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A Short Biography of Raymond Carhart, the “Father of Audiology”

Raymond Carhart

Most people are surprised to hear how young the discipline of audiology really is, and just how recently its founding father established the profession. To put this in perspective, if you wanted to find the founding father of biology, for instance, you’d have to go back in time by 2,300 years and read through the The History of Animals, a natural history text composed in the fourth century BCE by the Ancient Greek philosopher Aristotle.

In contrast, to find the founding father of audiology, we need go back only 70 years, to 1945 when Raymond Carhart popularized the term. But who was Raymond Carhart, and how did he come to produce a separate scientific discipline so recently? The story starts with World War II.

World War II and Hearing Loss

One of history’s most reliable lessons tells us that necessity is the mother of invention, signifying that challenging scenarios prompt inventions aimed at relieving the difficulty. Such was the case for audiology, as hearing loss was coming to be a bigger public health concern both during and after World War II.

Indeed, the primary driving force behind the progression of audiology was World War II, which resulted in military personnel coming back from combat with extreme hearing problems caused by direct exposure to loud sounds. While many speech pathologists had been calling for better hearing assessment and treatment all along, the multitude of people affected by hearing loss from World War II made the request impossible to ignore.

Among those calling for a new profession, Robert West, a respected speech pathologist, called for the development of the speech pathology field to include the correction of hearing in 1936 — the same year that Raymond Carhart would graduate with a Doctor of Philosophy degree in Speech Pathology, Experimental Phonetics and Psychology.

Raymond Carhart Establishes the New Science of Hearing

Raymond Carhart himself began his career in speech pathology. He received his Bachelor of Arts degree in Speech and Psychology from Dakota Wesleyan University in 1932 and his Master of Arts and Doctor of Philosophy degrees in Speech Pathology, Experimental Phonetics and Psychology at Northwestern University in 1934 and 1936. Carhart was in fact one of the department’s first two PhD graduates.

Following graduation, Carhart became an instructor in Speech Re-education from 1936 to 1940. Then, in 1940 he was promoted to Assistant Professor and in 1943 to Associate Professor. It was what took place next, however, that may have changed the course of history for audiology.

In 1944, Carhart was commissioned a captain in the Army to head the Deshon General Hospital aural rehabilitation program for war-deafened military personnel in Butler, Pennsylvania. It was here that Carhart, in the context of helping more than 16,000 hearing-impaired military personnel, popularized the term audiology, designating it as the science of hearing. From that point forward, audiology would divide from speech pathology as its own distinctive research specialty.

At the end of the war, Carhart would go back to Northwestern University to develop the country’s first academic program in audiology. As a skillful professor, he guided 45 doctoral students to the completion of their work, students who would themselves become notable professors, researchers, and clinical specialists throughout the country. And as a researcher, among innumerable contributions, Carhart developed and enhanced speech audiometry, especially as it applied to calculating the efficiency of hearing aid performance. He even identified a distinct pattern on the audiogram that indicates otosclerosis (hardening of the middle ear bones), eponymously named the “Carhart notch.”

Raymond Carhart’s Place in History

Of history’s founding fathers, the name Raymond Carhart may not be as well known as Aristotle, Isaac Newton, Albert Einstein, or Charles Darwin. But if you wear hearing aids, and you know the degree to which the quality of life is enhanced as the result, you might place Raymond Carhart on the same level as history’s greats. His students probably would, and if you visit the Frances Searle Building at Northwestern University, you’ll still see a plaque that reads:

“Raymond Carhart, Teacher, Scholar, and Friend. From his students.”

Questions to Ask Your Hearing Specialist Before You Buy Hearing Aids

Question Mark

When it’s time to purchase a car, the majority of us know exactly what to do. We conduct some research, compare options, and compile a list of questions to ask the dealership. We do this so that by the time we’re ready to visit the dealership, we have an idea of what we’re looking for and we know which questions to ask.

When it’s time to choose hearing aids, in contrast, many people don’t know where to get started. Even though the process is comparable to buying a car, it’s also in many ways more complicated (and probably not quite as fun). It’s more complicated because each person’s hearing loss is unique and each pair of hearing aids needs customized programming. If buying a car was like this, it would be like you bringing it home and having to install the transmission yourself.

Fortunately, you don’t need to know how to program your own hearing aids, but you do need to know the questions to ask to ensure that your hearing specialist covers all bases, correctly programming the most appropriate hearing aids for your requirements and lifestyle. In this way, producing a list of questions to go over with your hearing specialist is the single most important thing you can do prior to your hearing test.

But which questions should you ask? Here are 35 to get you started off, broken down by category:

HEARING LOSS

Specific kinds of hearing loss require specific kinds of treatment. The more you understand your own hearing loss, the better you’ll be able to compare hearing aid options. You need to know what type of hearing loss you have, if it will get worse, how soon you should treat it, and all of your treatment alternatives.

Questions to ask:

  • What kind of hearing loss do I have?
  • Do I have unilateral or bilateral hearing loss?
  • Can I have a copy of my hearing test?
  • Will my hearing loss get worse as time passes if left untreated?
  • Will hearing aids enhance my hearing?
  • How much of my hearing will hearing aids regain?
  • What are my other options besides hearing aids?

