During your hearing testing, you were probably asked to repeat some words at a comfortable level. This test is a test of word discrimination or speech understanding. It gives your hearing healthcare professional a small glimpse at how you perform and understand speech in one-on-one conversations. A number of words are given, asked to be repeated, and a percent correct score is calculated based on the responses. The percentage calculated is the percentage of speech that you would understand in an ideal setting (e.g., quiet, without distraction, and at a level loud enough/comfortable for you to hear).
It is possible to have a significant amount of hearing loss, but still have good word discrimination/speech understanding. However, without sound input, you may lose more and more of your comprehension ability over time. Our brains crave input to function properly. When a person has a hearing loss, part of that input is denied. The sounds that you can no longer hear are not being sent for interpretation. For example, if you have a high pitch hearing loss, then some high pitches are missing from the incoming sound (e.g. in the word 'sat', 's' and 't' are both high pitch sounds, only 'a' may be heard). Over time this lack of input leads to a deprivation situation in the brain. If the input is not coming in, the brain simply forgets how to code that input and moves on to something else. If the sound is reintroduced at a later date with a hearing aid, it will be harder for the brain to understand what to do with that sound – and speech may sound more garbled. In essence, the longer you wait – the more danger there is to your word discrimination/speech understanding!
Because the brain is ever-learning, and ever-changing, if you “don't use it, you lose it”. It moves on to a more important tasks. Even if your hearing does not change over the years, your speech understanding could most definitely get poorer. An auditory-rich environment that can be provided by the use of hearing instruments is crucial to preserving your hearing.
If too long of a period of time has passed since your hearing loss began, hearing aids will not provide optimal benefit. While your aids will still make sounds loud enough for you to hear, your brain may not process as well, and your speech understanding may still be poor. Wearing aids cannot stop hearing loss that is going to progress, but it may help preserve your speech understanding ability.
Dr. Sandra Ann Harper received her Professional Doctorate in Audiology from University of Florida Distance Learning Program. She completed her Master’s Degree in Audiology with a Gerontology Studies Certificate from Arizona State University. She specializes in digital hearing aids, hearing aid education, lip reading and auditory processing programs for children and adults.