Posts Tagged ‘auditory’

Now Hear this…. Are You at Risk for a Hearing Loss?

June 18th, 2010

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
www.doctorshearingclinic.com

Did you know hearing loss…

  • Is the third most prevalent chronic health condition in America, behind high blood pressure and arthritis?
  • Affects 36 million Americans (about 17% of adults)?
  • Is more common in men than women?
  • Costs our economy billions of dollars in lost wages and hidden costs annually?

Is not being adequately identified by healthcare professionals? Only 38 percent of adults ages 70 years and older and only 29 percent of adults ages 20 to 69 have had their hearing tested within the last 5 years!

Do you or someone you love have a hearing loss? If so, you’re not alone. Almost 20% of adults in the United States will develop hearing loss during the course of their lives, and if undiagnosed and untreated, its affects can be devastating. Impaired hearing can have a profound impact on emotional, physical, economic, and social well-being.  People with hearing loss have documented decrease in quality of life, reporting symptoms of depression, dissatisfaction with life, reduced functional health, and social isolation. Statistically, they have lower income levels, and frequently complain of frustration in relationships and various communicative situations, as well as inability to enjoy social situations, and fatigue. Despite the fact that most people with hearing loss can be helped with today’s state of the art amplification, many never seek help, or resist the use hearing aids or other assistive listening technologies.

The causes of hearing loss are varied and resultant impact on auditory capability may range from mild to pronounced. Sometimes the cause or etiology, such as wax build up in the external ear canal or an ear infection, is readily apparent. In other instances, the cause of hearing loss may be more obscure. Decreased hearing is often called “the invisible handicap”. Because hearing impairment (especially loss related to aging) often presents very gradually, those with significant hearing impairment can be unaware of their loss. Family members, significant others, co-workers and friends are frequently the first to notice communication problems related to decreased hearing sensitivity.

Given that 36 million Americans are faced with this “invisible handicap” what kinds of risk factors increase the likelihood that someone will develop hearing loss? Why do some people develop hearing loss and while others do not? Some risk factors are obvious, but others are much more obscure.

Perhaps the most widely recognized risk factor is aging. Presbycusis, or the loss of hearing that gradually occurs as we grow older, is a familiar scenario for those of us with older family members. In fact, about 30-35 percent of adults between the ages of 65 and 75 years have a hearing loss, while an estimated 40-50 percent of people 75 and older have a hearing impairment.

Loss associated with presbycusis is usually greater for high-pitched sounds, resulting in the frequent comment “I can hear people talking, but can’t understand them clearly”. It is most commonly binaural (in both ears), affecting the ears equally. Because this type of loss in hearing sensitivity is so gradual, people who have presbycusis frequently lose their frame of reference for normal loudness of sounds, and often do not realize that their hearing acuity is diminishing.

The resultant relationship dynamic is frequently the subject of jokes – “My husband suffers from ‘selective’ hearing and he’s driving me crazy”! In reality, however, hearing impairment is no laughing matter and can take quite a toll on communication with significant others. Research indicates that for couples where one person has unaddressed hearing loss, the divorce rate is actually significantly higher.

Most people would agree that we now live in a very noisy world. Noise levels for rock concerts, radios, motorcycles, traffic, industrial and lawn equipment, and even our personal listening devices constantly bombard our auditory system. It is not surprising that noise exposure is another one of the most frequently cited risk factors for hearing loss, and now rivals aging as the number one cause of hearing loss in this country.  Noise from occupational, recreational and sporting activities all pose significant hazards to hearing in the United States today. Firearm use is one of the biggest culprits in our area of the country. A single shot from a shotgun, experienced at close range, can permanently damage hearing.  Repeated exposures to loud machinery in the work place or as part of yard maintenance or recreational experience may, over an extended period of time, present a serious risk to hearing. Even something as seemingly benign as blow dryers for styling hair put hearing at risk.

