==Advanced Options== For the Paragon products, the Advanced Options screen is utilized to make channel specific adjustments to the Soft and Loud Gain, Soft TK, Loud TK, and Time Constants (Time Constants can be adjusted in the Paragon 4 product only). Additionally, on this screen, the MPO, Expansion Threshold, and Input mode can be adjusted. ==AGC-o== Programmable product with one channel and two bands that is available in all custom styles. This product is appropriate for fitting mild to severe hearing loss. Directional technology is available. ==Articulation Index== Calculated automatically based upon a patient's audiogram, the Articulation Index demonstrates the percentage of speech cues the patient should be able to hear given his or her hearing loss. ==Autofit== Adjusts the hearing aid parameters according to the patient's audiogram. Factors, such as degree of hearing loss, hearing aid style, and patient's listening needs, influence the hearing aid parameters. There are several different autofits available depending on the circuitry of the hearing aid and the patient's listening needs. * WDRC (Wide Dynamic Range Compression): Input compression that will give the most gain for soft input, average gain for average input, and minimal gain for loud input. This rationale is designed to imitate the function of the outer hair cells. Thus, WDRC utilizes a low compression threshold and a low compression ratio. This rationale is great for first time users with mild to moderately severe hearing loss (individuals with MCLs that are 75 dB or lower) or patients with a reduced dynamic range. * AGC-o (Automatic Gain Control): Output compression that processes sounds at a 1:1 ratio (linear) until the input exceeds the compression threshold. Once the compression threshold is exceeded, a high compression ratio is utilized so that the patient's UCLs are not exceeded. This rationale is most beneficial for previous users who desire comfort in the presence of loud noise or patients who have extreme sensitivity to loud sounds. * Linear: This autofit provides a 1:1 ratio of gain for every input level. While this rationale is similar to that in conventional hearing aid technology, it is being utilized in a digital hearing aid. Thus, since there is digital signal processing, the input is more clear and precise. This rationale is successful with previous users who liked how their old hearing aids sounded or for patients who desire a great deal of power. ==Backup/Restore== This feature makes it possible to archive patient records as well as transfer to other computers. ==Basic Options== Functions as a trimpot control to cut or adjust high and low frequencies in Paragon products. When utilized, additional adjustments can be made to the high and low frequencies. The corner frequency value chosen indicates the point at which high or low frequency cut-off begins without affecting compression. ==Compression Ratio== After compression begins, as there are further increases in the input level, the amount of gain decreases. The compression ratio describes how much the gain decreases. Therefore, the compression ratio is defined as the change in the input level required to produce a 1 dB change in the output level. The compression ratio is calculated automatically according to gain and the threshold kneepoint. ==Copy== Once we have a memory programmed as desired, the memory's fitting parameters can be copied to another memory program in the same ear. The Copy feature is utilized by clicking on the Edit toolbar and then clicking on Copy. Finally, click on the memory from which to copy. ==Crhi (Compression Ratio for High Frequency)== This feature is utilized to change the compression ratio for high frequencies in the DynamEQ3 programmable hearing aid. ==Crossover Frequency== To separate the channels, the cross over frequencies are adjusted. For example, the Paragon 4 has three adjustable cross over frequencies that separate the frequency response of the hearing aid into four separate channels. The cross over frequencies can be adjusted by dragging them with the mouse. ==Default== At default setting, the hearing aid is set at factory settings. ==Directional Microphone Technology== Available on all programmable and some conventional products in full and half shell styles to enhance the signal-to-noise ratio by de-emphasizing input arriving from the sides and behind the listener. ==DynamEQ3== Programmable product with two channels, two bands, and expansion threshold. This product is appropriate to fit mild to moderately severe hearing loss and is available in all custom styles. Directional technology is available. ==DynamEQ2== Programmable product with two channels and two bands. This product is appropriate to fit mild to moderately severe hearing loss and is available in all custom styles. Directional technology is available. ==Expansion Threshold== Often referred to as the “opposite of compression” and is adjusted to reduce the amount of amplification given to circuit noise and some ambient noise (i.e., fan noise, refrigerator hum, and 60 cycle hum). As the expansion threshold value increases, the amount of circuit noise amplification decreases. The expansion feature reduces circuit noise amplification across all of the hearing aid's channels ==External Volume Control== Trimmer or manual volume control features are available on all hearing aid styles. These volume controls are known as external volume controls. In the fitting screen, ensure that the External Volume Control box is checked if an external volume control is present. The User VC slider will automatically be set at 50%. This represents the setting