Variation in preferred gain with experience for hearing-aid users

This study aimed to determine whether gain adaptation occurs, and at which frequency bands, among new hearing aid (HA) users. Fifty new and 26 experienced HA users were fitted with three listening programs (NAL-NL1 and NAL-NL1 with low- and high-frequency cuts) in the same hearing instrument family. Real-life gain preferences and comfortable loudness levels were measured one, four, and 13 months post-fitting for the new HA users, and one month post-fitting for the experienced HA users. Relative to experienced HA users, new HA users preferred progressively less overall gain than prescribed as the hearing loss became more severe. Gain adaptation occurred in new HA users with greater hearing loss, but was not complete 13 months post-fitting, and was not explained by changes in loudness perception. Preferences for a high-frequency gain cut by half of all study participants could not be predicted from audiological data. Gain adaptation management is recommended for new HA users with more than a mild hearing loss.