- I frequently talk about the massive importance
of using real ear measurement
to verify the programming of your hearing aids
during your hearing aid fitting.
However, there are still occasions
where even real ear measurement is not enough
to make sure that you're receiving
the maximum amount of benefit from your hearing aids.
So in this video,
I'm talking about sound field testing
and how this can also be used
to make sure that you get the most out of your devices.
Coming up.
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Hi guys, Cliff R. Olson,
Doctor of Audiology and founder of Applied Hearing Solutions
in Phoenix, Arizona.
And on this channel,
I cover a bunch of hearing related information
to help make you a better informed consumer.
So if you're into that,
make sure you hit that subscribe button.
And don't forget to click the bell
to receive a notification every time I post a new video.
Real ear measurement is widely regarded as the gold standard
of hearing aid verification
when programming a set of hearing aids.
However, sometimes additional measures may be required
to verify if your hearing aids are programmed properly
to make you hear your absolute best.
Now, I wanna be clear here.
This video is not me saying that you can or should perform
different verification measures
other than real ear measurement.
What I'm saying is that real ear measurement
should still be performed,
but there are additional measures that can be also added
on top of real ear measurement
to make sure that you get the most out of your hearing aids.
In my opinion, there are only a few valid excuses
for not performing real ear measurement.
The first one being,
a patient who physically cannot have the measurements
performed on them.
Think of like a kid who won't sit still.
You can't perform real ear measurement on an individual
who is not a willing participant
to have these measurements completed.
The other one is, is if you are getting
a significant discount on your hearing aid treatment,
and only if you understand
that you are actually going to be giving up
a significant amount of benefit from your hearing aids.
That being said, there are some additional measures
that do provide some additional information
about how much benefit you are or should be receiving
from your hearing aids.
And those additional measures are obtained
through sound field testing.
The absolute best hearing aid clinics
are the ones that have the ability
to perform real ear measurement,
which are usually completed in a room that is quiet,
but not soundproofed like you see here.
These clinics also have the ability
to perform a variety of unaided
and aided sound field measures,
which are completed in a soundproof booth
with loudspeakers mounted in multiple locations
like you see here.
You may recognize a sound booth like this one
from your initial hearing test.
When I'm talking about unaided sound field measures,
I'm talking about testing performed inside of a booth
without hearing aids inside of your ears.
You're just using your natural hearing ability.
When I'm talking about aided sound field measures,
I'm talking about testing you're hearing
inside of a sound booth with hearing aids
inside of your ears that have been programmed
to overcome your level of hearing loss.
In general, this concept is not too complicated.
Basically, we're looking to see how well you perform
without hearing aids versus with hearing aids
and this can provide us with additional information
of how much benefit those hearing aids are giving you.
Hey guys, sorry to interrupt this video,
but if you could do me a huge favor
and click the like button,
it encourages YouTube to recommend these videos
to a greater audience.
So more individuals with hearing loss
can get the help that they need.
That being said, I greatly appreciate it
and now back to the video.
All right, let me go ahead and give you a few examples
on different types of sound field testing.
And the first one that I'll be talking about
is functional gain testing.
Now, some of my viewers who've been watching my channel
for a long time,
probably recognized functional gain testing
from a video I did about three years ago,
where I was saying how functional gain testing
is not as good as real ear measurement.
But that does not mean that functional gain testing
has no value.
Basically functional gains sound field testing
is when we're testing your hearing loss thresholds
at different frequencies using warble tones
or narrow band noise in an unaided condition,
and then testing you again for these thresholds
in the aided condition.
If functional gain testing and a sound field
has been conducted properly
on hearing aids that have been programmed
for your hearing loss,
then we should see an improvement
in your hearing loss thresholds,
which means that your hearing soft sounds better.
If your thresholds have not improved
or have only improved slightly,
then we know that your hearing aids
have not been programmed properly
to make sure that soft sounds are audible for you.
The second type of sound field testing that can be performed
is unaided versus aided word recognition in quiet.
The concept of this one is super simple.
