When To Get A Hearing Test
Do You Need A Hearing Test?
Communication Tips For The Family
Assistive Listening Devices
Tinnitus (Ringing in the Ears)
When To Get A Hearing Test
Most hearing loss develops gradually, so the signs are difficult to detect. To make a quick check on how you are hearing, answer these 10 questions. If you answer yes to two or more, then you would benefit from a more thorough audiologic exam.
- Do people seem to mumble or speak in a softer voice more than they use to?
- Do you feel tired or irritable after a long conversation?
- Do you sometimes miss key words in a sentence?
- Do you frequently need to ask people to repeat themselves?
- Do you have difficulty understanding the conversation in a crowded room?
- Do you often turn the volume up on the TV or radio?
- Does background noise bother you?
- Is it sometimes hard to hear the convesation on the telephone?
- Do you sometimes not hear the doorbell or telephone ring?
- Are your family or friends complaining about your hearing?
If you answered YES to two or more of these questions, you should schedule a hearing test by a doctor of audiology. Following that testing, the audiologist can tell you whether you have a hearing loss, as well as the nature and extent of the hearing loss. If a hearing loss is detected, the audiologist will recommend the appropriate course of action.
Do You Need A Hearing Test?
Your hearing is a precious gift – one you need to take care of or run the risk of losing it. An important part of hearing care is having your hearing checked periodically. There are several levels of hearing evaluation, from a basic hearing test to more complex diagnostic tests for specific problems.
Basic Hearing Testing
A basic hearing test is performed in a quiet area (preferably a Sound Booth). An audiometer is a device that produces various pitch sounds (frequencies) at different levels (intensities). The person responds by either raising his/her hand or pushing a button.
The results are charted on an audiogram, which gives the audiologist an indication of whether hearing is within normal limits or if a problem may exist.
If a hearing loss is detected, usually more testing is performed to better define the nature and extent of the hearing loss and to determine which treatments or referrals are needed.
Additional diagnostic testing
There are many other tests that can be performed by the doctor of audiology to understand the extent and possible cause of the loss. Each evaluates a different part of the ear. Some of the typical tests performed are:
- Tympanogram – tests the eardrum and the middle ear (the space behind the eardrum)
- Acoustic reflexes – measures the movement of the tiny bones behind the eardrum
- Otoacoustic emission (OAE) – checks the function of the tiny little “hair cells” in the inner ear
- Speech testing – evaluates the effect of the hearing loss on understanding of speech. Sometimes this is performed both in quiet and with a background noise, using live or recorded voice
- Auditory Evoked Potentials (ABR) – checks the acoustic nerve function up to and into the first part of the brain (Pons)
- Electronystagmography (ENG) – evaluates the part of the inner ear controlling balance. Usually performed on individuals who experience dizziness or balance problem
- Auditory Processing Testing (APD/CAPD) – evaluates how the brain perceives or understands what the ear sends to it. Many times this testing is recommended for children who experience attention or learning problems, or adults who have normal ear function but still have “hearing” difficulty.
Communication Tips For The Family
Hearing loss impacts not only those who suffer with it, but also the family. There are a number of things family and friends can do to help.
- Be patient. Hearing loss is as frustrating for the person with hearing loss as it is for those who are trying to communicate with him or her.
- Accept reality. In most cases, the hearing loss isn’t going away. It will require changes in how communication takes place.
- Speak slower. How fast a person talks will have more impact on understanding than the loudness of the voice.
- Don’t shout. It doesn’t help, and may make it worse to shout, particularly if your loved one wears hearing aids. Learn to speak distinctly.
- Don’t fight background noise. If the TV is on, it is very unlikely the hearing impaired person will “hear” what you are saying. Turn down the TV or radio. Turn off the running water. If you decrease the competing interfering noise, communication will be better.
- Face the person. Never talk with your back to people with hearing loss. Facing the person helps not only with visual cues but also because the sound is directed toward them.
- Don’t walk away. Don’t start talking and then walk away. The person will only hear the first part when you are facing him or her.
- Get the person’s attention before you start talking. Say their first name or “Dear,” “Sweetheart” or something else to get their attention. Once you have their attention, then say the rest.
- Don’t get angry with the person with a hearing loss – it is not always his/her fault. You may need to repeat yourself.
- Be supportive. Find ways to help your loved one. Encourage him/her to seek professional help if there are problems or questions.
Assistive Listening Devices
(ALDs)
An Assistive Listening Device is any device other than hearing aids that are designed to improve a person’s ability to communicate and to function more independently despite a hearing loss. There are many types of devices available which are in two basic categories.
1) ALARM DEVICES
These devices are sensory devices, which warn, signal and alert. They function by providing one or more tactile, visual and/or auditory signals. Examples include:
- Wake-up alarms
- Smoke detectors
- Door bell detectors
- Telephone ring detectors
- Other sounds detectors
These devices work by providing a vibration, flashing light or louder signal in a frequency range that can be heard which will alert the person to the particular sound.
