Can I make the adaptation process easier for my client?

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Let’s consider a typical hearing aid fitting to a new hearing aid user.  Your client says to you that everyone mumbles these days or that speech isn’t clear anymore, especially when there is noise around.  You then provide the necessary high frequency gain to give them back that clarity and they report that they can definitely hear better and clearer but it is too harsh.  To increase the chance that they will actually wear the hearing aids, you could decrease the high frequency gain to make it more comfortable, sacrificing some of the clarity.  We know that it takes time for our clients to rehabituate to those high frequencies and that, in general, they hear better with the amount of gain proposed by the various rationales available.

The dilemma is how do we adjust the gain gradually without needing a lot of extra appointments?  Oasisnxt now has a feature called Adaptation, which allows the clinician to set
1) a start and end point for the gain, and
2) a duration over which the gain gradually increases.
Adaptation is set through the Automatic Gain Adaptation control and is found in Fitting > Adaptation in Oasisnxt.


You can see from the image below that the different settings of the Automatic Gain Adaptation control produce a change in the high frequencies, which is what causes the most problems as far as sound quality acceptance is concerned.  The feature facilitates an increase in those high frequencies over the set period of time to the 100% point.


This is fantastic for you as the clinician as it is more likely that the client will accept the required gain, thus resulting in better speech clarity and a more successful fitting.  It is also fantastic for the client as the process is gradual and therefore more tolerable.

Automatic Gain Adaptation Control in Oasisnxt – what you need to know

  1. The control can be set manually to 80%, 90%, or 100% or it can be set to automatically adjust from a Start gain to an End gain over a specific period of time. When you choose the automatic option, the hearing instruments (HIs) need to be worn for 10 hours per day for the adaptation to occur. If the HIs are worn for less than this amount of time, the adaptation process will take longer.

  2. The Automatic Gain Adaptation control must be set to 100% before you complete any validation testing. Once you have adjusted the gain to meet the validation needs, this adjusted frequency response is now the 100% target gain. After validation, you can turn the Automatic Gain Adaptation on and set the start gain to 80% or 90% and the end gain to 90% or 100% depending on what is best for the client.

  3. If you use REMfit, Oasisnxt will automatically take note of the adaptation target gain setting prior to running the measurements, adjust it to 100% while running the measurement, and then it will revert to the earlier setting after you have closed REMfit down. It is important to know this as the client may notice a drop in gain after REMfit is complete.

  4. If the client comes in at some stage during the adaptation period and says that the HIs are perfect as they are then you can turn the automatic gain control off and the HIs will remain with this amount of gain. You will see a red or blue bar on the Start gain and End gain display that shows how far the client has progressed with their adaptation.



Adaptation is a really exciting improvement, which will allow you to tailor the fitting even more to your client’s needs. It is a new feature in Oasisnxt, available in all models and styles in our recently released product family Zerena 9|7|5. Visit our Zerena pages and sign up to our blog for all the latest news and information from Bernafon.


About the author:

Jodie Nelson
Jodie Nelson
Jodie completed her audiology degree at University of Melbourne, Australia. She has extensive experience working with hearing-impaired people, fitting hearing instruments, counselling, and providing rehabilitation programs. Jodie gains great satisfaction in helping hearing-impaired people enhance their quality of life through improving their communication. You will see Jodie on her way to work on her e-bike, rain or shine with a smile on her face.