Question
I have been looking at some of the literature on Acceptable Noise Level (ANL) and how it relates to fitting hearing aids. Based on a patient's ANL, would you recommend any guidelines for fitting a hearing aid?
Answer
Our lab has thought about the viability of using ANL as a type of fitting model. An example would be: Patients with low ANL would go through the fitting process without any modifications. Patients with mid-range ANL would need to take advantage of any type of technologies that would help their ANL scores such as directional microphones. Finally, patients with high ANL scores may need to go through some sort of aural rehabilitation, counseling or training to help prepare them for the hearing aid process in addition to advanced hearing aid technologies.
While you could use this as a general guideline, we are still researching this area and so I cannot recommend a definitive protocol. Our lab has published several papers on ANL and hearing aid fittings that may also be of help to you.
Nabelek, AK. (2005) Page Ten: Acceptance of noise may be key to successful fittings. Hearing Journal 58(4):10-15.
Nabelek AK, Freyaldenhoven MC, Tampas JW, Burchfield SB. (2006) Acceptable noise level as a predictor of hearing aid use. Journal of the American Academy of Audiology 17(9).
Melinda C. Freyaldenhoven, Ph.D., CCC-A (Assistant Professor): Mindy earned the Ph.D. degree in Speech and Hearing Science from The University of Tennessee (Knoxville) in 2006. She is currently an Assistant Professor at Louisiana Tech University (Ruston).
Patrick N. Plyler, Ph.D., CCC-A (Assistant Professor): Patrick earned the Ph.D. degree in Speech and Hearing Science from The University of Tennessee (Knoxville) in 1998. He then moved to Louisiana State University (Baton Rouge), where he was an Assistant Professor for 5 years. In 2004, Patrick returned to The University of Tennessee (Knoxville) as an Assistant Professor.
Melinda C. Freyaldenhoven, MA, CCC-A
Melinda Freyaldenhoven received the Master of Arts degree in Audiology in May 2003 and will receive the Doctor of Philosophy degree in Speech and Hearing Science in August 2006. Ms. Freyaldenhoven’s research has concentrated on the Acceptable Noise Level (ANL) procedure. She has 6 research manuscripts “in print” or “in press,” presented research at 12 national or international conferences, and received 5 grants/scholarships. Ms. Freyaldenhoven also served as an instructor for an Amplification Technology at The University of Tennessee.
Patrick N. Plyler, PhD, CCC-A
Assistant Professor.
Patrick Plyler graduated from The University of Tennessee with his Doctor of Philosophy in 1998. He then moved to Louisiana State University, where he was an Assistant Professor for 5 years. In 2004, Dr. Plyler returned to The University of Tennessee as an Assistant Professor. Dr. Plyler’s research interests are in the areas of diagnostic audiology, efficacy of advanced features in modern hearing instruments, and speech perception in quiet and in noise. Dr. Plyler has received external support for several research projects, most of which have investigated various features in digital hearing instruments. Dr. Plyler has published articles in the following journals: Journal of the American Academy of Audiology, Journal of Educational Audiology, Clinical Neurophysiology, Journal of the Acoustical Society of America, and Journal of Speech-Language Hearing Research. In addition, Dr. Plyler serves as an editorial consultant for the American Journal of Audiology, the Journal of Educational Audiology, Trends in Amplification, and the Journal of Speech-Language Hearing Research. Melinda Freyaldenhoven and Patrick Plyler have nothing to disclose.
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