Auditory acclimatization in new adult hearing aid users : a systematic review

Abstract

Background: Auditory acclimatization refers to gradual improvements in auditory performance over time due to changes in acoustic input from hearing aids, independent of task familiarity or training. This review examined acclimatization using behavioural, self-reported, and electrophysiological measures in studies of bilateral and unilateral hearing aid users.

Objectives: To investigate the presence and extent of auditory acclimatization after hearing aid intervention and the factors influencing this process.

Methods: A systematic search of CINAHL, PubMed, and Web of Science followed PRISMA 2020 guidelines. The protocol was registered on PROSPERO. Eligible studies included behavioural (e.g., speech recognition), self-reported (e.g., satisfaction), and electrophysiological outcomes.

Results: Forty-four studies were included: 32 on speech recognition, 23 on self-reports, and 9 on electrophysiology. Among controlled studies, 53% found acclimatization effects in speech recognition, 29% reported improvements in self-reported outcomes, and 57% showed neural adaptation. Changes were small to moderate, with self-reported gains stabilizing over time. Influential factors included consistent hearing aid use, hearing loss severity, and device features, while cognitive abilities and age showed no impact.

Conclusion: Auditory acclimatization had limited clinical significance, with variable and modest effects. Efforts should focus on promoting hearing aid adoption and consistent use through education, support, and counselling to enhance patient outcomes and quality of life.