Download dc hearing aids.vp - Lesner Hearing Center

Table 1
CHECKBOOK’s
top rating (!)
Percent of surveyed customers rating firm “superior” for...
Advice on choice &
use of products and
(number of ratings)
Promptness
of service
Quality of products
Variety of products
Ease of looking at/
testing products
Reliability
Overall quality
Price index score2
For quality
For price
Hearing
Centers1
75%
78%
76%
60%
66%
84%
77%
$100
703-333-2711
87%
(15)
87%
93%
77%
100%
100%
93%
$87
!
!
Auditory Services
301-434-4300
1734 Elton Rd #104, Silver Spring, MD
93%
(181)
94%
90%
79%
89%
97%
98%
$82
!
!
Blue Ridge Speech & Hearing
703-858-7620
19465 Deerfield Ave #201, Landsowne, VA
83%
(19)
74%
79%
41%
50%
82%
78%
$100
Carolyn Wyatt Audiology Services 301-656-1933
8218 Wisconsin Ave #106, Bethesda, MD
91%
(47)
87%
91%
51%
68%
91%
87%
$1243
Costco
All locations combined
60%
(159)
65%
67%
44%
52%
85%
75%
—4
—5
All-Firm Averages
American Auditory Centers
6373 Little River Tpke, Alexandria, VA
!
Costco
1200 S Fern St, Arlington, VA
703-413-3240
53%
(40)
57%
62%
45%
60%
76%
70%
—4
—5
Costco
4725 W Ox Rd, Fairfax, VA
703-332-3202
64%
(64)
77%
72%
42%
41%
86%
81%
—4
—5
Costco
880 Russell Ave, Gaithersburg, MD
301-417-1530
54%
(48)
51%
64%
43%
53%
88%
67%
—4
—5
Dr Richard Israel
301-589-3277
8830 Cameron St #310, Silver Spring, MD
92%
(26)
88%
88%
77%
83%
96%
92%
$97
Drake Hearing Aid Center
403 S Glebe Rd, Arlington, VA
703-521-1404
68%
(37)
78%
77%
60%
61%
78%
71%
$86
Family Hearing Center
301-738-1415
2301 Research Blvd #110, Rockville, MD
81%
(26)
88%
88%
72%
71%
96%
84%
$99
Feldman ENT Group
301-652-8847
5454 Wisconsin Ave #1535, Chevy Chase, MD
82%
(17)
94%
87%
86%
67%
88%
76%
—4
GWU Speech & Hearing Center
202-994-7360
2115 G St NW #B-01, Washington, DC
79%
(19)
68%
76%
63%
64%
75%
84%
$112
Hearing Associates
6862 Elm St #120, McLean, VA
703-748-3300
87%
(30)
80%
89%
67%
69%
79%
82%
$106
Hearing Health Care Center
703-369-0300
8650 Sudley Rd #209, Manassas, VA
94%
(18)
100%
100%
100%
88%
100%
100%
$923
Hearing HealthCare
301-946-2434
15235 Shady Grove Rd #100, Rockville, MD
89%
(71)
91%
72%
50%
71%
94%
83%
$107
Hearing Professionals
301-604-3177
14201 Laurel Park Dr #109, Laurel, MD
63%
(20)
89%
63%
47%
72%
79%
80%
$125
Hearing Solutions of Fairfax
3930 Pender Dr #140, Fairfax, VA
571-432-0640
95%
(43)
93%
71%
77%
87%
95%
95%
$93
!
Hull Hearing Aid Service
703-533-1622
6231 Leesburg Pike #510, Falls Church, VA
81%
(131)
89%
88%
73%
72%
93%
88%
$79
!
Lesner Hearing Center
5232 Dawes Ave, Alexandria, VA
703-820-3800
100%
(22)
90%
100%
79%
95%
100%
100%
$112
!
Otolaryngology Associates
703-573-7606
8316 Arlington Blvd #300, Fairfax, VA
62%
(42)
62%
64%
49%
56%
71%
60%
$109
Prince William Speech & Hearing 703-670-8126
4317 Ridgewood Center Dr, Woodbridge, VA
79%
(14)
71%
92%
55%
67%
100%
92%
$77
Professional Hearing Services
703-536-1666
6231 Leesburg Pike #512, Falls Church, VA
79%
(41)
85%
84%
68%
71%
79%
83%
$97
118
!
!
!
—5
!
!
!
!
!
Buying Hearing Aids
Reprinted from Washington Consumers’ CHECKBOOK, Volume, 15, No. 3.
© 2010 Center for the Study of Services. Ratings and reports are solely for the use of readers and may not be used in advertising or for commercial purposes.
Now Hear This!
Shopping for Hearing Aids
Is it difficult to hear the TV or radio, so much so that family
members often ask you to turn it down? Do you struggle to understand the cashier at the grocery store? Is it difficult to follow conversations at large gatherings? If so, it might be time to
get your hearing checked.
Most of us are guilty of “selective hearing” from time to
time. But not listening to what you don’t want to hear is one
thing—not hearing what you want to is another. That’s when a
hearing aid might be in order.
If you are hearing less than you should be, you can take a
measure of comfort in knowing that you’re not alone. About
10 percent of Americans have some hearing loss. The figure is
more than 30 percent for
persons over age 65.
The vast majority of those with hearing loss would benefit
from using hearing aids. But most go without these helpful devices either because they are hesitant to acknowledge a handicap or because they don’t think the benefit will justify the
trouble and cost.
It is true that hearing aids don’t fully make up for hearing
loss in the same sense that eyeglasses can restore 20/20 vision. They are rehabilitative devices that, when properly programmed and fitted, help their wearers attain their best
hearing potential. But this potential varies from person to person, depending on the nature and extent of their hearing loss.
Sometimes, persons who wear hearing aids find they can hear
sound but they can’t always understand the words being spoken. Often this type of experience is caused by damage to the
auditory system that can’t be helped by a
hearing aid.
Although hearing aids can’t restore norMost individuals who would benefit from hearing aids never get them.
mal
hearing, they have still improved the
Many who do are amazed at the resulting improvement in their lives. But
lives
of millions of people—enabling them
hearing aids can’t fully make up for hearing loss in the same sense that
to
enjoy
their senses more fully and to
eyeglasses can restore 20/20 vision.
communicate
more effectively with others.
Don’t get a hearing aid without first consulting with a medical doctor
Many
first-time
hearing aid wearers are
to be sure your hearing loss is of a type that can be helped by a hearing
surprised
at
the
improved
quality of their
aid—and that it can’t be assisted by medical or surgical treatment.
lives.
In
a
study
of
hearing
aids,
the AmeriYou will have to decide what matters to you in a hearing aid. Some aids
can
Association
of
Retired
Persons
(AARP)
have advanced features that may make them more adaptable to varying
reported
hearing
aid
user
comments
like
hearing environments than basic models, but these features cost more.
the
following:
“It’s
such
a
joy
to
go
for
my
In shopping for hearing aids, you will want to consider only businesses
walk
in
the
early
morning
and
hear
the
that have staff who offer thorough advice and explanations of your opbirds singing, which I could not hear betions, offer a wide variety of styles and makes of aids, and have flexible
fore. It is also a pleasure to hear all of a serpolicies allowing you to test out aids and return them with little or no fee if
mon at church or someone’s conversation
you are not satisfied.
rather than parts.”
