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This guide will serve as a reference for a greater understanding of hearing loss and the treatments available to you. This way you can be sure that wherever you decide to go to treat your hearing loss, and whatever hearing aids you elect to purchase, you will be able to hear your absolute best! NOW UPDATED FOR 2024!
Scroll down to read online version of the Hearing Aids Buyer's Guide or download the full version that contains additional benefits listed below:
Dr. Clifford R. Olson is widely regarded as one of the most recognized audiologists in the world. After serving as a Scout Sniper in the United States Marine Corps, Dr. Olson earned his Doctorate of Audiology from the University of Illinois at Urbana-Champaign in 2016.
Shortly after graduating, he started his clinic, Applied Hearing Solutions, located in Phoenix, Arizona. At the same time, he started his YouTube channel - Doctor Cliff AuD - to educate individuals with hearing loss on the importance of Best Practice care and treatment options.
After spending over 7 years creating 1,500+ informational YouTube videos, he has amassed a following of over 340,000 subscribers with over 58 milion total views. Nearly every aspect of hearing aid technology treatment is covered on his channel, and it's 100% free for viewers to watch.
Hearing loss has reached epidemic levels, every year impacting more and more individuals. The Center for Disease Control (CDC) has ranked hearing loss as the third most common chronic physical condition in the United States, even more prevalent than diabetes or cancer. According to the World Health Organization (WHO), approximately 466 million people worldwide suffer from disabling hearing loss. In the United States alone, Johns Hopkins Cochlear Center for Hearing and Public Health estimates that 38.2 million Americans (out of a total population of 328 million), report having hearing loss. Within the past decade, untreated hearing loss has also been linked to depression, social isolation, diabetes, increased rates of cognitive decline, and even dementia.
However, the good news is that treatment of hearing loss has become more widely accepted over the past several years. It is no longer something to hide, and with every new, exciting development in hearing aid technology, hearing aid adoption rates have steadily increased. Historically, individuals have waited an average of 7 years to treat their hearing loss after they started to notice difficulty hearing.
However, in 2022, MarkeTrak survey results saw this timeline shrink to only 4 years, indicating a significant shift in consumer behavior and reduced stigma surrounding hearing loss and hearing aid treatment. This number is expected to continue to shrink as the old stigma surrounding hearing aids is no longer a concern in younger generations.
Hearing aid satisfaction rates have also been increasing. In 1989, hearing aid satisfaction rates were only 58%, with satisfaction rates leaping to 83% as of 2022. The average age of hearing aid buyers has also decreased by about 7 years, indicating that hearing aids are not just for older individuals. Ear-level devices like AirPods are becoming more and more of a norm across age groups. Many hearing aids today are virtually indistinguishable from earbuds, and are often smaller and more comfortable. With increased wireless connectivity, hearing aid users have more options to enhance the performance of their hearing devices using their personal electronics. Bluetooth streaming for audio and phone calls has become the standard, and smartphone remote control apps make it easier than ever to personalize your hearing treatment.
Hearing loss is typically caused by a breakdown in one or more of these areas in the ear. Not all hearing losses are the same, and can be as unique as a fingerprint. Similar losses can be perceived differently by different people. In general, there are 3 different types of hearing loss - sensorineural, conductive, and mixed.
Several different aspects of hearing are tested during a comprehensive hearing evaluation. The combination of these tests will be able to identify the type and severity of hearing loss an individual has, which provides the audiologist with the information to make the best recommendation for treatment.
Here are many of the tests audiologists will commonly administer during a comprehensive hearing evaluation.
Otoscopy: This is when an audiologist looks into your ears with a tool called an otoscope in order to evaluate the health of your outer ear and eardrum. It also makes it possible to visually identify whether there may be middle ear conditions present, as well as if there is any cerumen or foreign objects that need to be removed before further testing can be completed.
Tympanometry: Tympanometry uses small changes in air pressure in your ear canal to assess the mobility and function of your eardrum and middle ear system. It can help detect the presence of many middle ear disorders.
Acoustic Reflex Thresholds: This is a test which is sometimes performed in conjunction with tympanometry, which tests the integrity of your middle ear reflex response to loud noises. It is often conducted to determine if the hearing loss is conductive, cochlear, or stems from a nerve pathway in the brain, such as when there is a tumor.
Air Conduction Testing: Air conduction testing is what you most likely picture when you think of a hearing test, where you raise your hand or press a button whenever you hear a beep through a set of headphones. It tests the hearing thresholds of the entire system working together. These thresholds are typically indicated by the X’s and O’s on an audiogram.
Bone Conduction Testing: Bone conduction testing uses a bone oscillator to stimulate the cochlea directly by vibrating the bones of the skull. The audiologist will compare these thresholds with your air conduction thresholds to determine whether the hearing loss is conductive or sensorineural. These thresholds are indicated by angle or square brackets on your audiogram.
