What are Real Ear Measures?

by | Jun 14, 2024 | Uncategorized | 0 comments

Real Ear Measurements (REMs)

For most people, investing in hearing aids can be a significant decision. Firstly, there is the acceptance that hearing is a problem. This can take many years, and once a decision is made, the next step is to find a provider who will carry out a hearing assessment. But who to choose from? Today, there are many high-street providers of hearing aids, often at discounted prices or involving free hearing aid trials. There are also smaller independent practices (like me). All hearing care providers claim to offer great service, a range of hearing devices and more. So how do you choose? And more importantly, will hearing aids purchased from different providers all sound the same? The answer to the first question could fill several blogs, and I will explore those at a later stage.

Today, I will focus on the second question, ‘Will hearing aids purchased from different providers sound the same?’. Crucial to this is a technique called Real Ear Measures, or REMs for short.

real ear meaurements

So, what are Real Ear Measures?

Put simply, Real Ear Measurements carried out during the hearing aid fitting ensure that the client is receiving the correct amount of amplification. Let’s dig into this in a bit more detail. Following a hearing test, the hearing aid software predicts how much sound should be produced in a person’s ear and programmes the hearing aids to deliver this sound into the ear. Great, all sounds good so far. However, unless Real Ear Measures are carried out, the audiologist cannot know IF this recommended amount of sound is actually being delivered into the ears. An audiologist can set up hearing aids which are faulty and send a client home with the faulty devices, if they haven’t performed Real Ear Measures.

Why are Real Ear Measures necessary?

The software to set up hearing aids is quite complex, and unlike having a prescription for glasses, prescriptions for hearing aids are changing constantly. All hearing aid fitting software assumes that you have an average-shaped ear canal. The size and shape of a person’s ear canal will affect the acoustics and sound that arrives at the eardrum. For example, the same hearing aid positioned in two different ears will deliver slightly different amounts of sound to the eardrums of the individuals, which is directly influenced by the size and shape of the ear canals. For some people, their ear canals are quite a bit different to the ‘average ear’, which can result in over or under amplification if Real Ear Measures are not performed.

Recently, I saw an elderly client who had spent a considerable amount of money on hearing aids from a well-known high street that regularly advertises on TV. His son arranged an appointment with me to check that his dad’s hearing aids were working properly. I carried out Real Ear Measurements, which highlighted that not enough sound was arriving in this client’s ears from his new hearing aids. Following adjustment, the client was hearing better and was able to get much more benefit from his hearing aids. The client went away much happier and hearing much better.

Real ear measures

How are Real Ear Measures performed?

A small tube is positioned in the ear canal to measure the sound in a person’s ear. This tube is connected to a microphone, which can then measure exactly how much sound reaches the eardrum. The audiologist will position the hearing devices into the ear canals and will then present various speech samples from a loudspeaker. By measuring how much sound is available in the ear canal and comparing this to the recommendation or prescription from the software, the audiologist can then adjust the settings of the hearing aids to match the recommendations. The whole process can take 15-20 minutes and can be tricky. For these reasons, many hearing aid providers do not carry these measurements out. Time is money, and for many high street providers who promise ‘free hearing tests’ and ‘low prices’, this is an easy step in the fitting process to leave out.

Are there benefits to carrying out Real Ear Measures?

Yes, is the simple answer. By including REMs as part of the hearing aid fitting procedure, clients are more likely to be satisfied with their hearing aids. And, more crucially, studies have shown that clients hear better when Real Ear Measures have been performed.


Paul Shaw director of the hearing space

How will I know if my hearing aid provider carries out Real Ear Measures?

The best thing to do is simply ask. When choosing a hearing aid provider, ask them how they will set up the hearing aids and, crucially, how they will verify that they are providing the correct amount of sound. Only Real Ear Measurements (REMs) can verify that the hearing aids deliver the correct amount of sound in the ears. Audiologists should have been trained to carry out these measures, but unfortunately, not everyone does this.

The bottom line

Investing in hearing aids and choosing a hearing provider requires careful consideration. Look for recommendations, check reviews and more importantly, talk to audiologists to find out how they will support you on your journey to better hearing.

To find out more about our hearing aid provision – see ‘Hearing Aids’ or call us for an intial discussion on 0113 8730444.

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