HEARING AID STYLES AND FEATURES

Hearing aids are sold in numerous styles, from several producers, armed with numerous features. You need a organized way to narrow down your choices to assure that you get the best hearing aid without wasting money on features you don’t need or want.

Questions to ask:

  • How many different kinds of hearing aid styles do you offer?
  • Which hearing aid style is most beneficial for my needs and lifestyle?
  • Which digital features would be beneficial to me, and which could I do without having?
  • What are telecoils and directional microphones and do I need them?
  • Do I need Bluetooth compatible hearing aids?
  • Do my hearing aids need to be professionally programmed?
  • Do I need one or two hearing aids, and why?

HEARING AID PRICES, FINANCING, WARRANTIES, AND TRIAL PERIODS

The total price of a pair of hearing aids often includes the professional fees associated with custom fitting and programming, along with several other services or accessories. You want to ensure that you understand what you’re receiving for the price, if financing is available, if insurance will help, what the warranty protects, the length of the trial period, and if any “restocking fees” apply to the end of the trial period.

Questions to ask:

  • What is the total price of the hearing aids, including professional services?
  • Do you provide any financing plans?
  • Will my insurance coverage help pay for hearing aids?
  • How much will my hearing aids cost me per year?
  • Do the hearing aids have warranty coverage?
  • How much do hearing aid repairs cost after the warranty has expired?
  • Are repairs completed at the office or somewhere else?
  • If my hearing aids have to be sent out for repairs, are loaner hearing aids supplied?
  • Is there a trial period and how long is it?
  • Is there a restocking fee if I return my hearing aids during or after the trial period?

HEARING AID OPERATION, CARE, AND MAINTENANCE

Your hearing specialist should explain to you how to care for, clean, and control your hearing aids. To make certain that nothing is forgotten, make sure all of these questions are answered:

Questions to ask:

  • How do I operate my hearing aids?
  • How do I use hearing aids with telephones and other electronics?
  • Can you show me how to use all of the buttons, features, and settings for my hearing aids?
  • What are environmental presets, and how do I access them?
  • Do I need a remote control, or can I use my smartphone to operate the hearing aids?
  • What batteries do I need, how long will they last, and how do I replace them?
  • How should I clean and store my hearing aids?
  • Do I need to come back for follow-up visits?
  • How long will my hearing aids last?
  • Do I need to update the hearing aid software application?
  • Do I become eligible for future hearing aid upgrades?

YOU’RE READY TO SCHEDULE YOUR HEARING TEST

Ok, so purchasing a pair of hearing aids may not be as enjoyable as shopping for a new car. But the quality of life you’ll obtain from better hearing might very well make you more happy, as you’ll reconnect with people and appreciate the intricacies of sound once again. So go ahead and schedule that hearing test — your new pair of hearing aids are waiting for a test drive.

The Digital Advantage: Analog Vs. Digital Hearing Aids

Digital Code

You’ve most likely heard that today’s hearing aids are “not your grandfather’s hearing aids,” or that hearing aid technology is light-years ahead of where it used to be, even as recently as 5 to 10 years ago. But what makes today’s technologies so much better? And what exactly can modern day hearing aids achieve that couldn’t be accomplished in the past?

The short answer is, like almost all electronic devices, hearing aids have benefited significantly from the digital revolution. Hearing aids have transform into miniaturized computers, with all of the programming adaptability you would anticipate from a modern computer.

But before hearing aids became digital, they were analog. Let’s see if we can understand why the move from analog to digital was such an improvement.

Digital vs analog hearing aids

At the simplest level, all hearing aids do the job the same way. Each hearing aid is made up of a microphone, amplifier, speaker, and battery. The microphone picks up sound in the environment, the amplifier strengthens the signal, and the speaker supplies the louder sound to your ear.

Fundamentally, it’s not very complex. Where is does get complex, however, is in the details of how the hearing aids process sound, which digital hearing aids accomplish much differently than their analog alternatives.

Analog hearing aids process sound in a fairly straightforward manner. In three basic steps, sound is detected by the microphone, amplified, and delivered to the ear through the speaker. That is… ALL sound is made to be louder, including background noise and the sound frequencies you can already hear properly. In other words, analog hearing aids amplify even the sounds you don’t want to hear — think of the scratching sound you hear from an analog recording on a vinyl record.

Digital hearing aids, conversely, apply a fourth step to the processing of sound: transformation of sound waves to digital information. Sound itself is an analog signal, but instead of only making this analog signal louder, digital hearing aids first transform the sound into digital form (saved as 0s and 1s) that can then be altered. Digital hearing aids, therefore, can CHANGE the sound before amplification by altering the information stored as a series of 0s and 1s.

If this seems like we’re talking about a computer, we are. Digital hearing aids are essentially miniature computers that run one specialized application that manipulates and enhances the quality of sound.

Advantages of digital hearing aids

A good number of today’s hearing aids are digital, and for good reason. Considering that analog hearing aids can only amplify incoming sound, and cannot alter it, analog hearing aids are liable to amplify distracting background noise, making it frustrating to hear in noisy environments and nearly impossible to talk on the phone.

