What Is A Hearing Aid Prescription?

What Is A Hearing Aid Prescription? Dr. Cliff Olson, Audiologist and founder of Applied Hearing Solutions in Anthem Arizona, discusses what a Hearing Loss Prescription is and why it is so important for treating hearing loss.

The first question I ask myself when it comes to recommending a hearing aid is "will this hearing aid allow me to meet your hearing loss prescription?". Only then can you start to look for other features and styles of hearing aids.

A Hearing Loss Prescription is a lot like an eyeglass prescription. Different types of vision loss require different prescriptions. You can't just take one prescriptions and fit them to everyone with hearing loss. This is the same when it comes to hearing loss. Different configurations and severity of hearing loss require different amounts of amplification.

To explain a Hearing Loss Prescription on a basic level, it is a calculation of the ideal amount of amplification required at each frequency to restore audibility to certain sounds. For example, if you have more hearing loss in the higher frequencies, you would require more amplification to restore sounds you are missing in these ranges, compared to other frequencies that you have less of a hearing loss in. The amount of amplification required in these ranges depends on a variety of factors, not just the level of loss alone.

This is one of the reasons why wearing a pre-programmed hearing aid does not provide the maximum amount of benefit, because individual variations including hearing loss levels are not taken into account.

There are several different prescriptive methods used to determine your prescription for hearing aid amplification requirements.

1. NAL-R - This was developed by the National Acoustics Laboratory in Australia. It is intended for use with Linear hearing aids that apply the same amount of amplification to all inputs (soft, average, loud sounds). Not many people wear Linear hearing aids anymore, but if you do, the NAL-R is the prescription for you.

2. NAL-NL2 - This was also developed by the National Acoustics Laboratory. It is the updated version of the NAL-NL1 which is intended for Non-Linear hearing aids. These devices prescribe different amounts of amplification for Soft, Average, and Loud sounds. This is the most commonly verified hearing loss prescription today.

3. DSL-5 - This stands for Desired Sensation Level Version 5. This was developed based on the need for verifiable prescription for children. However, adults can also use this prescription. Children often require more amplification than adults and ensures that they have access to sound critical for speech development. This formula results in different frequency response curves, insertion gain, and compression parameters than the NAL formulas.

4. Proprietary Manufacturers Prescriptive Methods - All hearing aid manufacturers have their own Hearing Loss Prescriptions. Phonak has its Adaptive Phonak Digital, Signia has NxFit, ReSound has Audiogram+, and Oticon has VAC+. However, the biggest problem with these prescriptions is that they cannot be verified like the 3 previous prescriptive methods. Remember, just because a hearing aid sounds good, doesn't mean the hearing aid is programmed correctly. Not using Real Ear Measurement results in an unverified prescription that won't let you hear your best.

The calculation of a Hearing Loss Prescription is more complex than just adding volume to make things more audible. Fortunately, there are organizations like the National Acoustics Laboratory, and individual researchers who have done extensive research to develop Hearing Loss Prescriptions that will help you hear your best.

So the next time you get a set of hearing aids programmed, be sure to ask your hearing care provider which prescriptive method they are using and why. Oh and don't forget to make sure they verify your hearing loss prescription with Real Ear Measurement.

[waynelynch]

Waited to see a sample of a ''Hearing Aid Prescription'' in clip but it never happened. I just went to a second ENT regarding Balance/Equilibrium problems. Doc gave me a set of eye exercises to do, but told me that he doubted there was a ''pill'' to fix my problem. Then why give me eye exercises? Then he wanted to sell me hearing aids.
1st ENT told me I had loose crystals. He referred me to Physical Therapist. Therapist did a few test & told me I did not have loose crystals. 1st ENT also wanted to sell me hearing aids. I'm making an appt to see a 3rd ENT, but at this point, it feels like selling hearing aids is more important then helping me w/Balance/Equilibrium problems. I don't trust any of them.
I asked if there was a prescription, like eyeglasses or meds? They gave me the results from my hearing test, with charts/graphs and said that is what I need to buy hearing aids. No detailed description of anything. I have had hearing loss since the 80's (Loud Music & Surfers Ear). Yes, it is difficult to talk in noisy environments, so I try to ignore large gatherings. For TV, I have used CC for years. I do miss the high sounds of music. If I do get hearing aids, I'm guessing it will just be to help in specific situations, but I'm clueless as to how it works, since neither ENT spent enough time w/me to describe my hearing loss or hearing aids.

[wayne-o]

I started wearing aids in 2001 with a pair of Resound Air. In 2010 I upgraded to Signa Pure 600 with modern features. My issue is that I am not understanding speech as well with the more modern, pricy Signa aids. The Resound aids are still working and although I use them as a backup set, I can understand speech better with those than I do with the Signa. My audiologist can’t give me a good reson for this. Any ideas?

[scottshevchik]

Hello Cliff went to audiologist the other day he said my hearing in my left ear was fine but my right needs help. That I only need one hearing aid is the ok or should I buy a pair any feed back would be great thanks

[imankalyanchakraborty]

Can acoustic neuroma patient hear sounds with a simple hearing aid before surgery or any kind of treatment?

[ifthkarmand]

Hi, what's your thoughts about fitting Manu prescription and doing REM's? as many Manu state technology benefits only by using their own prescription or do you prefer just to stick with NAL-NAL2 due to research? thanks

[ryandavid]

Hey Dr. Cliff. When you are measuring air conduction thresholds do you test the inter-octaves routinely or only when there is a 20dB difference in between octave thresholds?

[andrewr]

Random question. I have a wax buildup problem in my ear and my doctor told me to use a water pick with a mixture of peroxide and water. The problem with this is that I always end up with swimmers ear. Is there a better way of removing the wax?

[zacksalvatore]

Can u make a video about an audiologists’ salary?

[baderabdi]

doctor, may hearing amplifier hurt or make hearing loss bad?!

[trabei]

Most insurance companies only cover a small percentage of the cost of hearing aids because it is considered an elective. Hearing loss is a serious medical condition that can lead to other serious future medical conditions and cheap ass insurance companies should pay more just like they do for eyeglasses.

[SaltNBattery]

Here’s the difference. I CAN go buy glasses without a prescription, whether they work to correct my vision or not. I can’t however, without insurance just go buy a Signia or Phonak hearing aid. It seems extremely corrupt. The other thing that’s odd, is that I can’t buy a hearing aid directly from the manufacturer, even if I had a prescription. Why? Because the middle men (like you) need to get their cut.

Similar to how there are all sorts of absurd laws, policies and systems in place that prevent consumers from buying cars directly from manufacturers. Because then how would all the middle men be able to make money? It’s gross and you see what happens when someone like Tesla decides to direct to consumer sales.