Speech Reception Thresholds: This test determines the quietest level that you are able to understand speech, and is used as a cross check to confirm the accuracy of your air conduction hearing thresholds.
Word Recognition Scores: This is a test of your ability to understand speech when it is amplified loud enough to be comfortably audible. This is indicated on your audiogram by a percentage, which represents the percent of speech that will be able to make it to your brain when amplified enough to overcome your hearing loss. A low score on this test indicates lower functional ability and may mean that even with well-fit hearing aids, you may still struggle to understand speech. A higher score indicates that when speech is amplified loud enough, you will likely perform very well.
Speech-in-Noise Testing: This test measures how well you are able to understand speech in the presence of background noise. The results of this test are on a scale of 0 to 24, where a 0 indicates you can understand very well in background noise, while a 24 would mean that if you turned on a fan it would be very difficult for you to pick out speech. Audiologists use the results of this test to make the best recommendations for treatment in terms of hearing aid style and technology so you can hear your absolute best. They may also use this score to recommend whether you would benefit from assistive technology such as remote microphones.
Uncomfortable Levels (UCLs): This test determines the level at which sound becomes uncomfortably loud so that when your audiologist programs your hearing aids, they can customize the output so it never is loud enough to hurt your ears.
Most Comfortable Levels (MCL): This test determines the most comfortable volume that is the sweet spot between too soft and too loud.
A combination of these diagnostic tests paint a comprehensive picture of your hearing loss and what treatment would be most appropriate, whether it be hearing aids, a cochlear implant, or a bone anchored hearing aid. It can also indicate whether you should be referred to a physician such as an otologist or otolaryngologist (ENT) for medical treatment.
The accuracy of testing is critical for the correct diagnosis and treatment of hearing loss. It is recommended you only go to a licensed hearing care professional for testing, such as an Audiologist or Hearing Instrument Specialist. Online hearing tests may be convenient, but they are not reliable or accurate enough to make a treatment recommendation or to treat hearing loss. Additionally, they run a high risk of not identifying serious medical conditions that would be caught during a comprehensive auditory evaluation by a licensed hearing care professional.
With the exception of hearing losses which require surgical treatment (which is most often conductive losses or profound hearing losses that require cochlear implantation), the best and only treatment option for hearing loss is hearing aids. In general, hearing aids are designed to amplify sounds enough to bring sounds in each frequency into your comfortably audible range. No matter the style of hearing aid, they all have 4 main components: a microphone, a processor, an amplifier, and a receiver (speaker).
The microphones on a hearing aid pick up the analog sound vibrations from the air and convert them into a digital signal. Most hearing aids will have either 1 or 2 microphones to pick up sound. By having 2 microphones, one in front and one in back, hearing aids are better able to focus on speech sounds coming from a particular direction, while minimizing background noise.
Smaller in-the-canal hearing aids often only have 1 microphone due to their small size, however since these devices sit inside your ear canal, they are often able to preserve the natural directionality you get from the shape of your ear, called the pinna effect, making it less necessary to have multiple microphones.
Once the microphones receive the vibration of sound, this information is sent to the processor chip of the hearing aid. The processor will analyze the sound and use advanced algorithms to determine what the sound is, then employ a variety of digital features programmed by your audiologist to optimize the sound for your hearing loss. The processed digital signal is amplified and then transduced into an audible sound that is sent into your ear canal.
Hearing aids come in many different styles, anywhere from tiny invisible-in-the-canal (IIC) to ultra power behind-the-ear (BTE) hearing aids. However, you can typically break them down into two main categories – in-the-ear (ITE) and behind-the-ear (BTE).
These devices are suitable for most mild to moderate hearing losses. They are truly invisible, even if someone looks directly into your ear! These hearing aids are safely placed 4 mm away from your eardrum by a hearing care professional and are left in place for 6-8 weeks at a time.
They are very comfortable and resistant to minimal amounts of water exposure. There is no need to worry about remembering to put them in, take them out, or change the batteries. You may be a candidate as long as your ear canal is large enough and you don’t regularly skydive or swim with your head underwater.
The daily wear version of an IIC hearing aid is nearly as invisible as its extended wear counterpart, but is inserted and removed each day by the wearer. Most IIC’s are custom molded and are primarily intended for individuals with a mild to moderate hearing loss. They do have some limited controls, but often function without many adjustments from the user.
Slightly larger than an IIC, this custom molded hearing aid is more visible, but allows for more features like Bluetooth, push button controls, and a larger battery size for longer battery life.
