1. Self-Adjusted Amplification by Experienced Hearing Aid Users
Alexandra Lithgow, Carol Mackersie, Ph.D., Arthur Boothroyd, Ph.D.

2. Background Problem: Barriers:
Not enough individuals who could benefit from amplification get hearing aids
Approximately 14% of adults over 50 who could benefit from amplification actually pursue the acquisition of hearing aids1
Barriers:
Cost & accessibility

3. PSAPs & OTC Hearing Aids
Patients:
May turn to PSAPs as a more affordable & accessible option
PCAST:
Called for increased accessibility & affordability of hearing aids2
FDA:
Announced commitment to consideration of OTC hearing aids3
Audiological Concerns:
Over Amplification:
Under Amplification:
Further damage hearing
Lack of benefit

4. Potential Solution Primary Concerns: Self Fitting Hearing Aids
Fewer office visits
Can they do it?
How do patient adjustments compare to how we would fit?
How do they compare to targets?
Decreased costs
Increased accessibility
Primary Concerns:

5. Present Study Focused on experience hearing aid users
Also looked at sensitivity to noise
Do individuals w/ higher sensitivity select output levels below prescribed targets?
Research Question:
When given the opportunity to adjust the amplitude and
spectrum of speech, do hearing-aid users match the
familiar characteristics of their current conventionally fit aids?

6. Participants 13 experienced hearing aid users Mean Range Age 72 60-89
Years of HA Experience
6.08
1-20
4 Frequency HFA
47.21
MOCA Score 27
21-30

7. Materials: Software: Speech Materials:
Spectral adjustment using Goldilocks by Arthur Boothroyd, Ph.D.
Adjustments centered around 707 Hz
Low frequencies – cut up to -20 dB available
High frequencies – boost up to 8 dB/octave available
Step sizes – 5 dB
Speech Materials:
Sets of 4-word sentences recorded in quiet
Presented through Etymotic ER-5A insert earphone

8. Procedure 1 2 3 Hearing assessment User-Adjustments
Initial self-adjust
Speech recognition testing
Second self-adjust 3
Real ear measures & NAL-NL2 targets

9. Results – Adjusted vs. Starting
All participants able to make adjustments
77% of participants did not require assistance

10. Results – Adjusted vs. Own Aid & NAL Prescription
Initial Self-Adjustment
Second Self-Adjustment

11. Results – Relations between self-adjustment and other variables
No significant relationship between self-adjustments and:
Age
4 frequency HFA
Years of HA experience
Sensitivity to noise

12. Key Findings
Experienced HA users initially biased towards familiar amplification
Speech testing may have led them to seek more high-frequency output, as prescribed by NAL-NL2 1 2

13. Limitations Self-fitting performed in quiet
Goldilocks gain curves led to high mid frequencies to meet 3-4 kHz targets
Lack of control group without speech recognition testing

14. Benefits of Self-Adjusted Amplification to Audiologists:
Increased Time:
Lighten case-load allowing more time for:
Difficult cases
Follow up & management of hearing loss
Increased Reach:
Allows us to overcome barriers and reach more patients in need of hearing health care

15. In Conclusion Audiologist-fit amplification
Gold Standard:
Audiologist-fit amplification
Self-Fit
HAs
Potential option for patients who cannot readily access or afford audiologist-fit amplification

16. Acknowledgements
Funding provided by NIDCD 1R21DC We are grateful to Mark Datuin and Lauren Rynders who assisted with experimental setup and data collection

17. References
1Chien, W., & Lin, F. R. (2012). Prevalence of Hearing Aid Use Among Older Adults in the United States. Archives of internal medicine, 172(3), doi: /archinternmed President's Council of Advisors on Science and Technology. (2015). Aging America & hearing loss: Imperative of improved hearing technologies. Retrieved from 3U.S. Food & Drug Administration. (2016). FDA takes steps to improve hearing aid accessibility. Retrieved from

18. Questions?