STEP 1 – PATIENT DETAILS
- Enter Date of Birth
- When a patient is under the age of 18, Phonak Target software will automatically apply Junior Mode, which has 4 categories: 0-3 years, 4-8 years, 9-12 years & 13-18 years.
- Each category within Junior Mode has specific default settings, appropriate for the specific age group.
- Enter Gender
- Certain fitting formulas consider the anatomical differences in average male ear canals vs average female ear canals (size and length of ear canal) and appropriately adjust default settings to take such differences into account during programming.
- Enter Audiogram
- When using Phonak Target fitting software in standalone mode, you will manually need to enter the patient’s audiogram prior to programming the hearing aids. When using NOAH software, the previously entered audiogram will automatically be in the patient’s profile and thus be displayed in the fitting software without having to enter it again.
STEP 2 – CONNECTING THE HEARING AID
- Fitting Interface
- When installing new software, please ensure that the correct interface option is selected on software. In the example below, the HIPRO is selected as programming interface
- Correct Fitting Software
- For the current tender, please ensure you have Phonak Target 5.4.2 (or higher) installed.
- Correct Programming Cables
- Phonak BTE cables are typically black in colour and have the name “Phonak” printed them. You can also use these cables for programming Hansaton BTE devices.
- Phonak ITE cables are different from the BTE cables: they have a “battery pill” connector that fits into the battery compartment of a custom hearing device. They therefore come in different sizes, depending on the hearing aid’s battery size (13, 312 or 10).
- Click CONNECT to detect the hearing aids and follow the instructions. Please note that the hearing aids will automatically be muted once they have successfully been detected and connected.
STEP 3 – ACOUSTIC PARAMETERS
- Standard Tube vs SlimTube
- Please ensure that the correct tubing type is selected: this can GREATLY affect the hearing aid’s fitting range, as well as other parameters. Also be aware that when using a slimtube, the hearing aid’s fitting range is significantly reduced (compared to using standard size tubing).
- Vent Size
- Enter the correct vent size of the mould that will be used for the fitting. Even if the software suggests using a different vent size, it is crucial that you enter the vent size that will be used for the fitting session.
STEP 4 – FEEDBACK MANAGER
- Feedback & Real Ear test vs Enabling WhistleBlock manually
- We recommend that WhistleBlock (the feedback manager) be enabled with every fitting.
This can be done in two ways:
- With nearly all hearing aid fittings, potential feedback can be adequately managed by manually enabling WhistleBlock: simply click on “TURN ALL ON”
- If, after completion of the above step whereby you manually enabled WhistleBlock, residual feedback is still detected, proceed to run the Feedback & Real Ear Test:
Please ensure the hearing aid is firmly placed in the patient’s ear and that a good seal has been obtained with the ear mould. Instruct the patient that they will hear rather loud sounds from the hearing aid – only for a few seconds! – but not to speak during this time (you can also ask others in the room to be quiet for the direction of the test).
Familiarize yourself with the nature and results of feedback tests. In the example below, the purple feedback curve is unfortunately cutting into the red gain curve, which will result in reduced MPO (residual gain) at certain frequencies, leading to unfavourable hearing perception. In this example, it may have been that the mould was not creating a tight enough seal, causing excessive feedback that lead to these results. A new mould will need to be made in this case.
STEP 5 – FITTING FORMULA, COMPRESSION SETTING AND TARGET GAIN
- Imagine: You would like to bake a chocolate cake but have several recipes (or baking formulas) to choose from. Every recipe will result in a chocolate cake, but each recipe will add its own unique character to the cake and therefore each chocolate cake is likely to taste slightly different, yet delicious.
- Now, consider: You need to program hearing aids, but you have several fitting formulas to choose from. Each fitting formula will result in an appropriately programmed hearing aid, but each fitting formula will add its own characteristics and default settings to the programmed hearings aid. Each hearing aid will thus be adequately programmed (based on the audiogram), but the hearing experience would be slightly different, depending on which fitting formula was used to program the hearing aid (or “bake the cake”, so to speak).
- Ask yourself: What do I want to achieve with the hearing aid fitting or programming today, and which fitting formula will assist me the best in reaching that goal?
- TIP: Familiarise yourself with the rationale behind different fitting formulas!
- Points to consider:
- What was my patient’s previous hearing aid experience and what fitting formulas and compression settings were used in the previous hearing aids? And were there challenges or complaints with previous hearing aids? And would you be able to address a challenge such as “hearing aid too soft” with a change in fitting formula and compression setting first, before looking at gain adjustments?
- With Phonak’s Junior Mode, all paediatric fittings default to DSL v5a Paediatric.
- Consider DSL v5a Adult for severe-profound hearing losses in the adult population.
- Consider more linear gain compression for severe-profound losses.
- TIP: Explore what each fitting formula aim to achieve in a fitting and understand how a different compression setting can aid you in achieving that goal.
STEP 6 – MPO, GAIN & TK
STEP 7 – ADDITIONAL CONSIDERATIONS
- We recommend leaving this on the default setting. Do, however, consider counselling your patient on the effects of high Hz auditory deprivation, and the need to acclimatize to new high Hz input that is now accessible through the SoundRecover feature.
- Default Program Structure
- Does the hearing aid have an automatic start-up program that allows for automatic changes to feature-sets and various programs depending on the listening environment that the patient finds themselves in? If so, how advanced is this automatic program and how likely is it that the patient will require additional manual programs?
- Does the hearing aid only have manual programs (i.e. the patient must press the program button to access a different program every time the listening environment changes? This set-up may necessitate adding some environment-specific additional listening programs.
- Device Options
- Demonstrate signals & alerts to patient, for example low battery warning.
- Automatic FineTuning Assistant
- Using this might be helpful in making fine tuning adjustments.
- Can be very helpful during follow up sessions to assist with troubleshooting and/or counselling.