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

Raymond Carhart

Many people are surprised to hear how young the field of audiology actually is, and how recently its founding father founded the profession. To put this in perspective, if you desired to find the founding father of biology, for example, you’d have to go back in time by 2,300 years and read through the The History of Animals, a natural history text authored in the fourth century BCE by the Ancient Greek philosopher Aristotle.

In comparison, to find the founding father of audiology, we need go back only 70 years, to 1945 when Raymond Carhart popularized the word. But who was Raymond Carhart, and how did he come to start a separate scientific field 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, which means that difficult situations prompt inventions focused on limiting the difficulty. Such was the case for audiology, as hearing loss was proving to be a bigger public health concern both during and after World War II.

Indeed, the main driving force behind the advancement of audiology was World War II, which lead to military personnel coming back from battle with extreme hearing impairment due to exposure to loud sounds. While many speech pathologists had been calling for better hearing assessment and therapy all along, the multitude of people afflicted with hearing loss from World War II made the request impossible to ignore.

Among those calling for a new discipline, Robert West, a distinguished speech pathologist, called for the expansion 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 started 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.

Soon after 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 happened 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 rehab program for war-deafened military personnel in Butler, Pennsylvania. It was here that Carhart, in the setting of assisting 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 split from speech pathology as its own distinctive research specialization.

At the conclusion of the war, Carhart would go back to Northwestern University to establish the country’s first academic program in audiology. As a skilled teacher, he guided 45 doctoral students to the completion of their work, students who would themselves become notable teachers, scientists, and clinical specialists across the country. And as a researcher, among many contributions, Carhart developed and refined speech audiometry, specifically as it applied to calculating the effectiveness of hearing aid performance. He even identified a distinct pattern on the audiogram that reveals 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 familiar 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 buy a car, the majority of us know exactly what to do. We carry out some research, evaluate options, and compile a list of questions to ask the dealership. We do this so that by the time we’re ready to stop by the dealership, we have an idea of what we’re looking for and we know which questions to ask.

When it’s time to purchase hearing aids, on the other hand, most people don’t know where to start. While the process is comparable to buying a car, it’s also in many ways more complex (and probably not quite as fun). It’s more complicated because every person’s hearing loss is unique and each pair of hearing aids requires customized programming. If purchasing a car was like this, it would be like you taking it home and having to install the transmission yourself.

Luckily, you don’t need to know how to program your own hearing aids, but you do need to know the questions to ask to make sure that your hearing specialist covers all bases, properly programming the most suitable hearing aids for your requirements and lifestyle. In this manner, compiling a list of questions to talk about 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 up and running, broken down by category:

HEARING LOSS

Different types of hearing loss require different types of treatment. The more you understand your own hearing loss, the better you’ll be able to evaluate hearing aid alternatives. You want to identify what form 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 type 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 over time if left untreated?
  • Will hearing aids enhance my hearing?
  • How much of my hearing will hearing aids regain?
  • What are my other alternatives aside from hearing aids?

HEARING AID STYLES AND FEATURES

Hearing aids are available in several styles, from multiple manufacturers, loaded with numerous features. You need a orderly way to narrow down your choices to be sure that you get the right hearing aid without wasting money on features you don’t need or want.

Questions to ask:

  • How many different types of hearing aid styles do you offer?
  • Which hearing aid style is most advantageous for my requirements and lifestyle?
  • Which digital features would be meaningful 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 typically includes the professional fees associated with custom fitting and programming, along with many other services or accessories. You want to make sure that you fully grasp what you’re getting for the cost, if financing is available, if insurance will help, what the warranty includes, the duration 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 supply any financing plans?
  • Will my insurance policy help pay for hearing aids?
  • How much will my hearing aids cost me annually?
  • 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 someplace else?
  • If my hearing aids have to be mailed 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 teach you how to care for, clean, and control your hearing aids. To be sure that nothing is missed, see to it that 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 devices?
  • 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 cell phone to control 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 return 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 purchasing a new car. But the quality of life you’ll attain from better hearing might very well make you more happy, as you’ll reconnect with people and take joy in 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 probably been told that today’s hearing aids are “not your father’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 modern technology so much better? And what exactly can present day hearing aids achieve that couldn’t be accomplished in the past?

