We don’t really hear in our ears; we hear in our brain. Hearing aids help a person detect sounds, but they don’t provide good listening skills. There is a difference between hearing and listening. Normal hearing alone does not assure that one is a good listener. We all know people who have normal hearing but are poor listeners. Conversely, many hearing impaired individuals are wonderful listeners. While hearing is a physical function that requires an auditory system that allows access to sound, listening requires effort, and when a hearing loss is present, that effort becomes particularly difficult.
Good listening skills are one of the components essential for effective communication. As advanced as modern hearing aids are, they alone cannot produce the listening skills needed for communication. There are a number of reasons for this. For example, to be a good listener, one must integrate a number of skills including attending, understanding, and remembering. Unfortunately, many of these skills deteriorate as we age. This may show up as a worsening of short-term memory, or increased difficulty understanding rapid speech. Modern hearing aids have certainly improved the quality of hearing in noisy environments, but they do not eliminate background sounds. People with hearing loss have particularly great difficulty understanding speech in noise. In addition, we now have evidence that a loss of hearing in the ear literally produces physical changes in the brain. These changes are called neural plasticity and data shows that when parts of the brain are not being utilized, they actually change their function (not in a positive manner). Thus, the old adage, “use it or lose it” actually applies to listening because the hearing impaired person’s brain may not be receiving the kind of stimulation it needs to maintain proper function.
In addition, confidence that what you thought you heard was what was spoken, is vital. Often, when people lose confidence in their ability to communication in noisy social situations, they avoid those environments. While this may save them effort and embarrassment, it ultimately costs them important personal and social contact. Some individuals utilize compensatory strategies that may result in successful hearing aid use. Others are not so fortunate. In fact, it is not uncommon for people with hearing loss to develop counter-productive compensatory behaviors, such as nodding their heads as if they heard, or monopolizing conversation so that they don’t have to rely on their hearing.
The good news is you can optimize your hearing experience using a number of methods:
- Having realistic expectations about your hearing aids
- Using visual cues
- Teaching your social network “clear speech” (such as rephrasing and slowing down)
- Employing better communication strategies
- Using other assistive technology in addition to your hearing aids
- Use of captioned TV, movies, and telephones
Supplementing hearing aid use with additional methods mentioned above can be very useful in giving you the kinds of skills that make the difference between understanding and being left out of a conversation. Talk to your physician about your hearing difficulties and ask for a referral to an Audiologist who can test your hearing and establish a comprehensive communication plan for you.