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

by | Jan 21, 2019

For musicians with hearing loss, we offer this expert-verified checklist to take to your audiologist to create a better music program on your hearing aids.
Dr_Marshall_Chasin_Customizing_Hearing_Aids

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.

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. 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?

30 Comments

  1. Carol White

    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.

    Reply
    • Nancy M. Williams, Founding Editor

      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!

      Reply
      • Howard

        Hello Nancy. Just quickly following up, one year on! Now I have just been fitted with a more recent pair of Phonaks, the M70. Not quite ‘top end’ and not the latest, but hey, it’s UK National Health or nothing!
        Equipped with the insights of Prof Chasin, Prof Doug Beck, Dr Alinka Greasley… I entered a most constructive dialogue with my new audiologist. She said the standard training has little to do with music, it’s all about speech. She got really involved, asked lots of questions, enjoyed the challenge, and I am deeply grateful to her for restoring very believable hearing. Down to 40, and up to my limit of 4k but not beyond – because that provokes high whistles heard only by others as well as jittery ‘pumping’ on strong musical harmonics.
        She switched off all the fancy stuff – feedback suppression, directionality, multi-band compression etc – in favour of a simple wideband limiting for comfort. Live piano and recorded organ/orchestra/choir is much improved, I can do my job better – and speech also is easier to understand now the full vocal range is available.
        Now that hearing aids can reproduce the lows, one continues to wonder why UK clinical practice still ignores the region below 250Hz. As well as bringing out vocal nuances, it’s three octaves-worth of music!

        Reply
        • Nancy M. Williams, Founding Editor

          Hi Howard, thanks so much for this update! It is great to hear that Dr. Chaisin’s advice here, as well as that of other experts, has made such a difference for you. And I completely agree that the fact that hearing aids ignore the region below 250Hz is problematic. Sonova, Oticon, Signia, Resound, and Starkey, please take note.

          Reply
  2. Carol White

    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.

    Reply
    • Nancy M. Williams, Founding Editor

      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

      Reply
      • Nancy M. Williams, Founding Editor

        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

        Reply
  3. Howard

    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.

    Reply
    • Nancy M. Williams, Founding Editor

      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.

      Reply
  4. Melinda Neeley

    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.

    Reply
    • Dr. Marshall Chasin, Special Contributing Editor

      Hello! Regarding the tinnitus and poorer hearing above 8000 Hz…. I suspect that your tinnitus has little to do with your hearing loss. Just because tinnitus is perceived in the ear does not mean it is from the ear. With your relatively mild hearing loss, I am skeptical that the hearing aids will be of much use as a masker of the tinnitus. Stress is a major cause of tinnitus (and many other bodily dysfunctions as well). Stress is not the amorphous “air-fairy” thing we used to think about in the 1960s. It is relative to a well-defined series of biochemical changes in your body … that may cause tinnitus.

      Here is the short form… when you are stressed, cortisol (a stress hormone) is emitted by your adrenals glands. Cortisol can cross the blood-brain barrier and get into the brain. Once there, it creates higher levels of Glutamate. (You may never heard of Glutamate but its like Serotonin or Dopamine, a neurotransmitter substance that makes the brain and nerves work). Glutamate is the one that is important for hearing. High levels of Glutamate are toxic to the ear and can cause hearing-related symptoms such as tinnitus.

      A referral to a psychologist for stress-reduction strategies may be a great idea.

      Reply
  5. Stuart

    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.

    Reply
    • Dr. Marshall Chasin, Special Contributing Editor

      Hi, Stuart. Regarding the fine tuning for hearing aids that have been optimized for both music and speech…. Since about 2021, questions such as “what is the best hearing aid for music” are no longer valid. All hearing aids in the marketplace have the capability to be optimal for both speech and music. The audiologist will assess you and most importantly measure the result in your ear canal with a small microphone called a “probe tube microphone”. This helps to verify that the hearing aids have been optimized for speech and for music. Some audiologists may use other equipment such as music played through loudspeakers, but that is not as important as using a probe tube microphone to verify the hearing aid fitting.

      Reply
      • Stuart

        Thanls for the comment, Dr. Chasin. I believe the audiologist did use a tube probe mic in setting up my aids. Problem was that they weren’t really knowledgeable about setting up the music program, but thanks to the comments here, I will be well “pre-armed” with enough knowledge to be able to “help” them if needed. Your checklist here will be the main source of info, and I may even purchase your AES (?) paper for my own information.

        For my purposes, I don’t need to be able to stream audio (music) into them, it’s mainly for playing music through my system. I have long used superb headphones from Grado Labs for audio editing and recently bought both their on-ear and in-ear Bluetooth wireless phones, which have no noise-reduction circuitry. Oddly enough, I usually notice my hearing problems to a much lesser extent when listening over these, sometimes barely at all.

        Reply
  6. B Smith

    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.

    Reply
  7. Bob Williams

    I had a hearing test last week and my hearing loss is in the high frequencies like many older adults. My new Signia hearing aids will be fitted and programmed within the next week. I have the option for a “music” program, and I sing regularly in various choral groups. Should my audiologist follow Dr. Chasin’s recommendations for musicians, or are the adjustments to the program different for a singer versus a musician?

