Hearing Evaluation and Fitting

Once a hearing loss is identified, a hearing aid may be prescribed and fitted. A&A Audiology is a full dispensing center, offering the most advanced fully digital hearing aids. Our unique pricing structure features itemized pricing. Professional service fees include comprehensive fitting and follow-up services, including reprogramming and ongoing care. Each hearing aid comes with at least a two-year repair warranty, a one-time loss and damage guarantee and a 30-day adjustment period. Any returns during the adjustment period are given a full refund less the professional service fees for the audiological evaluation, communication needs assessment and fitting fee.

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Five Elements of a Properly Fitted Hearing Aid

  • 1. Hearing Aid Exam and Selection
    Following a comprehensive audiological evaluation, the audiologist will assess all of your audiological and non-audiological needs to determine which style and technology is best suited to meet your communication needs. Additional testing such as frequency-specific loudness discomfort levels are completed at this time and ear impressions are taken to ensure a proper fit of the earmolds or hearing aids.
  • 2. Hearing Aid Prescriptive Programming
    All hearing aids are preprogrammed based on an appropriate prescriptive method. Electroacoustic measurements are used to verify that the hearing aid's electroacoustic parameters are set appropriately according to your individual hearing loss. Such careful attention to programming is a first step in ensuring a properly fitted hearing instrument.
  • 3. Hearing Aid Verification and Validation
    On the day of the fitting, specialized real ear measurements are taken to verify that the gain and output of the hearing aid have been set to amplify speech appropriately within your dynamic range of hearing. Aided, objective testing is also performed to validate your ability to hear soft sounds, and to recognize speech at normal levels in quiet and in noise with your new hearing aids.
  • 4. Hearing Aid Orientation and Counseling
    Personal hearing aid orientation is provided to ensure that you understand how to properly care for and use your hearing aids. Counseling is provided regarding proper expectations based on your hearing loss, the need to allow for an adaptation period and the importance of using communication strategies to gain the most benefit from your new hearing aids.
  • 5. Hearing Aid Follow-up
    Initial and ongoing follow up is important to long-term success. During the initial adjustment period, the audiologist will closely monitor your performance and provide any adjustments to the hearing aids as necessary. Outcome measurements are used to assess if the goals of the fitting have been met. All follow up is included for two years and should occur regularly in three-month intervals.


A&A Audiology is located in Scottsdale, AZ. To schedule an appointment, please contact the clinic.

Hearing Aid Related Services

A&A Audiology offers hearing aid service, hearing aid repair and comprehensive, prescription-based reprogramming on any hearing aid regardless of make/model or where it was originally fitted. Walk-in hours are available on selected days; please call first so we know you are coming. The Repair and Service Clinic is staffed by our skilled hearing aid technician.


Hearing Aid Repair and Modification Laboratory

Sophisticated electroacoustic analysis equipment is used to objectively determine current functioning, appropriateness of the fitting and the need for service of your hearing aid. Minor in-office repairs, modification to electroacoustic settings and/or physical modifications can be done to improve hearing aid satisfaction. In-warranty or out-of-warranty manufacturer repairs are done as necessary.

Custom Earmolds for Hearing Aids

A properly selected and fitted custom earmold is an integral component of the overall fitting of behind-the-ear hearing aids. Our audiologists carefully select the earmold style and material needed to provide a comfortable and highly effective sound transmission to the ear.

Custom Specialty Molds for Recreation

Custom plugs are available to keep water from entering the ears when showering or swimming; communications earmolds allow for a custom, comfortable fit for pilots, and users of telephone headsets and cell phones. Custom earmolds also available for iPod-type earbuds.


Musician Earplugs and other Custom Hearing Protection Devices

A&A Audiology also provides custom-fitted ear protection for a variety of high-noise environments. Hearing protection is used by pilots, coaches, construction and factory workers, dentists, athletes, hunters/shooters, race car drivers, nightclub staff, musicians and anyone interested in protecting their hearing.

Hearing Aid Accessories

Hearing aid accessories such as dri-aid kits, tubing blowers, cleaning accessories, earmold tubing and hearing aid batteries are available for sale in the Hearing Clinic. If you wish to have batteries mailed to you, please contact us.


Audiological Assessments

A&A Audiology is a center of excellence specializing in comprehensive diagnostic evaluations for adults and children. A thorough diagnostic audiological evaluation is the first step if you suspect a hearing problem and essential before commencing habilitation. A comprehensive audiological evaluation at the A&A Audiology Clinic routinely includes otoscopy, air and bone conduction pure tone audiometry, full immittance testing to determine middle ear status, otoacoustic emissions (OAE), and thorough speech recognition measures, including speech-in-noise testing and/or screening for central involvement, to evaluate the presence, extent and nature of hearing loss.