of the external volume control and frequency response curves that will represent the response when the patient is wearing volume control at 50%. The slider can be adjusted to 25%, 50%, 75%, and 100% and the curves will move accordingly, but the patient will not hear changes in the response unless changes are made to the external volume control. The External Volume Control box can be unchecked to deactivate the external volume control. As a final note, if no external volume control is present on the hearing aid, ensure that the External Volume Control box is not checked. ==Fitting Wizard== This is a step-by-step programming guide that is used to assist with patient fittings. Use this to verify product model and style and whether an external volume control or multimemory option is present on the hearing aid. ==FBC (Feedback Control)== Available on the EQ3 programmable hearing aid, the FBC can be adjusted to notch a particular frequency that is causing feedback. There are several different frequencies from which to choose to eliminate the feedback. ==Fitting Solutions (Fine Tuning)== The fine tuning feature can be implemented to address specific patient complaints. Given the complaint that the patient has, a variety of fitting adjustments/tips are provided. A particular fitting adjustment can be automatically applied by clicking on the “Apply” button. Different fitting tips are also provided. These tips provide alternative options for addressing the patient's complaint that do not involve programming adjustments to be made. ==Flexstrip== Used to connect the hearing instrument for programming, the Audina flexstrip has four gold bands. Always use type CS54. Ensure that the four gold bands on the flexstrip are facing away from the battery door hinge. ==Frontwave™== This is Audina's directional, dual microphone technology system that is available in the Paragon 4 digital hearing aids in full and half shell styles. In order to access Frontwave™ technology, the hearing aid must have multimemory, which is available with either a pushbutton or toggle switch. The low frequency equalization and directional pattern of the Frontwave™ system can be adjusted in the Frontwave™ screen, which is accessed by clicking on the Frontwave™ icon in the fitting screen toolbar. ==Gain and Output Graph== To determine how much gain is present in a particular hearing aid across the different frequencies, refer to the Gain and Output Graph. On the horizontal axis, the frequency range is provided, and on the vertical axis, the amount of acoustic gain in dB is provided. The pale/pastel thick lines represent target curves and the darker, thin lines represent the actual frequency response of the hearing aid. In addition, there are several different colored lines. * Soft Curve: This blue curve represents the amount of gain given to soft sounds (~40 dB input). Typically, it is recommended to undershoot the soft target curve. * Average Curve: This green curve represents the amount of gain given to conversational-level sounds (~60 dB input). Typically, it is recommended to reach the average target curve. * Loud Curve: This teal curve represents the amount of gain given to loud input (~80 dB input). Typically, it is recommended to overshoot the loud target curve. * Output 90 Curve: This red curve represents the maximum output of the hearing aid across the different frequencies. This curve is obtained when the Output 90 box is checked. ==Glo (Gain Low)== Used to adjust the low frequency gain for the DynamEQ3 programmable hearing aids. ==Ghi (Gain High)== Used to adjust the high frequency gain for the DynamEQ3 programmable hearing aids. ==HB (High Band)== Used to adjust the high frequency gain for the DynamEQ2 programmable hearing aids. ==Head Room Extension (HRX)== Instinct/Paragon/Foundation have an enhanced Head Room Extension (HRX) circuit, which increases the input dynamic range of the instrument without any unwanted audible artifacts. This is accomplished by dynamically adjusting the preamplifier's gain and the post-A/D attenuation depending on the input level. * Headroom: the amount of room "to grow" so to speak -- like when you were little and your mom bought you sneakers a little big in the toe so that you had room to grow in them? (Megan Aldridge) * Extension: extends that room to prevent distortion. (Megan Aldridge) See these sites for more details: * [[http://www.gennum.com/sounddesign/tutorials.htm|Gennum's Sound Design Tutorials]] * [[http://www.gennum.com/sounddesign/hrx.htm|Why is the analog to digital converter the weakest link?]] ==HFC (High Frequency Cut)== Used to adjust the high frequency gain for the AGCO and Super60D programmable hearing aids. ==HiPro Test== The HiPro test is a diagnostic tool used to test communications between the PC and the HiPro. The HiPro test can be used to troubleshoot communication problems. ==HiPro Update== The HiPro Update utility updates the firmware for the circuitry inside the HiPro. This utility is provided with the ezFIT software. Periodic updates are recommended. ==Import== This feature is utilized to import settings from a previous fitting or from one side of a binaural fitting to the other side. The Import button is located on the fitting screen on the lower right side. Information, including fitting date, ear, fitting type, and circuitry, is provided when the Import screen appears. Under the heading, fitting type, it is important to ensure that “Programmed” appears. This means that adjustments made to the hearing aid were actually programmed into the hearing aid. If “Demonstrated” is indicated, this means that adjustments were saved to the database, but not