Digital hearing aids, however, have the flexibility to amplify select sound frequencies. When sound is converted into a digital signal, the computer chip can identify, label, and store specific frequencies. For example, the higher frequency speech sounds can be tagged and stored separately from the lower frequency background noise. A hearing specialist can then program the computer chip to amplify only the high frequency speech sounds while suppressing the background noise — making it effortless to follow conversations even in noisy surroundings.

Here are some of the other advantages of digital hearing aids:

  • Miniaturized computer technology means smaller, more discreet hearing aids, with some models that fit totally in the ear canal, making them virtually invisible.
  • Digital hearing aids tend to have more eye-catching designs and colors.
  • Digital hearing aids can be programmed by a hearing specialist to process sound in various ways based on the environment. By changing settings, users can attain ideal hearing for various situations, from a quiet room to a noisy restaurant to speaking on the phone.
  • Digital hearing aids can be fine-tuned for every patient. Each person hears different sound frequencies at different decibel levels. Digital hearing aids permit the hearing specialist to adjust amplification for each sound frequency based on the attributes of each person’s unique hearing loss.

Try digital hearing aids out for yourself

Reading about digital hearing aids is one thing, trying them out is another. But remember, to get the most out of any set of hearing aids, you will need both the technology and the programming capability from an experienced, licensed hearing specialist.

And that’s where we come in. We’ve programmed and fine-tuned countless hearing aids for individuals with all forms of hearing loss, and are more than happy to do the same for you. Give us a call and experience the digital advantage for yourself!

The Top 5 Hearing Aid Myths Exposed

Sometimes, it seems as if we prefer to mislead ourselves. Wikipedia has an page called “List of common misconceptions” that consists of hundreds of widely-held but false beliefs. Yes, I understand it’s Wikipedia, but take a look at the bottom of the page and you’ll see around 385 references to credible sources.

For example, did you know that Thomas Edison didn’t invent the lightbulb? Or that sugar does not in reality make kids hyperactive? There are countless examples of beliefs that we just assume to be correct, but now and then, it’s a good idea to reevaluate what we think we know.

For some of us, it’s time to reassess what we think we know about hearing aids. The majority of myths and misconceptions about hearing aids are founded on the problems connected with the outdated analog hearing aid models. But since the majority of hearing aids are now digital, those concerns are a thing of the past.

So how up-to-date is your hearing aid knowledge? Keep reading to see if any of the top 5 myths are stopping you or someone you know from getting a hearing aid.

The Top 5 Myths About Hearing Aids

Myth # 1: Hearing aids are not effective because some people have had bad experiences.

Reality: To start with, hearing aids have been proven to be effective. A study reported in the Journal of the American Medical Association comparing the performance of three common types of hearing aids concluded that:

Each [hearing aid] circuit markedly improved speech recognition, with greater improvement observed for soft and conversationally loud speech….All 3 circuits significantly reduced the frequency of problems encountered in verbal communication….Each circuit provided significant benefit in quiet and noisy listening situations.

Additionally, since the publication of this investigation, hearing aid technology has continued to get better. So the question is not whether hearing aids perform well — the question is whether you have the right hearing aid for your hearing loss, professionally programmed based on to your preferences by a trained professional.

Negative experiences are likely the result of choosing the wrong hearing aid, purchasing hearing aids online, contacting the wrong individual, or not having the hearing aids customized and professionally programmed.

Myth # 2: Hearing aids are big, bulky, and unsightly.

Reality: This one is relatively easy to disprove. Just perform a quick Google image search for “attractive hearing aid designs” and you’ll see a number of examples of stylish and colorful models from numerous producers.

Additionally, “completely-in-the-canal” (CIC) hearing aids are available that are virtually or fully hidden when worn. The newer, stylish designs, however, compel some patients to go with the somewhat larger hearing aid models to showcase the technology.

Myth # 3: Hearing aids are too expensive.

Reality: Presently, some flat screen televisions with ultra-high definition curved glass retail for $8,000 or more. But this doesn’t make us say that “all TVs are too expensive.”

Just like television sets, hearing aids range in price dependent on performance and features. While you may not want — or need — the top of the line hearing aids, you can likely find a pair that fits your needs, preferences, and finances. Also remember that, as is the situation with all consumer electronics, hearing aids are becoming more affordable from year to year, and that the value of better hearing and a better life is almost always worthy of the cost.

Myth # 4: You can save time and money buying hearing aids online.

Reality: Remember myth # 1 that alleged that hearing aids are not effective? Well, it was probably created by this myth. Like we said before, hearing aids have been proven to be effective, but the one caveat to that statement has always been that hearing aids have to be programmed by a professional to assure performance.

You wouldn’t dare purchase a pair of prescription glasses on the internet without contacting your eye doctor because your glasses need to be individualized according to the unique attributes of your vision loss. Buying hearing aids is exactly the same.

Sure, visiting a hearing specialist is more expensive, but consider what you get for the price: you can be confident that you get the right hearing aid with the right fitting and settings, together with follow-up care, adjustments, cleanings, instructions, repair services, and more. It’s well worth it.

Myth # 5: Hearing aids are uncomfortable and challenging to operate.

Reality: If this relates to analog hearing aids, then yes, it is mostly true. The thing is, nearly all hearing aids are now digital.

