One out of ten Americans struggles with some level of hearing loss.

People often think of hearing loss as a problem that mainly affects elderly people. In fact, it’s a problem that crosses all ages and backgrounds throughout the country. That adds up to 28 million adults nationwide. Here are some more striking statistics:

• Hearing loss affects more American families than any other chronic health condition.
• 60 percent of people with hearing loss are between the working ages of 21 and 65.
• 30 out of every 1,000 school-age children have hearing loss.
• People with hearing loss wait an average of seven years before seeking help.
• 75 percent of the people who could benefit from hearing aids do not use them.^{1 , 2}

It could be caused by exposure to noise, certain types of medication, an infection, changes in the structure of the inner ear that come with aging, heredity, medical conditions such as diabetes or even excess earwax.

There are two basic categories of hearing loss.

Sensorineural - the most common type due to damage to the sensory cell and/or nerve fibers of the inner ear. It is often called “nerve loss” although it's the hair cells that are damaged and not the nerve. People with this type of hearing loss have trouble hearing speech in noisy situations, and increasing the volume has no positive effect. They lose hearing in the high frequencies first, so they have more difficulty with female and children's voices than male voices. They also have difficulty differentiating sounds such as "f" and "s."

Though there is no cure for sensorineural hearing loss much can be done to improve the condition through hearing aids, implantable devices, and assistive technology. Coping skills and communication strategies also help to ease difficult listening situations.

Conductive - caused by a problem in the outer or middle ear. Sound is not effectively conducted to the inner ear. Individuals may feel as if they're wearing earmuffs. Increasing the volume of sound usually improves clarity. Possible causes include: wax in the ear canal, middle ear infections (common in children), punctured eardrum, and otosclerosis (a growth of tissue that hampers movement of the middle ear bones). Conductive hearing loss is treatable in many cases.

Hearing loss affects everyone and every area of life.

Hearing loss and children

• 3-6 out of 1,000 babies are born with a hearing loss.
• All children can be evaluated for hearing loss, regardless of age.
• Even newborns, only hours old, can be tested for hearing loss.
• Babies as young as three months of age can be fitted with hearing aids.
• The typical ear infection causes "plugged ear" hearing loss. Two-thirds of preschoolers have at least one episode of ear problems and 16 percent of preschoolers have six or more episodes. Half of all episodes go undetected by parents and teachers. Even with good follow-up, 10 percent of preschoolers continue to have chronic ear problems during critical language development years.
• 14.9 percent of children aged 6-19 have some degree of hearing loss in one or both ears.
• Children with hearing loss in one ear have ten times the risk of failing a grade in school. In fact, almost 50 percent of them are receiving support services from the school.
• Due to poor acoustics, the effectiveness of hearing aids can become significantly reduced for students in the regular educational setting. In th presence of typical levels of classroom noise, comprehension of student! with hearing loss may drop to 60 percent, or even as low as 27 percent if there is no carpeting to deaden the excess noise.
• Noise-induced hearing loss is another serious concern. Three percent of children in grades 1-3 were found to have high-pitch hearing loss. In grades 4-12, hearing loss leaps to 22 percent of the entire student population.

Hearing assistive technologies are devices and services that help people with hearing loss live more independently

In many cases, a hearing aid may improve a person's hearing ability. However, in certain situations, it may be necessary to use additional assistive devices.

There are three types of assistive devices (other than hearing aids):

• Listening systems that include amplifiers to help people hear better in restaurants, staff meetings, live performances, and movie theaters.
• Telecommunications equipment that helps people hear the TV better, amplifiers for the phone, and neckloops to couple a hearing aid to a cellular phone.
• Alerting devices that include light flashers or vibrating receivers to indicate a ringing phone or doorbell, a fire alarm, a baby's cry or an alarm clock.

Assistive technology is available through special device catalogs. Check to see if there is a demonstration center in your area where you can try out the equipment before you buy it.

Hearing loss and aging

One in three people over 65 can expect to have trouble with their hearing. Two out of three people in nursing homes have been found to have a hearing loss.

Hearing loss can be difficult to recognize because it often deteriorates slowly. It's most noticeable in group conversations, listening to TV or the radio, at the theater or religious meeting houses. Background noise can interfere with comprehending speech.

People with hearing loss that deteriorates with age often say they can hear but can't understand. That's because high-pitch sound sensitivity fades first. For example, different words might sound exactly the same, such as shock, ship, and shot.

They can hear when they want to. This is a common statement made by individuals who experience impatience and frustration with friends or family members who are losing their hearing. Because it is an invisible disability, hearing loss does not usually elicit the same degree of compassion as some other physical challenges.

Tinnitus (ringing, roaring or other uhead noise") is often associated with hearing loss and can be troublesome for some people.

