If a basic hearing aid is all the patient can afford, some degree of stimulation is better than no stimulation at all. Appropriate counselling would be needed, but I do prefer to have a greater degree of flexibility in a digital hearing aid. I personally think high end digital hearing aids are oversold to a large segment of the population. A mid level digital can give enough control of adjustment to satisfy most people. The high end digitals are very good and I do fit them. But unfortunately, until there is some flexibility on pricing, most elderly subjects can't afford them.
I do a first fit scenario using NAL-, then I modify from there depending on the programmability of the aid and the patient history and information. Some manufacturers have their own fitting strategies and do not incorporate the standard fitting formulas. The first fit is exactly what was said earlier - a way to get you into the ballpark. Finding the right seat is the goal.
>From: "Richard H." <auditory@AUGMENTICS.COM>
>Reply-To: "Richard H." <auditory@AUGMENTICS.COM>
>To: AUDITORY@LISTS.MCGILL.CA
>Subject: Re: Yet again on hearing aids - The Marriage of System and Desire
>Date: Mon, 29 Mar 2004 17:16:10 +0100
>
>A further digression: would you say that a basic digital WDRC aid rapidly programmed using NAL-NL1, IHAFF or whatever would always better than nothing for a client with a "typical" sensorineural loss?
>
>In other words, is the "fine tuning" essential to actually make an aid usable - or is it just a "nice to have"?
>
>regards,
>
>Richard
>
>
> ----- Original Message -----
> From: Harriet B Jacobster
> To: AUDITORY@LISTS.MCGILL.CA
> Sent: Monday, March 29, 2004 3:45 PM
> Subject: Re: Yet again on hearing aids - The Marriage of System and Desire
>
>
> In a message dated 3/29/2004 9:06:33 AM Eastern Standard Time, auditory@AUGMENTICS.COM writes:
>
> <<I wonder which one the audiologist should fit????>>
>
> Not at all a trivial point, but the bottom-line subject of this debate. My reply...we are lucky enough in this day and age to have the option of changing the hearing aid programming. Auditory behavior is learned and adaptive (for the most part). Fitting a hearing aid is an essential part of aural rehabilitation, i.e., retraining the auditory system to hear as close to acceptable norms as possible. Hopefully, by the time we get the patient, the system is plastic enough so we can gradually retrain it from "comfortable" without optimal performance to "comfortable" with optimal performance. Even in those patients with reduced plasticity, there is still the possibility of adaptive behavior and function.
>
> Anyone who has been in any type of physical therapy knows this routine.
>
> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> Harriet Jacobster, Au.D., CCC-A, FAAA
> Board Certified in Audiology
>
>
>
> ---
> Outgoing mail is certified Virus Free.
> Checked by AVG anti-virus system (http://www.grisoft.com).
> Version: 6.0.631 / Virus Database: 404 - Release Date: 17/03/04