Hearing loss most often physically occurs in the ear but also affects our brain and how we interpret and understand sounds, especially speech sounds. The use of hearings aids and cochlear implants help us to detect sounds easier but it is important to help re-train the brain to better understand sounds and make sense of the information sent through the devices.
For us to optimally understand conversation, our working memory is used to recall words and their context. Also, when a hearing loss is present, our brains have a hard time understanding the conversation because they cannot accurately interpret the information fast enough. Both of these characteristics have also been shown to decrease as we age.
Those with even a mild hearing loss and good speech understanding have experienced difficulty hearing conversations in noise. The hearing loss is causing ours brain to work harder to filter out the pertinent speech information from the background noise.
Auditory training is also referred to as “aural rehabilitation” and “hearing exercises”. The goal of auditory training is to help improve working memory and increase auditory processing speed. Hearing aid users who practiced auditory training, specifically hearing speech against background noise, for 3 hours a week were able to correctly identify 25% more words in sentences than when they started. It may be time to consider auditory training if any of the following applies when also wearing devices:
You are still avoiding noisy restaurants
You are asking family members to repeat themselves more often
Feeling fatigued after a conversation or being in a noisy listening environment
Auditory training can be done at home with a program set up by your audiologist or completed through apps available on smartphones, tablets, and computers. These programs are designed to act like a game so it is interactive and fun to do. Examples of some apps are:
If downloading an app isn’t the user’s preference, other ideas for auditory training include listening to audiobooks and having practice conversations with family members.
A bone-anchored hearing device (BAHD), also known as a bone-anchored hearing aid (BAHA), is made up of a surgically placed implant and a removable external processor. These devices are unique in that they send signals to your inner ear via vibrations. These vibrations are interpreted by your inner ear the same as any other sound signal. Patients with middle ear issues (chronic ear infections, previous surgeries, etc.) are often successful users of a BAHD because it bypasses the middle ear and directly stimulates the inner ear. The device is also beneficial for those with single-sided deafness. The BAHD is placed on the side of the head with the severe-to-profound hearing loss and the signal is sent to the better hearing ear.
One of the manufacturers of these devices, Cochlear Americas, has recently released a new bone-anchored hearing solution. The Cochlear Osia System utilizes a lightweight external processor and an osseointegrated implanted. The external speech processor is worn on the head via a magnetic connection with the implant under the skin.
Hear your best this holiday season with some helpful tips
from Cochlear Americas.
Prepare yourself. Make sure you’re hearing your best
before you gather with family and friends. Schedule an appointment with a
hearing specialist to explore what hearing treatment options will work best for
you or to fine-tune your current hearing device.
Plan ahead! Identify the best listening areas in a
room, such as a quiet corner. If attending an event, take advantage of
accessibility equipment offered. When sitting down for dinner, choose a seat
that works best for your hearing, possibly away from background noise and against
Travel smart. If you currently use a hearing device,
remember to bring extra batteries, chargers, remotes and accessories. You
should not need to remove hearing devices for security checkpoints. Take
advantage of visual alerts and hearing accessible accommodations. Pack any
equipment you bring for your hearing device in carry-on luggage.
Educate your loved ones. It is important that your
family and friends understand your hearing loss. They want you to take part in
the conversation and have fun too! Share tips with your loved ones on how to
best include those with hearing loss in the conversation including:
at a slower rate and at a normal volume
your attention before they begin speaking
eye contact throughout a conversation to take advantage of visual cues
During this holiday season all of us at JHBI and our Hearing Center pause to give thanks to our patients and their families, especially Veterans for their service to protect our freedoms. We’re grateful to all patients for putting their trust in us to help them hear better, especially those with severe hearing loss.
Also, we thank Clay Today* newspaper for an informative story on our patient, retired Navy Captain Mark Adrick, who had a Cochlear® implant surgically inserted to improve severe hearing loss. After decades of flying helicopters and airplanes, his hearing was completely lost. Most severe hearing loss patients have no idea about the lifelong effects of extended loud noises and how it damages the inner ear’s cochlear nerve and surrounding tissues, sometimes beyond repair.
