Hearing Aid Selection Research Articles

Practice Trends for Hearing Aid Fitting for Adults Among Audiologists in India: A Survey.

Audiologists are hearing healthcare specialists dedicated to the rehabilitation of individuals with hearing loss by prescribing the appropriate amplification devices. The process of choosing and fitting hearing aids involves several steps for which standardized guidelines have been issued. The aim of the present investigation was to evaluate the patterns of practice employed by Indian audiologists in the evaluation and fitting of hearing aidsfor adults. The survey was conducted using an Online questionnaire and distributed to Audiologists practicing in different parts of India via Google form link between April-August 2020. In all, 158 Audiologists participated in the study. The questionnaire consisted of 48 questions distributed over seven domains which included Respondent's Profile, Hearing aid fitting experience with Adults, Assessment protocols, Hearing aid selection, Hearing aid fitting, Hearing aid verification, and Skills and Confidence levels of Audiologists. The findings of the study revealed varying practice trends, particularly during the stages of hearing aid verification and validation. There were also differences in the Audiologists' proficiency and confidence in carrying out the various stages of fitting hearing aids.

Hearing Aid Fitting and Fine-tuning Strategies Implemented by Certified Audiologists in India

Background: Management of hearing-impaired individuals using hearing aids requires expertise in fitting formulas, compression methods, frequency adjustments, microphone directionality, noise reduction algorithms, and feedback management. There are abundant online resources/guidelines for programming and fine-tuning hearing aids. The fitting strategies for hearing aids can differ among professionals based on their expertise and convenience. Aims and Objectives: The survey study aimed to gain comprehension of the methods used by audiologists practicing in Indian subcontinent in choosing, fitting, and tuning hearing aids for adults with hearing impairment. Materials and Methods: A web-based survey with a 25-item questionnaire was carried out among audiologists nationwide, addressing topics such as hearing aid selection and fitting techniques. Among the audiologists practicing in India, 77 audiologists from various workplaces across India responded to the survey. The data gathered were then subjected to descriptive analysis. Results: The study showed that the selection of hearing aids depended on the extent of hearing loss and the main listening needs of the person. Audiologists generally used manufacturers’ initial fit and their expertise to adjust different signal processing features and considered patient feedback for additional adjustments. Most audiologists use only pure-tone audiometry for the initial evaluation of hearing abilities. Conclusion: The findings of the research underscore the absence of standardized procedures for audiologists in the fitting of hearing aids, considering the numerous signal-processing approaches present in contemporary hearing technology. Despite exponential advancements in hearing aid technology, there remains a scarcity of concise and accessible information that would enable audiologists to utilize such sophisticated technologies during fitting and tuning effectively.

DESIGN AND IMPLEMENTATION OF THE ACHIEVE HEARING INTERVENTION

Abstract The ACHIEVE trial required the development of a manualized best-practice hearing intervention designed to meet the needs of older adults with mild-moderate hearing loss. The hearing intervention (HI) was developed using an iterative process including input from a diverse professional panel and a feasibility study to confirm that expected outcomes from a best-practices, evidence-based HI would be obtained. The HI involves use of hearing aids and related technologies along with counselling, coaching and education to support self-management of hearing loss. The HI is delivered in four sessions after the completion of a comprehensive hearing evaluation. Individualized goals are developed using the Client Oriented Scale of Improvement (COSI), which guides selection of hearing aids and other technologies to meet prioritized listening needs and assessment of how well those needs are met. The most frequent COSI listening goal categories included: Conversation in Noise (n= 413; 29%), Conversations in Quiet (n= 296; 21%), and TV/Radio at Normal Volume (n= 280; 20%). Three levels of hearing aid technology differing by the number of signal processing approaches included were: Basic (n=223, 20%), Advanced (n=662, 56%), and Premium (n=283, 24%). Additional hearing assistive technologies included streaming devices, TV connectors, and remote microphones were provided. We discuss how the baseline audiological results and individualized goal setting informed delivery of the HI and how the use of manualization allowed us to maintain excellent treatment fidelity throughout the clinical trial.

