April 30, 2013

Ask the Audiologist – The Trouble with Background Noise

By Rachel King, Au.D., CCC-A
Audiology Consultants, P.C.

A very common statement I hear from hearing aid users is that even though they have hearing aids, they still don’t hear well in background noise. This is probably the biggest difficulty with hearing loss and hearing aids. What I mean by background noise is usually chatter in places like restaurants and parties, fan noise, TV noise, music, or any other type of noises that are going on at the same time you are trying to hold a conversation. The most difficult of these is probably chatter, or other conversations that you don’t want to listen to. Here is an illustration I use to help explain why this is so difficult.

Imagine doing a Jigsaw puzzle. You have your border and some of the middle pieces put together, so you can start to make out what the picture is, but it isn’t complete. You have your pile of pieces that you know fit somewhere in that puzzle and will help make the picture clearer. The more pieces you fit into place, the easier it is to complete the puzzle, or even guess what the picture is. This is kind of like listening to conversation in a quiet situation with some hearing loss. It is somewhat easy to figure out what someone is saying in this situation. Our brain knows what words are supposed to sound like, so when the ears aren’t giving it all the information it needs, the brain starts looking for ways to fill in the missing information. We do this by using our eyes to get clues from the face of the person that we are trying to communicate with. The brain also uses clues from the context of what information it is getting from the hearing loss. This is like the pile of puzzle pieces. The more severe your hearing loss, the fewer pieces you have completed to be able to guess what is being said, and the more pieces you have to try to fit from the other clues. Hearing aids help complete more of the puzzle for the brain, making it a little easier to fit the remaining pieces from the pile. Now, go back to doing your Jigsaw puzzle. Imagine as you are trying to complete your puzzle. Other people come by with their own puzzle pieces and dump them into your pile of pieces. Just how easy is it going to be for you to complete your puzzle? You now not only have to figure out where pieces go, you have to figure out which pieces even belong in your puzzle, and which ones don’t. This is a lot like what it is to understand conversation in background noise.

Different technology in hearing aids can help with sorting out some of those pieces that don’t belong. An audiologist can help you determine which technology is going to be the most helpful for you in the specific situations you struggle with. Your audiologist will also make sure your hearing aid is fitting properly and is programmed properly. Some important things to keep in mind, though, are that 1) that even the best hearing aids are not the same as having perfect hearing, and 2) there are times where even people with normal hearing struggle to understand in background noise. Audiologists are trained to help you develop strategies to more effectively communicate in these challenging situations. Hearing aids are only one tool we use in communication. You need all possible tools to help you have the best success with your hearing!