Category Archives: Thoughts from an Audiologist

Hearing Aids, part one: There’s a person attached to those hearing aids

Article by Glen Sutherland, MCISc
Audiologist

My previous post reviewed sensori-neural hearing loss and introduced you to the subject of hearing aids. If you have not already done so, you might find it helpful to read my previous posts. In the next few posts I will provide you with more information about hearing aids in hopes of helping you buy the best hearing aids for you and of helping you adjust to the hearing aids with realistic expectations.

Hearing is such an important sense to most of us! It connects us with so many aspects of our day-to-day world; family and friends, music, television and radio and other sounds in our environment.

Good hearing helps to keep us safe! It may warn us of potential danger in many situations such as when we’re driving, walking on busy streets or hearing alarms and smoke detectors, to name a few.

Really, take a moment and consider how your hearing helps your function well during your busy day on the telephone, at meetings and lectures, during religious services, at the theatre and at gatherings with family and friends. Hearing enables us to socialize, interact and communicate.

When hearing loss is present, it can diminish our quality of life. Problems with our hearing may lead to feelings of annoyance and anxiety at first; and later to feelings of loneliness and even depression. People who experience hearing loss may find they withdraw from communication and social situations and eventually, they isolate themselves completely.

At first, individuals tend to deny that they are losing their hearing. They ignore the signs of hearing loss for awhile. Some signs of hearing loss include but are not limited to:
• Having trouble hearing during phone conversations
• Turning the TV up louder; especially if people are noticing
• Thinking most people are mumbling
• Having trouble hearing in crowded or noisy environments
• Asking people to repeat what they are saying
• Misunderstanding conversations
• Family members and/or friends telling you that you are not listening
• Withdrawing from social situations

Eventually, they decide to get their hearing tested to find out if there is a hearing loss present. In fact, it has been determined that the average person waits 7 years before seeking help.

When you get your hearing tested, you undergo a series of tests which help the clinician ascertain which type of hearing loss you have. The results of the tests also help the clinician recommend how you can best be helped depending on your type of hearing loss.

It’s estimated that ten per cent of the Canadian population has hearing loss. That’s approximately 3.3 million Canadians. Approximately 95 per cent of those who can no longer hear well have a sensori-neural hearing loss. Close to fifty per cent of Canadians over the age of 65 have some degree of hearing loss.

In the vast majority of cases, sensori-neural hearing loss is not medically or surgically treatable. However, most people with sensori-neural loss notice a great deal of benefit from wearing some form of amplification device (traditional hearing aids, bone-anchored hearing aid (BAHA), cochlear implants, etc.).

Most people who have sensori-neural hearing loss purchase traditional hearing aids. Unfortunately, only 15 – 20% of people who require hearing aids are getting the help they need.

Hearing aids can improve the quality of your life. Nearly 95 per cent of people with sensori-neural hearing loss can be helped with the use of hearing instruments. A National Council on Aging (NCOA) survey regarding ‘hearing loss and older adults’ found that when people began to use hearing aids, many saw improvements in various aspects of their lives including mental health, social life, self-esteem, personal relationships and overall health. Family members reported an average of 15 per cent greater benefit than the hearing aid wearers, which indicates that family members and friends notice significant positive changes when their loved ones get hearing aids.

Hearing aids have come a long way over the years. Today, there are many makes and models to accommodate just about everyone. If you think a picture of the different types of hearing aids would be helpful while you read this post, simply, type, “hearing aids, makes and models” into your favourite browser and you will see many links to pictures of hearing aids.

When you buy hearing aids these days, you are buying a tiny computer which can be adjusted to fit your specific hearing loss and provide you with the maximum help you need. These new digital hearing aids provide a clear, comfortable sound and can be programmed to automatically reduce annoying background noise in changing environments.

While the hearing aids will eventually help you a great deal, it takes training and patience to improve your ability to understand through hearing aids. In fact, research indicates that it takes the brain several months to adjust to listening through hearing aids. However, in time you will adjust well to your new hearing aids which will increase your ability to participate more fully in day-to-day listening activities.

