Binaural Hearing Aids

The Hearing Loss Association of America 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, HLAA 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.

HLAA 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 knowledge.

HLAA 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.

HLAA recommends that hearing aids be purchased with a minimum 60-day money-back trial period, minus the direct cost of earmolds and a "reasonable" user's fee. We realize that the term reasonable isimprecise 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.