As we count our blessings this holiday season, we wish to thank our patients and their families for trusting us to give the best hearing care possible to improve the quality of life. We wish you and your family a healthy and happy holiday season.
For people with hearing loss, restaurants can be a challenging listening environment when trying to converse with family and loved ones. In a recent article in the Washington Post, Joyce Cohen explains the frustrations often felt by many while eating out. Though it may seem like there is little you could do to improve your ability to hear in challenging listening environments, there are some changes you could make to help limit the effect of background noise.
1. Choose your restaurant carefully. Modern restaurants often have high ceilings and hard cervices that often reflect noise instead of absorbing it. The more echo and reverberation present, the more difficult it is to understand speech. It is also important to choose a restaurant that has good lightening. Non-verbal cues such as lip reading, facial expressions and body language aid spoken language to help you understand others.
2. Booths are better than tables. The high backs of booths will block some of the environmental sounds that can drown out your conversation. In addition, booth seating is typically made of softer material that can absorb background noise.
3. Sit along the edges of the dining area. By sitting around the perimeter of the room you will avoid having outside noise bombard you from all directions and will allow you to focus on those you want to converse with most.
4. Sit Away from the Kitchen. Kitchens are often the noisiest places in the restaurant. Many open concept kitchens in modern restaurants give off noise pollution to the general sitting area. By choosing a place away from the kitchen, you are able to minimize it’s effect.
For more tips on how to deal with background noise and to learn more about your hearing loss contact Jacksonville Hearing and Balance Institute. Click on the link below to read Joyce Cohen’s article from the Washington Post.
WJCT Public Media and Jacksonville Hearing & Balance Institute are hosting this free informative seminar. Learn about identifying and treating vertigo/dizziness and surgical and non-surgical treatment options.
This event will take place at WJCT studios, 100 Festival Park Avenue Jacksonville, FL 32202.
This event is FREE but seating is limited and reservations are required. Lunch will be provided. Register today by calling 904-358-6322!
Are your hearing aids no longer the best solution for your hearing loss?
Jacksonville Hearing and Balance Institute has teamed up with Cochlear Americas and WJCT to discuss cochlear implants with the community. Attendees will be given the opportunity to meet with members of the Jacksonville Hearing and Balance Institute and Cochlear Americas team. At the event, there will be cochlear implant devices and accessories that can be viewed and held by the public. Lunch will be provided to those that RSVP prior to November 6th.
Please see below for further details.
Hearing loss can be a problem for the whole family, not just the individual. Below are a few strategies that can help with effective communication at home:
Maintain eye contact : Face the speaker and maintain eye contact. Facial expressions and body language add vital information to communication
Gain attention: Gain the listener’s attention before you begin talking. If the person with hearing loss hears better from one ear, move to that side of the person.
Keep hands away from face: When talking, try to keep your hands a way from your face. You will produce clearer speech and allow the listener to make use of those visual cues.
Speak naturally: Speak distinctly, but without exaggeration. You do not need to shout. Shouting may actually distort the words. Try not to mumble. Speak at a normal rate, not too fast or too slow. Use pauses rather than slow speech to give the person time to process what you are saying.
Rephrase rather than repeat: If the listener has difficulty understanding something you said, find a different way of saying it. If he or she did not understand the words the first time, it’s likely he or she will not understand the words the second time.
Converse away from background noise: Try to reduce background noise if possible. Turn off radio or television. Move to a quiet space away from the noise source. When going to a restaurant, ask for a table away from the kitchen, server stations, or large parties.
Move to an area with good lighting: Sit where there is good lighting so that your face can be more easily seen. Avoid strong lighting coming from behind you, such as through a window.
A cochlear implant can be a life changing treatment for people with severe hearing loss who receive little benefit from hearing aids. An important component of the cochlear implant process is to approach the first several weeks after activation with realistic expectations, commitment and patience. A cochlear implant is designed to bypass the damaged hair cells of the hearing organ, the cochlea, and deliver sounds to the brain by directly stimulating the auditory nerve. The brain then interprets the sound as a meaningful message. This mechanism is very different than the way our natural hearing system is designed so right away the brain is unable to recognize the sounds delivered by the cochlear implant. The good news is that the brain is an amazing organ and capable of learning new things all the time. The brain will learn to recognize speech and environmental sounds with exposure, experience and practice.
