Below is an excellent article explaining the differences in hearing loss regarding dB level, the speech banana and what our children can and can’t hear when having a hearing loss and more. It is very well put together. Excellent website!
Why Our Two Ears Process Sound Differently
by Neil Bauman, Ph.D.
A man asked:
Is there any difference between how our left and right ears hear and process sounds? I understand the process is different on the left and right side. Can you explain this?
Having two properly-functioning ears greatly improves our listening enjoyment and gives us more balanced hearing, especially when listening to music, or in small group situations. This is because our brains process different information from each of our ears. If we only have one properly-functioning ear, our brains only give us part of the message.
Our brains consist of two halves or hemispheres. The left side of our brain is the logical or the technical side. It gives us discrete pieces of information. The right side of our brain is the aesthetic side. It gives us our appreciation of beauty and our ability to recognize images and patterns of sound.
God wired our brains so that the sounds our right ears hear go mainly to the left side of our brains. There our brains interpret what a person is saying. The sounds our left ears hear go mainly to the right side of our brains. There our brains interpret how the person speaking means it. The two sides of our brains have many interconnecting links so they rapidly “talk” back and forth to each other as they are processing this information.
To be sure, some of the sound impulses from each ear travel to that same side of our brains. However most of the signals cross over to the other side of our brains. This extra information helps us hear and understand better. Thus we need both our ears to completely understand all sounds, speech and music.
For example, take the words “I love you.” Three simple words with a myriad of shades of meanings. Our right ear (and our left brain) would hear and interpret the actual words and analyze the context. Our left ear (and our right brain) would determine how we understand this message–whether sincere, sarcastic or casual.
When listening to music, we “hear” the sounds of the individual instruments of the orchestra in our right ear and “listen” to the blended beauty of the music itself with our left ear.
Therefore, only having one ear detracts from our ability to hear, understand and appreciate sound.
If you are hard of hearing, this is another reason why you need to wear hearing aids in both ears.
Left and Right Ears Are Not Created Equal
The new research could hold profound implications for the rehabilitation of people with hearing loss in one or both ears and help doctors enhance speech and language development in newborns with hearing impairment (Science, Sept. 10, 2004).
“From birth the ear is structured to distinguish between various types of sounds and to send them to the optimal side in the brain for processing, yet no one has looked closely at the role played by the ear in processing auditory signals,” said Yvonne Sininger, PhD, visiting professor of head and neck surgery at the David Geffen School of Medicine at the University of California-Los Angeles (UCLA). She conducted the research with colleagues from the University of Arizona.
Scientists have long understood that the auditory regions of the two halves of the brain sort out sound differently. The left side dominates in deciphering speech and other rapidly changing signals, while the right side leads in processing tones and music. Because of how the neural network of the brain is organized, the left half of the brain controls the right side of the body, and the left ear is more directly connected to the right side of the brain.
Prior research assumed a mechanism arising from cellular properties unique to each brain hemisphere explained why the two sides of the brain process sound differently, but the new findings suggest the difference is inherent in the ear itself.
“We always assumed our left and right ears worked exactly the same way,” said Dr. Sininger. “As a result, we tended to think it didn’t matter which ear was impaired in a person. Now we see that it may have profound implications for the individual’s speech and language development.”
Working with co-author Barbara Cone-Wesson, PhD, CCC-A, associate professor of speech and hearing sciences at the University of Arizona, she studied tiny amplifiers in the outer hair cells of the inner ear.
“When we hear a sound, tiny cells in our ear expand and contract to amplify the vibrations,” Dr. Sininger said. “The inner hair cells convert the vibrations to neural cells and send them to the brain, which decodes the input. These amplified vibrations also leak back out to the ear in a phenomena call otoacoustic emissions [OAEs]. We measured the OAEs by inserting a microphone in the ear canal.”
In a six-year study the UCLA/University of Arizona team evaluated more than 3,000 newborns for hearing ability before they left the hospital. Drs. Sininger and Cone-Wesson placed a tiny probe device in each baby’s ear to test hearing. The probe emitted a sound and measured OAEs.
The researchers measured the babies’ OAEs with two types of sound. They used rapid clicks and then sustained tones. They were surprised to find that the left ear provides extra amplification for tones like music, while the right ear provides extra amplification for rapid sounds timed like speech.
“We were intrigued to discover that the clicks triggered more amplification in the baby’s right ear, while the tones induced more amplification in the baby’s left ear,” Dr. Sininger said. “This parallels how the brain processes speech and music, except the sides are reversed due to the brain’s cross connections.”
“Our findings demonstrate that auditory processing starts in the ear before it is ever seen in the brain,” Dr. Cone-Wesson said. “Even at birth the ear is structured to distinguish between different types of sound and to send it to the right place in the brain.”
Previous research supports these new findings. For example, earlier research showed children with impairment in the right ear encounter more trouble learning in school than those with hearing loss in the left ear.
“Our findings may offer guidelines to surgeons for placing a cochlear implant in the left or right ear of a person who is completely deaf and influence how cochlear implants or hearing aids are programmed to process sound,” Dr. Cone-Wesson said. “Sound processing programs for hearing devices could be individualized for each ear to provide the best conditions for hearing speech or music.”
“Our next step is to explore parallel processing in the brain and ear simultaneously,” Dr. Sininger said. “Do the ear and brain work together or independently in dealing with stimuli? How does one-sided hearing loss affect this process? Finally, how does hearing loss compare to one-sided loss in the right or left ear?”
The study was funded by the National Institute on Deafness and Other Communicative Disorders.
The Right Ear Is From Mars
By ANAHAD O’CONNOR
Published: September 14, 2004
Belting out a few notes on key might take years of practice, and perfect pitch the right genetics, but when it comes to something as simple as telling noise from symphony, speech from music, all ears are created equal – or so it was once thought.
But in a new study, scientists have found that the left and right ears process sound differently. From birth, the right ear responds more to speech, while the left ear is more attuned to music, according to the study, published in Science on Sept. 10.