programmed, into the hearing aid. ==Input== This feature, which is located in the Advanced Screen of Paragon products, can be accessed to change the type of input processed by the digital circuit. Please note that to implement or use the various input options, the options must have been ordered. * One Microphone Omni-Directional Mode: Single microphone in omni-directional mode; this mode processes sound equally from all angles. * Two Microphone Omni-Directional Mode: When the Frontwave™ directional system is ordered, the hearing aid is equipped with two microphones. Research has indicated that when used simultaneously in omni-directional mode, two microphones can cancel out excess microphone noise, which, consequently, allows for a quieter hearing aid. * Frontwave™ Mode: When activated, this two-microphone directional system, works by creating a cancellation effect of sounds coming from behind the patient. This mode is most beneficial for increasing intelligibility in the presence of background noise. * Telecoil Mode: When utilized in this mode, the microphone is shut off and the electromagnetic field of either a telephone or an inductive loop system (found in some churches, theatres, airports, and meeting rooms) is utilized for amplification. * Microphone Plus Telecoil Mode: To benefit from use of both the telecoil amplification and the hearing aid's microphone, this mode is selected. This mode attenuates the microphone by 6 dB while the telecoil is in use. ==LB (Low Band)== Used to adjust the low frequency gain for the DynamEQ2 programmable hearing aids. ==LFB (Low Frequency Boost)== This feature, which is available on the AGCO and Super 60D programmable hearing aids, allows for greater low frequency amplification once the LFC (Low Frequency Cut) is set at the maximum. ==LFC (Low Frequency Cut)== Used to adjust the low frequency gain for the AGCO and Super 60D programmable hearing aids. ==Lookup== This feature, which can be utilized in the Patient screen, allows for a patient to be located in the database by last name, first name, right hearing aid's serial number, left hearing aid's serial number, or patient ID. This feature is used once a patient has been entered into the system and further programming or fine tuning is required or current hearing aid settings need to be examined. ==Loud Gain== To change the amount of gain given to loud sounds in each channel, the Loud Gain is adjusted. Changing the amount of loud gain in a channel will affect the compression ratio for that channel. When the soft gain is greater than the loud gain, the circuit is utilizing WDRC. ==Low Battery Tone Indicator== To warn the patient when a new battery is required, the Paragon digital hearing aids come equipped with a low battery tone indicator. The low battery tone indicator functions so that the patient will hear a series of beeps indicating that the hearing aid needs a new battery. The beep/tone intensity and frequency are both adjustable. This feature can be accessed on the fitting screen on the lower right hand side. ==Low Frequency Equalization== In directional mode, low frequency amplification is typically reduced. However, on the Frontwave™ screen for Paragon 4 products, low frequency amplification can be adjusted to provide the patient with a more full and natural sound in directional mode using the Low Frequency Equalization function. ==Maximum Memories== This refers to the number of memories programmed into the hearing aid. The toggle or pushbutton multiple memory option must be selected at the time that the order was originally placed (or added later). The maximum number of memories available with a toggle switch is two and the maximum number of memories available with a pushbutton is four. ==MCL (Most Comfortable Level)== The MCL is the level at which speech is most comfortably understood by a patient. Having the patient's MCLs is important to ensure that soft speech is amplified to a comfortable level for the patient. ==MPO (Maximum Power Output)== Control of output compression kneepoint across all the channels that is available in the Paragon and DynamEQ3 products. The MPO level indicates the threshold of the MPO from the peak Output 90 of the hearing aid. To visualize the effect of MPO, click on the Output 90 box to see the Output 90 curve. ==Notch Center== To manipulate the shape and/or peaks of the frequency curves, the notch center can be adjusted. The notch center functions by determining the frequency location of a variable decibel filter used for feedback control. Notch depth is dynamic and is determined by gain and frequency of the hearing aid. Notch center of between 2700 Hz and 3300 Hz is recommended to reduce feedback due to the natural ear canal resonance and the peak of the hearing aid response. ==Notch Width== The range of frequencies affected by the notch filter can be adjusted or manipulated depending on the notch width value. The notch width values range from 1/12 of an octave to a full octave notch. For feedback reduction, a value between ¼ to full is recommended to smooth out the hearing aid response. ==Notes== A convenient feature that allows for dated journal notes to be recorded and easily accessed. ==Gain Control== To adjust the gain for the hearing aid across all the channels, the overall gain control is increased or decreased. This is often referred to as the programmable or internal volume control. ==Paragon 4== Digital product with four channels, eight bands, and expansion threshold that is available in all styles. This product is appropriate for mild to severe hearing loss. There are over 40 adjustable parameters and Frontwave™ directional technology