The differences between Over The Counter vs Amplifiers vs Online vs Prescription hearing aids

There are a number of differences between Over The Counter hearing aids, Amplifiers, Online hearing aids, and Prescription hearing aids.

Over The Counter Hearing Aids (OTC)
Over the counter may be more regulated by Health Canada compared to personal sound amplifiers, depending on their indication for use. If the indication for use is not hearing loss, but simply amplification, they are not regulated. Regulated by Health Canada means being reviewed and approved for sale in Canada based on the requirements of the Canadian Medical Devices Regulations. Some of these requirements are safety, effectiveness and performance.
While inexpensive, they are basic in technology and are only recommended for mild to very moderate hearing loss situations as they will not help you understand speech or filter background noise in loud situations.
The United States, for example, has taken steps towards making OTC hearing aids available commercially, but they have cautioned people that it is only a temporary solution for those with mild to moderate hearing loss.
The concerns that have arisen from these devices is that you will not be required to have a hearing test, so more severe hearing losses can be missed. This can lead to the nerves in the ears not getting enough stimulation and hence the worsening of the hearing loss over time due to lower than needed amplification.
Other concerns that have come up is the possibility that serious to life-threatening conditions may be missed such as an Acoustic Neuroma. If your hearing is not properly checked these conditions may go unnoticed until permanent damage has been done.

Online Hearing Aids
Online hearing aids may or may not be licensed by the manufacturer for sale in Canada, but often do not come from a Canadian-based company.

Most online companies selling hearing aids are from US based sites. They require an online hearing test before sending you a hearing aid, but these are not accurate. As recognized by the government and medical field; a hearing test must be performed in a sound booth with an Audiometer in order to gain accurate readings. Many of these sites have online hearing tests you perform and the hearing aids are "programmed" for your hearing loss. What they are not telling you is they are simply raising the volume to meet your test results, just like you would crank up the volume on your personal headphones. A proper hearing test is vital to a successful fitting and obtaining the full health benefit from a hearing aid. While seemingly cheaper at the point of purchase, you run the risk of needing service and adjustments, and these will not be covered by the online company that originally sold you the hearing aids. Furthermore, in most cases local clinics will not have the software or parts available to service them because they are not sold from a licensed provider, and the manufacturers often don't cover warranty claims from these online purchases.

Personal Sound Amplifiers (PSAPs)

Personal sound amplifiers amplify all sounds to a degree while wearing them. The original intent of an amplifier was for people with normal hearing to have a bit more amplification in certain situations; such as if you keep your TV at low volume not to disturb others and just want to increase the sound for personal listening.
Some things have changed over time and now some of these devices are being marketed with a claim that they will help with your hearing loss, which has confused many people looking for help with hearing loss. Due to this, in the United States for example, the FDA has actually had to officially state that amplifiers are not made to help with hearing loss.

Prescription Hearing Aids
Prescription hearing aids were created to help people with varying degrees of hearing loss. They can assist with mild, moderate, moderately severe, severe, and profound hearing losses. They also were made to help with different types such as Sensorineaural, Conductive, and Mixed hearing losses.
Hearing aids are technologically superior to all other devices that amplify sound because they are made with more technological capabilities. Such as being able to reduce ambient noise, provide depth perception, increase speech understanding, help speech intelligibility in noisy environments, stream calls from your phone, and stream from your television. These hearing aids are regulated by Health Canada and must undergo approval prior to sale in the Canadian market.
The benefits that hearing aids bring is being backed by an industry that spends hundreds of millions of dollars each year to make improvements in research and development to improve how they perform, and stand behind them with local warranty, service and support.

Who is looking after your needs?

When thinking about hearing aids we also want to make sure we are receiving the best care possible by the provider looking after our needs. Companies providing PSAPs, Online and OTC hearing aids are not required to have a hearing care professional provide services to you, while hearing clinics must have a licensed, trained professional.
The Hearing Care Professionals who test, program, and fit devices have to be licensed and be a recognized provider by the government.

By: Patrick Quelhas
Hearing Aid Practitioner

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