Posts in category: Hearing Loss

One day you wake up fine and everything is normal, next thing, before you know it, you are up again, and your body is just not what it used to be. Although the aging process happens gradually, its effects hit you suddenly.

Like with all parts of the body, changes in hearing are common as people get older. Like with the start of grey hairs, an age-related hearing problem can be just as subtle.

John is a 60-year-old accountant who is close to retiring. He often finds himself in a situation where he constantly feels like people are mumbling when they talk to him. His wife and daughter keep telling him that he cannot hear, which he thinks might be true as he struggles to follow their conversations and feels left out. At work when in noisy meetings, it becomes exhausting for him to keep concentrating on what his colleagues are saying, especially when there are no visual aids. Sometimes he can have a quiet conversation at home with his wife but when they go out to a restaurant he often has to lean in to hear what she is saying or rely on visual cues. He tends to speak loudly and his family often feels frustrated when he does not end up understanding what they are saying.

It is not an easy process to come to terms with the sudden impacts that you are experiencing, but if it is any consolation, you are not alone. Over 466 million people in the world, of different ages, have some kind of disabling hearing loss that interferes with their routine functioning.

With such a common occurrence, it is no surprise that there is constant development in the field of Audiology to help people get their lives back and most importantly improve their overall quality of life. This is the first step towards fighting the desire to avoid time with family and friends. You might find that instead of being alone, you end up with a support system that can help.

Pay attention to the patterns that are forming and listen to what the people in your life are telling you. Often, they are the first to realize someone they care about has hearing loss.

The good news is that there are so many ways you can improve your hearing health, especially if you recognize the signs of hearing loss early. If even one of these scenarios sounds familiar, then it may be time to for a professional hearing test.

If you are concerned that you may have hearing loss, use this checklist to get more information. If you answer yes to one or more of these questions on the hearing loss checklist, it is time to investigate further.

1. Do you often find yourself asking people to repeat themselves?
2. Does everyone’s voices seem to be muffled or unclear?
3. Do you find yourself increasing the volume of the TV, where others complain that it is too loud?
4. Do you struggle to follow conversations in a group? Does it get worse when there is noise in the background?     
5. Do you have trouble hearing someone if they are not facing you?
6. Do you experience any ringing, buzzing, or other noises in your ears, when in a quiet place?
7. Do you find it difficult to follow a conversation on the phone?
8. Does hearing loss run in your family?
9. Do you find yourself avoiding gatherings because you are having trouble hearing?
10. Do your loved ones often complain that you cannot hear? 
11. Can you tell the direction from which a sound is coming?
12. Do any of these health or noise exposure issues apply to you?

•       Exposure to a single, explosive noise
•       Exposure to very loud sounds over a long period of time
•       High blood pressure, heart or circulation issues
•       Dementia
•       Diabetes or recent strokes

References:

Amplifon-Hearing Care Professionals. Hearing loss signs and symptoms. https://www.amplifon.com/au/hearing-loss/signs-and-symptoms. 2021. Retrieved January 2021.

Audiology Speciality Clinic. 5 common problems with hearing loss-which ones do you need to overcome? Retrieved from:https://www.audiologyspecialtyclinic.com/hearing-loss-articles/5-common-problems-hearing-loss-ones-need-overcome/.07 September 2017. Retrieved January 2021.

Compass WebMD. 6 Subtle Signs of Hearing Loss. Reviewed by Borgia, S.A. https://www.webmd.com/healthy-aging/hearing-loss-signs#1. 01 September 2019. Retrieved January 2021.

Griffin, H. Hope to cope when you feel left out. Retrieved from:https://www.wikihow.com/Cope-when-You-Feel-Left-Out. 12 March 2021. 

Hearing Loss Association of America (HLAA). Adapted from: Newman, C.W., Weinstein, B.E., Jacobson, G.P., & Hug, G.A. (1990). The Hearing Handicap Inventory for Adults [HHIA]: Psychometric adequacy and audiometric correlates. Ear Hear, 11, 430-433. Retrieved from:https://www.hearingloss.org/hearing-help/hearing-loss-basics/ February 2021.

