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Understanding Hearing Loss
Introduction
This section is aimed at people, who have recently lost some of the Hearing or who know somebody who has. Indeed anybody who wants to know a little and wants to update their knowledge about acquired hearing loss will benefit.
The IHHA is an Irish Organisation. Much of the information in general but references to other organisations and schemes are Irish.
We are not professional audiologists or ENT specialists. Between us we have all too many years personal experience. Where necessary we provide website links to other organisation that can give more details on issues discussed
We know very little about many issues faced by people who are deaf from birth or acquired their total at very early age before they learnt spoken language.
Terminology & Classifications
Deaf people (or sometimes called Deaf with a capital D or culturally deaf are people who were born deaf or became so within a year or two of birth. Their first language is Sign Language (ISL in Ireland ). There are between 4 and 5 thousand Deaf people in Ireland and a community of about 50,000 people who can sign. We refer you to Deafhear ( http://www.deafhear.ie) or the Irish Deaf Society (http://www.irishdeafsociety.ie) for more information on pre-lingual deafness.
Deafened people are people who became deaf later in life. This can be sudden or after a period of being Hard of Hearing, Some would group Deafened people under Hard of Hearing classifying their loss as profound.
Hard of Hearing people are people who acquired some degree of loss at some stage in their life. “Hearing impaired” is used in some parts o the world. The loss can be sudden or slow and progressive. It can happen at any age or stage in life or due to many causes. Their prime language is spoken English and most of the people they deal with have normal hearing .
Below are the 4 most usual classifications within “Hard of Hearing”. Technical definitions are impossible to understand for many but they are measured as the average decibel loss on the 500, 1000 and 2000 frequencies/pitch on an audiogram (standard Hearing Test Graph)
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Classification
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Population % (Est.)
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Technical Loss
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Comment
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Mild
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11%
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20-40DB
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Difficult to hear & understand in some noisy situations
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Moderate
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6%
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40-70 DB
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Many difficulties hearing & understanding in a normal environment without a hearing aid and will benefit hugely from lip reading
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Severe
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0.5%
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70-95DB
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People will be completely dependant on a powerful hearing aid, Lip reading and maybe sign language
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Profound
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0.1%
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>95DB
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Even with a powerful hearing aid they will hear very little
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Note people with normal hearing usually have some minor loss (less than 20 DB).
Hearing Loss increases with Age and it is estimated that one in two people over 60 years of age have some hearing loss
There is an excellent demonstration of different types of hearing loss on the Phonak website that might help people with normal hearing understand what it is like to have poor hearing. Click here if you want to visit the site.
Causes of Hearing Loss
There are many causes of hearing loss and deafness. There can be hereditary, congenital, medical or accidental reasons or more usually due to prolonged exposure to loud noise or simply age related. In many case it is not possible to say why and because there is a high correlation between age and the onset of hearing loss we make that assumption.
Of all these Noise damage is the one than can be prevented. Do not expose yourself to prolonged periods (30 mins) of loud noise (25% louder than normal. Try not to expose yourself to very loud noise at all. Be careful using IPods and MP3 players
Characteristics of Hearing Loss
No two people who are hard of hearing are the same. An identical loss can effect different people in different though they will have a lot in common. The are the main characteristics
Volume: This is simple the volume loss a person has and as stated above the Loss is classified as mild, moderate, severe and profound. Normal and total might be added to these at the ends of the scale for completeness.
Discrimination: This is the concept of quality. You may hear a noise but not understand what it is. You may hear a noise in the kitchen but not know if it is the washing machine or the dish washer. A person may hear a sentence but not understand it or only understand it after a few seconds. It can be compared to a person with normal hearing listening to radio in a foreign language they do not understand. You can hear it perfectly but understand nothing.
Tinnitus: Many people hear noise in the ears where others do not. If so normal conversation is competing with the ‘Internal’ noise and can create difficulties hearing. Tinnitus is a huge source of misery in addition to the person’s hearing difficulties
Recruitment: Many people (including people with normal hearing) are unable to tolerate loud noises. For hard of hearing people this may mean that the full benefits of a hearing aid cannot be gained. Modern hearing aids are getting better at dealing with the issue
Bi-Lateral or Single sided: In quiet situations a person’s hearing will depend on the better of their ears. The louder the background the less is the advantage
Environmental issues that effect hearing
There are many factors that affect your ability to ‘hear’ apart from your hearing ability. People with normal hearing will often be affected by some of these issues. The factors are
Background Noise: When there is noise in the background, sounds merge. Good hearing subconsciously filters out or muffs sound you do not want to hear. In a busy canteen somehow most people only hear the conversation at their immediate table. A person with hearing loss finds that all noise and conversations are boosted by hearing aids and are unable to distinguish between what they want to hear and they don’t
Group Conversations: Good conversations hop from topic to topic and person to person. Each person adds their piece and the conversation changes very quickly. People with poor hearing need a little extra time to keep up with a conversation and easily get lost or confused
Lighting: It is difficult to lip read in poor light. The better the lighting the better able a hard of hearing person will be able to ‘hear’
Sound Absorption: Materials like carpets, curtains and acoustic ceiling tiles absorb noise whereas noise reverates around a room with floor or wall tiles, loads of glass or raw concrete
Familiarity: If you know people well or are knowledgeable or enjoy a certain topic you will find you tend to ‘hear’ better
Tiredness: Tiredness slows down all functions of the brain. Hearing is no exception. So you will seem to hear less in long meetings without breaks will be difficult or meeting the day after a late night.
So combining all of the above a late night evening meal in a candlelit restaurant with piped music and polished wooden floors with a group of people from all over the world you don’t know is best avoided!
The Impact of Hearing Loss
Hearing is not an end in itself but a means by which you do things you want or should do. In this section we hope to open your eyes to possibilities. Hearing Loss effect people in many and different ways. We could write forever but are a few things under a few headings
Trivial (but not always)
People with hearing loss will pay for small items with notes or credit cards because they cannot hear the price the cashier says.
People with hearing loss will sing ancient songs to themselves
People with hearing loss will say many silly things
If you are clamped you cannot ring to get it unclamped
You cannot ring the plumber in an emergency
Practical:
If you cannot hear an alarm clock, you may sleep in and be late for school or work.
If you can hear on the radio the M50 is blocked you take a different route to the airport
If you cannot hear a teacher, the chances are you will miss out education wise.
You may not be a good team player in work as you miss out on all the team briefings
Explaining to your doctor what exactly is wrong can be very difficult if you can’t follow his or her questions
It is very easy to remain quiet or to interrupt a lot during meetings
Emotional / Psychological
It is very possible to be all alone and isolated at a wedding reception
It is extremely frustrating not to be able to participate in a group conversation
It is very easy to feel guilty about your hearing loss and incompetent over fact you cannot cope better
Relationships
A person with hearing loss may be always may always be rushing. It is easy to say you are in a rush rather stop and talk
Conversations will often be shallow, disjointed or repetitive
It is hard to meet people if you continue to avoid situations where it is difficult to hear
Your circle of friends will get very small unless you are active in seeking them out
It is easy to misinterpret misunderstandings as something deeper
One person’s hearing loss effects the other party in a relationship big time
Also see the Facts and FAQ’s section of our website (Currently under constuction)
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Understanding Hearing Loss 