Consider the noise levels for such activities as NASCAR, jet ski and power boat usage, and lawn equipment. The cumulative effects of these noise hazards and many others pose a serious risk for hearing. Noise exposure risk is a time weighted function – in other words, the longer the exposure time, the greater the risk, and lower the loudness level required to cause damage. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), 10 million Americans have already suffered irreversible hearing damage from noise, and 30 million more are exposed to dangerous noise levels each day. A one-time exposure to hazardous noise resultant from gunfire or a rock concert, no matter how brief the time, of 120 dB or more can leave hearing permanently impaired. Prolonged exposure to only 85 dB (which can be generated by a commonly used appliance such as a blow dryer or hand held power tool) can do the same. 

Children and young adults are bombarded with potentially damaging noise exposure, most of which is easy to overlook. Most people intuitively recognize that “boom boxes”  IPODS, and other personal listening devices, if played too loudly, constitute a risk to hearing. However, consider the noise levels inherent to playing in a school band or orchestra. Students engaged in this commonplace activity spend hours practice in noisy environments within the context of their academic activities, yet many of them are not wearing appropriate ear protection, nor are schools effectively addressing this problem. To complicate matters, for reasons that are not fully understood some people are more susceptible to noise exposure than others.  As an example, research indicates that those with blue eyes are more prone to noise exposure than those with darker eye color!

Aging and noise exposure are two rather obvious risk factors for hearing loss, but there are many other factors that are more insidious. Studies suggest that there is a strong genetic component inherent to hearing loss, both for childhood deafness as well as presbycusic loss. If your parent or grandparent had hearing loss, your risk factor for developing a similar impairment may increase. If you had a relative who was hearing impaired from birth, family members of child bearing age need to be mindful of this risk factor, and be particularly vigilant with regard to insuring that the newest members of the family are effectively screened at birth for hearing sensitivity.

Various diseases of the ear certainly pose risk to hearing sensitivity. Ear infection, otosclerosis (a bony growth in the middle ear cavity), Meniere’s Disease, acoustic neuroma (a tumor on the auditory nerve), and a host of other maladies are obvious risk factors for hearing loss. But did you know that hearing loss is about twice as common in adults with diabetes compared to those who do not have the disease, according to a new study funded by the National Institutes of Health (NIH)? Visual deficits have long been associated with diabetes, but hearing loss is an under-recognized complication. Because of the strong correlation between diabetes and hearing loss, The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), recently suggested that people with diabetes should consider having their hearing tested.

Use of common drugs such as antibiotics, aspirin, diuretics and chemotherapy can cause hearing loss. Typically, hearing loss from ototoxic drugs is high frequency, which often results in the hearing impairment less obvious to those it affects. All radiation and chemotherapy patients should insist on baseline hearing assessments before, during, and following their course of treatment to insure that auditory effects of ototoxic interventional strategies are carefully monitored and treated.

Race and gender also play a role in hearing loss risk factor determination. Researchers now know that compared to women, men are five and one half times more likely to have hearing loss. White and Mexican American men have a higher incidence of both high-frequency hearing loss and hearing loss in both ears than blacks, who were 70 percent less likely than white participants to present with hearing loss.

With the dramatic increase in airbag use, motor vehicle accidents (MVA’s) are common culprits for increased risk of hearing loss. In fact, 17% of those involved in MVA’s with airbag deployment will have permanent loss of hearing as a result. Other insidious risk factors for hearing loss include smoking and cardiovascular disease. The incidence of hearing loss is significantly more pronounced among smokers, as well as those with any type of cardiovascular disease.

Many healthcare professionals simply don’t make these associations, and as a result, do not refer patients for hearing evaluation as often as risk factors might dictate. So, the message is be aware, and be proactive in assessing your risk, or that of your loved one, for hearing loss. For a comprehensive audiometric evaluation, see a Board Certified Doctor of Audiology. If you’ve never had a baseline audiogram, it’s certainly in your best interest to do so. Only 38 percent of adults ages 70 years and older and only 29 percent of adults ages 20 to 69 have had their hearing tested within the last 5 years.   If you’re over 65, hearing evaluation each year by a Board Certified Audiologist should become part of your annual medical maintenance program.
(Sources: BHI, NIDCD, ABA)

Dr. Bettie Borton is a Board Certified Doctor of Audiology, and a nationally recognized expert in hearing healthcare. She has more than 30 years’ experience diagnosing and treating hearing impairment in children and adults. Dr. Borton has served as the President of the Alabama Academy of Audiology, National Chair of the American Board of Audiology, and currently serves on the National Board of Directors for the American Academy of Audiology.

