Lesson 1Clinical resources and evidence summaries from professional bodies (recommendations for REM use)Summarises guidelines from AAA, ASHA, BSA, and other organisations on verification. Stresses evidence for REM, suggested protocols, documentation, and integrating best-practice advice into everyday clinical routines.
Key AAA and ASHA REM recommendationsBSA and international REM guidanceEvidence comparing REM to first-fitBarriers to guideline implementationCommunicating best practice to patientsLesson 2Compression basics: attack/release times, number of channels, kneepoints, wide dynamic range compression rationaleExplains compression aims and settings, including attack and release times, channels, and kneepoints. Discusses wide dynamic range compression, speech clarity, and how adjustments impact comfort, distortion, and verification.
Goals of compression in hearing aidsAttack and release time trade-offsNumber of channels and fine-tuningKneepoints and compression ratiosWDRC and speech audibility benefitsLesson 3Functional verification: aided speech-in-noise testing (QuickSIN, HINT), aided warble-tone thresholds, aided soundfield testingCovers functional verification with aided soundfield tests. Reviews QuickSIN, HINT, warble-tone thresholds, and interpreting results with REM to inform counselling and fine-tuning.
Aided soundfield warble-tone thresholdsQuickSIN setup and score interpretationUsing HINT and similar speech testsRelating functional tests to REM dataCounseling patients using test resultsLesson 4REM protocols: aided response, speech mapping, measurement conditions (soft, conversational, loud inputs) and corrections for SPL vs dB HLDetails REM protocols for aided responses and speech mapping. Includes test signals, input levels, conditions, and converting SPL to dB HL for precise, comparable verification results.
Selecting test signals and stimuliSoft, conversational, and loud inputsAided response vs insertion gain viewsCorrections between SPL and dB HLManaging test–retest variabilityLesson 5Documentation and reporting for verification: recording REAR/REIG, target deviations and clinical decision rulesOutlines best practices for documenting verification, covering REAR and REIG plots, target deviations, and clinical reasoning. Focuses on clear reporting for legal needs, follow-ups, and team communication.
Recording REAR and REIG measurementsDefining acceptable target deviationsNoting MPO and loudness outcomesWriting clear clinical justificationsReporting for referrals and insurersLesson 6Real-ear verification (REM) fundamentals: probe placement, calibration, typical target curves and interpretationIntroduces REM basics, equipment, and calibration. Covers probe tube placement, reference mic use, and reading target curves like REAR, REIG, and speech mapping in clinical software.
REM equipment and signal typesCorrect probe tube placement techniquesCalibration and reference mic controlUnderstanding REAR, REIG, and RECDReading and interpreting target curvesLesson 7Fitting formulas: DSL v5 — principles, pediatric origin, use for severe losses and loudness managementExplores DSL v5 background, child-focused design, and loudness balancing. Covers suitability, target calculation, and managing severe to profound losses, stressing comfort, audibility, and verification in practice.
Historical development and pediatric rationaleLoudness normalization vs equalization conceptsDSL v5 targets for severe and profound lossesManaging loudness discomfort and safetyVerification of DSL fittings with REMLesson 8Maximum power output (MPO) and output limiting strategies for loudness and safetyCovers MPO concepts, measurement, and adjustments. Reviews limiting via compression or peak clipping, balancing audibility, quality, and safety to avoid discomfort and hearing damage.
Defining MPO and its clinical relevanceMeasuring MPO in coupler and real earCompression limiting vs peak clippingSetting MPO for comfort and safetySpecial MPO issues in pediatric fittingsLesson 9Overview of hearing aid styles and form factors (BTE, RIC, ITE, CIC, RITE) and clinical implicationsDescribes main hearing aid styles like BTE, RIC, ITE, CIC, RITE. Examines looks, sound, handling factors, and suitability based on dexterity, ear shape, and hearing loss degree.
BTE and thin-tube fittingsRIC and RITE design considerationsITE, ITC, and CIC custom devicesOpen vs occluded fittings and ventingStyle selection based on patient needsLesson 10Common manufacturer fitting software features that affect verification (real-ear simulated targets, coupler-based presets) and limitationsReviews how manufacturer software creates simulated real-ear targets and coupler presets. Discusses assumptions, age/venting effects, and need for independent REM to verify custom fittings.
First-fit algorithms and default presetsReal-ear simulated targets in softwareCoupler-based fittings and assumptionsImpact of venting and acoustic couplingWhy REM is needed beyond softwareLesson 11Technical classifications: analogue vs digital, receiver-in-canal vs receiver-in-ear, programmable featuresClassifies aids by processing and design. Explains analogue vs digital, RIC vs RITE terms, and programmable features affecting fitting options, verification, and patient results.
Analog vs digital processing basicsBTE, RIC, RITE, ITE, CIC distinctionsTelecoil, wireless, and streaming optionsDirectional microphones and noise reductionData logging and adaptive featuresLesson 12Fitting formulas: NAL-NL1/NL2 — principles, targets, strengths for speech intelligibilityCovers NAL-NL1/NL2 development, aims, and targets. Stresses speech understanding, loudness equalisation, and choosing between variants for adults and special groups.
Historical development of NAL formulasSpeech intelligibility and loudness goalsDifferences between NAL-NL1 and NAL-NL2Selecting NAL vs DSL for adultsVerifying NAL fittings with REM
