It Starts With The Fitting

How do you make sure your hearing aid fittings result in positive outcomes where patients become successful users? How do you avoid the negative outcomes where the hearing aid is not worn or is returned?

As you know, the negative consequences of untreated hearing loss are irritability, fatigue, stress, withdrawal, depression, reduced job performance and lower earning power. When a person with hearing loss is fit with hearing aids and subsequently has a negative outcome, they are unable to experience the benefits of amplification and overcome these negative consequences.

At the 2013 AudiologyNOW! conference, Laurel Christensen, Ph.D., outlined why some fittings have negative outcomes and suggested ways to increase the likelihood of positive outcomes.

As an audiologist you know that hearing aid users enjoy not only a better quality of life than non-users but also better overall health. Hearing aid users are less introverted and more likely to engage in social activities than those who don’t wear hearing aids. They also communicate better with people around them and have better personal relationships. So why do almost 20% of hearing aids get returned for credit? The graph below breaks down some of the more common return reasons:

ReasonsForHearingAidReturnsWhat do patients expect from their hearing aids? Patients want to “put on” their “invisible” hearing aids and forget the hearing aids are even there. Patients also expect to hear no matter what listening environment is presented. Luckily today the hearing aid user is successful in more listening environments than ever before as well as they have more choice in types and styles, but audiologists must gain an understanding of the communication needs of the patient, extent of the program (audiological evaluation) and the patients motivation/self-perception of the problem to truly drive a positive outcome.

Here are some common fitting tools & tips to help gain more positive outcomes:

  • Characterstics of Amplification Tool (COAT), 9-question intake form.
  • Red Flag Matrix as Counseling Tool


  • Self-Perception on Hearing Ability – ask the patient to rank their overall ability to hear.
  • Patient involvement – it should be a shared decision making process with the patient involved as much as possible and with the audiologist quantifying whatever and whenever he or she can.
  • Fitting Verification – optimize for speech intelligibility and sound quality and maximize audibility and “first-fit” acceptance.
  • Fitting Validation – how does the patient feel, how much benefit, how much satisfaction are they gaining?

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