These devices are noticeably larger than an ITC hearing aid, filling up half of your ear’s concha bowl. The increase in size allows for better wireless performance, Bluetooth streaming, and can treat a wider range of hearing losses as they can provide more powerful amplification. Typically, custom half-shell hearing aids can accommodate anywhere from a mild to a severe loss.
These devices fill the entire concha bowl and are not limited in terms of features or severity of hearing losses that they can treat. They are perfect for individuals with poor finger dexterity, as they are large and custom-molded to the ear, which makes them much easier to handle than other hearing aid styles. More and more full-shell ITE’s are also being offered in rechargeable options, have telecoil capabilities, and offer Bluetooth connectivity to a smart device.
These are by far the most common hearing aid dispensed and account for nearly 80% of all hearing aids. They are also one of the most invisible hearing aid options due to their small size behind the ear and nearly invisible wire that sits flush in front of your ear as it enters the ear canal. They can fit a wide range of hearing losses from mild all the way to profound and typically have the most digital features of any hearing aids.
They can be physically fit using a variety of generic rubber domes or with a custom earmold with appropriate venting on the end of the receiver wire. Since the receiver wires can be replaced, the amplification levels of RIC hearing aids can easily be increased should your hearing worsen without having to buy a whole new set of hearing aids.
These hearing aids are intended for severe to profound hearing losses and are typically more visible than other devices. They use a custom earmold with a thick tube to allow for high levels of amplification. Most have similar features to RIC hearing aids and similar performance capabilities.
They are primarily implemented with children and individuals who cannot use RIC hearing aids. BTE hearing aids are available in Power, Super Power, and Ultra Power options, depending on the amount of amplification they need to provide to accommodate your severity of hearing loss.
Hearing aids come in a variety of different technology levels. Most major hearing aid manufacturers develop anywhere between 3 and 5 levels of technology. The higher the technology level, the more customizations and digital features that are available to your hearing care professional to treat your hearing loss.
There is research that suggests there is no measurable benefit between premium technology and lower technology levels, however it is not uncommon for both new and experienced hearing aid users to anecdotally report more satisfaction with higher levels of technology. In general, if you want to guarantee that you are not leaving any benefit on the table, it is a good idea to go with the highest level of technology you can reasonably afford.
If you cannot afford a higher level of technology, go with a level that you can afford, and it is the job of your hearing care professional to maximize the performance of those devices. Hearing aid technology level is separate from style, so virtually any hearing aid style can have any level of technology inside.
Hearing aid manufacturers are constantly adding more features to their hearing aids. Prior to 1996, hearing aids were almost 100% analog and were programmed by adjusting trim pots with tiny screwdrivers. Basically the only thing a hearing aid user could do themselves was increase or decrease the volume.
Since 1996, digitization inside of hearing aids has dramatically increased the ability to process sound and customize programming using digital features. This digital processing has allowed for a variety of different features that improve speech understanding and reduce listening effort.
One of the most common complaints for hearing aid users is difficulty understanding speech in background noise. If a hearing aid simply turns the volume up, not only are people’s voices going to be amplified, but so will the background noise that the user wants to tune out! Hearing aid manufacturers have added sophisticated algorithms to the digital sound processing in their devices that assess the signal to determine what is speech and what is noise.
Once it determines where the signal of interest is, the hearing aid microphones will focus so they only amplify sound from the direction of speech and provide less amplification to the background noise, making it much easier to hear in these challenging environments. The higher the technology level of the hearing aid, the more sophisticated and better this processing is going to be.
We live in a modern world, which means that connectivity to technology has become more and more of a necessity in our daily lives. Nowadays, most of the hearing aids on the market are able to connect to your smart devices via Bluetooth. This enables you to stream audio directly into your hearing aids such as music, podcasts, and audiobooks.
Bluetooth streaming has been a game changer for making phone calls, as the call audio is delivered through the hearing aids instead of the phone speakers, significantly boosting speech clarity. Hearing aids also use Bluetooth connectivity to connect to remote control apps on your smartphone without having to fumble around for tiny buttons on the hearing aids themselves.
Hearing aid remote control apps are becoming more and more advanced. On top of being able to adjust the volume levels, you can also switch between different programs, increase noise reduction, locate a lost hearing aid, and even track different health metrics.
These hearing aid apps also allow for remote programming with your hearing care professional, so you don’t need to travel to their office. Some apps allow you to do more than others, so make sure you do your homework if these features are important to you.
Frequency bands are crucial for allowing you to hear your absolute best. Instead of simply turning up the volume overall, your audiologist makes adjustments to each separate frequency band to match your hearing loss prescription.
In general, the higher the technology level of the hearing aid, the more frequency bands it will contain, allowing your audiologist to make more nuanced adjustments to more precisely amplify to your prescription using Real Ear Measurement.
