Recent regulatory changes in the United States created a category of hearing aids that could be purchased over-the-counter (OTC), directly by a consumer without professional dispensing. Evidence supporting the benefits o...Recent regulatory changes in the United States created a category of hearing aids that could be purchased over-the-counter (OTC), directly by a consumer without professional dispensing. Evidence supporting the benefits of OTC hearing aids for adults with perceived mild-to-moderate hearing difficulty is somewhat mixed in the literature. The purpose of this study is to compare hearing aid benefits and satisfaction rates for OTC and traditional, provider-dispensed hearing aids within the MarkeTrak 25 survey data. Results of the survey demonstrate robust benefits and high satisfaction rates for both OTC and traditional hearing aids. However, there are some differences in trends between OTC and traditional hearing aids. Specifically, within owners of traditional hearing aids, there is remarkable stability in terms of benefits, satisfaction rates (83% of hearing aid owners are satisfied), and net promoter scores (+30 points for promoters relative to detractors). These values are essentially unchanged over the last several years, suggesting the introduction of the formal OTC hearing aid category has not affected the benefit or satisfaction rates of traditional hearing aids. The OTC hearing aids themselves have similar benefits as traditional hearing aids, although slightly lower satisfaction rates (76% of OTC hearing aid owners are satisfied). Compared to owners of traditional hearing aids, owners of OTC hearing aids were less likely to be satisfied with the size and reliability of their hearing aids, although they were more likely to be satisfied with the price of the hearing aids. The current data also highlight the importance of professional services, even within the group of OTC hearing aid owners. Not only did most OTC hearing aid owners (approximately 80%) utilize some type of professional service, but those who did receive professional support were more likely to be satisfied with their hearing aids than were those who did not receive professional services. Therefore, although the OTC hearing aids are beneficial and consumers are satisfied with them, professional support continues to be an important and beneficial aspect in the OTC category of hearing aids.
The purpose of this study is to review the current state of the over-the-counter (OTC) hearing aid market, specifically focusing on adoption, affordability, accessibility, and satisfaction rates in the MarkeTrak 2025 sur...The purpose of this study is to review the current state of the over-the-counter (OTC) hearing aid market, specifically focusing on adoption, affordability, accessibility, and satisfaction rates in the MarkeTrak 2025 survey. In a large-scale consumer survey, nearly 5,000 adults with perceived hearing difficulties completed a survey, which asked questions about, among other things, their hearing aids. The results of the survey suggest OTC hearing aids have had a small incremental increase (4 percentage points) in hearing device adoptions, a smaller impact than earbuds with features designed to support hearing loss. The introduction of OTC hearing aids has not affected the adoption rates of prescription hearing aids, where adoption rates (currently 39%) have been stable, or even increased, over the last decade. The data also demonstrate that most OTC hearing aid owners received some professional services, suggesting the accessibility of OTC hearing aids might not be fully successful if success means the ability to acquire hearing aids without professional support. However, OTC hearing aids have been successful in other respects. Relative to prescription hearing aids, OTC hearing aids are more affordable and have similarly high satisfaction rates. The OTC and earbud devices will be interesting to continue to monitor as the market adjusts to the widespread availability of direct-to-consumer solutions for management of hearing difficulties in adults. To date, the availability of OTC hearing aids has not disrupted the prescription hearing aid market, although they are more affordable, and most people who use them are satisfied.
MarkeTrak has been monitoring trends within the hearing industry for nearly 40 years. The latest edition, MarkeTrak 25, examines adoption rates, satisfaction with devices and professionals, coverage for hearing aids, and...MarkeTrak has been monitoring trends within the hearing industry for nearly 40 years. The latest edition, MarkeTrak 25, examines adoption rates, satisfaction with devices and professionals, coverage for hearing aids, and more. In this survey, OTC hearing aids were added to the device list to understand how they fit into the market and whether OTC buyers are using professional assistance, even though it is not required by the FDA for purchase. Key findings indicate that the overall adoption rate for all hearing devices (including earbuds with hearing improvement features) has increased to over half, satisfaction levels with devices and professionals have remained stable and very high, and financial assistance has increased since the last survey.
One of the factors that is presumed to influence the decision to obtain hearing aids is the cost of the product. The MarkeTrak 2025 surveyed individuals on a variety of factors about their decision to seek, or not seek,...One of the factors that is presumed to influence the decision to obtain hearing aids is the cost of the product. The MarkeTrak 2025 surveyed individuals on a variety of factors about their decision to seek, or not seek, amplification, including the financial implications. The survey included 1,173 hearing aid owners, either prescription or over-the-counter (OTC) devices, and 1,782 non-owners of hearing aids. Key financial factors identified in the survey included differences in demographics between those choosing prescription hearing aids and OTC devices, the impact of insurance coverage on decision to pursue amplification, and the continued conflation of hearing care with hearing aids. Owners of prescription hearing aids tended to be older, white, and had higher income levels. Conversely, owners of OTC devices were younger, still working, included more non-white individuals, and had lower income levels. Non-owners are demographically similar to those individuals who chose OTC devices.