Play a list of words, like say the word cat,
or say the word dog at a certain volume level
from the sound field speaker in the unaided condition.
Then, put hearing aids inside of your ears
and repeat this test at the same volume level,
but with a different list of words
and see if your percentage of words correct goes up.
This indicates how much improvement in speech understanding
and quiet that you were to receive from your hearing aids.
If there is little to no improvement
in the percentage of words correct in the aided condition,
then it could mean that you're not receiving enough benefit
with those hearing aids in a quiet situation.
And the third type of sound field testing
is speech-in-noise testing.
Now there are a variety of different speech and noise tests
that can be performed inside of a sound field,
so I'm just gonna cover a few of them right now.
First you have unaided versus aided QuickSIN testing.
QuickSIN testing is basically when you have to listen
for sentences being played from the speaker,
but there's escalating noise mixed in with those sentences
and the noise and the sentences
are both coming from the same speaker in front of you.
When we do this in the unaided condition,
we're trying to identify
what your signal to noise ratio loss is.
The lower the number, the better.
Then when we perform this test on you
in the aided condition,
we want to see that number drop even further.
If your hearing aids are programmed properly,
you should see a significant reduction
in your SNR loss score.
There was a terrific study done in 2012
by Leavitt and Flexor
that showed a significant improvement
in speech and noise scores
when digital hearing aid programming was verified
by real ear measurement,
once again proving the significant importance
of having real ear measurement performed
on your hearing aids prior to this type of cell
and field testing,
especially if you want to hear your best
in background noise.
You also have what is called the two minute speech
and noise test.
This is when individual words are being played
from a speaker in front of you
and speech babble is being played from a speaker behind you
to see if your hearing aids can help you separate the speech
from the background noise
when they're coming from two different locations.
During this test,
we are looking to see what your unaided
versus aided SNR 50 score is,
which indicates to us how much background noise
can be present for you to understand 50% of those words
that are being played from in front of you.
The lower the SNR 50 score is the better.
So ideally, if you were in the unaided condition,
you will have an SNR 50 score that is higher
than the aided SNR 50 score.
Now, there are a variety of different ways
that you can administer
these different types of functional gain,
speech and quiet and speech and noise sound field tests.
This all really just depends on what type of information
you're trying to obtain.
So if you're trying to identify
if someone would be a good candidate for a cross hearing aid
or a bone anchored hearing aid or even a cochlear implant,
these tests can be set up in different ways
to indicate whether or not
someone would actually receive significant benefit
from those different types of devices.
However, for the purpose of this video,
these sound field measures are used to identify
if your hearing aids are going to help you
understand speech better
by actually testing your ability to understand speech better
with your hearing aids versus without your hearing aids.
Now, I know I've said this several times
inside of this video, but at the end of the day,
there is still no better way
to verify your hearing aid programming
than to have real ear measurement performed on your devices.
Now, if you do not know what real ear measurement is,
then I highly recommend that you check out my video
that I will have linked in the description.
But sound field testing can be a valuable addition
to real ear measurement
to make sure that you're receiving
the most amount of benefit from your hearing aids,
especially if you have real ear measurement done
and you're still struggling to hear and understand speech
with your devices.
At a bare minimum, some form of verification has to be done
on your hearing aids.
So if you can't get real ear measurement done,
then you have to at least have some form
of sound field testing to know if your hearing aids
are actually going to provide you with real world benefit.
And if you don't have any form of verification performed,
then you are going to be leaving
a significant amount of benefit on the table.
When you really think about it,
there is a high probability that you're going to be spending
a good amount of your hard-earned money.
And if you want to get your money's worth,
then you have to make sure
that you're having verification performed
on your hearing aids.
And one of those types of verification
that you can have performed is sound field testing.
That's it for this video.
If you have any questions,
leave them in the comment section below.
If you liked the video, please share it.
And if you wanna see other videos, just like this one,
go ahead and hit that subscribe button.
Also feel free to check out my website,
Dr. Cliff aud.com.
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