This is a hallmark feature of modern digital hearing aids. Each manufacturer has their own algorithm that the hearing aids will use to classify the sounds around you. The hearing aids then use this information to automatically switch into the appropriate program for your environment, without you having to do anything.
For example, when you walk into a restaurant, your hearing aids will switch into your speech in noise program, then once you leave, they will switch back into your everyday program. This means you can spend less time worrying about what your hearing aids are doing. With more advanced technology, the more sophisticated the algorithms will be at classifying sound and by extension, the more environments the hearing aids will be able to automatically optimize to.
I’m sure you remember the giant, banana looking hearing aids your grandparents wore behind their ears when you were younger. You’ll be glad to know that as technology has advanced, hearing aids have been able to fit more and more features inside of a smaller and smaller device.
These days, most receiver-in-canal hearing aids are about the size of the tip of a small pinkie finger., allowing them to blend in much better and become practically invisible. Invisible-in-canal (IIC) hearing aids, as their name would suggest, have become even smaller as well, while still maintaining many of their advanced features.
This is a feature that is made possible by having two microphones on a hearing aid that can determine the direction from which sound is coming. This feature can dramatically improve your ability to understand speech in background noise as it allows the microphones to focus only on the direction you are interested in without amplifying the background noise behind you.
Hearing aids use this feature when there is a sudden loud noise in a quiet environment, such as a door slamming or a dog barking. They are able to quickly reduce the volume and return to normal so the noise doesn’t hurt your ears, but you are still able to hear what someone says to you right after the noise.
Everyone has what is known as a comfortable audible range. Sounds that are louder than this range will be uncomfortably loud, and sounds below that range will be inaudibly soft. Hearing aids use compression to provide more amplification to the soft sounds and less amplification to the loud sounds to “compress” them into your comfortable audible range, while still maintaining your perception of soft and loud.
Expansion is the opposite of compression. There will occasionally be very soft sounds that you do not want amplified, such as the hum of the air conditioner. Expansion takes these very soft sounds and reduces the amplification, essentially “expanding” them back out of your audible range to maintain comfort.
Occasionally, a person’s hearing loss in the very high frequencies will be so severe that the sounds in those frequency ranges will not be audible, even when amplified to their hearing loss prescription. If they were amplified to be audible, they would be so distorted that they would still be incomprehensible.
Frequency lowering is a technique that can be used to take these high frequency sounds and move them into a lower frequency range where there is better hearing, allowing them to be audible. However, research shows that this feature generally does not provide much additional benefit, and should not be a main factor in determining which hearing aids are best for you.
Research has shown that people with single-sided deafness struggle just as much as people with hearing loss in both ears. Not only do they have to position themselves so they can hear from their good side, but they will struggle with sound localization and a quieter input to their good ear for sounds coming from their bad side.
CROS transmission takes the sound from the deaf side and transfers it into the better ear, so the user is able to hear equally well no matter what direction the sound is coming from. There are a variety of ways this feature can be set up, and finding a hearing care professional who is experienced with this type of device is extremely important.
Telecoil allows hearing aid users to connect to the sound system of public venues that have a telecoil loop installed, allowing the sound to play directly through their hearing aids, amplified to their hearing loss prescription.
This is a game changer in venues like live theaters, churchs, and movies, as the hearing aid user will finally be able to understand everything, no matter where they are seated. It can also help understanding speech on the telephone by connecting to a T-rated landline phone.
Understanding soft speech is a main area of difficulty for individuals with hearing loss. Speech Enhancement is a hearing aid’s ability to add more amplification to soft level speech when in a quiet environment.
The future is NOW! Artificial intelligence is used by some manufacturers, to allow for more advanced signal classification. Some manufacturers even use Deep Neural Networks and perform Deep Learning to train their hearing aids. This technology is what guides the signal classification inside your hearing devices and is not limited to sound processing algorithms created by human engineers.
Gone are the days of squealing hearing aids! Modern digital devices are able to detect feedback loops and cancel them out before they happen so they can stop whistling before it even starts. This way, when someone goes in for a hug, the hearing aid is able to quickly cancel out the sound that is reflected back so whistling doesn’t happen.
Custom earmolds are nothing new, but with modern technology they are able to be made more accurately than ever. This means they will fit even better inside your ears for increased comfort and ideal sound flow for your hearing loss. While many providers do still use physical impressions, more and more clinics are beginning to use 3D digital scanning technology to scan your ear canals, and you can see the scan of your ear on the screen in real time as the audiologist works.
This scan is then used to create your custom devices. They can even be used to create custom earplugs or custom tips for your existing earbuds. Not only are 3D digital scans more precise, they are also FAR more comfortable and safer than having putty injected into your ears.