More on that in my next post! Stay tuned!

Disclaimer
Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.

Hearing aids can improve the quality of your life

By Glen Sutherland, MCISc
Audiologist

Welcome back! I hope you enjoyed your summer.

My last post before our summer recess talked about sensori-neural hearing loss. If you have not already done so, you might find it helpful to read my previous posts.

Sensori-neural hearing loss, typically referred to as “nerve deafness”, occurs when damage most often occurs in the “inner” ear but can also occur along the hearing nerve. Approximately 90% of people who have hearing impairment have sensori-neural hearing loss, making it the most common type of hearing impairment. Generally speaking, sensori-neural hearing loss is permanent and irreversible.

Treating any hearing loss depends on prompt diagnosis and treatment. All hearing losses should be evaluated by an audiologist and physician to explore all potential treatment options.

In the vast majority of cases, sensori-neural hearing loss is not medically or surgically treatable. However, most people with sensori-neural loss notice a great deal of benefit from wearing some form of amplification device (hearing aids, bone-anchored hearing aid (BAHA), cochlear implants, etc.).

The majority of people with sensori-neural hearing loss benefit from wearing hearing aids.

Unfortunately, only 15 – 20% of people who require hearing aids use them. My next few posts will focus on hearing aids, how they can help you (if you need them); why you need to start wearing them sooner than later; and how to buy hearing aids that are best for you.

Hearing aids can improve the quality of your life. If you have found out that you have a sensori-neural hearing loss and are going to buy hearing aids to help you, there are several factors to consider in choosing the best devices to help you in all sorts of day-to-day listening situations. The more you know, the better your decision will be in choosing hearing aids which are best for you!

The extent of improvement to your hearing is directly proportional to:

1. how much difficulty you are having: the more difficulties you are experiencing, the harder it will be for the hearing aids to restore your hearing to near normal, and,

2. the length of time that you’ve had a hearing loss: the longer you’ve had a hearing loss, the longer it will take for your brain to adjust to sounds heard through hearing aids.

Understanding speech is a brain function. When you put on hearing aids for the first time you’ll begin hearing sounds you haven’t heard in some time, including speech and many unwanted background sounds. Your brain actually has to re-learn how to hear all these sounds and how to filter the sounds you want to hear, like speech, from background sounds so you can hear speech better than background sounds.

While the hearing aids will eventually help you a great deal, it takes training and patience to improve your ability to understand through hearing aids. In fact, research indicates that it takes the brain several months to adjust to listening through hearing aids.

However, in time you will adjust well to your new hearing aids which will increase your ability to participate more fully in day-to-day listening activities.

Factors to consider in choosing hearing aids include, but are not limited to:
• Cost of the hearing aids,
• The level of sophistication of hearing aids: hearing aids are now offered in levels (entry, advanced and premium), offering advanced features so the hearing aids can be tailored to more effectively meet your specific needs,
• Styles and sizes of hearing aids: you no longer have to be self-conscious about wearing hearing instruments, there are a variety of styles to suit everyone and every situation,
• Ease of use for you, and,
• Hearing aids accessories (remote control devices, Bluetooth technology, etc.) to further help you in different listening situations.

In the next few posts, I will provide you more information about each of these factors in hopes of helping you buy the best hearing aids for you and helping you adjust to the hearing aids with realistic expectations.

Disclaimer
Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.

Mixed hearing loss – a combination of conductive and sensori-neural hearing loss

Depending on where you are experiencing problems in your ear will determine what type of hearing loss you have and what help you can get to improve your particular situation. If you have not already done so, you might find it helpful to read my previous posts. If you think a picture of the auditory or hearing system would be helpful while you read this post, simply, type, “anatomy/images of the ear” into your favourite browser and you will see many links to pictures of the ear.

