Degrees of hearing loss

Hearing loss occurs when any part of the ear or auditory system becomes damaged or is not working properly. It can be temporary or permanent. It can happen gradually over time or suddenly. 

Level of hearing loss is described in degrees. The four most commonly referenced degrees are: mild, moderate, severe and profound. They are based on how loud a sound needs to be in order for you to hear it. 

Decibels (dB) are a way to measure and represent how loud a noise is. 

  • Decibels are always written in numeric form with the abbreviation of “dB” (e.g., 30 dB, 55 dB, etc.). The higher the decibel number, the louder the noise. An increase of 10 points means that the power and intensity is actually 10 times as much. 
  • The abbreviation “dB HL” describes someone’s hearing loss in decibels. The numbers presented in the below categories are provided by the American Speech-Language-Hearing Association (ASHA). 

Mild Hearing Loss (26-40 dB HL)

If you can only detect sounds at 28 dB, then you’d be described as having a mild hearing loss. Someone at this level can hold a conversation but will have a hard time understanding some words when there is background noise. They might also have to raise the volume on their radio or TV more often. According to the Hearing Health Foundation (HFF), people are often able to hear loud vowel sounds but may miss soft consonant sounds in speech. They might struggle to hear young children and might ask people to speak up and repeat themselves. If you have normal hearing, plugging your ears with your fingers creates an effect similar to mild hearing loss. Hearing aids will typically benefit people in this category. 

Moderate Hearing Loss (41-55 dB HL)

In this category, you may have difficulty hearing in group conversations. Areas with a lot of background noise make hearing even harder. You may resort to lip reading. Deeper voices, those typically described as male, will be easier for you to understand. High-pitched voices, typically described as female or childlike, will be harder to hear. The HHF finds that these individuals miss consonant sounds and vowel sounds. They may be able to hear without hearing aids, but will have increased difficulty understanding without them. The CDC finds that people without hearing aids may hear almost no speech when someone is talking at a normal level. The Indiana Department of Health (IDH) estimates that people with moderate hearing loss miss 50-75% of a conversation.

Severe hearing loss (71-90 dB HL)

With a blend of moderate and severe hearing loss, speech may become inaudible. Increasing the amplification with hearing aids may not help. People may only hear some loud sounds without hearing aids. You may have to focus really hard in a conversation, which can lead to frustration and fatigue afterward  You might feel like you have less energy throughout the day. The IDH estimates that people with severe hearing loss may hear a loud voice if spoken 12 inches away from the ear. They may hear environmental sounds like traffic, but will appear as if they’re ignoring the people around them.

Profound Hearing Loss (91+ dB HL)

People with this level of hearing loss are usually considered deaf. They may be relying on lip-reading or sign language. According to the IDH, they may detect some very loud sounds but mostly rely on their other senses to communicate with the world. They can usually feel vibrations and movements around them. The HHF reports that without hearing aids, these individuals may be unable to hear fire alarms or airplanes. 

woman with hearing loss
Degrees of hearing loss can vary greatly.

Consonants in our language and hissing sounds (like “s,” “f,” and “sh”) are in the high frequency sound range. The a, e, i, o, and u vowels in our language register as low frequencies. Frequency means how low or how high a sound is. A drum, a deep voice and thunder are low, while a whistle or a child’s squeal are high. People with high-frequency hearing loss cannot clearly hear their talking mate. The way speech is perceived becomes choppy or botched. 

How Does Hearing Loss Happen?

ASHA reveals eight causes of hearing loss in adults: 1) ear disease that impacts the way the inner ear bones move, 2) Ménière’s disease with ringing in the ears, 3) autoimmune inner ear disease, 4) medications with ototoxic side effects, 5) loud noises like explosions, 6) a tumor, 7) physical injury to the structures, and 8) presbycusis with old age. High-frequency hearing loss is usually the first to occur.

The sounds around us that make life exciting like music, fireworks or bustling cities are also the culprits of hearing loss. Attending loud concerts or events can cause ear discomfort that night, but may lead to hearing loss in the future. Wearing earbuds or headphones can cause some damage, especially if at a high volume. Hearing loss can also be caused from where you work, such as farms, factories and construction sites. 

Noise-related hearing loss happens when the microscopic hair cells in our inner ear are compromised. They sense waves of movement that we comprehend as sound. A strong force or vibration can be too much for them to handle. These hair cells do not regenerate or rebuild once lost. 

Coping with Hearing Loss

Living with any level of hearing loss can potentially cause emotional stress. You may feel depressed, left out, isolated or like a burden. It may lead to embarrassment or low self-esteem. You may avoid the activities you enjoy. The National Institute on Aging suggests getting your talking partner involved. Have them face you and speak slowly. They should use a deeper voice without shouting. Pay attention to facial expressions, gestures and cues. Ask them to rephrase things instead of simply repeating. Their mouth should be visible and also not chewing on anything. Meeting with hearing aid professionals and audiologists may lead you to new techniques and hearing device technology for independence. 

How can it be Treated?

The Hearing Loss Association of America lists some treatments for hearing loss. Surgery, medical grade hearing devices and medications are all options depending on what type of condition you have. Some patients are eligible for corticosteroids or cochlear implants. Two types of hearing aids are bone-conducting (surgically implanted) and conventional (external). Further hearing aid styles can be found here.

Protecting Yourself 

You cannot avoid all noises at all times, but you can become more mindful of what sound waves are going into your ear. ASHA recommends wearing earplugs inside the ear or earmuffs over the ear. Move away from continuous loud sounds, like a street drill or buzzing alarm. Cover your ears when a vehicle’s siren is passing. Keep your listening devices at half volume or below. Check the noise levels on children’s toys or household appliances before you buy them. 

Review the references at Hear.com if you or someone you know is affected by hearing loss. It’s a good place to start if you’re curious about your level of hearing loss or are ready to take the step toward better hearing.

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