Although hearing impairment is one of the most prevalent disabilities, many people who are affected do not fully understand the problem and are often unwilling to seek treatment. Those who have adjusted to a gradual loss of hearing through the years often do not realize that the sounds reaching them are greatly diminished. They have almost forgotten the sound of ocean waves, the chirping of birds, a loved one’s whisper. Any suggestion that the use of a hearing aid might be needed is denied, and medical advice is strenuously avoided.
Since hearing impairment is an invisible condition, many people try to “pass” without it being detected. These people usually prefer the lost sound to the perceived stigma of using a hearing aid. Despite wishful thinking, a hearing loss can never be successfully concealed. In the attempt, the significant benefits available through medical and scientific technology are missed, friendships may be severed, and the person may gradually retreat to a life of isolation.
Three Basic Types Of Hearing Impairments
There are three basic types of hearing impairments. With a conductive loss, sound waves are blocked as they travel through the auditory canal or middle ear and cannot reach the inner ear. Sounds may seem muffled and an earache may be present. Children are often affected with this type of hearing loss. Common causes of a conductive loss include wax blocking the ear canal, infection, or a punctured eardrum. Many conductive hearing problems can be treated successfully.
Another cause of conductive-type loss is otosclerosis. In this disorder, the bones of the middle ear soften, do not vibrate well, and then calcify. If diagnosed properly, this problem can be corrected surgically.
A sensorineural hearing loss, commonly termed “nerve deafness,” involves the inner ear and is the result of damage to the hair cells, nerve fibers, or both. Sounds are distorted, high tones are usually inaudible, and ringing or buzzing sounds (tinnitus) may be present. Speech can be heard, but it is not easily understood. Unfortunately, this type of loss is permanent and irreversible. Causes include high fevers, excess noise, heredity, adverse reaction to drugs, diseases such as meningitis, head injuries, and the aging process.
The third major type of hearing problem is the mixed loss. In this instance a person has both conductive and sensorineural losses.
Early Intervention Is Critical
As with any medical condition, early intervention is critical. An ear specialist (otologist) should be consulted when the telltale signs of hearing loss are noted. These signs include ringing in the ears, the need to have spoken material repeated frequently, high volume on TV or radio, or inattentiveness, The problem may be a simple wax buildup which can be remedied with one office visit. If the impairment cannot be treated medically, then a referral to an audiologist should be scheduled.
Audiologists, specialists in the non-medical evaluation and rehabilitation of persons with hearing disorders, administer a variety of sophisticated tests. These include an audiogram measuring the degree of loss and types of sounds that cannot be heard. Another test is tympanometry which evaluates the middle ear’s ability to conduct sound. Hearing aid evaluations to test the individual’s response to one or more aids are also performed.
Hearing ability is measured by units of sound intensity called decibels. Zero to 25 decibels are considered normal hearing; 25 to 40 decibels a mild loss; 40 to 55 a moderate loss; 55 to 70 decibels a moderately severe loss; 70 to 90 a severe loss; and 90 or above is termed a profound hearing impairment. Beyond 90 decibels, many people would be called deaf, but with modern hearing devices they often can obtain usable sound.
If a hearing aid is recommended, there are many types from which to choose. These range from tiny, all-in-the-ear models for mild to moderate losses to large body aids for profound impairments. Some people require only one aid (monaural), while others receive the most benefit from binaural aids which is one aid for each ear.
In various situations, and especially with a severe to profound loss, a hearing aid may not be enough. Modern technology has again come to the rescue with a variety of Assistive Listening Devices and Systems (ALDS) for telephones, one-to-one and small groups, conferences, rooms, theaters, and places of worship. They include both portable and permanent telephone amplifiers, direct audio input devices, and personal FM and infrared systems. There are also alarm systems and telecaptioning devices. Although not all dealers stock these items, most can obtain information and place orders for needed equipment.
Speech reading and sign language are other modalities available to persons with severe hearing loss. Speech reading is a virtual necessity in cases of severe or profound loss and can be self-taught to some extent. However, professional training may be needed for many people. Depending upon the degree of impairment and individual needs, each person must decide which options offer the most advantages.
Hearing loss need not be a tragedy causing embarrassing moments, job change, or social withdrawal. Only procrastination in obtaining needed help has the potential for tragic consequences. One’s hearing should be preserved and protected as a most valuable possession.