Having a hard time accepting the Acceptance Manager?

By Erica Koehler

Acceptance Manager is back! It has made its return in Aventa 3.6 with a brand new makeover.  With the revamped Acceptance Manager, the fitter can make changes to both the start and end gains either together or independently. Other new options include a variety of choices for hours of use per day and an active progress slider.

The goal of the Acceptance Manager is to automatically move the wearer from an initially acceptable gain to a target gain as they become accustomed to the new hearing aids. When the fitter chooses to fit a patient with a “first time” or “comfort” fitting, the Acceptance Manager will gradually move them into an “experienced” fitting without requiring them to come back to the office. In fact, they likely won’t even notice the change. Follow the guide below to customize your fitting with Acceptance Manager.

Acceptance Manager Set-up

1. On/Off radio buttons: The feature is default off so the panel will be grayed out until the feature is turned on.
2. Duration and Average Daily Usage: The duration will indicate how many days the Acceptance Manager process will run and therefore how quickly it will run. The daily use will tell the device how many hours of use is considered a day. Setting these parameters actually determines the step size of the automatic gain change. The shorter the duration period, the larger the step size and the faster the end point will be reached. Note that automatic gain adaptation occurs only when the hearing aids are switched on.
3. Starting point: The starting point is the gain that was in the current session. This includes the fitting rule and experience level that was selected during the fitting. The “first time user” or “comfort user” profile should be selected prior to turning on the Acceptance Manager.
4. End point: This feature will move the gains from the experience level selected in the start screen, such as “first time user” to “Experienced non-linear.” Note that when Acceptance Manager has completed, the experience level shown in the software will change to “Experienced non-linear.”
5. Preserve fine-tuned gain:  By checking this box, any fine tuning that was completed prior to turning on Acceptance Manager will be included in the end targets as well. For example, if the instruments were fine-tuned because the listener felt they were unbalanced between ears, the “preserve” check box should be checked to maintain the balance throughout the Acceptance Manager process.
6. Synchronize: For devices that have device-to-device wireless connectivity this check box will display. Checking this box will keep the devices in sync as they progress. This means that if one device of the pair is not worn, the Acceptance Manager progress on the other ear will stop until both devices again are in use.

Fit screen when Acceptance Manager is activated

1. Combo box displaying End Gains (B): This combo box will display once Acceptance Manager is turned on. It will appear first as displayed above (1). This indicates that the gains currently shown in the gain handles are the end point gains. These are the gain settings that Acceptance Manager will advance toward.
2. Gain curve with dotted lines and circle icons: These features on the gain curve indicate that it is the active gain curve. This is the curve that is displayed in the combo box (1 and 3) and the curve that will adjust when changes are made to the gain handles. If the combo box is changed to display the opposite point (start of end) the dotted line and circle indicator will switch to the curve that is currently displayed as solid (3).
3. Solid gain curve: This indicates that the gain curve is inactive. This is the gain curve for either the start or end point; it will be the one which is not currently shown in the combo box. Changing the gain handles will not affect the solid gain curve.
4. Combo box displaying Current Gains (A): This indicates that the gains currently shown in the gain handles are the starting gains, or the gain setting that the wearer will hear when the initial fitting is complete.
5. Acceptance Manager Progress slider: The slider will progress from A (current gains) to B (end gains). At return visits the progress of the Acceptance Manager will be reported here as percent complete. The slider is active and can be moved forward or back at any point.

To conduct REMs with Acceptance Manager
Using REMs in both the start and end point

Follow these steps to preserve the offsets from REM in both the experience level selected at the start and the final “experienced non linear” targets at the end. Verify to new user settings with REM and use those offsets in end target.

1. Select experience level for user
2. Import targets into REM equipment
3. Conduct REMs in fit screen (with AutoREM or manually fine tune)
4. Select Acceptance Manager from the left navigation
5. Turn ON with the radio button (red arrow)
6. Check “preserve fine tuned gain” check box (green arrow)
7. Click done in the lower right corner

Using REMs in the end point
Follow these steps to include REM offsets for the final “experienced non linear” targets at the end.

1. Select experience level for user
2. Select Acceptance Manager from the left navigation
3. Turn ON with the radio button (red arrow)
4. Click done in the lower right corner (do not check preserve fine tuning)
5. When in fit screen conduct REMs (with AutoREM or manually fine tune) while “end gains” (circled in violet) are displayed