Prediction of high-power hearing aid for audiology patients using data mining techniques

Our research examined two of unsupervised Data Mining algorithms for both comparison and prediction to predict the High-Power Hearing Aid for audiology patients who suffer from hearing impairment. These Data Mining techniques are Manifold Learning and Multidimensional Scaling. Both algorithms define specific rules to choose the linear projection of the data. These methods can be effective, but sometimes miss the structure of non-linear data. Our research deals with new specific data set which collects and analyses depends on Audiology information and Patient's diagnosis. Note that the data set selected must be subject to accurate data analysis with pre-processing of data. It should be applicable and authoritative because these factors are very important to obtain the highest degree of prediction possible, as long, some data types are not appropriate for decision tree or some methods of classification. The data set we created consists of seventy-two fields distributed on seventy-one fields for data details and one further for class. All data set fields are categorical, and it contains some of missing values. The fact that our data was subjected to a very accurate analysis (before cleaning) based on the correct medical diagnosis and comprehensive information of the most important points that directly affect the selection of appropriate hearing aid for audiology patient, and via applying data mining techniques, we obtained a prediction of 100% for hearing aid selection, and 98% to determine which power type of hearing aid that those patients should use. To reach our goal, we examined Data Mining techniques utilizing Python for coding and modelling.

Rethinking the Audiogram for Hearing Aid Selection

Rethinking the Audiogram for Hearing Aid Selection

National Survey of Pharmacist Awareness, Interest, and Readiness for Over-the-Counter Hearing Aids.

Hearing loss is a major public health concern, affecting over 30 million Americans. Few adults who could benefit from hearing aids use them. Hearing aids are now available over-the-counter (OTC) for persons with perceived mild-to-moderate hearing loss. Community pharmacies will sell OTC hearing aids to increase public access to hearing healthcare. The purpose of this study was to describe pharmacist awareness, interest, and readiness to offer OTC hearing aids at community pharmacies. A multiple-item online survey was designed using the Theory of Planned Behavior and responses were collected from licensed pharmacists from July 2021 to December 2021. Descriptive statistics were used to summarize the 97 responses collected. Most respondents were not aware of the upcoming OTC hearing aid availability. Most respondents were somewhat or very interested in increasing their knowledge on OTC hearing aids, selling OTC hearing aids, and assisting patients with OTC hearing aid selection. Most respondents disagreed or strongly disagreed that they had the necessary knowledge to counsel patients on OTC hearing aids. The most reported supporting factor was training and educational resources. OTC hearing aids are a unique public health initiative which will expand patient access to hearing health care to community pharmacies.

Audiologic Assessment.

Prior to the fitting of hearing aids, clinicians and patients must discuss the best treatment options for the physical and audiologic needs of the patients. To be able to confidently make these decisions, the clinician should complete a medical and audiological case history. Additionally, clinicians need accurate results from a comprehensive audiologic evaluation. The evaluation should include the following: pure-tone testing, word recognition testing, speech-in-noise testing, and loudness discomfort level measures. This article will outline the process and procedures for acquiring this information in line with the Audiology Practice Standards Organization (APSO) Guidelines for Adult Hearing Aid Fittings Standards 1 and 4. This article will also discuss how results can affect decision-making during the hearing aid selection and fitting process.

APSO Standards: Implementing Hearing Aid Needs Assessments and Measuring Related Outcomes.

The proportion of individuals who pose to benefit from the use of hearing aids is much smaller than those who adopt them. Likewise, many adults who try hearing devices abandon using them after a short period of time. Most factors related to hearing aid use are unrelated to a patient's hearing loss severity. Hearing loss treatment requires more than the provision of hearing aids as a sole intervention. Adoption rates could be improved through the implementation of evidence-based clinical protocols which maximize patients' success. Recently, the Audiology Practice Standards Organization (APSO) released evidence-based, formal standards of practice addressing hearing aid selection, fitting, and rehabilitation for adult and geriatric patients. Notably, the standards acknowledge the importance of an amplification needs assessment, including hearing aid outcomes measurement. In this brief narrative, we describe Standards 3 and 14 ( Needs Assessment and Hearing Aid Outcomes Measurement ) and offer an example of the clinical implementation of a comprehensive needs assessment and hearing aid outcomes measurement currently being used in a multisite, longitudinal clinical trial.

