Dr. Chasin’s Checklist for Optimizing Your Hearing Aids for Music

Guidelines for Musicians with Hearing Loss to Bring to Their Audiologists

The music programs in the major manufacturers’ hearing aids are often “poorly thought out,” with “very little effort and research” put into them, declares Dr. Marshall Chasin, a Toronto-based researcher and audiologist who specializes in musicians with hearing loss.

In this first article of our new series on how to customize your hearing aids for playing and performing music, GRAND PIANO PASSION™ is pleased to offer this collaboration with Dr. Chasin: his comprehensive checklist to bring to your audiologist to create a music program suited to you and your hearing aids.

Music programs generally do not take into account musicians’ needs to hear unadulterated sound across the full frequency spectrum because hearing aids are optimized for listening to speech. “In speech, you can miss certain things, you can fill in the blanks,” explains Dr. Chasin. “But with music, we have to actually hear everything. So, we need hearing aids that replicate music precisely.”

Interestingly, Dr. Chasin thinks, “It’s best that the audiologist you see does not play any musical instruments. The moment you start playing a musical instrument you have these preconceived ideas and notions. It’s better if you go to an audiologist who just understands the technical differences between music and speech.”

Dr. Chasin’s Checklist for Your Audiologist to Create a True Music Program on Your Hearing Aids

Start with Post-16-Bit Architecture

What to tell your audiologist: First, be sure to select hearing aids that have 20-bit or 24-bit architecture to allow for a higher input level. Then start with the optimal “speech-in-quiet” program for the patient and make adjustments from there to create a custom music program.

Here’s why: In some hearing aids, all sounds can’t necessarily get into the hearing aid for processing because the old industry standard 16-bit systems have a maximum input level of 96 decibels. Music can be louder than speech with more dynamic peaks, so louder elements would be clipped or distorted. Many newer hearing aids do not have this problem, but it’s important to make sure you’re starting with an appropriate model.

Dial Down Compression

What to tell your audiologist: A low compression ratio of 1.7 to 1 (or a maximum of 2 to 1) is best for music.

Here’s why: The compression ratio represents the change in loudness that comes into the hearing aid versus the change in loudness that goes out of the hearing aid and into your ear. Too much compression essentially overprocesses the sound, causing music to sound dull and lacking in dynamics.

Turn Off Noise Reduction

What to tell your audiologist: Disable the noise reduction system for the music program.

Here’s why: The noise reduction system is designed to reduce the sound of the microphone inside your own hearing aid, but this feature sometimes has detrimental effects when used for music.

Turn Off Feedback Management Circuit

What to tell your audiologist: Disable the feedback management circuit when setting up the music program.

Here’s why: The feedback management circuit is designed to prevent you from hearing the squeal of your own hearing aid. But sometimes it can’t distinguish between the whistling of your hearing aid and a harmonic or a musical instrument.

Turn Off Frequency Shifting

What to tell your audiologist: Disable any frequency shifting or frequency transposition for the music program.

Here’s why: Frequency transposition customizes sounds to your particular audiogram by moving some tones to a lower frequency. It can help a lot when listening to speech—but for music, it means your hearing aids can actually change the notes and octaves on you if this feature is turned on!

Should your audiologist have additional questions, Dr. Chasin refers them to this article for practitioners.

We’d like to hear from you. How was your experience in working with your audiologist to implement this checklist?

Copyright © 2018 Nancy M. Williams. All Rights Reserved.


  1. I am a piano teacher with hearing loss, and experienced a sudden onset of more serious loss just 2 years ago. I made a change to Oticon hearing aids last summer, but am still having trouble with what I am hearing. I took your article to my audiologist and he confirmed that he is configuring as you stated in your article. I have a special setting for music, but I still have some buzzing and feedback when I play. I also have trouble hearing inner voices of chords and sometimes half-steps are not clear. Is this all my new normal? It has really been tough to teach upper level repertoire at times, because of the difficulty in hearing the quick changes and subtleties of the music. Any advice you can give, for myself or for my audiologist, would be greatly appreciated.

    • Hi Carol, thanks for writing, and I’m glad to hear that your audiologist created a setting based on Dr. Chasin’s advice. I’m not an audiologist, but if I were in your shoes, I would go back to my audiologist for additional programming if I still heard buzzing and feedback while playing. If your audiologist feels that he has done all he can, Dr. Chasin is available to fellow audiologists who have additional questions after implementing his recommendations. Hope this helps, and great to hear that you teach!