Evaluation of hearing can take place at any age. Special testing techniques and tests are used to assess the hearing ability in a very young child. Following the testing, your audiologist will present the results of the testing and answer any questions you may have. The audiologist will also give you recommendations based on the evaluation. If the audiologist recommends hearing aids or other assistive device, he/she will recommend that you return for a hearing aid evaluation appointment.

Immittance Audiometry

Acoustic immittance measures provide diagnostic information regarding middle ear functioning and the integrity of the acoustic reflex pathway. Advanced measures such as Multifrequency tympanometry and absorbance/reflectance measures are performed as necessary to increase the diagnostic information regarding the status of the middle ear.

Otoacoustic Emmissions

Measurements of otoacoustic emissions assess the function of the outer hair cells in the cochlea and are a key test in differentiating between cochlear and purely retrocochlear disorder. This objective test can help to determine if normal cochlear function exists even in difficult-to-test populations.

Auditory Processing Disorder Assessment


What is an Auditory Processing Disorder?

Despite normal peripheral hearing sensitivity and intelligence, children and adults with auditory processing disorder (APD) have an inability or decreased ability to attend, discriminate, recognize or comprehend auditory information. Individuals with APD also have difficulty understanding speech in the presence of background noise, and following spoken instructions. Children with an auditory processing disorder often behave as if they have a hearing loss, and parents and teachers often complain that the child is ignoring them or not paying attention. When concerns exist, an APD evaluation can help to determine if there are medical aspects of the disorder that require treatment, to promote appropriate educational planning and to implement interventions such as environmental modifications, management strategies, auditory training, and/or FM assistive listening devices as necessary. Prerequisites for an APD evaluation include normal hearing sensitivity, normal cognitive abilities and a minimum age of nine years.

  • Characteristics of children with APD
  • Understanding APD in children

What is an APD evaluation?

During the APD evaluation, a battery of tests designed to assess auditory processing abilities is administered to evaluate, diagnose and formulate intervention strategies for persons suspected of having auditory processing disorders. The specific tests selected depend on the age of the child, the referring complaint, test reliability and validity, and the specific auditory process assessed by each test. If an audiological evaluation to confirm normal hearing sensitivity has not previously been done, a peripheral audiologic evaluation including acoustic reflex testing, otoacoustic emissions and speech-in-noise testing will be completed prior to the tests of central auditory processing. An integral component of the APD assessment includes a thorough case history and observational checklists to be completed by the parent and classroom teacher. The entire APD assessment takes approximately two hours, depending on the client's age and needs. Once testing is completed, a report detailing the results, interpretation of results and recommendations will be provided.

Our goal is to provide a multidisciplinary approach to evaluating and managing auditory processing disorders. Therefore, a language assessment is recommended through our Speech-Language Clinic as part of our Language, Listening and Learning Program.

  • Information for parents about CAPD Tests
  • Language, Listening and Learning Program
  • Procedural guidelines for APD assessment at A&A Audiolog

Tests from the following behavioral categories are included in the APD evaluation:

  • Dichotic
    Dichotic tests present a different stimulus to each ear simultaneously in order to assess binaural integration (repeat everything heard in both ears) or binaural separation (ignore what is heard in one ear and repeat what is heard in the other ear). Linguistically loaded and nonlinguistically loaded dichotic tests are selected.
  • Low-redundancy Monaural Speech
    These tests, presented to each ear separately, modify the acoustic stimulus to reduce the signal's redundancy through low-pass filtering, added noise, etc., in order to test auditory closure ability, the ability to fill in missing components (e.g., phonemes, syllables, words).
  • Temporal Processing
    Tests using tonal stimuli, require the listener to discriminate sound based on a sequence of auditory stimuli or temporal order in order to assess pattern perception and temporal functioning abilities.
  • Binaural Interaction
    These tests present similar stimuli to each ear in a non-simultaneous or sequential manner in order to assess binaural integration or interaction between the two ears.


Additional Resources

  • CAPD management tips for parents
  • CAPD management tips for teachers
  • Auditory processing disorders in children

Diagnostic Services

Comprehensive Pediatric and Adult Audiological Assessment

A comprehensive audiological assessment is performed to determine the presence, type, configuration and severity of hearing impairment. In addition to routine audiometry, special testing is conducted such as immittance, otoacoustic emissions and speech-in-noise testing to provide recommendations as needed for medical intervention, further evaluation and/or avenues available to improve communication such as hearing aids or cochlear implants.