Hearing Aid Selection: Closed- versus Open-canal Fitting Hearing Aids

To select hearing aid is an essential process for successful hearing rehabilitation. The purpose of this study is to review hearing aid selection considerations between receiver in-the-canal (RIC) and custom hearing aid (CHA) in order to guide appropriate selection of the hearing aid. This study discussed three key factors in the hearing aid selection including physical, acoustic and electroacoustic characteristics and other aspects. Advantages of RIC types are comfort to wear, reduction of the occlusion effect, presence of directional microphones, on-site fit, easy connectivity with other devices, and use of rechargeable batteries. On the other hand, the CHA types have their advantage in terms of being comfort to wear with masks, proper insertion and placement, reduction of the acoustic feedback, good approximation of frequency response curve, improvement of speech in noise perception, expanded hearing aid candidacy with varying hearing thresholds, and easy telephone use. We concluded that appropriate selection of the hearing aid would contribute to successful hearing rehabilitation, if considering physical, psycho-social, and acoustical characteristics.

DARF: A data-reduced FADE version for simulations of speech recognition thresholds with real hearing aids

Developing and selecting hearing aids is a time consuming process which is simplified by using objective models. Previously, the framework for auditory discrimination experiments (FADE) accurately simulated benefits of hearing aid algorithms with root mean squared prediction errors below 3 dB. One FADE simulation requires several hours of (un)processed signals, which is obstructive when the signals have to be recorded. We propose and evaluate a data-reduced FADE version (DARF) which facilitates simulations with signals that cannot be processed digitally, but that can only be recorded in real-time. DARF simulates one speech recognition threshold (SRT) with about 30 min of recorded and processed signals of the (German) matrix sentence test. Benchmark experiments were carried out to compare DARF and standard FADE exhibiting small differences for stationary maskers (1 dB), but larger differences with strongly fluctuating maskers (5 dB). Hearing impairment and hearing aid algorithms seemed to reduce the differences. Hearing aid benefits were simulated in terms of speech recognition with three pairs of real hearing aids in silence (≥8 dB), in stationary and fluctuating maskers in co-located (stat. 2 dB; fluct. 6 dB), and spatially separated speech and noise signals (stat. ≥8 dB; fluct. 8 dB). The simulations were plausible in comparison to data from literature, but a comparison with empirical data is still open. DARF facilitates objective SRT simulations with real devices with unknown signal processing in real environments. Yet, a validation of DARF for devices with unknown signal processing is still pending since it was only tested with three similar devices. Nonetheless, DARF could be used for improving as well as for developing or model-based fitting of hearing aids.

Auditory Steady-State Responses to Narrow-Band Chirps in Predicting Aided Behavioral Thresholds

Purpose: A review of the existing literature shows that auditory steady-state responses (ASSR) to narrow-band (NB) chirps analyzed using q sample averaging is more reliable and accurate than ASSR for modulated tones in predicting behavioral thresholds. Studies in this direction have been carried out to predict hearing sensitivity. However, there is a dearth of studies investigating ASSR for NB chirps in persons using hearing aids. The present study evaluated if ASSR for NB chirps analyzed using q sample averaging could be used to predict aided behavioral thresholds during the hearing aid selection. Specifically, the study investigated the agreement and differences between behavioral thresholds predicted from aided ASSR with aided behavioral thresholds. Materials and Methods: Retrospective analysis of clinical records of 24 ears with hearing loss were carried out. The age of the children ranged from 3 to 5 years. Aided behavioral thresholds and aided ASSR for NB chirps were recorded at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. Results: Wilcoxon signed-rank test revealed no significant difference between aided thresholds predicted through aided ASSR and measured behavioral thresholds for all four frequencies. The Bland–Altman analysis also showed that the results of the two tests are comparable for all four frequencies. Conclusions: Aided ASSR can predict aided behavioral thresholds in children who fail to provide voluntary responses to behavioral tests, but the results need to be crosschecked using other measures. ASSR can thus be added to the protocol used for hearing aid fitting and validation in young children.

Classification of Hearing Aids Into Feature Profiles Using Hierarchical Latent Class Analysis Applied to a Large Dataset of Hearing Aids.

