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An approach to personalizing hearing aid fittings to better reflect the natural range of perceptual variation and sound processing preferences has been available since January, 2013. The Oticon Podcast program is a bi-weekly program of short videos covering advanced fitting information and strategies. The "rules" and assumptions applied when fitting a child with mild to moderate hearing loss may not apply when working with a child who has a severe to profound hearing loss.
Effective speech understanding, especially in complex environments, requires both a well-functioning auditory system and a cognitive system that can efficiently and accurately process information. In this course, we will dig deeper into this fitting approach to (1) clarify the need, purpose and advantages, (2) report on emerging data to show how this approach is being applied by audiologists and the effects on patient satisfaction, and (3) to review some of the most important implementation details in order to clarify the appropriate application of this approach. In this course, four editions of the video podcast program have been selected to present together as they all relate to the general challenge of finding the best individualized solution for patient.
However, in the area of hearing aid fittings, our knowledge base on how to treat patients with a variety of atypical profiles is limited. Our older patients can be challenged on both fronts: sensorineural hearing loss can significantly degrade the quality of the information that is fed to the central auditory system but natural, age-related declines in the efficiency of information processing can further limit how well the listener can decode the message.

Case examples will be used along with survey data to highlight the unique role that this approach can play in the modern fitting process. Modern hearing aid technology offers so much flexibility that we do not have to settle for one-size-fits-all solutions.
Attempts at applying standard fitting protocols often will not lead to a satisfactory solution.
This seminar will focus on a summary of the research on the cognitive nature of speech understanding in light of the extra pressure that is exerted when hearing loss corrupts the information that is passed along from the periphery. This presentation will focus on the fitting tools that are designed to make sure that the settings of the devices are best in keeping with the hearing and processing abilities that each individual patient brings to the task. Case examples will be presented in the final section to demonstrate how all of the principles can be applied in practice. Our opinions as to how to achieve satisfactory fittings for first time users, patients with ski-slope losses, low-frequency losses, severe losses, medically complex losses and asymmetrical losses will be shared. In general, we advocate the concept of residual capabilities: the fitting should be viewed in terms of the remaining capabilities that the patient presents.

Rather, it is about finding the optimal combination of signal processing that allows the patient to get the most from the incoming signal. Often, what it takes to allow the best access to information may not be what is called for by traditional fitting approaches.
Dragon Naturally Speaking interpretation (blue) when played recorded HINT sentences at a +5 dB signal-to-noise ratio.Figure 18. Speaking clearly for the hard of hearing I (why is this here?): intelligibility differences between clear and conversational speech.

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