Beyond the Audiogram

When you have your hearing tested, the audiologist constructs a graph called an audiogram. Typically, this graph represents how loud tones of various pitches have to be made before you can first detect them. Unfortunately, a lot of attention is given to this simple graph when it just doesn’t tell the whole story. Let’s be honest: Who among us is particularly concerned with how sensitive our ears are to high- or low-pitch tones? The graph is certainly important, but it doesn’t tell the whole story.

Word and speech recognition testing is, in my opinion, far more important and often determines how much rehabilitation will follow the hearing aid fitting. For instance, last month I saw an exceptionally jolly gentleman who came to the clinic because his wife had had enough of him “not listening.” After some thorough testing, it turned out that, despite his relatively moderate hearing loss, his ability to understand speech was abysmal. He mentioned several times that he could hear his wife “just fine,” but couldn’t make out what she was saying unless they were in the same room and he could look at her. Unfortunately, this ability to hear but not understand was misinterpreted by his wife as “not listening.”

There was no question this fellow needed hearing aids, and we selected a pair that met his listening and lifestyle needs as well as his budget. But then came the hard part: His initial tests showed that, even with appropriate amplification, he could only understand about 58% of speech in a quiet setting. It was a huge improvement, but still a long way from hearing well. Both he and his wife understood the limitations of his very damaged auditory system, but both also concluded that, with a little perseverance, he could do so much more.

They both (and it is key to his success to have such incredible support from his wife) began the LACE program and began to listen to books on tape in the evenings. A month later, he is flying high at an incredible 82% speech recognition score and is working for better.

Whether you have been wearing hearing aids for years or are just now considering taking the plunge, ask you audiologist about your speech scores and what they will mean for you in terms of overall satisfaction and the need for auditory rehabilitation.

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