Trouble Hearing Even with Normal Hearing

Millions of Americans live every day with hearing loss and the challenges it can present, but did you know there are also millions more facing those same challenges but without a diagnosis of hearing loss? It’s not that they haven’t gone for a hearing evaluation. It’s that they’ve been diagnosed with normal hearing.

What is normal hearing?

Normal hearing is considered any hearing that falls within the “audiometric zero” range. This range is generally from 0 dBHL (Decibel Hearing Level) and below to approximately 20 dBHL. This is the lowest level of sound that people can hear as determined by a study in the early 20th Century. When you have a hearing evaluation done by a hearing healthcare professional, they are testing your ability to hear within this range. If that is not possible, you are diagnosed with hearing loss (mild, moderate, severe, profound). Simple, black and white, right?

In fact, there may be more grey than many previously believed.

Normal hearing… almost

Those with hearing loss face unique challenges including the ability to hear speech in noisy environments. Conversations in crowded living rooms, bustling restaurants and similar spaces can be difficult if not impossible. Hearing healthcare providers counsel patients with hearing impairment to use hearing aids with the latest technology to help focus in on speech. They also recommend physical strategies such as closer proximity to those you’re conversing with and opting for well-lit spaces when possible. This helps those diagnosed with hearing loss, but what about the almost equally large population diagnosed with normal hearing but facing these same difficulties?

It is now estimated that approximately 26 million American adults whose hearing falls within the normal also have difficulty hearing speech in noisy environments. While many of these individuals are receiving little help due to the existing standards, researchers are now seeking out ways hearing healthcare providers can better assess hearing ability and guide those with hearing difficulty for improved quality of life.

Better options, better hearing

As experts dig into the issue of hearing difficulty and challenges of speech in noisy environments, even with “normal” hearing, many recommendations are being made both to better assess hearing ability and diagnose hearing loss and to assist those facing these challenges to thrive.

  • A more definitive definition of hearing loss – many point out that the “audiometric zero” range used to assess hearing is wide. While the range of “normal” hearing is considered 0 dBHL up to 20 dBHL (and in some cases, 25 dBHL), many experts stress that even 5 dBHL represents a change to hearing ability.
  • Better assessment tools: with this in mind, some see standard hearing evaluations as not sensitive enough to identify lower levels of hearing loss that may be affecting someone’s ability to hear speech in certain situations. Recommendations are now being made to get more extensive patient histories, make speech-in-noise tests a standard part of evaluations (just 15% of providers now include them in the testing process), and use assessment tools such as Client Oriented Scale of Improvement (COSI) and the Hearing Handicap Inventory for Adults (HHIA) more regularly.
  • Improved guidance and solutions – going beyond the current level of assistance which includes simple physical strategies such as better lighting and offering information and recommendations on technology options such as hearing aids that can provide directional and noise-reduction programming and remote microphone systems that allow users to “tune-in” more clearly to a certain audio signal.

Our hearing is as unique as we are. As experts learn more, they can better serve anyone experiencing hearing difficulty, no matter what a traditional hearing evaluation says about their hearing ability.

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