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What is Auditory Training and Why is it Important?

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:

  1. You are still avoiding noisy restaurants
  2. You are asking family members to repeat themselves more often
  3. 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:

  • AngelSound
  • Soundscape
  • Hear Coach

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.

Assistive Technology For Patients with Hearing Loss

In addition to hearing aids, cochlear implants, and osseointegrated implants, there are other devices on the market to help those who are hearing impaired. Devices such as amplified phones, lighted door bells, and amplified alarm clocks are just a few of these options.

For anyone with hearing loss, the telephone can be quite a difficult task. Two options that can help ease this stress are 1. Amplified telephones and 2. Captioned Telephones.  There are many national companies that provide captioned telephones to patients with hearing loss. Captioned telephones go through a transcription service to write out what is being said on a screen. Patients can then read what the other person is saying. Any audiologist or medical provider can certify a patient’s hearing loss.

*Check out CaptionCall.com for more information.

Devices such as amplified alarm clocks also have features such as a “bed shaker” that sends a small vibration at the alarm time. Patients have also utilized smart watches with a vibration feature for alarms.

*Check out Diglo.com for more assistive technology for patients with hearing loss

Hearing Aid Issues?

If you wear hearing aids and continue to struggle to understand your friends and family you may be wondering where to turn. There may be a few reasons why you find yourself asking others to repeat despite the use of your hearing aids

  • Hearing aids may be in need of cleaning or reprogramming.
    • Wax build-up in a hearing aid can cause the hearing aid to sound muffled leading to difficulty hearing. It is also possible the hearing itself has decreased and the hearing aids are no longer set to the level needed to hear your best.
  • Realistic expectations
    • A common belief is that when someone wears hearing aids they will be able to hear normally. Hearing aids amplify sound which allows easier hearing, but they do not replace normal hearing. This means that you may still miss out on words especially when in a noisy room or when the talker is standing far away or behind you.
  • Severe hearing loss
    • Hearing aids amplify sound and then the sound travels to the organ of hearing (the cochlea) which stimulates the hearing nerve. If the cochlea has a lot of damage sound will likely be distorted and unclear even when amplified.
    • In this case you may receive more benefit from a cochlear implant than a hearing aid. A cochlear implant directly stimulates the hearing nerve and bypasses the portion of the cochlea that has been damaged. With time and therapy this leads to clearer sound.

If you wear hearing aids and feel that you are still not hearing your best give our office a call at 904-399-0350 to further evaluate your hearing and treatment options. Perhaps it is as simple as cleaning and updating the hearing aid settings or perhaps your hearing has declined to a level where a hearing aid can no longer provide benefit. 

Noisy Toys and How to Protect your Children’s Ears

It’s finally the holiday season and everyone is excited for good food, (socially distant) gatherings, and presents, unless that is, you have young children with noisy toys constantly playing throughout your house. Although most parents can attest to how loud their children’s toys are, you may not know just EXACTLY how loud. 

The Arizona Commission for Deaf and Hard of Hearing (ACDHH) and the Sight and Hearing Association are two of many organizations that put out an annual list of noisy toys for the holiday season. There are toys on their list that have been tested and shown to have an output of 103 dB! Measurements were taken as if a child had their ear next to the speaker, which is very realistic as anyone with young children would know.  According to the American Speech Language Hearing Association and the American Academy of Audiology, 85 dB is the loudest that a child should be exposure to.  For reference, the Occupational Safety and Health Administration (OSHA) notes that exposure to 90 dB for 8 hours a day is considered a “permissible noise exposure”.  The permissible time of exposure for a 100 dB sound is only 2 hours. Many of theses toys are actually labeled as educational toys.

Here are some tips for testing to see if toys are too loud:

  • Test the toys prior to buying. Many toys have a “TRY ME” button
  • Hold the toy relatively close to your own ear and see if you think it is too loud

Ways to Reduce Volume

  • If there is a volume control, make sure it is set at the lowest volume
  • Put waterproof tape or glue over the speaker to dampen the sound
  • Put tape over the volume control to prevent your child from changing the volume.

The below list was organized by The Arizona Commission for Deaf and Hard of Hearing (ACDHH):

Hearing Loss and the Holidays

With everything going on during the holiday season, it’s easy to forget that some people struggle during holiday get-togethers for various reasons. One recent online study shows that 50% of families will host at least one person with hearing loss at their holiday table. For these loved ones, the holidays can be isolating and frustrating, because they don’t feel included in the celebration.

