Analyses are made of three problem areas in the realm of hearing disorder and its management, all of which are cogently informed by self-assessment: (a) prosthetic technology and the auditory ecology, (b) dimensions of benefit from amplification, and (c) dimensions of disability. Technology and ecology addresses the matter of “fitness for purpose” of different prosthetic schemes, moderated by people's hearing and listening environments (ecologies) and by what they bring to the task of hearing and listening. Dimensions of benefit covers what is achievable with prevailing technology, and also what people are aware of and identify as their needs. Dimensions of disability examines what has been recently learned about the range of hearing functions that need attending to in management of impaired hearing. A closing section provides a portrait of “auditory reality,” whose characteristics may be better appreciated when analyzed in contrast to and comparison with “visual reality.”
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