The short answer is, as with the majority of electronics, hearing aids have benefited considerably from the digital revolution. Hearing aids have become miniaturized computers, with all of the programming versatility 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 shift from analog to digital was such an advancement.

Digital vs analog hearing aids

At the most basic level, all hearing aids do the job the same way. Each hearing aid includes a microphone, amplifier, speaker, and battery. The microphone detects sound in the environment, the amplifier strengthens the signal, and the speaker delivers 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 counterparts.

Analog hearing aids process sound in a very straightforward manner. In three basic steps, sound is recognized 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. Put differently, 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, add a fourth step to the processing of sound: transformation of sound waves to digital information. Sound by itself is an analog signal, but instead of only making this analog signal louder, digital hearing aids first transform the sound into digital format (stored as 0s and 1s) that can then be modified. Digital hearing aids, therefore, can CHANGE the sound before amplification by changing the information saved as a series of 0s and 1s.

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

Advantages of digital hearing aids

Most modern hearing aids are digital, and for good reason. Seeing as analog hearing aids can only amplify incoming sound, and cannot alter it, analog hearing aids very often will amplify disruptive background noise, making it frustrating to hear in noisy environments and nearly impossible to talk on the phone.

Digital hearing aids, however, have the versatility to amplify select sound frequencies. When sound is converted into a digital signal, the computer chip can detect, distinguish, and store specific frequencies. As an example, the higher frequency speech sounds can be classified 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 circumstances.

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 practically undetectable.
  • Digital hearing aids tend to have more stylish designs and colors.
  • Digital hearing aids can be programmed by a hearing specialist to process sound differently according to the location. By switching settings, users can attain ideal hearing for many different situations, from a silent room to a noisy restaurant to talking 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 vary amplification for each sound frequency based on the properties of each person’s distinctive hearing loss.

Try digital hearing aids out for yourself

Reading about digital hearing aids is one thing, trying them out is another. But bear in mind that, to get the most out of any set of hearing aids, you will need both the technology and the programming proficiency 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 varieties 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

At times, it seems like we love to mislead ourselves. Wikipedia has an entry called “List of common misconceptions” that includes 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 notice around 385 credible sources cited.

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

For a number of of us, it’s time to reexamine what we think we know about hearing aids. The majority of myths and misconceptions about hearing aids are founded on the issues linked with the antiquated analog hearing aid models. But considering that most hearing aids are now digital, those problems are a thing of the past.

So how current is your hearing aid knowledge? Read below to see if any of the top 5 myths are keeping you or someone you know from buying 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: First, 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 determined 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 release of this investigation, hearing aid technology has continued to improve. So the question is not whether hearing aids work — the question is whether you have the right hearing aid for your hearing loss, professionally programmed based on to your preferences by a knowledgeable professional.

Bad experiences are likely the result of purchasing 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, cumbersome, and unsightly.

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

Also, “completely-in-the-canal” (CIC) hearing aids are available that are virtually or entirely hidden when worn. The newer, stylish designs, however, compel some patients to choose the slightly larger hearing aid models to display the technology.

Myth # 3: Hearing aids are too expensive.

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

Just like television sets, hearing aids vary in price depending on functionality and features. While you may not want — or need — the top of the line hearing aids, you can likely find a pair that meets your needs, preferences, and finances. Also remember that, as is the case with all electronics, hearing aids are becoming more affordable each year, and that the value of better hearing and a better life is almost always well worth the expense.

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 stated before, hearing aids have been proven to be effective, but the one caveat to that assertion has always been that hearing aids have to be programmed by a professional to ensure performance.

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

Yes, visiting a hearing specialist is more expensive, but take into account what you receive for the price: you can be certain 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 worth it.

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

Reality: If this makes reference 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 compact computer chip so that you don’t have to be concerned about manual adjustments; in addition, some digital hearing aids can even be managed through your mobile phone. The bottom line: digital hearing aids are being developed with maximum ease-of-use in mind.

