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Frequently Asked Questions

Here are commonly asked questions and answers that help you understand hearing loss and hearing care.

About Hearing Loss

Info for Parents

Info for Adults

Basics about Hearing Loss

How do you know if you have a hearing loss?


If you answer yes to one or more of the following questions, you may have a hearing loss.

        a. Do you have to turn the volume up on the television?
        b. Do you hear, but not necessarily understand what others are saying?
        c. Do you have trouble following conversations in busy places?
        d. Do you often ask people to repeat what they say?

“Understanding Hearing Loss.“ Understanding Hearing Loss. Phonak, n.d. Web. 26 Mar. 25.

What are the causes of hearing loss?


Learning about the causes of hearing loss you or a loved one could be experiencing, is the first step towards finding solutions that allow life to be lived to the fullest. Experiencing hearing loss - whatever the cause or extent - isn’t pleasant, but there is good news: thanks to modern hearing aid technology, hearing loss is a treatable condition.

Hearing loss falls into two broad categories: the first is congenital, which is hearing loss that is present at birth and caused by factors like genetics or premature birth. The second is acquired, which is hearing loss that occurs after birth, and is the result of factors like illness or damage to the ear.

Although we in fact "hear" with our brains, hearing loss happens when one part of the ear - the outer, middle or inner ear - is damaged or unable to function properly, and cannot conduct sound signals to the brain normally.

Causes in the outer ear
These are usually easy to address, and include problems like wax plugs and infections of the auditory canal.

Causes in the middle ear
Inflammation, fluid behind the eardrum, perforations of the eardrum and otosclerosis (a stiffening of the bones in the middle ear) are the most common middle ear issues. Most outer and middle ear problems can be effectively fixed with medication or surgery.

Causes in the inner ear
This is where most hearing issues arise. The most common cause is the natural aging process, but loud noise, some types of medication or skull fractures can also affect hearing. Fine hair cells in the inner ear become damaged and affect the transmission of signals to the auditory nerves. Usually, inner ear hearing loss cannot be addressed medically but can be corrected with hearing aids.

“Understanding Hearing Loss.“ Understanding Hearing Loss. Phonak, n.d. Web. 26 Mar. 25.

What are the types of hearing loss?


Here are general guidelines to help you identify the degree of hearing loss you or a loved one could be experiencing.

Degrees of hearing loss differ vastly, but most cases are categorized as noticeable or moderate. Having your hearing professionally tested is the only way to determine the extent of your hearing loss, and how best to treat it.

Mild hearing loss
Soft noises are not heard. Understanding speech is difficult in a loud environment.

Moderate hearing loss
Soft and moderately loud noises are not heard. Understanding speech becomes very difficult with background noise.

Severe hearing loss
Conversations have to be conducted loudly. Group conversations require a lot of effort.

Profound hearing loss
Some very loud noises are heard. Without a hearing aid, communication is no longer possible even with intense effort.

“Understanding Hearing Loss.“ Understanding Hearing Loss. Phonak, n.d. Web. 26 Mar. 25.

How do you get treatment to hear better?


There are several experts you can talk to who will assess your hearing based on a hearing test, and determine what steps to take on your venture to better hearing:

The Audiologist
A highly trained health care professional who is recognized for her specialty in testing hearing and providing solutions for hearing health care.

An audiologist counsels people with hearing loss and their families and build a plan of care that often includes hearing aids and other hearing assistive devices.

ENT Physician
A physician who specializes in medical issues regarding the ear, nose and throat (ENT). May also be referred to as Otologist, Otolaryngologist and neuro-Otologist are alternative names. Ask your family doctor for further details

Hearing Care Specialist
A hearing aid specialist is trained to fit hearing aids. He specializes in the details of hearing aids functionality.

Successful treatment for hearing loss is a lifelong process and involves ongoing evaluation, education, training, support and advocacy. Therefore, a comprehensive program of audiologic rehabilitation should follow the evaluation, fitting and purchase of a hearing aid.