Table 1 shows how area hearing centers were rated by their surveyed
Hearing aids have come a long way from
customers. For advice, some sellers were rated “superior” by more than
the
“ear trumpets” manufactured in the
90 percent of their surveyed customers while others got such favorable
early
1800s—and even from the devices
ratings from 60 percent or fewer. For the variety of products offered, some
available
just a few years ago. Today’s hearwere rated “superior” by more than 75 percent and others by fewer than
ing
aids
can
do much to meet the needs of
45 percent.
their
wearers
in the complex and varying
It is essential to get in writing how long you have to test out any aid you
listening
environments
they encounter.
purchase; what charges, if any, you will have to pay if you return it; and
As
hearing
aids
grow
smaller and more
whether the test period will be extended if instead of returning the aid,
technologically
advanced,
they are also
you agree to let the dispenser first try to adjust it to suit you better.
more
convenient
and
less
obtrusive
to wear.
Be sure to shop for price. For one hearing aid model, we found that
Today,
if
you
have
a
hearing
loss,
you
can
prices among local sellers ranged from $1,483 to $2,850. For another,
choose
from
hundreds
of
hearing
aids
with
prices ranged from $1,640 to $3,250.
varying degrees of size and sophistication.
Checklist
110
Buying Hearing Aids
“The ringing in your ears—I think I can help.“
© 2001 Leo Cullum/The New Yorker Collection/
www.cartoonbank.com. Reprinted with permission.
How Your Hearing Works
The ear is made up of three parts: the outer ear, the middle
ear, and the inner ear.
Sound enters the outer ear canal and strikes the eardrum,
which is the outer boundary of the middle ear. A chain of three
tiny bones in the middle ear receive sound vibrations from the
eardrum and transmit them to the inner ear. The inner ear includes a snail-shaped chamber called the cochlea, which is
filled with fluid. The vibrations transmitted by the bones of the
middle ear cause movement in the fluid of the inner ear. Thousands of hair cells in the inner ear are stimulated by the movement of the cochlear fluid, sending impulses along the fibers of
the auditory nerve, which goes to the brain. The brain processes this information, providing awareness of speech, music,
annoying cell-phone ringtone jingles—everything we hear.
How We Develop Hearing Loss
Hearing loss is extremely common.
It can be a normal part of the aging
process and, for many, an inevitable
result of living in a noisy society. There
are two primary types of hearing loss:
sensorineural loss and conductive
loss.
Ninety-five percent of all hearing
aid wearers have sensorineural hearing loss, which is characterized by impairment of the inner ear or the neural
pathways from the inner ear to the
brain.
Most sensorineural loss results
from when the tiny hair cells that line
the inner ear become damaged and
are no longer able to transmit signals
accurately to the auditory pathway
and the brain. Aging is by far the most
www.checkbook.org
common cause of this damage, but other causes include infection, high fever, trauma, noise exposure, genetics, and use of
certain prescription drugs.
In rare cases, hearing loss can be the result of damage to the
auditory nerve. For example, benign tumors can compress the
nerve. If found early, these conditions are often treatable.
Conductive hearing loss, which often can be treated medically or surgically, occurs when something interferes with
sound vibrations as they pass through the outer and middle
ear. A common cause is a blockage of wax buildup, which can
be addressed by using an earwax softener and then flushing
out the wax using a kit (both the softener and kit can be purchased from drug stores). A physician or audiologist can also
remove the wax.
Conductive hearing loss can also result from the presence
of fluid in the middle ear. The fluid disrupts the middle ear’s
ability to conduct vibrations to the inner ear. This can occur
when the eustachian tube (a tiny tube connecting the middle
ear to the back of the throat) is not functioning properly, often
due to inflammation. This sort of hearing loss, common in
children, usually can be treated medically.
A punctured eardrum or problems with the functioning of
the small bones in the middle ear can also cause conductive
hearing loss. These types of problems are often partially or
completely treatable with surgery, but hearing aids may be
used if hearing loss remains following the completion of medical intervention.
A combination of conductive and sensorineural hearing
loss, called mixed loss, is also possible.
How It Is Diagnosed
If you suspect that you have hearing loss, first consult with
a physician. Choose a physician—such as an otolaryngologist—
who is knowledgeable about hearing loss and treatments. The
right physician will be able to detect medical causes of hearing
loss (such as, fluid buildup in the middle ear, a disease, or a tumor), will often be able to treat them, and will be able to recommend hearing aids in cases where that is the best treatment
In This Article...
✓ Checklist 110
✓ How Your Hearing Works 111
✓ How We Develop Hearing Loss 111
✓ How to Find a High-Quality
Seller 117
✓ Hearing Health Resources 117
✓ How It Is Diagnosed 111
✓ Ratings of Area Hearing Centers
for Quality and Price 118
✓ How to Select the Right
Hearing Aid 113
✓ How to Get a Good Price 120
✓ Signs that You May Have
Hearing Loss 113
✓ Illustrative Low, Average,
and High Prices Quoted by
Sellers for Hearing Aids 120
✓ How to Avoid Being Stuck with the
Wrong Aid 116
✓ How to Maximize the Benefits 121
✓ Listening Strategies 121
111
Figure 1
Diagram of the Ear
Middle Ear
Outer Ear
Inner Ear
Bones of the Middle Ear
Audiology from the American Speech-Language-Hearing
Association). In addition to administering hearing tests, audiologists can give complete diagnostic evaluations of hearing
loss. After the hearing tests, audiologists usually help patients
select and purchase hearing aids.
Unlike an audiologist, a “hearing aid specialist” is not required to have a degree in the field of hearing. You can check
to see that a hearing aid specialist has voluntarily been certified by the National Board for Certification in Hearing Instrument Sciences, indicated by the letters BC-HIS. To receive
certification, applicants must have two years of experience
selling hearing aids and pass the National Competency Exam.
The Hearing Test
A complete hearing examination must consist of at least the
following tests: pure tone air conduction test, pure tone bone
Auditory Nerve
conduction test, speech recognition threshold test, and word
(to the Brain)
discrimination test. Additional tests may be given depending
on the examiner and the patient’s specific needs.
Cochlea (Inner Ear)
Eardrum
The pure tone air conduction test determines how well a person
hears at different frequencies, or “pitches.” Hearing
Ear Canal
threshold is determined by presenting tones at different
pitches through headphones or insert earphones and asking
Eustachian Tube
the patient to signal when he or she hears the tone.
The pure tone bone conduction test helps determine the nature of the hearing loss (sensorineural, conductive, or mixed).
During this test, a bone vibrator is placed against the mastoid
approach. For a list of area otolaryngologists who were most
bone, located behind the ear. Again, the patient tells the examoften recommended by their peers in surveys CHECKBOOK
iner the tones he or she is able to hear.
conducted, see CHECKBOOK, Volume 14, No. 2, or visit the
A comparison of the results of the air and bone conduction
“Top Doctors” section of www.checkbook.org.
tests helps localize the hearing mechanism responsible for the
It is important to rule out medical problems that may be
hearing loss. Air and bone conduction thresholds that are the
curable before investing in a hearing aid. Some hearing aid dissame suggest that the hearing loss is sensorineural. If bone
pensers have been known to sell aids to individuals who did
conduction thresholds are better than air conduction threshnot need them or who would have been better served with
other treatments. The U.S. Food and Drug Administration olds then there is reason to suspect the loss is conductive—
that the hearing function is failing in the outer or middle ear,
(FDA) prohibits the sale of a hearing aid to anyone who does
not present a written statement signed by a licensed physician before it reaches the inner ear.