Older people often take medication for high blood pressure or heart disease. Some medicines or combinations of medicines may cause hearing loss and/or tinnitus. At the same time, this group may also be facing the challenge of losing their eyesight, which in turn hinders their ability to speechread, making them feel even more isolated.

When selecting a hearing aid, special consideration should be given to arthritis sufferers who lack the dexterity to manipulate controls or change batteries.

In addition to hearing aids, there are other devices available to help you hear better. Assistive technology, for example, can help you hold a conversation face to face or on the telephone and allow you to live independently and safely in your own home.

Hearing loss and employment.

Hard-of-hearing people may not want to admit their condition for fear of being discriminated against by their co-workers or losing their jobs. They tend to be underemployed and retire earlier than their peers with normal hearing.³

The Americans with Disabilities Act (ADA) and other public policies provide protection to help hard-of-hearing people receive fair and accessible treatment on the job and when applying for a job.
 
To be successful in the workplace, employees with hearing loss need to use these basic strategies:

• Admit hearing loss
• Focus on developing marketable skills
• Keep abreast of and use technology that can make communication on the job easier
• Educate co-workers and employers about hearing loss and how to communicate effectively on the job
• Find a mentor who knows your capabilities and can provide ongoing support throughout your career
• Know what helps you to communicate on the job and articulate it to others
• Learn how to cope with the stress that accompanies living with hearing loss

Lack of assertiveness may be perceived as lack of interest, low intelligence or a personality disorder.

Dependence on others in difficult listening situations can negatively affect self-esteem and can interfere with relationships.

Individuals with hearing loss are more likely to experience a loss of intimacy in their relationships than the normal-hearing population.

75 percent of single people with disabilities don't date.⁴

You may be hard of hearing if:

• You notice that you have difficulty following the  conversation
• You often have to ask people to repeat themselves
• You're frequently turning up the volume on your TV
• You fail to hear someone talking from behind you
• You have difficulty hearing on the phone
• You have difficulty hearing in noisy situations
• You have difficulty hearing women and children

Get your hearing checked. Audiologists are educated professionals, skilled in performing thorough hearing evaluations. An audiologist can determine your type and degree of hearing loss and whether or not it can be helped by hearing aids. Based on your history, symptoms, and audiologic evaluation results, the audiologist may recommend a medical evaluation by an otolaryngologist-an ear, nose and throat doctor - also known as an ENT.

To locate an audiologist call:
American Academy of Audiology (AM) 800-222-2336 - www.audiology.org
American Speech Language Hearing Association (ASHA) 800-638-8255 (voice), 301-897-5700 (TIY) - www.asha.org

To make sure that your hearing loss is not caused by conditions of the ear that might require medical or surgical treatment, see an ENT doctor.

To locate an ENT doctor call:
American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS)
703-836-4444 (voice), 703-836-1585 (TTY) - www.entnet.org

Your primary care doctor can perform a basic examination to determine if there are any conditions causing hearing loss that can be treated, such as wax in the ear canals or fluid in the middle ear or refer you to an audiologist or an otolaryngologist.

Many people with sensorineural hearing loss (nerve deafness) are helped by hearing aids. If you are told by anyone that you have nerve deafness and just have to learn to live with it, SEEK ANOTHER OPINION.

National Resources for People with Hearing Loss

American Tinnitus Association
503-248-9985 (Voice)
www.ata.org

Cochlear Implant Association
202-895-2781 (Voice/TTY)
www.clcl.org

National Institute on Deafness and Other Communication Disorders Information Clearinghouse
800-241-1044 (Voice) 800-241-1055 (TTY)
www.nih.gov/nidcd/

Rehabilitation Research and Training Center (RRTC)
For persons who are Hard of Hearing or Late Deafened California School of Professional Psychology-San Diego (CSPP-SD)
800-432-7619 (Voice/TTY)
www.hearinghealth.org

Self Help for Hard of Hearing People (SHHH) and the National Center on Assistive Technology (NCAT)
301-657-2248 (Voice) 301-657-2249 (TTY)
www.shhh.org

Preventing Hearing Loss

Every day we experience sound in our environment, such as television, radio, vacuum cleaners, automobiles, buses, and trucks. But when an individual is exposed to harmful sounds - sounds that are too loud or loud sounds over a long time - sensitive structures of the inner ear can be damaged, causing noise-induced hearing loss.

More than 20 million Americans are exposed to hazardous sound levels on a regular basis. Individuals of all ages - including children, adolescents, young adults and older people - can develop noise-induced hearing loss.⁵

33 percent of people with hearing loss have experienced noise-induced hearing loss. This condition is preventable.⁶

Loudness is measured in units called decibels (dB). For example, usual conversation is approximately 60 dB, the humming of a refrigerator is 40 dB and city traffic noise can be 80 dB. Sources of loud noises that cause noise-induced hearing loss are motorcycles (90 dB), concerts (140 dB), and firecrackers or gunshot blasts (140 dB).