Your hearing specialist can also establish a custom mold for your hearing aids, ensuring a comfortable and correct fit. While a one-size-fits all hearing aid will very 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 finalized your hearing test. The hearing specialist is now entering the room and presents you with a graph, like the one above, except that it has all of these characters, colors, and lines. This is designed to provide you with the exact, mathematically precise attributes of your hearing loss, but to you it may as well be written in Greek.

The audiogram adds confusion and complexity at a time when you’re supposed to be directing your focus on how to enhance your hearing. But don’t let it mislead you — just because the audiogram looks perplexing doesn’t mean that it’s difficult to interpret.

After looking through this article, and with a little vocabulary and a few basic principles, you’ll be reading audiograms like a expert, so that you can concentrate on what actually matters: better hearing.

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

Understanding Sound Frequencies and Decibels

The audiogram is basically 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, representing progressively 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 move along the horizontal axis to the right, the frequency will steadily increase until it hits 8,000 Hz. Vowel sounds of speech are ordinarily low frequency sounds, while consonant sounds of speech are high frequency sounds.

So, if you were to begin 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 increasing the level of sound (moving from softer to louder volume).

Assessing Hearing and Marking Up the Audiogram

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

Simple. Begin at the top left corner of the graph, at the lowest frequency (125 Hz). Your hearing professional will present you with a sound at this frequency by way of headsets, beginning with the lowest volume decibel level. If you can hear it at the lowest level (0 decibels), a mark is created 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, advance on to 15 decibels, and so on.

This same technique is reiterated for every frequency as the hearing specialist travels along the horizontal frequency line. A mark is produced at the lowest perceivable decibel level you can perceive for every sound frequency.

Regarding the other symbols? If you see 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 typically used to mark the points for the left ear; an O is applied for the right ear. You may discover some additional characters, but these are less essential for your basic understanding.

What Normal Hearing Looks Like

So what is deemed as normal hearing, and what would that look like on the audiogram?

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

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

If, however, you can’t perceive the sound of a particular frequency at 0-25 dB, you probably have some type of hearing loss. The lowest decibel level at which you can perceive sound at that frequency pinpoints the tier of your hearing loss.

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

As an overview, here are the decibel levels correlated with normal hearing along with the levels correlated 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 might an audiogram with marks of hearing loss look like? Since many cases of hearing loss are in the higher frequencies (labeled as — you guessed it — high-frequency hearing loss), the audiogram would have a downwards sloping line from the top left corner of the chart sloping downward horizontally to the right.

This means that at the higher-frequencies, it requires a increasingly louder decibel level for you to experience the sound. Furthermore, given that higher-frequency sounds are linked with the consonant sounds of speech, high-frequency hearing loss impairs your ability to comprehend and follow conversations.

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

Test Your New-Found Knowledge

You now know the fundamentals of how to read an audiogram. So go ahead, book that hearing test and impress 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 explain to you the symptoms of hearing loss; you already know them all too well. You have a different kind of problem: persuading someone you care about to get their hearing assessed and treated.

But how are you expected to get through to someone who denies there is even a problem, or that simply 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 won’t see the need, and you won’t get very far with threats, ultimatums, or other coercive methods.

Even though it may seem like a hopeless scenario, there are other, more discreet strategies you can employ. In fact, you can tap into the massive body of social scientific research that teaches which practices of persuasion have been discovered to be the most consistently successful.

This means, you can utilize tested, researched, and validated persuasive strategies that have been shown to actually work. It’s worth an attempt, right? And scanning the strategies might make it easier to think of additional ideas.

With that in mind, here are 6 scientifically tested methods of persuasion and how you might use them to persuade a loved one to get their hearing tested:

1. Reciprocity

What it is:

The basic principle 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 asking your loved one to get their hearing examined at some point anyway, so why don’t you render the request just after you’ve done something special for them?

2. Commitment and Consistency

What it is:

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

How to use it:

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

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

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

3. Social Proof

What it is:

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

How to use it:

There are at minimum two ways to use this strategy. One way is to share articles on the many advantages of wearing hearing aids and how hearing aids elevate the quality of life for millions of people in the U.S. and globally.

The second way to use the approach is to set up a hearing test for yourself. Inform your loved one that you want to check on the health of your own hearing, but that you would feel better if they went with you and had their own assessment.

