Most Hearing Aids Fail at Clarity… Here’s Why

Added: 2026-05-30

[00:00:00]If you want to make your hearing aids sound as clear as possible, this is how you do it.

[00:00:05]Hey guys, Cliff Olson, Doctor of Audiology and founder of Applied Hearing Solutions in Phoenix, Arizona. And in this video, I'm going to teach you everything that you need to know to maximize the clarity from your hearing aids. I'm just going to come right out and say it. The majority of hearing aids suck at making speech and music clearer, especially if there's background noise involved. However, in most cases, this is not just a hearing aid problem. While hearing aids do have a lot to do with the lack of clarity that you experience, there are numerous things that will impact the amount of clarity that you get from your devices. And I'm going to cover all of them inside of this video.

[00:00:37]But before I do, do me a huge favor, click the like button. It really helps out the channel. And if you are not yet subscribed to the channel with notifications turned on, go ahead and do that as well. It's greatly appreciated.

[00:00:46]And let me know down in the comments section if you feel like your hearing aids are just making everything louder without making it clearer at the same time. The first thing that you need to maximize the clarity that you get from your hearing aids is to ensure that you're adequately amplifying high-frequency speech sounds. In most cases of hearing loss, you start to lose your high-frequency hearing first. This is typically true if your hearing loss is caused by things like age, noise exposure, or chemical exposure. However, it can also occur genetically or from head trauma. When you lose your high frequencies, you start to lose the consonant components of speech, like the K sounds, the SH sounds, the F sounds, the TH sounds, and the S sounds. And these consonant sounds are exactly where you derive all of the clarity from in human speech. While low-frequency speech information can also give you better clarity, low frequencies typically have all of your vowel sounds that give you the perception of volume. Now, the reason why I mentioned that the majority of hearing aids out there suck at restoring clarity in speech is because a lot of hearing aid manufacturer choose to under amplify the high frequencies with their manufacturer first fit settings. And if you do not have access to high-frequency speech information, you are not getting clarity back. But hearing aid manufacturers actually do this intentionally. What they're wanting to do here is under amplify the high frequency sounds, so their hearing aids sound more comfortable and increase first fit acceptance rates. This is because manufacturers also know that the majority of hearing care professionals will not properly counsel their patients to adapt to the high frequency amplification. So, what happens? Well, you end up with hearing aids that sound comfortable, but you end up sacrificing speech clarity from now until forever.

[00:02:21]And all of this just to make sure that you don't return your hearing aids for a refund. So, how do you maximize the clarity of your hearing aids in spite of this? You need to make sure that your hearing care professional is using real ear measurement when programming your hearing aids to verify that you're hitting your high frequency prescriptive targets. Instead of just leaving your hearing aids on the manufacturer first fit settings and asking you, "How does that sound?" If you're able to hit your high frequency prescriptive targets with the amount of amplification from your hearing aids between 6,000 and 8,000 Hz, you're going to restore the vast majority of high frequency speech information, which will help you maximize your clarity. And it's very important that your hearing care professional perform real ear measurement verification for average level speech, loud level speech, and soft level speech. Otherwise, the lack of clarity will continue to be an ongoing issue for you. Now, if you want to learn more about how hearing care professionals optimize the performance of your hearing aids using real ear measurement, I will have this video linked down in the description for you.

[00:03:16]This naturally feeds into the second thing that determines how much clarity that you will get from your hearing aids, which is how good are your hearing aids at amplifying high frequencies.

[00:03:25]When you work with all of the major hearing aid brands, you start to learn all of the strengths and weaknesses of each brand, and the ability to amplify high frequencies is definitely part of that. Some hearing aids claim that they can amplify high frequencies out to 12,000 Hz, and that is never true. Heck, most hearing aids can barely amplify sounds out to 4,000 Hz without running into feedback issues. Just in case you're unaware, feedback occurs when you have sound leaking out of your ears, and it recycles back through the microphones causing a whistling sound. Essentially, if you start to use real ear measurement, you'll learn very quick which hearing aid manufacturers are capable of amplifying for high frequencies and which ones just aren't.