  2. Hi Nancy, Thank you so much for your reply. I made a follow-up appointment with my audiologist. I have another question for you. Is there something he and I need to focus on so I can hear ½ steps more clearly? I have the most trouble in the lower middle register of the piano.

    • Hi Carol, glad to hear that you made a follow-up appointment with your audiologist. I don’t know the answer to your question, so I forwarded it to Dr. Chasin. More soon, I hope. Best, Nancy

      • Carol, I’m passing along this message from Dr. Chasin: “I would suggest that she ask her audiologist specifically about this- that’s something that is easily adjusted. Her hearing aid just needs a larger vent.” Good luck with your appointment with your audiologist. Best, Nancy

  3. My excellent NHS (UK) audiologist is keen on music and really wants to help me, as it is part of my work.
    However, fitted with a pair of more recent BTE aids, I was dismayed by the over-processed, warbling sound. Switching to a Music setting (yes I did have to ask) only partially remediated the awful noise, and of course in quiet speech without a whistle-blocker there was squealing.
    Ten year old Phonaks (minus pitch shift, minus feedback blocking) continue to do a reasonable job for me, dynamics are contained but not squashed, piano is believable and playable, and when I’m listening to organ, partial dislodging of moulds lets in the bass. An open/shut vent might be good!
    But how can musical needs be met, or manufacturers respond better to needs, when standard testing stops at 250 Hz? Even speech is for some people more intelligible with a fuller low-end. Male speech goes down to about 75.

    • Thank you for writing! It’s interesting that your ten-year-old hearing aids are producing a better sound on the piano and even to some extent on the organ than today’s models. It’s so true that hearing aids do not amplify the full range of the piano keyboard, especially as you point out, on the low end. A big problem for musicians, and an opportunity for the hearing aid companies.

  4. Hello! I am not a musician, but I do love music and my son is a musician. I have mild high frequency hearing loss that doesn’t affect my ability to hear speech, as well as severe tinnitus. I truly suspect my high frequency loss is at higher frequencies than what the standard heading test looks for (a loss higher than 8000 Hz), and this “silent” hearing loss is what causes most of my tinnitus. (I’ve taken YouTube hearing tests that show I can’t hear frequencies above about 9000 Hz.) Can the optimization Dr. Chasin speaks of here help my tinnitus? I believe my brain is reaching for these lost frequencies and making this terrible chatter. I have HAs but mostly for the masking sounds, which haven’t been effective.

  5. jJust acame across this as I am a retired musician (classical recording engineer & singer, if that matters) who has been wearing hearing aids for a couple of years now. They’re “OK” for music, but even fiddling with the Music program has only improved things a little. In a year or so I am thinkin of upgrading to proper musicians’ aids, with their wider frequency response, better mics and electronics etc. I have a fair bit of HF loss in both ears and approx. 15dB overall level loss in the right ear.

    I presume that proper setup of musicians’ aids would require the use of at least a reasonably decent set of small speakers in the audioologist’s office that I can play selected tracks on so I can assess the adjustments? I’d imagine the EQ would be very difficult to adjust successfully purely based on my verbal description of what I hear.

  6. The warble is due to an inappropriate feedback algorithm. All brands of aids that I tried have it. When the aid detects a steady tone, it interprets it as feedback and attempts to eliminate it by phase inversion or phase shift or other similar algorithm. If it’s actually feedback, the feedback stops. BUT if it’s the sound of an instrument being played (or other steady sound like a bell, etc), it does not stop. The aid’s attempts to eliminate such a persistent sound by shift/inversion methods interacts with the persistent sound and produces a warble. The only solution is to turn off the feedback control. BUT on most aids the feedback control can not be turned off independently of other digitial signal processing (DSP), so the only solution is to turn off all DSP. It’s a pain to manually switch programs when listening to music vs listening to conversation. To control feedback with DSP off, there are some strategies including (1) reducing the volume and (2) using earpieces with more occultation. This works. Since most feedback is above 5000 Hz and most instrumental sounds are below 3000 Hz, a good approach might be to set up the anti-feedback with a programmable (or fixed) cutoff frequency. BUT manufacturers apparently decided to do this, for some reason. Also, most aids do not allow the aid to boot/start up in a non-DSP mode. I guess the manufacturers don’t trust audi’s and/or customers to handle that feature properly. Finally, there might be a way to use forward and reverse directional mic’s available on some aids to determine if the feedback/instrumental sound is being generated within the aid (feedback) or outside (instrument). The above applies to all brands that I tried.

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