Digital hearing aids dynamically process sound with a mini computer chip so that you don’t have to worry about manual adjustments; in addition, some digital hearing aids can even be controlled through your smartphone. The bottom line: digital hearing aids are being produced with optimum ease-of-use in mind.

Your hearing specialist can also generate a custom mold for your hearing aids, ensuring a comfortable and ideal fit. While a one-size-fits all hearing aid will most likely be uncomfortable, a custom-fit hearing aid conforms to the curves of your ear.

How to Read Your Audiogram at Your Hearing Test

Audiogram

You have just finished your hearing test. The hearing specialist is now entering the room and presents you with a chart, like the one above, except that it has all of these icons, colors, and lines. This is intended to present to you the exact, mathematically precise attributes of your hearing loss, but to you it might as well be written in Greek.

The audiogram adds confusion and complication at a time when you’re supposed to be concentrating on how to strengthen your hearing. But don’t let it fool you — just because the audiogram looks perplexing doesn’t mean that it’s difficult to grasp.

After looking through this article, and with a little vocabulary and a handful of basic concepts, you’ll be reading audiograms like a professional, so that you can concentrate on what really counts: healthier hearing.

Some advice: as you read the article, reference the above blank audiogram. This will make it easier to comprehend, and we’ll cover all of those cryptic marks the hearing specialist adds later on.

Understanding Sound Frequencies and Decibels

The audiogram is really just a chart that records sound volume on the vertical axis and sound frequency on the horizontal axis. (are you having flashbacks to high school geometry class yet?) Yes, there’s more to it, but at a basic level it’s just a chart graphing two variables, as follows:

The vertical axis documents sound intensity or volume, measured in decibels (dB). As you move up the axis, the sound volume decreases. So the top line, at 0 decibels, is a very soft, faint sound. As you move down the line, the decibel levels increase, standing for gradually louder sounds until you get to 100 dB.

The horizontal axis records sound frequency, measured in Hertz (Hz). Starting at the top left of the graph, you will see a low frequency of 125 or 250 Hz. As you continue along the horizontal axis to the right, the frequency will progressively increase until it reaches 8,000 Hz. Vowel sounds of speech are in general low frequency sounds, while consonant sounds of speech are high frequency sounds.

And so, if you were to start off at the top left corner of the graph and sketch a diagonal line to the bottom right corner, you would be increasing the frequency of sound (progressing from vowel sounds to consonant sounds) while raising the level of sound (moving from softer to louder volume).

Evaluating Hearing and Marking Up the Audiogram

So, what’s with all the marks you usually see on this basic graph?

Easy. Begin at the top left corner of the graph, at the lowest frequency (125 Hz). Your hearing consultant will present you with a sound at this frequency through headsets, beginning with the lowest volume decibel level. If you can hear it at the lowest level (0 decibels), a mark is made at the intersection of 125 Hz and 0 decibels. If you are not able to hear the 125 Hz sound at 0 decibels, the sound will be presented once again at the next loudest decibel level (10 decibels). If you can perceive it at 10 decibels, a mark is created. If not, continue on to 15 decibels, and so on.

This exact technique is repeated for each frequency as the hearing specialist progresses along the horizontal frequency line. A mark is made at the lowest perceivable decibel level you can perceive for each individual sound frequency.

Regarding the other symbols? If you notice two lines, one is for the left ear (the blue line) and one is for the right ear (the red line: red is for right). An X is ordinarily applied to mark the points for the left ear; an O is used for the right ear. You may observe some additional symbols, but these are less significant for your basic understanding.

What Normal Hearing Looks Like

So what is thought to be normal hearing, and what would that look like on the audiogram?

People with regular hearing should be able to perceive each sound frequency level (125 to 8000 Hz) at 0-25 decibels. What might this look like on the audiogram?

Take the empty graph, find 25 decibels on the vertical axis, and sketch a horizontal line all the way across. Any mark made below this line may signify hearing loss. If you can hear all frequencies beneath this line (25 decibels or higher), then you likely have normal hearing.

If, on the other hand, you cannot perceive the sound of a particular frequency at 0-25 dB, you very likely have some form of hearing loss. The smallest decibel level at which you can perceive sound at that frequency defines the grade of your hearing loss.

For instance, take the 1,000 Hertz frequency. If you can perceive this frequency at 0-25 decibels, you have normal hearing for this frequency. If the smallest decibel level at which you can perceive this frequency is 40 decibels, for example, then you have moderate hearing loss at this frequency.

As an overview, here are the decibel levels identified with normal hearing along with the levels linked with mild, moderate, severe, and profound hearing loss:

Normal hearing: 0-25 dB

Mild hearing loss: 20-40 dB

Moderate hearing loss: 40-70 dB

Severe hearing loss: 70-90 dB

Profound hearing loss: 90+ dB

What Hearing Loss Looks Like

So what would an audiogram with indications of hearing loss look like? Given that many cases of hearing loss are in the higher frequencies (referred to as — you guessed it — high-frequency hearing loss), the audiogram would have a descending sloping line from the top left corner of the chart slanting downward horizontally to the right.

This indicates that at the higher-frequencies, it requires a increasingly louder decibel level for you to perceive the sound. Furthermore, seeing that higher-frequency sounds are connected with the consonant sounds of speech, high-frequency hearing loss impairs your ability to comprehend and pay attention to conversations.

