How do I find an audiologist who is good at programming hearing aids for reverse slope hearing loss?

Barbara Corbett

Professional Member

27 November 2017 - 1.22K Views

Good question. A reverse slope hearing loss is not a typical hearing loss but it does occur more often than you may think. The best way to find the right audiologist is to ask how they program their hearing instruments and how they verify the settings are appropriate. You want someone who uses the manufacturer's suggested settings as a starting point not as the gold standard. You also want an audiologist who uses Real-ear measures to verify their programming is meeting your hearing loss needs. 

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Barbara H. Jenkins

Doctor of Audiology in Centennial

27 November 2017 - 1.22K Views

There is a new hearing aid that just came out two weeks ago that works well for reverse slope hearing loss.  Previously, for low frequency sound waves to be amplified an occluding earmold had to be used to prevent the sounds from escaping.  Unfortunately,  this distorted natural sounds, especially your own voice. 

Go to the audiologist you prefer and have them order the 312 or 13 NX hearing aid from Signia.  I just fit a reverse slope patient two weeks ago and had wonderful success.  She had tried multiple other devices at various settings and this was spot on immediately.  I do not work for Signia and have a private practice with no exclusive contract with any manufacturer.  I order whichever is best for each patient.  It was just wonderful how this worked with no deviations from the first fitting.

If for some reason you cannot get an Nx Singia hearing aid in your area, have your audiologist use a "tulip" or "semi-open" dome in your ear to catch the mid frequencies to help you with speech clarity, while reserving the high-frequencies.  In doing so you will miss a few of the lowest sounds, but since it will sound more natural you are more likely to war them consistently.  It works like a charm in most cases.  Just tell your audiologist not to chase the lowest frequencies, and to focus on enhancing the more mid-frequencies as much as possible.

If you have other questions, reverse slope is one of my expertise.  Just let me know.

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Member 25 September 2018

Hello--I was recently diagnosed with a mild to moderate RSHL.  Fitted with Signia NX hearing aids less than a week ago.  I am experiencing two issues: 1) if I push the domes into my ear canal, I hear a very low frequency buzzing/humming.  If I take them out a little (rest them at the entrance to my ear canal), it goes away.  Not sure what is going on there. 2) As I have read here posted by previous commenters, low frequency noise amplified is actually making it MORE difficult for me to understand speech in noisy situations.  The noise is too amplified and the speech sounds sound muted (almost like voices are under water).  Prior to getting aided I only experienced difficulty hearing some male voices (lower frequency).  I rarely experienced difficulty hearing female or children's voices, even with background noise.  Not sure if these aids, or being aided at all, is right for me.   


Clifford Olson, AuD

Audiologist in Phoenix

27 November 2017 - 1.23K Views

Finding the right audiologist for you can be complicated.  Here is a video I made that can give you some helpful tips on finding that audiologist:

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Raji Parangad

Hearing Healthcare Provider in Wellington Point

27 November 2017 - 1.23K Views

The simplest way to answer the question is if your hearing aid provider solely relies on manufactures software for fitting and programming an aid for a loss predominantly at loss frequencies only this is not going to work. Given that in such losses high frequency hearing is intact we want to preserve high frequency cues. This will not happen if you have an aid which has occluding ear mould or smaller vent.... I am not sure how can you sort list a ' good audiologist'. I'm sure most of them are professionals and do a good job. However, a  reverse slope audiogram is not a  common one to see in clinic every day and the decision  has to be made case by case... Hope this helps

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Christine Pickup, AuD

Doctor of Audiology in Rupert

27 November 2017 - 1.23K Views

The best way to find out is to ask.  Audiology is a diverse field, and some professionals may or may not have encountered patients with reverse slope losses.  Do a search for audiologists in your area, and then call and ask.  If they aren't familiar with the unique way to fit reverse slope, ask them if they are willing to learn.  Most audiologists want to help, and are willing to do what is needed to help their patients hear better.  It is imperative that the professional you encounter can do real ear measurements.  It is also helpful to have a professional who can map cochlear dead regions.  You can find information regarding fitting reverse slope losses HERE and HERE.  

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Sheri Gostomelsky, AuD

Doctor of Audiology in Deerfield

28 November 2017 - 1.21K Views

Fitting hearing aids is an art.  My advice to you is to research providers in your area and interview the top 2 or 3.  Make sure that real ear measurements and or speech mapping are routinely performed. You can have the best technology, but ultimately  the dispensing professional and your relatiomship is the key to your success.  Best of luck.

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Mark Butler, AAS

Hearing Healthcare Provider in Sparks

27 November 2017 - 1.22K Views

Audiologists and hearing aid specialists both fit hearing aids.  The quality of the fitting has a lot to do with the training the dispenser has received.  Many audiology programs spend relatively little time on programming hearing aids whereas the handful of college programs in the country for hearing aid specialists spend a lot more time on the programming aspect.  That being said there can also be big differences from one dispenser to another even if they have both had the same training.  I would look first for someone who has had formal training in fitting.  I would check their reviews online and then specifically ask them about fitting a reverse slope.  If you are purchasing hearing aids from them there should be a trial period and if they cannot please you during that period then return the aids and find someone else.

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Jeffrey Cline

Board Certified Hearing Instrument Specialist in Hickory

29 November 2017 - 1.19K Views

Any hearing instrument specialist or audiologist can providing you with this programming need. We in our practice do this daily. We she reverse slopes often and work with patients having these difficulties just like patients with sloping hearing losses. The hearing loss is easily retreated and can be adjusted with any programmable hearing instrument within minutes. We also go over expectations and discuss benefits alone with limitations. Better hearing is our goal and we meet it almost every time. 

Thank you 

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Member 28 November 2017
Very helpful suggestions! Appreciate the insights.
Member 03 December 2017
I've read that with Reverse Slope, the 500 Hz frequency should NOT be amplified. Thoughts on that?
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