Is the hearing aid always to blame when things get really noisy?

1. ASA meeting May 2010, Sydney Is the hearing aid always to blame when things get really noisy? Gitte Keidser1, Elizabeth Convery1, Jürgen Kiessling2, and Ruth Bentler3 1 National Acoustic Laboratories (Australia) 2 University of Giessen (Germany) 3 University of Iowa (USA)

2. Background Mean: -4.9 dB re NAL-NL1 @ 65 Mean: -10.7 dB re NALSSPL Of 56 randomly selected hearing aid users, 82% reported experiencing loudness discomfort in real life

3. Question Is the hearing aid to blame or has our world become ‘uncomfortably’ noisy?

4. Normally hearing mature adults • Of 20 participants who passed the Telscreen hearing test, 85% reported experiencing loudness discomfort • 11 F/9 M • 60 years [50,67]

5. Reportedly loud sounds

6. Some variation • People/group (discussions with several people, specific voices) • Other negative aspects than loudness discomfort • Sudden transient sounds (door slamming, rustling, cutlery) • Could be the hearing aid – try noise reduction that target transient non-speech sounds

7. Reportedly loud sounds

8. Loudness tests suggest that LDL > 90 dB SPL

9. Clinical implications • Don’t just reduce the output level • Too low output levels can distort speech • A narrow range of output levels likely unacceptable • Understand the client’s complaints • Definition of loudness discomfort may be holistic • Reaction can depend on activity at the time of exposure, attitude toward the noise source, noise sensitivity, and controllability of the stressor (Berglund et al., 1996) • Counsel/educate your client • Normal hearing listeners rate the same sounds too loud • Use VC, change program, turn HA off, use ear plugs

10. Acknowledgement www.nal.gov.au The study was partly funded by HörTech, Germany