Teenagers

Hearing Better Through the Ages

By Rebecca Huzzy, Au.D.

Chances are, you visit your doctor for an annual physical, wear a seatbelt, and use sunscreen. These are just a few small efforts we regularly make to stay healthy and injury-free.

Tending to the health of our hearing is another important, simple way we can maintain our overall physical and emotional well-being. Supporting hearing health begins at birth, when we test newborns for hearing loss, and continues into our elder years, when assistive technology can vastly improve overall health and quality of life.

Diagnosing Newborns & Infants

According to the Centers for Disease Control and Prevention, hearing loss is one of the most common congenital conditions, impacting approximately 12,000 infants per year. About half of these cases are linked to certain genetic syndromes, such as Down syndrome, Treacher Collins, and Usher syndrome.

But with the advent of universal newborn hearing screening programs in the early 1990s, hearing loss can now be identified and treated very early. According to what we call the “1-3-6” EHDI (Early Hearing Detection and Intervention) national goals, infants should be screened by age 1 month; diagnosed by age 3 months; and in an early intervention program by age 6 months.

“The effects of providing acoustic stimulation to the immature neurological system, including the brain, and combining the input with a rich and meaningful environmental experience, allows children to develop sufficient auditory skills to learn spoken language at a very young age,” says Janice C. Gatty, Ed.D., the director of Child & Family Services at Clarke Schools for Hearing and Speech.

This means families should expose their infants to sound frequently and consistently—talking to them, naming objects, narrating actions, singing, and reading books. With access to sound and an early intervention program at this young age, a child with hearing loss can begin learning to listen, babble, and eventually talk.

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Common Risks for Adolescents & Teens

Since the prevailing cause of hearing loss in young people with typical hearing is noise exposure, we need to educate kids early, as many begin listening to music on personal devices, playing in bands, and attending concerts at a young age.

According to the American Speech-Language-Hearing Association, exposure to sound that is higher than 85 decibels (the volume of a blender, hair dryer, or siren) for an extended period of time can cause permanent hearing damage. And the maximum output of most MP3 players is a powerful 110 decibels!

Fortunately, there are options for volume-limiting software that can mitigate unhealthy sound levels. Many devices offer parental controls and volume-controlling apps that limit noise levels, and there are various kid-friendly, hearing-healthy headphones available.

Follow the 80/90 rule: Set the maximum headphone volume to be 80 percent (not 100 percent), and listen for up to 90 minutes daily. If you listen for longer, lower the volume even more.

How Sound Exposure Catches Up With Us in Middle Age

“Adult onset hearing loss typically progresses slowly over the course of a number of years,” says audiologist John Mazzeo, Au.D., the audiology supervisor at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.

Noise-induced hearing loss (NIHL) can have a sneaky, cumulative effect, similar to the impact of years of exposure to the sun. The people at the highest risk for NIHL work in noisy professions and include musicians, farmers, dentists, airport workers, and military service members. For those who spend time in loud environments, wearing hearing protection is the best way to guard against NIHL.

Ototoxic drugs (drugs harmful to hearing) and certain conditions, such as Ménière’s disease, can also contribute to progressive hearing loss over time. Regular screenings, prior to the recommended age of 50, are especially important if hearing loss runs in the family, or if you have symptoms associated with hearing loss, such as tinnitus, dizziness, or a perceived decrease in hearing.

Caring for Seniors as Hearing Abilities Change

Hearing loss becomes much more prevalent with age, affecting more than 30 percent of people over age 65, and 80 percent of adults over 80.

Hearing loss in seniors is linked to serious health conditions, including dementia. When communication is difficult, many people will avoid social situations, and research shows that social isolation is linked to cognitive decline, a key symptom of dementia. Additionally, difficulty hearing can impact the effectiveness of our other neural processes.

The risk of falls also becomes more likely with age, due to both decreased spatial awareness and increased cognitive load. A 2012 Johns Hopkins study found that older adults with mild hearing loss were nearly three times more likely to have a history of falling.

Staying Fit

If you’re diagnosed with a hearing loss, remember: Hearing loss is not only very common, it’s also very treatable! A licensed audiologist or hearing healthcare professional can discuss options with you, including hearing aids and assistive listening devices.

When it’s a loved one struggling to hear, or being stubborn about getting help, be patient. Gain their attention before talking, rephrase sentences instead of repeating them, and encourage trying out some kind of amplification.

Think of your hearing health as essential to your body’s complete performance. Our bodily systems are all interconnected; neglecting to protect our ears or refusing helpful interventions can have cascading health effects. When you take even small steps to protect your hearing health and that of loved ones, such as through regular hearing screenings and using earplugs in noisy environments, take heart in knowing you have bolstered your overall well-being.

