The Relationship Between Acceptable Noise Levels and Hearing Aid Success Measured Using a Multi-Dimensional Approach

The ability to predict hearing aid success prior to purchase is desired by the hearing healthcare community and consumers. Poor success with hearing aids can occur for several reasons, but the primary reason is difficulty understanding speech in noisy environments. The acceptable noise level (ANL) test measures a person\u27s acceptance of background noise and has been proposed to predict hearing aid success. However, little research has been done to substantiate the claim that ANL scores are predictive of hearing aid success. The purpose of this study was to investigate the association between ANL scores and hearing aid success, when hearing aid success was defined using a multi-dimensional approach.No universal description of hearing aid success has been published, but extensive literature reviews find a variety of hearing aid outcome dimensions that contribute to hearing aid success. The definition of hearing aid success for this study was composed of seven outcome domains: change in quality of life, satisfaction, subjective speech perception benefit, hearing aid use, remaining hearing problems following amplification, aversiveness to loud sounds, and objective speech perception benefit. Fifty experienced hearing aid users completed five self-report measures and two speech perception in noise tests. Seven outcome domains were obtained from these measures. In order to create a more parsimonious picture of the hearing outcomes, a principal components analysis was conducted using the seven outcome domains. Three components were identified: hearing aid benefit, remaining hearing problems, and negative reactions to loud sounds. The relationship between ANL scores and the seven outcome domains as well as the relationship between ANL scores and the three principal components of hearing aid success were explored. Results indicated that ANL scores were not associated with the seven outcome domains or the three outcome components.This research did not find a noteworthy relationship between ANL scores and any outcome domain of hearing aid success. Although the ANL test may prove to be useful for other applications, the results of the current study suggest that the ANL test is not an accurate predictor of hearing aid success by any measure