Previous posts have focused on two different types of hearing loss: conductive and sensori-neural. Today’s post will focus post on mixed hearing loss which occurs when a person has a sensori-neural hearing loss but may experience some conductive hearing loss as well.

Generally speaking, sounds are “conducted” from the environment around us down our ear canals (outer ear), causing the ear drums to vibrate. The movement of the ear drums causes the bones in the middle ear to vibrate against the oval windows which sit at the entrance of the inner ear. The inner ear hair cells change the vibrations from the middle ear into electrical impulses which are sent along the auditory nerve to the brain which makes sense of the things we hear around us.

Because the outer and middle ears are responsible for “conducting” sounds to the inner ears, anything that can go wrong with the outer and/or middle ears result in “conductive” hearing loss. Some people say it is like listening under water. They feel like their ears are plugged. As well, people with conductive hearing loss tend to speak softer than usual because they hear their own voice loudly.

Most conductive hearing losses are temporary and are resolved following medical treatment such as medication and/or an operation. Conductive hearing losses can also be permanent and may require hearing aids or implantable bone-anchored hearing implants.

Sensori-neural hearing loss, typically referred to as “nerve deafness”, occurs when damage most often occurs in the “inner” ear but can also occur along the hearing nerve.

Approximately 90% of people who have hearing impairment have sensori-neural hearing loss, making it the most common type of hearing impairment. Generally speaking, sensori-neural hearing loss is permanent and irreversible.

In the vast majority of cases, sensori-neural hearing loss is not medically or surgically treatable. However, most people with sensori-neural loss notice a great deal of benefit from wearing some form of amplification devices (hearing aids, bone-anchored hearing aid (BAHA), cochlear implants, etc.).

A mixed hearing loss occurs when a person experiences a combination of conductive and sensori-neural hearing loss. There may be problems in the outer and/or middle ear as well as the inner ear. One example of a mixed hearing loss is a conductive loss due to a middle-ear infection or wax build up combined with a sensori-neural loss associated with aging.

I have seen several patients over the years who have developed a sensori-neural hearing loss and who wear hearing aids. Occasionally, these individuals develop an ear infection or wax build-up in their ear canals. These conditions may cause more hearing loss. Most often these people will complain that their hearing aids are not loud enough or think that there is something wrong with their hearing aids.

In such instances, I would examine the ear canals and ear drums and perform a battery of tests to check for any changes. Typically my tests would indicate that there is a conductive component to their hearing loss.

I would recommend them to their family physician with a copy of my most recent results.The doctor would review my results and check the patient’s ears for any sign of ear infection or wax. Some of the clients may be referred to an ear, nose and throat doctor.

Typically, the hearing loss associated with these conditions is temporary and would return to where it was before the conductive portion of the hearing loss. Once the conductive portion of the hearing loss is gone, the hearing aids would perform the way they did before the condition. The person would still have the sensori-neural portion of the hearing loss but the conductive hearing loss would be gone.

Treating any hearing loss depends on prompt diagnosis and treatment. Whenever a person experiences some form of hearing loss, they should be evaluated as soon as possible by an audiologist and physician to explore all potential treatment options.

Glen Sutherland, MCISc
Audiologist

Disclaimer
Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.

Sensori-neural hearing loss

Depending on where you are experiencing problems in your ear will determine what type of hearing loss you have and what help you can get to improve your particular situation. If you have not already done so, you might find it helpful to read my previous posts. If you think a picture of the auditory or hearing system would be helpful while you read this post, simply, type, “anatomy/images of the ear” into your favourite browser and you will see many links to pictures of the ear.

Today’s post will focus post on sensori-neural hearing loss. When you get your hearing tested, you undergo a series of tests which help the clinician ascertain which type of hearing loss you have. The results of the tests also help the clinician recommend how you can best be helped depending on your type of hearing loss.

