What is Auditory Processing Disorder?

June 1, 2015

Our world is filled with the sounds of life: the wind rustling through the trees, the sounds of children laughing and most importantly, our ability to communicate with spoken language. How our brains are able to take in this auditory information and make sense of it is a very complex process. Amazingly, for most of us, it happens instantaneously, efficiently and effortlessly. For others, the process is not so simple.

For instance, some children may have no trouble hearing the sounds in our environment, but have difficulty or are seemingly unable to make sense of what they hear. Often, these children are said to have attention deficits, behavioral problems or an inability or lack of motivation to listen and learn when, in fact, the child in question may actually be experiencing an auditory processing problem.

So, what is Auditory Processing?
Researchers Katz, Stecker and Henderson (1992) simply defined auditory processing as “what we do with what we hear.” Auditory processing describes the highly complex brain function that occurs when the brain receives sound from the environment, recognizes it and then interprets it. Auditory processing allows us to find where sounds are in space, determine what a sound was, and discriminate the intricacies of our language and separate important sounds (i.e. speech) from non-essential sounds like noise.

hikingWhat is an Auditory Processing Disorder, then?
The term Auditory Processing Disorder (APD) refers to the brains inability or decreased capacity to efficiently process or interpret auditory information. Often, children with APD have normal hearing. That is, the mechanical parts of the ear are working normally. But children with APD behave as if they have trouble hearing, especially in difficult or complex listening environments. Children with APD can have a range of difficulties, especially in the classroom. These difficulties may include difficulty following multi-step directions, poor reading and/or spelling skills, responding inappropriately to questions and poor music skills.

Are tests available to determine if my child has an APD?
There are many tests available to determine if a child has an Auditory Processing Disorder. These tests will evaluate specific brain functions as they relate to the interpretation of auditory information. Not every test is appropriate for every child. The goal of the audiologist is to approach each child as an individual and consider his or her strengths and weaknesses in order to determine the tests that will be most appropriate for defining the auditory processing difficulties the child is experiencing.

Most tests fall into two categories: behavioral tests, which require the child to perform a task and electrophysiological tests, which do not require a response from the child. The results of both types of tests, when combined, will give a comprehensive picture of how the child processes sound. When the test results are further combined with information from other professionals, such as speech pathologist, psychologists and classroom teachers, an appropriate plan for management can be completed.

Management of an auditory processing disorder can be a long-term investment of time and energy by the child’s family and by those directly involved with the child’s education, health and wellness. In general, management will focus on how to change the environments the child finds most difficult, including in the classroom and at home, how to improve the child’s ability to listen and understand conversational speech through therapy or home-based activities and improving the child’s learning skills in the classroom.

If you suspect that your child may have an Auditory Processing Disorder, the thought of beginning such a process may be daunting. There is also no “crystal ball” to determine the likely benefit of such testing and management. But with a team approach and your motivation to succeed, your child will ultimately be the better for it. If you have any questions regarding APD or would like further resources, please contact one of our Audiologists. We’d be glad to help.

Diabetes & The Ear

May 25, 2015

Diabetes and hearing loss are two of America’s most widespread (and largely untreated) health issues. Nearly 26 million people in the U.S. have diabetes and an estimated 34 million have some degree of hearing loss. The numbers are so similar, you might wonder if there is a link between the two. The National Institutes of Health has found that hearing loss is twice as common in people with diabetes as it is in those who don’t have the disease. Also, of the 79 million adults thought to have pre-diabetes, the rate of hearing loss is 30% higher than in those with normal blood sugar.

What is Diabetes?
Diabetes is a disease that occurs when the body is unable to metabolize glucose. Inside the pancreas, beta cells make insulin, the hormone required for glucose to be processed by the body. With each meal, beta cells release insulin to help the body use or store the blood glucose it gets from food. In people with type 1 diabetes, the pancreas doesn’t make insulin. The beta cells have been destroyed or never developed. People with type 1 diabetes generally have a family history of diabetes and the signs of diabetes surface by adolescence. They will need insulin shots to use glucose that enters the body from digesting meals. People with type 2 diabetes make insulin but their bodies don’t respond well to it. Some people with type 2 diabetes need diabetes pills or insulin shots to help their bodies use glucose for energy. Type 2 diabetes generally develops over time and occurs more often in people who are overweight and over the age of forty.

