By Chun-Yi Lin, and Kuei-Ju Lin
Anyone with no experience with hearing loss may not know exactly how a child’s hearing is affected, what makes hearing easier, or how to get along with the hearing-impaired individuals. However, as long as we are willing to understand the facts about hearing loss, each of us can assist in improving the lives of people with hearing loss.
Hearing loss ≠ myopia: Patients with these conditions need to wear assistive technology, but the aided performances are quite different!
"You cannot hear me even when I am next to you?" The teacher asked Huang (an 8-year-old boy who wears bilateral hearing aids) with sarcastic voices in front of all the classmates. The teacher apparently believes that Huang has been wearing hearing aids, and he should be able to hear well like a normal-hearing person. Therefore, the teacher refused to wear FM system in class. Huang was frightened by the scenes of chaos and he refused to go to school again.
Hearing loss is often compared to myopia (shortsightedness), in that hearing aids (HAs) and cochlear implants (CIs), like glasses, can correct sensory function. However, this comparison often leads to misunderstanding of hearing impairment; corrected hearing is not always the same as corrected vision. Particularly, hearing-impaired people sometimes have difficulty achieving fluent communication because of environmental sounds, reverberation, and sounds coming from varying distances, to cite a few (Fleming, Giordano, Caldara & Belin, 2014).
Even if the HA or CI is adjusted appropriately, these devices are still not the same as the normal-functioning ears. The individual differences and learning demands of hearing-impaired listeners are not simply measured or predicted in decibels.
“Hearing” ≠ “listening clearly” ≠ “comprehending” or “communicating”
“My child had already worn his hearing aids, why he cannot understand my words?” a mother asked, and she thought her child should understand everything she said.
“When my student wears hearing aids, he seems aware I am talking to him, but he still cannot give me the correct answer for what I am asking. Are the hearing aids useful?” A teacher wonders.
HAs or CIs adjustments mainly depend on the individual's detection of sounds. However, the ability to hear is not the same as hearing clearly. For example, when a person with hearing impairment can hear the words “white” and “wine” at 50 dB HL, he or she cannot necessarily distinguish these two words correctly at 50 dB HL. That’s why, we can observe some children to be able to detect sounds but unable to identify the right word/s spoken.
Comprehension is the reception of information, meaning, and intent, and communication is the two-way transfer of meaningful information (Kiessling et al., 2003). Although daily communication seems straightforward, people with hearing loss need to grapple with many factors like the effectiveness of HAs or CIs, their hearing and speech abilities, a speaker's accent, intelligibility, rate of speech, and noise and distance, which can make communication more challenging (Howell, 2008; Kilman, Zekveld, Hällgren & Rönnberg, 2014).
Hearing voices and listening to the messages they convey clearly are the basic elements of comprehension and communication (as shown in Fig. 1). For instance, in school, if a student says "fidget spinner" to a hearing-impaired child, words that the latter may have never heard before, the hearing-impaired child may have trouble communicating because he or she does not comprehend the meaning of the words.
Language develops quickly and many new vocabularies emerge in our daily lives. Listening clearly is never enough for hearing-impaired people. The essential step is to comprehend the meaning of the content. Building up a two-way communication requires that the speaker and the listener both understand their conversation content. Thus, it’s vital to make sure that people with hearing loss could communicate with others by expressing thoughts and feelings that they deem important.
Hearing level cannot fully represent hearing performance
“You are severe hearing loss, and your senior has the same hearing level as you do. If he can pass the English listening exam, so do you.” An undergraduate student encountered the difficulties of listening to the electrical signals of listening exam. He wishes he could apply for the exemption for examination. However, the school teacher believed that if the senior student who has the same hearing level could participate and pass the exam, this undergraduate is no exception without questioning.
Even two people with the same hearing level might have different learning and hearing needs. For example, student A and B both have average hearing threshold at 60 dB HL. Their teacher may expect for them to hear at same levels. However, student A has hearing threshold at 60 dB HL in three different frequencies (500 Hz, 1k Hz, and 2k Hz). On the other hand, student B has hearing threshold at 30 dB HL for 500 Hz, 60 dB HL for 1k Hz, and 90 dB HL for 2k Hz. To compare with student A, the student B’s high frequency is apparently poorer, but the low frequency is better. Consequently, we should be aware the student B may have more difficulties in perceive high frequency sounds (e.g., /s, sh, f, t/ etc.), and hearing level cannot fully represent hearing performance. So, it is recommended to always consider the hearing thresholds at different frequencies when providing hearing rehabilitation goals.
Every individual is unique, but there is one thing we all have in common: we all want to be treated with respect. We can show our respect for people with hearing loss by breaking down the myths and preconceived ideas to better understand their unique challenges.
Author information: Chun-Yi Lin is an audiologist at the Children’s Hearing Foundation in Taiwan, where Kuei-Ju Lin is assistant research fellow while working as a primary school teacher. Both are completing their PhD in Special Education.
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