Exposure: Once the cochlear implant is activated the brain needs to hear sound in order to begin to learn to adapt. Although conversation will likely sound strange and unclear at first the only way to make progress is to expose yourself to all kinds of sound; conversation, music, environmental sounds…anything!
Experience: A key part of cochlear implant process is experience; wearing the cochlear implant all day every day, allows speech and other sounds to become more pleasant and clear. Think of the adjustment to a cochlear implant as being a marathon rather than a sprint.
Practice: Finally practice, practice, practice! Similar to completing physical therapy exercises at home following a hip replacement surgery, listening therapy must be completed to teach the brain to listen with a cochlear implant. There are many types of listening exercises that can make practice enjoyable. These can be done on your own or with a partner.
Keep in mind everyone progresses at their own pace, have patience with the process and know that the benefits will be worth the journey.
Synesthesia is a neurological phenomenon in which two or more senses interact; stimulation of one sensory or cognitive pathway leads to automatic, involuntary experiences in a second sensory or cognitive pathway. One of the most common forms of synesthesia is grapheme-color synesthesia, in which people perceive individual letters of the alphabet and numbers to be “shaded” with a color. Other forms of synesthesia include correlating sounds with scents, sounds with shapes, or sounds with taste. This brings us back to: sound and taste, where is the connection?
Sound and Taste
Although not directly described as synesthesia, Charles Spence, an experimental psychologist at the University of Oxford has devoted much of his career specializing in research about the integration of information across the different senses. His work helps to explain why food can be more or less enjoyable depending on environmental features/atmosphere, colors, or in this case, sounds. Some of his most noteworthy work relates to how our perception of taste is effected by other sensory modalities, say sound, for example. As Spence writes, “Many of the food properties that we all find highly desirable – think crispy, crackly, crunchy, carbonated, creamy, and of course, squeaky (like halloumi cheese) – depend, at least in part, on what we hear”. Perhaps his most notable experiment in the field of cross-modal research was “The Role of Auditory Cues in Modulating the Perceived Crispness and Staleness of Potato Chips,” published in the Journal of Sensory Studies in 2004. From this research, Spence concluded that food can taste different depending on changes in sound. In general, higher pitched crisps with more crunch were reported to be more fresh and more desirable in taste. More recently, he found that higher-pitched music enhances sweetness. The evidence shows that when people are asked to match tastes with a specific pitch or musical instrument, the majority of people will match sweet-tasting foods with sounds having a higher pitch and the sound of the piano while matching bitter-tasting foods with lower pitched sounds and the sound of a brass instrument. Another thought: Ever think about why tomato juice or a Bloody Mary is more appealing on an airplane? Spence explains that the 5th flavor of taste, umami—a meaty, protein-like flavor described by the Japanese is actually enhanced in flight. According to research done by Spence, the loud engine noise of the plane at upwards of 85 decibels can influence how you taste food and beverage. It tends to suppress sweet and salty whilst enhancing umami, thus, you choose to drink tomato juice. Many drink options on planes tend to be sweet, hence juice and soda. Tomato juice is one of the only savory options. In fact, the German airline Lufthansa estimates people consume about as much tomato juice as beer aboard its flights! Spence’s suggestion to make more things taste appealing in air is to simply use noise-cancelling headphones. There is also work being done looking at different music people listen to on flights and how that can possibly contribute to how things taste. More work is being done in this area related to how restaurants can use sound to enhance the dining experience and food and beverage companies can utilize sound to better market their products.
The Hearing Center At JHBI Proudly Serves Patients In Jacksonville (Jax), Jacksonville Beach, Neptune Beach, Atlantic Beach, Mandarin, Ortega, Ponte Vedra Beach, Flagler Beach, Fernandina Beach, Amelia Island, St. Augustine, St. Augustine Beach, Orange Park, Macclenny, Middleburg, St. Johns, St. Marys, Waycross, Nocatee, Vilano Beach, Green Cove Springs, Middleburg, Jacksonville Beach.