Real Ear Measurement in Lafayette, LA
Real ear measurement (REM) is the only way to confirm that a hearing aid is producing the correct sound level inside your actual ear canal. It is the difference between hearing aids that work and hearing aids that sit in a drawer. At ACI Hearing Center in Lafayette, our four Doctors of Audiology perform REM on every hearing aid fitting, following American Academy of Audiology best practice guidelines. If your current hearing aids were never verified with REM, that is one of the fastest fixes we can make.
What real ear measurement is
Real ear measurement, also called probe microphone measurement or speech mapping, is a short test done during a hearing aid fitting. A thin, soft silicone probe tube (about the diameter of a spaghetti noodle) is placed in your ear canal alongside the hearing aid. Calibrated speech-shaped signals are played through a nearby speaker. A tiny microphone at the tip of the probe measures the actual sound level at your eardrum, both with the hearing aid off and with it on.
The measurement is compared to a validated prescription target based on your hearing loss (typically NAL-NL2 or DSL). If the actual output does not match the target, we adjust the hearing aid programming and re-measure until it does. Total time: about 10 to 20 minutes.
Why REM matters more than most patients realize
Every ear canal is a different shape, length, and volume. Two people with the same audiogram can need very different hearing aid settings because of how sound bounces around inside their individual ear. When a hearing aid is programmed using the manufacturer's default software alone, the software assumes an average ear canal. Research consistently shows that assumption is off by 10 to 15 decibels in either direction for most patients.
Ten to 15 decibels is the difference between hearing your grandkids at the dinner table and asking them to repeat themselves. It is the difference between wearing your hearing aids all day and giving up after two weeks. REM is what closes that gap.
How rare REM really is
The MarkeTrak 10 study, published by the Hearing Industries Association in 2019, found that only about 22% of hearing aid dispensers routinely perform REM. Roughly 40% never perform it at all. This is despite REM being a standard of care recommended by the American Academy of Audiology since at least 2006.
If you are shopping for hearing aids, the single most powerful question you can ask any provider is: "Do you perform real ear measurement on every fitting?" A yes answer separates about one in five providers from the rest.
What REM looks like at ACI Hearing Center
Every new hearing aid fitting at ACI Hearing Center includes real ear measurement. Here is how it fits into your appointment:
- Ear canal check. Your audiologist looks in each ear with a video otoscope to confirm the canal is clear and comfortable to work in.
- Probe tube placement. A soft silicone probe tube is threaded gently into the ear canal, resting about 6 mm past the tip of your new hearing aid. Most patients say they do not feel it.
- Unaided measurement. We play conversation-level speech through a nearby speaker and measure the natural sound level at your eardrum without the hearing aid on. This is your baseline.
- Aided measurement. We turn the hearing aid on and repeat the measurement. The system draws a live curve showing exactly what your eardrum is receiving across the frequencies of speech.
- Target matching. The measured aided curve is compared to your personalized prescription target. We adjust the hearing aid programming and re-measure until the two curves line up within +/- 5 dB across the range that matters for speech.
- Loud and soft speech check. We repeat the measurement at soft, average, and loud speech levels to make sure your hearing aids compress loud sounds appropriately and amplify quiet sounds enough.
The whole REM portion of the appointment takes about 10 to 20 minutes.
Signs your current hearing aids were probably not verified with REM
- Speech sounds muffled or dull even at higher volume settings.
- You avoid restaurants, meetings, or gatherings because background noise overwhelms voices.
- Your own voice sounds echoey, boomy, or hollow (occlusion effect that was never addressed).
- Loud sounds like doors slamming or dishes clattering feel painful.
- You feel like the hearing aids are amplifying "everything," not just speech.
- Family members still complain that the TV is too loud when you are wearing them.
These are signs the hearing aid output does not match your prescription in your actual ear. A refit with proper REM verification (on your existing devices, not new ones) often solves it.
REM for pediatric hearing aid fittings
REM is even more critical for children. Kids cannot reliably tell an audiologist if a hearing aid sounds too loud, too quiet, or distorted. Children's ear canals are also physically smaller, which shifts the sound level at the eardrum compared to an adult ear. Every pediatric hearing aid fitting at ACI Hearing Center includes REM verification, and we re-verify periodically as your child grows. For more on how we handle pediatric fittings, see our pediatric audiology page.
REM for cochlear implant users
Real ear measurement principles also apply to cochlear implant audio processors and to the residual-hearing side of a bimodal fitting (a hearing aid worn on the opposite ear from an implant). If you have a cochlear implant and use a hearing aid in the other ear, we can verify the hearing aid programming with REM as part of your regular cochlear implant follow-up. Learn more about our cochlear implant program.
