A method and software program is used by patients in situ for fitting and refitting of a DSP-based hearing assistance device. Hearing is tested by selection of one of twenty four playbacks of speech, for each ear. Cognitive training/testing exercises test and train the user to relearn to distinguish between various sounds and particularly speech using the hearing assistance device. The preferred cognitive training/testing includes noise detection exercises, spatial hearing exercises, volume recognition exercises and speech differentiation exercises. The regimens for using the hearing aid depend upon the measured cognitive loss, with different sets of DSP parameters for self-directed, non-assessed cognitive training.