“Understanding Hearing Loss.“ Understanding Hearing Loss. Phonak, n.d. Web. 26 Mar. 25.

“Helping Others Cope With Hearing Loss.“ Helping Others Cope With Hearing Loss. American-Speech-Language-Hearing-Association. N.p., 2015. Web. 25 Mar. 2017.

Information for Parents

When should my child start talking?


Here are age developmental milestones that your child should go through.

At nine months, your child should already have an understanding of simple words such as “mommy”, “daddy”, and “no”.

By ten months, your child should be able to sound “speech like” syllables like “da-da-da-da.” Aside from that, your child’s first recognizable words is supposed to develop at about this time.

When your child is one year old, he should be able to speak one or more real words.

At eighteen months, your child should understand simple phrases, retrieve familiar objects on command (without gestures) and point to body parts. Aside from that, he should have a spoken vocabulary between 20 to 50 words and be able to use short phrases such as “no more”, and “go out”.

By the time the child is two years old, he should have a spoken vocabulary with at least 150 words coupled with simple two-word sentences. Your child’s speech should be understandable to adults who are not with your child daily. Aside from that, a toddler should also be able to sit, listen, and read aloud picture books.

When your child is three to five years old, he should have a spoken language that constantly expresses wants, reflects emotions, conveys information, and asks question. A preschooler should be able to understand nearly all that is mentioned. His vocabulary should range from 1,000 to 2,000 words which are linked in complex meaningful sentences. Moreover, all speech sounds should be clear and understandable by the end of this period.

These milestones are considered as rough rules of thumb for the majority of children. If your child is more than 3-6 months delayed compared to the mentioned age-groups, this might indicate a hearing loss or a delayed speech-language development.

What are the signs that my child is suffering from hearing loss?


There are various indicators that you should be aware and observant of to distinguish if your child is suffering from hearing loss. Sometimes, a lack of response is attributed to inattention, but it is important to determine if inconsistent or no responses actually stem from an inability to hear. Here are some common signs that you should know to find out if your child is hearing impaired:

        • Not aware someone who is out-of-view is talking, especially when distractions are minimal
        • Exhibits a startled or surprised look when he realizes their name has been called
        • Says “what?” or “huh?” frequently
        • Intently watching the faces of speakers
        • Sitting close to the TV when the volume is sufficient for other family members
        • Increasing the volume of the TV or stereo to unreasonably loud levels
        • Not responding to voices over the telephone and/or switching ears continually
        • Not reacting to intense loud sounds, the single most important sign of possible hearing loss,
        • If your child is not developing speech, especially compared to peers or older siblings

Is my child at risk of hearing loss?


There are various factors that indicate that your child is at risk of hearing loss. They are as follows:

For Newborns – Birth to 28 Days:
        • Family history of hereditary childhood sensorineural hearing loss
        • Utero infection, cytomegalovirus, rubella, syphilis, herpes and toxoplasmosis
        • Craniofacial deformities including those affecting the pinna and ear canal
        • Birth weight less than 1,500 grams
        • Hyperbilirubinemia at a serum level requiring transfusion (jaundice)
        • Ototoxic medications
        • Bacterial meningitis
        • Apgar scores of 0-4 at 1 minute or 0-6 at 5 minutes after birth
        • Mechanical ventilation lasting 5 days or longer
        • Findings associated with syndromes known to include sensorineural loss

For Infants – 29 Days to 2 Years:
        • Concern regarding communication or developmental delay
        • Bacterial meningitis or other infections known to cause sensorineural loss
        • Head trauma associated with loss of consciousness or skull fracture
        • Ototoxic medications
        • Findings associated with a syndrome known to include sensorineural loss
        • Otitis media with effusion for three months or longer

What is one of the most common causes of hearing loss?