2) LISTENING DEVICES Listening devices are designed to bring the listener closer to the source of the desired sound. They reduce undesirable background noise and provide greater clarity for speech. There are four main categories: Loop, FM, Infrared and Hardwired.
- Loop system
A Loop System is a loop of wire around a room. This system uses the hearing aid’s telephone switch. The loop is connected to an amplifier that receives signals from the sound source. This system can be used for groups, small or large. There are large systems in some churches, theatres and meeting rooms. Small portable systems are now available for home use.
- FM system
FM system is a radio system consisting of a small transmitter and microphone. The microphone is placed near the sound source and the signal is sent to the receiver which the person wears.
- Infrared system
Infrared systems consist of a transmitter and receiver. A microphone is placed near the sound source and the signal is transmitted to the person by lightwaves.
- Hardwire systems
This system is similar to the others except that the person is directly “wired” to the microphone or transmitter. It is designed for small areas at home.
Tinnitus
(Ringing in the Ears)
Tinnitus is ringing or other noise in the ear or head. Some describe it as sounding like crickets, hissing or other sounds.
There are an estimated 18 million people who experience chronic and, at times, distressing tinnitus.
Possible Causes:
- Hearing loss
- Ear infections
- Medications
- Excessive ear wax
- Allergies
- Sinus infections
- High blood pressure
- Nutritional deficiencies
- TMJ (temporomandibular jaw joint disorder)
- Cardiovascular disease
- Acoustic neuroma
- Cervical vertebrae problem
- Neurologic disorders
others
Things That Make Tinnitus Worse:
- Overexposure to noise
- Certain medications
- Alcohol
- Caffeine
- Excessive sodium intake
- Stress
- Some foods
Things That Make Tinnitus Better
- Relaxation
- Wearing hearing protectors around high noise
- Masking the symptoms with pleasant music or recordings of nature sounds (ocean, babbling brook, etc.)
- Learning about tinnitus and possible methods to treat it
- Patience with any therapy – it takes time
Possible Treatments for Tinnitus
- Hearing aids
- Tinnitus Retraining Therapy (Auditory Habituation)
- Masking
- Counseling
- Biofeedback
- Medications
Others – hypnosis, acupuncture, herbal and dietary supplements, etc.
Resources for Additional Information:
American Tinnitus Association www.ata.org
Dizziness & Balance Problems
Dizziness and balance disorders (also called Vestibular Disorders) occur frequently and can affect people of all ages. According to the National Institutes of Health as many as 90 million Americans complain to their physician at least once about dizziness.
Many people do not know, however, that most of these cases are caused by an inner ear disorder. Although most often the causes of dizziness are not serious, dizziness can lead to falls and other more serious problems. For that reason, dizziness or balance problems should be brought to the attention of your physician.
Some Common Causes
- Meniere’s Disease
- Labyrinthitis – inner ear infection
- Viral infections
- Head trauma
- High or low blood pressure
- Some medication or combination of medications
- Tumors
- Vascular – reduced blood flow to the inner ear due to a rupture of tiny blood vessels in the inner ear
- Neuronitis – irritation of the nerve from the inner ear to the brain
- Other neurologic disorders
Testing for Vestibular Problems
Various tests can be performed to evaluate the cause of the problem. The most recommended tests are:
- Electronystagmography (ENG)
- MRI or CAT Scans
- Posturography
- Rotation Tests
- Hearing Tests
Other tests depending on symptoms and history
Treatment
The treatment will vary depending on the cause and diagnosis. In mild cases, symptoms may go away on their own. Other cases require treatment, which may include:
- Medications
- Otolith Repositioning
- Vestibular rehabilitation
- Physical therapy
- Diets
- Surgery
- Various other treatments depending on origin of the problem.
Myths About Hearing Aids
When hearing loss cannot be corrected by medical means (medication or surgery), hearing aids are often recommended. Unfortunately, there are many who have inaccurate or incomplete information, which leads to disappointment and frustration. Firsts, let’s dispel the most common myths about hearing aids.
Myth: Hearing aids correct hearing loss.
A hearing aid is a device, which amplifies sounds that the ear is having difficulty “hearing.” It is not “fixing” the damaged ear, therefore, it is an “aid” – it helps you to hear better. It’s not a cure.
Myth: When wearing hearing aids you will hear speech clearly. Although hearing aids help you to hear better, depending on the type and extent of the hearing loss, they cannot clear up all speech. The goal is to help the brain to receive more pieces of the speech sounds so it can “hear” and understand more of the words. There can be situations due to the room acoustics, level of background noise or the speaker’s voice quality which prevent a complete understanding (discrimination) of the conversation.
