Informing People About Assistive Technology

Based on our market research we estimate that approximately 10% of hearing aid clients are candidates for FM. Of these candidates, many will never try FM. Recent surveys, soon to be published by HLAA have shown that a majority of consumers were never counseled about the need or the availability of FM at the time of hearing aid purchase. 

The case can be made that consumers have an expectation that dispensers let them know about all possible options so they can make an informed decision. Educating clients on assistive technology and successfully addressing all listening needs from the beginning enhances chances to reach maximum satisfaction with amplification.

Prepare Office for Wireless Promotion

• Order hardware/software/product literature needed.
• Have access to a fitting station with PC, printer and internet for ready use of the Phonak fitting software and FM CounselWare
• Review FM pricing
• Have your fitting room set up for real world FM demonstrations (radio, TV, bluetooth cellphone, noise CD, etc)
• Order a selection of FM Demo equipment for use in live FM demonstrations and a Phonak FM Demo Station (for additional information see section “FM Demos”). Special terms may be arranged for dispensers participating in the WirelessTechnologyCenter (WiTC) program.

Training

Consumers will have access to trained dispensers who are certified Wireless Technology Centers (WiTC).

We recommend that Centers appoint two staff members as “wireless technology experts” to become knowledgeable in fitting and counseling of advanced wireless technology. 

When demo FM equipment is received, schedule a half day hands-on staff training event, conducted by a Phonak FM Product Specialist.

The Center may elect to schedule private demo/fitting consultations with the assistance of the Phonak FM Product Specialist. 

Who should participate in an FM System trial?

In the past, the FM candidate was typically a user of BTE hearing instruments, including those using advanced technology instruments featuring directional microphones or noise reduction algorithms, who still reported difficulty or bother when communicating in noisy environments (i.e. restaurants, cars, and social gatherings) or those complaining about persistent feedback.

Today, FM candidacy has broadened to include traditional BTE users and those who wear certain customized (ITE) hearing instruments.  Besides the type of amplification system a candidate uses, there are several personal factors to consider.   

Ideal FM Candidates:

• Experience using hearing instruments or ability to demonstrate device function.
• Report hearing instruments are adequate in quiet situations, but ineffective in noisy environments.
• Have normal cognitive ability.
• Have no physical limitations that might impact using FM system.
• Are motivated to utilize additional equipment in difficult listening situations.

Evaluating your clients and their suitability for FM wireless technology will help guarantee your success in fitting the right hearing instrument solution to each client.

Phonak has created a self assessment tool which contains the most common listening situations as a basis for the CounselWare protocol.

Hearing Benefit Self-Assessment Scale (PDF, 26 kB)

Please enter results of self assessment. Listening situations identified as problem, degree of difficulty. Rating by client how important each problem is on scale of 1-4

(1 = very important, 2 = important, 3 = somewhat important, 4 = not important).

The self assessment achieves three important functions:

1. Measures the client’s degree of satisfaction with traditional amplification.
2. Sets goals that are customized for each client’s communication needs.
3. Measures benefit of FM system from pre-FM to post-FM fitting.

The first step is asking the client to perform a personalized needs assessment.

Clients provide their own self-assessment of hearing difficulty. It measures hearing difficulty in broad categories that are broken down into specific listening situations. Ratings marked as “Always”, Often” and “Sometimes” can likely be improved by using MicroLink FM systems.

In the second step, the self assessment becomes the intake form.

Reviews the results of the survey with the client and establish priorities for the treatment plan.

The responses from the self-assessment scale and intake interview may be used to select and adjust the amplification system.  Furthermore, the information may be used to establish treatment goals and to develop training and counseling protocols.

At the end of the fitting process the self assessment survey should be repeated to measure improvement in hearing benefit.

To qualify candidacy, a variety of additional tools are available. Key factors in selecting a suitable one for your office may be

• Ease of use in clinical settings
• Test/retest reliability

Some of the more popular objective measures that have been used to qualify candidacy include BKB SIN, Quick Sin, SPIN, RSIN, HINT, ANL.

Part of the goals for this study is to provide important information about criteria for candidacy for FM use in adults for two additional tools. We are asking, if possible, for you to provide results of the following:

• Speech recognition performance in quiet and noise as measured through a quick, easy to administer test – NU6 in quiet and in noise (noise version is the WIN test)
• Outcomes of hearing aid use as measured by the International Outcomes Inventory for Hearing Aids (IOI-HA)

Protocol for Speech Recognition Testing

• PURPOSE: We are asking you to administer the NU-6 in quiet and in noise (WIN) to help determine speech recognition performance levels that provide a cut-off for recommendations for FM use. By obtaining these scores and then comparing the outcomes from the trial periods, we believe we can find performance levels that clinicians can use as criteria for a recommendation for FM trial use. These criteria can then be used by clinicians to focus their efforts on patients/clients who are most likely to purchase an FM device.
• Stimuli: NU-6 in quiet AND Word in Noise Test (WIN)
  CD provided to clinical research participating sites

STEPS:

1. Calculate  right ear and left ear PTA (.5, 1, & 2K)
   a. Enter into database
2. IF PTA less than or equal to 40 dB HL
   a. Test word recognition in quiet by administering a 25-word list at 60 dB HL and a second 25-word list at 80 dB HL
   i. Keep track of number of words correct for each list
   ii. Input number of words correct at each level into the database
   b. Test word recognition in noise by administering the 70-word WIN at 70 dB HL (note this takes about 2.5 minutes to complete)
   i. Keep track of number of words correct
   ii. Input number of words correct into the database
3. IFPTA is between 41 and 60 dB HL
   a. Test word recognition in quiet by administering a 25-word list at 70 dB HL and a second 25-word list at 90 dB HL
   i. Keep track of number of words correct for each list
   ii. Input number of words correct at each level into the database
   b. Test word recognition in noise by administering the 70-word WIN at 80 dB HL (note this takes about 2.5 minutes to complete)
   i. Keep track of number of words correct
   ii. Input number of words correct into the database
4. IF PTA 61 dB HL+
   a. Word recognition in quiet
   b. Test word recognition in quiet by administering a 25-word list at 10 dB SL and a second 25-word list at 20 dB HL
   i. Keep track of number of words correct for each list
   ii. Input number of words correct at each level into the databas

International Outcome Inventory for Hearing Aids (IOI-HA)

The IOI-HA covers a minimal set of seven core outcome items which are sufficiently general to apply to many different types of investigations carried out in different countries in the world. The items are practically oriented and comprise a mini-profile more than a scale. It was developed at an international workshop on "Measuring Outcomes in Audiological Rehabilitation Using Hearing Aids" in Eriksholm in Denmark. The IOI-HA was not intended to replace existing outcome measures but to serve as a useful addendum to existing measures in a research context. It might potentially function as a stand alone tool for quality assessment.

The IOI-HA related specifically to hearing aid usage, but may be modified to relate to amplification systems in general.  At the end of the FM trial, the IOI will be administered again and this will relate specifically to hearing aid + FM usage.

International Outcome Inventory for Hearing Aids (IOI-HA)