Vestibular Assessment

Vestibular services include a comprehensive battery of tests that are designed to evaluate a patient's balance system. Electronystagmography and videonystagmography are used to record and analyze eye movements that help us determine how well the balance system is working. Recordings of those eye movements will be made with electrodes taped around the eyes or by infrared goggles.

Electrophysiological Assessments

Our electrophysiology lab provides a variety of specialized diagnostic testing including electrocochleography, auditory brainstem response, middle latency response, late latency response, auditory steady-state response, stacked auditory brainstem response and vestibular-evoked myogenic potentials.

Auditory Processing Disorder Assessments

Auditory Processing Disorder assessments are available for children (seven years or older) and adults who may have an impaired ability to attend, discriminate, recognize or comprehend auditory information. Audiology-based assessments are combined with language assessments to gain a complete picture of auditory processing as part of our Language, Listening and Learning Program.


Vestibular Assessment

Dizziness is one of the most common complaints people bring to their primary care physician. It is a problem that can affect individuals of any age, but it is more of an issue for older adults. We offer a comprehensive battery of tests that are designed to evaluate a patient's balance system. We begin by obtaining a thorough case history that includes a detailed description of the specific balance problems. Videonystagmography procedures are then used to record and analyze eye movements and help determine how well the balance system is working. This new state-of-the-art, computer-based instrument is used to assist in the diagnosis and treatment planning for the patient's balance disorder.

Case History

The word "dizzy" can mean different things to different people. It can mean "light-headedness," or a "floating" sensation and it can also mean a merry-go-round type of "spinning" feeling also known as vertigo. As part of our case history, we define the type of problem and then discuss severity, and when, where and how often the problem occurs. We will ask about your individual lifestyle and medical history that will help us to better understand your specific problem.


These tests are designed to examine the cause of the dizziness. Depending upon the patient, either electronystagmography (ENG) or videonystagmography (VNG) will be chosen. ENG uses several electrodes which are taped around the eyes while VNG utilizes infrared video goggles to detect and record very small eye movements. These movements are recorded in response to changes in head position, watching moving objects move across the visual field, sudden movement of the body or head as well as stimulation of the ear canal with warm or cool water or air.


To schedule an appointment, please contact the Clinic.

Additional Resources

Electrophysiological Assessments

Electrophysiological measures, such as those procedures listed below, play an important role in the assessment of hearing in difficult to test populations, such as very young children, as well as in the differential diagnosis of cochlear versus retrocochlear disorders. These tests are considered objective in that a behavioral response is not required of the patient. Auditory evoked potentials are very small electrical voltage potentials originating from the brain. They are usually recorded from the scalp in response to an auditory stimulus (i.e., clicks, tones, speech sounds, etc.). Evoked potentials are typically recorded using small disk-like self-adhesive electrodes which are stuck on the head and face. The electrodes do not hurt, and they come off easily after completion of testing. A typical recording requires the placement of three or four electrodes. These tests require the use of highly sensitive amplifiers and computer averaging equipment.

Electrophysiological services available at A&A Audiology

  • Electrocochleography (ECochG) These responses are comprised of the cochlear microphonic, the cochlear summating potential and the auditory nerve action potential. This test is useful in intraoperative monitoring and to evaluate possible cases of Meniere's disease.
  • Auditory Brainstem Response (ABR) These waves originate in the eighth cranial nerve and brainstem auditory structures in the region of lateral lemniscus and inferior colliculus. Auditory brainstem response is used in the neurodiagnosis of eighth nerve or auditory brainstem dysfunction.
  • Middle (MLR) and Late (LLR) Latency Responses The middle latency response is from the upper brainstem and/or auditory cortex. The middle latency response is used in the neurodiagnosis of auditory central nervous system disorders above the brainstem level. The late latency response originates primarily in the auditory cortex and is used for frequency specific estimation of hearing sensitivity in cooperative children and adults.
  • Stacked Auditory Brainstem Response (ABR) This is a modification of the standard ABR and involves collection of data using click stimuli mixed with high-pass masking noise. This generates activity in virtually all auditory nerve fibers rather than just a subset as in auditory brainstem response.
  • Vestibular Evoked Myogenic Potentials (VEMP) This potential is a change in the surface-recorded electromyogram (EMG) that can be evoked over neck and spinal muscles following a high-intensity acoustic input. Vestibular evoked myogenic potentials are important in the evaluation of a patient who is dizzy and can help to determine the origin of the problem.
  • Cochlear Hydrops Analysis Masking Procedure (CHAMP) involves looking at the response properties of the basilar membrane for reduced masking effectiveness of high pass noise in an auditory brainstem response when clicks are used. This may be used to establish the presence of cochlear hydrops.


To schedule an appointment, please contact the Clinic.

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