Hearing vs. Understanding
One of the most difficult problems people with hearing loss face is understanding speech. Yes, understanding. Notice, I did not use the word “hearing,” because with hearing loss it’s not really about hearing the speech but being able to discriminate “D” from “G” or “ringing” from “singing.”
Each vowel, consonant, word ending and sound corresponds to a specific frequency, and as hearing loss occurs and certain frequencies are lost, the brain simultaneously loses the ability to interpret those sounds correctly anymore. For example, I have hearing loss between 500 Hx and 4000 Hz of hearing, with an especially noticeable loss of about 70 percent between 500-4000Hz. As a result of this I have difficulty with the following letters and sounds: d, b, i, n, o, I, a, r, p, h, g, ch, sh, t, f, th, s and h.
Now consider how many words in the English language use any of the above letters.
Hearing loss isn’t simply a loss of auditory capability, it also significantly impacts the relationship between the neurological and auditory pathways by causing the brain to forget, overtime, how to interpret certain sounds. In 2012, researchers Arthur Wingfield and Jonathan Peelle found that the loss of hair cells located on the basilar membrane in the cochlea of the inner ear in aging patients with hearing loss impacted the perception of speech. There are 12,000-15,000 outer hair cells that work to amplify sounds to cochlea and another 3,000 inner hair cells that transduce the mechanical vibrations of sound waves into neural impulses that the brain can read through the eighth cranial nerve and identify as specific elements of speech. When hearing loss occurs and these hair cells are lost, it becomes incredibly difficult to understand speech, especially in noise.
In addition to determining that hearing loss and hair cell loss harms the communication pathways between the ears and the brain, the study also recognized that hearing loss can result in poor cognitive performance, slow speech perception and listening fatigue. Below is a summary of what Wingfield and Peelle stated in the abstract results of their study:
“This is the finding that successful perception of speech that is degraded by hearing loss can draw cognitive resources that might otherwise be available for encoding what has been heard in memory, or for the comprehension of rapid, informationally complex speech as often occurs in everyday life. Our emphasis here is not on failures of perception, but rather, the effect on cognitive performance even when it can be shown that the speech itself has been successfully recognized. This type of 'effortful listening' is associated with increased stress responses, changes in pupil dilation, and poorer behavioral performance (e.g., on memory tests for degraded speech). It is thus possible that even a mild-to-moderate hearing loss can inflate the appearance of cognitive decline in the older adult – a cautionary note for the geriatric clinician/diagnostician and family members alike. This sensory-cognitive interaction is a reminder that the auditory system may be the conduit to the brain, but it is the brain that 'hears'.”
So what can you do about it? Hearing aids and games.
The best help for better speech understanding is to combine hearing aids with auditory rehabilitation activities. Hearing aids can help improve the ability to hear various frequencies, but your brain still needs to re-learn how to interpret those frequencies. Auditory rehabilitation activities such as Hear Coach can help you to improve your speech perception and achieve better understanding.
Start your journey to better understanding today by learning more about what hearing aids can do for your lifestyle.