The ear per se is divided into three sections: the outer ear, the middle ear and the inner ear. Generally speaking, sounds are “conducted” from the environment around us down our ear canals, causing our ear drums to vibrate. The movement of the ear drums cause the bones in the middle ear to vibrate against the oval windows which sit at the entrance of the inner ear. The inner ear hair cells change the vibrations from the middle ear into electrical impulses which are sent along the auditory nerve to the brain which makes sense of the things we hear around us.

Because the outer and middle ears are responsible for “conducting” sounds to the inner ears, anything that can go wrong with the outer and/or middle ears results in “conductive” hearing loss. For more information about conductive hearing loss, please go to my previous post (April 2013).

Sensori-neural hearing loss, typically referred to as “nerve deafness”, occurs when damage most often occurs in the “inner” ear but can also occur along the hearing nerve.
Approximately 90% of people who have hearing impairment have sensori-neural hearing loss, making it the most common type of hearing impairment. Generally speaking, sensori-neural hearing loss is permanent and irreversible.

Most common causes of sensori-neural hearing loss include; but are not limited to:
• Aging
• Exposure to loud noise
• Viral infections
• Ototoxic drugs
• Head injury
• Genetic or hereditary predisposition

Generally speaking, because the problems associated with sensori-neural hearing loss result from damage to many of the hundreds of thousands of inner ear hair cells or the auditory nerve, the signals (messages) transmitted to the brain are not complete and, therefore, distorted and incomprehensible. Those who suffer from this condition may complain that people seem to mumble or that they hear, but do not understand, what is being said; they HEAR sounds but not always clear enough to DISCERN OR UNDERSTAND what is being said.

For a moment, liken the inner ear to a pedal (concert) harp which is a large, modern harp. Typically, it has 46 or 47 strings with a range of six and one-half octaves. If you were to listen to a song played on a harp that is in perfect working order, you would be able to hear the music from the harp AND discern or understand the song that is being played. However, if you remove half of the strings and listen to the same song being played, you would hear that “something” is being played on the harp but, most likely, you would not be able to discern or understand what song is being played!

Imagine the following sentence to be what it would be like to hear through an intact or healthy auditory system:

THE QUICK BROWN FOX JUMPED OVER THE LAZY DOGS.

When a person experiences a severe sensori-neural hearing loss, the same sentence would look something like the following sentence:

–E wI– b-OW- -og –Um- – – O-er –e la-y gOg-.

This sentence attempts to illustrate that sounds are getting through to the inner ear but, because so many hair cells in the inner ear are damaged, the signals (messages) transmitted to the brain are distorted and incomprehensible.

The brain receives a message and hears sound but the message is distorted so the brain has trouble deciphering what the message means!

In the vast majority of cases, sensori-neural hearing loss is not medically or surgically treatable. However, most people with sensori-neural loss notice a great deal of benefit from wearing some form of amplification devices (hearing aids, bone-anchored hearing aid (BAHA), cochlear implants, etc.).

Treating any hearing loss depends on prompt diagnosis and treatment. All hearing losses should be evaluated by an audiologist and physician to explore all potential treatment options.
Glen Sutherland, MCISc

Audiologist

Disclaimer
Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.

Conductive Hearing Loss

Did you know that there are different types of hearing loss? Depending on where you are experiencing problems in your ear will determine what type of hearing loss you have and what help you can get to improve your particular situation.

Today’s post will focus on conductive hearing losses and the next post will focus on sensori-neural hearing losses. When you get your hearing tested, you undergo a series of tests which help the clinician ascertain which type of hearing loss you have. The results of the tests also help the clinician recommend how you can best be helped depending on your type of hearing loss.

If you have not already done so, you might find it helpful to read my previous posts.

If you think a picture of the auditory or hearing system would be helpful while you read this post, simply, type, “anatomy/images of the ear” into your favourite browser and you will see many links to pictures of the ear.

The ear per se is divided into three sections: the outer ear, the middle ear and the inner ear. The outer ear consists of the parts of the ear that you can examine visually, including the ear canal and the ear drum.