Tinnitus (ringing in the ear), a muffling of sounds or a plugged-up feeling in the ears are some of the symptoms experienced after exposure to damaging noise. Difficulty understanding speech is also an important consequence of noise damage.⁷

There are four factors that determine risk criteria for noise-induced hearing loss: intensity of sound, duration of exposure, frequency of sound, and individual susceptibility.

Become knowledgeable about noises that have been proven to cause hearing loss. You can minimize the risk of hearing loss by using appropriate ear protection for you and your children. Also remember that hearing loss has been known to be a side effect of certain antibiotics and chemotherapeutic agents, which are ototoxic medicines.

What a person with hearing loss may experience

• Frustration: “I don't understand you.”
• Anxiety/Discomfort: “Will I appear stupid for not understanding? Will I ever comprehend anything again? Will I always appear confused?"
• Impatience: “Why can't people take the time to face me and speak clearly, face me and speak slowly? And why do people speak with food in their mouths or a hand in front of their faces?"
• Anger: “I wish people would try a little harder to include me in their conversations. I wish I didn't have to try so hard to be accepted.”
• Loss of Competence and Self-Esteem: More intense if a person is already struggling with other changes/losses such as retirement, reduction of income, or declining health.
• Self-Pity: “My condition is so beyond hope, it's not even worth trying anymore.”
• Guilt: “I’m much too big a burden for everyone. I don't blame them for not caring.”
• Withdrawal: “It's too embarrassing to constantly point out my hearing loss; I'd rather not get involved at all.”

Self Help for Hard of Hearing People (SHHH), based in Bethesda, Maryland, is a non-profit, educational association that speaks out for people with hearing loss all over the country. Our mission is to raise awareness and reduce the stigma attached to hearing loss through education, advocacy, and self-help. SHHH is the largest international consumer association of its kind, with 250 chapters nationwide to provide support to people of every age, from every walk of life.

SHHH is able to help people with hearing loss not to just cope, but to thrive. SHHH also offers support meetings at 250 chapters throughout the country. The SHHH website at www.shhh.org offers a wealth of information on hearing loss. On our website you can also find an online support network for parents of children with hearing loss. SHHH teaches hard-of-hearing employees about their rights and gives them the confidence they need to move ahead in their chosen careers. The contact information on the back of this brochure will show you how to learn more about SHHH and hearing loss.

People all across the country turn to SHHH for education, advocacy, and support.
Here's how you can contact them:

SHHH
Self Help for Hard of Hearing People
7910 Woodmont Avenue, Suite 1200
Bethesda, Maryland 20814
Voice 301-657-2248 
TTY 301-657-2249
Fax 301-913-9413
 www.shhh.org
E-mail national@shhh.org

AMERICAN ACADEMY OF AUDIOLOGY
800-222-2336
www.audiology.org

NIDCD
National Institute on Deafness and Other Communication Disorders Information Clearinghouse
800-241-1044 (Voice)
800-241-1055 (TTY) 
www.nih.gov/nidcd/

AMERlCAN SPEECH-LANGUAGE HEARING ASSOCIATION
.800-638-8255 (Voice)
301-897-5700 (TTY)
www.asha.org

 AAO
American Academy of Otolaryngology
703-836-4444 (Voice)
703-836-1585 (TTY) www.entnet.org

1. Noise and Hearing Loss, NIH Consensus Development Conference, January 22-24, 1990, NIH Office of Medical Applications of Research.
2. National Institute on Deafness and Other Communications Disorders, 1992; Hearing Industries Association, 1996; Nineteenth Institute on Rehabilitation Issues, 1992.
3. Hearing loss and age (a fact sheet), Australian Hearing Centre, www.hearing.com.au.
4. Disability Agenda: Disability and Social Life, National Organization on Disability, Volume 4, Number 5, Fall 1999.
5. People with Hearing Loss and the Workplace: A Guide for Employers to Comply with the Americans with Disabilities Act 1996, Self Help for Hard of Hearing People.
6. NIDCD Factsheet: Noise-Induced Hearing Loss, NIDCD Information Clearinghouse, 1 Communication Center, Bethesda, MD 20892-3456, 800-241-1044.
7. Occupational Hearing Conservation: Where Hearing Professionals Get Down to Business, The Hearing  Journal, Volume 49, Number 11, November 1996.

Home | ADRS | Employment | ADA/Legal | Education | Transition | Hearing Loss |
Technology | Resources | Events/Announcements

©2003 Alabama Department of Rehabilitation Services