Hearing Loss versus Lack of Understanding

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by Garth Brears, M.S., Aud(C) Clinical Audiologist

Does someone have a hearing loss when they do not respond when questioned? For example, when I am reading the paper and my wife says something about putting out the garbage and I do not respond, do I have a hearing loss? When I talk to someone with dementia and they respond incorrectly, do they have a hearing loss? If someone is in physical or emotional pain and I make a request but they don’t respond, is that hearing loss?. Perhaps you think that in those cases there are extenuating circumstances that explain the lack of response. Consider this: If someone is at a party where there is a lot of noise and someone cannot understand the person he is speaking to, is this what it is to have a hearing loss? The truth is this no more a hearing loss than any of the above examples. This is simply what it is, which is “lack of understanding”. The point to remember is that “lack of understanding” is very different from “lack of hearing”.

In my experience, many people assume normal hearing is the same thing as “understanding” speech, while hearing loss means “not understanding” speech. However, it is the middle step that is so easily forgotten. That is “focus”. My definition of focus is the amount of energy the brain uses in-order to process all the incoming and stored data before “understanding” takes place. Hearing speech is only one of the many streams of information that the brain is using while focusing on a speaker. Admittedly, the brain loves as much information as it can gather because less focus is then required to understand. Therefore people with normal hearing often do not need to focus as much in-order to get the same amount of understanding as someone with a hearing loss. However it is also true to say that most people with hearing loss continue to understand very well while simply utilizing more focus, even in noisy environments.