The findings could have substantial implications for deaf people who need cochlear hearing devices, which are implanted in only one ear, said Dr. Yvonne Sininger, a visiting professor of head and neck surgery at the David Geffen School of Medicine at the University of California, Los Angeles and lead author of the study.
While the idea that the left and right ears are not identical is new, scientists have known for decades that the two sides of the brain sort out sound in different ways. Speech is processed primarily in the left hemisphere of the brain, while music is handled largely by the right, hence the tendency to associate creativity with “right-brain” dominance and analytical thinking with “left-brain” supremacy.
But until now, most researchers overlooked the possibility that differences in auditory processing originated in the ear. “I think everyone just assumed that the two ears were essentially interchangeable,” Dr. Sininger said.
With help from researchers at the University of Arizona, Dr. Sininger tested hearing ability in thousands of infants using miniature microphones that emitted sounds in the subjects’ ears and measured amplification. Tiny cells in the ear respond to sound by expanding and contracting to enhance vibrations, which are then converted to nerve impulses that travel to the brain. But some of those vibrations bounce back in the opposite direction, allowing scientists to analyze the extent of amplification, a measure of how well the ear is responding.
Dr. Sininger found that a series of rapid clicks – resembling the rhythm of speech – produced a greater response in the right ear. The left ear seemed more attuned to tones representing music.
In other studies, researchers have found that children with hearing loss in the right ear tend to have more problems in school than children who are deaf in the left ear. The new findings suggest that the right ear is critical for learning situations.
Five things you may not know about your hearing
Contributed by Debbie Clason, staff writer for Healthy Hearing | Tuesday, October 20th, 2015
Here is the article link: http://www.healthyhearing.com/report/52549-Five-things-you-may-not-know-about-your-hearing
Stop for a moment and notice what you hear. Really pay attention. Beyond the likely suspects of people talking or the volume of the television, what’s going on in the background? Can you hear traffic? Is the neighbor’s dog barking? Are any of your appliances humming along?
Truth be told, much of your hearing is on autopilot. Our brain is processing the sounds our auditory system collects as automatically as we inhale and exhale. In fact, the way we hear is a fascinating and, sometimes mysterious, process. So, in honor of audiology awareness month, here are five things you may not know about how your hearing works.
Your brain is in on the act
Have you ever thought about what happens once sound enters your ears? Just as the brain interprets the images your eyes see, the brain is also responsible for interpreting the sound your ears collect. Very simply, here’s how it works:
- Your outer ear (pinna) acts like a satellite dish to collect sound in our environment and funnel it to the inner ear.
- The inner ear translates the sound into electrical impulses and sends it along the auditory nerve.
- Once the electrical impulses reach the brain, it interprets them into recognizable sound.
Hearing is a hairy situation
You cut and style the hair that grows on your head; sometimes the hair on your arms and the back of your neck stands up on end when you’re feeling uneasy — but did you know you have a completely different set of sensory hair cells in your inner ear which are responsible for how you hear?
Also known as stereocilia, the hair cells in the inner ear receive sound vibrations from the outer ear and change them into electrical impulses which they send to the brain along the auditory nerve. These hair cells — approximately 16,000 of them — are rolled up like a carpet inside your cochlea. The hair cells on one end of the carpet are responsible for translating vibrations for higher-pitched sounds and, much like a piano keyboard, those on the other end are responsible for sound vibrations in the lower register. When these hair cells die, you lose your ability to hear different sounds, depending on where the damaged stereocilia are located. Unlike the hair on your head, unfortunately, the hair cells in the inner ear do not grow back once they are damaged or die.
Many things can damage these delicate hair cells, but noise-induced hearing loss (NIHL) is one of the most common — and preventable. According to the National Institute of Health, approximately 26 million Americans between the ages of 20 and 69 have hearing loss and as many as 16 percent of teens age 12 to 20 have reported hearing loss that may have been caused by NIHL. Hearing healthcare professionals agree: if you can limit your exposure to noise louder than 85 decibels, you can minimize the permanent damage to the hair cells of the inner ear. (In other words, turn down the volume and use hearing protection if you have noisy hobbies, such as hunting or woodworking.)
Your left ear is more emotional than your right ear
One foot is larger than the other and, if you wear eyeglasses, one eye probably has a different correction than the other. Is it any surprise that your ears are different, too? If you have hearing loss, one ear probably has more than the other — but even more than that, since birth, your ears have been partial to different sounds.
Scientists have discovered that the left and right ears process sound differently. The right ear responds more to speech and logic while the left ear is more tuned in to music, emotion and intuition. Scientists believe it’s because speech is processed primarily in the left hemisphere of the brain, while music (and other creative functions) are processed in the right hemisphere.
This may explain why those with greater hearing loss in the left ear may have trouble understanding friends and family’s emotional issues while those who have greater hearing loss in the right ear seem to lose some of their ability to sort things out.
Both ears act like wingmen for your brain
OK — maybe your brain isn’t looking for a date, but it is trying to navigate a fairly chaotic environment at times. Having an ear on each side of our head — known as binaural hearing — helps the brain determine where sound is coming from, increases the range you are able to hear, and provides a more balanced, natural quality of sound. In fact, you may be able to hear up to four times better with two ears than you can with one. That’s the main reason why hearing healthcare professionals recommend wearing two hearing aids when you have hearing loss in both ears.
Hearing loss can make you tired
If you find you’re tiring more easily than you used to, it may not be your age — it might be hearing loss. Remember the automatic listening mentioned at the beginning of this article? When you have hearing loss, you have to concentrate more to understand what you’re hearing. You may even be guessing what people are saying by reading lips, facial expressions and body language.
In fact, a study by the Better Hearing Institute estimates that untreated hearing loss costs the United States $56 billion each year in lost productivity at work, much of which can be blamed on hearing loss fatigue. A survey by the Danish Institute for Social Research found that as many as one in five people with hearing loss stop working altogether. Of those who do work, 15 percent are too tired at the end of the day to pursue leisure activities.
