ROLE of BRAIN in HEARING LOSS
from a 2/15/03 SHHH-CA presentation by Dr. Robert Sweetow, Head of Audiology,
recorded by Laine Waggoner, MA, MS
and Joan Ireland
hear in our brains not our ears. The auditory cortex of the brain processes
sound at different levels. The
brain’s nerves take on different functions in hearing loss because the ear has
lost it’s fine tuning ability.
functioning continuously changes over time: the brain is structurally
inflexible, but functionally flexible. The brain tries to compensate for
the confusing high-frequency sounds provided by the new hearing aids.
These plastic changes can create a learning catastrophe, called “bad listening
syndrome”. What sometimes appears to be cognitive loss or dementia may
actually be a problem with plasticity of the brain.
is possible to train the brain: to alter the “brain map”.
hearing aids CAN do:
comfortable sound levels
feedback to noise
high pitched sounds which the brain has forgotten how to process.
hearing aids CANNOT or MIGHT NOT do:
all frequency resolution problems.
temporal resolution: separating sounds by time.
“bad listening” syndrome.
induce neural plasticity (molding brain’s patterns).
hearing aid facts:
are up 35%- mostly among the digital aids.
Sweetow anticipates that in five years all digital aids will cost less.
insurance companies will now reimburse for hearing aids.
aids are the latest in hearing aids: a mini computer converts sound into
numbers. This is not necessarily better sound than analog aids which run
sound through filters.
experimental “IN-SOUND” aid is in the works, which will be inserted
deeply in the ear canal by a physician using a microscope. It may avoid ear
wax problems. It requires little amplification and no feedback. It could be
used for 3-4 months.
digital features include:
Feedback canceling control allowing more amplification
before feedback occurs. (2) Multiple microphones available in all but
the smallest in-the ear (ITE) or in-the-canal (ITC) aids.
Possible noise suppression.
future developments in the practice of audiology:
will be more auditory training or audiological rehabilitation-with or
without hearing aids.
the brain may be more effective than constantly reprogramming hearing aids.
expectations will be stressed, such as the fact that even the most advanced
hearing aid technology may not be able to compensate for certain limitations
of an individual’s brain.
in communication will be important, much like physical therapy for a body
injury. At UCSF, study subjects are practicing a variety of sentences 30
minutes a day, five days a week for four weeks.
will, hopefully, be more counseling in the use of hearing aids, assistive
listening devices and communication strategies.
in enhancing listening skills will include techniques for effective hearing,
attending, understanding and remembering what is said.
Waggoner is the Director of HEAR (Hearing-loss
Education And Relationships), which conducts support
groups, facilitates seminars, and provides private coaching for individuals who
are experiencing hearing loss. Email:
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