Hearing aids - SHHH position paper

Steve Hoffman steve at accessone.com
Tue Apr 9 16:46:31 EST 1996

Self Help for Hard of Hearing People

Position on Hearing Aids

Binaural Hearing Aids

SHHH recommends that binaural hearing aids be the normal fitting
practice, to be modified by clinical considerations and the
expressed wishes of the hearing aid user. There are two reasons
for this recommendation.

First, it is a fact that two ears, normally provide superior
listening capabilities than one ear, for all normal hearing
people, and for the majority of those with hearing losses. This
fact have been known for many years. To determine if this
generalization applies to a specific person, SHHH recommends that
hearing aid evaluations include objective and subjective
comparison between monaural and binaural listening (including a
trial period when necessary or desirable).

Secondly, in recent years, evidence has been accumulating on the
phenomenon termed "adult-onset auditory sensory deprivation."
This body of research has demonstrated that the ability to
understand speech in an unaided ear deteriorates over time
compared to the ability in an aided ear. For many people, this
deterioration in speech recognition abilities in the unaided ear
is reversible if a hearing aid is later fitted to this ear
(provided the ear is suitable for amplification). However, if the
deprivation is long enough (presently undefined), and if the
person is not too old (also undefined), then not only is recovery
unlikely but binaural advantages may never be attainable. That
is, if we don't "use" it, we may indeed "lose" it.

SHHH recognizes the added financial burden that a second hearing
aid may present to many people with hearing loss. We also
recognize that the ultimate decision regarding binaural hearing
aid use rests with the prospective user. Hearing aid specialists
are simply obliged to provide the necessary information to
prospective users so that they can make their own, informed
decision regarding binaural hearing aid use.

National and Uniform Standards for Hearing Aid Dispensers

Hearing aids are the most direct and effective therapeutic tool
for the majority of people with hearing loss. They also represent
the beginning of a habilitative and rehabilitative process.
Developments in hearing aid technology and hearing aid evaluation
procedures provide almost daily additions to the body of
knowledge undergirding hearing aid fittings and follow-up. No one
should engage in the practice of hearing aid dispensing unless he
or she can demonstrate a high degree of mastery of this body of

SHHH believes that the nationwide variations in standards and
licensing requirements for hearing aid dispensers are
inappropriate, inefficient, and not in the best interests of hard
of hearing consumers. We recommend that a national and uniform
standard be adopted for state licensing of hearing aid
dispensers. Furthermore, we recommend that this standard be
sufficiently rigorous to ensure that only those with the
necessary knowledge and skills be permitted to dispense hearing
aids. To do less is to devalue the auditory channel as a major
sensory channel for human communication.

Hearing Aid Return Policies Hearing aid return policies vary
depending upon the state, manufacturer, and individual
dispensers. When a return policy is in force, it usually extends
for 30 days. During this time, a client can return a hearing aid
and receive a full refund, minus the cost of an earmold and a
"reasonable" user's fee.

For all hearing aid users, but new ones in particular, 30 days
may not be sufficient time to determine if the cost of the
hearing aid justifies the expense. We know that it often takes a
longer period before a hearing aid wearer realizes the full
benefits hearing aids can confer. During this period, the initial
apparent benefits may not persist, or not be sufficient to
justify the cost of the aids. On the other hand, with time and
practice, the positive contributions of the hearing aids may
increase and more than justify their expense.

SHHH recommends that hearing aids be purchased with a minimum
60day money-back trial period, minus the direct cost of earmolds
and a "reasonable" user's fee. We realize that the term
reasonable is imprecise and subject to wide variations in
interpretation. Whatever the lower limits, we believe that the
upper limits of this "user's" fee should not exceed one-tenth the
cost of the hearing aid.

Given appropriate pre-selection procedures, and a conscientious
and scheduled hearing aid orientation program, it is our judgment
that the incidence of returns would not impose an excessive
financial burden on hearing aid dispensers. Insofar as consumers
are concerned, this 60-day trial period should result in greater
satisfaction and more frequent use of hearing aids.


Self Help for Hard of Hearing People, Inc.
7910 Woodmont Ave - Suite 1200
Bethesda, Maryland 20814
301-657-2248 Voice
301-657-2249 TTY
301-913-9413 Fax

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