What are the technology levels and what do I get with each level?

This is a very fair question and it is also a very confusing question as it relates directly to the price of the hearing aid.  I will attempt to answer this question and give you the guidelines I use when looking at the technology tier levels in this section.

To began with Hearing Resources has broken the technology pyramid down into five technology levels with tier one [1] being the apex or premier (the highest technology level) technology level of the pyramid and tier five [5] being at the base (the most basic or lowest technology level) of the pyramid. 

As the technology level levels move from the base to the apex more richer feature sets are added along with greater sophistication (read greater fitting flexibility to meet the listening and clarity needs of our patients) and easier use with less adjustments to be made by the patient are added to the basic hearing device.  In addition, as each level of technology increases and the hearing aid becomes more sophisticated the time it takes to  fit the hearing aid to an individual hearing needs increase because we now have more control over the listening environments or soundscapes they interact in. 

So, what do you get with each tier of technology?  At Hearing Resources we define the tiers as listed below.  I have also given a lifestyle (activity) level that I feels matches the technology level.  This is one I have developed over 30-years of fitting hard-of-hearing individuals and feel is a fair guideline.  For more on lifestyle please review the section on our website dealing with lifestyle and listening needs with regards to technology levels.  I have also listed down my personal opinions on replacement times frames based on my experiences and the changes in the marketplace that digital technology is bringing about.  I have also listed the general warranty cover available with with each level of technology.  Please note that there are two warranties listed.  The parts and labor warranty covers all factory parts and circuits over the life of the warranty for basic repair or part replacement to return the hearing aid to its factory original specs.  This warranty will vary between one year and three years depending on the technology tier purchased.  The second warranty is designed for the more serious problem of the hearing aid being lost or damaged beyond the basic repair.  This warranty can be used once during the warranty period for the full replacement of the hearing aid with only a minimum co-payment required that is generally, at the time I am writing this, of less than $400.  The Loss & Damage warranty is only available on tiers 1 through 4 and not available on tier 5 products.  I personally feel this is a wonderful coverage as life happens and I have replaced hearing aids that have mysteriously disappeared, dogs or cats have chewed up, been stepped on, dropped in rivers, flushed, or otherwise lost. 

Definitions:

The first thing we should do when talking about technology levels is to define some of the terms we use and what they mean as these terms truly denote some of the differences between technology levels.  These terms also relate to the pricing structure you will be paying for. 

• Programs: In its most basic sense you can think of a program as a hearing aid within the hearing aid or as a virtual hearing aid within the physical hearing aid.  Each program can be adjusted independently of any other program and therefore designed with amplification characteristics that will meet or allow it to perform best for a particular listening environment or soundscape.  The more programs the fewer number of compromises that must be made while fitting a hearing aid to an individuals listening needs that will lead to improved speech clarity over a wider variety of listening environments.

  •  The greater the number of listening environments a person must function in or the less control a person has over their listening environments the more programs they should have.

• Channels: The very first thing you must understand about channels is the more of them we have the better the dispenser will be able to match the contour of a hearing loss and better an individual will be fit.  You can think of channels as slices of a pie.  The pie is the frequency range of speech plus a little.  The more slices the you have the more control you have over how much each person will get.  The more channels we have the finer we are able to adjust the gain, compressions levels, and many other things to match a hearing loss. 

  • Someone with a flat or gently falling audiogram (chart of a person's hearing loss) the less channels that are really needed.  Someone with a more sharply falling audiogram, reverse slope audiogram, or cookie bite audiogram will need more control of the frequency response and thus more channels to correctly match the hearing loss. 

  • Other factors can also effect the number of channels needed like reduced tolerance levels or an overloading of the cochlea due to over-amplifying at certain frequencies. 

It should also be noted that as we advance in technology levels each step up incorporates all of the features of the lower tier products plus adds the features listed for that tier.  Nothing is ever lost when moving up, only new features gained.

