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HEARING AIDS · INTERACTIVE TOOL
Device Selection Workshop
You can examine nine device types and eleven technologies against the same criteria, from behind-the-ear aids to cochlear implants. Which type is used at which degree of loss, why occlusion appears, when a directional microphone actually helps — you will find it here. The comparison is not made across brands but across how the device works .
For education · it does not recommend brands or models
9 device types
11 technologies
Decision table
Matcher by hearing loss
Glossary
SIDE BY SIDESame loss · different type
RIC / RITEReceiver in the Ear
LossSlight → severe
Visibility
Occlusion
ConnectivityYes
VS
CIC / IICCompletely in the Canal
LossSlight → mild
Visibility
Occlusion
ConnectivityNo
1 Filter→2 Select→3 Compare
This tool does not recommend products
Its purpose is to teach concepts, not to decide which device you should buy.
Educational
No brands or models
What is compared are device types and technologies. Products of specific manufacturers are not compared, ranked or recommended.
It does not replace a clinical assessment
Device selection is made by weighing the audiogram, speech tests, ear anatomy, lifestyle and budget together.
The fitting matters more than the device
A correct prescription (NAL-NL2, DSL v5) and verification with real-ear measurement — that is, the fitting — make more difference than the price segment of the device.
The values are typical ranges
The loss ranges and risks in the table are widely accepted tendencies; they vary with model and fitting.
Device Selection Workshop
Enter the air- and bone-conduction thresholds of both ears, plus UCL values if you have them, then answer the questions about the person and their listening environments. The tool shows which device types come to the fore, why the others are ruled out, which acoustic coupling is appropriate and how much a device could increase access to speech.
It is not a diagnosis or a prescription. It was built to support thinking during the decision process.
Case library14 ready cases — load with one click
Audiogram
Click, drag or press Tab + ↑↓
SRT (speech reception threshold · optional)
Vent / coupling trial
Abbreviations
SSO — pure-tone average (mean of the air-conduction thresholds at 500, 1000, 2000 and 4000 Hz)
HKA — air-bone gap (air-conduction threshold − bone-conduction threshold)
SRT — speech reception threshold (the lowest level at which speech is repeated with 50% accuracy)
SDS — speech discrimination score
UCL — uncomfortable loudness level
NR — no response
MPO — maximum power output of the device
WDRC — wide dynamic range compression
REM — real-ear measurement · RECD — real-ear to coupler difference
Person and environment
Age groupPaediatric and geriatric fittings have rules of their own
Condition of the earWhether the canal can be used directly determines the type
How important is visibility?Going smaller costs power and connectivity
Dexterity and visionTiny batteries and tiny devices make daily use harder
Where do they struggle?You can choose more than one
Is there tinnitus?A tinnitus program on the device may be considered
Keyboard shortcuts
Tab
Move to a frequency on the audiogram
←→
Change frequency
↑↓
Lower / raise the threshold by 5 dB
RL
Right / left ear
HKU
Air / bone / UCL
N
Mark no response
M
Toggle masked-threshold mode
S
Copy the active ear to the other
?
Open / close this card
Esc
Exit full screen
What are the rules based on?
The sources behind the tool
The scoring, the acoustic coupling advice and the target-gain estimates rest on the general principles of the prescription formulas and clinical guidelines below.
NAL-NL2Prescription formula — target gain calculation (National Acoustic Laboratories).
DSL v5Prescription formula used especially in paediatrics (Desired Sensation Level).
AAA Pediatric AmplificationBehind-the-ear aids with custom moulds, RECD and remote microphones in children.
ASHA / BSAAudiometry and masking procedures; classification of the degree of loss.
Katz, Handbook of Clinical AudiologyDevice types, acoustic coupling and the occlusion effect.
!This is an educational approach. A device cannot be selected without audiometric assessment, speech testing and otoscopic examination.
All device types
You can filter the list by degree of loss and by feature. When you tick two or three types, they open side by side below. Suitability is shown against the pure-tone average (500, 1000, 2000 and 4000 Hz); the type of loss, ear anatomy and speech discrimination results can change the picture.
Degree of loss
Type of loss
Suitable Borderline / depends Not suitableYou can select at most 3 types
Type
Loss range
Slight26–40 dB
Mild41–55 dB
Moderate56–70 dB
Severe71–90 dB
Profound91+ dB
Visibility
Occlusion
Handling
You can scroll the table sideways
Note: Bone-conduction devices are selected not by the air-conduction threshold but by the bone-conduction threshold . In non-surgical options (softband/adhesive) sound is attenuated by 10–20 dB crossing the skin, so the limit is tighter (~45 dB); in implanted systems this loss disappears (~55–65 dB). Cochlear implant candidacy, in turn, is decided far less by pure-tone thresholds than by aided speech understanding .