    Reply
    • Josef Franek

      Hi Bob,
      My wife has been evaluating the Signia Insio AX5 HAs. She is happy so far with understanding speech, but pretty unhappy with listening to music.
      She asked for, and the audiologist enabled, the Recorded Music program, however, she can’t hear any improvement. We don’t know what to do.
      How are you faring with your HAs? Are the ‘standard’ Signia music programs working for you? I would appreciate to hear your experience.
      My email: jfranek43@gmail.com

      Reply
    • Nancy M. Williams, Founding Editor

      Dear Bob, thank you for your question, and I apologize for the delay in answering. I believe that you should still follow Dr. Chasin’s recommendations. I will reach out to him to confirm. Best, Nancy

      Reply
    • Nancy M. Williams, Founding Editor

      Dear Bob, thanks for writing. I apologize for the delay in getting back to you. I reached out to Dr. Chaisin, and here is his reply: “The settings for vocal music are similar to that of speech but I am not sure that Signia has resolved the front end A/D limiting problem. I can’t get a straight answer from their engineers yet. Even though Signia and Widex are now owned by the same company, I am pretty sure that the two companies have not shared the necessary technologies… at least, not yet. While I do know that the front end of the Widex Moment is rock solid, I am not sure of the Signia.”

      Reply
  8. Ron Spencer

    Hello,
    I am testing out a new pair of state of the art Oticon More hearing aids. They have been wonderful for speech and birdsong, but there is an artifact in musical tones that is annoying. Basically , a pure tone, such as a piano note or a guitar string will be heard as a very rapid stuttering, rather like a subtle tremolo effect at high speed. I think this is because of the delay between the original sound wave’s arrival at the TM combined with the slightly delayed waves that had to travel a longer distance to reach the microphone then processed and transduced and sent to the TM . If this is the cause would it best be addressed with an in ear device? My audiologist indicates that anti-feedback is not engaged. Thank you if you can shed any light on this.

    Reply
    • Jans Smits

      Dear Ron,
      I have the same problem with a pair of Bernafon Viron 3 hearing aids. I guess they have the same hardware as your Oticons because they have both the same mother-company. If I play one note on my (well tuned) piano it sounds with the hearing aids working like it’s a honky tonk piano!
      Dit you find a solution?

      Reply
      • Dr. Marshall Chasin, Special Contributing Editor

        Hi, Jans. Bernafon and Oticon do share some technologies but not all. The same is true of Phonak and Unitron, and I suspect in the not-to-distant-future, so will Sivantos and Widex. However, it does seem to be that the compression circuit is the culprit…. generally for music, follow a “less is better” approach.

        Reply
    • Dr. Marshall Chasin, Special Contributing Editor

      Hi, Ron. Regarding the question about the Oticon More and the tremolo effect…. There are a few things that can cause a hearing aid is quickly alternate and provide an odd vibrating or tremolo effect. One of course is the feedback management system, but this can be disabled in most modern hearing aids and from your audiologist’s comments, this has been done. The digital delay is not a problem- this may have been an issue 5-10 years ago but modern digital delays are on the order of 1-2 msec and not 20-30 msec as in the “olden days”. This sounds more like a compression issue where your audiologist should minimize the amount of compression- making the hearing aid more “linear”. This is one more thing to try and has nothing to do with the brand or model of hearing aid that you are trying out.

      Reply
  9. Ron Spencer

    Jans,
    Not yet. Turning down the hearing aids’ volume reduces the artifact, as one would expect. I think it has something to do with phase canceling or comb filtering between the natural sound waves that bypass the ( open) dome and the processed sound waves from the hearing aid speaker. I’m going to try an occlusive dome sometime, eventually. Streaming audio sounds quite bad with my hearing aids. Airpods (occlusive) are much better, but of course don’t address the high end hearing loss.

    Reply
    • Jans Smits

      Dear Ron,
      I turned the feedback manager off in my Viron 3 hearing aids and the problem was gone. I used the TV/Music template. When I install it it turns the feedback manager on by default so I had to turn the off.
      Regards Jans

      Reply
      • Ron Spencer

        That’s great! I’ll see if I can do the same.
        Thanks so much.

        Reply
  10. Jans Smits

    Dear Ron,
    I had the same hypothesis but it is not true.
    I tried occlusive domes and the artifact is still there.
    When I stream the sound from the microphone from the Iphone there are no attifacts.
    When I stream to the occlusive domes there is a lot of bass. With my open domes there is no bass whatsoever.

    Regards, Jans

    Reply
  11. Jennifer

    Hi and thank you for any guidance you can provide. I was told yesterday by the audiologist that every musician she knows dislikes the Widex hearing aids. That could be because, when I presented her with Dr. Chasin’s hearing aid setting specifications, she didn’t have any previous knowledge of his work. In my preliminary research, the Widex seems to be a good hearing aid for musicians, providing it can be programmed according to Dr. Chasin’s specifications. Am I wrong in thinking that the Widex Moment would be a good bet for me (clarinet and saxophone)? Are there brands I should embrace and brands I should avoid? Thank you again.

    Reply
    • Nancy M. Williams, Founding Editor

      Hi Jennifer, thanks for writing. I’m copying here Dr. Chasin’s reply to a previous post which I hope will address your question: Since about 2021, questions such as “what is the best hearing aid for music” are no longer valid. All hearing aids in the marketplace have the capability to be optimal for both speech and music. The audiologist will assess you and most importantly measure the result in your ear canal with a small microphone called a “probe tube microphone”. This helps to verify that the hearing aids have been optimized for speech and for music. Some audiologists may use other equipment such as music played through loudspeakers, but that is not as important as using a probe tube microphone to verify the hearing aid fitting.

      Reply
  12. Ron

    Jans,
    Regarding the warbling/tremelo artifact…Well, my audiologist says the compression does not engage until a considerable volume or gain threshold is encountered. I guess this is more like a limiter. I can only minimize it by reducing the hearing aids’ volume. It’s tolerable, I guess.
    Regarding the bass.:
    Ultimately, it seems that AirPods give me the best streaming quality, but I have yet to try the occlusive domes. The audiologist did show me how to insert the domes further into the ear canal; this improved the general performance of the device. Subtleties like this and position of the device behind the ear make so much difference. For me it’s an ongoing learning experience! All good, though.

    Reply

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