The National Acoustic Laboratories’ long-awaited NAL-NL3 hearing aid fitting prescription formula was revealed today at the American Academy of Audiology (AAA) conference with major new features to have big implications for audiology prescribing worldwide.
The new formula features a suite of prescriptions, rather than the existing one size fits all solution, and will help practitioners solve one of the biggest problems in audiology worldwide – how to fit hearing aids to people with audiometrically normal hearing tests (minimal or no audiometric hearing loss) who have trouble hearing in noise. Estimates suggest half of new clients walking into audiology clinics are in this category.
Another key change advises how to fit hearing aids to help other clients hear better in noise.
The version to follow NAL-NL2, which launched 14 years ago, is set to become the most widely used fitting prescription for hearing aids in the world when it launches on the market later in 2025 and is embedded in hearing aid fitting and verification software used daily to fit hearing aids.
A NAL team travelled to the AAA conference in New Orleans and on 28 March 2025, Dr Padraig Kitterick, NAL’s head of audiological science who has overall responsibility for delivery of the NAL-NL3 project, and NAL director, Dr Brent Edwards, revealed details and the evidence behind it.
Next generation of fitting prescription
Dr Edwards said: “I’m probably most excited about delivering the next generation of fitting prescription that will help hearing health companies and hearing care practitioners provide the best hearing aid fittings possible.”
Dr Kitterick told Hearing Practitioner Australia: “We’re excited to provide not just the next generation of what has been a long line of evidence-based hearing aid fitting prescriptions but for the first time introduce brand new ways of fitting hearing aids.
“These new prescriptions will help clinicians address needs that they’re seeing in clients where they don’t have a really good evidence-based solution for fitting, particularly those with minimal hearing loss and those with difficulties in noise. It’s a whole new ball game.”
Dr Kitterick said a key new feature was the shift from one prescription for everybody in NAL-NL2 to a modular system that will expand over time which contains a suite of different prescriptions to achieve different things.
Audiometrically normal hearing test
The new formula aims to help audiologists fit hearing aids to someone with an audiometrically normal hearing test but who experiences difficulties when listening in noise and who is motivated to use hearing aids.
“NAL-NL3’s minimum hearing loss module solves how to fit hearing aids to people who we would traditionally class as not having hearing loss,” Dr Kitterick said.
“Depending on the audiology provider, we have heard estimates of anywhere between 40% and up to 60% of new clients walking through the door of clinics can have minimal or no audiometric hearing loss but are reporting problems listening in noisy environments.
“It’s a huge portion of the population seeking help for their hearing problems and for many of them being told they have normal hearing is not helpful; but it is really challenging clinically to know how to best help this kind of client.”
The prescription formula, the first upgrade in 14 years, will be integrated into clinicians’ fitting software, is compatible with Windows and will later be compatible with mobile apps.
The engineer responsible for the project, Mr Justin Zakis, will do a similar reveal at the Audiology Australia 2025 Conference in Adelaide next week, 1-4 April 2025.
NAL will release the final version of the software to manufacturers in September 2025 for them to integrate into fitting and verification software and equipment.
**Hearing Practitioner Australia magazine will run an in-depth feature on NAL-NL3 in its April-May edition where Dr Kitterick details more about the additions, the background to introducing them, and in-house and in-clinic studies at 25 Hearing Australia and Hearing Savers clinics which have revealed “exciting and important findings” that verify the new philosophies deliver the benefits they’re seeking with the new modules.
