Testing your hearing regularly is a good method of keeping track of any changes in your hearing over time. By doing this and understanding what your audiogram and other tests say about your hearing you can then discuss very specific hearing loss issues or strategies with your audiologists or other hearing loss specialists.

If you do have a hearing loss, you could ask your audiologist or specialist questions such as:
• what does the information on the audiogram mean in terms of your hearing loss
• how information from the audiogram will be used to program a hearing aid to suit your hearing loss
• what human speech sounds can you hear (or not hear) with or without your hearing aid
• what other hearing loss strategies (or technologies) could you use to manage your hearing loss
I was reminded of this recently when I had a hearing test done by an audiologist. I’ve tested my hearing quite irregularly and infrequently over my lifetime, as I was told (when a young adult) that I had a ‘stable’ hearing loss and thus didn’t need to do much testing. Now that I have become older, I have found that the characteristics of my hearing loss have changed, and that I haven’t been looking after what I have left very well at all.

What triggered this? In 2003, I replaced my trusty old analogue hearing aid with a digital one and, as they are quite different in terms of technology, I had to adjust to hearing things differently. In addition, I also became more involved with other people with a hearing loss. This experience was quite new to me as I hadn’t really socialised with other hearing-impaired people, for a variety of reasons, since early adulthood. My decision was influenced in part by the fact, that I lip read with skill, I can use the telephone and do not use sign language so I never felt the need. Through these two events, I’ve had opportunities to re-evaluate my hearing loss management strategies. For instance, I thought I knew everything about audiograms and what the squiggles meant, but I was in for a stiff learning curve! I also realised I hadn’t really taken responsibility for managing my hearing loss and this is critical, given that I may need to make informed decisions with hearing professionals and medical specialists if my hearing gets worse.

One important hearing loss management strategy is to ensure I am tested correctly, because audiologists use and audiogram to set up a computer program within my digital hearing aid to make sounds loud enough for me to hear according to particular sound frequencies described on the audiogram. As digital hearing aids are extremely powerful and can destroy what hearing you have left (if it doesn’t suit the characteristics of your hearing loss), it is essential that the audiogram is accurate. I also wanted to measure how important lipreading is to me in communicating with others and to assess how effective my lipreading skills are in supplementing my residual hearing abilities.

To test my residual hearing, I requested an audiogram and I was in for a surprise. Despite a profound hearing loss (where I am unable to hear any sounds of speech without my hearing aid), I am still able to hear the s, f, th and ch sounds in the high frequency ranges with my hearing aid. These sounds are linguistically the most significant consonants in the English language, particularly the S sounds. If I had not been able to hear these consonants, I would definitely need a cochlear implant. I realise now, more than ever, just how lucky I am with what hearing I have left.

In addition to an audiogram, I wanted to see how important lipreading was to me. So I tested for this by asking for a set of word discrimination tests:
• one without my hearing aid (but using headphones to receive a spoken word loud enough),
• one with my hearing aid (and not looking at a person’s lips), and
• a third test lipreading my audiologist’s lips.

The results were interesting because I could discriminate words reasonably accurately at about 50% for the first and second test, and very accurately at 90% for my lipreading test. Most of the words I discriminated in the first and second tests had the s, f, th and ch consonants, confirming for me the characteristics of my hearing loss as shown in my audiogram. As most of the lip movements making these particular sounds are visible on the lips, I was able to verify what I was hearing in my third test. Together with my ability to discriminate successfully 90% of words spoken on the lips, it is clear that my lipreading skills supplement my hearing loss extremely well.

Having had word discrimination tests in addition to my audiogram, I now have a more accurate understanding of the limitations of my hearing loss, and what I need to preserve – the high frequency sounds – by ensuring my hearing aid is not too powerful for those frequencies. I’ve also decided I should test my hearing every two years, to check my hearing aid still suits my loss and find out if there are any other changes in my hearing. For others, testing may need to happen more or less often, depending upon the nature of their hearing loss.

If you have a hearing loss, taking a step further and critically evaluating what you can or can’t hear with your hearing aid at regular intervals can make you much more confident when dealing with audiologists and other hearing loss specialists. Make sure you take that step!

This article is written by Rowena Vnuk. The purpose of this information to help people manage and live with their hearing loss. However, this information is intended only to provide a perspective on matters of interest and to enable people to seek other advice; information found in these essays are not definitive, and thus readers should seek other advice where necessary. For the purposes of BellaOnline website, I give Felicity Bleckly permission to publish this information on the BellaOnline deafness site.I confirm this is solely my own work and has not been published elsewhere.