The 2025 iteration of the MarkeTrak survey offers a comprehensive analysis of hearing aid adoption trends in the United States, with a particular focus on the impact of over-the-counter (OTC) hearing aids introduced in 2...The 2025 iteration of the MarkeTrak survey offers a comprehensive analysis of hearing aid adoption trends in the United States, with a particular focus on the impact of over-the-counter (OTC) hearing aids introduced in 2022. This study explores evolving consumer behaviors, demographic shifts, and clinical and psychosocial factors influencing hearing aid uptake. Findings reveal a continued increase in overall adoption rates, with OTC devices serving as a critical access point for first-time users-particularly younger, more diverse, and cost-sensitive populations. Despite the affordability and accessibility of OTC devices, traditional hearing aids remain the preferred choice among individuals with more severe hearing loss and those seeking professional support. The report highlights key differences in service delivery, satisfaction, and repurchase intentions between user groups, underscoring the enduring value of professional care. Additionally, the emergence of hearing improvement features in consumer electronics, such as earbuds, signals a broadening of the hearing device landscape. These insights have significant implications for clinical practice, marketing strategies, and policy development, emphasizing the need for flexible, patient-centered care models that accommodate diverse consumer pathways and preferences.
The MarkeTrak survey has been conducted approximately every 2 to 3 years by the Hearing Industries Association (HIA) since 1989. It provides insights into trends and consumer viewpoints on the products and services provi...The MarkeTrak survey has been conducted approximately every 2 to 3 years by the Hearing Industries Association (HIA) since 1989. It provides insights into trends and consumer viewpoints on the products and services provided by the hearing aid industry. The EuroTrak survey is conducted by the European Hearing Instrument Manufacturers Association (EHIMA) and collects key data on several countries in Europe and Asia. Although conducted separately, there are multiple areas of corresponding longitudinal data across the MarkeTrak and EuroTrak surveys, allowing comparisons within and between these markets.
Children who are deaf or hard-of-hearing (D/HH) are delayed in many aspects of language development, including acquisition of morphosyntax. One linguistic task that is particularly difficult for children who are D/HH is...Children who are deaf or hard-of-hearing (D/HH) are delayed in many aspects of language development, including acquisition of morphosyntax. One linguistic task that is particularly difficult for children who are D/HH is the acquisition of word-final bound morphemes. In this study, we adopted a training approach from second language (L2) acquisition, referred to as , that has been successful in training a number of grammatical forms in L2 learners. Seventy-seven children who were D/HH and between the ages of 5 and 12 years took part in a 16-session training program designed to improve both perception and comprehension of four bound morphemes: contractions, plurals, past tense, and possessives. In addition, we used a recently developed assessment procedure to obtain independent measures of perception and comprehension. Perception scores at baseline (prior to training) all exceeded 80% and there were small, but nonsignificant, gains in perception following training. In contrast, baseline comprehension measures for three of the four bound morphemes (all except contractions) were below ceiling, and training produced significant gains in all three of these bound morphemes. Implications for training acquisition of morphosyntactic structures and developing personalized audiological rehabilitation protocols are discussed.
Cochlear implants (CIs) are an incredibly effective surgical intervention for many adults with moderate-to-profound sensorineural hearing loss and ideally improve communication ability and quality of life. However, altho...Cochlear implants (CIs) are an incredibly effective surgical intervention for many adults with moderate-to-profound sensorineural hearing loss and ideally improve communication ability and quality of life. However, although CIs restore sound access, they do not guarantee real-world speech communication abilities. To optimize communication outcomes, CI users have access to numerous auditory training (AT) approaches, including patient-directed and clinician-guided interventions. Despite the widespread use of AT, research on its benefits in adult CI users remains limited, resulting in a critical gap in understanding the individual factors that drive variability in training outcomes among adult CI users. This review paper synthesizes evidence on demographic, auditory, cognitive-linguistic, and psychosocial factors that influence responsiveness to AT. Given the well-documented influence of these factors on speech perception outcomes in adult CI users, we propose that a set of shared or unique factors likely predict CI users' responses to AT interventions. By understanding individual differences, future AT interventions can be better tailored to the needs of each CI user, moving beyond a one-size-fits-all model. In addition, we discuss the need to broaden our outcome assessments of AT beyond traditional speech recognition measures to real-world speech communicative and social functioning, which are likely to impact hearing-related and overall quality of life in this patient population. These insights provide a foundation for more effective, personalized AT strategies that address the diverse needs of adult CI users.