Tier 5 Technology Level:
 Tier Five technology provides a very basic yet cost effective hearing aid without any real feature sets.  This will meet the basic listening needs of many people if they have a more sedate lifestyle. Generally this level of technology incorporates a single program that sets the gain configuration and other amplification parameters of the hearing aid.  This means the hearing aid's single program must work in every listening environment the patient is going to be listening in.  You can think of this as a Jack-of-All-Trades that must function in every listening environment but because of the many compromises it must make to do this it doesn't function well in any single listening environment.  Therefore this level of technology is best suited for someone whose listening environment can be easily controlled, with regards to background noise levels, or whose background noise levels do not vary much during the day.  In addition the number of people this person needs to talk to, at one time, is limited to about one to two individuals who can take turns talking. 

 Because of the lack of features the individual will probably replace this aid within three to four years because of the more restricted fitting adjustments which restrict the ability to reprogram the aid to match changes in hearing levels and loss configuration.  Also, should the patient's lifestyle or listening environment change, the hearing aid may not provide the flexibility to be reprogrammed to match their new listening environment.  Warranty coverage for Tier Five is generally 1-yrs Parts & Labor only.

Tier 4 Technology Level:

Tier Four technology is one step up from the base level and provides hearing aids with a wider feature set and more flexibility in fitting (generally between 3 to 4 channels {provides basic flexibility in fitting a hearing loss} and 1 to 2 manual programs {used to meet listening needs in varying soundscapes}) and meeting individual listening needs today and probably for the next three to four years.  There are no automatic adjustment features but the patient does have a small push button on the aid that allows them to move between a quiet listening environment and noisier listening.  The second program is designed to improve speech clarity  as background background noise increases.  In addition some environmental noise limiting features are available in this level. 

The tier 4 technology level is designed to meet a person’s basic listening needs if the person’s listening environment is more limited and their activity level is low.  This is a good aid for a person who may be living with a spouse, family member or in a foster care home whose activity levels are more limited to around the home or on occasional trips to places with slightly noisier listening environments like a shopping trip, the mall or an occasional, quieter, restaurant.  The patient should also have fair manual dexterity, to adjust the hearing aid to match the listening environment, and mental ability to notice when they need to change between programs for the best possible speech clarity.  In addition, with the limited number of channels, the loss configuration should be gently falling or rising without rapid changes between octaves in the speech range to provide the maximum benefit. 

Due too the more restricted level of features, while better than a tier 5 product, the individual will probably replace this aid within three to four years.  This is mainly due to the fact that as the patient's hearing loss changes in degree of loss and shape the hearing aid may not be able to match the new parameters as well as needed because of the lack of fitting flexibly.   In addition, should the patient's lifestyle or listening environment change, the hearing aid may not provide the flexibility to be reprogrammed to match their new listening environment.

The warranty coverage for Tier Four is generally 1-yrs Parts & Labor plus 1-year Loss & Damage.  A small co-payment is required for loss and damage replacement, currently under $400, and the factory will only replace the hearing aid once during the life of the warranty.

Tier Three Technology Level:

Tier Three technology provides hearing aids with a nice feature set along with good flexibility in fitting (generally between 6 to 8 channels {allows better adjustability in matching the shape and configuration of a hearing loss}.  At this level of technology we are starting to get into the beginning of hearing aids that will start making decisions about what listening program will provide the better speech clarity.  In tier three we offer a master program group composed of two sub-programs that will automatically adjust itself between the two sub-programs, one for listening in quiet and one for better speech clarity in nosier listening environments.  In addition the hearing aids will provide provide one to two manual programs that can be fit for special listening needs or soundscapes.   The hearing aids in this tier have a nice set of noise limiting features available to improve speech enhancement and listening comfort. Most of the hearing aids in this tier will also incorporate an automatic or easy telecoil that allows for clearer and easier telephone usage.  When the telecoil is activated it does use one of the two manual program slots and can be accessed through the manual button, should the person want to connect to an assistive listening system at the theater or movie house, or automatically with the telephone. 
Hearing aids in this technology tier are starting to incorporate some wireless capabilities.  What this means to the wearer is we have a good way to connect external assistive devices like cell phone interfaces (BlueTooth) and television listening devices directly into the hearing aids without having to go through an analog telecoil and the static that brings into the picture. 
This tier is designed for individuals who have a semi-active social  lifestyle involving a few friends and family members.  Some outside the home activities like shopping at the grocery store, church once a week, dinner in a quieter restaurant once to twice a month and have one to three friends over maybe once a week for visits. Hearing loss configuration should also have gentler slopes without sharp drops or rises.
This hearing aid will most likely be replaced somewhere between four to six years because the individual will want new features that come on the market and the aid, being more fitting flexible will meet additional hearing loss longer into the future.
Warranty coverage for Tier Three is generally 2-yrs Parts & Labor plus 1-yr Loss & Damage (each aid will be replaced once).