There are other, less typical patterns of hearing loss that can appear on the audiogram, but that’s probably too much information for this article.

Test Your New Knowledge

You now know the basics of how to interpret an audiogram. So go ahead, schedule that hearing test and surprise your hearing specialist with your newfound abilities. And just imagine the look on their face when you tell them all about your high frequency hearing loss before they even say a word.

How to Persuade Someone to Get a Hearing Test

We don’t need to tell you the signs and symptoms of hearing loss; you already know them all too well. You have a different type of challenge: persuading someone you care for to get their hearing checked and treated.

But how are you supposed to get through to someone who denies there is even an issue, or that merely shrugs it off as “just part of getting old”?

It turns out that it’s not as simplistic as just recommending to them that they need their hearing examined. They will not understand the need, and you won’t get very far with threats, ultimatums, or other coercive tactics.

Even though it may seem like an impossible scenario, there are other, more subtle approaches you can use. In fact, you can tap into the massive body of social scientific research that shows which techniques of persuasion have been determined to be the most consistently effective.

This means, you can use tested, researched, and proven persuasive strategies that have been established to actually work. It’s worth a chance, right? And scanning the techniques might enable you to think of additional ideas.

With that said, the following are 6 scientifically tested methods of persuasion and how you might use them to persuade a friend or family member to get their hearing tested:

1. Reciprocity

What it is:

The concept of reciprocity is very simple: if someone does a favor for you, you’re powerfully motivated to return the favor for them.

How to use it:

Timing is everything. You plan on requesting your loved one to get their hearing checked at some point anyway, so why don’t you make the request right after you’ve done something special for them?

2. Commitment and Consistency

What it is:

We all have a strong psychological desire to think and behave consistently.

How to use it:

The trick is to begin with smaller commitments ahead of making the final request. If you begin by ordering your loved one to get a hearing test, you probably won’t see much success.

Rather, ease into the topic by casually sharing an article on hearing loss and how widespread it is. Without mentioning their own personal hearing loss, get them to admit that hearing loss is a more prominent problem than they had believed.

As soon as they concede to a few basic facts, it may be easier to talk about their own personal hearing loss, and they may be more likely to disclose that they have a problem.

3. Social Proof

What it is:

We have a habit to think in terms of “safety in numbers.” We have a tendency to conform to the crowd, and we assume that if lots of other people are doing something, it must be safe or beneficial.

How to use it:

There are at a minimum two ways to use this method. One way is to share articles on the many advantages of using hearing aids and how hearing aids improve the quality of life for millions of individuals in the U.S. and around the globe.

The second way to use the technique is to arrange a hearing test for yourself. Explain to your loved one that you want to confirm the well being of your own hearing, but that you would feel better if they went with you and had their own exam.

4. Liking

What it is:

You are more inclined to be persuaded by people you personally like than by either a stranger or by someone you dislike.

How to use it:

Enlist the assistance of people you know your loved one likes or respects. Attempt to find that one particular person whom your loved one always seems to respond to, and have that person talk about and highly recommend a hearing test.

5. Authority

What it is:

We are inclined to listen to and respect the suggestions of those we perceive as authority figures.

How to use it:

Share articles on how celebrities, athletes, and other respected figures wear and benefit from hearing aids. You can also share articles from legitimate sources that summarize the importance of getting your hearing tested. For example, the World Health Organization recently published an article titled “1.1 billion people at risk of hearing loss.”

6. Scarcity

What it is:

Scarcity generates a sense of urgency when what we want is perceived as limited or in short supply. Scarcity creates the perception that, if we don’t act right away, we may lose something once and for all.

How to use it:

The latest research has connected hearing loss to a number of dangerous conditions, including Alzheimer’s Disease, dementia, memory impairment, and accelerated cognitive decline. Hearing loss also gets worse over time, so the sooner it’s dealt with, the better.

To apply scarcity, share articles, such as our earlier blog post titled 8 reasons hearing loss is more dangerous than you think, with your loved one. Show them that every day spent with untreated hearing loss exacerbates the hearing loss, degrades health, and increases the risk of developing more dangerous conditions.


If all else fails, just give it to them straight. Tell your loved ones how their hearing loss affects you, combined with how it’s affecting your relationship. When you make it about your needs and feelings rather than theirs, the response is usually better.

Have you had success persuading someone to have their hearing tested? Let us know your methods in a comment.

Source

The six principles of persuasion were developed by Dr. Robert Cialdini, and can be found in his book titled “Influence: The Psychology of Persuasion.”

5 Reasons Why People Deny Hearing Loss

It takes the average person with hearing loss 5 to 7 years before seeking a professional diagnosis, in spite of the reality that the signs and symptoms of hearing loss are apparent to others. But are those with hearing loss simply too stubborn to get help? No, actually, and for a couple of different reasons.

Perhaps you know someone with hearing loss who either denies the problem or refuses to seek professional help, and while this is undoubtedly frustrating, it is very likely that the indications of hearing loss are much more apparent to you than they are to them.

Here are the reasons why:

1. Hearing loss is gradual

In the majority of cases, hearing loss comes about so slowly that the impacted individual simply doesn’t experience the change. While you would notice an immediate change from normal hearing to a 25 decibel hearing loss (defined as moderate hearing loss), you wouldn’t notice the smaller change of a 1-2 decibel loss.

