Main Site
about the projectShared "Good Practice Procedures"
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Pre-fitting
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Shared views on optimal procedures
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Counselling and preliminary audiological talk
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Counselling/information about course of hearing aid provision. General information about assets and drawbacks of hearing aids, specific characteristics, possible applications. Open interview about problems and expectations
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Medical history and otological examination
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Structured interview about medical history and complaints (e.g. sudden deafness, otitis media, ear pain, ear surgery, tinnitus, congenital hearing loss, dizziness). Otoscopy, Tuning fork testing (optional), Tympanometry (optional)
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Questionnaire
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Collecting individual problems and aims
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Standard audiometry in quiet (headphones)
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Pure tone audiogram air and bone conduction with adequate masking
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Speech audiometry in quiet
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Test of patient's ability to recognise speech unaided in a quiet situation. Specific tests and parameters vary.
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Speech audiometry in noise
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Test of patient's ability to recognise speech unaided in a noisy situation. Specific tests and parameters vary.
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Loudness scaling
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Vary
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Goals and options
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Shared views on optimal procedures
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Defining goals
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Defining goals for rehabilitation based on anamnestic and otological data, the unaided measurements, and the questionnaire results. Counseling about realistic expectations
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Technical options
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Choice of ear(s) to be fitted. Choice of type of hearing aid(s). Specification of type of earmould
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Hearing aid fitting
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Shared views on optimal procedures
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Earmould
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Taking ear impression; creation of earmould or earshell. Final fitting of earmould
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Fitting and fine tuning
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Prescriptive fitting according manufacturer or current fitting rules. Verification of hearing aid fitting using Real Ear Measurements. First rating of speech intelligibility, sound quality.
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Handover fitted aid
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Explain handling and care of the hearing aid to the user. Arrange regular checkups. Present information about accessories to the user
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Trial use period
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Trial period in everyday listening situations and counselling during trial period. Fine tuning of at least one hearing aid (in several sessions). If necessary. Real Ear measurements if necessary, gradual build-up of amplification to adapt new users to hearing aid.
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Evaluation measurements
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Shared views on optimal procedures
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Selection
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Varies between countries
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Speech audiometry in quiet
(sound field) |
Single words measured for each individual aided ear (contra-lateral ear blocked) and for both ears bilaterally fitted
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Speech audiometry in noise
(sound field) |
Adaptive sentence testing to determine speech-to-noise ratio at intelligibility threshold
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Loudness scaling
(sound field) |
Adaptive loudness scaling (ACALOS) left/right.
Plug ear not in use in sound field measurements
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Horizontal localization
(sound field) |
See NL-AMC specification in country-specific views
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Insertion gain measurements
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The selected hearing aids are characterised with real ear measurements using broadband speech noise at 55, 65, and 80 dB SPL. The hearing aids are used in the preferred gain setting. The hearing aids are measured after deactivation of noise reduction circuitry in an omni-directional mode. The curves obtained are compared with generic prescription rules for non-linear hearing aids (usually NAL-NL1 or DSL i/o).
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Documentation of settings
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Print and save settings, if necessary coupler measurements. Hearing aid with trimpots: test box results
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Questionnaire
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The hearing aid benefit is rated by questionnaires.
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Follow-up
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Shared views on optimal procedures
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Additional rehabilitation needs
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Counselling about other training (speech-reading, hearing strategies and communication training). Strategies to encourage the client to wear the hearing aids. Determine need of other action (compare expectation with achieved aims), e.g. audiological therapy, psychosocial consulting.
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Closing of provision
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Remind clients about handling and care of the hearing aid and respond to problems raised. Arrange future care and support.
Present information about accessories to the user. Complete formal fitting documentation |
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Open access repair service
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Users may come without an appointment if they are having any problems
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