4. Liking

What it is:

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

How to use it:

Solicit the assistance of those you know your loved one likes or respects. Attempt to find that one person whom your loved one consistently seems to respond to, and have him or her discuss and recommend a hearing test.

5. Authority

What it is:

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

How to use it:

Share articles on how celebrities, professional athletes, and other distinguished figures use and benefit from hearing aids. You can also share articles from trustworthy sources that outline the necessity of having your hearing tested. As an 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 brings about 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 immediately, we may lose something forever.

How to use it:

The latest research has coupled hearing loss to a multitude of serious conditions, including Alzheimer’s Disease, dementia, memory impairment, and rapid cognitive decline. Hearing loss also gets worse as time passes, so the earlier it’s corrected, 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 each day spent with untreated hearing loss exacerbates the hearing loss, deteriorates health, and heightens the risk of developing more serious conditions.


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

5 Reasons Why People Deny Hearing Loss

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

Perhaps you know someone with hearing loss who either denies the difficulties or refuses to seek professional help, and despite the fact that this is no doubt frustrating, it is very possible that the indications of hearing loss are much more obvious to you than they are to them.

Here are the reasons why:

1. Hearing loss is gradual

In the majority of scenarios, hearing loss comes about so slowly and gradually that the afflicted person simply doesn’t perceive the change. While you would detect an quick change from normal hearing to a 25 decibel hearing loss (defined as moderate hearing loss), you wouldn’t perceive the modest change of a 1-2 decibel loss.

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

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

The majority of hearing loss scenarios are categorized as high-frequency hearing loss, which means that the impacted individual can still hear low-frequency background sounds normally. Even though speech, which is a high-frequency sound, is difficult for those with hearing loss to comprehend, other sounds can usually be heard normally. This is why it’s not uncommon for those with hearing loss to say, “my hearing is fine, everyone else mumbles.”

3. Hearing loss is not attended to by the family doctor

Individuals suffering with hearing loss can get a mistaken sense of well-being following 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 regularly test for hearing loss during the course of the yearly checkup. Not to mention that the primary 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 remedy hearing loss when there’s no cure? The answer is straight forward: 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 people with hearing loss promptly identify.

Those with hearing loss commonly crank up the volume on everything, to the detriment of those around them. TVs and radios are played extremely loud and people are made to either shout or repeat themselves. The person with hearing loss can manage just fine with this method, but only by passing on the burden to friends, family members, and co-workers.

5. Hearing loss is pain-free and invisible

Hearing loss is predominately subjective: it cannot be diagnosed by visible evaluation and it generally is not accompanied by any pain or discomfort. If those with hearing loss do not recognize a problem, chiefly because of the reasons above, then they most likely won’t take action.

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

How to approach those with hearing loss

Hopefully, this article has generated some empathy. It is always frustrating when someone with hearing loss refuses to accept the problem, but keep in mind, they may legitimately not recognize the extent of the problem. Rather than commanding that they get their hearing tested, a more productive method may be to educate them on the features of hearing loss that make the condition virtually invisible.

What to Expect at Your Hearing Exam

If the unfamiliar causes anxiety, then a trip to the hearing specialist is especially nerve-racking. While nearly all of us have experience with the family physician and the local dentist, the visit to the hearing specialist might be a first.

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

So here’s how it will go:

As soon as you arrive at the office, you will check in with a staff member at the front desk who will give you a couple of forms to fill out. Soon after filling out the forms, a hearing specialist will come with you into a room to start the hearing evaluation, 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 crucial, because this is where you get to describe to the hearing specialist the particulars of your hearing loss, what you expect to see from treatment, and your personalized hearing needs.

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

Next comes the testing.

Part 2: Otoscopy

otoscope

The initial diagnostic test to be performed is referred to as an otoscopy. An otoscope is used to visually assess the ear canal and eardrum to identify if your hearing loss is correlated to infections, earwax accumulation, or obstructions. If the cause of your hearing loss is something as minor as earwax accumulation, you could potentially start hearing better within a few minutes simply from professional earwax removal.

Part 3: Tympanometry

tympanometry

The second test is termed tympanometry, used to test the eardrum and middle ear. A device is inserted into the ear that will vary the air pressure, calculating how your ear responds to numerous pressures.