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Posted in Acoustic Neuroma, Assisitve Listening Technology, AudigyCertified, Audiogram, Audiologist, Audiometric Evaluation, Auditory, Bettie Borton, Binaural, Binaural Hearing, Clinical Audiologist, Diabetes, Doctor of Audiology, Doctors Hearing Clinic, Ear Disease, Ear infection, Ear wax, Hearing Aids, Hearing Assessment, Hearing Damage, Hearing Difficulty, Hearing Evaluation, Hearing Impaired, Hearing Loss, Hearing protection, Hearing Test, Hearing Tested, Impaired Hearing, Meniere's Disease, Noise Exposure, Noise Hazards, Noise levels, Otosclerosis, Ototoxic Drugs, Presbycusis, Signs of Hearing Loss, Treatable Hearing Loss, Uncategorized

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Hearing Loss, Dizziness and Balance Disorders in the Elderly

May 28th, 2010

By Neil W. Aiello, Au.D., FAAA, CCC-A
Doctor of Audiology
Cheif Operations Officer
Columbia Basin Hearing Center
1149 N. Edison Street, Suite D
Kennewick, WA 99336
(509) 736-4005
www.columbiabasinhearing.com  

Adults are now living longer.  But with increased longevity comes a corresponding increase in the incidence of hearing loss, dizziness and balance problems.  Each of these conditions are common problems among the senior population.  Some revealing statistics from the National Institute on Aging include: 

  • Approximately one-third of Americans between the ages of 65 and 74 have hearing problems. 
  • Nearly half the people who are 75 or older have hearing loss. 
  • As many as 40% of all adults will experience dizziness severe enough to warrant reporting it to their doctor. 

In fact, according to the National Institutes of Health, over 90 million Americans will experience dizziness or vertigo in their lifetime.  Dizziness or vertigo is the #1 complaint of patients over the age of 70, and is the third most frequent complaint among all patients after headache and back pain.  Approximately 85% of all vertigo and balance problems are due to an inner-ear incident.

Neil Aiello, Au.D., Doctor of Audiology | Columbia Basin Hearing & Balance CenterHearing loss can have many causes including aging of the auditory system, overexposure to loud noises over a period of time, infections, ear wax buildup in the ear canal, heart conditions or stroke, head injuries, tumors, certain medicines and heredity.  Common symptoms of hearing loss include; if you often can hear people talking, but simply have difficulty understanding them; struggling to hear conversations clearly in background noise or in group situations; having difficulty hearing over the telephone or needing to turn the TV volume higher so that others complain.  These Sound Voids ™ are the result of some form of hearing loss, either temporary or permanent, and may result in situations where an individual’s hearing loss does not permit them to detect or understand important sound and speech cues.  Individuals often find that Sound Voids result in tiring, frustrating, and embarrassing situations.

Dizziness is a symptom with a multitude of possible causes.  Determining the underlying cause is one of the biggest challenges for physicians.  The most common causes are related to the inner ear; therefore, referral to an audiologist is highly recommended.  Other causes include central nervous system problem in the brain or brainstem, related heart conditions, medications, as well as infections of the inner-ear or vestibular nerve.  Specificity is the key to finding the source of the problem.  The more specific you can be about when the symptoms began, when they are most likely to occur and exactly what they feel like will help the audiologist or physician develop a more accurate diagnosis.  Be aware that determining the source of dizziness is very complex and difficult to localize.  In fact, many times the exact source of the dizziness is never found.  However, more serious sources of the problem are ruled out.