Fortunately, hearing aids can reduce hearing loss fatigue. When the sounds in your environment are amplified, it takes less effort for you to hear speech and other sound. Today’s technology makes it even easier. Many hearing devices have features which isolate and amplify the sound you want to hear while significantly reducing or removing background noise.
Now that you’re more aware of how your hearing works, don’t forget to schedule a visit to a hearing healthcare professional for a thorough hearing evaluation. Even if you don’t have hearing loss, establishing a baseline level for your hearing as well as a relationship with a reputable hearing healthcare professional is a great first step toward hearing health awareness.
By Melissa Tumblin, Founder, Ear Community
It is important for parents to understand how unilateral hearing loss (also known as single-sided deafness, SSD) can affect children from the moment they are born.
Having unilateral hearing loss is like having an invisible disability. While someone who is hard of hearing may be responding to you in a conversation, they may be missing out on hearing much of what you are saying to them. There can even be a slight delay in their response because of taking time to piece together what you just said to them. This is known as an auditory processing delay.
When one ear is not working, it is not only more difficult to hear, but the ability to determine where sound is coming from is also compromised. This is called sound localization. Not being able to localize where sound is coming from can be a safety issue, especially if a child is crossing a street with traffic and not hearing where the direction of cars are coming from.
Having two hearing ears allows us to hear background sounds, surrounding sounds, and determine where sound is coming from. However, always remember that when someone has a unilateral hearing loss, they are not hearing everything as well as someone who has two hearing ears.
Unilateral hearing loss can be challenging for young children while they are growing up. Higher and lower pitched sounds may not be heard. It may also be challenging to hear how to enunciate and pronounce words correctly when language and vocabulary skills are coming in during the critical years of development (birth to three).
Did you know that “30% of children with unilateral hearing loss may have to repeat a grade level by 3rd grade?”*
Unilateral hearing loss may also cause children to act out or be tired after getting home from school because they have been trying extra hard to hear in school all day.
* Bess et all (1998), Bess et al (1986) English and Church (1999) as demonstrated in a study on hearing loss.
Ponto and the School Age Child – A Parent’s Perspective
July 25, 2016
By, Melissa Tumblin (for Audiology Online and Oticon Medical)
Interview with Melissa Tumblin
AudiologyOnline: Melissa, thanks for your time today. The last time we spoke with you, your daughter Ally was a toddler and using the Ponto bone anchored system. Ally is now six and a half – how have her hearing needs evolved?
Melissa Tumblin: As Ally has gotten older, I have noticed that she struggles with understanding what is explained to her whether someone is describing how to play a game or at school when her teachers are describing what they will be doing in class. Ally has a auditory processing disorder, in addition to her hearing loss, making it a challenge for her to process information that is explained to her, quickly. Ally performs much better when she is aided and does not appear to lose as much information when she is having things explained to her. Helping Ally be more of a visual learner has also helped her manage her hearing loss better. She is being taught to be alert and attentive. Also, now that Ally is older and able to communicate and advocate for herself, she understands how her hearing device helps her hear better. When Ally was younger, it was difficult trying to obtain information from her and feedback on what worked for her. Now, she is able to help me advocate with her.
AudiologyOnline: Ally has worn the Ponto from a very young age on the soft band. Given what you know now, would you make that same decision again?
Melissa: Yes. Ally began wearing the Ponto at 11 months of age. Ally is now 6.5 years old and if we had not discovered Ponto for Ally, she would have been struggling with her hearing loss. When Ally does not have her Ponto on, she questions things more by saying “what did you say mommy?” or “say that again.” She truly is hard of hearing and just doesn’t hear everything when she is not aided. When Ally is aided, she hears so much better and when I call for her, she looks in my direction and comes directly to me. When Ally is not wearing her Ponto, this does not happen and she looks all over for me. Ally is at the age now where she wears her Ponto every day, from morning until night. She also asks for her Ponto when I haven’t given it to her and she has begun advocating for herself with her hearing loss at school, at home, at dance class, at camps, and while playing with friends.
AudiologyOnline: It’s great to hear about those benefits. Have you seen benefits in academic skills and social skills as well?
Melissa: Yes, absolutely. Before Ally was aided she really didn’t respond much and was very quiet. Ever since Ally has been aided, she is more vocal and I see her facial expression is so positive and lit up. Ally also enjoys listening to music more and singing in school. I know she is enjoying listening to music because she often comes home from school singing songs that she is learning word for word. This tells me that she is enjoying hearing music and hearing well enough to be able to recite songs on her own. I can see the excitement in her face and she is very outgoing now. She enjoys playing games with her peers and being out on the playground much more now because she can hear what her friends are asking her to do and what to play. I just watched her play a game of freeze tag at the park the other day with other kids and it made me smile that she could participate and know what to do. At school, her teachers say that she is very responsive, especially during story time. She listens and answers their questions and mimics the sounds that are made during the stories. Now that Ally is learning her alphabet, hearing is important to help her develop reading and higher language skills. She carries on very well with her friends, even in loud places such as the cafeteria and gym.
Ally and her doll both wearing their hearing devices.
AudiologyOnline: When Ally attends new situations like a new school or classroom, a new play group, or other social activities, how have you prepared her and others regarding use of the Ponto?
Melissa: Ever since Ally began attending preschool, all of her teachers have known about her Ponto. Her teachers help her with her Ponto when she needs help. The school audiologist also conducts periodic checks on Ally’s Ponto to make sure the volume is alright and everything is still in line with her hearing loss. Whenever we are around new friends or when Ally is in gymnastics or at a camp, we let everyone know that Ally has a hearing loss and that this is her hearing aid. Everyone has been great with helping Ally in all situations. If your child goes to a school where there is not a hearing loss program available, just make sure you talk with your child’s teachers about his/her hearing device and show them how the battery goes in and to maybe help make sure the hearing device stays on their head.
AudiologyOnline: You mentioned that now Ally is becoming her own advocate. Can you expand on that?
