Bay Area Hearing & Speech Center | Audiologist

Below you'll find answers to some frequently answered questions (FAQ).

If you don't see your question here, please contact us for more information.

What is an audiologist?

Why should I see an audiologist for my hearing aids?

How do I know if I need hearing aids?

If I have nerve deafness, will hearing aids help?

Will hearing aids make me hear normally?

Do I need a hearing aid for each ear?

Are hearing aids expensive?

How often will I need to purchase hearing aids?

How much does a hearing aid cost?

How long will it take me to adjust to my hearing aids?

What are Assisted Listening Devices?

What is that ringing in my ears?

What is Central Auditory Processing?

What is noise-induced hearing loss (NIHL)

What are some good listening habits I can adopt in my day-to-day life?

If have a family member or friend that has diminished hearing capability. How can I communicate more effectively?

What is an audiologist?

An audiologist is a professional who diagnoses, treats, and manages patients with hearing loss and/or balance problems. After performing comprehensive audiological and balance assessments, the audiologist discusses and presents treatment options to patients with hearing loss or balance deficits. Some of these options include extensive balance exercises or hearing aids as part of an auditory rehabilitation program. The minimum entry level for Audiologists is now a Doctorate from an accredited university graduate program.

Audiologists are the only health care providers formally trained on the measurement, evaluation and diagnosis of hearing disorders. As a primary hearing health care provider, an audiologist can refer patients to physicians when the hearing or balance problem requires medical or surgical intervention.

A comprehensive audiological evaluation is the first step in answering this question. After discussing the degree and type of hearing loss, your audiologist typically encourages you to fill out one or more questionnaires designed to help you assess how much difficulty you experience in your daily activities as well as quantify how much of an annoyance your hearing difficulties seem to be for you and your loved ones. These questionnaires are designed to help you cope with the denial that so many times accompanies hearing loss as well as help you decide if you are emotionally ready to move on to try hearing aids.

Whether your hearing loss is caused by a problem in the middle ear (conductive loss), loss of sensory cells and associated nerve fibers in the inner ear (sensorineural loss; also referred to as “nerve deafness,” an obsolete term) or caused by a combination of middle and inner ear problems (mixed loss), hearing aids can help if properly fitted. Because hearing loss is so particular to each individual, it is important to begin with the most comprehensive assessment to determine the type and degree of loss before you decide on a particular brand or style.

Hearing aids modify surrounding sounds and speech to make you communicate better, they do not alter your hearing sensitivity. It is, however, interesting to note that research studies indicate that many patients who wear hearing aids slow down the process of secondary neural degeneration: the loss of nerve fibers that are not being used or stimulated (auditory deprivation effect). It is also a documented fact that patients who wear their hearing aids since the onset of their hearing loss and wear them routinely, have better word recognition skills than patients who use them only for certain situations or sporadically.

Unless you have a unilateral hearing loss (only one ear is affected), the answer is yes. Wearing two hearing aids prevents auditory deprivation effects by keeping both ears active. It also helps you understand speech better in group and noisy situations as well as localize where sound is coming from. Wearing two aids reduces the need for an increase in the loudness of sounds preventing distortion and feedback (whistling sound that a hearing aid makes when it is set too loud). The softer volume reduces fatigue and headaches associated with loud listening systems. Finally, the stereo effect of wearing two aids gives an improved feeling of balance and helps to mask out your own ear sounds (tinnitus).

Considering that you basically have a computer in each ear and that all that technology has been miniaturized to fit in less than a few millimeters, the answer would be not really. Nevertheless, as compared to other products with bigger market penetration, many patients feel priced out. For example, there are at least 1 or more computers and televisions in most households, yet, hearing aid sales, nationwide, do not exceed 2 million units even though there are about 40 million Americans in need of hearing aids. Ironically, neither computers nor televisions, improve quality of life as much as hearing aids. Among the potential benefits are greater earning power, improved interpersonal relationships, reduced anger and frustration, reduction in depression and anxiety, enhanced emotional stability, reduction in paranoid feelings, increased self-esteem, improved mental acuity, and greater level of social interaction, among other.

There are more insurance companies offering hearing aid benefits and it is wise to weigh the monthly fees of these against a one-time fee for aids every 5 to 7 years. There are also flex plans that allow you to set aside wages for medical purchases the following year.

Hearing aids should be replaced every 5 years. Technology advances at a very rapid pace and most hearing aid companies do not repair aids beyond this point or keep parts or software beyond 5 years. It is always important to ask how long the manufacturer of the aids recommended has been around and how solid a company it is. Still, with mergers, no one can guarantee that a company will be around forever. Thus, when making your decision about hearing aids, count on a good 5 years; after that, research shows satisfaction drops to 46% because the physical fit is no longer adequate, the hearing loss has progressed and the technology starts to become obsolete.