Rebecca Huzzy, Au.D., CCC-A, is an educational audiologist at Clarke Schools for Hearing and Speech at its Philadelphia location and a clinical audiologist at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware. For more, see clarkeschools.org. This article also appeared in the Spring 2018 issue of Hearing Health magazine. For references, see hhf.org/spring2018-references.

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The Listening Project

By Vicky Chan and Lauren McGrath

“Most people still assume that if a person is deaf, they’re not able to speak,” narrates Jane Madell, Ph.D., in the opening moments of her documentary film “The Listening Project,” released in March 2018. Her statement sets the tone for the following 38 minutes of personal stories that shatter stigmas about hearing loss.

A New York City-based pediatric audiologist, speech language pathologist, and auditory verbal therapist, Madell created the documentary with award-winning filmmaker Irene Taylor Brodsky to reveal how technology has improved communication—and life—for people with hearing loss.  

Richard, a cochlear implant recipient, is one of the participants in "The Listening Project" who works as a software engineer.

Richard, a cochlear implant recipient, is one of the participants in "The Listening Project" who works as a software engineer.

Brodsky captured interviews of 15 individuals with hearing loss, most of whom Madell treated when they were children. Madell says filming  allowed her to reconnect with her former patients to “see what they had to say about growing up with a hearing loss and what advice they might have for parents of newly identified children with hearing loss.”

The subjects of “The Listening Project” are vibrant young adults living and working all over the world—connected by their gratitude for the technologies and treatments that enable them to hear and talk. The majority are cochlear implant recipients, while the remainder wear hearing aids. They experienced similar anxieties, including not being able to hear everything in social settings, disclosing hearing loss to new acquaintances, and accepting their hearing loss.

If not for modern medical progress, the film’s subjects may not ever have been able to overcome these hurdles. When Madell began her career in audiology 45 years ago, hearing loss treatments were very restrictive. Only children with mild to moderate hearing loss could hear well with hearing aids, and the Food and Drug Administration had not yet approved cochlear implants. Such limitations challenged Madell emotionally early in her practice. Though she smiled and appeared optimistic in front of her patients and their families following a hearing loss diagnosis, she knew how hard they would need to work with inadequate accommodations for their children to succeed.

Madell’s former patients and millions of others are fortunate  changes in hearing technology and policies in recent decades have been dramatic. “We are so lucky we live now and not 30 years ago, 40 years ago,” says one. Another young man adds that the ability to communicate and feel comfortable doing so is “a core human value.” Advancements have made it possible for children with hearing loss to learn spoken language, which Madell believes is critical for educational, social, and professional development and gives them options they would not have otherwise.

Madell hopes the personal stories in “The Listening Project” will help parents of newly diagnosed children, as well as legislators, educators, and healthcare workers. “Parents of children with hearing loss have told me that if they had seen the film before the diagnosis, it would have been easier to deal with,” she says. It shows parents that with the resources and hearing technology available today, hearing and speech are possible for every child.

To learn more about the film for either personal or educational use, visit thelisteningprojectfilm.org.

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Music-Induced Hearing Loss: What Do College Students Know?

By Frankie Huang

Music-induced hearing loss (MIHL) is a result from listening to music that exceeds 85 decibels for prolonged periods of time. A decibel, or dB, is a unit to measure sound intensity, and 85 dB is roughly equivalent to the sound of heavy city traffic. Our listening devices and preferred listening levels are the leading cause for MIHL. For example, when you’re working out at the gym and you up the volume of your music to 100% to drown out the music the gym is broadcasting, you are putting yourself at risk for permanent hearing loss.

The frequent use of these devices to listen to music and watch videos typically requires the use of headphones, increasing the risk of MIHL. Portnuff, Figor, and Arehart (2011) found that a person should only use their listening devices for no more than 4 hours per day at 70% volume, or 90 minutes per day at 80% volume.

In a recent study, researchers measured college students’ knowledge on the proper use of listening devices and the effects of listening to music at high volumes. It was found that prolonged use of these devices coupled with loud preferred listening levels is higher in males than in females, with males being less aware of safe listening habits and were more likely to exceed the recommended daily limit. The study also found that female students were more conscious of these limits and more knowledgeable about the maximum listening levels per day, compared with their male counterparts. Furthermore, younger students (freshmen) were less aware of safe listening levels compared with older students who were sophomores.

The use of certain headphones can also increase the risk of MIHL. Among college students, in-ear headphones (e.g., earbuds) are more commonly used than over-the-ear, noise-canceling headphones, and in-ear headphones are associated with a higher risk of MIHL. The biggest difference between in-ear and over-the-ear headphone users was the individual’s listening levels: The study found that in-ear headphone users preferred to listen at a higher volume, while over-the-ear headphone users favored a lower volume because the noise-canceling features meant ambient noise was less of an issue.