Just beyond the ear drum is the middle ear which contains the three smallest bones in the human body, the malleus (hammer), incus (anvil) and stapes (stirrup). These bones connect the outer ear to the inner ear.

The inner ear (cochlea) is a snail-shell shaped cavity in the temporal bone of the skull. It is filled with a special fluid and hundreds of thousands of tiny hair cells.

So, how do we hear? Generally speaking, sounds are “conducted” from the environment around us down our ear canals, causing the ear drums to vibrate. The movement of the ear drums cause the bones in the middle ear to vibrate against the oval windows which sit at the entrance of the inner ear. The inner ear hair cells change the vibrations from the middle ear into electrical impulses which are sent along the auditory nerve to the brain which makes sense of the things we hear around us.

Because the outer and middle ears are responsible for “conducting” sounds to the inner ears, anything that can go wrong with the outer and/or middle ears result in “conductive” hearing loss.

Conductive hearing loss may result from a variety of reasons which include but are not limited to, earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstructions in the ear canal, deformations, perforations (hole) in the eardrum, hardening or breaking of the bones in the middle ear and pressure build up due to issues with the Eustachian Tube.

A conductive hearing loss results in a reduction of loudness of sound reaching the inner ear. Some people say it is like listening under water. They feel like their ears are plugged. As well, people with conductive hearing loss tend to speak softer than usual because they hear their own voice loudly.

Try this little experiment:
1. Put your forefingers (index fingers) over the portions of the ears that sit over the entrance of your ear canals (tragi).
2. Press on the tragi so they block the entrance to both ear canals.
3. Have someone speak to you. You should be able to hear them but at a softer level than normal.
4. Talk to yourself. You should sound louder and your voice should sound like it is “inside” your own voice.
5. Try eating a carrot or some celery. The crunch of the vegetables should sound much louder to you.

Generally speaking, because the problems associated with conductive hearing loss are in the outer and/or middle ear, the inner ear hair cells are still working well and can transmit any sounds that are picked up to the brain. Simply put, when a person experiences a conductive hearing loss, sounds will be softer but won’t be distorted.

Imagine the following sentence to be what it would be like to hearing through an intact or healthy auditory system:

THE QUICK BROWN FOX JUMPED OVER THE LAZY DOGS.

When a person experiences a conductive hearing loss, the same sentence would look something like the following sentence:

ThE quick BROWN FOX jUMPED OVER THE LAzY DOGs.

Notice that some of the letters appear smaller in the second sentence. This sentence attempts to illustrate that sounds are getting through to the inner ear but not with as much power because something isn’t as it should be along the “conductive” portion of the ear (the outer/middle ear). The transmission of sound is impeded and results in a conductive hearing loss.

Most conductive hearing losses are temporary and are resolved following medical treatment such as medication and/or an operation. Conductive hearing losses can also be permanent and may require hearing aids or implantable bone-anchored hearing implants.

Treating any hearing loss depends on prompt diagnosis and treatment. All conductive hearing losses should be evaluated by an audiologist and physician to explore all potential treatment options.

Glen Sutherland, MCISc
Audiologist

Disclaimer
Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.

Factors which affect our ability to understand speech – Part 1

Why we all have difficulty hearing and understanding sounds, in particular speech, from time-to-time: Factors which affect our ability to understand speech – Part 1

Most people encounter difficult listening situations every day; situations when they can hear speech and/or noise but they can’t always decipher and understand what the sounds mean. There are many factors which challenge our ability to hear and understand speech. I will explain some of those factors in this post.

First, though, in a previous post I explained the anatomy of the ear and how we hear. For those readers who may not have seen that post, a quick review is warranted.

If you think a picture of the auditory or hearing system would be helpful while you read this post, simply, type, “anatomy/images of the ear” into your favourite browser and you will see many links that will provide you with pictures of the ear.

The ear per se is divided into three sections: the outer ear, the middle ear and the inner ear. The outer ear consists of the parts of the ear that you can examine visually and includes the ear canal and the ear drum.