Side-by-side comparison
Technologies
See what the features quoted in brochures actually do, when they really make a difference and where their limits begin.
Directional microphone
Speech in noise
Directional microphone
What it does
Uses the time difference between two microphones to favour sound from the front and reduce sound from the sides and back.
When it helps
The most effective in-device feature: it measurably improves speech understanding in noise.
Its limits
If the talker is behind you it attenuates them as well. Automatic systems can misread the environment. Two microphones do not fit into very small devices (CIC/IIC).
Digital noise reduction
Speech in noise
Digital noise reduction · DNR
What it does
Detects steady, non-speech-like noise and reduces gain in those bands.
When it helps
The most consistent benefit is in listening comfort and reduced listening effort (fatigue); some algorithms and settings have also been reported to help speech understanding.
Its limits
Its contribution to speech understanding is not seen in every condition: the effect depends on the algorithm, the type of noise and the signal-to-noise ratio, and in studies it is often limited. Aggressive settings can also suppress weak speech cues.
Feedback management
Acoustics
Feedback management
What it does
Detects and suppresses the whistle produced when amplified sound leaks back into the microphone.
When it helps
Lets the device deliver more gain in open fittings and at high gain levels.
Its limits
Aggressive settings can create artefacts on tonal sounds such as music; if whistling persists, the answer is a different mould or dome.
Channels and bands
Signal processing
Channels / bands
What it does
Shows how many separate regions of the frequency axis can be adjusted independently.
When it helps
When the audiogram is irregular (steep slopes, notches), more channels allow finer tuning.
Its limits
"More channels = better hearing" is not true. Beyond a certain number no added benefit has been demonstrated; it is often a marketing argument.
Wide dynamic range compression (WDRC)
Signal processing
Wide dynamic range compression
What it does
Amplifies soft sounds more and loud sounds less, fitting the wide world into the narrowed dynamic range of the impaired ear.
When it helps
Because of recruitment it is the basic processing strategy in nearly all sensorineural losses.
Its limits
Fast compression can reduce the natural contrasts of speech.
Frequency lowering
Acoustics
Frequency lowering · compression / transposition
What it does
Moves inaudible high-frequency sounds (e.g. /s/, /sh/) down into a better-heard region.
When it helps
When there is profound high-frequency loss or a cochlear dead region; it makes /s/ audible, especially in children.
Its limits
It can harm sound quality and, if set wrongly, confuse speech sounds. It is not enabled for everyone.
Telecoil
Connectivity
Telecoil
What it does
Switches the microphone off and picks up the magnetic signal of an induction loop directly.
When it helps
Gives noise-free listening in looped halls, places of worship, theatres, counters and compatible telephones.
Its limits
Useless where no loop is installed. It does not fit the smallest devices, and loop infrastructure is limited in Türkiye.
Bluetooth / direct streaming
Connectivity
Streaming
What it does
Streams sound from phone, television and computer straight into the device.
When it helps
Greatly improves the signal-to-noise ratio on phone calls and while watching TV.
Its limits
Increases battery drain; not every protocol works with every phone.
Remote microphone
Speech in noise
Remote microphone · FM / DM
What it does
A microphone clipped to the talker sends their voice straight to the device.
When it helps
The single largest improvement in signal-to-noise ratio in noise and at a distance — classroom, meeting, car.
Its limits
Requires the talker to wear the microphone; it is an extra device and an extra cost.
Rechargeable battery
Everyday use
Rechargeable
What it does
The device sits in a charger overnight; no fiddly battery changes.
When it helps
Makes daily use far easier for users with limited dexterity or vision.
Its limits
If it runs out you cannot swap in a spare; heavy streaming shortens the day; the battery reaches end of life after a few years.
Tinnitus masker
Everyday use
Tinnitus masker
What it does
The device generates a soft background sound (noise or nature sound) that helps mask tinnitus.
When it helps
Combined with counselling, it can bring relief in users with tinnitus.
Its limits
It is not a treatment on its own; most of the benefit usually comes from amplifying the loss itself.
For clinicians and students
The list on the left sets out the principles most often overlooked in device selection; the flow on the right shows how the tool can be used in class.
Core principles of device selection
Expectations must be realistic: What helps most in noise is not the price segment of the device but the signal-to-noise ratio. Moving closer to the talker, or using a remote microphone, makes more difference than most in-device features.
The trade-off between gain and concessions: To gain one property you give up another: as the device shrinks it becomes less visible, but gain, occlusion control and connectivity all fall back. Putting a CIC next to a BTE turns that balance into numbers.
Acoustic coupling comes before the brand: Dome or mould, how many millimetres of vent — this is the variable that decides satisfaction. The vent trial shows how low-frequency gain melts away.
