Hearing access specialists
Hearing access specialists

Profile photo of ANNA PUGH

“We gradually forget how to listen as our hearing mechanism deteriorates,” says award-winning Hearing Therapist Audiologist, Anna Pugh, in this fascinating article.


You can hear someone talking, but you don’t know what they are saying

Does that sound familiar?  It can be a hurtful blow when someone blithely asks “Are you wearing your hearing aids?” when you are wearing them and yet you sometimes are still unable to hear.

If you’re one of the 20% of people who wear their hearing aids all day, everyday, there are still likely to be times when you won’t catch everything that being said, especially if there are competing noises like the washing machine, the road noise in a car, or other people talking nearby.

Hearing aids are simply that. They are aids. They don’t replace your natural hearing, and even with them, you still have a hearing loss, so there are sounds your brain just doesn’t hear.

And there’s a world of difference between Hearing, when sound travels through the ear mechanisms to the brain, and Listening, where the brain makes sense of the sounds it receives.

Hearing is a passive art: your ear will transport the sound waves through to your brain even when you’re asleep. Listening, however, takes effort.

We gradually forget how to listen as our hearing mechanism deteriorates, usually over time, but sometimes quicker due to noise damage, illnesses such as diabetes, and medications for life saving treatments like cancer.  This means it takes more effort to listen and make sense of sounds, even with hearing aids.

Because listening takes effort, we can find that we stop trying to listen and join in. Instead, we ‘zone out’ and get out of the habit of listening.

The effort of listening can particularly great for hearing aid users when they are in noisy environments, which is why the work that Ideas for Ears does around hearing access is so important. If you think about noise like being in a fog, then even with glasses you won’t see everything, and so it is with noise and hearing aids.

Hearing aids have limits

I see lots of people who have been using hearing aids, but who are disappointed or frustrated that they’re not doing what the person had hoped or expected that they would do.  Quite often this is simply because the individual is not fully aware of what the hearing aid can and cannot do.

For instance, hearing aids concentrate on collecting sound that is about 1.5m in front of you (even with the most sophisticated technology).  This means it has limited capability for hearing voices from another room, or over noise coming from a TV that is in front of them, or when they are being spoken to from behind.

And, of course, the 2m social distancing will also stretch the hearing aid’s capabilities, so the COVID situation is having quite an impact.

When hearing aid users are aware of these things, they can do more to get the best from their hearing aids, which are highly sophisticated these days and have incredible capability.

Listening skill can be improved

It is not just the sophistication of hearing aids that is important, success in hearing is also related to your listening skill.

If your hearing mechanism has deteriorated and you have become used to zoning out, then your brain will have lost some of its ability to distinguish one sound from another.

Your listening skill can be improved.  Hearing Therapists talk about Auditory Training, which is rehabilitation focused on training your listening skills. This can make a remarkable difference to your communication skills, confidence, concentration and tiredness.  It does take time to achieve, and … yes, that word again … effort, but it can be very worthwhile.

Listening effort can be measured

Audiologists can measure this listening effort as part of a rehabilitation programme to help you use your hearing aid technologies, and also to help you keep your brain active.

A simple listening effort test would be a speech-in-noise test. This is where a series of phonetically balanced sentences are played through a speaker or headphones at a measured volume, and there is an increasing level of competing noise with every sentence.  This makes it increasingly hard to make out what is being said.   The test will involve you being measured on how many words you can make out at each level of noise, and this is converted into a listening effort score.

By having knowledge of your listening skills and listening effort, you can then understand more about why you have difficulties in some situations and not in others.

You are also more able to make decisions with your audiologists about any other hearing technologies that might help you.  For instance, additional programmes in a hearing aid, or assistive devices for certain situations where the hearing aid alone is unlikely to be sufficient.

Better hearing is possible

As an Audiologist and a Hearing Therapist, I help to make sure people can hear as well as possible.   Using a hearing aid isn’t as straightforward or as simple as many think and that is probably one of the reasons why only 20% of people use them all the time.

Hearing aids cannot fix your hearing loss, but they can help you listen better.  For anyone not using their hearing aids as much as they could be, or who finds that they are not helping as much as they need, then I would urge them to speak to their Audiologist or Hearing Therapist.

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