So a gradual loss of 1-2 decibels over 10-20 years, while generating a 20-40 total decibel loss, is not going to be noticeable at any given moment in time for those afflicted. That’s why friends and family are almost always the first to notice hearing loss.

2. Hearing loss is often partial (high-frequency only)

The majority of hearing loss examples are categorized as high-frequency hearing loss, meaning that the impacted person can still hear low-frequency background sounds normally. While speech, which is a high-frequency sound, is strenuous for those with hearing loss to follow, other sounds can usually be heard normally. This is why it’s commonplace for those with hearing loss to say, “my hearing is fine, everyone else mumbles.”

3. Hearing loss is not addressed by the family doctor

People struggling with hearing loss can obtain a mistaken sense of well-being after their yearly physical. It’s common to hear people state “if I had hearing loss, my doctor would have told me.”

This is of course not true because only 14% of physicians routinely screen for hearing loss during the annual checkup. Not to mention that the foremost symptom for most cases of hearing loss — difficulty comprehending speech in the presence of background noise — will not present itself in a quiet office setting.

4. The burden of hearing loss can be shared or passed on to others

How do you treat hearing loss when there’s no cure? The solution is simple: amplify sounds. The problem is, while hearing aids are the most effective at amplifying sounds, they are not the only way to accomplish it — which individuals with hearing loss promptly identify.

Those with hearing loss regularly turn up the volume on everything, to the detriment of those around them. Television sets and radios are played excessively loud and people are made to either scream or repeat themselves. The individual with hearing loss can get by just fine with this strategy, but only by passing on the burden to friends, family members, and colleagues.

5. Hearing loss is painless and invisible

Hearing loss is mainly subjective: it cannot be diagnosed by visible assessment and it normally is not accompanied by any pain or discomfort. If individuals with hearing loss do not recognize a problem, mainly due to the reasons above, then they probably won’t take action.

The only way to correctly diagnose hearing loss is through audiometry, which will determine the specific decibel level hearing loss at numerous sound frequencies. This is the only way to objectively determine whether hearing loss is present, but the hard part is needless to say getting to that point.

How to approach those with hearing loss

Hopefully, this essay has manufactured some empathy. It is always frustrating when someone with hearing loss refuses to recognize the problem, but remember, they may legitimately not perceive the magnitude of the problem. Instead of demanding that they get their hearing tested, a more reliable strategy may be to educate them on the elements of hearing loss that make the condition essentially invisible.

What to Expect at Your Hearing Exam

If the unfamiliar triggers anxiety, then a trip to the hearing specialist is particularly nerve-racking. While the majority of us have experience with the family physician and the town dentist, the visit to the hearing specialist may be a first.

It certainly would be useful to have someone summarize the process up front, wouldn’t it? Well, keep reading, because as you’ll discover, the process of getting your hearing examined is ordinarily easy, comfortable, and pain-free — with aspects that can actually be fun.

So here’s how it will go:

After you arrive at the office, you will check in with an employee at the front desk who will hand you a few forms to fill out. Not long after filling in the forms, a hearing specialist will come with you into a room to start the hearing assessment, which is composed of four parts:

Part 1: Case History

case history

The hearing specialist starts the process by getting to know you, your health history, and your hearing loss symptoms. Getting ready for this step is critical, because this is where you get to express to the hearing specialist the specifics of your hearing loss, what you are looking for from treatment, and your unique hearing needs.

This part is all about you: what do you want to accomplish with better hearing? Do you wish to play a music instrument again? Do you wish to be more engaged in work meetings? Do you want to be more energetic at social gatherings? The more you can reveal to your hearing specialist the better.

Next comes the testing.

Part 2: Otoscopy

otoscope

The first diagnostic test to be carried out is called an otoscopy. An otoscope is used to visually explore the ear canal and eardrum to establish if your hearing loss is correlated to infections, earwax buildup, or obstructions. If the explanation for your hearing loss is something as elementary as earwax buildup, you could possibly start hearing better within a few minutes simply from expert earwax removal.

Part 3: Tympanometry

tympanometry

The following test is called tympanometry, used to test the eardrum and middle ear. A device is inserted into the ear that will modify the air pressure, evaluating how your ear responds to numerous pressures.

To understand this test, you have to first recognize that hearing loss falls into one of two general classes:

  1. Sensorineural hearing loss — this is the most widespread hearing loss. It is also referred to as noise-induced hearing loss and it involves destruction of the nerve cells of hearing.
  2. Conductive hearing loss — this hearing loss results from blockages or obstructions that restrict sound conduction before the sound hits the nerve cells of hearing.

Tympanometry is a test that can help to rule out conductive hearing loss, to make sure that there are no blockages, infections, or middle-ear-bone ailments. Conversely, Audiometry, which is described next, will quantify sensorineural hearing loss.

Part 4: Audiometry

audiogram

The concluding group of tests will be completed in a soundproof room. These tests are collectively referred to as audiometry and will evaluate your hearing range and sensitivity. Audiometry is the best methodology to measure sensorineural hearing loss.

