Hearing Without Understanding Could Be A Sign of Hearing Loss

A common complaint of people with hearing loss is, "I can hear fine, and just can't understand what people are saying!” If you have trouble hearing, it doesn’t necessarily mean the volume isn’t loud enough. It could be that you hear some sounds just fine, and others not so well, allowing you to hear someone speaking but not understand everything they’re saying. This is often the case with high-frequency hearing loss.

What is high-frequency hearing loss?

High-frequency hearing loss is the most common type of hearing loss. It generally affects people who are older or those who have had excessive exposure to loud noise. In both cases, lower-pitched sounds (under 1000 Hz) are usually heard just fine, while higher-pitched sounds (over 1000 Hz) get distorted or lost altogether.

Lost sounds at higher frequencies

In speech, vowel sounds (A, E, I, O and U) are low-pitched sounds, while many consonant sounds (K, P, V, F, Sh, Th) are high-pitched. When someone with high-frequency hearing loss is engaged in conversation, they’ll be able to hear some of it (often the vowel sounds), but won’t be able to hear the high-pitched consonants. Words like “hat” and “cat” or “dime” and “time” can be easily confused, leading to questions like, “I’m sorry, I didn’t quite understand – can you speak up?”

Hearing in loud environments

People with high-frequency hearing loss often have a hard time following conversations, even in quiet environments. Noisy social situations can make conversations even harder for those with untreated hearing loss. This can lead to avoiding social situations altogether, because it can be frustrating and exhausting to try to follow conversations when you can’t understand much of what’s being said.

Signs of high-frequency hearing loss

If you have any of these symptoms, it could be a sign that you have high-frequency hearing loss:

• Difficulty understanding conversations on the phone
• Difficulty following conversations in loud places
• Trouble understanding higher-pitched voices, like females or young children
• Music sounds distorted, especially when the volume is turned up
• Feeling tired from trying so hard to listen attentively

Hearing without understanding is one of the most common reasons people visit an audiologist. If any of these signs are familiar to you, book yourself a hearing test with an experienced audiologist today.

If you have high-frequency hearing loss, hearing aids can help amplify the high-pitched sounds you’re missing and bring back the full spectrum of sound around you. You’ll likely hear and understand speech better, and you may hear sounds you didn’t realize you were missing, like birds singing or the tea kettle whistling. There’s a whole world of sound waiting for you!

What happens during a hearing test?

The first thing to know is that a hearing test – called a pure tone audiometry test – is painless and completely non-invasive. The test is designed to show the softest, quietest sound you can hear.

During the test, you wear headphones which play sounds at different tones and volumes. Some sounds are deeper, others are higher. Some are loud, and some are quite soft. All you have to do is sit still and raise a finger on your right hand when you hear a tone in your right ear, and raise a finger on your left hand when you hear a tone in your left ear.

A word recognition test will show the audiologist how well you can differentiate speech from background noise. You’ll simply be asked to repeat the words you hear when you can hear them. It’s as simple as that.

What will the audiogram show?

Your hearing test results in an audiogram that shows which sounds you can hear and the point at which sounds drop off.

On an audiogram, the volume of a sound is measured in decibels (dB). A whisper is about 20 dB. Loud music is usually between 80-120 dB. The tone of a sound is measured in frequencies (Hz), with low bass tones around 50-60 Hz, and high-pitched tones measured at over 10,000 Hz. Someone with normal hearing will hear all the tones tested during a typical audiogram (250-8000 Hz) at 25 dB or lower.

The audiogram shows the audiologist which frequencies you struggle to hear, and helps them determine which hearing aids will help you hear your best.

Hearing aids: Providing just the right amplification at just the right frequencies

New technologies in hearing aids make them highly programmable, and customizable to each person’s specific hearing needs. This is far superior to the one-size-fits-all approach of simple off-the-shelf amplification devices.