Melissa: Ally is very lucky as she attends a public school that offers a deaf and hard of hearing program, while being mainstreamed with her hearing peers in the same class. Ally has other children in class with her who also wear hearing devices, so she does not feel different. When Ally is around other children who do not have hearing loss and they ask, “What is that on you head?”, she just tells them that this is her hearing aid and that it helps her hear better. The younger kids usually think Ally’s Ponto is pretty cool because they think it is “bionic” or has “extra hearing power”. Otherwise, Ally puts her Ponto on every morning when she gets ready for school just as she gets dressed and eats breakfast, and wears it straight through until bedtime. Ally used to ask to take her Ponto off after wearing it for so many hours. During the past couple of years, she keeps her Ponto on from morning until night. She also protects it when it rains.
When Ally was younger, I was the one always putting on her Ponto and making sure she wore it for so many minutes to hours at a time until she accepted wearing her hearing device for long enough periods. Over the past couple of years, we’ve taught her to advocate for herself in putting her hearing device on at school, when to ask for a new battery if the hearing device has stopped working, and how to connect to the FM system. If she ever needs a break from her Ponto, I of course allow her to take her hearing device off for a break. Ally is proud of her Ponto and she enjoys personalizing it too. She has a butterfly clip in place of the clip that comes with the safety line and she often likes to put stickers on her Ponto and bling it up for the holidays and for the school year. She has also put bows on her soft band head band that match her outfits.
AudiologyOnline: Does Ally use any accessories with her Ponto?
Melissa: Ally faithfully wears the Streamer at school, every day, with the school’s provided FM system. All of the kids in Ally’s class who wear hearing devices utilize the FM system so they can hear their best in gym class, music class, and in the regular classroom. Ally also enjoys using the Streamer to help her listen to her tablet, quietly, so no one else has to hear the loud sounds of games and movies when she is playing and watching them. The Streamer makes it easy for her to listen to her tablet without having to wear extra head phones that don’t stay on her head well – everything goes right through her Ponto, which fits her perfectly and easily. The Streamer has been an absolute life saver when we travel via plane, and also at her sister’s sports activities when it is paired with her tablet.
Ally using Ponto and the Streamer with her tablet.
AudiologyOnline: We know that each child is unique and everyone’s situation is different. Given that, what general advice would you give to parents who have a child with hearing loss based on your experience?
Melissa: First, if your child has a hearing loss even if it is in one ear or minimal, always allow your child to try a hearing device if it is recommended. When someone has a hearing loss, especially a child, they may not tell you when they are struggling. Also, when someone has been challenged with hearing loss since birth, they may not realize how many sounds they are truly missing out on since they have never experienced hearing with two ears. Remember, one ear will never be as good as two ears.
2. Understand your child’s hearing loss. There is a reason why we have two ears. Two ears allow us to hear better when there is background noise, to hear softer sounds, and allow us to determine where sound is coming from. When someone only has hearing in one ear, they are missing out. Understand that someone with hearing loss may also struggle to hear in loud areas such as in restaurants or in areas where there are echoes. Realize that your child’s hearing loss may also change over time and that it is important to monitor their hearing loss through regular hearing tests with an audiologist.
3. Find what works best for you and your family, and learn how to advocate for your child. Inquire about an IEP (Individualize Education Plan) that can help customize a plan for your child so that they can achieve their maximum potential in school.
4. Don’t be afraid to ask questions and get the help you need. If your child uses a hearing device, ensure the device is optimally adjusted for your child. Hearing devices today are very smart and can be adjusted based on the child’s environments and daily activities. Even if it takes several visits to the audiologist to optimally adjust the hearing device, It will be worth it for your child to hear better. Ask questions about the hearing device and learn how to get the most out of it. Understand how to dry the hearing device in the event it should get wet or rained on. Learn how to use the hearing device for your child’s everyday needs, and learn how to use apps that can help make using the hearing device easier. Learn how to pair the hearing device wirelessly to tablets, to a mobile phone, and for streaming music. Learn about the accessories that may be available with the hearing device. For example, some hearing devices have accessories that connect to the TV, so your child can hear the TV volume consistently using their device, while other family members are listening to TV at their preferred volume.
5. Be persistent and do not get frustrated. When trying to aid a younger child (infant/toddler) with a hearing device, it isn’t always easy as younger children like to pull their hearing devices off/out. It may be a struggle to get your child to wear their hearing device for long periods of time. It is important to know that you are helping your child hear better already by simply getting them to wear their hearing device even if it is for only 5 to 20 minutes a day. Slowly work your way up to longer periods of time. Just keep trying and don’t get frustrated. You can use a timer and then when the timer dings, you can allow your child to take off their hearing device for a break. You can try to make it fun and play music or sing or dance when putting their hearing device on so they can connect a positive experience with their hearing device. Maybe personalize their hearing device with stickers your child would enjoy. It helps to wear a hearing device on a child when he/she is in an upright position rather than lying down to where the hearing device can be easily knocked off. Also, make it easy on yourself too as the parent…if your child makes you nervous wearing his/her hearing device while eating and you are concerned that your child will smear peanut butter and jelly in their hearing aid, then remove it while they eat and put it back on after they are done. Try not to stress about this because your child may pick up on your tension when working with their hearing device. Also, remember that kids just as well as adults may not always be willing to admit that they are having trouble hearing. Try and support your loved one and let them know that is no big deal to wear a hearing device, especially when they will be able to hear better, fit in better socially, and have more confidence. Encourage your loved one to just try a hearing device. It can only help and definitely won’t hurt and millions of people wear hearing devices today. Hearing devices are accepted more today than ever before.
6. Get connected to other parents and other families of children with hearing loss. Ask your child’s audiologist about support groups or community groups in your area, and check out our online community, Ear Community. The emotional support of others who are in similar situations can make a big difference.
AudiologyOnline: Thank you for sharing your experience, Melissa. It is always a pleasure to talk with you.
