Top Programming Issues and Resolutions_Final

Common Programming Issues & Resolutions
August 21, 2014 Common Programming Issues and Resolutions Hansaton Acoustics As a hearing professional, you encounter the daily challenge of resolving issues presented by your patient. Some issues are due to hearing instruments that are not optimally adjusted, while others are the result of the inexperience or misconceptions of new hearing instrument wearers. This document is intended to provide introductory-­‐level guidance on some of the most common issues and their resolutions using Hansaton instruments and the Hansafit fitting software. Many common complaints can be handled well with the Fitting Assistant, which describes many specific listening situations and issue resolutions. To access the Fitting Assistant, Go to Expert Tuning and find it under Details (Gain and Compression). Find the situation and complaint most similar to your patient’s report. Using this simple tool will often resolve the issue with a couple clicks of the mouse. Although the Fitting Assitant has many detailed issue resolutions, there are a few that seem to come up often enough that we would like to have some easy steps to handle them quickly. The following are our top issues and suggestions for quick fixes. 1 1. “It just doesn’t sound right.” a. Counsel. This is a very common report from first timers and experienced hearing aid wearers using new amplification. Reassure them that time and patience are essential to adjusting to a new sound. b. Repeat First Fit with a different prescriptive formula. If you started with ExpressFit (which we suggest always starting with), changing to NAL-­‐NL1 or NL2 will increase high-­‐
frequency gain. c. Expand dynamic range by i. Increasing gain for high inputs (Express Tuning or Expert Tuning). ii. Decreasing compression ratio (Expert Tuning CR1 or CR2). iii. Setting aid to linear operation (CR=1.0). This option is perhaps best reserved for experienced hearing instrument wearers who have no issues tolerating amplified sound. d. Adjust balance between low and high-­‐frequency gain (Expert Tuning). 2. Speech is not clear. a. Follow detailed instructions in the Fitting Assistant which are customized for specific situations. b. Increase high-­‐frequency gain c. Increase gain in major speech frequency range (500-­‐4000 Hz). You can do this quickly by clicking the Speech bubble on the right. 2 d. Increase Voice Detection feature in the Expert Tuning>Situation Management e. Decrease compression ratio (CR) in Details (Gain and Compression) f. Set aid to linear operation (CR=1.0) (Details window) g. Change fitting formula to NAL-­‐NL2 3. Too sharp or shrill a. Go to the Fitting Assistant and follow detailed instructions. b. Decrease gain at freqs > 3 kHz c. Go to Express Tuning>Tonal Perception. Balance is like a teeter totter. The “moon” increases lows, decreases highs; the “sun” increases highs, decreases lows 4. Too loud in a noisy place a. Go to the Fitting Assistant and follow detailed instructions. b. Increase Noise Reduction. c. Decrease gain for high input levels. 3 d. Decrease max output. e. Decrease gain in the low frequencies. 5. “My voice sounds strange.” a. Follow detailed instructions in the Fitting Assistant. b. Test for occlusion effect. If present, enlarge or step back vent. c. If no true OE, adjust low-­‐freq gain. d. Adjust the freq range of the response slope (transition from low to high frequencies). e. Ensure proper fit 6. Feedback a. Make sure to run Critical Gain in First Fit b. Set Feedback X to premium. 4 c.
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Decrease HF gain Decrease vent diameter Check fit of aid or earmold. Check direction of receiver outlet relative to canal bends. If it is too close to the canal wall, shorten canal portion of the aid or earmold. Far away speech better to understand than nearby speech a. Decrease gain for low input levels b. Increase gain for mid and high input levels c. Decrease compression ratio Unrealistic Expectaitons a. Counseling the patient as well as the patient’s family is very important. b. A useful comparison is comparing hearing loss to vision loss, especially macular degeneration. “I can’t hear well with the television.” a. Encourage use of the miniMedia. Program a memory for transmitter to stream television. “I am hearing too much; things are too loud.” a. Reduce output. Go to the Situation Management tab and adjust MPO b. Raise Compression ratio c. Increase Sound Impulse Management Receivers keep breaking down on X-­‐ minis a. Cerumen management and counsel patient on the importance of clear ears. b. Proactively changing the click domes and the miniReceiver wax guards. 5