What are hearing aid settings? And how do I customize mine?

Today’s hearing aids are designed to naturally adapt to the soundscapes you enter—that is, as you go from a loud restaurant to your quiet bedroom, your hearing aid will shift accordingly, choosing programs that match the sound levels of your environment. 

“Most hearing aids come with several automatic programs that the hearing aid will actually switch into depending on what it thinks is best,” says Laura Sherry, AuD, research audiologist at Johns Hopkins Cochlear Center for Hearing and Public Health. 

These default programs are sophisticated and helpful—but as you go through your day, you might find that there are certain environments where the programs don’t fully meet your needs. In those scenarios, you may benefit from customizing your settings and adding personalized programs to the hearing devices. 

How are programs on your hearing aid set? 

The process begins at your audiologist: After hearing tests, real ear measurement and selecting hearing aids, the test results are imported into the devices, Sherry explains. This helps the hearing aid know where extra volume is needed; you don’t want a hearing aid to amplify all noises equally, but rather, be strategic about increasing the volume only in the pitches where it’s needed. 

“When you import the hearing test results into the hearing aid, then the hearing aid knows to add a little bit of volume where they have a little bit of hearing loss, but much more volume where they have more hearing loss,” Sherry says. 

This is the point in the process, known as hearing aid fitting, when audiologists talk programs and settings. 

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Many of these setting are automatic, with the hearing aid transitioning from one program to another without input from the person wearing the device. The hearing aid will switch in and out of programs, as well as making determinations about how much additional volume to add, Sherry notes. 

If it detects soft sounds, hearing aids are likely to boost the volume. But hearing aids don’t add volume indiscriminately. Say you’re around a loud-talking friend or a TV with the volume at its max level. The hearing aid will notice that the volume of the input is high, and won’t add extra volume, Sherry says. 

“The goal of the hearing aid is to preserve that quality of keeping soft sounds soft, medium sounds medium, and loud sounds loud,” she explains. 

“We can make a custom [hearing aid] program for a person for whatever sound environment they might be struggling in,” Sherry says. 

But of course, the hearing aid is just a machine. There are situations where a person might want more control than the automatic moves from the hearing aid. To that end, users can manually turn on the program of their choice, Sherry says. 

Another option: A personalized program. 

“We can make a custom program for that person for whatever environment they might be struggling in,” Sherry says. 

Available hearing aid modes, programs and settings

The programs and settings present in your hearing aid depend on the specific device you have. Around three to five programs tend to come as a default, such as a program for hearing speech in quiet environments, and another for hearing conversations when it’s loud, Sherry says. 

“Your audiologist can add more or take them away,” she says. Typically the default program is set for listening in a quiet environment. 

With more processing power, hearing aids may offer programs such as: 

• A wind noise reduction program that’ll cut down on the sounds of wind whipping around the mic
• Feedback suppression—to quell a whistling reverb in your ears 
• A car program, which adjusts the microphone’s direction to help you pick up what the person in the passenger seat (or behind you) is saying, to help overcome a common hearing problem when driving
• A birding program to help pick up the fast-moving, high-pitched sounds of birdsong

Music lover? Request a custom program

It’s very common for people to request a program for listening to music or TV, Sherry says. 

“Music is an example of when we might need a manual program because hearing aids are really optimized to understand speech. Music is a different ballgame entirely,” she says. 

Music programs tend to remove a lot of features, so that what you hear with the help of hearing aids closely matches the input, Sherry explains. An audiologist can target the program for the exact circumstances where you listen to music, whether that’s a choir singing in church or streaming music through at-home speakers. 

A job for the pros

As a hearing aid wearer, you have some control. Often, you’ll be able to adjust the volume within programs, for instance, or manually switch from one program to another. 

Creating programs, however, is a job for the pros. An audiologist will be able to craft the program to meet your needs, taking advantage of features that are often only available in the audiologist’s software. 

Have a unique hearing situation? Talk to your hearing care provider

“To design and really fine tune the parameters within each program, that's something that you'd want to sit down with your audiologist and talk about,” Sherry says. 

This process will likely require at least one follow-up appointment (and maybe several), Sherry says. Once the new program is in place, you’ll want to test out what it sounds like in a real-world setting, which can sometimes vary from the serenity of the audiologist office. 

Once you’ve tested out the program in your everyday life, you can share feedback, and your audiologist will “make minor adjustments” as needed, Sherry says. 

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