There are an estimated 38 million people living with HIV globally. Another 1.5 million people became infected in 2020. HIV is significantly associated with an increased risk of developing sensorineural hearing loss (permanent) in patients between the ages of 18 to 35 years, and more commonly in male patients. Up to 84% of persons with HIV present with signs or symptoms that may warrant being seen by a hearing health practitioner.

Diseases of the head and neck which include auditory and otological symptoms, often occur in persons with HIV. Symptoms recorded consist of ear pain, loss of balance, ringing in the ear, discharge and hearing loss.

The regular occurrence of f middle ear infections is often attributed to the impairment of conductive hearing loss (temporary if treated), however the precise etiology of cochlear, and central auditory processing deficits still remains unclear. Direct effects of HIV, opportunistic infections, ototoxic side effects of antiretroviral therapy (ART), and immunologic responses to the central nervous system involving the auditory pathway have been attributed to hearing loss and HIV as follows:

• The direct effects of the virus on the central nervous system and eighth cranial nerve
• Opportunistic infections in persons with HIV that are commonly associated with hearing loss include, Otitis media, cholesteatoma, otosyphilis, cytomegalovirus, herpes zoster virus, toxoplasmosis and meningitis. These opportunistic infections can cause conductive hearing loss, sensory hearing loss, neural hearing loss and mixed hearing loss.
• Ototoxicity as a result of highly active antiretroviral treatment (HAART).Different  antiretroviral (ARV) therapies have been indicated to cause ototoxic effects on hearing (drugs that cause hearing loss). Furthermore the use of nucleoside reverse transcriptase inhibitors (NRTI’s) has shown a higher prevalence of ototoxic-induced hearing loss, simultaneously taking into account the effect of other possible drug interactions.
• Ototoxicity as a result of medication administered in the treatment of opportunistic infections

As a result of the disease, the patient is at an increased risk of developing multiple and recurrent opportunistic infections due to their immunocompromised state.  Treatment sometimes involves medication with known ototoxic effects. Thus increasing the risk of ototoxic- induced hearing loss.  An example of this is the medication used to treat Tuberculosis, particularly for the multidrug resistant strains – high doses of antibiotics, such as streptomycin, which is potentially devastating to hearing abilities. Fortunately a great deal of research has been conducted and new solutions are in process to overcome the effects of hearing loss.

There have been significant improvements in the treatment and management of HIV globally and the focus has shifted from survival to the level of the quality of life.

Healthy hearing is central to a good quality of life, relationships, independence and optimal functioning. This highlights the need for early detection of auditory and otological symptoms and emphasises the need for regular audiological monitoring  and the importance of it in a routine medical check up. 

References:

De Jong, M. A., Luder, A., & Gross, M. (2019). Main Aspects of Peripheral and Central Hearing System Involvement in Unexplained HIV-Related Hearing Complaints. Frontiers in neurology, 10, 845.

UNAIDS, (2021). Global HIV and AIDS statistics. Retrieved from:

Van der Westhuizen, Y, (2017). ENT and Audiology news. HIV and Hearing Impairment. Retrieved from:

Difficulty understanding speech, social isolation, communication difficulties, and socially odd behavior are some of the things that spring to mind in association with hearing loss. Interestingly, the same features are commonly associated with autism spectrum disorder (ASD), which can often make the diagnosis a tricky one.

Autism is defined as a complex neurobehavioral disorder. It is generally characterized by impaired social interaction and a lack of, and/or delay in, the development of communication skills. Autism is commonly referred to as Autism Spectrum Disorder (ASD) because the degree of impairment and functionality differs from person to person. This more correctly describes the multitudinous forms in which the disorder presents itself.

Children with ASD often present with impaired social behaviors, such as the avoidance of direct eye contact or a visible preference to be isolated. They may also display odd behaviours in reaction to a sensory overload (the environment overstimulates their senses), and a seemingly distracted personality. Since these symptoms are similar to what a hearing-impaired child would have, it can sometimes be difficult to distinguish between the two disorders. 

