What makes a better hearing aid?

If you are considering purchasing hearing aids you need to know the factors that determine a good hearing aid versus one of poor quality. Despite the brand or manufacturer, there are certain things that all hearing aids should offer. You need to know some basics of what to look for to ensure that you are indeed buying the best device for your specific hearing needs.

First of all, we are talking only about Hearing Aids here, not Amplifiers. Hearing aids are FDA regulated and are custom programmed by a licensed hearing professional to the meet the specific needs defined by your professional hearing test. Amplifiers not custom programmed – they simply amplify all the sound in your environment making things louder, but not clearer. Amplifiers cost anywhere for $25 - $500. Programmed Hearing aid start at about $650 each.

Who makes hearing aids?

Despite the many different brands of hearing aids, there are only six manufacturers that make the vast majority of high-performance devices. Each one puts their technology into several different brands. They are:

  • Sonova (makes Phonak, Unitron and Hansaton).
  • Starkey
  • GN ReSound (makes ReSound and Beltone)
  • Sivantos (makes Siemens, Signia and Rexton)
  • Widex
  • William Demant (makes Oticon and Bernafon)

Each of these brands offer multiple performance or technology levels of hearing aids. The lower end levels offer good performance in quieter settings and watching TV, while the higher end levels perform better in environments like noisy restaurants, meetings and large open spaces. Some hearing aids are focused simply on enhancing your ability to hear while others may offer expanded functionality like streaming music and fitness apps. Not all of these extra functions enhance hearing. In fact, they may confuse matters for some individuals. Reliable technology that enhances hearing and can automatically adjust to, and isolate, conversations in noisy environments is the baseline for quality. It makes for the most satisfactory hearing experience.

It all begins with your hearing test

Like a car that is built around a good engine, hearing aids are built around a clinically sound audiology exam conducted in person by a trained and licensed audiologist or hearing professional. The data from the hearing test will be used to custom program your hearing aids. Although there are a few basic hearing screening tests available online, they are not clinically reliable and often lead to under-performance of hearing aids. Hearing aids should be calibrated only with clinically exacting data which can only be achieved by a licensed specialist in a properly sound proof setting with calibrated equipment. The point to remember is this: hearing aids are only as good as the audiology test upon which their programming is based. Need help finding a test location? Ask a friend or your regular doctor for a recommendation.

Once the hearing test has generated accurate results, the hearing aids are programmed to those exact specifications.

The different types of hearing aid styles

Hearing aid design can enhance the performance for your needs. There are two main types of hearing aids:

  • Behind-the-ear (BTE): The hearing aid electronics sit behind the ear.

    • BTE Receiver-in-the-Canal (RIC): The electronics are behind the ear but the speaker is at the end of a very thin wire inserted directly into the ear canal

    • BTE “Slim Tube”: The electronics and speaker are behind the ear and the sound is sent to the ear via a hollow tube. This looks a lot like a RIC but the hollow tube delivers much lower sound quality and is very tough to keep clear of wax.

  • In-the-Canal (ITC or CIC): The entire hearing aid fits into the ear canal. The “In-Canal” models are preferred by many wearers because they are very discreet but they also can initially give you a bit of a plugged-up feeling. You can read more about BTE versus CIC hearing aids HERE.

The most popular choice of hearing aid design is the a BTE “RIC” model.  It looks similar to the design of the slim tube but does not have the same sound reception issues. With the Receiver in Canal style, the sound is much clearer and the “RIC” is much more easily kept clean and in top performance.

With each “Style” you will find that there are a number of performance levels. The lower end models work well in quieter, 1 on 1 settings and watching TV. The higher end models perform much better in tougher situations like restaurants, large group events or meetings.

Some important features to look for:

Dual Directional Microphones: High-quality hearing aids always come with dual directional microphones – two microphones on each hearing aid that face forwards and backwards to give you a 360-surround sound effect and help you hear people behind you (e.g. In a car). With higher end self-adjusting hearing aids in areas with a lot of background noise, voices coming from the front of the user will be enhanced while sounds coming from the back will be reduced.

How many hearing aid processing bands or channels do you need? Not as many as you might think. A processing channel isn’t like a TV channel that can be changed. It is a band that covers a range of sound frequencies that are processed by the hearing aid. The amplification within each channel is set by the audiologist to meet the specific needs defined by the user’s hearing test. A lower end model might have four to eight channels while higher end models will have approximately 20. Some budget hearing aids claim to offer 40 or more channels but data shows that beyond 20 channels your brain can’t tell the difference. That is why most audiologists will program only up to 24 channels.  

Automatically adjust to your environment: In the past, when you went into a restaurant or crowded area, you could change the program of your hearing aid to be a little more suitable for that area. Most hearing aids still offer this but the best hearing aids actually self-adjust, automatically to the environment around you. For example, if you move from a quiet car into a noisy restaurant the hearing aids will detect the change in background noise and adjust for it automatically. When you leave the noisy area, they will adjust back to normal. You can still do this manually, but you won’t have to.

What about service and adjustments?

Like many other industries, customer service has evolved in the hearing aid industry. Today, storefronts may not offer the best service. You will have to book appointments several days in advance and although you can talk to someone face to face about the hearing aid, that singular privilege can cost up to $4,000 more than purchasing, and servicing, hearing aids online.

Purchasing online is a much more affordable option. You start by getting a hearing test locally and then the programming is done by licensed professionals using precisely the same software as used locally, it is just not done across the table from you.  Technology has advanced to the point where most hearing aid adjustments and repairs can be made remotely, over the phone or online. If there is any issue at all, in a simple phone call, the hearing aid technician can direct the hearing aid user to make the minor adjustments that are needed to improve hearing aid performance – 24 hours a day, 7 days a week with no appointment needed. These advances have greatly improved hearing aid performance and customer satisfaction while significantly reducing cost. Higher cost for hearing aids does not necessarily indicate higher quality performance.

We are going to examine the cost of hearing aids at length in our next blog. Keep an eye on this space.