Rehabilitation Procedures

In HearCom our coverage of auditory rehabilitation is focused on specific aspects of the individual fitting of hearing aids and cochlear implants.

We have compiled an inventory of the procedures used in Germany, the Netherlands and the UK in the fitting and evaluation of hearing aids. These three countries exhibit three different but well-established pathways for the provision of hearing aids. Selected elements of this inventory, together with procedures for the assessment basic hearing abilities and speech recognition drawn from the HearCom "auditory profile" have been put forward as a basis for good practice. The feasibility of a more common set of procedures for hearing aid fitting and evaluation based on this proposal depends upon the willingness of audiology professionals to make some changes in their current practice. An internet survey has been used to assess the willingness to make such changes, and results will be made available during 2007.

Modern compression hearing aids have many adjustable parameters and it can be very time-consuming to explore these manually. Hearing aid users are likely to be willing to expend much time on finding the best settings, but audiology professionals have limited time. Research is in progress that uses automated parameter adjustments based on the hearing aid users performance in distinguishing speech sounds presented in noise.

Similarly, cochlear implants have many adjustments that can be made, and we also plan to evaluate automated fitting procedures for these devices.

There is increasing interest in the combined use of hearing aids with cochlear implants, and as audiometric criteria for cochlear implantation have changed to include severe-to-profound hearing losses, there are increasing numbers of CI recipients with residual hearing in the non-implanted ear. But there are many differences between the hearing achieved with a cochlear implant and the hearing available from residual hearing supported by amplification. Current clinical approaches to the joint fitting of hearing aids and cochlear implants pay little attention to many of these differences, and our research aims to develop fitting approaches that enable a more effective combination of these two modes of hearing.