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Abstract
This study aimed to determine whether gain adaptation occurs, and at which frequency bands, among new hearing aid (HA) users. Fifty new and 26 experienced HA users were fitted with three listening programs (NAL-NL1 and NAL-NL1 with low- and high-frequency cuts) in the same hearing instrument family. Real-life gain preferences and comfortable loudness levels were measured one, four, and 13 months post-fitting for the new HA users, and one month post-fitting for the experienced HA users. Relative to experienced HA users, new HA users preferred progressively less overall gain than prescribed as the hearing loss became more severe. Gain adaptation occurred in new HA users with greater hearing loss, but was not complete 13 months post-fitting, and was not explained by changes in loudness perception. Preferences for a high-frequency gain cut by half of all study participants could not be predicted from audiological data. Gain adaptation management is recommended for new HA users with more than a mild hearing loss.
| Abbreviations | ||
| 4FA | = | Four-frequency-average |
| ABR | = | Auditory brainstem response |
| BTE | = | Behind-the-ear |
| DLI | = | Discrimination limen for intensity |
| DSL[i/o] | = | Desired sensation level (input/output) |
| EN | = | Environmental noise |
| FAAF | = | Four-alternative auditory feature |
| FF | = | Free field |
| HA | = | Hearing aid |
| HFA | = | High-frequency average |
| HFC | = | High-frequency cut |
| HL | = | Hearing level |
| HTL | = | Hearing threshold level |
| ITC | = | In-the-canal |
| ITE | = | In-the-ear |
| LFA | = | Low-frequency average |
| LFC | = | Low-frequency cut |
| NAL | = | National Acoustic Laboratories |
| NAL-NL1 | = | National Acoustic Laboratories non-linear version 1 |
| NAL-R | = | National Acoustic Laboratories revised |
| PHAP | = | Profile of hearing-aid performance |
| REIG | = | Real-ear insertion gain |
| SD | = | Standard deviation |
| SE | = | Standard error |
| SLM | = | Sound-level meter |
| SPL | = | Sound pressure level |
| VAD | = | Voice activity detection |
| VC | = | Volume control |
| WDRC | = | Wide dynamic range compression |
| Abbreviations | ||
| 4FA | = | Four-frequency-average |
| ABR | = | Auditory brainstem response |
| BTE | = | Behind-the-ear |
| DLI | = | Discrimination limen for intensity |
| DSL[i/o] | = | Desired sensation level (input/output) |
| EN | = | Environmental noise |
| FAAF | = | Four-alternative auditory feature |
| FF | = | Free field |
| HA | = | Hearing aid |
| HFA | = | High-frequency average |
| HFC | = | High-frequency cut |
| HL | = | Hearing level |
| HTL | = | Hearing threshold level |
| ITC | = | In-the-canal |
| ITE | = | In-the-ear |
| LFA | = | Low-frequency average |
| LFC | = | Low-frequency cut |
| NAL | = | National Acoustic Laboratories |
| NAL-NL1 | = | National Acoustic Laboratories non-linear version 1 |
| NAL-R | = | National Acoustic Laboratories revised |
| PHAP | = | Profile of hearing-aid performance |
| REIG | = | Real-ear insertion gain |
| SD | = | Standard deviation |
| SE | = | Standard error |
| SLM | = | Sound-level meter |
| SPL | = | Sound pressure level |
| VAD | = | Voice activity detection |
| VC | = | Volume control |
| WDRC | = | Wide dynamic range compression |
Sumario
El propósito del estudio fue determinar si es que ocurre la adaptación a la ganancia y en cuáles bandas de frecuencia, entre usuarios nuevos de un auxiliar auditivo (HA). Cincuenta nuevos usuarios de HA y 26 con experiencia fueron adaptados con tres programas diferentes (NAL, NL1 y NAL-NL1 con cortes de frecuencia altos y bajos) con aparatos de la misma familia. Se midieron las preferencias de ganancia en la vida real y los niveles de confortabilidad a los cuatro y a los 13 meses después de la adaptación en los nuevos usuarios de HA y un mes después de la adaptación en los usuarios experimentados. Con respecto a los usuarios experimentados, los nuevos usuarios prefirieron progresivamente una ganancia menor que la prescrita conforme la hipoacusia era más severa. La adaptación a la ganancia ocurrió en los nuevos usuarios de HA con mayor hipoacusia, pero aun no era completa a los 13 meses después de la adaptación y no se explicaba a partir de los cambios en la percepción de la intensidad. No fue posible predecir a partir de los datos audiológicos, la preferencia por un corte de alta frecuencia que tuvieron la mitad de los participantes del estudio. El manejo de la adaptación de la ganancia es recomendado para nuevos usuarios de HA con una pérdida auditiva mayor a la hipoacusia leve.