The speech recognition threshold test determines the softest
saying that the patient’s hearing has been evaluated. A hearing
level of sound that can be heard and repeated. Ten to 15 twoaid dispenser may lawfully sell an aid to someone without
syllable words (with equal stress on both syllables) are delivsuch a statement only if the seller has informed the consumer
ered to the listener at progressively softer volumes. The
that getting a medical examination is in the best interest of the
threshold is the softest point at which the patient is able to reconsumer’s health and if the consumer has signed a waiver of
peat words correctly 50 percent of the time. This test is a way
the right to a medical examination. An AARP study conducted
to check the reliability of the pure tone air conduction tests.
in Florida found that dispensers often ignored the FDA reIn the speech discrimination (word recquirement. You’ll be wise not to; before
ognition) test, 25 to 50 words from a
getting a hearing aid, be sure to have a
standardized list are presented to the
physician checkup.
If you suspect that you
patient at a level identified as “comfortIf the physician advises that a hearing
have hearing loss, first
able” for listening. The patient is asked
test is in order to determine the type
to repeat the words. This test assesses a
and degree of your hearing loss and
consult your physician to
patient’s ability to discriminate speech
whether or not you are a candidate for a
determine its cause. It is
at his or her most comfortable level for
hearing aid, an audiologist or a “hearing
listening. The results can provide an inaid specialist” can administer one.
important to rule out
dication of how well a person can be exAn audiologist has extensive training
medical problems that may
pected to understand words when
and usually holds a clinical doctor of auwearing a hearing aid.
diology (AuD) degree but may hold a
be curable before investing
Testing may also be given to deterScD or PhD. Audiologists may also be
in a hearing aid.
mine most comfortable level and uncomidentified with the letters CCC-A (Cerfortable level. These are subjective
tificate of Clinical Competence in
112
Buying Hearing Aids
measures that a listener determines based on the level of
sound intensity that feels comfortably loud or uncomfortably
loud.
Additional testing includes immittance testing, in which a
probe tip is inserted into the ear to measure the eardrum’s mobility and middle ear functions. This test helps rule out conductive hearing loss.
The examiner should also check a patient’s ears to assure
that hearing loss is not due to a physical condition of the ear.
This is especially important in cases where the patient has
waived a medical evaluation. Ears should be checked for visible signs of drainage, blood, wax blockage, or other visible
problems in the ear. The examiner should ask the patient
about dizziness, tinnitus (ringing in the ears or other “head”
sounds), discomfort, and any sudden hearing loss he or she
has experienced.
If you buy a hearing aid, you should have your hearing retested periodically to determine if any adjustments might
help. How often you should have your hearing retested depends on the extent of your hearing loss and other factors;
most hearing aid wearers should be retested at least every
other year, but some may need to be retested every six
months.
The Audiogram
The results of a hearing test are recorded on an audiogram,
a graph showing the patient’s thresholds for hearing sensitivity. Several examples are shown in Figure 2.
The horizontal axis of the graph shows frequency, or pitch,
measured in “Hertz” (Hz). The measurement progresses from
low pitch to high pitch, left to right, like a piano keyboard.
The vertical axis, often labeled “HL” for “hearing level,”
graphs the loudness of the test signal, measured in decibels
(dB). Softer levels are recorded toward the top of the graph
and louder levels at the bottom.
The plots on the audiogram indicate the configuration and
Signs that You May
Have Hearing Loss
If you answer “yes” to some of these questions, it
might be time to get your hearing checked.
• Do I often ask people to repeat themselves? Does it
often seem that people are mumbling?
• Do I often feel tired or stressed during conversations?
• Do I often misunderstand conversations? Do I miss
the point of jokes because I miss too much of the
story?
• Do I turn up the volume on televisions or radios so
that others complain?
• Do I have difficulty understanding speech in noisy
places?
• Do I find that when I look at people I can more easily
understand what they are saying?
www.checkbook.org
degree of the hearing loss. For example, if the markings are
farther down on the graph at higher frequencies, this means
that the patient has more difficulty hearing high-pitched
sounds than low-pitched sounds. This information helps determine what hearing aids will be most appropriate for the patient and also is used later in the programming and
adjustment process.
Levels of Loss
The severity of hearing loss is determined by how loud the
tone needs to be at various pitches for the patient to hear it.
The standard used is:
0 to 15 dB ...........Normal hearing
16 to 25 dB .........Slight hearing loss
26 to 40 dB .........Mild hearing loss
41 to 55 dB .........Moderate hearing loss
56 to 70 dB .........Moderately severe hearing loss
71 to 90 dB .........Severe hearing loss
91 and above ......Profound hearing loss
When hearing is impaired, often some pitches can be heard
better than others. You might have normal or near-normal
hearing for low-pitched sounds but worse hearing loss for
high-pitched sounds. Age-related hearing loss often creates
these types of patterns. Hearing deficiencies with varying degrees of loss are given labels such as “mild-to-moderate loss”
or “moderate-to-severe loss.”
For example, in normal speech, vowel sounds tend to be
stronger in presentation than many consonant sounds. Vowel
sounds also tend to have most of their energy in the lower
pitches (toward the left side of the audiogram). Softer consonant sounds, on the other hand, (such as “s,” “t,” “f,” and “th,”)
tend to be higher pitched sounds (toward the right side of the
audiogram). So if you have mild-to-moderate hearing loss, you
may have little or no difficulty hearing vowel sounds, but may
lack the ability to hear many of the softer consonants, making
it difficult to distinguish between words like “top” and “stop,”
particularly in the presence of background noise. Knowing
these configurations helps in describing—and treating—the
problems patients have.
How to Select the Right Hearing Aid
Hearing aids have three main parts: a microphone that
takes in sound; a circuit that processes and amplifies sound;
and a speaker that conveys sound to the wearer’s ear. All of
these components are powered by a small battery. Almost all
new hearing aids use digital processing technology.
Hearing Aid Styles
Hearing aids vary in shape, size, and how they are worn.
They range from tiny devices that nestle completely in the ear
canal to larger, more visible models that sit behind the ear. Although many technologies can be put into any style, the smallest aids tend to have less power to address severe hearing loss.
The two general categories of hearing aid styles are behindthe-ear (BTE) and in-the-ear (ITE). Within these two
113
categories, there are a number of subcategories.
occupies the entire ear opening to deliver the sound; the two components are
linked by a tube.
A relatively new concept for BTE aids is
“open-fit,” or “open-ear,” models. Like a
traditional BTE model, an open-fit aid is
comprised of components that sit behind
the wearer’s ear, a speaker placed in the
ear opening to deliver sound, and a tube
that connects the behind-the-ear piece to
the speaker. But instead of using an
Behind-the-Ear
As Figure 3 illustrates, a BTE hearing
aid is so named because part of the device—the casing that holds microphone
and circuitry components—sits behind
the ear. A traditional BTE model is comprised of the behind-the-ear component
and a custom-made “earmold” that
Figure 2
Your Audiogram Shows, for Various Pitches,
How Loud a Sound Must Be for You to Hear It
The audiograms below are for different individuals, one with normal hearing
and three with different types of hearing loss. The vertical placements of the
circles and triangles show how loud a sound must be to be heard. The horizontal
placements represent different frequency, or pitch, levels. Most sounds needed to
understand speech are in the 500 to 3000 Hz pitch range.
