OTC Hearing Aids 

There are limited similarities between the two types of hearing aids – although both make sound ‘louder’. But, prescription hearing aids allow for a greater amount of adjustment and customization as to which sounds are made louder, and by how much. They also have advanced features for assisting hearing in more complex sound environments that aren’t present in OTCs.Hearing aids selected and programmed by an Audiologist are governed by the regulations of The South African Health Products Regulatory Authority (SAHPRA), who is responsible for overseeing the safety, quality, and efficacy of medical devices. Importantly, the role of fitting a prescription hearing aid (hearing medical device) is a legally role allowed only for hearing care professionals registered under the Health Professions Council of South Africa.  OTC hearing aids have limitations in their loudness and certain features as compared to prescription hearing aids. There are some similarities between the two types of hearing aids, but prescription hearing aids allow for a greater amount of adjustment and customization, and the sound quality and processing is far superior in prescription hearing aids.

Hearing aids are highly sophisticated medical devices. While the internet makes many products more accessible, buying hearing aids online can expose consumers to significant risks, including:

• Incorrect device fitting: Without professional testing and fitting, hearing aids may not provide adequate amplification (meaning, insufficient volume), potentially meaning that money spent on these devices may under-address a person’s needs and communication difficulty. Even a small under-amplification in the short-term can lead to larger losses of function over several years. In addition, there is also the danger of OVER amplification, which risks further damage to a person’s hearing due to excessive sound exposure over time. Even a small amount of excessive sound, if worn consistently, can cause lasting, long-term damage to hearing.
• No medical screening: Hearing loss can sometimes indicate underlying medical conditions (such as wax impaction, middle ear infections, or sudden sensorineural hearing loss) that require medical attention. These may be missed without a professional evaluation. Some of these less serious problems if identified, could
  mitigate the need for any hearing aids. Some of the more serious conditions (such as sudden sensorineural hearing loss) require emergency assessment and medical treatment preferably within the first 72 hours of experiencing a sudden loss, which may result in saving a person’s hearing.
• Lack of customization: Hearing aids require fine-tuning for each individual’s hearing profile, lifestyle, and listening environments. Online devices are typically not programmed to your unique needs. Best practice guidelines indicate that hearing devices, even when programmed according to one’s hearing loss, need to be fitted using “real ear” measurement which accurately measures the amount and resonance of sound reaching the eardrum in relation to each person’s hearing loss and the unique ear canal shape and size. The size and shape of an ear can significantly impact the level of sound needed to compensate for the hearing loss – with smaller ear canals naturally increasing the sound energy at the eardrum, and larger ear canals, reducing it. Therefore, YOUR hearing aid/s fitment should be a customized, tailored adjustment that takes YOUR ear canal size and shape into consideration, which isn’t available from a retail, over-the-counter or online “sale”, but can only be obtained by a licensed professional who follows best practice standards.
• Limited aftercare: Professional support is critical for long-term hearing success.  Online purchases often lack ongoing care, repairs, or counseling.
• Warranty & service issues: Many manufacturers do not honor warranties for devices purchased outside of authorized professional channels.
• Locked devices: In some cases, products purchased from online stores or even ‘retail’ outlets may be locked for use, meaning that other professionals cannot access the settings or help you with adjustments. A patient who purchases a locked device may therefore be locked into the relationship with the person they purchased it from! This can become challenging if you move to a new location or if you are not happy with the service or professionalism of your provider.
• Purchases may seem cheaper, but arrive at the customer as a factory setting: To make the device useful, the purchaser may find themselves needing an assessment, fitting, verification and adjustment at an audiologist or acoustician to set the device. There is a cost in obtaining the expertise of these services, resulting in an outcome that may have a similar cost to having visited a hearing care professional in the first place.

OTC hearing aids are marketed towards individuals with perceived mild to moderate hearing loss. If you are struggling to hear in a quiet environment, and others have to raise their voices to be audible to you, it is unlikely that an OTC hearing aid will be powerful enough for you. This indicates a more severe hearing loss which must be diagnosed and managed by a trained Audiologist or Acoustician using prescription hearing aids.

No. Online devices are often amplifiers, not medical-grade hearing aids. Even if you find a device that is equivalent to what you may purchase in a professional’s practice, they may lack the input of a professional fitting, warranty, and support, and may be an expensive error if a diagnosis and treatment plan are not provided to you, prior to any purchase.

No, OTC hearing aids can only be used by adults. Children who may be at risk of hearing loss need to be assessed by an Audiologist trained in paediatric audiology to gain an accurate picture of the child’s hearing ability and any ear-related medical conditions that may need to be addressed. Children have specific needs when it comes to prescription hearing aids related to their growth and development. These hearing aids need to be programmed by a licensed Audiologist with extensive experience working with the paediatric population, as there are several requirements and parameters that the hearing aids must meet to adequately provide benefit for a child with hearing loss. The Audiologist plays a key role in managing referral pathways as children with hearing loss need speech therapy and often need special school placement, among referral to other healthcare providers based on their overall health and development. They also need routine follow-up to monitor progress and to ensure speech and language milestones are met.

In order for a medical aid to pay for hearing aids, they require a written motivation, the audiological assessment results and quotes for suitable hearing aids from an Audiologist or Acoustician. When making recommendations for hearing aids, Audiologists or Acousticians will advise on hearing aids that they are familiar with, and which have undergone rigorous research and development to prove that these devices are effective in improving hearing performance and communicative experiences. It is best to consult with an Audiologist or Acoustician to discuss the best options that are suited to your unique hearing abilities.

To ensure that you or your loved one receives the best care:

• Start with a hearing test from a qualified Audiologist (for adults and children) or Acoustician (over 12 year olds, only).
• Discuss all available options, including hearing aids, assistive listening devices, and other rehabilitation tools.
• Ensure your device is fitted by a registered professional, who can provide proper post-fitting measurements, follow-up care, adjustments, education about how to correctly use and care for your devices, and counseling.
• Ask about warranties, service policies, and upgrade options before purchase.
• While hearing aids are the most important tool in use to provide accessibility to sound, there are many benefits to obtaining a diagnosis from a qualified hearing care professional, including:
  • ✔ Accurate diagnostics which differentiate between medical disorders requiring medical or surgical intervention and possibly NOT hearing aids.
  • ✔ Diagnosis that recognizes any concerning symptoms or results that could point to health needs that do not only involve the ear and need referral to an ear nose and throat specialist or other medical specialties.
  • ✔ Difficulty hearing is not always isolated to the ear itself but may involve other parts of the auditory system. Measurement of more than the ear is required during an assessment of difficulty.
  • ✔ Because a hearing professional can provide a comprehensive measurement of all parts of the auditory pathway including areas of the brain that interpret sound, they can ensure that you have an overview of a complete plan to address your communication challenges for optimum outcomes. A full understanding of the implications of your needs may allow more efficient cost planning, avoid expensive errors, and allow you to reap the benefits of healthcare that goes beyond the tool (hearing aid) only.