Here is the link to this article: http://www.audiologyonline.com/interviews/ponto-and-school-age-child-17792
Melissa Tumblin, Founder and Executive Director of the Ear Community Organization
Melissa Tumblin is mom to Alyssa “Ally” Tumblin, a child born with right sided Microtia and Aural Atresia. She is the Founder and Executive Director of Ear Community, a nonprofit organization that promotes educational and public awareness about Microtia and Atresia and hearing loss, in an unbiased manner, while promoting advocacy and connecting individuals in the same situation. She is also the founder of the Microtia and Atresia Support Group on Facebook. She is a past board member for the Hands & Voices Organization and a past council member for the Parent Advocacy Family Council for Children’s Hospital Colorado (Bill Daniels Center for Children’s Hearing). She has spoken at microtia and atresia surgical conferences and has presented at past EAA (Educational Audiology Association) conferences and for AudiologyOnline. Melissa has over 15 years experience in marketing medical device equipment.
Success For Kids With Hearing Loss
Founded by, Karen Anderson
This helpful resource focuses on improving the futures of children with hearing loss through education and helpful articles and information. Success for kids with hearing loss is a wonderful helpful resource to help you understand hearing loss in children and the affects it can have on children, including the options that are available to help make life better and easier. Karen’s website provides excellent articles, research, and facts on hearing loss and events that are going on in communities.
to Evidence-Based Practice
American Journal of Audiology,
September 2016, by:
Effectiveness in Treating Single-Sided Deafness with the Baha System
An article discussing the benefit of helping treat single-sided deafness with the use of a BAHA. By Carol A. Sammeth, PhD and George Cire, AuD (Cochlear Americas) in the April 2009 issue of Hearing Science and New Technology.
Effectiveness in Treating Single-Sided Deafness with the Baha System
Affects of Hearing Loss
Bone-Anchored Hearing Aid (BAHA) For Single Sided Deafness
Below is a video explaining how the loss of hearing in one ear may cause difficulties in hearing/speech in your environment when compared to having two functional ears previously. Offered by, OR-Live.com webcast January 17, 2008, 6:00 PM EST (23:00 UTC) From Hartford Hospital, Hartford, CT
Singled Sided Hearing Loss in Children
What is the effect of single sided hearing loss on my child’s function and development?
There is much discussion about whether or not children with UMA should be aided. Children with standard UMA have a one-sided 60 dB conductive hearing loss, commonly referred to as single sided deafness or SSD. Most conversations take place at 40 to 50 dB. The standard philosophy until recently has been “one working ear is good enough” However, over the past 10 to 15 years, a growing body of research seems to be showing that for some children, one working ear may not be good enough to develop normally. Dr. Roberson of the California Ear Institute has summarized his position in the following article:
Singled Sided Hearing Loss in Children
What is the effect of single sided hearing loss on my child’s function and development?
“Traditionally, physicians and audiologists have been taught that if one ear is normal then auditory, speech, and language function anddevelopment will be normal. We now know this long-held belief is WRONG.
Untreated single sided hearing loss in children produces several functional and developmental problems. Summarizing the research at the end of this article, it is fair to say that “the more difficult the listening situation the more dysfunctional single sided hearing becomes”. For example, a child with unilateral hearing impairment will function relatively normally at home in a quiet environment with a single person interaction with known speakers. That same child may have extreme difficulty in a noisy classroom. Even if teachers, parents, and professionals think the child is doing “just fine” with hearing only on one side, it is well documented that untreated single sided hearing loss has a significant potential impact to adult earning potential.
Let’s be more scientific. First, you need to understand the basics of auditory function. In the simplest description, the ear canal and eardrum and inner ear serve as a mechanism to convert the vibrational energy of sound in our environment to electrical pulses presented to the brain by the hearing nerve. The brain takes that signal and analyzes it to give us the sensation we know as hearing. In noisy and low volume environments, the brain has to have a signal from both ears to do its job correctly.
We have all had the experience of being in a very noisy restaurant and trying to listen to someone across the table from us. That is a very practical example of what someone with hearing only on one side experiences a significant portion of their day. When children or adults have hearing in one ear only, that same feeling occurs with very low levels of background noise.
Here are summaries of the different functions two ears allow:
- Sound Localization:
When a sound comes at us from any angle the brain measures the difference in time it takes for the sound to reach each ear. For example a sound coming from the right will register in the right ear before it does in the left. This intra-aural time difference is very small, but when two ears hear a sound at slightly different times, the source of the sound can be “localized” and the listener can turn to it if desired. Just like the loss of vision in one eye eliminates depth perception, the loss of hearing in one ear eliminates the hearing equivalent which is sound localization. Imagine yourself on the playground and someone is calling your name and you can hear them but cannot tell where the sound is coming from – that is what hearing with a single ear produces. We believe this is one reason children with hearing loss have almost twice the rate of injury than those with normal hearing in both ears.
- Hearing in Noise
Every day we select out the speech we want to listen to from a sea of noise. To go back to our analogy above, all of us have had trouble in very noisy situations (like a restaurant or party) hearing what another was speaking to us. The brain, not the ear, is responsible for our ability to selectively listen in noise. For this system to function correctly, two ear hearing is essential. Without two ears, a child will have difficulty hearing in even small amounts of background noise. Every brain is different in its ability to perform this task and testing can be done to quantify the function. On some occasions, the brain has trouble with this task even when two normally hearing ears are present – called Auditory Neuropathy. Children with one hearing ear have functional Auditory Neuropathy.
- Cognitive Load
Understanding speech in noisy environments while conducting tasks is difficult even for people with normal levels of hearing. The louder the background noise, the longer it takes the individual to complete the task and the more speech they miss. This concept is called “cognitive load” and can represent a subtle but constant problem for school-aged children attempting to understand what a teacher is saying while taking notes in a noisy classroom.
- Binaural Loudness Summation
When two ears hear a sound, it registers more loudly with the brain than if the same decibel level sound was only heard with one ear. This makes sense when you know that nerve cells in the brain which register sound receive input via nerve connections called “axons” present in both ears. With a sound, the brain hearing nerve cell will have a stronger stimulation with the same sounds when two ears hear it instead of one. Intelligibility in low volume situations improves significantly with two ears compared to one.