Meet our audiology team
All four of ACI Hearing Center's Doctors of Audiology perform real ear measurement on every fitting:
- Dr. Kimberly L. Allred, Au.D. — Owner and lead audiologist. Trained at the University of Florida. Serving Lafayette since 1984.
- Dr. Elizabeth LeMaire, Au.D. — Doctor of Audiology with ULL and LSU Health training.
- Dr. Sarah Lalande-Davies, Au.D. — LSU and LSU Health New Orleans trained.
- Dr. Courtney Barbier, Au.D. — Doctor of Audiology with ULL and LSU Health training.
For each provider's full credentials, see our audiology team page.
Frequently Asked Questions
What is real ear measurement?
Real ear measurement (REM), sometimes called probe microphone measurement or speech mapping, is a test that confirms your hearing aids are producing the correct sound level inside your actual ear canal. A thin silicone probe tube is placed in the ear alongside the hearing aid, calibrated speech is played, and a microphone measures the true output at your eardrum. This is compared to a personalized prescription target and the hearing aids are fine-tuned to match.
Why does real ear measurement matter?
Every ear canal has a different shape, length, and volume. Two people with identical hearing loss can need very different hearing aid settings because of how sound behaves inside their unique ear canal. Without REM, the hearing aid is programmed using an average ear model, which is often wrong by 10 to 15 decibels in either direction. That gap is the difference between hearing aids that work and hearing aids that sit in a drawer.
Do all audiologists perform real ear measurement?
No. According to the MarkeTrak 10 survey published by the Hearing Industries Association, only about 22% of hearing aid dispensers routinely perform REM, and about 40% never do it. This is despite REM being the standard of care recommended by the American Academy of Audiology best practice guidelines. Any audiologist or hearing aid dispenser you consider should be able to answer yes to the question, "Do you perform real ear measurement on every fitting?"
Does ACI Hearing Center perform real ear measurement on every hearing aid fitting?
Yes. Real ear measurement is a standard part of every new hearing aid fitting at ACI Hearing Center and is repeated any time the hearing aids are significantly reprogrammed or refit. Our four Doctors of Audiology follow American Academy of Audiology best practice guidelines and consider REM a non-negotiable step, not an optional add-on.
Does real ear measurement hurt or feel uncomfortable?
No. The probe tube is a soft, flexible piece of silicone about the diameter of a spaghetti noodle. It rests gently against the side of the ear canal, not deep in the ear. Most patients say they do not feel it once it is in place. The measurement itself takes 10 to 20 minutes and involves listening to conversation-level speech through a nearby speaker.
How does REM change my hearing aid programming?
When we plug a new hearing aid into the fitting software, the software uses an assumed average ear canal to set the initial output. REM shows us how far off that assumption is from your actual ear. If soft speech is 8 dB too quiet at 2000 Hz, we raise 2000 Hz by 8 dB. If loud speech is 6 dB too loud at 500 Hz, we bring 500 Hz down by 6 dB. The result is that the hearing aid matches your prescription in your real ear, not in a computer model.
Should I ask for a hearing aid refit if my current aids were never verified with REM?
Yes, especially if you feel your hearing aids are too quiet, too loud, muffled, tinny, or you avoid wearing them in certain situations. REM verification on existing hearing aids is one of the most common reasons patients switch to ACI. A same-brand refit with proper REM often solves "my hearing aids do not work well" complaints without buying new devices.
Is real ear measurement done on children's hearing aids too?
Yes. REM is even more important for pediatric fittings because children cannot reliably tell us if a hearing aid sounds right. Children's ear canals are also smaller and change size as they grow, which shifts the sound level at the eardrum. Every pediatric hearing aid fitting at ACI Hearing Center includes REM verification and periodic re-verification as the child grows.
How long does the real ear measurement portion of a fitting take?
About 10 to 20 minutes on top of the standard hearing aid fitting appointment. Most new hearing aid fitting appointments at ACI Hearing Center are scheduled for 60 to 90 minutes to allow for full REM verification, sound demonstration, and patient education.
Schedule a hearing aid fitting or REM refit
Call ACI Hearing Center at (337) 223-9448 or request an appointment online. We are located at 103 Saint Thomas Street, Lafayette, LA 70506. If you already have hearing aids and want them REM-verified, mention that when you call so we can schedule the right amount of time.
For financing options on new hearing aids fit with REM verification, see our financing page (Cherry, CareCredit, PowerPay, HSA and FSA).