Driven to Extremes by Noise and Silence

Audiologists counsel patients on a variety of noise-related situational topics and they do so repeatedly and repetitively.  Here are some common talking points in audiology offices, as well as a quick look at noise in the extreme.

 

Realistic Assessments

 

It’s important for people with hearing loss and hearing aids to make realistic assessments of speech-in-noise situations.  Basically, if listeners with normal hearing are shouting to hear themselves in a situation, then it’s realistic to surmise that the noise level is winning the competition and no hearing aid on earth is going to “fix” the situation.

That’s not to say that hearing aids won’t help — they’re absolutely necessary to have a fighting chance at hearing.  But, it’s also realistic for those with hearing loss and hearing aids to adopt the everyday, automatic solutions used by normal listeners in such situations:

  • They move away from the noise to a quieter place if they want to have a conversation.
  • They move closer to the speaker and watch his/her face if they can’t get away from the noise.

 

Hearing Aids are for All Listening Situations

 

Another item that bears repeated counseling is the necessity to become familiar with the “sounds of silence.”  So many hearing aid users think they only need to use their hearing aids in difficult listening situations, such as the noisy situations described above.  In the absence of insurmountable noise, some elect not to use their hearing aids in what they consider quiet situations. 

That’s a big mistake because it reduces the auditory brain’s exposure to the low-level sounds — and their absence– which surround us and contribute important information to our environments.  We’ve talked about such noises in prior posts.  

 

Recruitment is an Unfair Fact of Life

 

A third item has to do with the patient’s own hearing system.  The perceptual phenomenon known as recruitment accompanies most cochlear hearing losses. Though recruitment is complicated and poorly understood, its effects are unmistakable to those with hearing loss.  Recruitment makes it harder in general for most people with hearing loss to function happily in high noise situations.  It’s just harder and it can prove a limiting factor for people with hearing loss when they consider what to do and where to go to enjoy life. 

Basically, people with hearing loss face a potentially handicapping situation brought about by noise levels more easily tolerated by those with normal hearing. Sad to say, recruitment is discriminatory. It takes work, strategizing, and early intervention on the part of all involved — patient, family, friends, audiologist — to side-step the handicapping danger and lead a fully active life.  

 

Noise as a Right or an Extreme Condition

 

This brings us to the last point of discussion:  public awareness of noise and silence.  Everyone has probably heard or read about the woman-with-cell-phone-on-the-train who talked for 16 hours straight in a so-called “quiet car” and was finally escorted from the train by law enforcement.  The story, which happened in 2011, is now apocryphal because it raises the concept of “enforcing” quiet areas, not to mention plain old politeness.

 In 2011, New York City began enforcing the rule of silence in eight designated quiet zones in Central Park with fines of $50 to $200. Although the eight areas comprise only 5% of the 800-acre park, enforcement was highly controversial and opposed by groups such as the NYTimes, which had this to say:

“This is New York City, a very big, noisy place that should not be forced to keep quiet.”

Pickets went up protesting the “right” to make noise.  The fight continues, as evidenced by a 2016 article advising people in desperate search of peace and quiet in the city.    

Perhaps those with hearing loss and recruitment, together with their audiologists, friends, and family, should band together and picket for the “right” to silence, or at least low-level noise.  How else are people with hearing loss going to learn to use their hearing aids, train their auditory brains, have a fighting chance to hear in public places, avoid restricting their activities and becoming …. handicapped?  

Hearing impaired of the world, has the time come to unite and march against noise?