Patient education: Tools for people with hearing loss (The Basics)

What is hearing loss? — 

This is when a person cannot hear as well as usual in 1 or both ears. Some people with hearing loss can hear some but not all sounds. Others cannot hear at all.

Some babies are born with hearing loss. For others, hearing loss starts later in life.

Sometimes, hearing loss is temporary, for example, while a person has an ear infection. Other times, it is a lifelong condition.

There are tools that can help people with permanent hearing loss.

What are tools for people with hearing loss? — 

These are devices and software (called "hearing assistive technology") as well as skills to help people with permanent hearing loss:

●Communicate

●Understand certain sounds, such as speech, music, and fire alarms

Some of the most common tools include hearing aids and cochlear implants. Most of these use a person's remaining hearing to help them hear better. They cannot completely return their hearing. But they can make certain daily activities easier.

Your or your child's doctor and a hearing specialist (called an "audiologist") can help you decide if these might work for you or your child. The best device for you or your child depends on many things, including how severe the hearing loss is and the type of hearing loss. In some cases, it also depends on your or your child's age.

There are many other tools to help with hearing loss. These include other devices and software to help with daily activities, as well as sign language. These can often be used along with hearing aids and implants.

What are hearing aids? — 

These are devices that help you (or your child) hear by taking sounds and playing them more loudly into the ear.

●Hearing aids can help people with any type of hearing loss. But they do not work for everyone.

●Hearing aids can help you hear some sounds you cannot normally hear. But you might not be able to hear, or have a hard time hearing, certain things even when wearing hearing aids.

●You can get 1 or 2 hearing aids, depending on if you have hearing loss in 1 or both ears.

●Hearing aids go in or around the ear. There are different types you can choose from. Some people worry about other people seeing their hearing aids. If you do not want people to know you use hearing aids, some options are smaller or less noticeable.

●An audiologist can help you put on your hearing aids for the first time. They can also help you learn how to use them. It can be frustrating to learn how to use a new device. If you have trouble with your hearing aids, talk to your doctor, nurse, or audiologist.

Some hearing aids can be bought at a pharmacy without a prescription. These are best for people who cannot get hearing aids prescribed by their doctor. They are usually used by people with only mild hearing loss. They might be a less expensive option if your health insurance does not cover prescription hearing aids.

Another option, called a "bone conduction" hearing aid, uses vibrations to help a person hear. A headband holds the device is held against the skull. The device turns sounds into vibrations, which travel through the skull to the inner ear for the person to "hear."

What are implantable hearing devices? — 

These are devices that are placed, or "implanted," to improve certain types of hearing loss. In general:

●They can help people with any type of hearing loss.

●These are a good option for people whose hearing loss is not helped by hearing aids.

●People with hearing loss in both ears can get an implant in 1 or both ears. Those with hearing loss in only 1 ear can get an implant in only the affected ear.

●The devices are implanted during surgery. In general, the surgeon makes a cut ("incision)" in the scalp to implant the device.

●After surgery, you or your child will need to work with an audiologist to learn how to hear using the implant. This usually takes several months.

Examples of implantable hearing devices include:

●Cochlear implant (figure 1) – This is a device that is implanted into a part of the inner ear called the "cochlea."

•There is a removable part that sits around the ear or on the scalp. It detects sounds, turns them into electrical signals, and sends them to the cochlea through a small device called an "electrode." The cochlea then sends these signals to the brain for the person to "hear."

•People of all ages can get cochlear implants, including babies.

●Bone-anchored hearing aid, or "BAHA" – This is a small metal device that is implanted into the skull.

•There is a removable part that sits on the scalp. It detects sounds, turns them into vibrations, and sends them into the skull. The sounds travel through the skull to the cochlea for the person to "hear."

•A BAHA is a good option for people with conductive hearing loss or mixed hearing loss.

•In general, people over the age of 6 years can get a BAHA. This is because the skull needs to be big enough for the implant to work.

What are some other types of hearing assistive technology? — 

There are other devices and software that can be used in daily activities to help with hearing loss. Examples include:

●Assistive listening systems and devices – These are types of technology that can help you or your child hear better. They work by reducing background noises or making the thing you want to hear louder. Some systems, such as "infrared systems" and "FM systems," work for 1-on-1 conversations and in large areas like a theater or museum. These systems can be helpful in noisy or busy places. Many of them have several listening modes depending on your surroundings, and some can change the mode automatically. Other devices, such as "amplified telephones," can be used to help with phone calls.

●Alerting devices – These use visual or physical signals, such as a flash of light or vibration, to tell you or your child when a specific event happens. Examples of events these devices can alert you to include when the doorbell rings, a smoke alarm goes off, a door in your home opens, or a child is active.

●Text telephones – These are devices that can turn phone conversations into text. This lets you or your child read what a person says. Some also let you type back a message. You or your child can also speak in response.

●Captioning – This uses written text to describe all audio information, such as speech, music, and sound effects. You might have seen these when watching TV or movies. These can also be used during performances and telehealth appointments.

What is sign language? — 

This is a way of communicating using gestures and signs. Some people use sign language along with devices to help them hear. Others might only use sign language.

You can learn more about American Sign Language through organizations such as the National Association of the Deaf. Their website is www.nad.org.

Where can I learn more? — 

You can get more information about hearing loss and tools that can help from many organizations. Here are some places to start:

●My Deaf Child has free sign language lessons for parents of children with hearing loss – Their website is www.mydeafchild.org/resources.

●American Speech-Language-Hearing Association has more information about hearing loss and tools that can help – Their website is www.asha.org/aud/pei.

More on this topic

Patient education: Cochlear implant in children (The Basics)
Patient education: Hearing loss in adults (The Basics)
Patient education: Hearing loss in children (The Basics)
Patient education: Audiometry (The Basics)