We developed a framework for objectively comparing hearing aids, independent of brand, type, or product family. This was done using a large dataset of commercially available hearing aids. To achieve this, we investigated which hearing aid features are suitable for comparison, and are also relevant for the rehabilitation of hearing impairment. To compare hearing aids objectively, we distinguished populations of hearing aids based on a set of key hearing aid features. Finally, we describe these hearing aid subpopulations so that these could potentially be used as a supporting tool for the selection of an appropriate hearing aid. In this study, we used technical (meta-)data from 3911 hearing aids (available on the Dutch market in March 2018). The dataset contained about 50 of the most important characteristics of a hearing aid. After cleaning and handling the data via a well-defined knowledge discovery in database procedure, a total 3083 hearing aids were included. Subsequently, a set of well-defined key hearing aid features were used as input for further analysis. The data were split into an in-the-ear style hearing aid subset and a behind-the-ear style subset, for separate analyses. The knowledge discovery in databases procedure was also used as an objective guiding tool for applying an exploratory cluster analysis to expose subpopulations of hearing aids within the dataset. The latter was done using Latent Class Tree Analysis, which is an extension to the better-known Latent Class Analysis clustering method: with the important addition of a hierarchical structure. A total of 10 hearing aid features were identified as relevant for audiological rehabilitation: compression, sound processing, noise reduction (NR), expansion, wind NR, impulse (noise) reduction, active feedback management, directionality, NR environments, and ear-to-ear communication. These features had the greatest impact on results yielded by the Latent Class Tree cluster analysis. At the first level in the hierarchical cluster model, the two subpopulations of hearing aids could be divided into 3 main branches, mainly distinguishable by the overall availability or technology level of hearing aid features. Higher-level results of the cluster analysis yielded a set of mutually exclusive hearing aid populations, called modalities. In total, nine behind-the-ear and seven in-the-ear modalities were found. These modalities were characterized by particular profiles of (complex) interplay between the selected key features. A technical comparison of features (e.g., implementation) is beyond the scope of this research. Combining a large dataset of hearing aids with a probabilistic hierarchical clustering method enables analysis of hearing aid characteristics which extends beyond product families and manufacturers. Furthermore, this study found that the resulting hearing aid modalities can be thought of as a generic alternative to the manufacturer-dependent proprietary "concepts," and could potentially aid the selection of an appropriate hearing aid for technical rehabilitation. This study is in line with a growing need for justification of hearing aid selection and the increasing demand for evidence-based practice.

Второй уровень аудиологического скрининга: стоит ли проводить его в кабинетах развития ребенка организаций ПМСП?

Второй уровень аудиологического скрининга: стоит ли проводить его в кабинетах развития ребенка организаций ПМСП?

The disuse of hearing aids in elderly people diagnosed with a presbycusis at an old age home, in Johannesburg, South Africa: a pilot study.

Hearing loss is the most common form of human sensory deficit with its prevalence highest within the geriatric population. Approximately a third of adults aged from 61 years exhibit the characteristics of presbycusis, a number one contributor to communication disorders among the elderly, thereby affecting the social, functional and psychological wellbeing of the elderly. Subsiquently, this leads to loneliness, isolation, dependence and frustration. To explore reasons why elderly people diagnosed with presbycusis and fitted with hearing aids stop using hearing aids post fitting. A qualitative research design was adopted. Through purposive sampling, ten participants consisting of three males and seven females, aged between 74 and 85 participated in face-to-face and semi-structured interviews. The following themes emerged: discomfort, lack of information about hearing aids, difficulty with function and maintenance and the lack of patient involvement in the hearing aid selection process. There are different reasons for disuse of hearing aids in elderly patients. Audiologists should ensure that hearing aids selection is patient specific and inclusive. Expectations of the elderly regarding hearing aids benefits and limitations should also be addressed by audiologists before fitting hearing aids.

A Follow-Up Clinical Trial Evaluating the Consumer-Decides Service Delivery Model.