Just beyond the ear drum is the middle ear which is a space about the size of a pea. The middle ear contains the three smallest bones in the human body, the malleus (hammer), incus (anvil) and stapes (stirrup). These bones together are called the ossicular chain which is attached to the ear drum at one end and the oval window at the other end. Also, the middle ear is connected to the back of the throat by the Eustacean tube.

The purpose of the middle ear is to make sure that sounds get from the outer ear to the inner ear accurately and to equalize the pressure in the environment around us with the pressure in the middle ear so the ossicular chain can vibrate as it should.

The inner ear (cochlea) is a snail-shell shaped, fluid-filled cavity in the temporal bone of the skull. It is filled with a special fluid and hundreds of thousands of tiny hair cells which change the vibrations from the middle ear into electrical impulses which are sent along the auditory nerve to the brain.

I consider the brain to be the fourth and a very important part of the auditory or hearing system. Without the brain you wouldn’t be able to understand what all the electrical impulses from the inner ear mean.

So, how do we hear? Sounds are conducted from the environment around us down our ear canals, causing the ear drums to vibrate. The movement of the ear drums cause the ossicular chains (in the middle ear) to vibrate against the oval windows which sit between the middle ear and the inner ear. Generally speaking, the movement of the ossicular chains helps to determine the power (loudness) of the sounds which are sent to the brain.

The vibrations of the oscciular chain are conducted into the inner ears and are changed into electrical impulses by hundreds of thousands of inner hair cells. The electrical impulses are sent along the auditory nerve to the auditory cortex in the brain. It is the brain’s responsibility to receive the electrical impulses and make them meaningful to us so that we hear and understand what is being said by the listener.

Simply put, the ear is the mechanism that sends the sounds to the brain. The brain is the mechanism that helps us decipher and understand what the sounds mean. I constantly marvel at how this system works to help us communicate with others!

Even with normal hearing there are obstacles which interfere with our ability to listen. We may hear sounds around us but we can’t always decipher what the sounds mean.

Some of the factors that may interfere with out listening include; but are not limited to:

1. The loudness of the sounds. Is the speaker whispering or is s/he talking over the extraneous environmental sounds?

2. The distance the sounds are made from the ears. Is the listener close to the speaker making it easy to hear and interpret the message or is the listener a distance from the speaker so that the listener is aware that the speaker is saying something, but can’t make out what is being said? Is the speaker talking next to the listener or is the speaker calling from another room or floor in a house?

3. The extraneous noise that is between the sound source and the ears. Are the speaker and listener in a quiet cozy corner with a little bit of extra noise or are the speaker and the listener in a crowded, noisy place making it hard to hear and interpret what the speaker is saying?

4. How clearly the speaker is talking. Does the speaker speak softly and mumble or does s/he enunciate words so they are easier to hear and interpret?

5. How interested the listener is in what the speaker is staying. Is the speaker entertaining and telling the listener something new or is the speaker telling a boring story that the listener has heard many times before?

6.How tired the listener is and able to hear and decipher what is being said. Is the listener interested and alert to conversation even in a noisy environment or is the listen tired and thinking about other things while trying to listen to the speaker?

7. And, the condition of the “listening environment”. Are there wall hangings on the walls and carpets on the floor or, is the room decorated with tiles and bricks which reflect the sound waves and make it more difficult to hear?

Hearing and understanding become more and more difficult as the listening conditions become more challenging.

Now, add a hearing loss to the mix and it is no wonder that, in many circumstances, people with hearing loss have trouble hearing and subsequently, understanding. Often they will tell you that they can hear something but they can’t understand what they are hearing.

But, that’s a topic to be addressed in future posts. Stay tuned.

If you have not already done so, you might find it helpful to read my previous posts. To a certain extent I have designed my posts sequentially, although the information in each post does “stand alone” and can help you understand more about hearing and hearing loss. Enjoy!

