Client Preferences for Compression Threshold in Single-Channel Wide Dynamic Range Compression Hearing Aids

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Abstract
Objective: Compression in hearing aids can be applied with low compression ratios over a wide range of input levels, but reverts to linear amplification below the compression threshold (CT). In this study, we aimed to determine which of two CTs was preferred by subjects as they used their hearing aids in their own environments, and whether they would prefer to have no low ratio compression at all. Design: Subjects were fitted with a multimemory hearing aid incorporating input controlled compression with a 2:1 compression ratio and output controlled compression limiting. The two memories contained identical programs except that they differed in CT. Sixteen mild to moderately sensorineurally hearing-impaired subjects compared low (≈40 dB SPL) and moderate (≈65 dB SPL) CTs over 2 mo of field trials using hand held remote controls to switch between the alternatives. In a third month's trial, the preferred option (which also included output controlled compression limiting) was compared with compression limiting alone. Results: The higher CT was preferred by 14 of the subjects. The combination of input compression and output compression limiting was preferred to compression limiting alone by 14 of the subjects. Conclusions: Several real world advantages of frequency independent 2:1 compression with a CT of about 65 dB SPL were demonstrated over linear amplification. Extending the compression to much lower input levels appears to carry more disadvantages than advantages, at least for clients with mild and moderate hearing losses, when fitted with single-channel compression aids with a 2:1 compression ratio.