Hearing Aid Services: Real Ear Measures (REM)
"Real Ear Measurements" (REM) is the most important, yet underused, under-advertised, and misunderstood hearing aid service. Supported by objective research and academic institutions, this in-person service makes use of extensive research, the purpose of which is to verify the actual sound that a hearing aid makes in the individual ear canals of each client.
Digital hearing aids are programmed by specialists using manufacturer-supplied software. However, the manufacturer has never met and never will meet a client in person. Thus, when the hearing professional selects a certain acoustical responses when programming a hearing aid, the software does its best to guess the best way to setup the hearing aid.
The problem is, each client's ear canals are significantly different and unique only to them. This uniqueness manifests itself in significant changes to sound in the actual ear canal. Much like a violin body, sound quality is dictated by the shape and texture of the ear canals. However, manufacturer software is only able to estimate average values for ear canal size.
It seems this average is good enough for most hearing clinics or online hearing aid who either choose not to, or are unable to, perform REM. However, evidence shows that adjustments of sound intensity of five times or more (20db HL) are not uncommon in certain resonant frequencies. If these adjustments are not performed at first fitting of a hearing aid, the client may never be exposed to the optimal sound levels. The sad fact is the client may never know what they are missing.
[It is important to note that sound comfort (as opposed to physical comfort), while important, should never be the primary goal of a hearing aid. This comfort almost always comes at the expense of effectiveness. Without effectiveness, hearing aids are unable to offer meaningful benefit in more difficult environments. REM results typically reveal a need for more high-frequency sound - the same sound that offers greater speech clarity and directly impacts the effectiveness of (sometimes expensive) hearing aid speech enhancement features.]
REM are used in conjunction with fitting formulas, the latest an most effective is NAL-NL2, which takes into account years of research into what sound presentations are most effective, yet pleasing, to those with hearing aid experience versus new users, women versus men, older versus younger clients, and other factors.
REM is performed by looping microphones around the ears of a client and inserting mic probes in the ear canal (5mm from the eardrum) while the hearing aids are in the ear. With "live speech mapping" speech sounds of various volumes and frequencies are presented to each ear one-at-a-time and the response of the hearing aid is measured. If the measured sound does not meet targets, (as defined by NAL-NL2), the hearing aids are adjusted and the test is redone until all sound targets are met.
UBHearing™ performs NAL-NL2 REM as a starting point for our "effectiveness-first" approach. Using REM, a rehabilitative goal can be set and hearing aid adaptation management features can work to that goal for our clients over the first few months of use, offering them a higher level of satisfaction, both on day one (when comfort is typically a main concern) to day ninety and beyond (when speech-in-noise effectiveness is typically the main concern).
UBHearing™ hearing aid services and pricing...
Digital hearing aids are programmed by specialists using manufacturer-supplied software. However, the manufacturer has never met and never will meet a client in person. Thus, when the hearing professional selects a certain acoustical responses when programming a hearing aid, the software does its best to guess the best way to setup the hearing aid.
The problem is, each client's ear canals are significantly different and unique only to them. This uniqueness manifests itself in significant changes to sound in the actual ear canal. Much like a violin body, sound quality is dictated by the shape and texture of the ear canals. However, manufacturer software is only able to estimate average values for ear canal size.
It seems this average is good enough for most hearing clinics or online hearing aid who either choose not to, or are unable to, perform REM. However, evidence shows that adjustments of sound intensity of five times or more (20db HL) are not uncommon in certain resonant frequencies. If these adjustments are not performed at first fitting of a hearing aid, the client may never be exposed to the optimal sound levels. The sad fact is the client may never know what they are missing.
[It is important to note that sound comfort (as opposed to physical comfort), while important, should never be the primary goal of a hearing aid. This comfort almost always comes at the expense of effectiveness. Without effectiveness, hearing aids are unable to offer meaningful benefit in more difficult environments. REM results typically reveal a need for more high-frequency sound - the same sound that offers greater speech clarity and directly impacts the effectiveness of (sometimes expensive) hearing aid speech enhancement features.]
REM are used in conjunction with fitting formulas, the latest an most effective is NAL-NL2, which takes into account years of research into what sound presentations are most effective, yet pleasing, to those with hearing aid experience versus new users, women versus men, older versus younger clients, and other factors.
REM is performed by looping microphones around the ears of a client and inserting mic probes in the ear canal (5mm from the eardrum) while the hearing aids are in the ear. With "live speech mapping" speech sounds of various volumes and frequencies are presented to each ear one-at-a-time and the response of the hearing aid is measured. If the measured sound does not meet targets, (as defined by NAL-NL2), the hearing aids are adjusted and the test is redone until all sound targets are met.
UBHearing™ performs NAL-NL2 REM as a starting point for our "effectiveness-first" approach. Using REM, a rehabilitative goal can be set and hearing aid adaptation management features can work to that goal for our clients over the first few months of use, offering them a higher level of satisfaction, both on day one (when comfort is typically a main concern) to day ninety and beyond (when speech-in-noise effectiveness is typically the main concern).
UBHearing™ hearing aid services and pricing...