Frequently Asked Questions:
· How do I know if I have a hearing loss?
· How can I improve my listening skills?
· Why can I hear but not understand?
· Why do hearing devices cost so much?
· Why do my ears ring?
· What is an auditory processing disorder?
How do I know if I have a hearing loss?
Symptoms of a Hearing Loss:• You can hear, but not understand speech in conversations.
• Straining to hear when someone talks.
• Difficulty hearing a phone ring.
• Difficulty hearing when in a group of people or in the presence of
background noise.
• Avoiding social gatherings because of fear of misunderstanding
speech.
• Speech needs to be repeated.
• Turning their head or cupping their ear to focus on a certain
sound or speaker.
• The volume on TV or radio needs to be louder for you to
hear what’s being said.
• Ringing or buzzing in your ears
Facts about Hearing Loss
• Hearing loss is second only to arthritis as the most
common complaint of older adults.
• Less than 20% of hearing losses are helped by surgery or other
medical treatment
• The majority of hearing losses can be treated with the use of
hearing instruments
• Noise above 80-90 decibels on average over an 8-hour workday is
considered hazardous
• Firearms, music, airplanes, lawnmowers, power tools and
many appliances are louder than 80 decibels and potentially
hazardous to hearing with prolonged exposure
• A live rock concert produces sounds from 110 to 120
decibels—easily high enough to cause permanent damage
to hearing over a 2- to 3-hour period
How can I improve my listening skills?
TECHNIQUES TO IMPROVE COMMUNICATIONIf you have a hearing loss, or know someone with a hearing loss, the following information can help maximize your communication skills, and reduce your frustration!
Pay attention to the speaker. Concentrate on what is being said. Others may need to get your attention before talking with you, by calling your name, or tapping you on the shoulder.
Use your eyes! You can gain valuable information by paying attention to the speaker’s facial expressions, lips, gestures and body language.
Get closer to the person speaking. Physics, plain and simple: The closer you are to the speaker, the better your will hear. Sound loses energy as it travels away from the sound source. In meetings, church, classrooms, etc. Position yourself as close as possible to the speaker.
Tell people you have a hearing loss. Ask them to slow the rate of speech down, not to shout.
Do not try to communicate between rooms.
Reduce the noise level in the room. If you have any control, turn off the T.V. or radio while trying to listen. Move away from the noise source, if you can. Noise interferes with the ability to hear and understand.
Don’t “pretend” you have understood something if you really haven’t. Your may get in trouble! If you haven’t understood a message, ask the speaker to repeat it, or to say it a different way, if necessary.
If one ear has better hearing than the other, than be sure to keep the “good” ear toward the speaker or sound source.
USE YOUR HEARING AIDS, if recommended, to maximize your hearing potential and improve the quality of your life.
Why can I hear but not understand?
Donna M. Mallory, Au.D.Board Certified Audiologist
One of the most frequent statements that I hear from adult patients is that they suspect hearing problems because it seems like people are mumbling. They are frustrated because they know someone’s talking, but they just can’t seem to make out all the words. This problem is especially difficult if there is any amount of noise in the background. What is this all about?
Most adults who acquire a hearing loss will do so very gradually over many years. These hearing losses most often affect the high pitch range of speech well before they affect the lower pitched range. Speech has energy in both the lower and higher pitches, but most of the important information in the speech signal happens in the higher frequencies. The soft consonant sounds of speech such as s, th, t, p, f and sh are made up of high frequency energy. These sounds are the first to go when a person develops a hearing loss. There are plenty of strong speech sounds with a lot of energy in the lower frequencies (for examples, the vowels a, e, i, o and u). These sounds are easy to hear, but they are not enough to let the listener understand what is being said.
Hearing loss is rarely total. It is far more common to develop a mild to moderate loss that affects primarily the higher frequency sounds. This makes listening, especially in noisy rooms, frustrating. You can hear some of the speech, you know someone is talking, but you have to strain to follow what is being said.
Statistics show that the typical adult will wait seven years between the time they first noticed hearing difficulties and when they seek out a professional evaluation. This is simply too long. Over those years, bad listening habits develop, and one may tend to withdraw from many of your favorite social situations and the relationships with loved ones may become strained.
If you notice that you have hearing difficulties, now is the time to have your hearing evaluated. Ignoring a hearing loss will not make it go away. The first place to start is to consult with an Audiologist for a comprehensive, diagnostic evaluation. Your hearing will be explained to you, and if a hearing loss is indeed present, the treatment options will be discussed.
Don’t wait any longer! Call Dr. Mallory at 540.829.9005 for an appointment today.
Why do hearing devices cost so much?
When most people hear how much hearing devices cost, they are usually taken aback by the high cost. They are expensive, and are rarely covered by insurance. Medicare and most insurance companies will pay for a hearing evaluation based on medical necessity, but will not cover any part of the devices themselves.What exactly are you paying for?
• Superior quality, high technology computer based digital products
• An instrument that can be expected to last anywhere from
3 – 7 years
• Manufacturer’s warranty for repair and service
• Accidental loss and damage insurance
• Personalized professional service to determine what is best
for your needs and lifestyle
• Follow up adjustments and service for the length of the warranty
• The peace of mind that comes with better hearing
When you consider the benefits of better hearing and enhanced communication, the cost will be justified. There is a solution that will fit any budget. It’s guaranteed!
Why do my ears ring?