- Head Shadow Effect
A person with normal hearing and brain function can preferentially listen with one ear instead of the other. Imagine you are walking down a sidewalk with traffic to one side and a friend talking to you from the other. Your brain will preferentially listen to your friend and “turn down” the ear toward traffic to improve your understanding. Now imagine a teacher walking around a classroom (they ALL are noisy to some extent) and imagine what happens when the teacher walks to the side with hearing loss or turns to write on the blackboard. With that image, you can understand how two ears are preferable to a single ear in the classroom and other life situations.
So what impact should this have on how I treat my child?
The brains ability to hear in noise is not present at birth, and develops over time during the first 10-12 years of life. This system only develops fully when both ears are providing auditory input to the brain. Waiting until late in this process to provide hearing in both ears does not make sense from a developmental aspect.
For this reason and the reasons listed above, it is our medical objective to return hearing to two ears if at all possible as early as possible. As stated above, in the past, physicians have been historically taught that one ear is “good enough” and many do not recommend treatment of single sided deafness. These physicians, who are poorly informed about the current research, do not perceive a problem in delaying treatment of single sided hearing loss during the very critical period of development of the auditory system during the first few years of life. Unfortunately, this delay can create permanent and irreparable harm to the child whose hearing loss goes untreated.
Individual situations must be assessed by a professional able to give treatment options and chances of success. These options may change over time as well. For example, surgery to perform atresia repair may be the right choice if a CT shows a high chance of success at the appropriate age. Additionally, soft-band BAHA may be the right treatment to stimulate the ear and hearing nerve with unilateral atresia from a few weeks of age until this CT evaluation for surgery is possible.
Children with Single Sided Hearing Loss should receive a comprehensive medical examination and specialty care from an Otologist, who is an otolaryngologist (ENT) who has undergone two additional years of training and specializes in hearing only. With appropriate medical treatment and therapy, these children can fully function in a hearing world.”
See references at http://www.californiaearinstitute.com/ear-disorders-singled-sided-hearing-loss-children-ear-institute.php
Ultimately, the choice of whether or not to aid a child with UMA is the parents’, and it is true that many children with UMA do “just fine” without being aided. However, CEI feels strongly that all parents should at least be made aware of this research so they can make a fully informed decision about whether or not to aid their child with UMA. This information was submitted by one of our support group members, Sheri Bryne-Haber.
Here is another article that states that recent research shows language skills being affected in children with a unilateral/single side hearing loss:
The name of this article is: 1-Sided Hearing Loss Lowers Language Skills
Kids With Hearing Loss in 1 Ear Have Lower Speech-Language Scores Than Siblings With Normal Hearing
WebMD Health News
“May 10, 2010 — Children with hearing loss in one ear have lower speech-language scores than siblings with normal hearing, new research shows.
A team of scientists at the Washington University School of Medicine in St. Louis recruited 74 children from the St. Louis region between the ages of 6 and 12 with one-sided hearing loss. Each child was compared to a sibling with normal hearing.
This allowed the researchers to take into account the possible effects of environmental and genetic factors on language skills.
The children with one-sided hearing loss, called unilateral hearing loss, scored worse than their siblings on tests of language comprehension and oral expression. Children with unilateral hearing loss were also more likely than normal-hearing siblings to have received speech-language therapy. There were no differences between children with unilateral hearing loss in the right ear vs. the left ear or with different degrees of severity of hearing loss.”
Unilateral Hearing Loss Affects Language Skills
Judith E. C. Lieu, MD, a Washington University professor and ear, nose and throat specialist at St. Louis Children’s Hospital, says in a news release that previous research has suggested children with hearing loss in one ear might experience problems in school.
“Now our study has shown that, on average, children with hearing loss in one ear have poorer oral language scores than children with hearing in both ears,” she says.
The study is published online in advance of its appearance in the June print issue of the journal Pediatrics.
Other factors affecting test scores were family income and maternal education level.
“This study should raise awareness that if children with hearing loss in one ear are having difficulties in speech or reading in school, their hearing may be part of the problem,” Lieu says. “Parents, educators and pediatricians shouldn’t assume that having hearing in one ear means children won’t need additional assistance.”
She suggests that studies in the future should examine whether hearing aids or amplification systems in classrooms would help children with unilateral hearing loss.
“The effect of hearing loss in one ear may be subtle,” she says. “These children may shun large group situations because the noise overwhelms them, and they have a hard time understanding speech.”
Such children could have trouble playing team sports because “they can’t localize sound well and can’t tell who is calling to them,” Lieu says. “For them, listening takes a lot more work, and they may have to put in extra effort.”
It’s possible that hearing loss affects overall educational achievement and even occupational choice, she says.
The researchers write that the common practice of withholding hearing-related accommodations from children with hearing loss in one ear should be reconsidered, that further research is needed, and that parents and educators ought to be told about the negative impact of unilateral hearing loss on oral language skills.
It is estimated that one in 50 per 1,000 school-aged children have hearing loss in one ear, according to the researchers.”
Bone Conduction Hearing Loss Simulations
Hearing Loss…What Does it Sound Like? How much is your child or adult loved one really hearing? By watching and listening to a conductive hearing loss simulation you can experience what dB level of hearing loss your child or adult loved one may be experiencing. Individuals having Microtia and Atresia may experience a hearing loss range near a 35dB level to a moderate to severe hearing loss at or around 75dB to 85dB .
I personally, was shocked at how much I could not hear when I listened to one of these bone conduction simulations. My daughter, Ally, has approximate 65dB level of hearing loss in her right (microtic/atretic) ear with normal hearing at a 20dB level in her left (non-microtic/atretic) ear. I guess I thought Ally was hearing better or more than I had expected. Especially, when I hear some say her hearing is similar to “underwater hearing.” Ally has a 65dB level of hearing loss that is termed “moderate to severe” and what I experienced hearing in this simulation showed me that she can not hear very well at all in her Atretic ear, much less than I had expected or thought she was hearing.
Living with a Hearing Disability: Single-Sided Deafness (SSD)
This article does a great job explaining what it is like living as an individual with single-sided deafness.
