This article has been kindly written by Chelle Wyatt, who writes the excellent My Hearing Loss blog. She was asked to write a post about the impact of hearing loss, not specifically confined to people who suffer as a result of workplace noise, but who may have experienced hearing loss in a wide number of ways. We are grateful to Chelle for her piece and encourage you to check out some of her other posts, in particular an article about hearing aids, which inspired the request for this post.
The most common kind of hearing loss is high frequency hearing loss. Causes range from noise induced, to presbycusis (age related hearing loss), hereditary conditions and more. Even though high frequency hearing loss is common, it's also the most misunderstood. People with this kind of hearing loss can hear well enough to know someone is talking but will have trouble understanding the words, even with hearing aids in. These people will hear the garbage truck but can't hear birds. They hear men's voices better than woman's and will have the most problem with childrens voices. A little more volume might help but a lot of volume distorts sound. High frequency hearing loss is a selective hearing loss, letting them hear some sounds but not others. It's important to understand they DO NOT chose selective hearing, it's how the hearing loss works.
High frequency hearing loss is selective to many sounds of speech. Many consonants fall into the high frequency and are left unheard. The first letters to go are F, S and TH followed by K. Words with these letters are then difficult to decipher in conversations. “Word- wi– –ese letter- are –en di–icult to dis–er in conver-ation-.” Sometimes people can fill in the spaces at the sound of speech and sometimes they can't gather enough information fast enough to make sense of the sounds they can hear.
Thats with a mild, untreated hearing loss. With a moderate high frequency hearing loss P, H, G, CH and SH are also lost. This makes speech much harder to understand and filling in the spaces becomes more difficult. “–is make- s-ee– mu– -arder to under-tand and -illin- in –e –ace- become- more di–ult". With a severe / profound high frequency hearing loss, some vowels become harder to understand. Lesser I, A and O sounds start fading as does the consonant R. "W– – -eve-e/–o-ound -i– –equency -e–ng l– –m- vowel- become —d-r -o under-t-nd." Can you see why people with high frequency hearing loss have such a hard time with speech?
Will hearing aids fix hearing loss?
Hearing aids help but won't fix this kind of hearing loss totally. For one thing, hearing aids operate optimally within a 4-6 foot range in a quiet setting. After that, their effectiveness drops. That's why talking to someone with hearing aids from another room will rarely work. That's why they can't hear lectures unless sitting directly in front of the person.
Hearing aids are made to amplify all sounds. Today's digital hearing aids can boost the higher frequencies and dampen lower tones but it has it's limits and cannot replace what's lost. Another issue is background noise which is the biggest complaint of hearing aid users. Hearing aids can't process sounds like normal hearing. The hearing aid industry has worked some of this out with directional microphones but background noise can still can be overwhelming.
Audiologists often don't clue people into the real deal when fitting hearing aids which leads to disappointment – and disappointment may lead to hearing aids being put away in drawers forever. That's too bad because hearing aids will help. Without hearing aids someone may have a 30% word discrimination, with hearing aids they get a 60% word discrimination which is a big difference when it comes to filling in all the missing pieces.
Others may continue to wear their hearing aids doing their best to cope with the holes left by hearing aids. They might even think it's their fault. Questions like, "are your ears on?!" come up and might prompt many to fake it. It doesn't make sense to have all this great technology (unless an audiologist warned about it) and still not be able to understand so a bluffing strategy might be adopted. It's the first coping strategy many people take on but it's not the best because people may agree to things they shouldn't have as they do the "deaf nod". Hearing the words "never mind" are the most hurtful words to those with hearing loss. It tells them they aren't worth the effort when they are actually trying their very best to understand but the selective hearing of high frequency hearing loss isn't allowing everything to reach their ears. Seeing the impatience in people as they repeat, again, amplifies the discomfort felt by the person trying so hard to hear putting more pressure on them to understand the next repeat. When understanding does not occur the person may revert to bluffing.
The key is not slinking away or bluffing but educating one another. This is how I hear. This is why I miss certain things. This is why I know you are talking and why I can't understand. This is what I need to understand… What do you need to understand speech better? Experiment and research to find out exactly what helps you.
Good coping strategies for hearing loss
Be upfront about hearing loss. It helps when the other person knows you can't hear, most people will be willing to work with you. It helps even more when you tell them what you need. Saying "I can't hear" will probably only make them talk louder. Volume isn't needed, clarity is. Have them face you and tell them slow down only a little to enunciate more clearly. Once you educate them, they will know how to work with you and every other hard of hearing person who comes along.
Tell people you need to see them to hear them. Most hard of hearing people use lipreading to some degree even if they don't consciously accept it yet. Telling others you lipread will also get people to face you making the sound come directly to you and it might stop people talking from other room. Don't feel guilty telling others you lipread in the beginning. The more you consciously use it, the better you will get it. This, like sign language, is an ongoing effort so don't expect instant results.
Ask people to turn down the background noise such as the radio or TV. With less competition there will be less repeats. Don't be afraid to ask restaurants and businesses either. Chances are it's interfering with other people's hearing as well.
People get stuck on certain words and there's several ways around this. If after the second repeat the key word is still missing, ask them to rephrase. Find another word like it or expand the sentence to offer more clues. Another option is to learn sign language which is not a fast, easy fix. This takes time and only works if the other person is willing to learn sign language as well. An easier way might be to learn the manual alphabet because it's a sound that missing in the word. If the person can fingerspell the first couple of letters most likely you will get the rest of the word.
There is a difference between being passive, aggressive and assertive. Being passive is bluffing or faking it. This may seem like the easiest way to get out of situations but it could also lead you to agree to something your normally wouldn't. Being aggressive with your requests to other people might put them on the defensive side and make them unwilling help to you. The middle ground is being assertive. Tell people how you communicate and why.
Take charge of your hearing loss
Take charge of your hearing loss, don't let it take charge of you. Join a support group, follow hearing loss on the internet and learn about technology available like assistive listening devices that take away the distance problem for hearing aid users. Join a lipreading or sign language class (this is even better if you have someone to take it with you). Remain as independent as you can. We all need a little help but don't rely exclusively on someone in your life to take care of situations for you.
There are a few bad apples. No matter how much you try to educate them they will not cooperate. Weed these people out of your life if possible, which can be heartbreaking when it's a good friend or family member. Seek support, counseling, a hearing loss class, show them what it's like with online hearing loss simulators.
Take your significant other to your hearing test. Let them go in the booth with you so they can experience what you hear and don't hear first hand. Keep them there for the word discrimination test too. Then have the audiologist do the word discrimination test again with hearing aids in so they can see even in the best circumstances you won't be able to hear everything. They ask the audiologist any questions they may have and they just might have comments valuable to your programming needs.
Learn about the different assistive listening devices (ALDs) out there. There are FM systems to help in lecture settings and hearing loops which take away the distance problem with hearing aids. Personal amplified devices can help in vehicles. Some cinemas have headphones and captioning devices available such as CaptiViews and Sony Caption Glasses. There are alerting devices, specialised telephones and more. Ask your audiologist or join a support group to find out more.
If you're reading this with healthy hearing protect your hearing. Noise induced hearing loss happens and anything above 80 decibels has the potential to cause harm. Your hearing is precious. If you have a hearing loss yourself don't isolate yourself. There's always a way around obstacles and one of the best things you can do is find others like yourself to share knowledge, build confidence and empower one another.
Some useful links to get more information about living with high frequency hearing loss
Please visit our links and resources page for more information about organisations who can help you.