How much does a hearing aid cost?

Depending on the flexibility of the programming and the number of programs and sound bands (or channels) a hearing aid might contain, you would expect to pay from about $1,200.00 to about $ 2,500.00 each.

What are all of these programs, channels, memories, and directional microphones capabilities that make hearing aids so different from the past?

Programmability is the inherent capacity a microchip has to accept modifications. In the case of a hearing aid, it means that the microchip has the ability to support one or more “listening” formulas so that based on your hearing loss, the audiologist can choose the most appropriate one for you and your listening needs. The high-end hearing aids further allow the audiologist to “tinker” with the chosen formula to suit your needs, within reason.

Channels and/or sound bands should be thought of as bass and treble bands. The sounds of speech fall between a certain range of pitches. The more pitch bands a hearing aid contains the better it will be able to analyze incoming speech and amplify it to give you better clarity. In general, the more sound processing bands an aid has, the better clarity you get from its amplification. In addition to manipulating pitch, the more advanced aids, allow the audiologist to adjust the loudness of soft and loud sounds within these bands to deliver the smoothest, mellower sound possible while still making speech audible enough for you to hear soft conversation.

Memories are actually similar to having more than one hard drive in a computer or in lay terms, having one or more hearing aids in one. For example, you could have a memory for listening in quiet surroundings, one for listening in noisy environments, one for listening to music and one for listening on the telephone.

In the past, hearing aids had as a standard, one microphone. Research has shown that in order to localize sound better and understand speech better in noisy situations, you need two microphones. The more advanced aids have a standard setup of two microphones and some are introducing 3 microphones.

How long will it take me to adjust to my hearing aids?

This is dependent on the degree of loss, the number of years you have waited to do something about and your personality. In theory, the technology exists to satisfy even the most demanding of consumers. Nevertheless, if you have not heard many sounds for many years, the sudden re-introduction of these sounds can be challenging until you make sense of what you are hearing and where it is coming from.

When a baby comes back from the newborn nursery, every sound at home startles him. Within days his brain assigns significance and importance to mommy’s footsteps, a sound associated with getting fed, changed and cuddled and in time learns to ignore “irrelevant sounds.” Your brain will undergo a similar process. The more hearing loss you have, the greater the degree of adaptation you will need to make. The more impatient personalities are found to get easily frustrated. The initial weeks are crucial and you and your loved ones should make a commitment to see your audiologist a minimum of 3 sessions during the 30-day trial mandated by law. Do not be surprised if in the beginning of the process you need the aids set at a softer level and 6 months down the road you want them slightly louder.

This is normal for some patients and is all part of the follow up your audiologist provides.

Assisted Listening Devices are the selection of appropriate devices used alone or in addition to a hearing aid, such as telephone amplifiers, text telephones, flashing light doorbells, vibrating smoke alarm, to name a few.

What is that ringing in my ears?

Tinnitus (tin-NIGHT-us or TIN-in-tus) is also called “ringing in the ears,” and is a condition where you actually can hear a sound internally, either localized to one or both ears or somewhere in the center of your head. It is present in, at least, 17% of the general population and reported by more than 35% of the senior population.

It is present in most patients with a history of noise exposure. It can also precede the onset of hearing loss. In some cases it is the result of head or neck trauma (i.e. whiplash injury following a car accident or a fall), ear infections, allergies, cardiovascular problems (i.e. reduced blood flow to the brain due to plaques in the carotids), a tumor (i.e. acoustic neuroma), diabetes, thyroid problems, temporomandibular joint (TMJ) problems, Meniere’s Disease and certain medications (amynoglycosides, some of the “mycin” antibiotics, among other).

Stress has been shown to increase tinnitus and some of the more effective therapies to reduce tinnitus that is not caused by an active disease process, include relaxation techniques.

National Institutes of Health
U.S. National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894

What is Central Auditory Processing?

In lay terms it is the complete or final analysis of the auditory information sent by the ears to the brain. The auditory system must be able to concentrate attention to sound over lengthy periods of time; perform sound analysis in the presence of competing background (i.e. noise or conversations); tell whether two or more sounds are the same or different; retain sounds in memory to complete a task (i.e. follow a 2-3 part command); be able to remember sounds in the proper sequence; recognize patterns of duration, pitch and loudness; be able to discriminate pauses and sequencing of sounds; etc.

Any person at any age can suffer from central auditory dysfunction. In an adult, it can be the result of a neurological impairment (i.e. stroke, seizure disorder, head concussion, a demyelinating condition such as AIDS or multiple sclerosis, etc.)

