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Richard,
Not at all a digression, but rather great fodder for thought.
Personally, I rarely "rapidly" program. Secondly, I don't believe there is a "typical" SNHL. Thirdly, I try not to make generalizations about my patients or a fitting (thus to answer any question that asks about "always" is something I try to avoid) and address each individual's needs as much as possible. And, fourthly, I try to abide by the dictum "Primum non nocere."
Having said all that, my answer to your question would be "it depends." By introducing a "rapidly programmed" hearing aid, are we adding additional distortion to an already, presumably, distorting system? In that case, yes, nothing would be better than something that further digresses the system.
Bearing that in mind, I now have a question. I recently tested two young (5 y-o and 9-y-o) sisters with SNHL (most probably hereditary). The 5-y-old's loss has fluctuated most of her life going from mild to moderate. Her discrim (in noise) was excellent and she has no complaints of any trouble in school or in social interactions (based on her and her parents' reports which may be skewed). So, here is a child who's auditory system adapted, presumably, to her loss. My initial thought, as well as that of others who tested her hearing, was that this child needs hearing aids for proper cognitive development and prevention of auditory deprivation. However, now I'm thinking, if the child is not "cognitively impaired" at this moment and seems to have excellent discrimination and functions well in school etc., should we put hearing aids on her that very well may introduce distortion to her system? Would we then actually be doing more harm than good?
Now, is "fine tuning" essential to make an aid usable? Not essential to make it "usable." But certainly desirable to enable optimal results.
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Harriet Jacobster, Au.D., CCC-A, FAAA Board Certified in Audiology |