[00:04:03]So, how do you make sure that your hearing aids are actually capable of amplifying high frequencies to your hearing loss prescription? Well, I kind of just gave it away. It's real ear measurement. If you do not measure the amplification levels of a hearing aid inside of your ear canals using real ear measurement, you have no clue if your hearing aids are actually capable of amplifying the high frequencies. I do not care what the hearing aid manufacturer says or what the marketing material say. And if your hearing care professional does run real ear measurement and they're not able to hit your high frequency prescriptive targets, that is a clear sign that you need to switch away from that hearing aid brand. Or, they need to go into the third consideration that will determine how much clarity that you get from your hearing aids, which is should you be using a rubber dome or a custom ear mold. Some hearing care professionals look at domes and ear molds as a black and white issue, meaning that you either need to go with a dome 100% of the time or a custom ear mold 100% of the time in order to maximize clarity of speech.

[00:05:01]Personally, I believe that this depends on the configuration of your hearing loss, the severity of your hearing loss, and the size and shape of your ear canals. Open rubber domes can be great for clarity if you have normal low frequency hearing with a mild to maybe moderate high frequency hearing loss.

[00:05:16]This is because low frequency speech information, can still hear and understand naturally, can enter your ear canals and vibrate your eardrum while you're actually amplifying the high frequencies with the hearing aids. This is because low frequency speech sounds that you can still hear and understand naturally are able to enter into your ear canal unobstructed and then you use the hearing aids to supplement amplification for the mids going into the high frequencies. And as long as you can hit your high frequency prescriptive targets without experiencing feedback, this is a terrific option. However, if you also have some hearing loss in the low and mid frequencies or you have more than a moderate level of high frequency hearing loss, open domes are not going to work very well. In these particular cases, you need to retain more amplification inside of your ear canals.

[00:06:00]And this usually requires using a vented rubber dome or a custom earmold that uses acoustically optimized vents in order to maximize clarity. The first way to identify which one of these would actually be best for you is to run a feedback manager check inside of the hearing aid manufacturer programming software. This is where the hearing aids will create an internally generated sound and measure the amount of leakage that you're having outside of your ear canals that would potentially cause feedback. If the feedback manager shows that you're leaking too much sound outside of your ear canals that would restrict the ability to amplify high frequencies, then you need to use more of a closed-off dome inside of your ear or a earmold that has a smaller vent. I should also mention that if you have a low-frequency hearing loss, there is also speech information in the low frequencies like I mentioned earlier, but in order to amplify low-frequency speech information, you need to have a smaller vent and trap more amplification inside of your ear canals. Open domes just allow low-frequency amplification to leak out of your ears and you never perceive it at all. So, how do you make sure that you're restoring the correct amount of amplification for low, mid, and high-frequency sounds with your hearing aids to get back maximum clarity? You guessed right again, it's real ear measurement. Hopefully at this point you are picking up what I'm putting down. You have to verify the amount of amplification that you're receiving from your hearing aids to make sure that you're restoring clarity. And this is exactly why real ear measurement is a cornerstone of my clinic's Applied 360 Fit process. Applied 360 Fit is our proprietary best practice hearing aid fitting process that ensures that we're able to maximize every aspect of your hearing aid selection, fit, and programming for maximum performance and clarity. This means that if you happen to live in the greater Phoenix area and you want to hear your absolute best, my clinic Applied Hearing Solutions has got you covered. However, if you live too far away from my clinic and you're not going to be able to make it in, make sure that you check out my website hearingup.com and find a Hearing Up Network member in your area. All Hearing Up members have been vetted and are committed to following comprehensive audiologic best practices including real ear measurement so you can get the maximum amount of speech clarity out of your hearing aids. That being said, the fourth thing that will determine how much clarity you get out of your hearing aids is your word recognition score.

