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Complex versus Standard Fittings: Part 1

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1.  A focus on maximizing audibility assumes The professional does need to use real ear approaches The patient can extract information from the audible signal The audiogram provides no useful information Audibility precludes intelligibility

2.  Fitting algorithms Were developed using patients with a broad range of audiograms Are designed to maximize frequency resolution Are often based on mean loudness perception data Are designed to maximize temporal resolution

3.  NAL-NL1 and DSL i/o are Based on some shared but some different principles Designed based on individual psychoacoustic performance Provide full audibility for all hearing losses Require the same compression ratios at all frequencies

4.  The audiogram provides Enough information to provide an audible speech signal Complete information of the usability of remaining hearing Complete information concerning loudness perception Complete information concerning frequency resolution

5.  Average Psychoacoustic data Are not used in the development of fitting algorithms Provide full predictive power for speech understanding Are only available for frequency discrimination May provide a misleading picture of the range of patient to patient differences

6.  Restoring significant audibility Works well for all patients Cannot be verified via real ear Does not guarantee accurate perception Cannot be predicted from the audiogram

7.  Residual Capabilities Means the same as correcting for the audiogram Emphasizes making best use of the hearing that the patient has Emphasizes returning hearing to normal Emphasizes strict adherence to real ear targets

8.  Providing gain in a region of normal hearing Allows a patient to have a more salient signal in a region where hearing works well Is a violation of the code of ethics Only works in combination with frequency lowering Provides the same result as target matching

9.  The speech signal Has equal information content across frequency Has peak information below 1000 Hz Has peak information above 4000 Hz Has peak information from 1000 to 4000 Hz

10.  Fine Tuning Should be expected for a significant number of patients given what is known about fitting rationales Is a violation of the audibility model Invariably reduces speech understanding Should not be needed if targets have been verified