Advice for before you buy

With hearing aids now available over-the-counter from Walmart to Walgreens and even online in some states, these devices are meant to be used on older adults with mild-to-moderate hearing loss. These are sold ranging from very low entry pricing as rechargeable hearing amplifiers to more expensive, rechargeable hearing amplifiers in a casing that resembles medical-grade hearing aids. Self-service hearing aid selection can help someone find a quick solution to a mild hearing problem.

Untreated hearing loss results in depression, dementia, isolation, balance issues and falls. Low-entry OTC hearing aids can make better hearing more affordable for those with a high need. 

They are not suitable for use on children or for adults with significant hearing loss or medical hearing loss from illness or injury.

What you should expect with an OTC/PSAP type hearing aid:

  • The FDA classifies these as PSAPs – personal sound amplification products, and are not medical devices or operate at the same level as a professionally fit hearing instrument.
  • One type of amplification at all low-to-high noise ranges, whether or not you also require it at low and high ranges.
  • Some improvement with clarified speech, alone or in a group at normal volumes
  • Lower volume required when watching TV or radio along with others
  • Noisy environments will still present a challenge to the wearer
  • Bluetooth connections to TV or cellphone for volume boosting
  • Poor seals with your ear canal resulting in squealing or feedback noise
  • Low selection of color to blend in with your skin tones or hair color

With the FDA guidelines released concerning Over The Counter (OTC) hearing devices, we anticipate that some people with early-stage hearing loss may choose this option as a first step.  

You will first need to know how well you hear in order to determine if you are a candidate for this level option, and there are many self-exam applications available.  An online hearing screening is a very basic test which only checks for speech understanding mixed with a high-noise environment, not your ability to hear or understand quiet sounds or high-frequency sounds, such as birds, dogs whining, or your own footsteps.

In order to protect yourself, and get the most accurate test results, we suggest the following:

  • Conduct the hearing screening in the quietest environment possible with earbud style headphones connected to your computer
  • See your PCP or an Audiologist if the findings suggest a difference between ears of 15 dB or greater. This is an indicator of a possible medical issue which requires assistance.
  • See an Audiologist if you have had a history of medical problems with your ears or hearing. There are additional factors that may make you a better candidate for a custom-fit solution.
  • Understand that this is only a screening and there are many factors at play which effect your hearing as well as the accuracy of this type of screening.

The FDA classifies these as PSAPs – personal sound amplification products, and are not medical devices or operate at the same level as a professionally fit hearing instrument.

Once you have your hearing screening test results, you will be shopping for devices.  While we cannot recommend any particular devices or stores, here are a few things to keep in mind:

Some Audiology practices will also sell these same devices and they will likely cost less than they would at a big-box store. Further, you will have the ability to have them serviced by an expert when it needs service or cleaning.

If your hearing screening indicates normal or near-normal hearing sensitivity for the low to mid-speech frequencies, you should select an option that does not block your ear canal.

You will be seen and serviced by a “hearing instrument specialist” salesperson. The training for this position is a work requirement under supervision or in NYS, 3 months of coursework to obtain a certification. Companies that typically employ hearing instrument specialists are Miracle-Ear, Starkey and Beltone.

  • If you are concerned about a child with potential hearing loss, they should see their pediatrician for a recommendation to a pediatric Audiologist or ENT.
  • If improperly fitted, a PSAP has the ability to actually harm your hearing.
  • These devices will not last as long a well-engineered hearing instrument, so expect to replace them every 2-3 years, even with a warranty.
  • If you do not hear well with an OTC hearing aid, it does not mean you won’t hear well with a professionally fitted hearing instrument.  The testing, wide selection and custom fitting available through an Audiologist office looks at multiple facets of your personal hearing range and lifestyle requirements to address each concern fully.

When in doubt, seek out professional help.  There is much more to a hearing-instrument fitting than just making things louder.  Professionally fitted, high-quality hearing instruments and assistive devices have the ability to help you hear better in all listening situations, and often for less money than you might expect. 

If your career or general life satisfaction is critical to you, seeing a licensed hearing professional is the first step in hearing at your best.

Links for more information:

NIH – National Institute on Deafness and Other Communication Disorders – Over the Counter Hearing Aids