One of the most common, and yet completely preventable cause of permanent sensorineural hearing loss is noise exposure. High level of noise can cause temporary or permanent damage to the sensory hair cells within the cochlea. High level of noise could be caused by vehicles, appliances and music devices, depending on how close the noise source is and the length of exposure. In addition, some toys or computer games and certainly rock music concerts may damage hearing. Children should be taught about the dangers of noise exposure and should be instructed to use ear protection when necessary.

What are the different types of hearing tests?


1. Pediatric Tests - There are two tests performed specifically for toddlers: behavioral tests and play audiometry. These tests evaluate the responses of toddlers to warble tones and tones with different frequencies and intensities.
2. Auditory Brainstem Response (ABR) – It is an objective hearing test that evaluates your hearing up to its brainstem level. This carefully determines the degree of your hearing loss and at the same time, evaluates the integrity of your hearing nerve.
3. Auditory Steady State Response (ASSR) – It is an objective test that suggests what your hearing threshold is.
4. Otoacoustic Emissions (OAE) – It is a hearing test that assesses your outer hair cells in the cochlea.
5. Tympanometry – It is a test that diagnoses and monitors problems in your middle ear.

When is a child diagnosed with permanent hearing loss?


The medical care of a child with hearing loss is provided by a physician (ENT specialist). The audiologist or hearing instrument specialist provides help in testing, monitoring and fitting of hearing aids and then a speech therapist provides auditory therapy. The goal for children with permanent hearing loss is to optimize auditory abilities to help them with language learning and academic development.

What technological solution/s can I use for my child who may have hearing loss?


In our society today, there is virtually no hearing loss that cannot be aided with the use of appropriate technology. This technology may take the form of a cochlear implant with an electrode which is surgically implanted in the inner ear and an external processor. This option is increasingly utilized in cases of severe to profound hearing loss. In many cases however, the most appropriate choice may be hearing aids. These amplify sounds and can help children of any age.

Hearing aids amplify sound and can be provided at any age. A young child is usually fitted with behindthe-ear (BTE) style. These are placed behind the ear, attached to a custom-fit ear mold, which fit inside the ear canal. These hearing instruments come in a variety of colors and can help a wide range of hearing losses from mild to profound levels. Older children may be candidates for the in-the-ear (ITE) and completely-in-the-canal (CIC) styles hearing instruments which are custom-made to fit inside the ear canal and help with mild-to- severe hearing losses. Another option for older children is external receiver style hearing instruments. The microphone remains in the BTE casing but the receiver is externally placed in the ear canal. This allows the hearing instrument to be smaller and more cosmetically appealing. The decision whether the child should be fit with one or two hearing aids depends mainly on the configuration of the hearing loss.

FM Systems can be additional devices to help in a child’s language development. There are times when hearing aids cannot always guarantee good hearing in many situations. Noise or room acoustics may severely affect hearing. In a classroom, where many children are often speaking at the same time, it might be impossible for the listener with a hearing loss to filter out the background noise. Distance also dramatically reduces intelligibility, as does reverberation and echo. The best way to overcome such problems is to use FM system. It is designed specifically to pick up speech signals directly at the source (ex. teacher) and transmits them clearly and without distortion directly to the user’s ears. At a young age, delivering a very clear speech signal to the child supports the development of language, speech and learning.

It is best to talk to your Audiologist or Hearing Care Professional about what might be suitable for your child.

Information for Adults

What are the causes and types of hearing loss?


Numerous variations of hearing loss occur to people nowadays. And each type of hearing loss is caused by multiple factors. Listed below are five types of hearing and their various causes.

Conductive Hearing Loss is due to some sort of blockage in the outer ear or middle ear, preventing the sound from being conducted normally to the inner ear. Conductive loss results in a loss of loudness. Basically, sounds are not loud enough to be heard well. This can be temporary or permanent depending on what is causing the loss. It is usually temporary and is treatable with medication or surgery.

