Auditory Acclimatization in New Adult Hearing Aid Users: A Registered Systematic Review of Magnitude, Key Variables, and Clinical Relevance

Journal of Speech, Language, and Hearing Research

Wentzel, C., Swanepoel, W., et al. (2025).

Journal of Speech, Language, and Hearing Research, 68(7), 3445-3479.

<div>This systematic review investigates auditory acclimatization in new adult hearing aid users.</div>

National Institutes for Health and Care Research Manchester Biomedical Research Centre (United Kingdom)

From database inception to March 16, 2024

<div>Peer-reviewed journal publications</div>

25

<div>Findings were as follows:</div> <div> <ul> <li>There was inconsistent evidence for acclimatization for aided speech recognition in quiet. Some studies showed improvements for the ear fitted with a hearing aid, while others showed stable performance.</li> <li>For aided speech recognition in noise, most studies showed improvements, though some studies considered improvements to be the effects of practice.</li> <li>Unaided speech recognition in quiet was stable in most studies, though there were some declines in nonfitted ears.</li> <li>Unaided speech recognition in noise showed stability or slight declines, with occasional improvements that may have been due to practice effects.</li> <li>Acclimatization was most often noted in studies of self-reported measures assessing general hearing aid benefit, though some studies of specific measures of aversiveness, distraction, expectations, satisfaction, and situational responses did not show evidence of acclimatization.&nbsp;</li> <li>Findings on acclimatization through electrophysiological outcomes were mixed; four studies showed improvements in neural measures, while three showed no significant changes over time.</li> </ul> <div>Overall, statistically significant changes in speech recognition were seen, but improvements were modest in size. In terms of self-reported measures, small-to-moderate, statistically significant improvements were often seen, particularly with regard to communication-related benefits. Studies of electrophysiological outcomes suggest that hearing aid use leads to significant auditory processing changes.</div> <div>&nbsp;</div> <div>Limitations to this review include the small number of included studies, reduced methodological rigor of the included studies, heterogeneity of the timing and outcome measures across studies, and lack of meta-analysis.</div> </div>

<div>Hearing aid acclimatization improvements in speech recognition and self-reported measures generally occurred within the first few months, with benefits continuing up to a year. Electrophysiological studies showed significant improvements as early as 2 weeks following hearing aid fitting, with changes continuing beyond 6 months. The most significant changes occurred within the first 3-12 weeks following fitting. Inconsistent findings were seen with regard to duration of hearing aid use and degree of hearing loss.</div> <div>&nbsp;</div> <div>Limitations to this review include the small number of included studies, reduced methodological rigor of the included studies, heterogeneity of the timing and outcome measures across studies, and lack of meta-analysis.</div>