Hearing Aid Fitting

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The Fitting

Hearing aids are essentially tiny computers you wear on your ears.  They can be fine-tuned for your specific hearing profile and may incorporate sophisticated features such as directional microphone technology, noise management technology and wireless connectivity.  Because we want to be sure we are maximizing the value you get from your new devices, please plan to spend an hour to 1.5 hours for a hearing aid fitting at Pacific Hearing Service.   Here is what you can expect at your hearing aid fitting appointment:


The first step in the process is determining the appropriate amount of amplification for your unique hearing profile. This is done using speech mapping (also called real ear measures), to make sure the hearing aids are helping you as much as possible. Click on this link to read a more detailed article on speech mapping.

Next we will provide instruction on how to insert the devices, how to change the batteries, cleaning the hearing aids and other information you will need to use and maintain them.

We will review with you what to expect during the first two weeks of hearing aid use and strategies you may use to adapt to hearing again. (Sounds in your normal environment might be surprising!)

Many people find it is helpful to bring a friend or family member. We recommend it because we find that if the people you spend the most time with understand what hearing aids can and cannot do, you will have a more positive experience. We will also talk about best communication strategies for both of you. (No more talking from one end of the house to the other!)

Hearing Aid Evaluation Period

The fitting appointment is the beginning of the 45-day evaluation period with your new hearing aids. During this time we usually see you back after about two weeks (or earlier if you have questions or concerns) to see how you are doing with your new devices.  Any of the following may happen at your first-check appointment:


Your audiologist may adjust the programming of your devices or add additional programs for specialized situations like restaurants, lectures, or concerts.

We will address any problems or questions you may have had during your first two weeks of hearing aid use.

This is also a good time to review any instructions regarding the use and care of your new instruments.

Other recommendations may be made such as the use of assistive listening devices, lipreading classes, brain training exercises (read about LACE on our website) or referral to our free series of hearing loss management classes (see schedule here.)

It is important that you wear your new hearing aids as much as possible during the trial period so you can give your brain a chance to get used to all the new signals it will be receiving. It takes about three days for your brain to really begin to adjust to the new input. At first it may seem loud and overwhelming, but that is because your brain has been missing out on all the information you couldn’t hear. It has to reacclimatize itself to the additional input and learn which signals to listen to (speech) and which to ignore (traffic, extraneous voices, etc.).  In fact, it is not unusual for new hearing aid wearers to think their plumbing is broken because they can hear running water or call their mechanic about their car turn signals because they have not been able to hear them for such a long time.

It may also take some time for both you and the people around you to learn how loud to talk once you have the devices. You are all accustomed to talking louder than normal and will need to modulate your voices to account for your improved hearing.

We want you to be completely satisfied with your new hearing devices. If for some reason you are not happy with your hearing aids by the end of your evaluation period, we will do everything we can to find the right solution for you.

What Else?

For patients who purchase their hearing devices from Pacific Hearing Service, any programming changes or adjustments within your first year of service are complimentary. Our service to you also includes complimentary lifetime cleaning of hearing devices purchased from us.  For most people, we recommend you have your devices cleaned every 2-3 months. Some people need this service more often due to their lifestyle or other factors. Although we teach you to clean your hearing aids yourself, we have specialized tools that allow us to do a more thorough cleaning than you are able to do at home.  Our patients tell us their hearing aids sound brighter and clearer after using our cleaning service. It also helps prolong the life of the hearing aids. No appointment is necessary for a hearing aid cleaning. It is done on a drop-in basis by our front office. It only takes about 10-15 minutes and both of our offices have plenty of free parking.

What is Speech Mapping?

At Pacific Hearing Service, we will always use speech mapping to be sure the hearing devices we fit you with are programmed appropriately for your unique ear. During this process, we place a tiny microphone in your ear canal to measure the sound that is actually coming into your ear through the hearing aid. Every ear has a unique shape and volume, which means that each ear canal has its own natural resonance frequency range where speech is enhanced. Using speech mapping, we program the aid so that soft speech is audible, conversational speech is comfortable, and loud speech is tolerable. Our goal is to maximize the clarity of speech, but it also must be comfortable to your ear.

In the example below, the patient’s hearing loss (red line) becomes higher than the soft speech volume (green) at about 2000 Hz. Since we know what components of speech occur in that high frequency region, it allows us to determine which sounds are not audible without amplification. Therefore, we would tune the higher frequencies of the hearing aid’s response to ensure that the patient could hear soft speech, but keep the level below the maximum that the patient could tolerate. The pink and blue lines show how the hearing aid is modifying the speech signal.  The asterisks on the graph represent how loud this person can tolerate sounds.  The gold line tells us exactly how loud the hearing aid is as measure in their ear canal.  This way we can be sure the sound will never exceed their tolerance level.  It also helps us to be sure we are in a “safe” zone and the hearing aid will never become so loud that it could damage their hearing.