Unilateral Hearing Loss in Children: Challenges and Opportunities
This article does an excellent job explaining unilateral hearing loss in children and the challenges they face in school and when being at risk for academic, speech-language, and social-emotional difficulties when compared with their normal-hearing peers.
Hearing Device Timeline
The following link will help you learn more about the history and the development of assisted hearing devices: http://beckerexhibits.wustl.edu/did/timeline/index.htm
An Article by AG Bell
Hearing Aid/Cochlear Implant Use: Persistence Matters!
Hearing children grow up in a world filled with sounds. For them, language learning begins at birth. When hearing loss is pres…ent at birth, or occurs within the first years of life, listening and speaking skills are compromised. Technological advances and newborn hearing screening make possible early identification of hearing loss
earlier than ever before – even at birth! Aggressive audiological management could mean that once babies are identified, they could be wearing amplification within a few weeks or months of birth. With early identification and intervention, families can begin to give their babies similar early listening experiences to those experienced by the baby with normal hearing. But this means that the child must be wearing his/her amplification all waking hours. This is no easy task, but here are some facts
Consider this: A normally hearing baby listens for about 10 waking hours per day, 365
days per year. That adds up to 3,650 listening hours per year.
Consider this: lf your baby wears amplification only 3 hours a day, it will take over 3
years to give your baby as much listening experience as a hearing baby or
a baby who wears amplification all waking hours!
Consider this: A normally hearing toddler or preschooler listens for about 12 waking hours per day, 365 days peryear. That adds up to 4,380 listening hours per year.
Consider this: lf your toddler or preschooler only wears his amplification at school (2.25 hours/day), it would take more than 9 years of preschool for the child
to have as much listening experience as a hearing preschooler or a
preschool-aged child who wears his/her amplification all waking hours (12
These mathematical facts have huge ramifications for the development of spoken language! The normally hearing baby listens 10 hours a day to develop normal speech and language. The baby with hearing loss deserves no less. Set goals for your family to increase the amount of time your infant or toddler wears his/her amplification.
reasonable goal would be to turn things around and establish full-time amplification within 6 to 8 weeks. Talk to your child’s early intervention professional. Work together to set and accomplish this goal!
Copyright O 2003 Alexander Craham Bell Association for the Deaf and Hard of Hearing, lnc (Reproducible materials for families).
* This article was posted by Heidi Jeffs, a member of the Microtia and Atresia Support Group and was sent to her by her child’s early intervention contact. Thanks Heidi! Melissa
Talking To Somebody Who Is Deaf In One Ear
An article of what someone experiences when being single side deaf or hard of hearing…
This article does an amazing job of explaining what someone experiences or goes through with a unilateral hearing loss or single sided deafness. There is a video of how the ear works and some tips as to help to help make it easier on friends and loved ones who have a hearing loss.
This article was posted by Angela Sabal, a member of our support group and a Board of Director Member for Ear Community.
Hearing Loss In Only One Ear
We just found out that our child has a permanent hearing loss, but it’s only in one ear.
This doesn’t seem like a big deal What should we know?
This article is great and was submitted by one of our support group members. Thank you Gean!
Why it’s a big deal:
One ear cannot listen the same as two ears in all situations. Two ears working together are needed to figure out where sound is coming from. Two ears help us hear better in noisier places. Also, two ears listening together hear just a bit better than one ear working alone. It is very important for learning both at home and at school for a child to hear as well as possible with both of their ears!
Children are like little sponges and learn language by hearing it from the people who are around them every day. Any time when listening is not easy it will be harder for a child with unilateral hearing loss to pick up new words. One of the biggest challenges for people with hearing loss in one ear is listening in noisy situations. Having the TV on a lot is just noise to a baby and it can make it really hard for your child to pick up new words from you. Hearing from a distance is also a challenge. Your child can hear you best if you are within a few feet of your child when you talk to him. Because of these listening challenges, children with hearing loss in one ear often need help to clearly hear what you say, as well as what teachers say in school, and what their friends say during play. Without this help, children with unilateral hearing loss may be 10 times more likely to fail a grade in school or need special help to keep up in school. 1/3 to 1/2 of children with hearing loss who have not received help to hear better have problems learning in school! Also, because most rules of social interaction are learned via subtle auditory cues and visual cues, rather than direct teaching, it isn’t a surprise that about 1/5 of these children will develop behavior or social issues.
Learning issues are largely due to missing incidental speech that occurs in the environment. Even though a child hears typically in one ear, whenever there is noise or the speaker is at a distance the child will miss part of what is said. It is recommended that children with some usable hearing in their worse ear begin to wear a hearing aid in their poor ear starting in infancy. This will provide more ‘balanced’ hearing and allow the child to pick up incidental language around them, thereby preventing some/all of the possible language delays and behavior/social issues. Waiting to amplify the poorer hearing ear until school age (child is in kindergarten or older) may be too late as their brain will take considerable time to learn how to use the information to localize sound and listen in noise. Until that happens, the child may report that the hearing aid actually makes it more difficult due to amplification of all noise along with speech. Don’t wait! Learning challenges include difficulty learning sound/letter associations in typically noisy kindergarten and grade 1 settings, feeling ‘out of step’ due to missing parts of directions and the inability to hear/understand what peers are saying in the classroom unless they are close and it is relatively quiet.
Hearing Loss in One Ear– This information briefly reviews why parents of young children should be concerned about unilateral hearing loss, what they should watch for, and what they should do.
Possible effect on learning: Relationship of Hearing Loss to Listening and Learning Needs – Unilateral Hearing Loss – This single-page handout can be used to assist in planning a young child’s transition to school. It can also be used to inform teachers, other school staff, and medical providers on the potential effects of unilateral hearing loss on learning.
Accommodations in the Classroom for the Student with Unilateral Hearing Loss
- Teacher inservice is important. Provide teacher with Relationship of Hearing Loss to Listening and Learning Needs – Unilateral Hearing Loss It is also helpful to ask the teacher to wear one noise protection ear plug (purchase at drug stores or hardware stores) and demonstrate listening from various parts of the classroom, with and without noise, with back turned and from different seats in the classroom.