Headphone users tend to increase the volume if they can’t block out environmental noises. New York City, for example, is usually noisy so individuals are more likely to listen to their music at a higher volume, which is putting individuals at a greater risk of MIHL. There’s also a greater preference for in-ear headphones between males and females. According to the studies, 52.8% of males believed that in-ear headphones delivered better sound than over-the-ear headphones, compared with 46.4% of females.

Overall, the study suggested that individuals should refrain from listening to music and watching videos at the maximum volume for an extensive amount of time. However, if there’s too much background noise, and it's a distraction, the individual should only increase the volume to 80% of the maximum for no more than 90 minutes daily. In addition, education about the risks of hearing loss and how to prevent it is important, including how noise-canceling headphones drown out environmental noises so the wearer can enjoy music on their personal devices at safer levels.

Hearing loss is irreversible, so investing in a quality headphone that can reduce the risk of MIHL is priceless.

References

Berg, Abbey L. et al. Music-Induced Hearing Loss:What Do College Students Know?. 43rd ed. 2016. Web. 12 Dec. 2016.

http://www.asha.org/uploadedFiles/ASHA/Publications/cicsd/2016F-Music-Induced-Hearing-Loss.pdf

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Hair cell regeneration is a plausible goal for eventual treatment of hearing and balance disorders.

The question is not if we will regenerate hair cells in humans, but when.  

However, we need your support to continue this vital research and find a cure!

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Psychology Effects of Hearing Loss in Teens

By Ann Steele, Psy.D., LMFT

Hearing loss is frequently associated with older folks. When we think of younger people and teens as being deaf or hard of hearing, we tend to assume they have been that way since birth. But that’s not always the case; children and teens can lose their hearing just as older people can, sometimes quite suddenly.

It is important to understand not only the causes of hearing loss, but also the serious issues that result. Hearing loss affects social interaction and emotional well-being, and only by appreciating these effects can friends, teachers, parents and other support figures help teens navigate the troubled times ahead. The below blog post discusses more root causes and the importance hearing has on our society. 

What causes hearing loss in teens?

Hearing loss in teens can result from many factors, including congenital defects, ear infections, autoimmune diseases, blows to the head or exposure to loud noises. This is not a complete list, unfortunately; hearing loss can result from many other issues besides.1

Understanding levels of hearing loss

While we tend to think of people as either hearing or deaf, hearing is not an absolute sense. Rather, it exists on a scale.2 So while some teens may have no hearing ability whatsoever, others may have some. When hearing begins to fade, people first have trouble picking up softer noises, then louder ones. Teens may first lose their ability to hear low hums and birds chirping and then lose spoken words in a vacuum. Eventually, in full hearing loss, they cannot hear even loud noises such as helicopters or gunshots.

The cultural importance of hearing

Sadly, hearing is not only a valuable means of communication; it is also fraught with cultural importance. Not being able to hear causes teens to miss many social cues that other, hearing, teens rely on.

For instance, they may miss the physical characteristics of voice, different dialects, varying speech registers (the ways we speak in informal versus formal situations, or at work versus at home), and the internal or emotional states of the people around them.3 These are all crucial pieces of cultural information to which the deaf and hard of hearing do not have access.

Learning impacts of deafness from birth

Deafness from birth, especially when it comes to deaf teens born to hearing parents, comes with a price tag not attached to deaf teens born to deaf parents or hearing teens who later become deaf.4 This is because when children are able to interact with parents on a daily basis during their formative years – hearing children with hearing parents or deaf children with deaf parents – they benefit from crucial language interaction.

However, teens who were born deaf to hearing parents often suffer from a disconnect that results from being unable to communicate easily. Reading levels, memory, emotional adjustment and other aspects of life may suffer.

Emotional, social and educational results of hearing loss

Even if children are able to skip the often negative effects of early deafness, hearing loss of any type has huge impacts socially, emotionally and educationally.

Teens who experience hearing loss and can’t compensate for its effects often respond in typical ways: becoming confused, checking out, losing self-reliance, feeling isolated and losing their identity.5 This impacts their ability to engage in school, to form peer relationships, to be close to their families and to pursue their interests. Such issues can be hard to overcome, but with good communication, it’s possible.

Tips for communicating with the deaf and hard of hearing

It can be quite difficult to learn to communicate with deaf or hard of hearing teens if you have never learned sign language, especially if the onset of hearing loss is sudden. However, there are a number of steps that you can take to make communication easier.

Remember, hard-of-hearing teens will rely heavily on your facial and mouth movements, so give them a full view of your face, avoiding moving or fidgeting. Don’t exaggerate your words, because this distorts how you form them, and supplement the conversation with bodily and facial gestures as you normally would.6

Mitigating the psychological effects of teen hearing loss

Helping teens foster a sense of self that moves past the disability is important, as is helping them to establish an understanding community. Supporting their efforts to communicate is crucial, but offering space where needed is very important as well. Overall, it will take time and effort – on the teen’s part and on the part of his or her support team – to overcome the disability and learn to lead a full and natural life once more. But with understanding, love and help, teens can get there.