Normal Hearing
250Hz
500Hz
1000Hz
2000Hz
Sensorineural Hearing Loss
4000Hz
8000Hz
250Hz
500Hz
1000Hz
2000Hz
4000Hz
8000Hz
0 dB
20 dB
40 dB
60 dB
80 dB
100 dB
Conductive Hearing Loss
250Hz
500Hz
1000Hz
2000Hz
Mixed Hearing Loss
4000Hz
8000Hz
250Hz
500Hz
1000Hz
2000Hz
4000Hz
8000Hz
0 dB
20 dB
40 dB
60 dB
80 dB
100 dB
Key:
114
Range of normal hearing
Air Conduction pure tone ! Masked Bone Conduction pure tone
earmold that takes up the entire ear opening, the microphone for an open-fit model
is smaller, leaving the ear opening largely
unobstructed and allowing unaltered
sounds to enter the ear. These models are
particularly useful choices for users who
have good or fairly good hearing in certain pitches, but need help in others. Filling these users’ ears with earmolds would
mean taking away natural sounds that
could be heard without the help of hearing aids—often contributing to a disconcerting, inside-a-barrel sense, called
“occlusion.” Open-fit BTEs allow for a
more normal mixture of amplified and
natural sound and a more comfortable,
less occluded experience for the wearer.
Some open-fit hearing aids simply
guide processed sound into the ear canal through a very thin tube, usually
ending in a rubber tip. Other open-fit
models use a wire instead of a tube, and
contain the speaker (or receiver) at the
end of the wire, in the ear canal. These
aids are referred to as “receiver-in-the-canal” models, and are currently a very
popular hearing aid style.
In-the-Ear
With ITE models, the entire aid is
worn within the ear opening, or even
entirely within the ear canal. Impressions of patients’ ears are made and sent
to the hearing aid manufacturers, and
the aids are custom-molded. As Figure 3
shows, there are several styles of ITE
models, ranging in size from “full-shell,”
which fill the concha (bowl) of the ear,
to “completely-in-the-canal” (CIC)
styles, which are almost completely hidden inside the ear canal. “Half-shell”
styles are a bit smaller than full-shell
styles, and “in-the-canal” (ITC) styles
are a bit larger than CICs.
A new variation of ITE aids is the extended-wear device. This hearing aid is
placed into the ear canal by an audiologist or physician and remains there until
the battery expires two or three months
later or it fails for some other reason. It
is then replaced with a new device. But
not all patients are good candidates for
this option; so if you’re interested in it,
you’ll want to discuss it carefully with
your physician or audiologist.
Choosing a Style
Since ITE aids are smaller than BTE
models, they are popular with patients
Buying Hearing Aids
Figure 3
Hearing Aid Types
Completely-inthe-Canal
In-the-Canal
Half-Shell
Full-Shell
In-the-Ear (ITE) Aids
Full-Shell
BTE
Open-Ear
BTE
Behind-the-Ear (BTE) Aids
Illustrations © Taina Litwak.
who want a less visible hearing aid. But
newer BTE models are now smaller than
they once were, and also because of the
benefits of open-fit technology, BTE
aids are more appealing than before. On
the other hand, some patients still prefer ITE aids because they are compact
and keep everything contained within
the ear.
If you have severe hearing loss, you’ll
likely be buying a BTE style, since ITE
aids can’t deliver the power you’ll need.
Also, BTE aids tend to be more reliable
than ITE models, and BTE aids have
space for larger, easier-to-operate controls.
Regardless of preference, some patients are limited to one selection over
another because of the shape of their
ear openings or because their ears secrete too much wax.
Features to Consider
Most new hearing aids come with a
number of features, some of which used
to come with a hefty price tag. Features
you should expect with even a basic
new model:
www.checkbook.org
• Directional microphones allow hearing
aids to take into account direction
and timing cues for sound reaching
them. This feature helps enhance
speech sounds and reduces noise. It
gives the user control over what gets
amplified by facing the source.
• Automatic volume control provides different levels of “gain” for different inputs. In other words, the hearing aid
can sense the level of the sound
reaching the microphone and adjust
amplification accordingly. Most hearing aids also come with an option
that lets wearers manually control
volume.
• Feedback cancellation reduces the
likelihood of getting that whistling or
squealing sound you may have heard
coming from a hearing aid at some
time. This sound results when a hearing aid re-amplifies sound coming
from its own speaker. More expensive models often have more sophisticated controls for this feature, but
even a modestly priced hearing aid
should have some mechanism for
reducing feedback.
• Multiple processing channels allow a
hearing aid to divide up sound processing into separate frequency regions. This allows for more flexibility
for programming the hearing aid specifically to take into account a user’s
different degrees of hearing loss at
different frequencies. In general, the
more channels, the more advanced
the aid, both in terms of performance
and price. But even fairly low-priced
hearing aids provide processing in at
least a few separate channels, and
often more.
• Telephone coils (T-coils) allow hearing
aid wearers to use a phone without
getting feedback. The coils in the
hearing aid pick up the signal from
the phone in the form of a magnetic
field put out by the phone. This feature now is used with many other
forms of assisted living technologies,
such as TV and audio equipment listening systems. Many ITE models
come with T-coils, and virtually all
BTE models have the feature, but the
smallest hearing aids can’t carry the
feature because of size limitations.
115
• Multiple programs allow the hearing
aid to react to sound differently to accommodate different listening environments. Because no single type of
signal processing is ideal for every listening situation, multiple programs
are like having several hearing aids in
one. Examples of different listening
environments, where the user might
benefit from different programs, are
a noisy restaurant, a meeting, or
watching TV at home. Switching
among programs may be performed
manually by the user or in more advanced aids may be performed automatically.
You might consider buying
via mail order or the
Internet. This purchase
option, however, offers
little of the support you
can get when buying from
a local firm. Most hearing
aid purchases require
several follow-up
appointments before
customers are comfortable
and satisfied with their
new aids.
The more advanced hearing aid features usually mean advanced prices—
the most expensive models can cost
$5,000 or more per hearing aid—so
you’ll want to think carefully about
whether or not the added benefit of special features is worth
the cost. Factors to consider include the severity of your hearing loss and your lifestyle. For example, if you lead a relatively
quiet life and won’t often benefit from an aid that has advanced sound processing, your needs will be different from
someone who regularly attends noisy parties, attends conferences, or has business dinners in restaurants.
Some of the non-basic features available (usually for extra
cost) include—
• Bluetooth connectivity lets the hearing aid receive a
Bluetooth signal. This is nice for cell phone use, of course,
but some manufacturers also offer systems allowing you to
use the Bluetooth signal with a TV or landline phone.
• Remote controls allow wearers manually to adjust volume,
program switching, and other settings using a small remote
rather than having to fiddle with controls on the aid itself.
• Communication between hearing aids is a feature that enables
right- and left-side aids to share information that can optimize hearing response in certain settings. Some hearing
aids use this communication simply to synchronize manual volume adjustments and program changes, so if the
wearer changes a setting on one ear, it will automatically
make the same change to the other.