is available. ==Paragon 2== Digital product with two channels, four bands, and expansion threshold that is available in all custom styles. This product is appropriate for mild to severe hearing loss. There are over 20 adjustable parameters. ==Polar Plot== With the Frontwave™ directional system, the directional pattern of amplification can be adjusted using the polar plot feature. The default polar plot setting of 0.71 was chosen because this setting was found in research studies to provide the greatest directionality by cutting more amplification from the back and sides. ==Print Preview== This screen provides a printer-friendly summary of a patient's hearing aid information, including the patient's audiogram and hearing aid settings. This screen is accessed by clicking on the Print Preview icon. ==Program== Pressing this button burns the settings from the software to the computer chip inside the hearing aid. Although the changes are heard in real-time, it is imperative that the program is burned onto the chip. Thus, please do not forget to click Program. ==Push Button== To utilize the multimemory option, a pushbutton can be placed on the hearing aid. The maximum number of memories possible with the pushbutton is four, but the number of memories is adjustable from one memory to four memories. ==Read== To "read" the hearing aid and display the current settings of the hearing aid on the software, the Read button, which is located on the lower right side, is clicked. ==Set Environment== There are a variety of Set Environment Autofits from which to choose, such as restaurant, telephone, theatre, intense noise, music, and television. These different Set Environment Autofits can be accessed in the Autofit Fitting screen, as well as through the EzFit Fitting Wizard. ==Simulate== When no hearing aid is detected, the fitting screen can still be accessed in simulation mode. The simulation mode can be used to become familiarize with the EzFit software. In simulation mode, any fitting adjustments made will not be burned to the computer chip in the hearing aid. ==Socket== One method used to connect the hearing aid for programming. Requires the socket cover on the hearing aid to be taken off so the hearing aid can be connected. ==Soft Gain== To increase or decrease the gain for soft input in each channel. Adjusting the soft gain affects the compression ratio. As a reminder, when the soft gain is greater than the loud gain, the circuit is utilizing WDRC. When the soft gain is equal to the loud gain, the circuit is utilizing linear mode. However, it is not possible to have the loud gain greater than the soft gain. ==Soft TK== This is described as the level at which the hearing aid begins to go into compression. This is the channel-specific lower threshold kneepoint. ==Speech Sounds/Speech Shadows== This excellent counseling tool, based on the Articulation Index, which is automatically calculated for the patient depending on the patient's audiogram and displays the percentage of speech cues the patient should be able to hear given his or her hearing loss, can be helpful in showing the patient that the speech sounds or shadow regions below his or her thresholds should be audible to him or her. However, those speech sounds or speech shadow regions located above his or her thresholds should not be audible to him or her. ==SRT (Speech Recognition Threshold)== This is the lowest level at which a patient can comprehend and repeat back what he or she hears. ==Super60D== Programmable product with one channel and two bands that is available in the full shell style. This product is appropriate for moderately severe to profound hearing loss. ==Time Constants== Adjustable in Paragon 4 products, this is the rate of attack and release times utilized by a hearing instrument to govern compression characteristics. This feature can be manipulated for each channel, although it is recommended to be consistent and use the same time constant in each channel in a particular memory. * Twin Average: Utilizes two level detectors (a fast and slow detector) to control both fast, sudden loud noises (i.e., a door slamming) and steady, consistent noise (i.e., crowd). * Twin Peak: Utilizes two fast level detectors to ensure that the UCL of the patient is never compromised. * Single Slow: Fixed slow attack and release times (greater than 275 ms) to avoid rapid fluctuations in gain. * Syllabic: Characterized by a low threshold of activation, short attack times (less than 50 ms with the average syllable around 150 ms), and variable release times. * Phonemic: Characterized by low threshold of activation and short attach and release times (5-50 ms). Smoothes out the peaks of the signal to make speech input a constant level. ==TK (Threshold Kneepoint)== This is the level at which the hearing aid begins to go into compression. This feature is available in all Audina programmable technologies. ==Toggle Switch== This feature is available to utilize the multimemory option (maximum number of memories available is two) or Telecoil option. It is important to ensure that in the Memory Access section, Toggle Switch is checked. However, the only exception pertains to programmable products with the telecoil option. In such cases, ensure that Toggle Switch is not checked. ==UCL (Uncomfortable Level)== To set the OSPL90, knowing the level at which speech is uncomfortable for a patient is beneficial. Simply put, the Output 90 should be set so that amplified input does not exceed the patient's UCL. ==Upper TK== This is the input level at which output compression limiting will be applied. This is a channel-specific upper threshold kneepoint.