Ann Steele, Psy.D., LMFT is the author and publisher of the "Psychology Effects of Hearing Loss in Teens." 

  1. Hearing Loss Association of America (2016). Types, Causes and Treatment. Retrieved from http://www.hearingloss.org/content/types-causes-and-treatment.

  2. World Health Organization (2016). Grades of Hearing Impairment. Retrieved from http://www.who.int/pbd/deafness/hearing_impairment_grades/en/.

  3. Krauss, Robert M., & Pardo, Jennifer S. (2006). Speaker Perception and Social Behavior: Bridging Social Psychology and Speech Science. Retrieved from http://www.columbia.edu/~rmk7/PDF/Bridges.pdf.

  4. Henderson, Valerie, Grinter, Rebecca E., & Starner, Thad (2005). Electronic Communication by Deaf Teenagers. Retrieved from https://smartech.gatech.edu/bitstream/handle/1853/8451/05-34.pdf.

  5. Better Hearing Institute (2016). Consequences of Hearing Loss. Retrieved from http://www.betterhearing.org/hearingpedia/consequences-hearing-loss.

  6. South Carolina Hospital Association. Tips for Communicating with Deaf and Hard-of-Hearing People. Retrieved from http://www.scha.org/files/documents/tips_for_communicating_with_deaf_and_hard.pdf.

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Eight Reasons to Get Your Hearing Checked This May

By Elizabeth Thorp

Did you know that nearly 50-million Americans have some sort of hearing loss? I'm one of them—I was born deaf in my left ear from genetic nonsyndromic senorineural hearing loss.

Hearing loss is actually the country's most common birth defect. In fact, two to three of every 1,000 children born in the United States are deaf or hard-of-hearing. And ninety percent of those kids have parents who can hear, like me. I wasn't fully diagnosed until I was a teen.

Perhaps even more interesting, the National Institute on Deafness and Other Communication Disorders (NIDCD) says that only 20% of the staggering number of people who could benefit from hearing aids are actually using them. Hearing research and technology have made huge leaps and bounds since I was a child, and the 40-million people not taking advantage of them are missing an opportunity to hear much better.

So in honor of Better Hearing and Speech Month—which continues through the end of May—here are eight reasons to get a hearing check now:

1. You've probably noticed a hearing problem already but done nothing about it. Don't worry, you're not alone. People generally wait seven to ten years between the time that they notice a hearing problem and the time they actually make an appointment with an audiologist or ENT.

2. Even if you've had regular physicals and appear to be in good health, you could have a hearing issue. Only 16% of physicians routinely screen for hearing loss.* Since a hearing exam is not a standard part of most examinations, you typically have to make a separate appointment—and you may not have known to do so since many general practitioners don't suggest it.

3. If you are a recent veteran, chances are your hearing was damaged during your service. 60% of veterans returning from Iraq and Afghanistan come home with hearing loss and/or tinnitus.

4. Hearing loss can cause learning delays, and your child might be among the 20% of preschoolers to fail a hearing screening*, but the earlier the problem is caught, the better.

5. Hearing loss can lead to depression and social isolation—it can affect nearly every aspect of your life. Treating hearing loss can help people re-engage with their communities and even be able to stay more involved with their families.

6. A recent study out of Johns Hopkins showed that people with mild hearing loss are twice as likely to develop dementia—a likelihood that increases with the severity of the hearing loss. Researchers are still searching for reasons for this correlation, but one hypothesis is that the isolation and depression caused by untreated hearing loss may contribute to cognitive decline. It's possible that, by treating hearing loss, we may be able to stave off dementia.

7. One in five teenagers now has a hearing loss. The supposition is that this is caused by toxic levels of noise from mp3 players. While parents have for years been encourage their teens to turn the music down (listening at maximum volume for more than 15 minutes a day can cause a permanent hearing loss!), it's also important to ask if they're having trouble hearing and get their hearing checked.

8. If you pledge to get your hearing checked, you can help the Hearing Health Foundation raise money. For each online pledge up to 10,000, healthyhearing.com will donate a dollar to the Hearing Health Foundation to help fund hearing research. And a bonus: the Foundation will help you find local audiologist and otolaryngologist and provide information about what questions you should be asking when you visit.

Elizabeth Thorp is a family travel expert and writer. She is the founder of Poshbrood, a curated catalog of mom-tested, upscale, family-friendly vacation properties. She has been navigating public affairs and communications in Washington for 20 years. Elizabeth lives in Bethesda with her husband, Almus, and three young daughters Isabelle, Lucy, and Penelope.

*Statistic provided by Center for Hearing and Communication, from data collected in New York City.

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