• CROS adaptation is a system used by persons who have unilateral hearing loss (hearing loss primarily in one ear)
whereby a microphone for the ear with poor hearing sends
sound it receives to the other ear. The idea is that instead of
trying to compensate for hearing loss on one side by amplifying sound on that side, sounds that ear should hear are
delivered largely unchanged to the ear that can hear them.
But this set-up requires patience—and motivation—from the
wearer to get used to a new way of listening.
• Additional features—There are other features available to
make life with hearing aids easier, such as a low battery indicator and a mute feature to reduce feedback during insertion and removal of the aid.
116
One Aid or Two?
If you have hearing loss in both ears,
it is generally considered a good idea to
purchase aids for both ears. Buying two
aids will mean you’ll probably have to
pay twice as much. But the benefits of
two aids are significant: they will improve your balance and safety because
you’ll be more easily able to localize
and differentiate sounds, and they’ll
make it easier for you to understand
speech in noisy environments because
each aid can be used at lower listening
levels.
On the other hand, if most of your
hearing aid use will be in a quiet home
environment and in one-on-one conversation, you may not benefit much by the
extra sound information two aids would
supply and you might reasonably decide to just buy one aid. Some patients
find it difficult to maintain and manage
two hearing aids. Others simply want to minimize the appearance of a handicap, and feel one aid will be less apparent than
two.
There are some uncommon instances where using just one
hearing aid is preferable; for example, if one ear has poor ability to discriminate speech or if one ear has a medical condition
that contraindicates the use of amplification for health
reasons.
How to Avoid Being
Stuck with the Wrong Aid
Most hearing aid purchases go off without a hitch. But
some don’t. It’s not easy to get it right since each patient’s
hearing loss is unique and the expectations of each are different. Even if two patients have the same hearing loss on paper,
their rehabilitative needs may be very different.
Dispensing hearing aids is also difficult because most
hearing aids are custom-molded, so patients can’t try out various makes and models exactly as they would fit in their ears.
But it is possible to try different technologies. Many BTE
models can be fitted with special pliable earpieces and then
set up for tests. The sound quality you get in the test should
be fairly close to what you will get when fitted with your own
device.
Such demonstrations might be helpful in making your selection. But no in-store demonstration will show you what
your experience with a particular technology will be once you
are in real-life listening environments. Too much depends on
your specific hearing loss, and a sample hearing aid will likely
sound different from one that is custom-fitted for you. For this
reason, some audiologists prefer not to perform these demonstrations, and instead rely on the real-life experiences of the
client, making adjustments as necessary. Ultimately, time and
experience with a particular hearing aid may be the only way
to determine how well it works for you.
Buying Hearing Aids
When purchasing a hearing aid, you can take steps to protect yourself from bad choices. There are also laws to protect
you from being locked into a hearing aid purchase that does
not meet your needs.
According to District, Maryland, and Virginia law, you have
30 days after buying a hearing aid to return the aid for a refund. You may, however, still have to pay a portion of the hearing aid costs. That portion varies tremendously from company
to company: some charge nothing; others charge a flat fee of
$50 to $100; others charge a fee equal to 10 percent of the
price of the hearing aid(s). So it is important to ask about refund policies and get a dispenser’s policy in writing.
Some dispensers will extend the 30-day trial period if
more time is needed—it is not unusual for a dispenser to allow 60 or more days for wearers who have special needs or
who have bought particularly complicated hearing aids. Dispensers’ flexibility is generally dependent on their willingness and ability to negotiate with the manufacturer to take
back aids beyond the usual 30 days. If you feel you might
need extra time to decide about an aid, you should ask the
dispenser if an extension is possible and get the dispenser’s
promise in writing.
Hearing aid dispensers usually offer a free adjustment period during which the dispenser will provide assistance after
your purchase. We found that this period varies from seller to
seller, with some giving free adjustments for six months and
others for the life of the aid. If you are buying a hearing aid for
the very first time or trying a new type of aid, be particularly
aware of the dispenser’s policy regarding follow-up
appointments.
Also, find out whether your return period will be extended
if you need to have adjustments made, and get this promise in
writing. You don’t want to lose your right to return an aid simply because you have spent weeks or months trying to get it
adjusted to meet your needs before determining that it just
won’t suit you.
To back up newly purchased aids, most manufacturers provide a minimum warranty of one year. Warranties from some
manufacturers last two years and for some aids the warranty
period is even longer. In most instances, you can buy an extended warranty that keeps the normal warranty in effect for
an extra year.
You can also buy hearing aid insurance to cover an aid for
damage or loss, either as an add-on to a manufacturer’s warranty or as a separate policy. A hearing aid dispenser should
be able to provide information about insurance; check also
with your homeowners insurance carrier, as you may be able
to purchase a personal articles floater for hearing aids as part
of your policy. Before buying any insurance, compare the cost
of it against the price of the aid. Usually, these types of insurance policies aren’t worth their premiums.
With luck and a little effort, you can avoid having to buy
new hearing aids often. One way to expand your hearing aid’s
lifespan is to keep it clean. The industry standard for a hearing
aid’s lifespan is about four years, but it is not uncommon for a
person to use the same hearing aid for much longer than that—
sometimes ten or more years. On the other hand, hanging
onto the same aid for so long may mean missing out opportunities to try new technologies.
www.checkbook.org
How to Find a High-Quality Seller
Two words of advice for those looking for a good place to
purchase a hearing aid: be wary. Because of the “scientific” nature of the purchase, consumers are often vulnerable to misinformation and bad deals.
An AARP study conducted in Florida revealed many
shoddy sales practices. AARP had consumer testers make a total of 169 visits to 23 different hearing aid dispensers. The
study revealed that half of the dispensers in the study failed to
follow the state’s minimum hearing evaluation standards
Hearing Health Resources
AARP
www.aarp.org/health
Academy of Doctors of Audiology
866-493-5544
www.audiologist.org
Alexander Graham Bell Association
for the Deaf and Hard of Hearing
202-337-5220
www.agbell.org
American Academy of Audiology
800-222-2336
www.audiology.org
American Academy of Otolaryngology
703-836-4444
www.entnet.org
American Speech-LanguageHearing Association (ASHA)
800-638-8255
www.asha.org
Better Hearing Institute (BHI)
800-327-9355
www.betterhearing.org
Hearing Industries Association (HIA)
202-449-1090
www.hearing.org
Hearing Loss Association of America (HLAA)
301-657-2248
www.shhh.org
International Hearing Society (IHS)
734-522-7200
www.ihsinfo.org
Lions Club Sight and Hearing Foundation
630-571-5466
www.lionsclubs.org
117
Table 1
Quality of products
Variety of products
Ease of looking at/
testing products
Reliability
Overall quality
Price index score2
75%
78%
76%
60%
66%
84%
77%
$100
For price
Promptness
of service
All-Firm Averages
Advice on choice &
use of products and
(number of ratings)
Hearing
Centers1
For quality
CHECKBOOK’s
top rating (!)
Percent of surveyed customers rating firm “superior” for...