According to a distinguished expert in the field of dizziness and balance disorders; Doctors of Audiology have an educational and clinical advantage in the identification and diagnosis of many forms of dizziness and vertigo problems.  The high incidence of inner ear symptoms with balance and vertigo disorders, in conjunction with the increasing number of elderly patients that need our expertise is on the rise.  In fact, many insurance companies are seeing the proven benefits and under-utilization of Doctors of Audiology who specialize in dizziness, vertigo and balance disorders.

If you or your loved ones have hearing loss, Sound Voids™, dizziness, vertigo and/or balance problems, seek out your local Doctor of Audiology for the latest in modern professional hearing, dizziness and balance services.  General information on these topics can be found online at www.ColumbiaBasinHearing.com , www.audigygroup.com or www.dizzy.com

Definitions:

Audiologists (noun): are autonomous professionals who identify, assess, and manage disorders of the auditory, balance, and other neural systems. Audiologists provide audiological (hearing) rehabilitation to children and adults across the entire age span. Audiologists select, fit, and dispense amplification systems such as hearing aids and related devices. Audiologists currently hold a Master’s or Doctoral degrees in audiology from an accredited university or professional school.

Sound Void™ (noun):

  1. A moment lacking in clarity in hearing or understanding.
  2. An empty space in one’s life caused by the absence of sound clarity.

Hearing Loss (noun):

  1. Impairment of the sense of hearing.

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Posted in Audigy Group, AudigyCertified, Audiologist, Balance, Clinical Audiologist, Columbia Basin Hearing & Balance Center, Dizziness, Doctor of Audiology, Hearing Aids, Hearing Impaired, Hearing Loss, inner ear, Signs of Hearing Loss, Sound voids, Treatable Hearing Loss, Uncategorized, vertigo, vestibular nerve

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A Guide to an Exceptional Sound Experience

April 29th, 2010

A Guide to an Exceptional Sound Experience

By: Peter J. Marincovich, Ph.D., CCC-A
Audiology Associates
1111 Sonoma Ave., Suite 308
Santa Rosa, CA 95405
(707) 827-1630
www.audiologyassociates-sr.com

May is Better Hearing month- but despite the fact that more than 34 million Americans report hearing problems, relatively few are screened annually. Hearing loss is the third most common health problem in the United States. Although hearing problems are commonly associated with the aging process, they affect all age groups. More than half of hearing impaired persons in the United States are under the age of 65, including 6 million people between the ages of 18 and 44- and more than 14 million are school-age children. Here are some things to be aware of concerning hearing.

Sound voids. Do you hear “ool” but not sure if someone is saying “pool” or “cool”? Do you find yourself saying, “I hear OK, but I have trouble understanding,” or “Soft sounds are too soft but loud sounds are too loud.” Hearing clearly when there’s background noise can be especially difficult for someone with hearing loss, as can be trying to explain your hearing situation.

It’s common for people to be unaware of their hearing loss due to the gradual nature of its progression. As hearing slowly declines, an individual develops compensation strategies without even realizing it. Often it’s others, who are trying to communicate with the individual, who are more aware of the situation. Sometimes it takes years before sufferers seek professional help.

Causes. Sometimes it’s readily apparent, such as wax buildup. Other causes include hereditary factors, trauma, ear disease and certain medications. The cause of hearing loss is sometimes presumed. For instance, noise induced hearing loss is attributed to the use of stereo systems or portable music players is a growing phenomenon.

There are eary ways to tell if a particular sound is potentially harmful. Do you have difficulty talking or hearing others talk over sounds? Does the sound make your ears “ring” (tinnitus), “hurt” or seem “muffled ” after exposure? If you answered “yes” to any of these questions, the noise may be damaging your hearing. Most people don’t realize how loud everyday sounds actually are. Nearly 30 million Americans are exposed to dangerous noise levels each day and 10 million Americans suffer from irreversible hearing damage due to noise.

The diagnostic hearing evaluation. The purpose of a complete evaluation is to determine the true nature of any hearing loss. The diagnostic process may include a variety of tests: audiometric tests to measure hearing at different pitches; speech evaluation to measure how well you hear and recognize ordinary conversation at different volumes; immitance tests of the middle ear; and complete medical evaluations.