Glen Sutherland, MCISc
Audiologist

Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.

The Hearing Tests, part two

Glen Sutherland, MCIs
Audiologist

HAPPY NEW YEAR! I hope you had a delightful Holiday Season. Here’s to a wonderful year ahead!

In previous posts I have explained some of the tests that you should expect to experience during your first hearing assessment appointment. So far, I have reviewed otoscopy, impedance and puretone testing. Following is a short review of each of these tests but for more detailed information, read my previous posts. Just click on the category “Thoughts from an Audiologist” to the right of the screen on Rosemary’s blog, Read My Lips.

During the otoscopic examination, the clinician checks the outer part of the ear (the part you can see at the sides of your head) to make sure everything looks okay. Then s/he looks down the ear canal to make sure it is clear to proceed with the hearing test.

Impedance testing includes a series of tests that help the clinician determine if the middle ear is working properly or not and if the ear is able to transmit the sound waves through the middle ear into the inner ear.

Perhaps the most familiar hearing test to our readers is the puretone test or “the test where you hear the beeps and you raise your hand or push a button or say ‘beep’ every time you hear a beep”. The puretone test determines your ‘threshold of hearing’ or the lowest level where you just barely hear sounds (the beeps). The clinician records the softest level that you hear on a graph called an audiogram. S/he will be able to compare your hearing graph to a graph of normal hearing to determine your degree of hearing loss.

In addition to the tests I have just reviewed, typically most clinicians conduct a series of speech tests to determine how well you perceive speech, where you find speech comfortable to listen to and where you find speech uncomfortable. These tests include the Most Comfortable Listening test, the Uncomfortable Listening test, the Speech Reception Threshold test and the Word Discrimination test.

The Most Comfortable Listening Test (MCL):

The MCL test determines the loudness at which you prefer to listen to speech. The clinician will talk to you through the audiometer, ask you some questions or have you listen to a poem or a story while the level of the sound is raised and lowered. As you listen, you indicate to the clinician the level when the sound is comfortable to hear. The clinician will record the level at which speech is easy and comfortable for you to hear and understand speech.

The Most Uncomfortable Listening Test (UCL):

The UCL test indicates the loudest level at which you can stand to listen to sound. As the name would suggest, the sound is uncomfortable and anything above that level would approach being painful. The clinician will talk to you through the audiometer, ask you some questions and have you listen to a poem or a story while the level of the sound is slowly increased. As you listen, you determine when the sound is uncomfortable to hear, much too loud! The clinician will record the level that you indicate.

The Speech Reception Threshold Test (SRT):

The SRT determines the threshold of your hearing for speech; that is to say, the lowest level that you can hear two-syllable words 50% of the time. The clinician will acquaint you with some two-syllable words: airplane, iceberg, baseball, etc. Once you know the words that the clinician will say, the clinician will repeat the words through the audiometer and make them softer and softer. You will repeat the words as long as you can hear them. The clinician will record the softest sound for speech on the audiogram.

The Word Discrimination Score (WDS):

The WDS is the percentage of words that you can repeat accurately from a list, typically presented at your most comfortable listening level (MCL). The clinician presents the words at one level and you repeat back the word that you hear. The clinician records which words you repeat correctly and which words you repeat incorrectly and calculates the percentage of correctly repeated words and records that score as your WDS. This test can be completed for each ear and then binaurally (the speech going into both ears at the same time).

These tests, in addition to the tests which have been explained in my last few posts, form the battery of tests used to assess your hearing. Once the hearing assessment is completed, the clinician should review the results with you, thoroughly explaining what they mean and the implications of the results to you. Depending on the outcome of the results, the clinician will make suggestions and recommendations about what you should do next. For example, the clinician may recommend that you see your doctor for a referral to an Ear, Nose and Throat (ENT) specialist or you may be ready to get hearing aids. The results of the hearing assessment will help your clinician guide you in the direction you need to go!

Disclaimer
Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.