INFORMATION ABOUT TINNITUSTinnitus is the name given to a perception of noise in the ear (ringing, buzzing, cricket sounds, waterfall sounds, etc.). The sound is heard internally only – others cannot hear your tinnitus. It can be described as a ‘phantom’ sound; there is no physical manifestation (similar to someone who feels pain with a missing limb). It can be perceived in one or both ears, or centrally in your head. It can be constant or intermittent. It is often associated with a hearing loss or noise exposure, but even people with normal hearing can experience it. It is not necessarily an indication that a serious medical problem exists or that you are losing your mind, but if you notice tinnitus and it bothers you, it should be checked. Tinnitus can be treated successfully, but there isn’t a cure for it.
Tinnitus is more noticeable when it is quiet, or if you are under a lot of stress. The use of certain medications, aspirin, drinking excessive amounts of caffeine or alcoholic beverages, using nicotine or marijuana are all factors that MAY increase your tinnitus, although this is controversial. Exposure to loud noise can increase your tinnitus.
WHAT CAN BE DONE TO REDUCE TINNITUS?
When trying to sleep, if you are bothered by tinnitus, keeping your head elevated with one or two pillows may help. You can use a radio by your bedside to “mask” your tinnitus by tuning the radio between stations to produce static. Simply listening to music or television helps some people. Fans or air conditioners that produce noise may also help. Commercial devices that make noise can be ordered, as well. The important thing to remember is to avoid totally silent rooms.
If you smoke, or use excessive amounts of caffeine or nicotine, try reducing the amount of intake. Check with your doctor about any changes in medication that may be acceptable.
Reduce the stress in your life!
If you have a diagnosed hearing loss, using hearing aids can help reduce the tinnitus. The theory is that a hearing aid picks up many environmental sounds that can make the tinnitus less noticeable (and will help you hear well).
Tinnitus Re-training Therapy (TRT) has been successful for many patients. This is based on the neurophysiologic theory of tinnitus. To read more about this, visit www.tinnitus.org. This website has very detailed information about this model and treatment.
Tinnitus Re-training Therapy is offered at Culpeper Hearing Center; please call the office at (540) 829-9005 for more information.
Other websites to visit for information or treatment options:
• University of Virginia Tinnitus Clinic (434)982-0129
www.hsc.virginia.edu/otolaryngology/patient_tinnitus.html
• University of Maryland Tinnitus Center (410)328-1279
www.tinnitus-hyperacusis.com
The American Tinnitus Association is a non-profit organization that provides information on tinnitus; in addition to the website, a membership is available that includes a newsletter on the latest research and theories about tinnitus. www.ata.org
What is an auditory processing disorder?
Several definitions have been offered - one of the simplest was offered by Katz & Stecker (1992): "what we do with what we hear". We really 'hear' with our brains - the ears are the pathway to get the sounds to our brain. The brain has to figure out what the meaning of what is heard.Evaluating a central auditory processing disorder (C)APD requires the use of tests that will allow us to try and understand the mechanism that is causing the disorder. The central auditory processes are the auditory system mechanisms and processes responsible for the following behavioral phenomena (from American Speech & Hearing Association):
• sound localization and lateralization
• auditory discrimination
• auditory pattern recognition
• temporal aspects of audition, including
• temporal resolution
• temporal masking
• temporal integration
• temporal ordering
• auditory performance decrements with competing signals
and with degraded acoustic signals
Who's appropriate for testing? Candidates are children (at least 7 years old) and adults who have normal cognitive function and have normal peripheral hearing.
What are the symptoms? The typical characteristics of (C)APD are as follows:
• difficulty understanding with competing messages,
noisy background, or in a reverberant environment
• saying 'huh' or 'what'
• difficulty localizing sound
• poor prosody (for example, difficulty understanding jokes)
• poor rhyming/musical skills
• history of ear infections
• reading and spelling difficulties; sometimes writing
• questionable ADHD diagnosis
Central Auditory Processing disorders can co-exist with other disorders, such as learning disabilities, ADHD or ADD. A careful case history or parent interview, along with current speech/language evaluation and psychological/educational assessment, is the first step in determining who is a candidate for evaluation.
What is (C)APD testing? CAPD testing is a way of evaluating the auditory pathways which are central to the ear (in the brain). Hearing is a very complex skill; with analysis of sound beginning at the outer ear and continuing through the cochlea, VIII nerve, auditory brainstem and auditory cortex. Standard hearing testing will evaluate how well a patient can detect sound. Auditory processing testing looks at how the sounds are perceived beyond the cochlea. Two types of test categories may be used: behavioral testing and electrophysiological testing. Determinations of which specific tests are used are on an individual basis. Behavioral testing involves listening to tones, noise or speech through ear insert phones. Electrophysiological testing requires having electrodes placed on the forehead, ears, or side of head. Signals are presented and an analysis is made to determine how well the auditory information moves through the pathway through different parts of the brain.
What causes (C)APD? Exact causes are unknown. (C)APD may run in families. In children, maturation plays a role in processing, as well. There may also be subtle structural and/or biochemical differences in the brain which may cause a more disorganized neural relay system. It is rare that a specific injury or disease causes problems in children; this is the opposite in adults. Causes in adult (C)APD may include MS, vascular disease, strokes, hearing injuries, traumatic brain injury and tumors.
Is there a cure? Not to date, but there is treatment. The goal of an (C)APD evaluation is first to determine if the disorder exists, and secondly and most important is to provide helpful information with regard to patient management. These may include specific therapy, informal home based activities, home based computer programs, techniques for (C)APD management, or environmental modifications.