Tinnitus is a medical condition characterized by persistent ringing in one or both ears. These sounds can come and go; however most sufferers experience symptoms constantly. The American Tinnitus Association estimates mre than 50 million Americans suffer from tinnitus. It’s also the number one complaint from United States Veterans. In some cases, tinnitus retraining therapy TKT and tinnitus retraining instruments TRI may provide individual solutions.

The balance system. Due to its close proximity to the hearing mechanism, balance is also a part of the comprehensive hearing evaluation. Fear of falling is a major health concern of older individuals. Nearly 300,000 hip fractures result from balance related falls every year. The natural aging process may affect one or all of these senses, as well as the central nervous system’s ability to interpret and react quickly to them. It’s very common to hear from someone who has fallen that they saw the curb or step, but just were not able to react fast enough. With proper diagnosis and therapeutic exercise called balance retraining, many older adults are able to return to a more active lifestyle.

The Communication Needs Assessment. In addition to a medical evaluation and after medican and/or surgical intervention, if an individual still suffers from difficulty communicating, a complete communcation needs evaluation is now the gold standard of hearing care. The first step is identifying the individuals needs: What are the listening situations where they individual would like to hear well? The second step is indentifying the individuals lifestyle. For example, not just if they have trouble hearing in restaurants, but how often they do, or would like to, go to restaurants.

Technology alone doesn’t help people hear better. Instead, it’s how well the practitioner works with the individual and applies the technology. If an individual doesn’t see well through a pair of glasses, it’s not due the “glass”, per se. It has to do with either the measurement of the individual’s vision, the prescription or fit, or some combination. Hearing technology is similar in application. What helps someone hear better is the correct amount of sound at the appropriate pitches for that individual’s heairng loss, environment, and communication needs. Individuals with similar hearing loss may require completely different amplification strategies based on all of the factors mentioned here.

The all-important aftercare completes a comprehensive communication needs assessment for an exceptional sound experience. This includeds assessment of need for assistive listening systems for telephone, Bluetooth, TV, loops, or music systems. In addition to assistive solutions, aftercare will include lip reading and listening skills counseling.

It is important that a hearing-impaired individual take an active role in listening and participate in the recommended auditory retraining and rehabilitation program. The auditory system may not have heard the certain voices and sounds for many years, and the reintroduction of new sounds and voices needs to be presented gradually. In other words, just as the hearing loss may have occurred gradually, the reintroduction of new sound needs to occur gradually.

A hearing screening can quickly and accurately evaluate an individual’s hearing, determine the degree of hearing loss and put him or her on the path toward treatment. After treatment, it’s important to monitor the hearing loss to ensure the technology is meeting an individual’s needs.

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Posted in AudigyCertified, Audiologist, Balance, Dizziness, Hearing Aids, Hearing Device, Hearing Difficulty, Hearing Impaired, Hearing Lifestyles, Hearing Loss, Hearing Technology, Ringing in the Ears, tinnitus, Treatable Hearing Loss, Uncategorized

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Invisible Pervasive Handicap in the Classroom

April 12th, 2010

Invisible Pervasive Handicap in the Classroom

By Linda S. Remensnyder, Au.D.
Doctor of Audiology      
Hearing Associates, P.C. . . . Eliminating the Sound of Silence
755 S. Milwaukee Avenue, Suite 189
Libertyville, IL 60048
www.hearingdoc.com

One-Third of Young Children Affected:  Recent research confirms that, on any given day, one third of all children, kindergarten through third grade, have impaired hearing/listening. 

The vast majority of these statistics reflect children missed in hearing screenings.  Their ranks are comprised of so-called “normal hearing children” who experience greater speech-recognition difficulties in classroom noise and reverberation than previously suspected. These subtle hearing deficits cause the affected child to experience an invisible handicap—a handicap comprised of not being able to hear well consistently.

These kindergarten and primary grade children have slight or “minimal” hearing loss for a variety of reasons. Causes can be as innocuous as occluding ear canal wax or as serious as otitis media (fluid accumulation behind the eardrums). Otitis media (middle ear fluid) ranks second to the common cold as the most common health problem in young children.  Ear infections, which have increased by 224% since 1975, cause five million school days to be missed annually and half of all episodes are undetected by parents or teachers. Even the ventilating tubes resorted to in serious cases can become plugged by infection or debris and cause hearing deficits.