Speech intelligibility among competing talkers becomes more difficult with age, even for older adults with clinically normal hearing. Recently, there has been a growing interest in the implementation of auditory-cognitiv...Speech intelligibility among competing talkers becomes more difficult with age, even for older adults with clinically normal hearing. Recently, there has been a growing interest in the implementation of auditory-cognitive training to improve speech-in-noise recognition performance, particularly for older adults. In this study, we implemented two levels of cognitive demand in an adaptive auditory-cognitive training program that used a competing-speaker paradigm. Older adults with normal to near-normal hearing thresholds were assessed on training performance (at the individual and group level), self-reported training strategies, and far-transfer learning in a speech-perception-in-noise task. Training performance analysis revealed that some older adults, particularly those in the more demanding training, performed poorly during the auditory-cognitive training itself. Some participants in this group reported disengagement, potentially due to the low level of those individuals' self-reported satisfaction with engaging in challenging tasks in daily life. Despite these challenges, however, both groups generally improved in the far-transfer learning assessment, though there was variation among participants. Our results suggest that too-high levels of cognitive demand within the auditory-cognitive training may limit some aspects of training outcomes for speech perception in noise; however, higher cognitive demand may be beneficial for those who enjoy challenging tasks.
Following from the World Health Organization's consideration of multiple systems (e.g., sensory, motor, and cognitive) in defining healthy aging, this study presents a review of research on training that has the primary...Following from the World Health Organization's consideration of multiple systems (e.g., sensory, motor, and cognitive) in defining healthy aging, this study presents a review of research on training that has the primary goal of improving complex multitasking outcomes that approximate the everyday contexts in which hearing is important, whether or not older adults are living with clinically significant audiometric hearing loss. Background on the interplay between sensory, motor, and cognitive systems establishes the rationale for considering complex listening behaviors as primary outcomes, and for focusing training on domain-free executive function (EF) processes such as selection, inhibition, and working memory updating. Approaches to cognitive training in later life are discussed to provide a foundation for a deeper examination of targeted EF training and complex listening outcomes that reflect performance in everyday activities. Where available, studies involving older adults with hearing loss are included, although many studies include a mixture of older adults with good audiograms, sub-clinical audiometric loss, or clinically significant but untreated audiometric loss. Overall, the reviewed literature suggests that older adults, with or without audiometric hearing loss, can benefit from EF training that improves complex listening performance. Future clinical considerations are discussed, including rehabilitation that extends from communication training to realistic multitasking training.
OBJECTIVE: To review research on the effectiveness of computer-based auditory training (CBAT) in new adult cochlear implant (CI) recipients. METHODS: Studies by the primary author on auditory training in new adult CI rec...OBJECTIVE: To review research on the effectiveness of computer-based auditory training (CBAT) in new adult cochlear implant (CI) recipients. METHODS: Studies by the primary author on auditory training in new adult CI recipients were reviewed, focusing on a database of auditory training data in >100 patients followed over their first-year post-activation. RESULTS: CBAT, as used in a standard outpatient setting, affords benefits compared to other commonly employed exercises/programs. In new adult CI users, CBAT was associated with greater improvement in CNC words, AzBio sentences, and Cochlear Implant Quality of Life-35 (CIQOL-35) Profile scores at 3 months post-activation compared to CI recipients who did not train or used other resources. By 12 months, patients showed similar improvement in speech recognition scores, regardless of training modality; however, patients who used CBAT continued to show significantly greater improvement in CIQOL global and all domain scores compared to CBAT nonusers. This benefit was noted regardless of whether CBAT was started before or after 3 months post-activation. No demographic/lifestyle factors, audiological measures, or pre-CI CIQOL/CIQOL-Expectations scores were associated with CBAT use. CONCLUSION: CBAT during the first-year post-activation may contribute to early gains in CI speech recognition and to persistent improvements in functional abilities, as measured via the CIQOL-35 profile, in new implant recipients. Consideration of specific recommendations for the use of CBAT resources may be valuable, given the minimal risk, ease of access, and affordability of these programs.
