Do new hearing aid users prefer less low- frequency, high-frequency, or overall gain than experienced users?
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There seems to be a widespread belief among clinicians that new hearing aid users prefer less gain than experienced hearing aid users, and therefore that new users will acclimatize to more gain over time. This belief is reinforced by tools in most proprietary fitting software (variously called Adaptation Managers, Acclimatization Levels, Client Experience Levels, etc.) that allow the clinicianto select reduced gain levels relative to target before the fitting is verified and validated. Intuitively, the assumption that new hearing aid users prefer less gain than experienced hearing aid users may seem reasonable as many clients who are being fitted with a hearing aid for the first time have lost their hearing gradually over a period of years, and therefore have become accustomed to a quieter environment. However, a literature review by Convery et al. (2005) found very little support for gain acclimatization in new hearing aid users. Specifically, data from three studies (Cox & Alexander, 1992; Horwitz & Turner, 1997; Humes et al., 2002), providing gain preferences relative to the NAL-R prescription (Byrne & Dillon, 1986) for 98 new and 77 experienced hearing aid users in total, suggested that the difference in preferred gain between new and experienced users was no more than 2 dB. This difference was not statisticallysignificant nor did it appear to change over a period of up to 12 months. The paper further concluded that no studies have directly investigated this matter with appropriate control of all relevant parameters.