If you skipped straight to this section, I don’t blame you. As a hearing aid buyer, you want to know what the top of the line products on the market are so you can be sure you are getting the device that will allow you to hear your absolute best. However, it is important to note that the largest variable when it comes to success with hearing treatment is not the devices themselves, but your hearing care provider.
We don’t believe in ranking hearing aids because every device will have features that are better for different individuals. In addition, the more familiar your provider is with the brand you choose, the better they will be able to program that device to suit your needs. Of course, if you want to be sure you are hearing your absolute best, you should find a hearing care provider who follows Best Practices. The best devices in the world, when not fit & programmed following Best Practices, will limit your overall performance, and could even lead to an unsuccessful treatment outcome.
That being said, this section will serve as an overview of the major brands accounting for the majority of the quality hearing aids currently on the market, including current product lineups, features, and additional accessories.
Phonak is a Swiss-based company that falls under the umbrella of Sonova. They were founded in Zurich, Switzerland in 1947, and currently account for 31% of the global hearing aid market. This makes them one of the oldest and largest hearing aid brands in the world today.
Phonak’s philosophy is that hearing treatment is an essential part of improving overall health and quality of life. They specialize in optimizing speech in noisy environments, and boast the largest lineup of hearing accessories amongst the major brands. Phonak also has the widest compatibility in terms of Bluetooth connectivity through the use of Bluetooth Classic.
Phonak’s latest platform is the Phonak Infinio Sphere platform, which introduces the new DEEPSONIC chip with dedicated AI to better separate speech from noise and expand listening range in all directions. This Spheric Speech Clarity is the defining feature of AutoSense OS 6.0. The Phonak Audéo R Infinio model uses the new ultra-responsive ERA chip, which enhances universal Bluetooth connectivity.
Flagship Model: Phonak Audéo Sphere Infinio
Custom: Phonak Virto Infinio
Power BTE: Phonak Naída Paradise
Extended Wear: Phonak Lyric
BTE: Phonak Bolero Marvel
Pediatric: Phonak Sky Lumity
Accessories
Phonak TV Connector
Phonak PartnerMic
Phonak Remote Control
Roger On
Roger Select
Roger Table Mic II
Roger Focus II
Roger Touchscreen Mic
Roger Neckloop
Chargers
Phonak Charger Case Go
Phonak Charge and Care
Phonak Charger Ease
PHONAK APP: MyPhonak
The MyPhonak app, available on the App Store and Google Play, allows users to adjust volume, switch programs, mute and unmute your hearing aids, control accessories, adjust audio using a three-band equalizer, access information about your devices, and connect to a remote support session with your hearing care professional.
Oticon is based in Denmark and was established in 1904 by Hans Demant. Oticon is a subsidiary of Demant. They are one of the oldest hearing aid manufacturers today and the second largest, accounting for 30% of the hearing aid market.
Oticon’s philosophy centers around hearing in the brain. They have funded many significant studies around hearing loss and the brain, including the notable Johns Hopkins study linking hearing loss with increased susceptibility to dementia. Oticon’s hearing aid processing is designed to mimic the way human brains process sound.
Oticon’s latest platform is the Sirius platform, available in the Oticon Intent lineup. It features an updated Deep Neural Network with 256 analysis channels, a 4D Sensor for adaptive noise reduction, and updated smart receivers. It is preceded by the Real and More lineups, which incorporate the Polaris R and Polaris chips, respectively.
Flagship Model: Oticon Intent
Battery Operated & miniBTE: Oticon Real
Custom: Oticon Own
Pediatric: Oticon Play PX
Entry-level: Oticon Zircon
Accessories
Oticon TV Adapter 3.0
Oticon ConnectClip
Oticon EduMic
Oticon Phone Adapter 2.0
Oticon Remote Control 3.0
Chargers
Oticon Intent Charger
Oticon Charger
Oticon SmartCharger
OTICON APP: Oticon Companion
The Oticon Companion app, available on the App Store and Google Play, allows users to adjust volume, switch programs, mute and unmute your hearing aids, control accessories, adjust audio using a three-band equalizer, access information about your devices– including their location on a map, and connect to a remote support session with your hearing care professional. Apple users can also activate the Live Listen remote microphone and Speech Booster features through the app. The Oticon Companion app is also compatible with Apple Watch, allowing you to control your hearing aids with your watch.
ReSound is another Denmark-based company, falling under the umbrella of GN Group. ReSound was founded in 1943 and currently makes up 15% of the hearing aid market in sales.
ReSound’s philosophy centers around innovation and organic hearing. They are constantly introducing new stylistic designs for their hearing aids designed to utilize the natural anatomy of our ear to create more natural sound. ReSound is also one of the first major hearing aid manufacturers to incorporate Bluetooth Auracast compatibility in their Nexia line and in their TV Streamer+.