These “minimal” hearing loss statistics also reflect youngsters who have allergies causing them to be chronically “stuffed up”, bilateral high frequency hearing loss in ranges not screened in hearing screenings, or unilateral hearing losses in which excellent hearing is limited to one ear.  They reflect youngsters with developmental delays, articulation disorders, or dyslexia.  Students who have central auditory processing disorders (CAPD), attention deficit disorders (ADD), and behavioral problems also fall into this category.  In addition, the slight hearing impairment statistics include children for whom English is not their primary language because language comprehension requires sustained effort.

A “Minimal” Condition with Maximal Consequences: A “minimal” hearing loss, which requires neither medical intervention nor hearing aids, does not constitute a minimal handicapping condition with minimal consequences, especially during the younger elementary school years when the child’s brain is assimilating and developing language.  Hearing is the acknowledged bridge to reading and to future academic performance and this critical period to learn language is time-locked (generally considered age 0 through 7).

Children with minimal hearing loss experience problems hearing faint or distant speech and the esteemed educational audiologist, Carol Flexer, calculates that these children are missing more than 25% of classroom instruction. What 25% of the speech signal do these children miss?  They miss the soft intensity sounds — the endings of speech, the sibilants (s, sh, ch) and the fricatives (f, th).  They miss the subtleties of speech — the plurals, the tenses, and the possessives/auxiliaries.  They miss the innuendoes and the asides, the responses from fellow classmates in the back of the classroom, and they miss the whispers.  And they definitely miss what the teacher is saying when the room is noisy, when other classmates are conversing, or when the teacher’s back is facing them.

It is believed that 90% of a young child’s knowledge is attributed to incidental reception of conversations around them.  Thus, learning and understanding are hindered even with the slightest hearing difficulty.

How, then, are these children with “minimal” hearing loss able to learn language when language is learned by hearing it in full context? They’re not — they’re handicapped by their inability to hear consistently well.

It is important to keep in mind that the classroom is a difficult listening environment. Chatting students, humming air conditioners, squeaking desks, and outside traffic contribute to a level of background noise that distracts from the teacher’s voice.  The problem becomes even more significant when the noise echoes off uncarpeted floors in rooms with high ceilings and hard desks and windows.

In addition, Dr. Flexer also believes that “children are not short adults; they bring a different ‘listening’ to a learning situation.”  Research has documented that children do not develop an adult-like capacity to recognize speech in noise until approximately 13 to 15 years of age.  The central auditory system of children is not neurologically mature until a child is about 15 years old.  Thus levels of classroom noise and reverberation can deleteriously affect the speech perception of those younger than 15 even if the children do possess normal hearing sensitivity.

IMPACT of an Enhanced Signal and Improved Acoustics:  Research has confirmed that if the teacher wears a lapel microphone and if her or his voice is amplified via suspended speakers placed in each of four corners of the classroom, all children are able to hear better and all children benefit (even those who already wear hearing aids).  These sound field systems simply make it easier to understand or focus on the teacher’s voice. 

Teachers who use these systems have less vocal strain, are less fatigued at the end of the school day, and require fewer sick days off.  More importantly, the ability of all children to hear an enhanced speech signal has resulted in improvements in reading (comprehension and test scores), fewer discipline and behavioral problems, and increased classroom participation.

The trend is to place these sound field systems in all kindergarten and primary grade classrooms.  Strides are also being made in terms of classroom acoustics insuring that new construction and planned renovations take into account the need to limit ambient noise levels.  PTA’s and school fund-raisers are providing funding for the technology to promote optimum hearing. Parents can make it happen and make the future brighter (and more audible) for all.

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Posted in Audiologist, Classroom Hearing handicap, Hearing Aids, Hearing Device, Hearing Difficulty, Hearing Impaired, Hearing Loss, Kids Hearing Loss, Treatable Hearing Loss

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