ObjectivesThere were 2 main objectives. The primary objective was to replicate a prior clinical trial of a consumer-decides (CD) approach to selecting hearing aids in older adults as a potential model for over-the-counter (OTC) intervention using less front-end screening of participants and a wider range of frequency-gain characteristics in the devices. The 2nd objective, only feasible if participant choices allowed, was to evaluate the efficacy of the CD approach relative to a CD-based placebo device.DesignThe design of this study is a single-site, prospective, double-blind clinical trial. Outcome measures were obtained after a typical 4- to 5-week trial period. An optional follow-up of a 4-week audiology-based (AB) best practices trial was also included for replication and comparison purposes.SettingOlder adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic.ParticipantsParticipants were adults, aged 54–78 years, with mild–moderate hearing loss. Forty-one participants enrolled as a volunteer sample; 40 completed the intervention.Intervention(s)All participants received the same high-end digital mini–behind-the-ear hearing aids fitted bilaterally. CD participants self-selected their own preprogrammed hearing aids via an OTC-type model. One of the 3 devices from which participants could choose was programmed to be a placebo device with no functional gain.Primary and Secondary Outcome MeasuresThe primary outcome measure is the 66-item self-report Profile of Hearing Aid Benefit (Cox & Alexander, 1990). The secondary outcome measure is the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing aid benefit and usage were also obtained.ResultsPer-protocol analyses based on the data from the 40 (of 41) participants who completed the study were performed. Hearing aid outcomes from this follow-up CD (CD2) cohort were positive and generally the same as for the original CD cohort. CD service delivery model was efficacious relative to CD-based placebo control, with medium effect sizes observed. Approximately half of the CD2 group was likely to purchase hearing aids after the trial, similar to findings for the original CD cohort. Outcomes improved significantly for the 32 CD2 participants who elected to complete the optional 4-week AB trial. For this largely unscreened sample, more individuals with healthy hearing sought amplification, and many of these individuals (35%) chose placebo devices for both ears.ConclusionsPrior positive outcomes for CD service delivery have been replicated in a less restrictive approach to participant recruitment. The CD approach was again found to be efficacious. Significantly better outcomes were observed after subsequent AB service delivery follow-up, also replicating prior findings. Efficacious OTC models, including those using similar CD approaches to hearing aid self-selection, may increase accessibility and affordability of hearing aids for millions of older adults. Front-end guidance to consumers regarding the best path to intervention, ranging from self-screening of hearing online to a full audiologic assessment, appears to be critical to optimize the success of OTC approaches.Trial RegistrationClinicaltrials.gov: NCT01788432; https://clinicaltrials.gov/ct2/show/NCT01788423Supplemental Materialhttps://doi.org/10.23641/asha.7728479

Clinical protocol for Hearing Health Services for the care of adults and elderly.

To develop a clinical protocol for patient care in the selection, verification, and validation process of hearing aids; to verify the viability of the protocol during its use by specialists in the field; to establish the graphical representation of the protocol by means of a flowchart with algorithms. We conducted a literature review to collect the procedures required for developing clinical protocols in healthcare services and the main procedures at each step along the process of fitting hearing aids. Subsequently, we developed the protocol, which was evaluated by eight audiologists in terms of its content and ease of use. We considered the issues raised by the professionals and then drew up a final document, as well as a flowchart with process algorithms. A protocol after having conducted an extensive survey of the literature was developed; all audiologists reported that the use of the instrument was of great value in their clinical practice; finally, we created the flowchart with algorithms after having developed the protocol and, by extension, we also created the Standard Operational Procedure for the selection, verification and validation process of hearing aids. The clinical protocol for the care of patients in the selection, verification and validation process of hearing aids was developed and validated by means of its use by professionals. The information and data we collected allowed a graphical representation of the protocol and its steps as a flowchart with algorithms.

Prediction of uptake and retention of conventional hearing aids in Korean pediatric patients with unilateral hearing loss

ObjectiveThe purpose of this study was to describe and predict hearing aid uptake and retention in Korean pediatric patients with unilateral hearing loss (UHL) in a secondary referral hospital. MethodsThis was a retrospective study using clinical data collected at the time of UHL diagnosis. The study included data collected from 2009 to 2016. Serial audiograms were extracted from clinical charts, and follow-up status and rehabilitation decisions were analyzed. ResultsOf 102 children and adolescents (9.5 ± 5.1 years, 64 male), 52.9% followed a check-up schedule, and 31 (30.4%) obtained a hearing aid. Hearing threshold and speech discrimination scores were predictive parameters of hearing aid uptake. Among those who used a hearing aid, 17 (56.7%) subjects used it successfully based on significant predictive parameters of channel number. ConclusionHearing aid retention in pediatric patients seems less predictable than in adults with UHL. No good predictable parameter for hearing aid retention was identified except channel number for pediatric UHL cases. Regular monitoring of hearing and selection of a multi-channel hearing aid are crucial to minimize the potential negative effects of UHL.

Health-Related Quality of Life Among Young Children With Cochlear Implants and Developmental Disabilities.

