1. Hearing test (tymps, audio – air, bone, SRT, WRS)
2. Modified Listening Situation Questionnaire & modified APHAB with current HAs
3. Outcome measures with currents HAs bilaterally in soundfield
   • Calibrate with BKB Cal tone
   • 1 trial list of BKB-SIN, then 4 test lists (2 pairs) of BKB-SIN + 1 list of CNC words/phonemes) presented at 60 dB SPL (49 dB on the dial) through Clarujust Sound Player function:
     • BKB-SIN: sentence in L speaker, noise in L/R
4. Obtain Clarujust scores on current HAs at 60 dB SPL (do not connect HAs to Clarujust)
   • Calibrate Clarujust using Sound Calibration function (1K scaled)
   • Record 60 SPL presentation level in Sound Calibration window
   • Present 1 set (14 phonemes) in quiet as a trial
   • Present 1 set in quiet with current HAs
   • Present further sets until 50% SNR breakdown point is found
5. Clarujust scores measured without any hearing instrument at 60 dB SPL
   • In quiet
   • At 50% breakdown SNR level
     • If they need higher than +6 SNR to get 50% just record the score at a + 6 SNR
6. Real Ear measurements (Speechmap in 3 settings: 1. no HA, 2. HA in but off, 3. HA on)
   • Insert USB memory stick and set Verifit to save XML data
     • Press SETUP and pick PRINTING
     • Pick PRINT TO USB FILE
     • Press SETUP
     • Pick SESSION
     • Pick ENABLE FILE BASED DATA EXCHANGE
     • Pick USB DRIVE and Continue
   • Run Tests – Speechmap “carrots” at 55dB, 65dB, 75dB, MPO in 3 settings
     • Press SESSION and pick ERASE ALL DATA and Select STORE SESSION TO FILE and Continue
     • Transfer XML data to study laptop and email data to Steve
7. Earmold impressions if necessary
   • Send earmold impressions to Audina
8. Send all audiometric information (and earmolds in applicable) to Audina to order HAs

1. Audina will Autofit the instruments to subject’s audio (Single Memory, NR will be turned off, Directional mics off)
2. Obtain Clarujust scores with Autofit at 60 dB SPL (do not connect HAs to Clarujust)
   • Calibrate Clarujust using Sound Calibration function (1K scaled)
   • Record 60 SPL presentation level in Sound Calibration window
   • Present 1 set (14 phonemes) in quiet as a trial
   • Present 1 set in quiet with current HAs
   • Present further sets until 50% SNR breakdown point is found
3. Real Ear measurements (Speechmap in 3 settings: 1. no HA, 2. HA in but off, 3. HA on)
   • See #6 above for detailed procedure

1. Outcome measures with Audina Autofit HAs bilaterally in soundfield
   • Calibrate with BKB Cal Tone
   • 1 trial list of BKB-SIN, then 4 test lists (2 pairs) of BKB-SIN + 1 list of CNC words/phonemes) presented at 60 dB SPL (49 dB on the dial) through Clarujust Sound Player function
     • BKB-SIN: sentence in L speaker, noise in L/R
2. Listening Situation Questionnaire & modified APHAB with Audina HAs
3. Read instruments settings using ezOrange and save snapshot to file
   • Steve will send – should not need to ever go into ezOrange screen except to go save to file
4. Run optimization bilaterally for 20 minutes at medium level (60 dB SPL or 49 dB on the dial) * *
   • Calibrate Clarujust using Sound Calibration function (1K scaled)
   • Record 60 SPL presentation level in Sound Calibration window
   • Present 14 phoneme sets to determine subject’s 50% SNR breakdown point
   • Select 50% breakdown test number as new Baseline
   • Unflag all previous tests not done at this presentation level, SNR and on these instruments
   • Record test number for new baseline and optimized maps
   • Run optimization bilaterally for 20 minutes at loud level (80 dB SLP or 69 on the dial) * *
   • In Sound Calibration window, note 80 dB SPL as presentation level
   • Present 14 phoneme sets to determine subject’s 50% breakdown point
     • If their percentage is >50% at -3 SNR just record the score at -3 SNR.
5. Save snapshot of settings to file
6. Set compression and bump, tilt & gain based on optimization from the best performance at 60 dB SPL
7. Real Ear with optimized setting
   • See Session 1, #6 for detailed procedure

1. Outcome measures with Audina HAs with Opt 1 bilaterally in soundfield
   • Calibrate with BKB Cal Tone
   • 1 trial list of BKB-SIN, then 4 test lists (2 pairs) of BKB-SIN + 1 list of CNC words/phonemes) presented at 60 dB SPL (49 dB on the dial) through Clarujust Sound Player function
     • BKB-SIN: sentence in L speaker, noise in L/R
2. Listening Situation Questionnaire & modified APHAB with Audina HAs
3. Read instruments settings using ezOrange and save to file
   • Steve will send – should not need to ever go into ezOrange screen except to go save to file
4. Run optimization bilaterally for 20 minutes at medium level (60 dB SPL or 49 dB on the dial) * *
   • Calibrate Clarujust using Sound Calibration function (1K scaled)
   • Record 60 SPL presentation level in Sound Calibration window
   • Present 14 phoneme sets to determine subject’s 50% SNR breakdown point
   • Select 50% breakdown test number as new Baseline
   • Unflag all previous tests not done at this presentation level, SNR and on these instruments
   • Record test number for new baseline and optimized maps Is there some way this could be saved automatically in Audigence?
5. Run optimization bilaterally for 20 minutes at loud level (80 dB SLP or 69 on the dial) * *
   • In Sound Calibration window, note 80 dB SPL as presentation level
   • Present 14 phoneme sets to determine subject’s 50% breakdown point
     • If their percentage is >50% at -3 SNR just record the score at -3 SNR.
6. Save snapshot of settings to file
7. Set compression and bump, tilt & gain based on optimization
   • Exactly how? Do we “Save to HI” from Clarujust after reselecting parameters from best performance at 60 dB HL? Do we need to use any functions in ezOrange?
8. Real Ear with optimized setting
   • See Session 1, #6 for detailed procedure

1. Listening Situation Questionnaire & modified APHAB with Audina HAs Opt 2
2. Run Outcome measures bilaterally (1 trial list of BKB, then 4 test lists/1 list of CNC)
   • Calibrate with BKB Cal tone
   • 1 trial list of BKB-SIN, then 4 test lists (2 pairs) of BKB-SIN + 1 list of CNC words/phonemes) presented at 60 dB SPL (49 dB on the dial) through Clarujust Sound Player function
     • BKB-SIN: sentence in L speaker, noise in L/R
3. Real Ear with current settings
   • See Session 1, #6 for detailed procedure
4. Set hearing aids to subjects preferred settings

* * Prior to each optimization find SNR level for ~ 50% phonemes correct