[00:08:07]When you receive a professional hearing test, you will be tested on your ability to clearly understand single syllable words that are presented at a fully audible level taking your hearing loss into account. This is called word recognition or discrimination testing.

[00:08:21]This test sounds something like, "Say the word cat." or "Say the word tree."

[00:08:24]These words must be presented in a recorded format for them to be valid. If the person testing you is just speaking them into their microphone and having you repeat them back, then that is not a valid test and you cannot take those scores and make any assumptions off of them. Now, when you hear these words, you have to repeat them back to the person testing you and they're going to score you on whether you got the word correct or whether it was incorrect. And you do not get to cheat on this. There is no visual cues and there's no context for these words. Your word recognition score is a percentage based on how accurate you were at repeating these words back and it ranges anywhere from 0% up to 100% and the higher the score, the better. Now, remember these words are presented at a elevated level to ensure that even if you have a hearing loss that you have access to the speech information when you're performing the test. If you repeat a higher percentage of these words back correctly, then that shows us that you will get a lot of clarity out of your hearing aids in a quiet situation. However, if you repeat a low percentage of these words back correctly, that tells us that even if we do everything perfectly when we're treating your hearing loss with hearing aids, you are still not going to get a ton of clarity out of it. This is because a large part of the ability for you to hear and understand speech clearly has to do with the health of the inner hair cells inside of your cochlea, which is your hearing organ. Now, I am not going to get into the anatomy and physiology of how humans hear. That is an entirely separate video. But, in general, hearing aids are designed to amplify sounds externally to overcome the deterioration of outer hair cells inside of your cochlea, which are your natural ear amplifiers. And hearing aids do a fantastic job of replacing the function of these outer hair cells as long as your hearing aids have been fit and programmed correctly to your hearing loss prescription by your hearing care professional. However, if you also have damage to the inner hair cells inside of the cochlea, these are responsible for receiving the vibrations of sound and converting them into a neural impulse that travels up your auditory nerve to your brain, which means that if you do not have very many inner hair cells left, it doesn't matter how much you amplify the sound, it can never make it up to your brain cleanly. In fact, if you hardly have any inner hair cells left, then your word recognition scores are going to be very, very low, and you may not even be a good candidate for hearing aids at that point. You might actually need to go and get a cochlear implant candidacy evaluation. But, assuming you still have some decent function of your inner hair cells, you then have to consider the fifth thing that will determine how much clarity that you get from your hearing aids, which is your auditory processing abilities. Auditory processing is your brain's ability to actually comprehend what it is that you're hearing quickly and accurately. And it is one variable that is often overlooked when you're trying to optimize the clarity from hearing aids. Humans hear with their brain, not their ears. And even if hearing aids are able to restore access to missing sounds due to a hearing loss, the brain still has to process that information correctly. If you have good auditory processing abilities, then you'll get better clarity from your hearing aids. However, if your brain struggles with auditory processing, you'll get less clarity. This is especially true when it comes to understanding speech in a background noise situation, which is exactly why your hearing care professional should always test your speech in noise. Speech in noise testing is simply a way that we can measure how good you are at separating speech from noise. Several common speech and noise tests include the QuickSIN, the two-minute speech and noise test, and the audible contrast threshold test, otherwise known as the ACT. The goal of each of these tests is very similar. We're just trying to figure out how much separation you need of speech over the background noise for you to understand what someone is saying. Some people need very little separation of speech from background noise, and other people need a lot of separation, and a lot of those individuals have auditory processing issues. In some cases, individuals even have auditory processing disorders, which means that even though they should be receiving a lot of benefit from properly amplified hearing aids, they just can't piece together the information correctly. In these cases, auditory training is often required. The point is, if you're looking to maximize the clarity of speech, music, or any other sound for that matter, it is not as simple as just getting a better pair of hearing aids. Will better hearing aids help when it comes to clarity?

[00:12:22]Absolutely. But, you can see that there's a lot of other variables that go into this as well. Fortunately, most of them are within your control as long as you have a hearing care professional who knows what they're doing.