Lesson 1Clinical resources and evidence summaries from professional bodies (recommendations for REM use)Summarizes guidelines from AAA, ASHA, BSA, and other bodies on verification. Emphasizes evidence for REM, recommended protocols, documentation, and how to integrate best-practice statements into routine clinical workflows.
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 goals and parameters, including attack and release times, channels, and kneepoints. Discusses wide dynamic range compression, speech clarity, and how settings affect 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 aided warble-tone thresholds, aided soundfield testingFocuses on functional verification using aided soundfield tests. Reviews QuickSIN, HINT, warble-tone thresholds, and how to interpret results alongside REM to guide counseling and fine-tuning decisions.
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. Covers test signals, input levels, measurement conditions, and converting between SPL and dB HL to ensure accurate, 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, including REAR and REIG plots, target deviations, and clinical reasoning. Emphasizes clear reporting for medico-legal needs, follow-up, and interprofessional 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 concepts, equipment, and calibration. Covers probe tube placement, reference microphone use, and interpretation of common target curves, including REAR, REIG, and speech mapping displays 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 history, pediatric focus, and loudness normalization. Covers candidacy, target derivation, and handling severe to profound losses, with emphasis on comfort, audibility, and verification considerations in daily clinical 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 safetyDetails MPO concepts, measurement, and clinical adjustment. Reviews output limiting via compression and peak clipping, balancing audibility, sound quality, and safety while preventing loudness discomfort and long-term auditory 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 major hearing aid styles, including BTE, RIC, ITE, CIC, and RITE. Examines cosmetic, acoustic, and handling implications, plus candidacy considerations such as dexterity, ear anatomy, and degree of hearing loss.
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 generates simulated real-ear targets and coupler-based presets. Discusses assumptions, age and venting effects, and why independent REM is still required to confirm individualized 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 hearing aids by signal processing and form factor. Explains analog versus digital, RIC versus RITE terminology, and key programmable features that influence fitting flexibility, verification, and patient outcomes.
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 and NAL-NL2 development, goals, and target derivation. Emphasizes speech intelligibility optimization, loudness equalization, and clinical selection between NAL variants for adults and special populations.
Historical development of NAL formulasSpeech intelligibility and loudness goalsDifferences between NAL-NL1 and NAL-NL2Selecting NAL vs DSL for adultsVerifying NAL fittings with REM