Professional Hearing Services
150 Elden St #235, Herndon, VA
703-707-0002
55%
(13)
69%
64%
56%
38%
67%
46%
$98
Professional Hearing Services
8314 Traford Ln #C, Springfield, VA
703-569-0355
55%
(23)
70%
77%
60%
55%
67%
57%
$105
57%
(45)
56%
44%
31%
43%
68%
49%
—4
—5
301-365-6270
60%
(15)
67%
64%
46%
62%
79%
64%
—4
—5
Sears/Miracle-Ear Center
301-593-9521
11255 New Hampshire Ave, Silver Spring, MD
86%
(14)
71%
36%
31%
50%
79%
62%
—4
—5
Sonus/Alexandria Hearing Center 703-823-3336
4660 Kenmore Ave #409, Alexandria, VA
67%
(24)
71%
74%
67%
56%
82%
63%
$107
Sonus/Arlington Hearing Center
3260 Wilson Blvd, Arlington, VA
703-525-1898
57%
(22)
77%
55%
45%
58%
68%
50%
$96
Sonus/Rockville Hearing Aid Center 301-231-9520
133 Rollins Ave #2, Rockville, MD
63%
(16)
69%
56%
43%
60%
81%
69%
$94
Sonus/The Hearing Center
301-949-8070
10313 Georgia Ave #101A, Silver Spring, MD
76%
(29)
75%
69%
62%
60%
81%
72%
$114
Vienna-Fair Oaks Hearing Service Ctr 703-938-5060
201 Park St SE, Vienna, VA
64%
(33)
69%
58%
43%
39%
67%
63%
$99
Sears/Miracle-Ear Center
All locations combined
Sears/Miracle-Ear Center
7103 Democracy Blvd, Bethesda, MD
FOOTNOTES:
1 See text and page 144 for description of research methods,
dates, and limitations. We’ve included all firms for which we received at least 10 ratings on our customer survey. If a firm is not
listed here, it simply means that we did not have at least 10 ratings
for it; that fact has no negative or positive implications.
2 For each firm, this index is intended to suggest the price a customer might expect to pay for hearing aids that would cost $100 at
the “average” firm. The basis for the index is prices quoted by
firms for some or all of 12 specific models of hearing aids, includ-
before recommending a hearing aid. Of the consumer testers
who had not visited a physician prior to their appointment,
only 14 percent were advised that it was in their best interest
to see a physician before purchasing an aid, despite the federal
law requiring that they be so advised. The consumer testers
complained of being tested in “noisy” rooms in 11 of the 23
sites. In many instances, sellers recommended hearing aids
for persons who did not need them. Overall, dispensers told
57 percent of the consumer testers that they needed a hearing
aid. This compares with the 45 percent judged to need an aid
by the audiologist hired by AARP to evaluate the study participants. Some dispensers recommended aids to as many as 90
percent of the consumer testers.
The Florida study also found many instances of deceptive
sales statements. The most common was the claim that a hearing aid would help slow down hearing loss or ear damage. This
is completely misleading, since hearing aids can only make you
hear better and will have no impact on your natural hearing capacity. The study also found instances of vague pricing policies.
Some dispensers advertised that a hearing aid was on sale, only
to reveal a “sale” price that was the same price that the
www.checkbook.org
ing an audiogram and any fitting costs. Unless otherwise noted,
each score is based on at least three price quotes.
3 Price index score is based on two price quotes.
4 Insufficient data.
5 Insufficient data to determine whether checkmark is warranted.
dispenser always charged for the hearing aid. Others advertised
“free” hearing evaluations, later adding the caveat that the test
was free only if a hearing aid was purchased the same day.
In our own surveys of hearing aid buyers, sellers were for
the most part rated favorably by their customers. But we did
receive several comments that echo the problems cited in
AARP’s study:
• “Very pushy people... Hearing test done in five minutes only,
very amateurish. I did not feel comfortable with recommendations. Also prices are very high.”
• “Attitude of staff seemed more like sales personnel than hearing
specialists. I always felt like I was being sold a product rather
than feeling that they were trying to help me hear better.”
• “Complete used-car sales pitch, taking control of communication to get me to upgrade to a more expensive hearing aid.
When I resisted, she got irritated.”
• “Pushed me into a product which may or may not be the right
product... [O]ffered free hearing test which was perfunctory,
done using a portable desktop unit and not conducted by an audiologist.”
119
Table 2
Illustrative Low, Average, and High Prices
Quoted by Sellers for Hearing Aids1
Description
Low price
Average price
High price
Siemens “PURE” receiver-in-the-canal (RIC)
$1,483
$2,140
$2,850
Widex “MIND 440” behind-the-ear (BTE)
$2,100
$3,076
$3,600
GN ReSound “Dot 20” behind-the-ear (BTE)
$1,640
$2,412
$3,250
Phonak “EXALIA” in-the-ear (ITE)
$2,450
$3,119
$3,895
Oticon “EPOQ-VW” behind-the-ear (BTE)
$2,100
$3,048
$3,600
1 Some prices were rounded to the nearest whole dollar. Prices include the cost of one hearing aid, a hearing exam/audiogram, and
fitting.
• “Over-promised the improvement my
wife would experience with new digital
technology which ultimately showed no
benefit for her.”
• “I didn’t feel that the technician tried to
understand what I was telling her and
she continued to make things worse. I
went back to my 20-year-old aids.”
To help you find advice you can trust,
Table 1 shows how area hearing centers
were rated by CHECKBOOK and Consumer Reports subscribers. On page 144,
we further describe our customer survey and other methods.
When shopping, it is important to
know as much as possible about the
purchase you are about to make, arrive
equipped with good questions, and
shop around.
Check the dispenser’s credentials.
You are assured that the person has had
substantial training and has demonstrated some level of competence if he
or she is a Doctor of Audiology (AuD)
and/or holds a Certificate of Clinical
Competence in Audiology (CCC-A). If
not, look for other evidence of training
and several years of experience.
Check the facilities. The room in
which a hearing test is administered
needs to be quiet. Most hearing test
rooms are not actually “sound proof”
but they are “sound treated.” In order to
block out office noise and increase the
sound absorption of the room, extra
drywall, insulation, and sealant may be
used in the construction of the room.
120
The best way for a hearing center to ensure the room is properly soundproofed
is to install a “sound booth.” There are
companies that specialize in the construction of audiometric testing rooms,
or sound booths, which can be ordered
in a variety of sizes and sound absorption levels and built on-site. While hearing centers can also construct their own
booths or sound-treat existing rooms,
this does not ensure the reliable construction offered by professionally built
booths. It is worth asking about the nature of the testing room used by a facility you might use. While the type of test
room is not a definitive indication of
whether a hearing test will be performed properly or not, the presence of
a professional sound booth at least demonstrates the office is equipped to
obtain the most accurate results.
Make your own judgment about the
quality of advice the staff provides. Do
they seem interested in you? Do they
ask detailed questions about the problems your hearing causes you and the
circumstances in which you would most
benefit from hearing aids? Do they provide a thorough explanation of the testing process and their diagnosis? Do
they present several options? Do they
give easy-to-understand explanations
for any recommendations they make?
Are important choices like buying one
aid versus two discussed in ways you
can understand?
Once your hearing aid has been ordered, make sure it is properly fitted.
You should be concerned if staff simply
asks “how does it sound?” or asks if you
can hear voices from behind you that
are whispered. Such tactics are unscientific and can’t determine how much
you’re benefiting from hearing aids. Instead, the staff should use “real ear”
measurements, a process that monitors
the response of the hearing aid in the
ear canal as adjustments and decisions
about hearing aid settings are made.
