Assessing The Effects of Hearing Aid Prescription On The Patient’s Functioning

The purpose of hearing aid prescription is to improve the patient’s functioning and quality of life. This post has some resources for assessing the effect of hearing aid prescription on those metrics.

From Audiologic Management of Adult Hearing Impairment Adopted Clinical Practice Guideline ACPG-06, 2014:

“A variety of tools exists to assess communication needs and function, as well as
assisting in evaluating patient expectations of hearing aid use. These include, but are not limited to, the Client Oriented Scale of Improvement (COSI) (1),
Abbreviated Profile of Hearing Aid Benefit (APHAB) (2), Hearing Handicap Inventory for the Elderly (HHIE) (3), and Expected Consequences of Hearing Aid Ownership (ECHO) (4). Lifestyle questionnaires are also available from specific hearing aid manufacturers and network providers. Most of these tools can be administered quickly so that goals can be outlined in a pragmatic and timely fashion. Use of these assessment tools can assist in the selection of particular amplification features such as directional microphones, direct audio input, environmental noise management, frequency modulated (FM) systems, and so on.”

“Following the fitting, these same measurement tools can be used to help quantify the patient’s functional benefits/satisfaction with amplification. Following the administration of the above-mentioned tools, a list of realistic patient goals can be developed. It is important to include both “cognitive” and “affective” goals. For example, a “cognitive goal” may be “improved conversation with a spouse in a quiet environment” or “improved communication with unfamiliar speakers on the telephone without removal of thehearing aid.” An “affective goal” could be “feeling less embarrassment or distress during
communication.” These goals can be evaluated as to the amount of change with the use of
amplification. The statements or questions in the HHIE, COSI, and ECHO contain both cognitive and affective characteristics.”

“The importance of specifying patient goals continues to be a challenge with the
introduction of new hearing aid features. Patient demands and expectations increase due to the commercial promotion of certain hearing aid features such as adaptive directional microphones, environmental noise reduction, and automatic telecoils.”


(1) Client Oriented Scale of Improvement (COSI):                                                                      the COSI™ Questionnaire                                                                                                           instructions for administration of COSI™ to adults                                                             COSI-C™ Questionnaire for children                                                                                               instructions for administration of COSI-C™ to children 

Shedding New Light On An Old Tool: Using the COSI During the Pre-fitting Appointment, 2009. Brian Taylor, AUDIOLOGY PRACTICES ■ SPRING 2009

The Hearing Aid User’s Questionnaire (HAUQ) is designed to assess hearing aid use, benefit, problems and overall satisfaction. 

(2) Abbreviated Profile of Hearing Aid Benefit (APHAB) [PubMed Abstract

(3) Hearing Handicap Inventory for the Elderly (HHIE) [PubMed Abstract]

(4) Expected Consequences of Hearing Aid Ownership (ECHO)     Echo Questionnaire          ECHO Scoring Instructions

(5) Does the Fitting Satisfy the Patient? Donald J. Schum PhD, Audiology Online, January 7, 2013.

(6) Self-Report Assessment of Hearing Aid Outcome – An Overview. Brian Taylor AuD, Audiology Online, October 22, 2007.


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