One of the local groups I've joined is the Oregon Association for Better Hearing, a group facilitated by Corvallis audiologist Ron Leavitt that tests different types and brands of hearing aids. We are not supported, endorsed, or in any way influenced by any manufacturer. We test standard production model aids, not those specifically supplied by the manufacturer for our testing. We seek realistic and provable data from the real life experiences of everyday hearing aid wearers. Based on ten years of this group's existence, we have compiled a list of consensus statements around successful hearing aid use. This is not as simple as it seems due to the wide variety of experiences people have with hearing aids, nor does it provide a clear answer in terms of the best aids for the money, but it serves as a fairly reliable foundation for a most consumers. I should also point out that in many of these statements we are verifying the results of many other researchers and organizations, and we try to acknowledge these sources when possible.

1. Two aids if wearer has two aidable ears.

An article in the November 1998 Journal of the American Academy of Audiologists, written by Raymond M. Hurley and entitled, "Is the unaided ear effect independent of auditory aging?" cites an average 2% loss per year in the unaided ear for wearers using one aid when they could have been using two. It seems the brain gradually loses its reliance on the unaided ear.

2. Programmability for all.

This means in the office by the audiologist while the wearer is wearing the aids. This seems to add about $600 to the cost of a given aid, but provides more accurate fitting, plus flexibility in fitting, which means that if your hearing changes, the aids are easily adjusted to accommodate.

3. Venting for all.

I've heard of a few cases where the wearer prefers closed or no vents, but by and large the consensus is that without vents your own voice sounds unnatural, and head-borne noises such as chewing are overwhelmingly loud. In my own case, I'll add that many other sounds seem so much clearer with larger vents.

4. Loudness limiting for all.

"Peak clipping" in analog-type aids is the least satisfactory type of loudness limiting, due to the distortion effects it introduces. Other aids will hush the entire spectrum of frequencies, while some affect only a narrow band surrounding the offending frequency. In my opinion, satisfactory loudness limiting features are crucial to comfort and satisfaction.

5. 90-minute rule.

Adequate fitting of the many important functions of good quality hearing aids require some time and testing. A Chicago area Marketrac study by Sergei Kochkin, of over 25,000 wearers verified a dramatic difference in the satisfaction of the wearers when they spent a cumulative total of 90 minutes or more in their fitting visits, as opposed to 30 minutes or less. This was true regardless of the individual's degree of loss, or the type of aids being used.

6. Behind-the-ear for reliability

Behind-the-ear aids are not plagued by moisture or wax problems, and can easily be substituted for in the rare instances they may be away for repair. Additionally, they are the least feedback prone, offer more effective directional microphone capability, and are almost always the least expensive type of aid.

7. Loudness tolerance measurements for all.

We feel that everyone should be carefully checked and accommodated for in this area.

8. Impedance and audiologist a must.

A percentage of people faced with hearing difficulties have medically treatable conditions that should be addressed before prescribing hearing aids.

9. Real ear aided testing for all.

By placing a very small microphone near the eardrum while the wearer is using the aid, and with the use of accurately calibrated measuring equipment, it is possible to watch the effects of programming adjustments as they occur. Along with the wearer's participation, this enables the most effective programming possible.

10. Multiple brands a must.

There are just too many different personal requirements and choices for everyone to be adequately served by only one manufacturer or one type of hearing aid.

11. Consumer education a must.

We think this says it all!