Signia programming

welcome to auditory precision and today I'm gonna go over programming Signia products and with the fake patient that I'm using you can see that it's a pretty common high frequency loss and so the first thing that's gonna be important is again picking my correct dome venting or my venting from a custom and so what I really care about is from 250 to about a hundred and even here because 250 and 500 or so well I would probably still use an open fit or a pretty large event if I was doing a custom the reason for this is that I don't want to give too much attention to low frequencies by occluding the ear because low frequencies being more powerful than highs I'm gonna get an upward masking where I'm really not gonna get the clarity which is usually the big reason that patients are finally ready to get hearing aids so just because they're high frequencies might get severe or even profound I'm really not gonna do any justice or get to them any better by utilizing a bunch of power and a double dome really really venting is super important to get the right sound and so in this case I'm gonna be using an an open fit so in my hearing aid here let me go back here and I'll show you is that you can see that my hearing loss is staying within this grey area if I was to do a high power I'm still encompassing it but I have all of this extra MPO here that could really amplify things to be too loud a standard would still cover it but usually if I'm on the border I prefer to do medium and will sometimes give a little bit more bass than a standard receiver and sometimes it can sound a little bit smoother so that's one of the tricks I like to do as far as utilizing medium when I can now coming here to the fitting before I do any of the first fit I need to make sure that my dome selection is correct okay if I go ahead and do the first fit with the wrong dome selected everything will be off and so once I have that picked correctly it's very important that I do the Institute or direct audiogram whatever the manufacturer calls it because what you're seeing right here is just my insertion gain that I got from my results in the sound booth but that's done with an occluded insert or maybe some old-school headphones now what I'm not taking into consideration is the open ear response where our ear canal will naturally increase two and three thousand Hertz more than everything else and if I go ahead and stick something in their ear whether it be a custom hearing aid or maybe a double dome I'm gonna be flattening that out and causing an occlusion response so I want to actually do another pure tone test with the hearing aids in place and you'll find that it will slightly be off what you got in the sound booth but it's very important to run this because now I have my insertion gain plus my open ear response which will give me my instigate after I run this and again you can see here where my MPO is and so it's not too aggressive even though this will never substitute you putting in your you see OHS which is very important but I definitely don't want all of this space where we'll be over amplifying loud sounds now if I go to my critical gain which is your feedback reduction depending what manufacturer you're using what you're gonna see when this is run here is I'm going to actually see a light red or a light blue buffer and what this is doing is it's basically testing for a slit leak insignias case it does it with static and it wants to see how much sound will be picked up a second time by the microphone causing it to whistle okay and I'm going to show you something interesting in this case is that when I go ahead and I pick my correct fitting formula which I'm always going to use the newest they actually have an ex fit out now if I had a patient who's been wearing very old hearing aids and they preferred that sound I can kind of go back in time and utilize an au NL fitting formula once I recalculate this you can see here that my soft sounds look to be compressed most likely by the hearing aid trying to block any type of whistling so I definitely want to look into that sometimes if you're venting is maybe too aggressive you might see this happening but again this video is just to kind of show you some tricks of the trade when it comes to fitting Signia now over here I can go to my own voice processor which is something unique to Signia and what this is going to try to do is record the patient's voice and take it out of the algorithm and so once I go ahead and I prepare the training I'm gonna get a big record button on my screen and once I click that I want the patient to start counting from twenty to thirty I don't want them yelling but I definitely want them to be pretty enthusiastic so it picks up their voice and I want them to count without spaces in between the numbers like Twenty twenty one twenty two twenty three and by the time they get to thirty you'll see a big green check and then you'll get an orange buffer that will show you what it's taking out and then you can make it more aggressive or less aggressive they'll always start at default but I tend to leave it there it does pretty well now and other manufacturers as far as where you want to start the patient I usually won't start them at a hundred percent I like to treat patients like a rehabilitation process not like here get used to it and wear it I definitely want to do this as a team and so they don't really have an acclamation program so I might just want to turn it down by one but you'll notice that that's a pretty significant change usually don't have to do that as far as turning down volume more than that for it to be comfortable now as far as this goes I usually prefer to use fine-tuning when it comes to playing with loud sounds or soft sounds or even speech in general the one thing I do like about Signia is that I can start to tip it if you see here it's starting to bring up my lower frequencies or bass and tipping the high frequencies this will make it sound smoother but I can also turn it in the other direction which will bring down my lows making things very crisp now there's always a seesaw effect so yes as I bring up higher frequencies things might become more crisp but too much becomes artificial in robotic yes Milo's can bring up some volume and help smooth out sound but too much things will become occluded and so usually I find that patients tend to have a bigger reaction to the higher frequencies because it's new to them and so if I wanted to go into my fine tuning here you're also gonna notice that yes I have all my channels but when I play with everything I'm definitely changing my soft medium and loud sounds so if I wanted to treat them individually I'm going to find that in my compression screen and this is kind of neat Signia has always been bigger on compression ratios than necessarily amplitude or decibels but you can see here my insertion gain of 50 which is soft sound 65 medium sounds and 84 loud sounds if I'm having a problem with maybe somebody at a restaurant or a family gathering that they do often and people talking over one another I might want to go ahead and turn down loud sounds but if they're at a restaurant that they go to often and it's really Forks on a plate or maybe chairs being moved in that might be more of a soft sound so I really want to diagnose what decibel the sounds at so I'm not just encompassing a frequency in general and lowering it or raising it I really want to try to track down where it might be because the more that you take them off of their target lines the more that well you're taking away their hearing loss and the other reason why I was bringing up of them going to these spots often is you really don't want to make a change for just one situation okay obviously there's going to be restaurants that even people without hearing loss have trouble hearing in so again nothing will substitute counseling now like with most manufacturers you're going to notice a feedback I'm sorry a frequency compression where it's going to be moving these higher frequencies to lower frequencies I do keep it on I find that there's other manufacturers that I prefer to have it on usually with Signia I don't again the frequency compression can be helpful if they don't have a complaint with it it's usually something that can be necessary but again if they complain that things sound lispy or that s's are too evident i'm gonna go ahead and want to take that off so moving on to sound management the one thing here is that I usually don't touch any of this unless I absolutely have to because after maybe a couple weeks of wearing the hearing aids we're still running into problems I need to understand that yes directionality is great the more aggressive directionality is the harder it's going to be able to hear people on the side or maybe behind them and also a lot of the times if they're having issues with background noise it could be the placement of the hearing aid a lot of times if the receivers too long and the hearing aid is being worn too far back on the ear they're going to hear things behind them better than they should the other thing is the speech noise management what I have to understand is that hearing aids usually follow a 15 decibel rule where noise has to be 15 decibels louder than speech for this function to work properly if speech and noise are very close together the hearing aid is gonna modulate both and that's gonna take away clarity so I really want to ask myself are they having problems in a restaurant because they're not understanding the person they're having a conversation - I might not want to turn this up but if it's we don't like going to the restaurant because it's so loud I'd rather not even go then I might want but again if I find that I'm touching too much stuff there's probably an issue with my counseling which is actually really nice I can then say that they're having a problem with speech what the problem is and whether it is with female voices and I can apply this you definitely want to also see what they're doing to it so you can teach yourself but other than that I just hope that this was kind of helpful again counseling is the most important and I'll see you on the next one

Channel: Auditory Precision

Views: 5,072

Rating: 4.878788 out of 5

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Id: IXlCDgB2_YE

Length: 12min 35sec (755 seconds)

Published: Sun Dec 22 2019