Hearing aids (HAs) improve speech perception in quiet environments but remain less effective in noisy conditions, posing significant communication challenges for older adults. Musical training has been proposed as a pote...Hearing aids (HAs) improve speech perception in quiet environments but remain less effective in noisy conditions, posing significant communication challenges for older adults. Musical training has been proposed as a potential intervention to enhance speech-in-noise (SIN) perception through auditory neuroplasticity. This randomized controlled trial investigated the impact of a 14-week music-based intervention on auditory outcomes in older adult HA users. Forty-seven participants were randomly assigned to one of three groups: choir singing ( = 14; active music training), music appreciation ( = 13; passive music engagement), or a do-nothing control group ( = 12). Primary outcome measures included SIN perception, while secondary outcomes assessed pitch perception and frequency-following response (FFR). Results revealed that participants in the choir singing group demonstrated significant improvements in unaided SIN perception and FFR compared to the do-nothing control group, but not in aided conditions. No significant differences were found between the choir singing and music appreciation groups, suggesting that both active and passive music engagement may enhance auditory processing. These findings highlight the potential of music-based training as a complementary intervention for older adults with hearing loss, though further research is needed to establish long-term benefits and effects in everyday listening conditions.
Adults living in rural communities of Alabama have limited or no access to hearing healthcare for a variety of reasons. Hearing loss can result in decreased social contact, potentially leading to loneliness, and it has b...Adults living in rural communities of Alabama have limited or no access to hearing healthcare for a variety of reasons. Hearing loss can result in decreased social contact, potentially leading to loneliness, and it has been associated with depression and cognitive decline. To improve access to hearing healthcare, the FDA released its Final Rule in 2022 stating that adults with perceived mild-to-moderate hearing loss can purchase over-the-counter hearing aids (OTC HAs) on their own without clearance from a physician or through the care of an audiologist. Current research suggests, however, that adults benefit from professional support when purchasing and setting their OTC HAs. Understanding how much support is needed and how to best provide the support will be necessary for successful OTC HA use. Considering that these devices can now be purchased at pharmacies, one model in rural areas could involve the pharmacy technician who could assist and support those with hearing loss in community pharmacies. This article outlines a pharmacy technician educational training program that will incorporate didactic, interactional, and experiential learning components to promote the use of OTC HAs. The outcomes from this project will provide the foundation for the development and implementation of one model for improving access to hearing healthcare in rural communities.
Implementation of over-the-counter (OTC) hearing aid sales can take many forms. The OTC Hearing Aid and Self-Care Symposium included one panel of speakers who addressed considerations for implementation from the perspect...Implementation of over-the-counter (OTC) hearing aid sales can take many forms. The OTC Hearing Aid and Self-Care Symposium included one panel of speakers who addressed considerations for implementation from the perspectives of pharmacists, audiologists, and consumers. This article, written by the panel moderator, offers an overview of implementation options and issues addressed by the speakers and a pharmacist's perspective on the need for interprofessional collaboration.
The product information label (PIL) is the consumer-focused tool required by the Food and Drug Administration (FDA) to transmit essential health information about candidacy to potential users of over-the-counter (OTC) he...The product information label (PIL) is the consumer-focused tool required by the Food and Drug Administration (FDA) to transmit essential health information about candidacy to potential users of over-the-counter (OTC) hearing aids. The OTC hearing aid PIL has not undergone a systematic comprehensibility study, nor have consumers' viewing habits of the OTC PIL been evaluated. The goal of the present study was to use eye-tracking to determine what consumers attend to when looking at an OTC hearing aid package (which includes the PIL), and conduct an assessment of comprehension of the PIL's content in a group of consumers who either spoke English only (EO) or reported English as a second language (ESL). Eye-tracking data showed that the OTC hearing aid PIL did not capture sustained attention from both groups, and most of the PIL content was not comprehended by potential ESL consumers. The OTC hearing aid PIL may not be useful and accessible to consumers in its current form.
This article describes the breadth of experiences associated with pursuing commercially available over-the-counter hearing aids (OTC-HAs). Dr. Katz behaved as a consumer pursuing various OTC-HAs. This activity was part o...This article describes the breadth of experiences associated with pursuing commercially available over-the-counter hearing aids (OTC-HAs). Dr. Katz behaved as a consumer pursuing various OTC-HAs. This activity was part of a larger project aimed at identifying overarching consumer listening goals, creating metrics to assess consumer-identified desired usability, features, and performance, and designing a consumer-friendly web-based application to support thoughtful hearing self-care. Additionally, we provide a review of the aims of the larger project to set the context for this work.
This article explores the steps and factors that audiology clinics should consider to successfully integrate over-the-counter (OTC) hearing aids, ensuring that patients with mild to moderate hearing loss have access to a...This article explores the steps and factors that audiology clinics should consider to successfully integrate over-the-counter (OTC) hearing aids, ensuring that patients with mild to moderate hearing loss have access to affordable and effective intervention options. In 2017, Mass Eye and Ear (MEE) began recommending and selling personal sound amplification products in anticipation of the OTC hearing aid market. Audiology practices may be interested in incorporating the recommendation and sale of OTC hearing aids into their services, but they might be unsure about how to approach this process.