This requires special equipment independent of the fitting software and
equipment that are used to program the
hearing aid. Real ear measurement can
use a variety of stimuli to view and manipulate actively the response of the
hearing aid in order to maximize access
to speech and ensure overall listening
comfort. This takes time and expertise,
but is critical because simply programming the hearing aid using the manufacturer’s software cannot adequately
ensure proper hearing aid settings.
The staff can also verify the hearing
aid is working optimally using more traditional testing in the sound booth (by
repeating portions of the hearing test
while the patient wears aids), but the results of such testing provide less specific
information.
Staff should also provide you with a
full orientation on your new aids, showing you how to insert them, work controls, maintain and care for them, store
them, and replace batteries, and should
give you strategies to help you get used
to hearing with them.
The trial period and refund policy
will, of course, be critical, as will the period for you to get free adjustments.
How to Get a Good Price
For some, the costs of buying a hearing aid might not be an important consideration, since some health insurance
policies have coverage for hearing aids.
But most health insurers don’t provide
such coverage, and neit her does
Medicare. So it’s likely that you’ll have to
pay out of your own pocket, probably
from $1,500 to $5,000 or more for a
single hearing aid.
Table 1 will help you find a seller
that’s a good bet on price. The table includes a price index score for each firm.
These scores are intended to show how
Buying Hearing Aids
the firm’s prices quoted to our shoppers
compared to the average prices for the
same aids quoted by all the firms that
quoted on those aids. The scores are
based on prices for a hearing test, fitting,
and one hearing aid. CHECKBOOK’s
shoppers (who did not reveal their affiliation with CHECKBOOK) asked for
prices for 12 hearing aid models. A price
index score of $110 means a firm, on average, quoted prices ten percent higher
than the average of all the firms quoting
on the same models. Price index scores
ranged from a low of $77 to a high of
$125.
The prices quoted for the same aid
varied widely, as you can see on Table 2.
While the price index scores on Table 1 are a helpful starting point, to get
the best price, you will need to shop. We
recommend the following:
• For your hearing test, consider only
businesses that will allow you to
keep a full, written copy of the results.
• Find out how much the provider
charges for hearing testing if you
choose not to buy a hearing aid from
it. Find out if the provider charges for
the test if you don’t keep the written
test results or if you do. But be wary
of businesses that market heavily using “free hearing screening” ads;
these providers usually aren’t in the
business of providing full, evaluative
examinations.
• After the hearing test, get the seller’s
price for the aid it recommends and
get the full specifications for the device. Also get a full description of return privileges and any follow-up
services included.
• Call or visit other firms to get their
prices based on your test results.
Compare prices for the hearing aid
recommended by the testing firm,
but also seek the other firms’ recommendations.
The cost of a hearing test alone will
vary from firm to firm. Many firms
charge nothing, but some charge $100
o r m o re . W h i l e we h e re a t
CHECKBOOK usually adore the word
“free,” in this field it’s not necessarily
the best choice. A free screening may
not be the equivalent of the full evaluation you need to get. Also, be sure that
www.checkbook.org
Listening Strategies
There is only so much that hearing aids can do to improve your ability to
hear. The rest is up to you. There are a number of tactics you should use to
better your chances of hearing well in difficult listening environments. They require considering the sort of situation you will be in and taking the necessary
steps to make it a more listening-friendly environment.
• Lessen background noise. Make sure to create the best listening environment
wherever you go. Loud music and televisions can be turned down if they
are competing with someone for your attention. At restaurants, ask for a
quiet table. At a friend’s house, suggest that the conversation be moved into
another room if kids are playing games nearby. At the office, move away
from the air-conditioning unit when you are trying to have a conversation.
• Find a good spot. Position yourself in a room so that you minimize the distance between yourself and the speaker. When in a group, seat yourself in
the center where you can see and hear everyone. In a large group listening
situation, show up early so you can choose a good position in the room.
• Turn the lights on. To the extent that you can, make sure rooms where you
will be listening are well lit. In rooms with poor lighting, find a bright area
and ask your speaker to stand there.
• Plan ahead. If you know you will be in a particularly difficult listening environment, take some steps beforehand to make sure you won’t be wasting
your time by showing up. You can always call ahead of time and talk to
someone who knows the environment in which you will be. Are there quiet
tables? Is there front row seating available? Will there be a light shining on
the speaker? In a large group listening situation (such as a place of worship
or a concert), call ahead to see if assistive listening devices will be made
available. These devices transmit sound to a special receiver that you wear,
reducing the loss of clarity that occurs when the sound travels a distance
through the air.
• Ask for it. Don’t be afraid to politely but firmly assert your needs. Call out
from the audience for the speaker to talk into the microphone. If unamplified questions are being asked by audience members, ask that the questions
be repeated by the speaker before being answered. If you are in a restaurant
where the music is too loud, ask your waitperson if it is possible to turn the
volume down so that you can better hear your companion. If need be, ask
people to face you head-on when they speak to you. People will appreciate
your candor and your hearing will benefit tremendously.
the “free” firm will not charge a “consultation” or “fitting” fee, thereby negating any real savings. And be aware
that a dispenser that charges nothing
for a test may feel pressure to sell you
something and might not be as flexible
as you would like about giving you a
copy of test results.
In an effort to keep your costs down,
you might consider buying via mail order or the Internet. You can send an
impression of your ear and a recent
audiogram. This purchase option,
however, offers little of the support
you can get when buying from a local
firm. With a local firm, you get to meet
with a specialist before and after your
aid purchase to ensure that your aid
works well. Most hearing aid purchases require several follow-up appointments before customers are
comfortable and satisfied with their
new aids.
How to Maximize
the Benefits
You want to make sure your hearing
aid works properly, that you get the
maximum benefit it has to offer, and
that it lasts a long time.
121
Judging How Well It Works
Once your hearing aid has been
properly fitted and adjusted, it is probably a good idea to hold off on any immediate judgments about how well it
works until you have had some time to
get used to the new sounds you are experiencing. At first, you might want to
wear your aid for short periods of time
or in listening environments that aren’t
taxing. You’ll have to learn to integrate
background noises—such as the hum of
a refrigerator—into the spectrum of
other noises you will process. You may
need to adjust to the sound of your
own voice, which might seem much different when heard through your hearing aid. You may even have to relearn
what certain sounds are that you’ve forgotten.
Once you have given yourself two or
three weeks to adjust to your new aid,
the following might help you determine
whether it is functioning optimally:
• Overall, does the hearing aid seem to
be helping you hear better?
• Does the hearing aid physically feel
comfortable when you wear it?
• Are the sounds that enter your ear
from the aid comfortable? Are soft
sounds audible? Are loud sounds too
loud?
• Have you been able to adjust to any
new sounds you hear from the aid?
Does it seem there is an echo or that
there are hollow or tinny noises?
• Have you been able to insert the aid,
clean it, and deal with battery
changes?
If at this point (or any other time)
you feel the aid is not meeting your reasonable expectations, return to the
122
dispenser. Good sellers will be willing to
help. Minor complaints about sound
quality or fit usually can be resolved easily. More serious complaints may require that a mold be remade or that
sound needs to be delivered to the ear in
a different way—maybe by using a different hearing aid model.
If the dispenser wants to make some
adjustments, get the dispenser to put in
writing that its return period will be extended to allow you time to decide
whether any adjustment makes the aid
acceptable.
