An audio engineer, pianist, clarinetist, and bass guitarist, Rick Ledbetter has programmed his hearing aids for music since 2002. With his own digital audio production studio, Rick is especially attuned to musicians’ needs for in-depth hearing aid programming. Hearing aids, by design, prioritize understanding speech and reducing background noise. Music, however, requires more of an unmodified, full range approach, like that of audio production. Musicians want to experience the full, unfiltered dynamic range of instruments and voice. In essence, musicians with hearing loss want music to still sound like music. 

As part of our series on how to program your hearing aids for music, Grand Piano Passion™ is pleased to share Rick Ledbetter‘s expert advice.

Step One: Find An Audiologist who Performs Real-Ear Measurements

What to do at home: Take the time to research an audiologist that is best for your needs. Locate an audiologist that consistently performs real-ear measurements as part of their practice and ideally has experience working with musicians. An audiologist who has high-fidelity speakers in their office is a bonus, as discussed in Step Three below.

What to tell your audiologist: When making the appointment, request that real-ear measurements be performed.

Here’s why: Real ear measurements customize your programming to the shape and acoustics of your specific ear canals. Audiologists appreciate a heads-up when scheduling to allow for ample time for these adjustments to be performed.

Step Two: Request Real-Ear Measurements and Specific Adjustments

What to tell your audiologist: First, perform real-ear measurements on both ears and make in-situ adjustments. Ensure sound processing is off and release time is set to fast or syllabic prior to running real-ear measurements. 

Here’s why: In-situ adjustments, made with the hearing aids in your ears, fine-tune your hearing aid programming to the unique shape of your ear canal. This ensures that the sound delivered to your ear canal matches the programming suited for your specific hearing loss. 

What to tell your audiologist:  Increase the maximum power output (MPO) of frequencies below 500 Hz by about 4dB. In order to allow for such gain in the lower frequencies, you will need to make sure you have a ‘closed fit’, either through domes or earmolds. 

Here’s why: Hearing aids place a strong emphasis on frequencies, or pitches, present in speech (particularly 1000Hz through 4000 Hz in audiologist parlance), yet music requires a far broader range of frequencies. By making lower-pitched sounds louder, you will experience more bass and a fuller sound. Hearing aid domes with holes allow some natural sound to filter through to the ear canal, but these so called ‘open-fit’ hearing aids can also allow lower pitched sounds to leak out, complicating the goal of amplifying the lower pitches.

The solution is to close off the ear canal using a dome that does not have any holes, called a ‘closed fit.’ If you are in an ‘open fit’, ask your audiologist about switching to a ‘closed fit.’

The risk of the closed-fit approach is that your voice may sound louder to yourself, a phenomenon audiologists call ‘occlusion’. Ask your audiologist to work with you to find the right earmold for your desired sound quality. 

Step Three: Test the Setting In Office

What to tell your audiologist: If your audiologist has high fidelity speakers, request to listen to music in the office to check your programming. While recorded music varies slightly from live music due to compression, it will provide a good estimation of the accuracy of your programming. For best results, listen to familiar songs at live music levels to be able to identify potential sound quality issues more easily.  

Here’s why: By immediately testing the programming with familiar music, you can quickly assess if the programming sounds true to your memory or if more adjustments are immediately needed. 

Step Four: Fine-Tune Settings After Testing with a Piano

What to do at home: Prior to your next appointment, sit down at a piano, playing one note at a time. Consider how each pitch sounds, particularly whether some notes are louder or softer than others. Record this information on a “pitch to frequency” chart (free versions may be found on the Internet by searching for “free pitch to frequency chart”). Conduct the same process with chords.

What to tell your audiologist: Share these findings and ask for programming changes accordingly, requesting any changes be made only one step size in gain at a time.

Here’s why: Making micro-programming changes to each specific pitch will assure a more balanced and purer music listening experience. Musicians generally have very sensitive ears and very good critical listening skills. 

Grand Piano Passion™ would like to hear from you. How was your experience in working with your audiologist to implement this checklist?