Our speaker was Nicci Maynard. Nicci is a clinical audiologist.  She is a graduate of the University of Vermont; and the University of Massachusetts Amherst where she received her audiology degree (Au D). She did her clinical externship at DHMC, and practiced there for 3 years until she joined the audiology practice at Johnson Audiology in Hanover in 2023.
Nicci Maynard, Au. D.
Nicci shared information about the variety of over the counter (OTC) and prescription hearing aids.
She started her talk by sharing that hearing loss is the 3rd most prevalent health problem. In the United States, 13% of people ages 12 and older have hearing loss in both ears. The rate of disabling hearing loss increases with age, affecting 5% of adults ages 45–54, 10% of adults ages 55–64, 22% of adults ages 65–74, and 55% of adults 75 and older. Hearing loss can be a comorbidity associated with cancer treatments, cardiovascular disease, depression, diabetes, kidney disease and fall.  She sited research that has shown efforts to correct hearing loss with hearing aids can help slow loss of cognition for individuals diagnosed with dementia and Alzheimers.
She described the education to become an audiologist.  Audiologists can be either masters or doctorally prepared.  They are required to have 1,800 hours of clinical work and must pass a PRAXIS exam.  They are educated to cover all age groups, can do diagnostic evaluations, can treat people pre and post surgery, and can help with cochlear implants.  From the State of NH licensing page:
  • Master’s or doctoral degree from a recognized educational institution
  • 350 hours of supervised clinical practicum (for holders of a master’s degree)
  • Nine months postgraduate professional experience
  • Passage of a national exam or valid Certificate of Clinical Competence (CCC) issued by ASHA
Others who can provide hearing aids are Hearing Aid Dealers.  A dealer can fit and sell hearing amplification systems to adult individuals in retail establishments. Test auditory system of hearing-impaired individuals, using test equipment and applying standardized evaluation procedures. Interpret and evaluate auditory test results and confer with hearing-impaired individuals to demonstrate, select, fit, adapt, and modify hearing amplification systems. May replace defective parts or make repairs to hearing amplification systems returned by customers. Education: From the State of NH licensing page”
  • Have an Associate’s degree in any field; have earned 60 credits toward a baccalaureate in any field; or have earned Board Certification by the National Board for Certification in Hearing Instrument Sciences
  • Have taken a training course no longer than six months approved by the National Institute of Hearing Instrument Studies (NIHIS), with home study acceptable; or a training program supervised by a licensed audiologist or registered hearing aid dealer with a minimum of two years’ experience
  • Pass written and practical examinations
There are three types of hearing assistance devices:
Two are over the counter,
  • Amplification Devices.  This is the most basic type, and cost about $200. They do not differentiate between high and low pitch sounds.  They are basically a microphone that have a volume control to sound up and down. Often a person my select these as an entry device when they self determine they have hearing loss.  Often there is NO return policy.
  • Self-fitting and Self-regulating aids that can split both low and high pitch sounds. Most come with an application that needs to be downloaded.  Hearing can be assessed from afar, and then you as an individual can set the aids based on the hearing test done online.  These aids can be satisfactory for mild hearing loss, and for a person who is computer savvy. Frequently, there is NO return policy if you can’t make them work for you.  Make sure you investigate if a return is possible prior to purchase since the cost can be around $1,500.
Prescription Hearing Aids are the third device type and are regulated by the FDA.
  • A formal hearing evaluation must be done prior to being fitted for this type of hearing aid. Prescription hearing aids can be fine tuned by the audiologist to optimally cover a range of pitches. The audiologist can split sounds into 20 different pieces. Prescription hearing aids are required to have a return policy per the FDA.  Always check to see what the return policy is.  In NH, it is 60 days, and in VT it is 45 days. Cost can range from $2,000 to $7,000.
Nicci reminded us that hearing aids will not solve all hearing loss issues.  So set realistic expectations.  If you do get devices, wear them all the time even if you are by yourself. The best results come from using them all the time you are awake.
Insurance coverage will vary greatly from no coverage to some coverage.  If you are a veteran, consider going the VA as they provide coverage at limited cost to the veteran. Call you insurance provider prior to exploring hearing aids and the cost associated with them.
Nicci’s final take away message was that she believes it is important that when you are looking for prescription hearing aids it is important to go to someone who can do Real Ear Measurements (REM).  Only 24 of Audiologists and only 22% of hearing aid dealers are able to do this type of measurement.
Real ear measurement (REM) is a procedure that measures the sound pressure level (SPL( in a patient’s ear canal while they are wearing a hearing aid. It’s also known as hearing aid verification or probe microphone measurement. REM is a crucial part of the hearing aid fitting process because it helps audiologists ensure that a patient’s hearing aid is providing the right level of amplification for their hearing loss