With the use of an audiometer, the hearing specialist will be ready to establish:

  • Which frequencies you can hear well and which you have a hard time with.
  • The minimum decibel levels, at multiple frequencies, at which you perceive sound.
  • The precise measurements connected with your hearing loss (as captured on an audiogram).
  • Your ability to comprehend speech, with or without background noise.

The test itself, from your perspective, will be comfortable and easy. You will be presented with sounds and speech through headsets and will be told to reveal when you can hear the sounds by pressing a button or raising your hand.

Reviewing results and planning treatment

Soon after the testing is complete, your hearing specialist will review your results with you. If your hearing loss requires medical or surgical treatment (due to infections or middle-ear-bone problems, for instance), your hearing specialist can make the appropriate referral.

If your hearing loss can benefit from assistive listening devices or hearing aids, your hearing specialist will collaborate with you to pick the best solution for you, your budget, your lifestyle, and your aesthetic concerns.

Pretty painless for a lifetime of better hearing, isn’t it?

Exploring a Career in the Hearing Care Profession

Although the majority of us remain current with our yearly physical, dental cleaning, and eye examination, we generally fail to take into account the well-being of our hearing. And when our hearing does start to deteriorate, it develops so gradually that we hardly notice and fail to take action. It’s this lack of interaction with hearing care professionals that makes people curious to know what the profession actually entails.

And that’s a shame, because hearing care professionals account for a key part of the healthcare system. It’s through the hearing care professional that the proper functioning of one of our major senses — one for which we have a tendency to take for granted — is preserved or restored.

Considering the fact that we take hearing for granted, we usually also fail to keep in mind just how essential hearing is. With precise hearing, we can greatly improve focus, take pleasure in the details of sound, converse better, and strengthen working relationships. And the hearing care professionals are the ones who see to it that this key sense is functioning properly.

If you’d like to know more about this interesting but little-known healthcare field — or if you’re interested in entering the field yourself — read on.

Attraction to the hearing care field

Hearing care professionals are driven to the field for a number of reasons, but a few key motivating factors are frequently present. First, several practitioners have endured, and continue to experience, hearing issues themselves. Due to the fact that they were themselves helped by a hearing care professional, the urge to return the favor for other individuals is strong.

As an example, Zoe Williams, a hearing care professional in Australia, has moderate to profound hearing loss in both ears. This would have produced an inability to communicate, but thanks to cochlear implants and hearing aids, Zoe is now able to communicate normally. Understanding first-hand how enhanced hearing leads to a much better life, Zoe was determined to enter the field and to assist others in the same manner.

Other practitioners are pulled into the hearing care field thanks to its unique mixture of counseling, problem solving, science, and engineering. Together with learning about the science of hearing and the engineering of hearing technology, practitioners also learn how to work with people in the role of a counselor. Coping with hearing loss is a sensitive situation, and patients present a variety of emotions and personalities. Practitioners must be able to apply the “soft skills” needed to address these difficulties and must work with patients on a personalized level to beat hearing loss.

Training and education

Part of the allure of working in the hearing care profession is the compelling mix of subjects covered as part of the education and training. Those pursuing a career in the field master interesting topics in a range of fields such as:

  • Biology – topics include the anatomy and physiology of hearing, balance, the ear, and the brain, as well as classes in hearing and balance disorders and pharmacology.
  • Physics – topics include the physics of sound, acoustics, and psychoacoustics (how the brain processes sound).
  • Engineering – topics include the design and functioning of hearing technology such as assistive listening devices, hearing aids, and cochlear implants, in addition to the programming of digital hearing aids.
  • Counseling – topics include how to interview patients, how to teach coping skills, and how to train on the use of hearing aids, in addition to other interesting topics in psychology and counseling.
  • Professional practice – topics include diagnosing hearing problems, carrying out and interpreting hearing tests, implementing hearing treatments, fitting and programming hearing aids, professional ethics, and starting a business.

Job functions

Hearing care professionals work in a variety of settings (schools, hospitals, private practices) performing varying activities such as research, teaching, and diagnosing and treating hearing and balance issues.

Basic duties consist of conducting diagnostic tests, interpreting hearing tests, and working with patients on deciding on the most effective hearing treatment, in many cases including the use of hearing aids. Hearing care professionals custom-fit and program hearing aids to best fit the individual and will teach the patient on how to use and maintain them. Hearing care professionals also work with organizations and businesses to reduce the risk of hearing damage in loud work settings.

Benefits

The benefits cited most regularly by those in the hearing care profession center on the ability to positively influence people’s lives on a very personalized level. Long-lasting friendships between patients and hearing specialists are also common as a result of the personal nature of care.

When patients convey that they can hear again for the first time in a very long time, the emotions can be intense. Patients frequently describe a sense of reconnection to the world and to family, along with improved relationships and an improved overall quality of life.

How many occupations can claim that kind of personal impact?

Avoiding the Biggest Mistake in Treating Your Hearing Loss

Do you recall the Q-Ray Bracelets? You know, the magnetic bracelets that promised to deliver instant and substantial pain relief from arthritis and other chronic diseases?