Myth: You only need to wear hearing aids when you think you need them. We really hear with our brain! The ears just pick up sound and send it to the brain. When you have a hearing loss, the brain will need to re-learn what it has been missing to achieve the best results. For this reason, wearing the hearing aids consistently throughout the day is critical to “hear” the best you can in a variety of situations.
Myth: Digital hearing aids are always the best. Although digital hearing aids are technically superior to the older “analogue” type, there are some types of hearing losses that will react as good or even better with the older type. A doctor of audiology will determine the type that is best for each individual patient.
Myth: The smallest hearing aids are more sophisticated. Just because it is small does not make it better. For cosmetic reasons, most people like the idea of a smaller hearing aid but there are not any electronics in the hearing aids that make them electronically better. In fact, due to the size, in some cases there is not enough room in the smallest hearing aids for circuits that may be better for the patient. The doctor of audiology will help sort through the advantages and disadvantage of each type and style.
Obtaining hearing aids is an important step to improve your life, therefore, take the time to learn about your hearing and hearing aids. Everyone’s hearing loss, lifestyle and brain functioning is different so there is no one hearing aid that is right for all. Ask your doctor of audiology what is best for you and why.
Facts About Hearing Aids
When hearing loss cannot be corrected by medical means (medication or
surgery), hearing aids are often recommended. Unfortunately, there are many who have inaccurate or incomplete information about hearing aids which leads to disappointment and frustration. Here are some hearing aid facts.
FACT: Hearing aids do work for those with “nerve” type (sensorineural) hearing loss. In fact, most hearing aids are designed for just this type of hearing loss. It is true that hearing aids do not fix the ear, but they can help most people to hear better.
FACT: No hearing aids eliminate background noise. It is true that there are newer digital hearing aids that help people to hear in noisy environments, but hearing aids do not know what a person wants to hear and what he or she does not want to hear. Consistently wearing the appropriate hearing aids, set properly will however, allow the brain do what it does best -- sort through the information and focus on what is important while ignoring the rest. When you have a hearing loss, it is almost always going to be difficult in noisy settings. The goal is to still be able to follow the conversation in those settings. Hearing aids may help, but do not expect “miracles.”
FACT: No one type of hearing aid is right for all. There are many types and brands of hearing aids. Although advertising may lead a person to think that there is the “perfect” hearing aid for everyone, that just isn’t the case. Each person has a unique hearing loss, hearing needs, and brain processing; which hearing aid will work best is a very individual thing. Working with your doctor of audiology is essential to determine the best device for you. Close follow-up after the hearing aid are obtained will help to ensure the hearing aids are truly meeting the person’s hearing needs.
FACT: It is not that difficult to grow accustomed to wearing hearing aids. Sure, anything new will take some time to get accustomed to, but if the hearing aids are fitting comfortably and work properly allowing the person to “hear” better, this adjustment period will be short. Patience and realistic expectations are vital to the process and make it going smoothly. If the person is motivated to do what it takes to hear better, the time it takes to feel comfortable with new hearing aids will go quickly. Follow-up with the doctor of audiology is important to answer any questions and to be sure the hearing aids are adjusted properly.
FACT: Thorough hearing testing is critical to determine whether hearing aids are necessary and what type is appropriate. All too often only a cursory hearing test is performed before hearing aids are recommended. The more precise the testing the more accurate the recommendations will be for either medical exams or hearing devices. A doctor of audiology will perform the necessary testing and provide appropriate recommendations.
Preventing Hearing Loss
Fact: According to research sited by the Deafness Research Foundation, at least 70% of what has been traditionally diagnosed as “age-related hearing loss” is, in fact, due to a lifetime of toxic noise exposure.
Fact: Hearing loss affects more than 30 million Americans and that number is rising every day.
Fact:According to the National Council on Aging, untreated hearing loss has been linked to increased susceptibility to numerous other health complications, such as arthritis, diabetes, hypertension, depressions, and anxiety, to name a few.
Fact: California researchers documented a 300% rise in the presence of permanent noise-induced hearing loss in second graders over a 10-year period, and a 500% increase among eighth graders. (At this rate, permanent high frequency hearing loss will be present in more than 90% of the eighth grade population by 2012!)
What these statistics say to us all is simple: without any attempt to lower the effects of toxic noise exposure, it is projected that by 2030 virtually every American over the age of 50 will have enough
permanent hearing loss to require hearing aids to communicate.
So, what can you do to prevent noise-induced hearing loss?
- Increase your awareness of noise and avoid prolonged exposure to loud noise—anything above 80 decibels.
- If you cannot avoid exposure to noise, wear appropriate hearing protection—available from a doctor of audiology.
- Visit a doctor of audiology who offers a hearing-loss prevention program for yourself and your family.
- Encourage your children or grandchildren to become noise-conscious—paying special attention to head-phone stereos and toys that make noises (and are often held close to a child’s head).
