Expectations about hearing aids and their relationship to fitting outcome.

Clinicians are often concerned that unrealistic prefitting expectations can have a negative impact on fitting success for new, hearing aid wearers. To investigate this concern and to explore the potential value of measuring expectations, we developed the Expected Consequences of Hearing aid Ownership (ECHO) questionnaire as a companion to the Satisfaction with Amplification in Daily Life questionnaire. Four experiments were conducted to (1) determine realistic expectations for hearing aids, (2) evaluate expectations of new users, (3) measure reliability of prefitting expectations, and (4) assess relationships between prefitting expectations and postfitting satisfaction. Novice hearing aid users were found to have stable prefitting expectations about hearing aids, and these expectations were unrealistically high for the typical individual. There were many different expectation patterns across subjects. Of the four subscales of the ECHO, only one was predictive of the corresponding satisfaction data. Potential clinical applications are described.