ReSound’s current lineup is the Nexia family, featuring the smallest rechargeable behind-the-ear hearing aid to date, a new CROS transmitter for single-sided deafness, and Auracast Bluetooth future-forward compatibility.
Flagship Model: ReSound Nexia
Power BTE: ReSound ENZO Q
Custom: NEXIA Customs by ReSound
Entry Level: ReSound Key
Accessories
ReSound TV Streamer+
ReSound MultiMic+
ReSound TV Streamer 2
ReSound MicroMic
ReSound MultiMic
ReSound Phone Clip+
ReSound Remote Control 2
ReSound Remote Control
RESOUND APP: ReSound Smart 3D
The ReSound Smart 3D app, available on the App Store and Google Play, allows users to adjust volume, switch programs, mute and unmute your hearing aids, control accessories, adjust audio using a three-band equalizer, adjust directionality, access information about your devices, and connect to a remote support session with your hearing care professional. The app also includes the Check My Fit function, so you can make sure your hearing aids are on correctly. The ReSound Smart 3D app is also compatible with Apple Watch, allowing you to control your hearing aids with your watch.
Signia is a subsidiary of the company Sivantos, which was formerly known as Siemens and founded in 1878. They are based in Germany. In 2019, they merged with Widex under the group WS Audiology. Together, WS Audiology accounts for 19% of the global hearing aid market in sales.
Signia is known for their sleek, stylish hearing aid designs. Their focus is on natural-sounding speech and improved speech clarity.
Signia’s latest platform is their Integrated Xperience (IX) platform, featuring their RealTime
Conversation Enhancement technology, which allows for better understanding in group conversations by enhancing and following multiple conversation partners simultaneously. It is preceded by their AX and X platforms.
Flagship Model: Signia Pure Charge&Go IX
Non-Custom IIC: Signia Silk Charge&Go IX
Slim RIC: Signia Styletto IX
Custom: Signia Insio
Accessories
Signia Streamline TV
Signia Streamline Mic
Signia miniPocket
Chargers
Signia Inductive Charger II
Signia Dry&Clean Charger
SIGNIA APP
The Signia app, available on the App Store and Google Play, allows users to adjust volume and directionality, switch programs, mute and unmute your hearing aids, control accessories, adjust audio using a three-band equalizer, access information about your devices, and connect to a remote support session with your hearing care professional. The Signia app also features Mask Mode to understand people wearing face masks, as well as the Signia Assistant, an AI assistant that can make adjustments to your hearing aid settings in real time based on your feedback.
Starkey was founded in Minnesota in 1967. They are the only global hearing aid manufacturer that is American-owned. Starkey makes up 4% of the global hearing aid market in sales.
Starkey is focused on cutting-edge technology. They implement artificial intelligence and machine learning into their hearing aids. Starkey is also very focused on philanthropy, and provides hearing aids to people in need through the Starkey Hearing Foundation.
Starkey's new Genesis Al platform features the new Starkey Neuro Processor, which uses a Deep Neural Network to adapt to different listening situations and apply fast and slow compression to reduce listening effort. With this generation, Starkey not only completely redesigned the outside of their hearing aids, but also introduced the new Starlink charger, the new My Starkey app, as well as a new fitting software to allow your hearing care provider to make even better programming adjustments.
Flagship Model: Starkey Genesis AI
BTE: Starkey Evolv AI
Accessories
Table Microphone
TV Streamer
Remote Microphone +
Mini Remote Microphone
Remote
SurfLink Mini Mobile
SurfLink Media 2
SurfLink Remote
Surflink Remote Microphone 2
Chargers
Starlink Charger
Standard Charger RIC R
Mini Turbo Charger
STARKEY APPS: My Starkey & Starkey Thrive
Starkey has two different apps: My Starkey, which is only compatible with the new Starkey Genesis AI line, and Starkey Thrive, which is compatible with all other Bluetooth-enabled Starkey hearing aid models. Both apps are available on the App Store and Google Play, and allow users to adjust volume, change programs, mute and unmute your hearing aids, control accessories, adjust audio using a three-band equalizer, access information about your devices, and connect to a remote support session with your hearing care professional.
They also feature a fall detection feature, engagement and activity tracking, medication reminders, a mask mode, a self-check feature so you can make sure you are wearing your hearing aids correctly, and real-time translation of up to 71 different languages. The My Starkey app also includes Edge Mode+, which uses AI technology to optimize sound quality for clearer speech or improved listening comfort; as well as a Smart Assistant that allows you to adjust settings on your hearing aids using your voice.
