The goal is not simply making sounds louder; the goal is improved, successful listening.
Hearing is a sense; listening is a skill. We “hear” with the brain—the ears are simply the sensor and conduit through which sound travels to access the brain. In that respect, hearing loss and poor acoustic environments prevent sound from reaching the brain. Listening can be thought of as applying meaning to sound: allowing the brain to organize, establish vocabulary, learn, and internalize concepts. When we have a hearing loss, we have fewer cognitive resources available to accomplish our listening goal. Hearing is a passive process; it takes no effort to hear. Listening is an active process; it requires paying attention to things that are of interest to us, while dismissing things of less interest. Paying attention has everything to do with listening and cognition. Indeed, psychologist David Strayer, PhD, recently noted that “Attention is the Holy Grail,” where you attend is how you will do.
People with normal cognitive and normal hearing ability are remarkable at processing the tiniest bits of barely perceptible acoustic information into meaningful percepts, concepts, ideas, thoughts, and more. For people with cognitive decline, their ability to attend to particular speech stimuli is impaired, often leading to incorrect or erroneous conclusions about spoken words, meaning, and intention. When factors such as cognitive decline are combined with hearing loss, the outcome is worse! “Audition matters more as cognition declines, and cognition
matters more as audition declines”.
The fact is: the brain can only organize itself based on the stimuli it receives. When complete acoustic events are received, the brain organizes itself accordingly. Conversely, when hearing loss filters speech sounds and prevents these same sounds from reaching auditory centers within the brain, the brain organizes itself differently. When the brain centers do not realize full and typical auditory sensations, auditory areas may be reassigned. “When we want to remember (or learn) something we have heard, we must hear it clearly because memory can
be only as clear as its original signal…muddy in, muddy out.
The core reason we endeavor to help people hear is to help people listen successfully, through the appropriate use of advanced hearing access technologies, such as hearing aids. These strategies center on the ability to make cognitive sense of sound, to listen better and to apply appropriate meaning to the cornucopia of sounds around them. The goal is not simply making sounds louder; the goal is improved, successful listening.
All of this clearly argues for proactive aural rehabilitation—learning to listen using a strategic approach—to enhance the acoustic environment and to apply active cognitive processes to the sounds perceived.
In summary: For those individuals with hearing aids that struggle with difficult environments, stay at it!! Hearing is a sense and listening is a skill that requires attention with tremendous cognitive coordination and effort, especially when the hearing is impaired. For those who have a hearing loss and want to wait, DON’T.
1.Douglas L. Beck, AuD Carol Flexer, PhD Listening is Where Hearing
Meets Brain…in Children and Adults Hearing Review Feb 2011: 30-33
2.Douglas L. Beck, AuD Interview with Brent Edwards PhD and
Kath Pichora-Fuller PhD The Hearing Journal Oct 2011 64 (10) 21-24