How to Conduct a Hearing Aid Trial
A hearing aid trial should be conducted over a 2-week initial period without support, followed by an additional 4-week period with access to fine-tuning adjustments, for a total of 6 weeks. 1, 2
Trial Duration and Structure
The most commonly recommended approach is:
- Initial 2-week take-home trial without any professional support or adjustments 2
- Additional 4-week period with access to fine-tuning and support (total 6 weeks) 2
- Most audiologists globally recommend a 2-week minimum trial period 1
This structured approach allows patients adequate time to adjust to amplification while providing a baseline assessment of initial acceptance before introducing modifications.
Trial Protocol Components
Initial Fitting Options
You have two evidence-based pathways:
Audiologist-Fitted Approach:
- Fit hearing aids according to NAL-NL2 prescriptive gain targets
- Use real-ear measurements (REMs) for verification - this is the gold standard 3
- Provide hearing aid use instruction 2
Self-Fitting Approach (for OTC devices):
- Patient sets up hearing aids using manufacturer's instructional materials
- Smartphone application guides the fitting process
- Remote support available after initial 2-week period 2
Both approaches yield comparable outcomes at 6 weeks, with self-fitting showing initial advantages at 2 weeks on self-reported benefit measures 2.
Support Structure During Trial
First 2 weeks: No adjustments or support - allows assessment of initial acceptance and identifies immediate problems 2
Weeks 3-6:
- Remote support for self-fitting devices (on patient request) 2
- In-clinic audiologist adjustments for traditional fittings 2
- Address patient-directed gain adjustments based on real-world experience 3
Number of Devices to Trial
Trial with two different hearing aids - this is the most common practice among audiologists who offer trials 1. This allows patients to compare performance and comfort across different devices.
Outcome Measurements
Assess at baseline, 2 weeks, and 6 weeks:
Primary measures:
- Self-reported hearing aid benefit (Abbreviated Profile of Hearing Aid Benefit - APHAB) 2
- Speech recognition in noise testing 2
Secondary measures:
- International Outcome Inventory for Hearing Aids (IOI-HA) 2
- Hearing aid adherence (daily duration and weekly frequency) 4
- Quality of life assessments 5
Critical Implementation Points
Common Pitfall to Avoid
Only 72.63% of audiologists offer hearing aid trials 1, yet trials are essential for successful long-term outcomes. Trialing should be standard practice, not optional 1.
Patient Selection
The trial process works for patients with:
- Mild to moderate sensorineural hearing loss 3, 2
- Self-perceived hearing difficulties 2
- Both new users and experienced hearing aid users 3
Follow-Up Requirements
After the 6-week trial period, continue monitoring:
- Hearing aid use skills and maintenance 4
- Motivation for continued use 4
- Address barriers to consistent daily use 6
The evidence strongly supports that adequate trial duration with structured follow-up produces clinically equivalent outcomes whether conducted remotely or in-clinic 2, making this approach accessible for diverse practice settings.