In some cases, however, the diagnosis of a hearing loss can be a precursor to another developmental disorder- such as ASD. The Gallaudet Research Institute estimates that as many as 40 percent of children with hearing loss exhibit an additional disability, and estimates the prevalence of ASD among children who have hearing loss to be 1 in 59.

A research study that took place in 2016, found that about half of autistic children have at least one kind of peripheral hearing problem, compared with only 15 percent of their typical peers.

Families often end up seeing numerous professionals and may receive conflicting advice before arriving at the diagnosis of ASD. Given that some symptoms overlap, what are signs that can be looked out for that differentiate autism from hearing loss?

New-born hearing screening is an advanced method used to rule out significant forms of hearing loss at an early age. This can narrow down the diagnosis of autism which can be confirmed at the age of 24 months.

Other symptoms of autistic behavior are:

• Repetitive language or gestures (i.e. rocking, spinning)
• Disinterest in social relationships
• Repeated fixation on particular objects or their minute details
• Repeated hand gestures
• Sitting or standing in odd postures
• Certain environmental stimulation (sounds, lights or texture) cause over sensitivity- referred to as sensory overload
• Lack of imaginative play
• Unawareness of others feelings
• Does not respond well to a disruption in routine
• Banging of the head in response to excitement or sensory overload

The nerves that are responsible for delivering sound to the brain may malfunction (known as auditory processing disorder, APD), making it hard for the child to make sense of what is being said to them. Children with autism also may struggle with other types of sensory experiences, as well, known as multisensory processing disorder.

Autism affects each child differently, including their ability to hear and process sounds. 

There is a wide range of how autism affects hearing. An audiologist or specialist in ASD can suggest strategies to help them cope and facilitate communication development. These strategies may include:

• Hearing aids or other amplification devices
• Use of assistive listening devices (ALD)
• Auditory and speech training
• Musical training
• Computer-based tools
• Training with a speech pathologist

The spectrum of ASD is so vast which makes it a continuously researched topic, where health professionals are constantly seeking new developments to improve their understanding of this disorder. If you suspect your child’s hearing is affected by ASD, consult his/her pediatrician and hearing healthcare professionals to who can offer professional advice for the best intervention outcomes.

References:

Classon, D. 24 July 2019. Autism, auditory processing disorder and your child’s hearing health. Retrieved from:https://www.healthyhearing.com/report/52743-Autism-spectrum-disorder-and-your-child-s-hearing-health

Demopoulos, C., & Lewine, J. D. (2016). Audiometric Profiles in Autism Spectrum Disorders: Does Subclinical Hearing Loss Impact Communication?. Autism research: official journal of the International Society for Autism Research, 9(1), 107–120. https://doi.org/10.1002/aur.1495

DeRamus, M. (2015). When It’s More Than Hearing Loss: Be attuned to signs of autism spectrum disorder in children with hearing loss. The ASHA Leader, 20(4), 10-11. Retrieved from:https://leader.pubs.asha.org/doi/10.1044/leader.FMP.20042015.10

Gallaudet Research Institute. April 2011. Regional and national summary report from the 2009–10 annual survey of deaf and hard of hearing children and youth. Available at: 

Hear well, live well. 24 August 2020. Autism and hearing loss. Is there a connection? Retrieved from: https://www.hearwelllivewell.com/%EF%BB%BFautism-and-hearing-loss-is-there-a-connection/

Hemavathy, S. CAPAAR. 22 December 2020. Autism and Hearing loss. Retrieved from: https://issuu.com/capaar4autism/docs/autism_and_hearing_loss.pptx

Madhusoodanan, J. 12 August 2020. Confusion at the crossroads of autism and hearing loss. Retrieved from: https://www.spectrumnews.org/features/deep-dive/confusion-at-the-crossroads-of-autism-and-hearing-loss/