Widex was founded in Denmark in 1956. In 2019, they merged with Signia to form WS Audiology, which makes up 19% of the global hearing aid market in sales. (see Signia)
Widex’s focus is on natural sound quality through limited sound processing strategies, and tinnitus masking. Widex hearing aids have the shortest processing time of the major brands on the market right now, which contributes to natural-sounding quality. Widex is often favored by musicians for this reason. They also have a strong tinnitus masker program incorporating fractal tones developed using extensive research into tinnitus.
Widex’s current lineup is the Widex SmartRIC, featuring an updated design for improved directionality and comfort and improved battery life. It is preceded by the Widex Moment family, which includes all form factors.
Flagship Model: Widex SmartRIC
Battery Operated RIC: Widex Moment
BTE: Widex Moment
Custom: Widex Moment
Accessories
Widex Sound Assist
Widex TV Play
Widex SoundConnect
Widex COM-DEX
Widex RC-DEX
Widex TV-DEX
Chargers
Widex Portable Charger
Widex Standard Charger
Widex Charge N Clean
WIDEX APP: Widex MOMENT
The Widex MOMENT app, available on the App Store and Google Play, allows users to adjust volume, switch programs, mute and unmute your hearing aids, control accessories, adjust hearing aid audio and streamed audio, control tinnitus maskers with Widex Zen, and access information about your devices including location and battery life. The Widex MOMENT app is also compatible with Apple Watch, allowing you to control your hearing aids with your watch.
Knowing which hearing aid will work best for you is a daunting endeavor, especially given that every brand out there touts themselves as the best in the industry. Thankfully, the job of a hearing care professional is to make that decision much easier for you. Here is a step-by-step guide to make sure you get the best hearing aids for you, fit the right way:
When you purchase your hearing aids from a hearing care professional, there are two different types of providers that you may see: an Audiologist or a Hearing Instrument Specialist (HIS). When choosing your provider, it is important to know the difference.
Hearing Instrument Specialist
The requirements to be a licensed hearing instrument specialist are either a high school diploma or a GED with time spent shadowing another hearing instrument specialist. Some hearing instrument specialists complete their training through a two year certificate program where they learn about hearing aid dispensing and fitting. Following their licensure, hearing instrument specialists may choose to complete national board certification. This is a higher level of certification that hearing instrument specialists can obtain after at least 2 years of licensed practice. It indicates that they have continuously met specific continuing education requirements and have passed a comprehensive competency exam in hearing aid dispensing.
These providers have the title of NBC-HIS. The highest credential for a hearing instrument specialist is audioprosthologist, which indicates they have completed an additional higher educational program to their National Board Certification. These professionals will be denoted by the ACA suffix.
Audiologist
An audiologist is required to have either a master's or doctoral degree for licensure. Audiologists have a larger scope of practice than hearing instrument specialists, as in addition to fitting hearing aids, they are educated in the treatment of hearing and balance disorders. Audiologists will have completed an undergraduate degree in speech and hearing sciences or other area of study. Historically, audiologists were required to complete a 2 year long master's degree program, which consists of a combination of classes on the diagnosis and treatment of hearing and balance disorders, as well as supervised clinical practice. Today, Audiologists complete a clinical Doctorate of Audiology, or AuD, which is a 4 year long program following their undergraduate degree. The final year of this program is a full-time clinical externship, which is similar to a medical residency. Audiologists may also have their PhD, which means the audiologist has devoted a significant amount of their education to audiological research in addition to clinical practice.
At the end of the day, it is important to choose a provider based on their level of knowledge about hearing testing and treatment through hearing aid fitting. But the most important factor for your success with hearing treatment is your provider's commitment to Best Practices. Regardless of the level of education or years of experience, if your provider does not follow Adult Hearing Aid Best Practices, you will not have optimal treatment success.
If you’ve been keeping up with Dr. Cliff, chances are you have heard him mention Best Practices once or twice, and that they are the key to success with hearing treatment. But what are they?
Best Practices are a series of comprehensive procedures that have been proven by research to result in the best possible patient outcomes. Best Practices can apply to any industry, whether it be surgery, dentistry, or even dog grooming! Major governing bodies in audiology such as the American Academy of Audiology (AAA) and the American Speech and Hearing Association (ASHA) have compiled lists of guidelines for hearing care providers to follow for optimal patient outcomes. These guidelines are based on extensive research and clinical data.
Here is an overview of some Best Practice procedures you should expect from your hearing care provider.
A hallmark of a Best Practice audiologist is always verifying hearing aid fittings using Real Ear Measurement (REM). When a hearing aid is first received from the manufacturer, it comes programmed with “first fit” settings. Essentially, this is the manufacturer’s best guess for the amplification needed to overcome your hearing loss. However, every person is different, and there is no way to know if these settings actually meet your prescription without verifying the output of the hearing aid while it is in your ear. Everyone’s ear canals are shaped differently, which means that sound will resonate differently in different people’s ears, so it is important that your audiologist verify your prescription in person.