To fully grasp this test, you have to first know that hearing loss is categorized into one of two general categories:

  1. Sensorineural hearing loss — this is the most regularly occurring hearing loss. It is also described as noise-induced hearing loss and it involves injury of the nerve cells of hearing.
  2. Conductive hearing loss — this hearing loss results from clogging or obstructions that limit sound transmission before the sound gets to the nerves of hearing.

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

Part 4: Audiometry

audiogram

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

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

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

The test on its own, from your viewpoint, will be comfortable and straightforward. You will be presented with sounds and speech through headsets and will be told to specify when you can hear the sounds by pushing a control or lifting your hand.

Reviewing results and planning treatment

After the testing is complete, your hearing specialist will analyze your results with you. If your hearing loss calls for 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 profit from assistive listening devices or hearing aids, your hearing specialist will collaborate with you to determine the ideal option for you, your finances, your lifestyle, and your aesthetic considerations.

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

Exploring a Career in the Hearing Care Profession

While the majority of us stay current with our annual physical, dental cleaning, and eye exam, we notoriously forget to give consideration to the health of our hearing. And when our hearing does begin to worsen, it appears so gradually that we barely notice and neglect to take action. It’s this lack of interaction with hearing care professionals that makes people want to know what the career actually entails.

And that’s a shame, because hearing care professionals make up a vital part of the healthcare system. It’s through the hearing care professional that the correct performance of one of our vital senses — one for which we have a tendency to take for granted — is preserved or restored.

Given that we take hearing for granted, we usually also fail to fully grasp just how priceless hearing is. With precise hearing, we can increase focus, take pleasure in the details of sound, communicate better, and strengthen family relationships. And the hearing care professionals are the ones who make certain that this key sense is functioning efficiently.

If you’d like to find out more about this interesting but little-known healthcare field — or if you’re considering joining the field yourself — read on.

Attraction to the hearing care field

Hearing care professionals are attracted to the field for various reasons, but a few main motivating factors are frequently present. First, several practitioners have endured, and continue to endure, hearing troubles themselves. Due to the fact that they were themselves helped by a hearing care professional, the desire to return the favor for other individuals is strong.

To provide an example, Zoe Williams, a hearing care professional practicing 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 currently able to communicate normally. Knowing first-hand how healthier hearing leads to a much better life, Zoe was motivated to enter the field and to assist others in a similar manner.

Other individuals are pulled into the hearing care field thanks to its distinctive blend of counseling, problem solving, science, and technology. In combination with learning about the science of hearing and the engineering of hearing technology, practitioners also learn how to work with individuals in the role of a counselor. Coping with hearing loss is a sensitive situation, and people present a number of emotions and personalities. Practitioners must be able to make use of the “soft skills” required to address these difficulties and must work with patients on a personalized level to defeat hearing loss.

Training and preparation

Part of the allure of working in the hearing care profession is the intriguing mix of subjects included as part of the education and training. Those pursuing a career in the field master fascinating topics in numerous fields such as:

  • Biology – topics include the anatomy and physiology of hearing, balance, the ear, and the brain, as well as courses 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 development and functioning of hearing technology such as assistive listening devices, hearing aids, and cochlear implants, along with 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, along with other fascinating 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 managing a business.

Job functions

Hearing care professionals work in various kinds of settings (schools, hospitals, private practices) performing varied tasks such as research, teaching, and diagnosing and treating hearing and balance ailments.

Basic responsibilities include carrying out diagnostic tests, interpreting hearing tests, and working with patients on selecting the best hearing treatment, often including the use of hearing aids. Hearing care professionals custom-fit and program hearing aids to best fit the individual and will train the patient on how to use and maintain them. Hearing care professionals also work with employers and businesses to prevent hearing damage in high decibel work locations.

Benefits

The benefits reported most regularly by individuals in the hearing care profession center on the capacity to favorably impact people’s lives on a very personalized level. Long term friendships between patients and hearing specialists are also typical thanks to the personal nature of care.

When patients declare that they can hear again for the first time in years, the emotions can be overwhelming. Patients more often than not report a feeling of reconnection to the world and to family, together with strengthened relationships and an enhanced overall quality of life.

