Importance of Loudness Perception in Hearing Aid Programming

Hello.

Loudness is a physical property of sound and it is subjectively perceived by people. The concepts of loudness and intensity are often confused, but a sound of the same intensity can be perceived at different levels of loudness by different people. Studies have shown that loudness perception is not influenced by physical changes in the stimulus, such as frequency or intensity. For example, when we double the intensity of a sound, we should not expect the perception of loudness to also double.

In the programming of hearing aids, sometimes the intensity of the hearing aids can be raised unnecessarily high due to a lack of stock in the device or the expert not providing proper guidance, or because older device users (especially those with a history of using analog devices or sound amplifiers) expect high intensity sound. This unnecessary increase in intensity can ruin the perception of loudness for young and new device users and negatively affect their future device experiences. For example, applying a super powerful hearing aid to a person with moderate hearing loss can ruin their perception of loudness and also fail to provide the expected performance of the hearing aid if the hearing loss progresses over time.

When I talk about my own device applications, I try to meet the user on common ground based on the information I mentioned above, especially with first-time device users. With older device users, even if I adjust the sound intensity sufficiently on a frequency basis, I sometimes cannot achieve satisfaction due to the damaged perception of loudness caused by long-term exposure to high intensity sound. In these cases, unfortunately, I sometimes have to increase the intensity more than necessary.

While we are on the subject, I would also like to mention sound amplifiers, which was a term I never encountered during my license training. When I entered the industry, it was common for people to use illegal sound amplifiers because of their economic advantages. However, these amplifiers, which provide high intensity sound without providing any frequency-based adjustments, can cause serious damage to hearing. I always recommend my patients to use hearing aids, which provide both intensity and frequency-based adjustments and protect their hearing.

Thank you for reading. I am open to your suggestions and recommendations on the subject.