I wear hearing aids and from my experience I’d say there are a few things:
1) my hearing aids are calibrated for my specific hearing loss, to amplify certain frequency regions more than others
2) hearing aids set the speakers pretty far into your ears, mine have silicone “cones” to help center them and hold them in place so the sound is going as straight into the ear as possible.
3) they have advanced programming to aid in hearing beyond what I’ve mentioned in #1
4) hearing aids have to be prescribed
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