Do you have difficulty understanding speech in noisy places?

The hearing organ - the cochlea - is the smallest organ in the body and is “fed” by the blood supply. Changes in medications (over 3,000 prescription meds can affect the cochlea/balance system), changes in the vascular system, excess noise, gradual changes in genetic messages, can cause hearing loss, or perceptual loss, or processing changes, even tinnitus. In systemic illnesses we develop... we all experience sensory changes, even if we don't develop a hearing loss. Abnormal loudness growth, ability to hear in noisy places, difficulty with sound localization, tinnitus, frequent/abrupt loss of balance are examples.

Some individuals with normal hearing report difficulty understanding speech in noisy places. Fewer individuals with hearing loss report no difficulty hearing in noise. How well you hear in noise is variable, not tied to the degree of hearing loss, or age, or gender.

If you have difficulty understanding speech in noisy places, tolerating loud sounds, or understanding rapid speech, you've probably said a few of the following statements:

  • "I hear someone is speaking, but I don't understand what's being said."

  • "I avoid restaurants now because the background noise makes it too difficult to maintain a conversation."

  • "My grandchildren talk too fast for me to always understand what they are saying.”

  • "I avoid going to the theater because movies are always too loud!"

  • "The church’s public address system isn’t helping, so, I avoid going now."

  • "I use to enjoy Masterpiece Theatre, but the British accent is so hard to follow"

Some refer to tolerance to noise as dependent on how your brain is "hard-wired." You may recall you were the teenager who could listen to the Top 40 on the radio, pet the dog, talk on the phone, and simultaneously complete your algebra homework. Yet, you may have had a brother or sister who slammed their door, turned off the radio, put on noise canceling headphones in order to do their homework. Looks like you may be "hard-wired" to tolerate more noise than your sibling. Research shows your "wiring" persists throughout the lifespan.

At Appalachian Audiology, we test three aspects of communication before we discuss hearing solutions:

  • Ability to perceive speech in quiet, then in noise

  • Tolerance to loud sounds: what is the loudest sound you perceive to be comfortable?

  • Ability to process rapid speech

Three Signs of Hearing-in-Noise Difficulty

There are three measurable problems that make diagnosing hearing loss and providing real solutions to hear better in noisy places possible.

  1. Difficulty understanding speech in noisy places

    The level of background noise and how it affects your word understanding ability is measurable. An audiologist can quantify your tolerance of background noise and create verifiable solutions to address your specific needs.

  2. Intolerance to loud sounds

    Paradoxically, individuals with reduced ability to hear SOFT sounds often report a reduced tolerance for loud sounds. We measure this at key frequencies by gradually increasing the level of the tone and instructing the patient to signal when the sound reaches a level judged to be uncomfortable. Research shows that two individual with exactly the same hearing loss may vary in tolerance to loud sounds by as much as 30 dB. Measuring the softest and loudest tolerable sounds helps the audiologist program the hearing aid so that soft sounds are audible and loud sounds are comfortable. At a minimum, properly fit hearing aids should:

        • Make soft sounds audible

        • Make speech clear

        • Make loud sounds comfortable

  3. Difficulty understanding rapid speech

    For each decade of living, people report they must ask the speaker to slow down their speech. The speed that is optimal for you can be measured and addressed in today's hearing aid technology

Real Solutions For Hearing In Noise

At Appalachian Audiology, aspects of hearing-in-noise are measured and incorporated into recommendations for hearing aid circuits and accessories.

  1. Hearing aids with highly developed digital noise suppression

    Improving your ability to understand conversations in noisy places varies, based on the sophistication of the hearing aid directional microphones.

  2. Level 1 or Standard microphones usually found in entry level hearing aid technology will raise the speech of the person you are facing and reduce 4-6 of the loudest noises behind you by a few decibels.

  3. Level 2 or Advanced microphones are adaptive. This means they will raise the speech of the person you are looking at and reduce 8-12 of the loudest sounds to the sides and behind you.

  4. Level 3 or Premium hearing aid microphones will raise the speech and lower up to 32 of the loudest sounds or noises in the room in order to significantly improve the signal to noise ratio. In addition, premium circuits can differentiate between noise and music. This new technology has the following labels: Augmented Focus in Signia aids, UltraZoom in Phonak aids, Binaural Directionality in ReSound aids and OpnSound Processing in Oticon aids.

    Budget concerns often lead people to question if one hearing aid can adequately compensate for their hearing loss in both ears. While the audiologist must address this concern with each patient individually, wearing two hearing aids offers several advantages including an improved ability to understand speech and participate in conversations in noisy environments.

  5. Bluetooth Accessories

    Bluetooth is a wireless technology that permits electronic devices to send information without a cable to another device, such as, a phone to a hearing aid.

    Bluetooth compatible hearing aids are available at all levels of technology. First viewed as a luxury, Bluetooth connections now enable clarity in challenging listening or hearing situations. For example, Bluetooth connection to a cell phone or land line often improve the clarity of the caller’s voice simply because you hear the caller in both hearing aids, hands free. Bluetooth can also be used for improved clarity in TV listening, computer streaming, Zoom meetings, holiday dinners, etc. Hearing aids may require an accessory to access some Bluetooth functions. This is customized based on your lifestyle and comfort with the technology. When needed for employment, no charge purchase is available through the ADA.

  6. FM Systems / Remote Microphone Technology

    Both Bluetooth and FM accessories improve hearing. A wireless microphone is worn by others or placed closer to the speaker of interest. This helps provide a clearer signal overcoming issues of distance, noise and reverberation in the environment. This is often used with children who find it difficult to hear in a busy classroom.