The Brain and Hearing: Information on hearing loss from Audiology Specialists

Hearing loss is complicated. The ear hears many sounds at the same time. Often, people with hearing impairment can’t distinguish between the sounds happening around them.

Understanding hearing loss requires an understanding of how the ear hears. The outer ear collects sound and funnels it to the auditory system so sound can be perceived. External sound goes through transformations from the vibration of air particles to mechanical, hydraulic, and finally electrical energy to be transmitted to the brain.

The outer ear detects the sounds present in order to send that sound to the brain. That is where hearing aids help. They assist in sound detection. There are many options for how hearing aids assist the ear in the perception of sound. Some of the ways advanced hearing aids help the brain are by: distinguishing the location of sounds and giving priority to those sounds occurring in front of you; by distinguishing voice sounds from other environmental sounds; by recognizing the most prominent speech signal and giving it increased emphasis and by using two hearing aids, communicating with each other, to improve focus on a particular sound.

While technology helps to improve the ear’s ability to detect a sound and send it to the brain, ultimately it is the brain which must decode the sound, understand what is decoded and compose a response. If the brain is not receiving a good signal from the ear, or if the brain is overwhelmed by the effort required to decode, understand and respond to the sound, then listeners with hearing impairment still have trouble hearing. Hearing aids don't work directly with the brain, but through the auditory system.

Improving hearing is more challenging than improving vision. Hearing aids are more sophisticated than glasses. Good vision is, however, essential to hearing, so it shouldn't be neglected. People need to be able to see faces clearly and use all visible cues to assist understanding.

There are additional ways to help improve the brain’s ability to understand speech. An audiologist can give information about accessories that work with hearing aids to help improve attention to the auditory signal, and can help with the negative effects of competing noise or distance.

An audiologist can help someone with hearing loss or impairment with a learning program to help retrain the brain to better listen to speech sounds. For example, Listening Auditory Comprehension Exercises, or LACE, can be purchased online from Neurotone. LACE requires a computer with sound, and works best if used for at least 20 minutes, four times per week. People who complete the LACE program report improved confidence in hearing.

An iPhone app called App MyEar will convert spoken conversation into text. It may be useful to confirm understanding of what others say. For more information, visit itunes.apple.com/us/story/id1398057616.

A tired brain cannot perform as well as a rested one. Anyone who will be in a challenging listening situation should try to be well rested. The brain has a limited amount of energy it can devote to processing speech. When the brain is overwhelmed, it doesn't perform. Try adjusting the listening situation to have an advantage, by doing things like turning off competing sounds like the television, running water or other noise sources. Ask people to look face to face, and make sure there is good lighting. Ask them to take a breath every 3-4 words, so they talk more slowly and give the brain a chance to keep up.

Although it may be frustrating to admit it, don’t bluff about hearing ability. Ask people to repeat their statement with different words if something isn't understood. Ask for important details in writing. Bring along a friend or family member to help fill in gaps, especially when attending important appointments or meetings.

Research demonstrates that brain matter shrinks when uncorrected hearing loss is present, also a sign of dementia. There is also an increase in the risk of falling. Hearing aids can help, as they retrain the brain to hear. To be effective, it’s important to wear hearing aids for the majority of waking hours. Sometimes, it might be better to purchase a less-advanced hearing aid with accessories that can assist in situations when listening at a distance or with competing noise. An audiologist can help determine what is best.

Communicate needs and frustrations with an audiologist. Give them all the information to help understand specific circumstances to be able to provide the best advice for the situation. Plan to return again. Getting help with hearing is not one-stop shopping. Hearing changes over time and technology keeps improving. Remember, obtaining hearing aids is a great start, but more help may be needed to help follow a conversation. It starts with the ears, but also requires the brain.