Dr. Rae’s Story: Hearing Aids, Hope, and a Trunk Full of Baby Joggers

I came into this field after being influenced by a follower of Dr. Jack Katz, the “father of auditory processing disorder,” while I was doing a postdoc at Gallaudet University. My very first patient flew in from out in the desert because she had been sitting on a two-year waitlist at the House Ear Institute for APD testing. Everyone had given up hope.

She was behind in everything. She had dyslexia and dyspraxia. She struggled to function with sound at all. She couldn’t hear in noise. She rarely spoke. Her mom and I had connected in a Yahoo group for parents of Deaf and hard of hearing kids, and when I heard her story, I offered to help. I invited them to fly out, and we did the full APD evaluation for free with help from my mentor.

We used a borrowed audiology office for the formal testing, but we didn’t stop there. We spent two full days doing real-world listening. We took her kayaking. We drove around the D.C. metro area. And somewhere between one side of the Beltway and the other, she went from silent to interrupting from the backseat like a totally typical, obnoxious teenager.

Her test results were terrible. But something shifted. And while I haven’t been in touch, I’ve heard she went on to do really well. She was my first.

It was my idea to try hearing aids. I wasn’t a fan of FM systems. They felt too restrictive, like a leash. I didn’t want her dependent on someone else wearing a mic just to hear. This was before you could easily integrate FM with hearing aids, so we had to choose one or the other unless we went with huge, clunky devices that would have made her ears stick out awkwardly. We decided on hearing aids, not FM.

I don’t have to make that choice anymore. Now I can use both.

So I brought in three different brands of hearing aids and we tried them all. We landed on Unitron. She said it sounded the best, and I liked their trial flexibility. That was the beginning of everything.

After that, I stepped away for a while. I had a baby in 2013. I tried to keep going. I was working toward a research doctorate, and my dissertation focused on personality type and tolerance of background noise, how long someone could endure it before irritation set in, and how that affected hearing aid satisfaction. But my committee didn’t accept it. Or rather, one person didn’t. And that was enough to shut the whole thing down.

So I dropped out.

I had to be satisfied with a clinical doctorate and not a research one. I wanted to focus on my family, so I went back to work. I took a job at an ENT office. It was steady, but it wasn’t satisfying. You had 15 minutes to do everything, whether you were finished or not. Lunch breaks were half an hour, and sometimes patients would fall asleep in the booth while you were trying to eat. Honestly, half the staff did too. People napped on the sofas and in the sound booths like it was normal. That might have been the only part I liked about that job. I always need a nap. It’s so much better working from home now.

I had another baby in 2016, and that just added to the pressure. Trying to parent, keep pace with the job, and keep my head above water wore me down. It made me more and more willing to walk away. Because that’s all it was. It wasn’t a career. It was a pointless job.

There was some kind of bonus system, but no one ever explained it to me. We were only supposed to fit the one brand of hearing aid that had paid for the office furniture in their newly remodeled suite. The practice had taken out a loan from the manufacturer, and that meant quiet loyalty was expected.

I broke all of those rules.

I brought in other brands. I offered more options. I tested speech in background noise because I knew it mattered. I brought in flatscreen TVs and bookshelf speakers to simulate real-world environments. I took too much time. I used too much space. I created visual schedules and color-coded drawers and workarounds that made sense to my autistic and ADHD brain, even if they didn’t match the aesthetic of the clinic.

The patients loved it. They felt seen. They felt understood. And it was profitable. The clinic was doing well. But they never attributed that success to me. All they saw was the disruption. I was breaking their long-standing routines. I was inconvenient. I took up time and space they hadn’t budgeted for, and instead of thanking me for what was working, they saw me as the problem.

Did I have permission for any of those things? No. I believe in asking for forgiveness, not permission, especially when kids aren’t getting the help they need.

I fit a child with hyperacusis due to craniosynostosis around 2015 using a low-gain hearing aid program. It helped. But when I asked to do it again, I was told the liability was too high. That was the moment I knew. I could not do this kind of work inside a standard medical model. If I wanted to help the kids no one else was helping, I had to build something outside of that system.

So in 2017, I started again. I fit ten kids for free using trial hearing aids. I didn’t have grant money or funding, so I started flipping Baby Jogger strollers. I would find them on Craigslist, pick them up, clean them, resell them, and save every penny until I could afford ten pairs of trial hearing aids from Unitron.

Eight out of those ten kids did well. Really well.

At the time, no one had heard of this kind of fitting. Low-gain hearing aids for kids with normal audiograms just weren’t being discussed. But then Unitron had a sale, a buy-one-get-one deal, and eight out of those ten families decided to purchase permanent hearing aids at cost. I wasn’t convinced there was enough research to justify charging more than the price of materials, so we kept it simple. Each family kept one of the permanent pairs for their child, and several donated the second pair from the promotion back to me. That generosity freed up the trial inventory. I replaced the receivers so they were clean, and kept fitting more kids.

The results stayed consistent. Probably 70 to 80 percent showed real-world improvements in speech, focus, self-regulation, and learning.

I knew what I was seeing. It wasn’t subtle. It was more effective than anything else I had ever done in audiology. It wasn’t placebo. But I still wasn’t ready to charge beyond the cost of materials. I kept going. Thankfully, my family could afford it, and I was able to keep helping families who needed this.

Eventually, I started getting licensed in more states and expanding virtual care. Now, all these years later, this is what I do full time. I’ve worked with over 3,000 patients.

A lot of the kids I see have sound sensitivities like misophonia, hyperacusis, and phonophobia. Many are autistic or have Ehlers-Danlos syndrome or struggle with sensory integration. Some have normal hearing but can’t function in noisy environments. Others have inconsistent thresholds, middle ear scarring, or fluctuating asymmetry that makes spatial hearing unreliable. They often don’t qualify for traditional interventions, yet they are falling behind socially and academically because they’ve never had consistent access to sound.

That’s where these low-gain fittings come in. And they work. My model is still based on Dr. Francis Kuk’s original research, but I’ve adapted it through experience. Real ear targets don’t apply well to this population. I’ve spoken with leading researchers in the field who agree. When you are working with kids who have atypical MCLs and UCLs, fluctuating conductive loss, auditory sensitivities, and cognitive fatigue, the traditional formulas break down.

So why hasn’t this been studied more?

Because it’s hard to research.

These kids aren’t like adults with acquired hearing loss. You can’t put them into tidy categories. They’re too heterogeneous. They have multiple diagnoses, overlapping sensory and cognitive differences, and variable listening environments. Their thresholds fluctuate. Their needs change. Some of them can’t participate in standardized testing.

You also can’t ethically run a randomized control trial where one group of children gets access to sound and the other doesn’t, especially not when the benefits are already showing up in real time.

And then there’s the cost. FM systems are easier to study. They’re external. They’re uniform. You can pass them from child to child. Hearing aids aren’t like that. They require customization. They need to be programmed and adjusted over time. They can’t be reused across patients. And most clinics can’t afford to keep large quantities of trial devices in stock when there’s no insurance reimbursement for fitting kids with “normal hearing.”

I don’t have a university lab. I don’t have a grant. What I have is clinical experience, careful documentation, and years of testimonials. I’ve seen the difference this makes. And I’m not going to stop just because the system doesn’t know how to measure it yet.