The present study examined differences in health-related quality of life (HRQoL) between deaf children with cochlear implants (CI) with and without developmental disabilities (DD) and differences across HRQoL domains within both groups of children. Ninety-two parents of children with CI aged 3-7 years participated in this cross-sectional study. Of these children, 43 had DD (i.e., CI-DD group) and 49 had no DD or chronic illness, demonstrating overall typical development (i.e., CI-TD group). Parents of children in both groups completed the KINDL, a generic HRQoL questionnaire. Parents also provided anecdotal comments to open-ended questions, and parent comments were evaluated on a CI benefits scale to assess parent-perceived benefits of CI for the deaf children with and without disabilities. Children in the CI-DD group had significantly lower HRQoL compared to children in the CI-TD group, including lower scores on the self-esteem, friend, school, and family HRQoL subscales. No significant differences among groups were found on the physical well-being and emotional well-being subscales. For the CI-TD group, age at implantation correlated negatively with self-esteem and school HRQoL subscales. In the CI-DD group, children's current age correlated negatively with family and with the total HRQoL scores. Parent anecdotal comments and scores on the CI-benefits scale indicated strong parent perceptions of benefits of implantation for children in both groups. Based on parents' proxy report, findings suggest that having DD affects multiple domains of HRQoL among young children with CIs above and beyond that of the CI itself. Parents of deaf children with DD may need greater support through the CI process and follow-up than parents of deaf children without DD.

Outcome of audiometric masking therapy on subjective tinnitus patients in different age groups

<p class="abstract"><strong>Background:</strong> Theoretical consideration suggests an impact of the age at tinnitus onset influencing tinnitus distress. The use of masking for tinnitus is a primary method of treatment of tinnitus. The objective was to study effectiveness of masking by introducing audiometric reference signal in treatment of subjective tinnitus.</p><p class="abstract"><strong>Methods:</strong> The 90 patients (45 males and 45 females) were assessed by pure tone audiometer. Patients were divided into 6 age group sets for evaluation. The reference signal (90 to 100 dB SPL for 2-3 minutes in tinnitus ear of frequency 1000 Hz) was used for masking therapy. Outcome of the study was measured by using the tinnitus handicap inventory (THI) score and awareness time (tinnitus perception) before and after audiometric reference signal masking therapy. Success rate was measured to measure therapeutic efficacy. </p><p class="abstract"><strong>Results:</strong> Our results depict improvement in subjective tinnitus by 57.78% (in males), 55.56% (in females) and overall 56.67% success in patients aged between 21 to 60 years by using our audiometric reference signal masking therapy. Regarding gender, the finding of THI score, Awareness time and Success rate in our study showed females being affected more than males. Our study also evidenced a highest percentage of tinnitus after the age of 70 followed by the decades 61–70 and 51–60.</p><strong>Conclusions:</strong> Our new economically viable approach to subjective tinnitus patients by audiometric reference signal seems to be an effective in improv­ing the patient’s distress in age group 21 to 60 years. Before taking decision for selection of high cost hearing aids, we can use it for poor people.

Efficacy of Directional Microphones in Hearing Aids Equipped with Wireless Synchronization Technology.

This study aimed to evaluate the use of directionality in hearing aids with wireless synchronization on localization and speech intelligibility in noise. This study included 25 individuals with bilateral mild to moderate flat sensorineural hearing loss. For the localization experiment, eight loudspeakers (Genelec 8020B) arranged in a circle covering a 0-360° angle and the Cubase 6 software were used for presenting the stimulus. A car horn of 260 ms was presented from these loudspeakers, one at a time, randomly. The listener was instructed to point to the direction of the source. The degree of the localization error was obtained with and without directionality and wireless synchronization options. For speech perception in a noise experiment, signal to noise ratio-50 (SNR-50) was obtained using sentences played through a speaker at a fixed angle of 0°. A calibrated eight-talker speech babble was used as noise and the babble was routed either through 0°, 90°, 270° (through one speaker at a time) or through both 90° and 270° speakers. The results revealed that the conditions where both the wireless synchronization and directionality were activated resulted in a significantly better performance in both localization and speech perception in noise tasks. It can be concluded that the directionality in the wireless synchronization hearing aids coordinates with each other binaurally for better preservation of binaural cues, thus reducing the localization errors and improving speech perception in noise. The results of this study could be used to counsel and justify the selection of the directional wireless synchronization hearing aids.