In children, it can be present when there is normal hearing sensitivity as well as in conjunction with a hearing loss. When it is present at birth, it might be due to delayed maturation of the central auditory nervous system because of prematurity, drug exposure, asphyxia at birth, very low birth weight, among many other causes. There are also conditions that can occur after birth that have been identified as possible causes of central auditory dysfunction, such as chronic ear infections (more than 5-6 per year).

What is noise-induced hearing loss (NIHL)?

It is hearing loss that develops from exposure to noise levels greater than 85 dBA (dBA is a weighted measure of loudness levels). Since normal conversation typically takes place at about 40-50 dB, it follows that the levels of noise responsible for NIHL refer mostly to machinery (i.e. jackhammers, steam winches, tractors, conveyors, to name a few). Computers closely “packed” in small rooms can also cause hearing loss as well as the steam valve of some cappuccino machines. Estimates suggest that there may be as many as 30 million Americans occupationally exposed to noise levels high enough and/or constant enough to cause noise-induced hearing loss. At the present time, one in four workers occupationally exposed to noise, will develop a permanent hearing loss as a result of trying to earn a living. According to the National Institutes of Health, about

one-third of all hearing loss can be attributed to noise exposure, and “occupational hearing loss is the most common cause of noise-induced hearing loss.” The typical NIHL

begins by damaging sensitivity for the high-pitched sounds (i.e. soft consonants) and eventually can extend to the entire speech range. Not only does the loss affect daily communication with family and co-workers but also poses a real occupational safety hazard, as many workers get injured annually because they did not hear a warning or approaching equipment.

Click here for more information on NIHL.

What are some good listening habits I can adopt in my day-to-day life?

Hearing aids are a good start towards better communication but you must also change your listening patterns:

Move closer – the closer you are to the person you want to hear, the easier it is for you to see and understand what is being said. The eyes and the brain fill in and compensate for the ears.

At a gathering – if you need to converse with several people and they are seated at a long table, don’t sit at the end, move to the center where you have a better view and can hear and see everyone.

In a noisy room – try to stay away from the noisiest areas: the kitchen, the entrance of a restaurant, open windows to traffic, music, exhausts fans, etc.

If you have directional microphones – sit with your back towards the noise and try facing a wall, in this manner you reduce noise from the back and enhance the sounds from in front of you. Also, make certain that the light is on the speakers’ face not against you so that the glare does not prevent you from seeing the face and lips of the speaker.

Be proactive – call restaurants ahead of time and ask for a quiet corner. Call theatres and cinemas and ask if they have assistive listening devices or whether they have specific seats or sections for hearing impaired people.

Arrive early at lectures, the church or temple of worship and ask that they use a microphone and seat where you can be close to the microphone and speakers.

Remind your loved ones to “quiet the area” if they want you to hear them: turn down the radio, TV or move to a quieter place. If the dishwasher or the water is running,

If the kids are screaming or horsing around or the other person speaks to you while walking away or from another room, call time out, and gently remind them that you now have hearing aids – not “bionic ears.”

I have a family member or friend that has diminished hearing capability. How can I communicate more effectively?

Face the person you want to talk to. Don’t try to talk while walking away or tinkering in an adjacent room. Visual cues are very important in communication and help the hearing impaired person understand better.

Stand whenever possible, where your face is lit and preferably at eye level. Sound does not search for ears, it leaves the mouth pretty much in a straight fashion, therefore, if you are kneeling or much higher up than the hearing impaired person, you deny the person important visual cues.

Talking while chewing, smoking, covering your mouth, holding your face or looking into the newspaper makes it harder to understand what you are saying.

Don’t walk to the person’s ear and shout into the hearing aid – this creates distortion. More than anything, speaking SLOWLY and clearly is the best way to communicate with the hearing impaired person. When we speak slowly, we have the opportunity to enunciate clearly and this helps counter the natural distortion present in hearing loss.

If your friend or loved one did not hear you the first time, do not repeat, REPHRASE. Some sounds are simply hard to hear depending on the degree of loss and the position of the sound in the sentence. Repeating is not going to alter these facts and you might as well search for substitute words.

At a social event, try to cue your friend as to changes in the topic of conversation. When a person knows the context of the conversation (i.e. football versus opera), it is easier for the brain to fill in missed words.

Try to reduce background noise. If you desire to be heard, turn down the TV, radio, don’t start doing dishes or brushing your teeth or using the electric razor. If you are at a party, move closer to your friend and try to face him, if you talk on his side he will not be able to see your face.

Finally, be kind and compassionate. No one chooses to have a hearing loss. Yet, because hearing loss is invisible and puts the onus on the hearing person to speak slowly and attract attention to themselves, it creates quite a bit of frustration and animosity. Many couples and friends become strangers and enemies. Accusations fly: he mumbles, she does not listen and so on… If you could incorporate some of the above habits into your routine, you might actually find that living with the hearing impaired is a lot easier than you think.