What is Severe to Profound Hearing Loss?
Hearing loss comes in many different forms. It can vary in both type of hearing loss and the degree of severity. Individuals will experience different situational awareness based on the type and degree of hearing loss they have. Not all experiences will be the same. Often individuals with significant hearing loss tell others that they are “deaf.” Although they do have great difficulty hearing sounds and often communicating with those around them, they may not actually be deaf in the clinical sense of the term. They just may have severe to profound hearing loss.
Severe to profound hearing losses are the highest classifications of hearing loss in audiology. This means that on an audiogram, the graph used to depict one’s hearing ability, the hearing thresholds start at 70 decibels (dB) or greater. This means they are unable to hear regular conversational speech and the sounds of their environment. Hearing thresholds, which are the softest sounds a listener can hear at different frequencies, are what an audiologist is measuring during the “beeps” portion of a hearing test. To put this in perspective to everyday sounds within our environment, this is comparable to the sound level of a vacuum cleaner. The average decibel level of a vacuum cleaner is 70 dB. Due to the severity of their loss, some individuals with severe to profound hearing loss, may not even be able to hear the vacuum cleaner. Whereas, for someone with normal hearing you may say the vacuum cleaner is too loud.
Severe to profound hearing loss can greatly impact one’s ability to effectively communicate with those around them. Without correction, all of the speech sounds are inaudible to their auditory system. Average speech sounds are 55 dB to 60 dB which makes communicating very difficult for the listener. These individuals will often rely heavily on lip reading and their knowledge of spoken language to help them fill in the gaps that their ears were unable to decode. This still can cause significant difficulty in conversation. If you have a friend or family member who seems to have great difficulty with communication: face them, slow your rate of speech, and minimize the distractions in the environment around you. You do not need to yell or shout. Creating a positive listening environment will assist all participants in better communication. If you need to relay an important message, consider text messaging, emailing, or writing the message down so it is not misinterpreted. In today’s world there are many forms of communication. Sometimes you may need to use an alternative method to ensure your message was appropriately received!
Other individuals with severe to profound hearing loss choose to embrace their hearing loss and immerse themselves in Deaf culture. They will use a manual language, which in the United States, is predominantly, American Sign Language. For members of the Deaf community the goal is not to restore hearing, but to live fully immersed within their culture. Not everyone with a hearing loss views it as a “problem” needing to be corrected. Their wishes, like all medical decisions, should be respected and supported by those surrounding them.
Treating Severe to Profound Hearing Loss
When someone is diagnosed with severe to profound hearing loss they will be presented treatment with options. One option would be to treat the hearing loss with hearing aids. After a hearing aid trial or in the instance of a progressive hearing loss a cochlear implant may be recommended. The type of devices recommended depend on the individual, their listening goals and environment, and/or any insurance requirements for insurance coverage, if a cochlear implant is an option.
Do hearing aids work for severe to profound hearing loss?
Hearing aids can help individuals with severe to profound hearing loss, although the amount of benefit varies from person to person. The overall goal of the hearing aids would be to provide sound awareness and even better, conversation. This means that the listener would be able to hear loud sounds around them for safety purposes, like an ambulance siren, smoke detector, or cars driving down the road. If the hearing aids provide speech understanding, that is an added benefit but does not happen for everyone. If that is your goal, aural rehabilitation should be included in your treatment plan to help your brain adapt to how you listen. Auditory training includes practicing listening to different speech sounds with the hearing aids to help you rewire your brain in order to adapt to this new form of listening. For some individuals who have had hearing loss for a very long time, hearing aids may not be their best option.
Can profound hearing loss be cured?
Treating severe to profound hearing loss will take time. It is not a one size fits all approach. Well fit hearing aids will provide a substantial amount of sound to return to your ears and brain. This is not a cure, but a treatment plan, to regain a life that you once lived. At first, this will be very overwhelming. In the introduction of the sound phase of this process, we will slowly reactivate your brain to the sounds around you. It will take time for your brain to adapt to the sounds. Through consistently wearing the devices and placing yourself in noisy situations. Your brain will start to adapt and require more volume. Over time, we will slowly increase the amount of volume provided by your hearing aids until you are meeting/close to meeting your prescriptive target values. These targets are generated by researched fitting formulas for your hearing loss and they determine the amount of volume you should be getting at individual frequencies. Once your hearing aids are set to target, your audiologist can work on “fine tuning” the programming so that they are most comfortable to you, in your listening environment.
Best Hearing Aids for Severe to Profound Hearing Loss
The best style of hearing aid for severe to profound hearing loss is called a Behind-the-Ear (BTE) style device. This device is the biggest style of hearing aid, which allows for the biggest computer operating chip. Hearing aids are tiny computers, and the chips act as the brain. The larger the chip, the larger the brain, and the more volume the hearing aid can provide. BTE hearing aids have a base that sits behind your ear and a custom earmold connected by a plastic tube. The custom earmold is made by taking earmold impressions of your ears and allows us to present the most amount of sound into your ear without it escaping. The tubing can be removed from both the base and earmold to be replaced, and this is done typically every 6 months to a year. The earmold can also be removed to be cleaned. The backside of the hearing aid typically includes buttons. These can be used to adjust the volume or change to any additional programs that are in your hearing aids. Additional programs can include a noise program to reduce background noise, a music program to enhance your listening experience, or even an outdoor program to help in wind noise. Almost every hearing aid manufacturer provides a power BTE style hearing aid.
Currently, treating profound hearing loss with hearing aids, or a cochlear implant are our best options currently. A cochlear implant is a surgical device where an electrode is inserted into your inner ear to stimulate your cochlea via electrical current. To qualify for a cochlear implant you must meet specific criteria. In general, you must have severe to profound hearing loss and score poorly on sentence recognition tests in quiet and in background noise. Cochlear implants are not indicated for all profound hearing losses. It is a surgery that you must medically qualify to receive. If you medically qualify you must also complete a hearing aid trial, first, to prove that hearing aids alone are not successful in correcting your hearing loss. Outside of these two forms of amplification, there are currently no other treatment methods for profound hearing loss. Although there is no cure for hearing loss, many patients have received corrective amplification. It is through these devices, in which successful treatment plans have been created to bring a sense of natural hearing to the patient. Neither corrective measure will restore your natural hearing to its natural state.
Is profound hearing loss a disability?
Profound hearing loss is a disability. It limits the natural abilities of your sense of hearing. Depending on the age of your diagnosis there are ways to receive assistance as you navigate your hearing loss. You can receive accommodations to assist you within your educational and workplace environments to protect your ability to learn and earn a living. Preferential seating, captioning, interpreters, and assistive listening devices are all options that can be provided. The first step to receiving these accommodations would be to sit down with your teacher/professors/manager to discuss areas in which you are struggling. You can include your audiologist, as well, so they can help provide options to reduce any communication barriers. Disclosing that you have profound hearing loss is very important, and is not something that can go unnoticed. According to the American Disabilities Act (ADA), your workplace cannot use your hearing loss diagnosis to discriminate against you.