How many vocations 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 wristbands that vowed to provide instant and significant pain relief from arthritis and other chronic conditions?

Well, you won’t find much of that advertising anymore; in 2008, the producers of the Q-Ray Bracelets were legally required to reimburse customers a maximum of $87 million as a result of deceitful and fraudulent advertising.1

The problem had to do with rendering health claims that were not supported by any scientific verification. On the contrary, strong research existed to reveal that the magnetic bracelets had NO influence on pain reduction, which did not bode well for the creator but did wonders to win the court case for the Federal Trade Commission.2

The wishful thinking fallacy

Fine, so the Q-Ray bracelets didn’t show results (beyond the placebo effect), yet they ended up selling astonishingly well. What gives?

Without diving into the depths of human psychology, the straight forward answer is that we have a strong proclivity to believe in the things that may appear to make our lives better and quite a bit easier.

On an emotional level, you’d love to believe that sporting a $50 wristband will get rid of your pain and that you don’t have to bother with high-cost medical and surgical procedures.

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

        a. Booking surgery for a complete knee replacement

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

Your instinct is to give the bracelet a shot. You already want to believe that the bracelet will work, so now all you need is a little push from the marketers and some social confirmation from witnessing other people using them.

But it is specifically 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…

Bearing in mind the Q-Ray bracelets, let’s say you’re struggling from hearing loss; which decision sounds more attractive?

       a. Scheduling a consultation with a hearing practitioner and obtaining professionally programmed hearing aids

       b. Buying an off-the-shelf personal sound amplifier on the internet for 20 dollars

Much like the magnetic wristband seems much more appealing than a trip to the physician or surgeon, the personal sound amplifier seems to be much more appealing than a trip to the audiologist or hearing instrument specialist.

Nevertheless, 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 impression, I’m not saying that personal sound amplifiers, also referred to as PSAPs, are fraudulent — or even that they don’t deliver results.

On the contrary, personal sound amplifiers often do give good results. Just like hearing aids, personal sound amplifiers consist of a receiver, a microphone, and an amplifier that capture sound and make it louder. Thought of on that level, personal sound amplifiers work fine — and for that matter, so does the act of cupping your hands behind your ears.

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

  1. How well do they deliver the results?
  2. For which type of individual do they function best?

These are precisely the questions that the FDA addressed when it released its guidelines on the distinction between hearing aids and personal sound amplifiers.

As stated 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.”

Even though the distinction is transparent, it’s simple for PSAP manufacturers and sellers to circumvent the distinction by simply not pointing it out. For example, on a PSAP package, you may find the tagline “turning ordinary hearing into extraordinary hearing.” This claim is obscure enough to avoid the issue completely without having to explain exactly what the catch phrase “turning ordinary hearing into extraordinary hearing” even means.

You get what you pay for

As stated by the FDA, PSAPs are simplified amplification devices created for people with normal hearing. So if you have normal hearing, and you want to hear better while you are hunting, bird watching, or tuning in to remote conversations, then a $20 PSAP is perfect for you.

If you have hearing loss, however, then you’ll require professionally programmed hearing aids. While more costly, hearing aids offer the power and features necessary to address hearing loss. Listed below are a few of the reasons why hearing aids are superior to PSAPs:

  • Hearing aids amplify only the frequencies that you have difficulty hearing, while PSAPs amplify all sound indiscriminately. By amplifying all frequencies, PSAPs won’t permit 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 perfected for optimum hearing; PSAPs are not programmable.
  • Hearing aids contain numerous features that minimize background noise, allow for phone use, and provide for wireless connectivity, for example. PSAPs do not usually include any of these features.
  • Hearing aids come in a variety of styles and are custom-molded for optimum comfort and aesthetic appeal. PSAPs are in general one-size-fits-all.

Seek the help of a hearing professional

If you think that you have hearing loss, don’t be tempted by the low-priced PSAPs; rather, arrange for a visit with a hearing specialist. They will be able to precisely appraise your hearing loss and will ensure that you receive the correct hearing aid for your lifestyle and needs. So while the low-cost PSAPs are enticing, in this instance you should listen to your better judgment and seek expert assistance. Your hearing is well worth the work.

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

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