What happens at a hearing aid fitting?

Following a hearing assessment, the days leading up to your child’s first hearing aid fitting might include a lot of uncertainty and questions.
 

Will the process scare my child?
What if the hearing aids don’t work?
How exactly does the fitting work?

A hearing aid fitting is a standard process, and not anything to be nervous about. It will help you child better understand you and others around them. Here’s what to expect on the day.

The fitting and programming of the hearing aid



Once your ear mould has been sent back from the manufacturer and a fitting is ready to be done, your audiologist will let you know and book you an appointment. The hearing aid will be adjusted to fit neatly in your child’s ears, and individually programmed to improve the hearing in each ear. They’ll then show you how to use the aids, and how to help your child wear them and get used to them. The audiologist will programme the hearing aids by:
  • Looking at any hearing test results to develop amplification targets.

  • Measuring and adjusting the hearing aids to meet the amplification targets as closely as possible in each ear.

  • Investigating how well your child is hearing with their hearing aids. They’ll assess if they are hearing well, progressing with language and learning. If not, they’ll decide what should be checked or changed.

NAL-NL2 prescription

The NAL-NL2 prescription is a set of formulas used by an audiologist to fit a hearing aid. It aims to maximise your child’s speech capabilities and keep amplified sound at a comfortable level. For example, having a loud frequency up too high may cause your child discomfort, whereas a soft frequency too low may be hard for your child to pick up on. The NAL-NL2 formulas allow for a happy medium on all sound levels. Programming a hearing aid to meet these targets should allow the softer parts of speech to be heard while keeping the louder sounds comfortable and clear.

Real-Ear Measurements (REM)

Real-Ear Measurements measure the hearing aid’s effectiveness while it’s being worn. To get Real-Ear Measurements, a headset is put on the ears and a soft thin tube is placed into the ear canal. Then the hearing aid is put into the ear with a programming cable connected. A short burst of sound is played from a speaker and the results are displayed on a screen. The audiologist can then make adjustments to match the targets as closely as possible. This procedure is best suited to children five years and older as it requires them to sit still and be quiet for five to 10 minutes for each ear.

Real-Ear-To-Coupler Difference (RECD) measurements

For young children that can’t sit still or quietly long enough for REMS to be completed, the RECD measurement can be used instead. This only requires a single measurement for each ear. A sound is measured in the child’s ear with the hearing aid and ear mould in place. The same sound is also measured with the hearing aid in a test box.

Your audiologist can then measure the sound in the test box and accurately determine the level of sound in your child’s ears when hearing aids are worn. The hearing aids can be adjusted in the hearing aid test box to achieve the best possible match to the prescription targets.

Hearing aid test box (or “coupler”) measurements

A hearing aid test box is a small, sound-treated enclosure that allows accurate, repeatable measurements to be made of a hearing aid. Test box measurements are fast and are often used to quickly check how a hearing aid is working in comparison to previous test box measurements.

Getting started with hearing aids

Once the aids are adjusted to suit your child’s loss, the audiologist will show you how they operate and help you practice putting them onto your child’s ears. They will also give you information about helping your child get used to the aids and start wearing them consistently.

Evaluating the hearing aid’s effectiveness

At the next appointment, your audiologist will evaluate how well your child is progressing with the hearing aids. Evaluation is important to ensure that your child is getting the predicted real-life benefit from the hearing aids.


Australian Hearing is the leading specialist and provider of Government-funded hearing services. For more information about the services available for children with hearing loss, contact us.