The Gift of Hearing: Is Fitting A Hearing Aid Art or Science?

Thank you to Rayovac Hearing Aid Batteries for sponsoring my participation in this hearing mission. All opinions expressed in this piece are my own. To read my other post about this mission click here.

As someone with hearing loss, I appreciate my hearing aids and the freedom they give me to interact with others and live my life as fully as I can. Without my hearing aids, I would miss my children calling to me at night and laughing with them at play. Social situations and business meetings would be more challenging. I would often feel isolated and alone. So when I had the opportunity to share the gift of hearing with others, I jumped at the chance.

As my propeller plane touched down in Dominica after a long day of traveling, I had no idea what was in store. I was here as a guest of Rayovac Hearing Aid Batteries, the company that supplies the batteries for Starkey Hearing Foundation’s hearing missions. I was to help fit the people of Dominica with hearing aids.

I wondered how this would work. I am not an audiologist — although I have visited quite a few. How would I be able to assess someone’s hearing loss, find the right device and adjust it to enhance communication? It turns out I didn’t have to do it alone.

Day 1 of the mission was training where we reviewed the history and purpose of the hearing missions, and practiced the patented multi-step fitting process. I quickly realized there is not only a science to fitting hearing aids, but also an art.

The mission aids are simple analog amplifiers, without sophisticated programming or other functions. They are basic, which makes them cost-effective to distribute in large numbers in disadvantaged communities around the world. While these are not the advanced digital aids many of us use, they are far superior to nothing, which is what most of the recipients would have otherwise.

The biggest challenge in fitting the hearing aids was often the patient’s gratitude. He or she was frequently willing to accept the first aid and the first setting offered so not to be difficult or cause a fuss. It took patience and persistence to extract the truth from each person, repeating the assessment questions multiple ways to triangulate to the best result.

The process reminded me of my annual trip to the eye doctor. Do the letters look sharper and clearer in one (flips the lens) or two? One, or two? She asks me the same question several times until I can confidently reply. Then she waits a minute and asks me again.

It was the same for fitting the aids. Does my voice sound clearer now or (turns up the volume) this way? Is that too loud (turn the volume down) or just right? Back and forth until the answer becomes clear. This was done for each ear individually and then to balance the two sides.

I sometimes wondered if we were asking too much of the patients, particularly those that have not heard before or for a very long time. Would they know if something is too loud or too soft or even understand that concept? Only someone with typical hearing can really assess this. That’s why I often ask my husband or children if someone is hard to hear and use my decibel reader app to alert me to dangerously loud sounds.

But maybe getting the volume exactly right is not really the point. That is where the art comes into play. Making sure the person can hear and understand what I am saying is the more important task, and that is what we achieved through the fitting exercises.

Reflecting on my mission experience each evening, I imagined the patients returning home not only with hearing aids, but also with hope. Perhaps they were now better able to communicate with a family member or friend. Maybe they could converse on the phone with more ease or watch TV at a more comfortable volume. It will take hard work, but I have faith that each person will make the most of the gift of hearing he received. I am grateful for my small part in this extraordinary experience.

Readers, have you given the gift of hearing?

Connect with Living With Hearing Loss on Facebook and Twitter!

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.




18 thoughts on “The Gift of Hearing: Is Fitting A Hearing Aid Art or Science?

  1. What an interesting experience. Sad, though, they cannot receive state-of-the-art aids as we may be able to here. Though I live in this country it’s difficult to afford new ones every 4-6 years!!

  2. Shari,
    What you did was really kind and generous…bless you.
    I’m a HOH speech pathologist (retired, because of the hearing loss…sadly).
    I can tell you that one of MY biggest problem is hearing speech in noisy places (as you’ve discussed many times).
    of course, …these analogue hearing aids are not really able to filter out background noise. So, although these people can now hear speech sounds more clearly, they ARE going to struggle with hearing speech in noisy rooms. Even my fancy, digital hearing aids, are NOT perfect. That’s why I must use an assistive listening device (bluetooth streamer and external microphone), when I’m in noisy restaurants, etc.


  3. What an exciting opportunity for everyone in that program. It must have been thrilling for you to be there as someone had the sound turned on, or maybe turned up. It made me think of the day, 20 years ago, when I had the sound turned on. It was wonderful and somewhat of a shock – learning how seriously I was impaired. I would guess you witnessed similar emotions in Dominica.

  4. Someone do it here for Kenyans living with hearing loss. I wish I could have one, they are prohibitively expensive here.
    The last one broke down in the middle of a job group interview, I failed.
    My teaching job bemes disturbing when I get to question and answer session. I use expository teaching method.

  5. Hi Shari

    What a wonderful experience you had. It is sad though that developing countries are not gifted even basic digital hearing aids that can be programmed more accurately than the old analogue aids.

    Whilst it is true that any hearing aid may be better than no hearing aid I know from when I asked an audiologist who fitted my latest aids that the fitting process for the old analogue hearing aids was less than satisfactory because of the dialogue based process.

    That does sound awkward given that the patient will having some degree of difficulty hearing let alone understanding what the audiologist says.

    And as we all know, louder is not better, even with digital aids.


  6. Hi Shari,

    What a wonderful experience for you, thanks for sharing with us. It was amazing you were able to help people who are not as fortunate as we are. What works for one person, won’t always work the same for another with hearing aids. So it’s both a science and an art to be able to successfully fit someone with the right aid.

    I have been greatly blessed with my hearing aids and they have opened up my whole world , enabling me to work and stay in the hearing world. But with a profound hearing loss, hearing aids do not always correct the loss adequately, and most
    HOH and profoundly deaf develop amazing lip reading skills as a survival mechanism, as I have. So I would have to say that I have been blessed with these skills, as well as gifted with better hearing with hearing aids.


  7. I dispensed hearing aids from 1970 unitl 2018 when age and health forced me into retirement. I have so many fond memories of those that I fitted with hearing aids.

    One experience. A family drove ovde 150 miles to come to my office. Their son had been fitted with OTE and said that he still does not hear. When I checked his hearing aid, there was no earmold. HEY! So I fitted him correctly and when I turned the HA on, he jumped from his chair and was very very excited,

    At night, in my dreams I still fit hearing aids.

    John W Dudley

  8. I have a very big problem. There are many new technical ways of improving hearing. My mom has a hole in hear drum. I’m told they are doing “paper” grafts to cover the hole and even skin grafts if the “paper one” doesn’t work.
    Also my mom has been deaf in one ear for quite a few years, no one even knows why. Shouldn’t she be seen by a neuro ontological doctor? To see if there are new surgeries to repair the problem. Been hearing about the BAHA also. Is not the best Dr. to determine all issues,the “best” ear doctor in neurological procedures?
    Then,of course,there’s the cochlear implant. Who can determine the best option? She spent 1600$ for one aide(as the other ear is deaf), told the “hole”may or may not heal over. Was not told about fixing the hole, found this out myself from a nurse that works with these special ear doctors.
    Please, what is your input on all this?

Leave a Reply