Tier Two Technology Level:

Tier Two technology provides hearing aids with a rich feature set and good flexibility in fitting (generally between 12  to 16 channels {provides flexibility in fitting a hearing loss} and 3 to 5 programs {used to meet listening needs in varying soundscapes) along with an advanced master program composed of a subset of 3-programs (a quiet listening environment program, a speech in noise listening program and a program designed for comfort in noise for those very noisy listening environments like sporting events, the Safeway checkout counter on Friday night and such.  This allows greater flexibility in meeting an individual’s listening soundscapes automatically plus being able to meet the individual's listening needs today and probably for the next 4-6 years and possibly longer.  The automatic adjustment features provide a good, if somewhat limited, selection of settings for listening environments.  These hearing aids will make a distinction between speech and noise in the soundscape and will enhance speech some while reducing unwanted background noise.  Some models, in this tier, incorporate the streaming of telephone information from one ear to the other ear which improves telephone speech clarity, since both ears are used on the telephone instead of only one ear. 
This technology is designed for those individuals leading fairly active lifestyles with a fair amount of social interaction but whose soundscapes are not as demanding or dynamic on effecting conversations.   
Hearing loss configuration can have sharply falling or rising audiograms. 
Warranty coverage for Tier Two is generally 2-yrs Parts & Labor plus 2-yrs Loss & Damage (each aid will be replaced once) although some products do have 3-year warranties.  .

Tier One Technology Level:

Tier One of technology is the latest State-of-the-Art instruments and provides hearing aids with the fullest feature sets and greatest flexibility in fitting (generally between 16 to 20 channels {provides flexibility in fitting a hearing loss} and 5 to 9 programs {used to meet listening needs in varying soundscapes} with a premium master program composed of a subset of 4-programs and/or a blend of the subset <{meeting an individual’s listening soundscapes automatically})  and meeting individual’s personal listening needs today and probably for the next 5 to 8 years or longer.  This level also provides the best automatic adjustment to match listening soundscapes  as they change around an individual to insure they continue to enjoy the conversation and sound around them with the least amount of work and adjustment.  These hearing aids also employ the most sophisticated decision making abilities in choosing which speech you want to listening instead of who is just in front of you.  Several of the hearing aids in this tier have information sharing between the right and left hearing aids which allows them to do dual processing of information and to take speech information from one side and send it to the other side.  One example would be for improved speech clarity in a car where the aids can turn the microphone off on the driver's left ear and share the sound coming in the right ear with the left ear  so both ears will hear the conversation from the passenger while reducing the road noise and giving improved speech clarity.  This also allows for, on some models, the ability to blend between programs instead of having a hard this program or that program.  This also helps improve speech clarity over a wider range of listening conditions. 
Also includes all of the feature sets of the lower tier levels within this tier. 
Designed for those individuals leading an dynamic lifestyles with within varied soundscapes and have demanding listening needs that they must carry on conversations within.  This is the best tier to those who have demanding listening needs on the job or who may have to incorporate assistive listening equipment to work in mid to large size meetings or at range.  Also for those who enjoy or work with music. 
Hearing loss configuration can be gentle to radical falling or rising. 
Warranty coverage for Tier One is generally 3-yrs Parts & Labor plus 3-yrs Loss & Damage (each aid will be replaced once during the warranty period). 

I hope this helps you to understand better some of the differences between technology tiers.  If you have any questions please contact us and we will be glad to attempt to answer them for you.