Question: When using hearing aids, does your brain no longer pick up certain stimuli, meaning that over time your brain stops even trying to detect the sound?
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This raises a number of issues related to hearing and understanding speech.
It is true that as we age our hearing does diminish, although this does not occur at the same rate for everyone. Most people start losing some sensitivity to sound from about 45 years of age. This is usually so gradual that you don’t notice and it’s often hard to convince people that there is anything wrong.
Typically we lose sensitivity for the high-pitched (high frequency) sounds more than the low pitches and this leads to two problems. One is that we are less able to understand speech when other noises are around, and the other is that we make more errors in identifying words.
The loss is usually due to a loss of sensory cells in the inner ear, but this also affects the brain which is where we actually analyse complex sounds like speech.
Hearing aids, when properly fitted, can improve hearing sensitivity and therefore assist in understanding speech. It is difficult, however, for hearing aids to bring hearing back to normal, particularly in a noisy situation.
It is a good idea to use hearing aids consistently when you have a significant hearing loss as this will keep active the areas of the brain involved in analysing sound.
There is good scientific evidence that if the hearing areas of the brain are not stimulated for a prolonged period, they will lose some of their ability to analyse sound, and might not return.
It has even been shown that if you are born with no hearing, some areas of the brain that are usually involved in sound get “taken over” by different functions.
We should look after our hearing by avoiding exposure to loud sounds and accept that as we get older our hearing ability declines and it will be necessary to consider using hearing aids.
Modern hearing aid technology is excellent but needs proper fitting and advice from a qualified audiologist to be most effective.
In general, it will take some considerable time and perseverance to get the most from hearing aids and it is unlikely that they will bring hearing back to completely normal, but your brain will thank you for persisting.
Response: Professor Richard C Dowell, Audiology and Speech Science, University of Melbourne.
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