A Guide to an Exceptional Sound Experience

Sonoma State, Green-Music-Center

May is Better Hearing month—but despite the fact that more than 34 million Americans report some type of hearing problem, relatively few are screened annually. With about 1 in 10 Americans reporting some type of hearing difficulty, hearing loss is the third most common health problem in the United States. Although hearing problems are commonly associated with the aging process, hearing loss affects all age groups. More than half of hearing impaired persons in the United States are under age 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 said “pool,” “tool” 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 and trying to explain your hearing situation can often be difficult.

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 hearing-impaired individual, who are more aware of the situation. Hearing problems often go unrecognized, sometimes taking years before sufferers seek professional help.


There are many causes of hearing loss. Sometimes it’s readily apparent, such as wax build-up in the external ear canal, a condition that’s easily treated but unfortunately goes unrecognized in many individuals. Other causes can include hereditary factors, trauma, ear disease and certain medications. The cause of hearing loss is sometimes presumed. For instance, noise-induced hearing loss attributed to the use of stereo systems or portable music players is a growing phenomenon.

There are easy ways to tell if a particular sound is potentially harmful. Do you have difficulty talking or hearing others talk over the sound? 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, depending on the assessment of your needs: audiometric tests to measure hearing at different pitches; speech evaluation to measure how well you hear and recognize ordinary conversation at different volumes; immittance tests of the middle ear; and complete medical evaluations.

Tinnitus is a medical condition characterized by persistent ringing in one or both ears, which can only be heard by the affected individual. These sounds can come and go; however, most suffers experience symptoms 24 hours a day, 7 days a week. The American Tinnitus Association estimates more than 50 million Americans suffer from tinnitus. It’s also the number one complaint from United States veterans. In some cases, tinnitus retraining therapy (TRT) and tinnitus retraining instruments (TRI) may provide individual solutions.

The Balance System

Due to its close proximity to the hearing mechanism, is also part of a comprehensive hearing evaluation. Fear of falling is a major health concern of individuals in their latter years. Nearly 300,000 hip fractures result from balance-related falls every year. The natural aging process may affect any one or all of the 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 or to keep their balance. 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 the diagnostic hearing evaluation and after medical evaluation, if an individual still suffers from difficulty communicating; a complete communication needs evaluation is now the gold standard of hearing care. The fist step is identifying the individual’s need: What are the listening situations where the individual would like to hear well? The second step is identifying the individual’s lifestyle. For example, not just if they have trouble hearing in restaurants, but how often they do, or would they 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 to 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 hearing 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 includes 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’s important that a hearing-impaired individual take an active role in listening and participate in the recommended auditory retraining and rehabilitation program to ensure he or she hears and understands as much as possible. The auditory system may not have heard 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. Through this process, each individual will adapt and develop necessary listening skills.

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



Peter J. Marincovich, Ph.D, CCC-A, is clinical director and owner of Audiology Associates, a full-service audiology practice since 1984, with offices in Santa Rosa, Fort Bragg, Novato and Mill Valley. You can reach him at (707) 523-4740 or temporarysite.info.