Some causes of conductive hearing loss include:
        • Otitis media
        • Perforated eardrum
        • Cholesteatoma
        • Otosclerosis
        • Excessive or impacted earwax
        • Collapsed ear canal

Sensorineural Hearing Loss occurs when there are problems with the hair cells and some distortion in processing of sound signals by the brain. Permanent hearing loss is usually referred to as sensorineural hearing loss because it is hard to establish exactly how the cochlea and the brain are contributing to the hearing problem. Sensorineural loss leads not only to a loss of loudness but clarity as well. Sometimes incorrectly referred to as “nerve deafness”, there is generally no medical or surgical help available to correct for sensorineural loss. However, today’s digital hearing instruments can provide significant assistance.

Some causes of sensorineural losses include:
        • Presbycusis – age related
        • Acoustics trauma – sudden exposure to very intense sound
        • Noise induced hearing loss – prolonged exposure to loud noises
        • Genetics
        • Viral infection (eg. measles & mumps)
        • Meniere’s disease
        • Acoustic neuroma
        • Encephalitis
        • Ototoxic / cytotoxic medication
        • Multiple sclerosis
        • Stroke

Sensory Hearing Loss is due to problems with the hair cells in the inner ear. This prevents the cochlea from sensing normal sound.

Neural Hearing Loss occurs when the brain either completely fails to process electrical pulses, or fails to interpret them correctly. The term “auditory dys-syn-chrony” can also be used to describe a neural hearing loss.

Mixed Hearing Loss is a combination of conductive and sensorineural hearing loss. In this type of loss, sound is not being transmitted normally from the outer or middle ear to the inner ear, and there are problems with the inner ear and neural parts of the auditory system.

What are the degrees (levels) of hearing loss?


There are multiple degrees of hearing loss. Generally, the degree of hearing loss is described using one of the five categories: Mild (average from 25 – 40 dbHL), Moderate (average from 45 -60 dbHL), Moderately Severe ( average from 60-75 dbHL), Severe (average from 75 -90 dbHL), Profound ( average above 90dbHL).

What are the types of hearing aids?


There are four types of hearing aids; namely, Behind the Ear (BTE), In the Ear (ITE), Completely in the Canal, and the Receiver in the Ear (RITE) or Canal Receiver Technology (CRT).

Behind the Ear (BTE) hearing aids are suitable for every kind of hearing loss. The sounds pass through a clear plastic tube into an earmold, which is custom-made to fit the ear, so that it looks and feels just right. BTE instruments are slim, and fit neatly behind the ear. They follow the curve of the ear so well that they are often difficult to see.

In the Ear (ITE) hearing aids are worn inside the ear. They are usually suitable for mild to severe hearing losses. They are custom-made to fit the ear exactly.

Completely in the Canal (CIC) hearing aids are smaller in size than the ITE instrument.They are ideal for those who consider cosmetic appearance and aesthetics to be of primary importance.

Receiver in the Ear (RITE) or Canal Receiver technology (CRT) is a smaller sized BTE and one of the greatest innovations in hearing aid design. All RITE hearing aids have their electronics, battery, and microphone inside a casing worn behind the ear (BTE). An ultra-thin, sculpted wire carries the amplified sound to the speaker in the ear canal. Many people prefer this type of hearing aid.

RITE hearing aids has some great benefits:
        • Because of its unique design, it does not fill the ear canal with plastic.
        • A vented tip leaves a passageway in the canal for natural hearing to still access the eardrum.
        • This unique design produces a very natural sound quality as it blends a person’s residual natural hearing with enhanced sounds provided by the hearing instrument.
        • Its wonderful design makes it virtually unnoticeable.
        • RITE designs applied both mini-BTE and standard BTE design.

Why wear two hearing aids?


It is best to wear two hearing aids, referred to as binaural amplification, for they provide the following benefits:
        • Localization – determining where sound is coming from
        • Improved hearing in noisy environment
        • Improved sound quality
        • Requires less volume so listening is more comfortable and less tiring