducted at a university audiology clinic. Digitally literate iPhone users (n = 25, ages 20-72 years) independently used AirPods Pro 2 to complete the Apple Hearing Test Feature and activate the OTC-HAF. The sample size aligns with usability model recommendations for moderately complex systems. Outcomes were assessed immediately after setup.
Results:
Usability was high, with a mean mHealth App Usability Questionnaire score of 6.7/7 (SD = 0.3) and a mean Hearing Aid Skills and Knowledge Inventory-Clinical score of 93.4% (SD = 9.0%). Study-specific questionnaire responses showed high satisfaction, good sound quality, and ease of use. Qualitative feedback highlighted affordability, convenience, and dual-purpose design, with some noting occlusion and difficulty locating settings. Some participants reported they would only use the device situationally. The audiogram import feature showed limited accuracy: 71% of thresholds were within 5 dB of the reference when both ears were scanned together and 73% when each ear was scanned separately, with 12% and 8% of thresholds missing for these methods, respectively. Objective performance measures showed nonsignificant speech-in-noise benefit (Quick Speech-in-Noise Test mean benefit of 0.1 dB SNR, SD = 1.9), and real-ear measurements showed gain levels generally below National Acoustic Laboratories-Non-Linear 2 targets.
Conclusions:
The Apple OTC-HAF showed high usability and satisfaction among digitally literate iPhone users, but nonsignificant speech-in-noise benefit and gain levels generally lower than prescriptive targets. Further research should explore broader applicability, long-term outcomes, and strategies to support uptake and consistent use.
Supplemental Material:
https://doi.org/10.23641/asha.31366123.
More Related Videos
Related Concept Videos
Hearing
Design Example
Sound Intensity Level
The human ear can perceive an extensive range of sound intensity, necessitating the use of the logarithmic scale to define a physical quantity—the intensity level. It is a ratio of two intensities and...
Auditory Perception