Well, you won’t see much of that advertising anymore; in 2008, the creators of the Q-Ray Bracelets were legally obligated to return customers a maximum of $87 million due to deceitful and fraudulent advertising.1

The problem had to do with rendering health claims that were not backed by any scientific studies. For that matter, strong research was there to reveal that the magnetized wristbands had NO effect on pain reduction, which did not bode well for the manufacturer but did wonders to win the court case for the Federal Trade Commission.2

The wishful thinking fallacy

Ok, so the Q-Ray bracelets didn’t function (besides the placebo effect), yet they sold extraordinarily well. What gives?

Without delving into the depths of human psychology, the straight forward reply is that we have a powerful tendency to believe in the things that may appear to make our lives better and quite a bit easier.

On an emotional level, you’d absolutely love to believe that donning a $50 wristband will wipe out your pain and that you don’t have to bother with pricey medical and surgical procedures.

If, for example, you happen to suffer the pain of chronic arthritis in your knee, which approach seems more attractive?

        a. Scheduling surgery for a complete knee replacement

        b. Going to the mall to pick up a magnetized bracelet

Your natural inclination is to give the bracelet a chance. You already wish to believe that the bracelet will do the job, so now all you need is a little push from the marketers and some social confirmation from observing other people donning them.

But it is exactly this natural tendency, combined with the tendency to seek out confirming evidence, that will get you into the most trouble.

If it sounds too good to be true…

Keeping in mind the Q-Ray bracelets, let’s say you’re suffering from hearing loss; which choice sounds more appealing?

       a. Scheduling a consultation with a hearing specialist and acquiring professionally programmed hearing aids

       b. Ordering an off-the-shelf personal sound amplifier on the web for 20 bucks

Just as the magnetic wristband seems much more attractive than a visit to the physician or surgeon, the personal sound amplifier seems much more attractive than a trip to the audiologist or hearing instrument specialist.

However, as with the magnetized bracelets, personal sound amplifiers won’t cure anything, either.

The difference between hearing aids and personal sound amplifiers

Before you get the wrong idea, I’m not implying that personal sound amplifiers, also referred to as PSAPs, are fraudulent — or even that they don’t work.

On the contrary, personal sound amplifiers often do deliver results. Just like hearing aids, personal sound amplifiers contain a receiver, a microphone, and an amplifier that pfor that matterick up sound and make it louder. Viewed on that level, personal sound amplifiers work fine — and for that matter, the same is true for the act of cupping your hands behind your ears.

However when you ask if PSAPs work, you’re asking the wrong question. The questions you should be asking are:

  1. How well do they work?
  2. For which type of person do they function best?

These are exactly the questions that the FDA answered when it issued its advice on the distinction between hearing aids and personal sound amplifiers.

As reported by the FDA, hearing aids are defined as “any wearable instrument or device designed for, offered for the purpose of, or represented as aiding persons with or compensating for, impaired hearing.” (21 CFR 801.420)3

On the contrary, personal sound amplifiers are “intended to amplify environmental sound for non-hearing impaired consumers. They are not intended to compensate for hearing impairment.”

Although the distinction is transparent, it’s easy for PSAP manufacturers and retailers to get around the distinction by simply not discussing it. For instance, on a PSAP package, you may find the tagline “turning ordinary hearing into extraordinary hearing.” This claim is imprecise enough to avoid the matter completely without having to explain exactly what the phrase “turning ordinary hearing into extraordinary hearing” even means.

You get what you pay for

As stated by the FDA, PSAPs are simple amplification devices created for people with normal hearing. So if you have normal hearing, and you desire to hear better while you are hunting, bird watching, or tuning in to far off conversations, then a $20 PSAP is well suited for you.

If you have hearing loss, on the other hand, then you’ll require professionally programmed hearing aids. While more expensive, hearing aids offer the power and features required to address hearing loss. Here are a few of the reasons why hearing aids are superior to PSAPs:

  • Hearing aids amplify only the frequencies that you have trouble hearing, while PSAPs amplify all sound indiscriminately. By amplifying all frequencies, PSAPs won’t allow you to hear conversations in the presence of background noise, like when you’re at a party or restaurant.
  • Hearing aids have built in noise reduction and canceling functions, while PSAPs do not.
  • Hearing aids are programmable and can be fine-tuned for maximum hearing; PSAPs are not programmable.
  • Hearing aids contain several features and functions that block out background noise, enable phone use, and provide for wireless connectivity, for example. PSAPs do not normally contain any of these features.
  • Hearing aids come in diverse styles and are custom-molded for maximal comfort and cosmetic appeal. PSAPs are as a rule one-size-fits-all.

Seek the help of a hearing professional

If you believe that you have hearing loss, don’t be enticed by the low-priced PSAPs; rather, schedule a consultation with a hearing specialist. They will be able to accurately quantify your hearing loss and will ensure that you get the most effective hearing aid for your lifestyle and needs. So although the low-cost PSAPs are tempting, in this circumstance you should go with your better judgment and seek expert help. Your hearing is worth the hassle.

Sources

  1. Federal Trade Commission: Appeals Court Affirms Ruling in FTCs Favor in Q-Ray Bracelet Case
  2. National Center for Biotechnology Information: Effect of “ionized” wrist bracelets on musculoskeletal pain: a randomized, double-blind, placebo-controlled trial
  3. Food and Drug Administration: Guidance for Industry and FDA Staff: Regulatory Requirements for Hearing Aid Devices and Personal Sound Amplification Products