Once the audiologist has determined what your hearing profile looks like based on your audiogram, he or she can program your hearing aids to match your profile. Depending on which frequencies are lost to you at which volumes, your audiologist will program your hearing aids so that you’ll be able to hear those previously lost sounds. After programming your hearing aids, your audiologist should test that the amplification being provided by your hearing aids is adequate using real-ear measurements.

Features that help you hear better

Programming and fine-tuning your hearing aids to correct your specific level of hearing loss isn’t the only way the devices will help you hear better. Depending on the level of technology you buy, hearing aids come with numerous advanced features:

• Directional microphones help amplify the voice you’re listening to in a conversation.
• Noise cancellation technology helps you hear better in a noisy room like a restaurant or at a party.
• Artificial intelligence (AI) and machine-learning hearing aids can "denoise" the listening environment or separate speech from background noise
• Your phone and TV audio can be streamed via Bluetooth directly to your hearing aids.
• Most advanced hearing aids will recognize the listening environment you're in and automatically adjust the volume and other settings depending on the level of background noise in your environment
• Rechargeable hearing aids may help if you struggle to change batteries due to poor vision or dexterity.
• Accessories like remote microphones, TV streamers, telecoils, as well as Auracast broadcast technology can bring the signal directly to your ears

Why can it be difficult to understand speech even with hearing aids?

Numerous factors can affect your ability to understand speech, including the nature and severity of your hearing loss, the ability of your hearing aids to amplify the frequencies you are missing in different listening environments, the status of your auditory processing system, and the time you've spent becoming accustomed to the hearing aids.

Studies show that most people wait an average of 7 years from the time they first notice hearing trouble to get help. Hearing aids can help significantly reduce the impact of hearing loss, but it is not the same as restoring our normal, natural hearing before it was damaged and left untreated for years. “A good analogy would be asking the question, 'I have been bedridden for 7-10 years. Now I have a walker. Why is it still difficult to walk?'” explains Alina Phoenix, a hearing care provider based in Champaign, Ill. “A walker assists us in walking but does not heal the damage and atrophy to our legs, just like hearing aids assist us in hearing but do not heal the damage in our ears or eliminate the auditory deprivation. Because of factors like the extent of the damage that exists and length of time that the problem was left untreated before help was received, there will always be some degree of distortion in our hearing and deficit in our understanding ability.”

Hearing aids are simply bringing in the environmental sounds and funneling them through a system that has been damaged. In this way, the hearing aids don't actually treat the hearing loss but are more like prosthetics that amplify and boost the sounds at discrete frequencies. However, through a process known as neuroplasticity, the brain, with repeated practice, can gradually “rewire itself” and get better at making sense of the new amplified sounds generated by your hearing aids—including "tuning out" the new distracting noises or changes in how your own voice sounds while wearing the devices. Auditory training, aural rehabilitation, and exercises like reading aloud to yourself (or your spouse, a grandchild, etc.) also lean on these "brain retraining” principles. This is one reason you should follow your provider's advice to wear your hearing aids for most or all of the day, every day.

We might hear with our ears, but we listen and make sense of speech with our brains. Between the ear and brain are also nerve fibers that transmit signals and can become damaged (a condition sometimes referred to as "hidden hearing loss"). As we age, most people's ears, auditory nerves, and brain sound-processing regions all become less efficient.

Some people may have severe to profound hearing loss that can make speech discrimination extremely difficult. “Therefore, if there is distortion in the inner ear, the hearing aid will make environmental sounds louder but will not 'fix' the distortion,” wrote Dr. Alicia Spoor, AuD, in HearingTracker's Expert Answers column. “Depending on your individual hearing acuity and difficulties understanding, a cochlear implant candidacy evaluation may help provide more information and options for clear speech.”

The good news is that today there is a solution for almost any hearing loss.

Recover lost sounds

Acknowledging the above, today’s hearing aids won’t just help you understand speech better. With properly fitted hearing aids, most people will notice that music sounds fuller and richer, or that you can now hear the sound of leaves rustling in the wind. Hearing aids can open you up to a world of sound you didn’t even know you were missing and get you back into a groove in life you didn’t realize had been lost.