by Neil Bauman, Ph.D.
A man explained,
My wife has hearing loss and suffers greatly in trying to understand speech. She is certainly not completely deaf. She can hear noises, music, slow and clear talk, but not many other words. Is there any solution?
Your wife not only has problems hearing, she also has a problem with speech discrimination.
Note: some people get confused between the words “discrimination” and “comprehension” and use the terms interchangeably. Technically, discrimination is whether you can distinguish one sound from another—for example, did you hear the word “put” or the word “but”?
In contrast, comprehension is whether you understand what the sounds/words mean. You could have normal hearing and perfect discrimination, but zero comprehension.
A good example would be listening to a foreign language. In that case you could hear and distinguish all the individual sounds, but not have a clue what it all means. However, in real life, you don’t have perfect hearing.
Typically as your hearing drops, your discrimination also drops. Thus, speech becomes fuzzier and fuzzier. As a result, you miss many of the words. This, in turn, causes your comprehension of the message to drop drastically too.
High-frequency hearing loss and speech discrimination often go hand-in-hand. In fact, the most common cause of poor speech discrimination is poor hearing in the higher frequencies.
The reason high-frequency hearing loss affects discrimination so much is because in order to understand speech, you need to hear the critical high-frequency components of speech.
Unfortunately, most hard of hearing people hear low-frequency sounds much better than they do high-frequency sounds—yet these low frequency sounds, although relatively loud, don’t add much intelligibility to speech like the soft high-frequency sounds do.
Thus a common complaint of many hard of hearing people—and your wife is no exception—is that they can hear people talking (because they can hear low-frequency sounds quite well), but have a great deal of difficulty understanding what people are saying (because they can’t hear the softer high-frequency sounds that are so critical to understanding speech).
There are three basic things you can do to help correct this problem.
One is to get close to the person speaking.
Two is to amplify the high-frequency component of speech. Three is to cut out competing background noise.
All three of these are important. Let’s look at each of them in turn.
1. Get Close If you have a high-frequency hearing loss, the reason you want to get close to the person speaking is that those critical to understanding high-frequency sounds do not travel well in air and are quickly attenuated. The ideal would be to have a person speak just 2″ from your ear so all the high-frequency components of speech enter your ear canal and don’t get “lost” in the air with increasing distance. In most cases this is impractical, but you can simulate the same degree of closeness by using an assistive listening device that has its microphone at the speaker’s lips and by wearing ear buds plugged into the same amplifier as the microphone.
2. Amplify the High-frequency Components of Speech The way you do this is to get and wear properly-fitted hearing aids. The hearing aids will be set to amplify the high-frequency component of speech without amplifying the lower-frequency sounds which you already hear fine. Now, since you can hear many/most of the higher-frequency sounds, you can better understand speech.
3. Cut Out Background Noise Typically, background noise is mostly made up of the louder low-frequency sounds. Since low-frequency sounds mask (or hide) the critical higher-frequency sounds, you now don’t hear those high-frequency sounds critical to understanding speech. So again, you hear people talking, but don’t have a clue what they are saying. When you cut out all background noise, you greatly increase the chances of understanding speech.
The Ultimate Solution In order to hear and understand people the best, your wife needs to do all three things at the same time.
First, she needs to cut out any background noise so it doesn’t mask the high-frequency speech sounds. Second, she needs the person speaking to get close to her ears. (Remember, high-frequency sounds don’t travel far through air.) And third, she needs a device to amplify the high-frequency component of speech. (The best way to do this is by her wearing hearing aids.) When she does all three of these things, your wife will hear the best that her ears will permit her to hear.
Unfortunately, since some of the hair cells in her inner ears are dead, doing all this won’t give her normal hearing, and she will still miss things. Thus, there is one more thing she needs to do—and that is to use her eyes.
This takes several forms. People can write down key words she misses; she can watch gestures and facial expressions; but the most important thing she needs to do is to speechread whoever is talking.
Speechreading is far from perfect, but it often greatly increases your comprehension. This is because your eyes can often see the speech sounds that your ears can’t hear.
You see, many of the high-frequency speech sounds you can’t hear are relatively easy to speechread. When your brain puts together what your ears hear and what your eyes see, your comprehension soars.
Thus, to best hear and understand what people are saying, your wife needs to remember to cut out background noise, get close to the speaker, wear hearing aids and/or use assistive listening devices and speechread. This sure works for me. It will work for her too!