A fitting is verified by measurement: Whether the prescription target has been met can only be seen with real-ear measurement (REM); a person saying "I hear well" is not verification.
A bilateral loss needs bilateral devices: Overcoming the head shadow, binaural summation and localisation cannot be achieved with a unilateral device; the unaided ear also risks auditory deprivation.
Using it in class
Warm-up
Give the students the same audiogram, run the matcher and discuss the types it puts forward.
Balance
Have them place a CIC next to a BTE and defend what is given up for what in terms of gain, occlusion and connectivity.
Case
Give them a child with aural atresia: why bone conduction, why not an in-the-canal device?
Debate
"Do more channels mean better hearing?" — have them read the limits on the technology card and argue it out.
Glossary
Short definitions of the concepts used on this page and in the comparison tables.
The arithmetic mean of the air-conduction thresholds at 500, 1000, 2000 and 4000 Hz. The degree of loss is classified from this value, and the tool's scoring, power class and coupling advice all build on it. Frequencies with no response enter the average at just above the equipment limit, so in audiograms containing NR the PTA can look more optimistic than the true loss.
Classification by pure-tone average: 0–25 dB normal, 26–40 dB slight, 41–55 dB mild, 56–70 dB moderate, 71–90 dB severe, 91 dB and above profound hearing loss.
Found by subtracting the bone-conduction threshold from the air-conduction threshold at the same frequency. A gap above 10 dB indicates a conductive component; it is the tool's main criterion for deciding the type of loss.
The whole process of selecting the device for the person, programming it with a prescription formula based on the audiogram (NAL-NL2, DSL v5), adapting it to the acoustics of the ear (dome/mould, vent) and verifying it with real-ear measurement. The outcome is decided by this process far more than by the device itself.
Your own voice sounding boomy and blocked when the ear canal is closed. The more the canal is closed the stronger it gets; opening a vent or using an open dome reduces it.
The hole in a mould or dome. It lets low frequencies escape and so reduces occlusion, but it also leaks gain and increases the risk of whistling.
A soft, non-custom silicone tip that sits in the canal. It comes as open, semi-open and closed, and it directly determines the acoustics.
A custom piece made from an impression of the ear. At high gain a good seal is needed to prevent whistling.
The level (dB) the device adds to sound. Prescription formulas (NAL-NL2, DSL v5) set a target gain frequency by frequency according to the loss.
Measuring how much gain the device really delivers in the ear, with a thin probe microphone placed in the canal. It is the gold standard for verifying a fitting.
Real-ear to coupler difference. Especially in children, whose ear volume is small, it allows the output of the device to be estimated correctly.
In sensorineural loss, soft sounds become inaudible while loud sounds become more uncomfortable than normal. The dynamic range narrows, which is why compression (WDRC) is needed.
A region of the inner ear where the hair cells serving certain frequencies have lost their function. Amplifying that frequency brings no benefit; frequency lowering comes onto the agenda.
How far speech rises above the noise. People with hearing loss need a few dB better SNR than normal hearers for the same intelligibility; a remote microphone improves it the most.
Price mostly buys extra features (number of channels, automatic programs, wireless streaming); basic gain and intelligibility are decided by prescribing correctly and verifying in the ear (REM). A well-fitted mid-range device outperforms a poorly fitted premium one.
No. Completely-in-the-canal devices (CIC/IIC) are limited in power and are generally used in slight-to-mild losses. Because they close the canal completely, occlusion is felt most here; their tiny batteries and lack of wireless features are further concessions.
If both ears are impaired, bilateral devices are the rule: localisation, separation in noise and sound quality are meaningfully better with two ears, and the unaided ear can develop auditory deprivation over time. If the loss really is unilateral, CROS/BiCROS, bone-conduction devices or, in suitable candidates, a cochlear implant come onto the agenda.
A hearing aid makes sound louder, but it cannot restore the frequency and timing resolution of a damaged inner ear. What helps most in noise is improving the signal-to-noise ratio: directional microphones, a remote microphone, sitting close to the talker, quietening the room.
No. A properly fitted device does not make hearing worse. On the contrary, an unstimulated auditory pathway can develop auditory deprivation over time, so delaying amplification is usually harmful.
If dexterity or vision is limited, a rechargeable device makes daily use far easier. On the other hand you cannot swap in a spare when it runs out, heavy Bluetooth use shortens the day, and the battery must be replaced after a few years.
In people with good low-frequency hearing an open dome prevents occlusion and keeps sound natural. As the loss grows, a more closed acoustic — ultimately a custom mould — is needed to deliver enough gain without whistling.
For nearly all of your waking hours. The brain needs weeks to adapt to the new acoustic input (acclimatisation); wearing the device only "when needed" delays that adaptation.
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