If things just aren’t working out and
you are still within the period when you
are allowed to return the aid, decide
whether that is what you want to do.
Caring for Your Aid
Proper care will prolong the life of
your hearing aid and keep it functioning
as it should.
First, avoid damaging your aid. Although they are built to be durable,
hearing aids can be damaged if they are
dropped on a hard surface or become
wet. It is important to remove them
when swimming or showering. Dogs enjoy chewing on hearing aids, so the aids
should always be kept in a secure place
when they are not being used. Aids’
doors for batteries and access to controls should open easily, so if you’re having trouble, don’t force the issue.
Keep your hearing aid clean. Moisture and wax can clog and damage components. If you can, remove your
hearing aid when doing any activity that
causes excessive perspiration. Follow
the seller’s and manufacturer’s directions on how to clean the aid—and make
a habit of actually doing it. Most aids
need to be cleaned every day.
Plan on taking your aid to the seller
periodically for more thorough cleaning
and maintenance. Some aids will need
these tune-ups every three months, others only once per year.
Hearing and Listening Training
Purchasing a hearing aid is one aspect of an overall treatment plan. There
are other steps that can be taken—including hearing and listening training
and counseling—to help integrate
someone with hearing loss into the
hearing world by taking full advantage
of the person’s existing hearing resources. These steps can include learning to use speech reading and other
visual cues, understanding how to position oneself in hard-to-hear situations, and learning how to assert one’s
needs in different hearing environments. Family members can be an integral part of this process.
You may be able to get the needed
services from your hearing specialist,
but there are other sources available.
Community colleges and universities often offer classes in hearing training or
aural rehabilitation. Gallaudet University is a fantastic resource.
You may also want to consider joining a support group for hearing aid
wearers. In addition to providing moral
support, the group can share ideas
about what does and does not work
when wearing an aid. You can contact
the Hearing Loss Association of America (HLA A), a national organization
with local chapter networks, at 301-6572248 for more information about the
national organization and groups in
your area. More information about publications and membership is available at
HLAA’s website (www.shhh.org).
Buying Hearing Aids
How We Gather (and How to Interpret) Our Data
Our tables rating individual firms will be
more valuable to you if you know how the
data were gathered and how they should be
interpreted.
Opinion Surveys
the number of complaints by the best measure we can devise of each firm’s business
volume and exposure to complaints.
There are limitations to the complaint
data. One problem is that some complaints
may be unjustified, simply filed by cranks.
Another problem is that, in some cases, we
didn’t have a measure of business volume
and therefore couldn’t control for differences in firms’ exposure to complaints.
We always recommend that you look for
substantial differences in complaint counts
and rates. We also advise giving little weight
to complaint counts if the total count
against a firm is less than three or four.
Customer survey scores reported on our
tables are from our surveys of Consumer Reports and CHECKBOOK subscribers, conducted via e-mail and regular mail.
Since many firms were rated by rather
small numbers of raters, small differences
between two firms in the percentage of raters who gave a particular rating (say, “superior”) should be ignored. The table below
gives a rough guide to minimum differences you should look for in deciding on
one firm over another.
When using these survey data, remember that the questions are to some degree
subjective and that the differences among
firms might be explained by differences in
the personalities, backgrounds, critical
standards, and other characteristics of the
raters or by biases these raters might have.
To gather much of the other information
on our tables, we surveyed the firms. In
general, our researchers surveyed firms by
phone (sometimes without revealing their
affiliation with CHECKBOOK), but in some
cases, data were collected by mail or from
firms’ websites, or phone responses were
confirmed by mail follow-up.
Complaints
Price Index Scores
Our ratings tables on carpet and rug
cleaners, fence builders, funeral homes,
heating and air-conditioning services, and
window installers show the number of
complaints filed against individual firms
with government offices of consumer affairs in Fairfax, Howard, and Montgomery
counties; the Office of the Attorney General
for the District of Columbia; the Consumer
Protection Division of the Maryland Attorney General’s Office; and the Virginia Office of Consumer Affairs. These complaint
counts are for a two-year period.
Our ratings tables for the topics listed
above also show counts of complaints filed
with the Better Business Bureau of Metropolitan Washington, DC (BBB) for a threeyear period.
On the ratings tables, we calculate complaint rates, where we are able, by dividing
Survey of Firms
To compute our price index scores, we
calculated an average price for each job or
item for all the firms that quoted on that
job or item. Next we compared each firm’s
price to the average. One firm might come
in at 120 percent of the multi-firm average
for a particular job, and another firm might
come in at 90 percent. We took each firm’s
percentage score on each job or item, standardized it, and assigned a weight to each
job or item, based on our judgment. We
then averaged the standardized, weighted
percentage scores to find how the firm
compared to other firms overall. Finally, we
multiplied this overall percentage score by
a flat dollar amount, say, $100.
The price index score, then, is intended
to indicate the relative prices we found for
the firms, adjusted to the base of this flat
dollar amount. These index scores are
If one firm had
this number of
ratings:
And a second
firm had this
number of
ratings:
Do not give much importance to the
difference between the frequency with
which the two firms experience a particular
rating or result unless the difference is at
least this many percentage points:
Assuming the average of
the two firms’ percentages
is 50 percent
10
30
60
120
10
30
60
120
45
26
18
13
Assuming the average of
the two firms’ percentages
is 80 percent
10
30
60
120
10
30
60
120
36
21
15
10
A Rough Guide for
Deciding Whether the
Difference Between
Two Percentages is
Important
144
imperfect for various reasons: for instance,
the jobs or items checked may not be representative; the weighting of various jobs or
items in the index may not accurately reflect typical expenditure patterns; and the
number of jobs or items is small.
Timeliness of the Data
All of the data must be interpreted in
view of timeliness.
Our customer survey data are from surveys conducted from January 2004 to April
2010. Survey respondents were asked to report on experiences in the preceding year.
Our data on complaints for the BBB are
for a three-year period dating back from a
date in November or December 2009. Our
data on complaints for the government offices of consumer affairs are for a two-year
period between September 1, 2007 and August 31, 2009.
The data from our survey of firms were
collected from December 2009 to March
2010 for fence builders and heating and airconditioning services; from January to
March 2010 for window installers; and
from February to March 2010 for carpet
and rug cleaners.
Our price data were collected from July
to December 2009 for heating and air-conditioning services and window installers;
from August 2009 to March 2010 for opticians/optometrists; from September to November 2009 for fence builders; from
October to December 2009 for florists;
from October 2009 to March 2010 for carpet and rug cleaners; from January to
March 2010 for funeral homes; from January to April 2010 for hearing centers; and
from March to April 2010 for tire stores.
For the most part, our tables include firms
for which we collected 10 or more ratings on
our customer survey during the customer
survey period mentioned above, but we do
not report data for periods prior to firms’
changes of name and ownership. As a result,
some large firms are not listed at all. If only
name or ownership changed, we do report
the data. Changes subsequent to the dates
listed above may not be taken into account.
Top Ratings
We give checkmarks to firms that score
highest on a scoring system that we devise
for each service field. Our scoring systems
weight the various data in our tables and
text based on our subjective judgment of
their importance. Since the scores are
based entirely on information presented,
you can apply your own subjective judgments, and decide whether you prefer
firms we have not given checkmarks.
Where we do not have important data on a
firm, we cannot give our checkmark.
How We Gather (and How to Interpret) Our Data