Real-ear measurements (REM) are objective measurements used by our doctors of audiology to verify that a hearing aid delivers the appropriate amount of amplified sound into an individual patient’s ear canal. They are considered a gold-standard method for verifying hearing aid fitting because they measure the actual sound reaching the eardrum rather than relying solely on manufacturer software predictions.

There are 5 benefits of using Real Ear Measurements:

A. Every ear is acoustically different

Two people with identical audiograms may receive different sound levels from the same hearing aid settings. Ear canal size, shape, resonance, middle-ear characteristics, and the fit of the dome or earmold affect the sound delivered to the eardrum.

REM accounts for these individual differences, rather than assuming that every ear responds the same way.

B. They verify prescribed amplification

Hearing aid programming software estimates the sound output based on an average ear or standardized coupler. These estimates do not guarantee that the prescribed amplification reaches the patient’s eardrum.

REM allows the audiologist to compare actual output with targets for different input levels and frequencies, then adjust the hearing aid as needed.

C. They improve speech audibility and understanding

Patients with hearing loss often need additional amplification at specific frequencies, particularly in the high frequencies where many consonant sounds occur.

REM helps ensure that speech sounds are amplified sufficiently to make them audible, supporting speech understanding in everyday situations.

D. They help prevent under-amplification and over-amplification

  • Under-amplification: Speech may remain too soft or unclear, even when the patient wears the hearing aids consistently.

  • Over-amplification: Sounds may be uncomfortable, excessively loud, or potentially unsafe if output is not appropriately limited.

REM helps the audiologist balance audibility, comfort, and appropriate maximum output.

E. They improve fitting accuracy and reduce guesswork

REM provides objective evidence of hearing aid performance. This is especially important when a patient reports that the hearing aids sound too loud, too soft, tinny, or unclear. Rather than relying on subjective feedback alone, the audiologist can measure the output and make informed adjustments.