Here are some suggestions to help you have a hearing-friendly holiday:

  1. Minimize background noise. Skip the holiday music or television in the background. Background noise can make it difficult to hear. Consider having rowdy football fans enjoy the game in a different room.
  2. Pay attention to seating. Seat the individual with hearing loss at the head of the dinner table or middle of the table, making it easier for them to see all the guests’ faces. Round tables enable easy viewing for everyone. When setting your table, try decorating with shorter centerpieces to avoid blocking sightlines.
  3. Rephrase, don’t repeat. Instead of repeating the same words, try rephrasing. It’s very likely when someone with hearing loss mentions they can’t hear you; they may be having trouble understanding a specific word or phrase. This approach draws less attention to the individual with hearing loss by keeping the conversation more natural. For those uneasy or self-conscious about hearing loss, this will be appreciated.
  4. Skip the mood lighting. A well-lit room helps those with hearing loss see the mouths and facial expressions of those speaking.
  5. Capture attention. Look directly at the person with hearing loss when speaking to them, so they can see your mouth and facial expressions. To get their attention, gently touch them on the hand, arm or shoulder, or say their name before starting to speak.
  6. Speak clearly. Be deliberate while speaking clearly. Be careful to project, but don’t shout. Keep your hands away from your face when speaking. Avoid disturbances which make following a conversation more difficult.
  7. Ask how you can help. Be respectful and discrete by taking aside the individual with hearing loss and asking if there’s anything you can do to make their visit easier. Demonstrate understanding and compassion, and you’ll be an example of the true meaning of holiday spirit.

If you’re concerned about possible hearing loss for you or a loved one, consider scheduling a consultation with one of our audiologists.

Happy Holidays from JHBI!

Everyone at Jacksonville Hearing and Balance Institute would like to wish you a happy holidays!


See below for a message from Dr. Green!


Congratulations Dr. Judy Nelson!

Judy Nelson, one of our physician assistants, has been a member of the Jacksonville Hearing and Balance Institute team since 2003. Her care and compassion is well-known by her patients. We are very proud to say that in addition to having more than 36 years of experience, she has recently completed her Doctor of Medical Science degree through the University of Lynchburg, with a specialty in Neurotology.  

Congratulations Judy Nelson, DMSc, PA-C!

Judy Nelson, MPAS, PA-C

Dr. Nelson works with patients with dizziness, vertigo, imbalance and hearing loss. If you would like to schedule an appointment, please call us at 904-399-0350.

Hearing Loss in the Time of Covid-19

Communication difficulties have increased since the start of the Covid-19 Pandemic in March with the addition of masks to everyday life. A major part of the connection that we make with others depends on our facial expressions. They are universal – a smile is a smile in every culture and language. Even those who are not hard of hearing can find communicating, while wearing a cloth facemask, difficult.

Having a hearing loss makes even the easiest listening environments difficult to understand conversation. Those who are deaf or hard of hearing often rely on reading lips to communicate. Wearing a mask is one of the recommended strategies to mitigate the current global pandemic, and facemasks that cover the mouth can be a challenging and frustrating barrier. Covering the bottom part of one’s face and mouth makes communication more difficult, especially for persons who are hearing impaired or older adults.

Wearing a transparent mask that allows your mouth to be viewed is a beneficial option to allow those with a significant hearing loss to be better able to understand conversation. Clear face masks make it possible for us to communicate more effectively and maintain that human connection, while still practicing the protective measures necessary during this global pandemic.

Clear face masks can be found from many online websites such as www.Walmart.com, www.Etsy.com, and Safe’N’Clear, Inc. – The only FDA approved mask with clear window made in the USA

5 Tips for Wearing Your Hearing Aids with a Face Mask

With the COVID-19 pandemic, the CDC recommends wearing face masks in public to prevent the spread of the virus. For individuals who wear behind-the-ear hearing aids, the use of a face mask with elastic worn around the ears can cause irritation on the ear, as well as an increased risk of losing the hearing aid. Adults or children may forg​et they are wearing hearing aids. Then, when a face mask is removed, it can cause the hearing aids to come off or be lost.

Here are five solutions that may help prevent problems when wearing hearing aids and face masks:

  1. Pull back any long hair into a bun or with an elastic tie.
  2. Rather than looping the elastic of the mask on the ears, utilize a mask extender. This can be home made (with ribbon and buttons) which can be made or bought offline.
  3. Obtain a mask that has four strings and ties behind the head rather than worn with elastic on the ears.
  4. Check that the hearing aid is still in plac​e during and following removal of the mask.
  5. Remove your mask at home in an open area. This is so that if the hearing aids fall to the ground, they can be found more easily.

If your hearing aid is compatible with a smart phone, you may be able to use a phone app to help detect a lost hearing aid. In gener​al, the app indicates the last time the hearing aid and phone ​were connected. If you have lost or broken your hearing aid, contact the Hearing Center at 904-399-0350 to find out if you are eligible for a replacement device.

Advancements in Bone-Anchored Hearing Technology

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.

The external Osia speech processor and Osia implant from Cochlear Americas.

To learn more about the Osia system and if it may be a good option for you, visit https://www.cochlear.com/us/en/home/products-and-accessories/cochlear-osia-system/osia-2 or schedule an appointment at Jacksonville Hearing and Balance Institute at 904-399-0350.