During your fitting appointment, or any time your audiologist makes any adjustments to your hearing aid programming, they will place a small tube in your ear with your hearing aid. This tube measures how much sound is coming out of the hearing aid at the level of your eardrum. Your audiologist can then use these measurements to program your hearing aid as closely as possible to your hearing loss prescription.
This may seem like common sense, but surprisingly only 20-30% of audiologists consistently use it in their practice, even though 4 out of 5 patients report better satisfaction with their hearing aids when their programming is verified with Real Ear Measurement!
Electroacoustic analysis (EAA), also known as test box measures, is a mechanical test of the function of your hearing aids. Most of the time, this test takes place behind the scenes before you even come in for your appointment, but that doesn’t make it any less important. Your hearing care provider should always be performing test box measures any time a new hearing aid is received from the manufacturer, whenever a hearing aid comes back from repair, as well as when a patient reports their device is malfunctioning. Think of EAA like the tests the mechanic runs on your car to make sure every part is functioning within manufacturer specifications.
If the device is not within specifications, it will need to be sent back to the manufacturer for repair. There is nothing more frustrating than receiving your brand new hearing aid only for it to malfunction from the start, which is why test box measures are so important. Additionally, if your audiologist fits your hearing aid while it is not functioning to manufacturer specifications, even if it is verified to match your prescription using Real Ear Measurement, once the hearing aid comes back from repair the programming could actually be far off target!
It should seem like a no-brainer for your hearing care provider to routinely conduct those measurements. According to survey data, however, less than 10% of audiologists regularly use their test box. Make sure to always ask your provider if your new hearing aids have been tested in the test box before you take them home!
Another tenet of Best Practice care is subjective validation measures to evaluate the benefit you are receiving from your hearing aid programming. Your audiologist should perform some sort of questionnaire both before and after you have been fit with your hearing aids. These questionnaires usually pinpoint the areas of your life in which you experience the most difficulty hearing. After you have had the chance to wear your new hearing aids in the real world for a few weeks, your audiologist should then re-administer the questionnaire to ensure you are actually receiving benefit from your treatment. If the results of the validation measures don’t show significant benefit, that means additional adjustments need to be made so your treatment will be effective.
Person-Centered Care is another foundation of care that is essential for hearing your absolute best. It was championed by the Ida Institute, which was formed in 2007. They were founded on the philosophy that the person with hearing loss should be at the center of their hearing care treatment. Over the years, they have created a global movement toward a Person Centered Care approach.
Patient-Centered Care is separate from Best Practices in that it is not a specific set of procedures, but rather a philosophy guiding your relationship with your hearing care provider. A provider who practices Patient-Centered Care works with you to find the best treatment plan for you according to your wants, needs, and values. It is important to note that a provider can follow Best Practices and still not practice Patient-Centered Care.
In the traditional medical model, instead of working with you to find the best treatment option for you based on your wants, needs, and values, the provider simply tells you what they are going to do for your treatment. You have probably had the experience of going in to see your primary care physician and having them glance at a clipboard for a moment, quickly write you a prescription, and send you on your way. While they may be following Best Practices with all of the steps of your treatment, you are not an active participant in the decision making process in this model.
Ultimately, if you want to hear your absolute best, you will find a provider who follows Best Practices and does so with a Person-Centered Care approach. This way, you will be an active participant in the decision making process, and your provider will have every motivation to ensure you are an informed consumer so they can be sure your plan of treatment is ideal for you based on your wants, needs, and values. The treatment that works best for you may be completely different than for someone else who may have the exact same hearing loss! It is up to your provider to work together with you to pinpoint what that option will be, and make adjustments along the way based on your real-world experiences with the treatment.
The process of hearing your absolute best with hearing aids can be complicated. From identifying your unique hearing loss - including the severity, configuration, and type of loss - to determining the proper technology to treat your loss according to your wants, needs, and values, and finally to programming your devices to optimize your performance.... many steps are required along with the considerable efforts and abilities of your audiologist.
Whew! Thankfully, there are some amazing resources out there to make the process a lot less daunting. If you would like more information about hearing treatment, make sure to check out the Doctor Cliff, AuD YouTube channel, which has over 700 videos on every aspect of hearing care, all completely free to watch. You can also reach out to your local HearingUp provider for Best Practice care so you can be sure you are hearing your absolute best.
For information about OTC hearing aids, be sure to check out the OTC Buyer’s Guide (coming soon).
Name-brand hearing aids, fit by a local hearing healthcare provider who follows Best Practices.
Best Practices ChecklistHearing Aid Buyer's Guide
