The NAL-NL3 Prescription

NAL-NL2 is used worldwide to prescribe hearing aid gain and compression for new and experienced hearing aid users. The NAL-NL3 Prescription was developed to further optimise fitting targets to maximise predicted speech intelligibility without exceeding normal-hearing loudness, and to address clinical feedback about NAL-NL2.

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

NAL-NL3 is a direct successor to the widely adopted NAL-NL2 prescriptive target; audiologists should monitor validation studies and manufacturer firmware support before switching clinical default prescriptions, but this warrants close attention as an evidence-based update to a cornerstone fitting tool.

✦ Why It Matters ✦

NAL-NL3 represents a potential paradigm shift in prescriptive fitting targets, which underpin first-fit and verification workflows across virtually every hearing aid platform globally.

✦ Key Points ✦

01NAL-NL3 is a new prescriptive target for hearing aid gain and compression, succeeding NAL-NL2.
02Published as a peer-reviewed study in International Journal of Audiology.
03Designed to further optimize aided audibility and listening comfort beyond NAL-NL2.
04Likely to require updates to fitting software and real-ear measurement targets for clinical adoption.
05Clinical uptake will depend on validation studies and manufacturer integration into fitting software.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

NAL-NL3 further optimizes hearing aid gain and compression prescription compared to NAL-NL2.

studypartially supported

NAL-NL3 is developed to improve upon the widely used NAL-NL2 formula.

studysupported

✦ Research metadata ✦

PMID: 42908374
DOI: 10.1080/14992027.2026.2743347.
Journal: International Journal of Audiology
Publication type: research_article
Evidence level: 2b
Population: Individuals with hearing loss fitted with hearing aids using prescriptive targets
Intervention: NAL-NL3 prescriptive hearing aid fitting formula
Comparator: NAL-NL2 prescriptive formula

Primary outcomes

Prescribed hearing aid gain and compression settings; Optimization of aided audibility relative to NAL-NL2

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