- Allow child to change seat locations to direct the normal hearing ear toward the primary speaker. Seating in the rightmost (for good left ear) or leftmost (for good right ear) row is suggested so student’s better hearing ear will almost always face the teacher. Student should be encouraged to turn in his or her seat to face a classmate who is speaking.
- Allow student to close the classroom door if he/she is bothered by hall noise.
- Teacher should summarize key points spoken by classmates so that this information is accessible to the student.
- Trial period with a personal FM system to enhance reception of the teacher’s voice, typically in the student’s better hearing ear or placement in a classroom with a sound field amplification system (amplifies what the teacher says for the whole class) is warranted. Pre/post testing with the Listening Inventory For Education will assist in determining the student’s need for and benefit of assistive amplification.
- Educational monitoring is warranted. Teacher completion of the Screening Instrument For Targeting Educational Risk in October, January and May will allow the student’s function in the classroom in comparison to peers to be easily monitored.
- If amplified, student should be involved in regular amplification monitoring and should receive instruction in how to become his/her own ‘Technology Specialist’.
- Student will benefit from being in contact with other students who have typical hearing in only one ear as a source of mutual support. Facilitated contact through chat rooms, skype, penpal, or face-to-face formats is strongly suggested so that the student does not feel as isolated in the issues faced due to unilateral hearing loss.
- Teacher should be aware of the potential impact of unilateral hearing loss on socialization and behavior and provide support when natural opportunities occur to help the student to fit in and be seen as a valuable group member.
- Here is the link to this article: https://successforkidswithhearingloss.com/resources-for-parents-of-children-with-hearing-loss/unilateral-hearing-loss
Here is also another helpful link that can offer some insight and guidance when discussing a unilateral hearing loss with schools and educators, etc…
By Dr. Judith E.C. Lieu, MD (ENT)
Source: Washington University School of Medicine
Currently rated 5.0 by 3 people
Published on July 20, 2013 at 7:22 AM
Children born with a complete absence of the external ear canal, even if only one ear is affected, are more likely than their peers to struggle in school, according to new research at Washington University School of Medicine in St. Louis. Hearing amplification and corrective surgery are available for the condition, called aural atresia. But many children with single ear atresia (unilateral atresia) often are not treated, even though they have significant hearing loss in their affected ear. The assumption has been that having one good ear is adequate for children with the condition. “Until the 1990s, any kind of hearing loss that occurred in just one ear and was present from birth was not considered a serious disability,” said Judith E.C. Lieu, MD, co-author of a study that looked at the effects of aural atresia on speech development. “It was assumed that these children would adjust and develop normally. But we know now that isn’t always the case.” The research is published July 18 in JAMA Otolaryngology. Aural atresia occurs in about one of 10,000 live births. In two-thirds of cases, only one ear—more commonly the right ear—is affected. The condition is almost always accompanied by a malformed or absent external ear.
Because ears affected by atresia lack an ear canal, sound is not conducted to the inner ear, which in most cases is healthy. Children born with unilateral atresia may have completely normal hearing in their other ear. A number of surgical and amplification techniques that enable sound to reach the inner ear can restore hearing for this condition. Many of these children, however, do not use devices that would enable hearing with both ears. “There are cost issues, comfort issues and vanity issues behind this,” said Lieu. “And society has a long history of believing that one good ear is sufficient.” Lieu calls it an invisible impairment. “That is part of the problem,” she said. “Because the child appears normal, it is easy to forget that they have an impairment. A child with unilateral atresia who fails to pay attention in class or keeps talking when he or she should be quiet, might be labeled a problem student when the real issue is that he or she simply does not hear the teacher. Armed with recent studies indicating that children with unilateral hearing loss from causes other than atresia have an increased risk of speech and language delays that can affect school performance, Lieu and her colleagues at Washington University School of Medicine set out to determine if the same was true for children with aural atresia. The investigators analyzed medical records collected by the Center for Communication Disorders at St. Louis Children’s Hospital over a 35-year period to select 74 children who were seen at the clinic from the age of two to 12. “There were slightly more males and more than twice as many cases of right atresia as left atresia,” said Lieu, who noted that those proportions are consistent with the general demographics of children seen for the condition. The study also included seven children with both ears affected (bilateral atresia). Nearly all children with the condition had a moderately severe hearing loss in their affected ears. And those with atresia in only one ear had normal hearing in their other healthy ear. Of note is that all children with atresia in both ears wore two hearing aids, but fewer than 5 percent children with atresia in one ear had received a hearing aid.
As part of the study, the investigators analyzed data from speech pathologists’ evaluations and from clinic notes by psychologists and nurses, and parental reports to evaluate rates of speech or language delays, prevalence of speech therapy and educational interventions. The data showed that in children with unilateral atresia, about 40 percent required speech therapy and 25 percent experienced difficulties learning in school. As expected, children with atresia of both ears had received speech therapy, and none of these children had any academic performance issues. “This may be because their impairment was more fully appreciated and addressed, and their learning environment was modified,” said Lieu. Compared with children who have atresia of the left ear, those with the condition on the right may be more likely to have problems learning in school. In previously published studies, nearly 35 percent of those with right unilateral hearing loss had repeated a grade, compared with fewer than seven percent of children with left unilateral hearing loss. Based on their findings, the investigators advocate close, early and ongoing monitoring of children with unilateral aural atresia for early signs of speech or academic struggles and adoption of a low threshold for interventions. “There are bone-anchored devices and bone-conduction hearing aids that can either restore hearing or make it significantly better,” Lieu said. “Even if parents do not choose these options, or children refuse to wear them, teachers, parents and physicians should be vigilant about watching for signs of language delays and school problems and attempt to understand the root cause.”
Here is the link to this article: http://www.news-medical.net/news/20130720/Children-with-unilateral-hearing-loss-are-more-likely-to-struggle-in-school.aspx