How Hearing Loss Affects Sound Processing
July 18 is World Listening Day. To celebrate, I want to discuss the processes that allow us to experience the wonderful sounds around us. Did you know that we don’t actually listen with our ears? Instead, we hear sounds with our ears and listen with our brains. Our ears are responsible for detecting sound and transmitting the signal to our auditory cortex where the sound is interpreted. Integrity, or proper function of the auditory system, is required for sending the sound to the brain. Once the sound reaches the brain, higher level processing such as attention, working memory, and executive function all play crucial roles in listening and interpreting the sound.
My job as an audiologist is to treat hearing loss that affects sound transmission to the brain. A person with untreated hearing loss will have difficulty interpreting sounds. Though this problem is often perceived as a lack of listening, it is more likely caused by unintentionally mishearing or misunderstanding the message because the person lacks information.
A variety of reasons cause individuals with hearing loss to sometimes appear to not listen. First, they may actually not hear what is being said! Oftentimes, people with hearing loss have trouble hearing from a distance, such as when the speaker and the listener are in separate rooms or not facing each other or when the speaker is soft spoken. In these situations, a person with hearing loss may not even detect that another person is talking.
Another common occurrence for individuals with hearing loss is misinterpreting the message. The word “cat” may be mistaken for the word “hat,” leading to a communication breakdown or misinterpretation of what is being said. This may come across as a lack of listening when, really, the individual misunderstood. Mishearing the word happens frequently for people with hearing loss because, if they do not hear every part of the word, their brain has to fill in the gaps. Gap-filling is accomplished by using context and visual cues; however, context or the speaker’s face is not always apparent. In these cases, the brain must guess at possible options. For example, if someone at a baseball game says, “Look at their hat!” this could be misinterpreted as “look at their bat!” because both “hat” and “bat” make sense in this situation.
Hearing loss is difficult not only for the individual experiencing the problem but also for friends and family. Constant repetition can be very frustrating, and feeling as if the other person is not listening can lead to anger or annoyance. One of the first things I do with new patients is sit down with them and their communication partners to discuss good communication strategies. These strategies help optimize the listening environment and make sure the individuals with hearing loss are able to hear their partner’s words.
If you have a friend or relative with hearing loss, remember that they can mishear you even when they are listening. It is important to seek out help for hearing problems, to use good communication strategies, and to have patience with one another on the journey to better hearing.
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