What is an Audiologist?

Audiologists are the primary health-care professionals who evaluate, diagnose, treat and manage hearing loss and balance disorders in adults and children.

How do you know if someone has hearing loss?

Often a spouse, relative, friend or business associate is the first to notice a hearing loss. Initially, those who interact with the hearing impaired person often remark, "he doesn't pay attention", or "he ignores me." As time progresses, it is not uncommon for interpersonal relationships to become strained and for family members and friends to become frustrated and even angry at the hearing impaired individual.

In the meantime, the hearing impaired person is going through emotional changes, which usually occur in stages. Being aware of these emotional stages, and the behaviors associated with them, will help you to better grasp how that person is dealing with their hearing loss and at what stage they are in relative to seeking help. This is important if you want to help them move toward help.

What are the stages of hearing loss?

The first stage is denial, which can take two forms: (1) the person doesn't believe he/she has a hearing problem, and/or (2) the person cannot talk about the hearing problem. It is characterized by placing blame or responsibility on others. "I don't have a problem. They mumble. They don't speak clearly. They talk too fast." are common comments during this stage. Denial is usually temporary, and it's important to acknowledge the person's fears and uncertainties. Be reassuring and supportive to help them move toward treatment.

Withdrawal often occurs after denial, since the person simply doesn't expose him or herself to situations where hearing is difficult.

Anger is the next stage. You may notice that the hearing impaired person is "grouchy" or "has become difficult to live with." Hearing impaired people may become less tolerant of others because of the comments, frustration, jokes and anger that have been directed at them. They are angry about the loss and how they are treated when they respond incorrectly or inappropriately in conversations with others. Respond with understanding and compassion.

Bargaining for just one more day of normal hearing or one more day of not having to deal with their problem is the most private stage of the process. Often, it will not be visible to others, including family members. It may stem from guilt that the loss could have been prevented or from being unable to do things that they could in the past. At this stage, they are not ready to accept help for their hearing loss.

Loss of self-esteem, difficulty in doing today what was easy yesterday, suspicion of others, social isolation and loneliness are all part of the depression stage. Making sure the hearing impaired individual is included in conversations, activities and decisions can help to prevent or shorten this stage.

The last stage is acceptance, when the individual admits he/she has a hearing loss and is ready to seek treatment — including hearing instruments, aural rehabilitation and auditory training.

What are the different types of hearing loss?

There are a few different types of hearing loss: conductive, sensory, mixed (conductive and sensory combined), and neural.

Conductive Hearing Loss. This happens when there is a problem with a part of the outer or middle ear. Most kids with conductive hearing loss have a mild hearing loss and it is usually temporary because in most cases medical treatment can help. Examples of conditions that may cause a conductive hearing loss include: *Conditions associated with middle ear pathology such as fluid in the middle ear from colds, allergies (serous otitis media), poor eustachian tube function, ear infection (otitis media), perforated eardrum, benign tumors *Impacted earwax (cerumen) *Infection in the ear canal (external otitis) *Presence of a foreign body *Absence or malformation of the outer ear, ear canal, or middle ear

Sensorineural Hearing Loss. This happens when the cochlea is not working correctly because the tiny hair cells are damaged or destroyed. Depending on the loss, a kid may be able to hear most sounds (although they would be muffled); may be able to hear in quiet but not in noise; only some sounds; or no sounds at all. Sensory hearing impairment is almost always permanent and a kid’s ability to talk normally may be affected. Sensorineural hearing loss not only involves a reduction in sound level, or ability to hear faint sounds, but also affects speech understanding, or ability to hear clearly. Sensorineural hearing loss can be caused by diseases, birth injury, drugs that are toxic to the auditory system, and genetic syndromes. Sensorineural hearing loss may also occur as a result of noise exposure, viruses, head trauma, aging, and tumors.

Mixed Hearing Loss. Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss. In other words, there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve. When this occurs, the hearing loss is referred to as a mixed hearing loss.

Unilateral Hearing Loss (UHL).  UHL means that hearing is normal in one ear but there is hearing loss in the other ear. The hearing loss can range from mild to very severe. Approximately one out of 1000 children is born with UHL. Unilateral hearing loss can occur in both adults and children. Nearly 3% of school-aged children have UHL.  Children with UHL are at higher risk for having academic, speech/language and social/emotional difficulties than their normal hearing peers. Some children with UHL experience these difficulties but others do not. Many times we do not know the cause of hearing loss.

How can hearing aids help?

Hearing aids are primarily useful in improving the hearing and speech comprehension of people who have hearing loss that results from damage to the small sensory cells in the inner ear, called hair cells. This type of hearing loss is called sensorineural hearing loss. The damage can occur as a result of disease, aging, or injury from noise or certain medicines.

A hearing aid magnifies sound vibrations entering the ear. Surviving hair cells detect the larger vibrations and convert them into neural signals that are passed along to the brain. The greater the damage to a person’s hair cells, the more severe the hearing loss, and the greater the hearing aid amplification needed to make up the difference. However, there are practical limits to the amount of amplification a hearing aid can provide. In addition, if the inner ear is too damaged, even large vibrations will not be converted into neural signals. In this situation, a hearing aid would be ineffective.

Is financial assistance available for hearing aids?

Hearing aids are generally not covered by health insurance companies, although some do. Medicare does not cover hearing aids; however, diagnostic evaluations are covered if they are ordered by a physician for the purpose of assisting the physician in developing a treatment plan.

For eligible adults, Medicaid will pay for the diagnosis and treatment of hearing loss and a single hearing aid.

For eligible children, Medicaid will pay for the diagnosis and treatment of hearing loss, including 2 hearing aids, under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service. Also, children may be covered by First Steps (birth-3).

Some nonprofit organizations provide financial assistance for hearing aids, while others may help provide used or refurbished aids. Contact our office for further information regarding financial assistance programs for hearing.