Understanding Hearing Loss

Introduction

This section is aimed at people who have recently lost some of their hearing or who know somebody who has.  Indeed anybody who wants to know a little and wants to update their knowledge about acquired hearing loss will benefit.

The IHHA is an Irish organisation.  Much of the information is general but references to other organisations and schemes are Irish.

We are not professional audiologists or ENT specialists.  Between us we have all too many years’ personal experience.  Where necessary we provide website links to other organisation that can give more details on the issues discussed.

We know very little about many issues faced by people who are deaf from birth or about those who acquired their total loss at an age before they learned to speak.

Terminology & Classifications

Deaf people (or sometimes called Deaf with a capital D or culturally deaf) are people who were born deaf or became so within a year or two of birth.  Their first language is Sign Language (ISL in Ireland ).  There are between 4 and 5 thousand Deaf people in Ireland and a community of about 50,000 people who can sign.  We refer you to Deafhear (http://www.deafhear.ie) or the Irish Deaf Society(http://www.irishdeafsociety.ie) for more information on pre-lingual deafness.

Deafened people are people who became deaf later in life.  This can be sudden or after a period of being Hard of Hearing.  Some would group Deafened people under Hard of Hearing, classifying their loss as profound.

Hard of Hearing people are people who acquired some degree of hearing loss at some stage in their life.  “Hearing Impaired” is a descriptive term used in some parts of the world.  The loss can be sudden or slow and progressive.  It can happen at any age or stage in life or due to many causes.  The prime language of the Hearing Impaired is spoken English and most of the people they deal with have normal hearing .

Below are the four most usual classifications within “Hard of Hearing”.  Technical definitions are impossible to understand for many but they are measured as the average decibel loss on the 500, 1000 and 2000 frequencies/pitch on an audiogram (standard Hearing Test Graph).

Note that people with normal hearing usually have some minor loss (less than 20 DB).

Hearing loss increases with age and it is estimated that one in two people over sixty have some hearing loss.

There is an excellent demonstration of different types of hearing loss on the Phonak website that might help people with normal hearing understand what it is like to have poor hearing. Click here if you want to visit the site.

Causes of Hearing Loss

There are many causes of hearing loss and deafness.  There can be hereditary, congenital, medical or accidental reasons, although hearing loss is more usually due to prolonged exposure to loud noise or simply age-related.  In many case it is not possible to say why the hearing loss has occurred and because there is a high correlation between age and the onset of hearing loss we make that assumption.

Of all those possible causes, noise damage is the one than can be prevented.  Do not expose yourself to prolonged periods (30 mins) of loud noise (25% louder than normal).  Try not to expose yourself to very loud noise at all.  Be careful using IPods and MP3 players

Characteristics of Hearing Loss

No two people who are hard of hearing are exactly the same.  An identical loss can affect different people in different ways even  though they will have a lot in common.  The following are the main characteristics:

Volume: This is simply the volume loss a person has suffered and, as stated above, the loss is classified as mild, moderate, severe or profound. Normal and total might be added to these at the ends of the scale for completeness.

Discrimination: This is the concept of quality. You may hear a noise but not understand what it is.  You may hear a noise in the kitchen but not know if it is the washing machine or the dishwasher.  A person may hear a sentence but not understand it or only understand it after a few seconds.  It can be compared to a person with normal hearing listening to radio in a foreign language they do not understand.  You can hear it perfectly but understand nothing.

Tinnitus: Many people hear noise inside the ears while others do not.  If so, normal conversation is competing with the ‘internal’ noise and can create hearing difficulties.  Tinnitus is a huge source of misery in addition to the person’s hearing difficulties.

Recruitment: Many people (including people with normal hearing) are unable to tolerate loud noises.  For hard of hearing people this may mean that the full benefits of a hearing aid cannot be gained.  Modern hearing aids are getting better at dealing with the issue

Bi-Lateral or Single-Sided: In quiet situations a person’s hearing will depend on the better ear.  The louder the background noise, the less advantage gained.

Environmental issues that affect hearing

There are many factors that affect your ability to ‘hear’ apart from your hearing ability.  People with normal hearing will often be affected by some of these issues.  The factors are

Background Noise: When there is noise in the background, sounds merge.  Good hearing subconsciously filters out or muffles sounds you do not want to hear.  In a busy canteen somehow most people only hear the conversation at their immediate table.  A person with hearing loss finds that all noise and conversations are boosted by hearing aids and is unable to distinguish between what they want to hear and what they don’t want to hear.

Group Conversations: Good conversations shift from topic to topic and person to person.  Each person adds their piece and the conversation changes very quickly.  People with poor hearing need a little extra time to keep up with a conversation and can easily get lost or confused.

Lighting: It is difficult to lip read in poor light.  The better the lighting the better able a hard of hearing person will be able to ‘hear’

Sound Absorption: Materials like carpets, curtains and acoustic ceiling tiles absorb noise, whereas noise reverberates around a room with floor or wall tiles, lots of glass or raw concrete.

Familiarity: If you know people well or are knowledgeable or enjoy a certain topic, you will find that you tend to ‘hear’ better

Tiredness: Tiredness slows down all functions of the brain.  Hearing is no exception, so you will seem to hear less.  Long meetings without breaks will be difficult or meetings that take place during the day after a late night.

So, combining all of the above, a late night evening meal in a candlelit restaurant with piped music and polished wooden floors with a group of people from all over the world who you don’t know is a situation best avoided!

The Impact of Hearing Loss

Hearing is not an end in itself but a means by which you do things you want or should do.  In this section we hope to open your eyes to possibilities.  Hearing loss affects people in many different ways.  We could write  about these forever- but here are some under different headings

Trivial (but not always)

People with hearing loss will pay for small items with notes or credit cards because they cannot hear the price  called by the cashier

People with hearing loss will sing ancient songs to themselves

People with hearing loss will say many silly things

If your car is clamped, you cannot phone to get  unclamped

You cannot phone the plumber in an emergency

Practical:

If you cannot hear an alarm clock, you may sleep in and be late for school or work

If you hear on the radio that the M50 motorway is blocked, you’ll take a different route to the airport

If you cannot hear a teacher, the chances are that you will miss out  a lot on education

You may not be a good team player in work,  as you’ll miss out on all the team briefings

Explaining to your doctor what exactly is wrong can be very difficult if you can’t follow his or her questions

It is very easy to remain quiet or to interrupt a lot during meetings

Emotional / Psychological

It is very likely that you’ll  be left alone and isolated at a wedding reception

It is extremely frustrating not to be able to participate in a group conversation

It is very easy to feel guilty about your hearing loss and incompetent because  you cannot cope better

Relationships

A person with hearing loss may be always  rushing

It is easy to say you are in a rush rather than stop and talk.

Conversations will often be shallow, disjointed or repetitive

It is hard to meet people if you continue to avoid situations where it is difficult to hear

Your circle of friends will get very small unless you are active in seeking them out

It is easy to misinterpret misunderstandings as something deeper

One person’s hearing loss affects the other party in any relationship

Finally

There are many sources of information on Hearing Loss. Here are 3 good ones

Deafhear https://www.deafhear.ie/DeafHear/informationAndResourcesHearingLossAndDeafness.html

Action on Hearing Loss http://www.actiononhearingloss.org.uk/your-hearing/about-deafness-and-hearing-loss.aspx

Wikipedia http://en.wikipedia.org/wiki/Hearing_impairment

Mayo Clinic http://www.mayoclinic.com/health/hearing-loss/DS00172