How are Diabetes and Hearing Loss Connected?
Diabetes leads to high glucose levels in the blood, which in turn causes severe long-term effects on the body’s ability to function normally, such as kidney failure, cognitive degeneration and vision changes. Diabetes can also affect the delicate hair cells of the inner ear, which can ultimately cause sensorineural hearing loss. It is believed that the hearing loss caused by diabetes stems from the effect high glucose levels in the blood stream has on the blood supply to the inner ear. Research indicates that diabetes can cause hearing loss of any configuration and severity. In other words, two people with similar body types, family history, environmental factors and lifestyle can have very different hearing losses. And, some people with diabetes will never have trouble with their hearing. Researchers are unsure of what causes this difference.

Controlling your diabetes with the proper medication as well as with lifestyle changes can decrease or alleviate the effects diabetes has on the body long term. To keep hearing loss from increasing unnecessarily, follow your doctor’s advice for best controlling your diabetes.

If a hearing loss does develop, a hearing aid can help compensate for the difficulty you may have with hearing, especially in the presence of background noise. Hearing aids have come a long way in the past several years and there are more choices in size, technology and even color than ever before. Working with an audiologist, you’ll be able to find the hearing aid that’s right for you and one that fits your budget.

So, what’s my first step?
Once you have realized that you’re not hearing like you used to, a diagnostic hearing evaluation by an audiologist is the best first step toward better hearing. Several tests are necessary to determine the extent of the hearing loss and its effects on communication. All of the necessary tests will be conducted during a one hour appointment and you will leave the office with a greater understanding of how the hearing system works, how your hearing compares to someone with normal hearing and how and why your hearing loss affects your ability to communicate.

If you are finding it more difficult to hear and understand and you have diabetes or “pre-diabetes,” it’s in your best interest to have a hearing test to establish a baseline in order to watch for any sort of progression in the hearing loss over time. And, once you have determined the extent of the hearing loss you can then work to find a solution. Call our office today and we’ll get you on the road toward better hearing today.

Home-Based Program Helps People with Hearing Loss Listen Up

May 18, 2015

If I had a penny for every time a patient told me, “I can hear just fine, she just mumbles,” I’d be rich! And, if you’re reading this, chances are that you or someone you know has a hearing loss and you’ve probably heard something very similar. Maybe you have your own explanation for not hearing your spouse or loved one. Here’s another one I hear fairly often: “If she wouldn’t talk to me from another room, I’d hear her just fine.” That reminds me of a joke I once heard. It goes something like this: A man suspected his wife of having a hearing loss. So, he decided to test it out. He stood behind her a few feet while she cooked dinner. He asked, “Honey, what’s for dinner?” No answer. So, he stepped closer and asked again, “Honey, what’s for dinner?” Still no answer. So he stepped even closer and asked once again, “Honey, what’s for dinner?” and he finally got a response…”For the THIRD time…Chicken!” Sound familiar?

Hearing instruments have come a long way to help people with hearing loss to hear in many different listening situations. But, there will still be situations that most people with hearing loss will find difficult, even with the latest technology advancements. One of these is hearing in a background of noise. In fact, hearing in noise is the number one complaint of hearing instrument wearers. But the fact of the matter is it may not be just the instruments. It may be you!

We know that the mechanical, working part of the ear – the outer ear canal, the eardrum, middle ear bones and the cochlea – are what help us to hear. But, it’s what happens after the sound reaches our brain that helps us to listen. Hearing instruments provide the means by which a hearing loss can be overcome. They make sounds more hearable. But they can’t help a person listen or understand the message being delivered to the ear from the hearing aid. Even people with normal hearing can be poor listeners. Anyone with a teenager in the family can testify to that! Good listening skills are one of several important components for making sure the message is understood clearly. In addition, confidence in your listening skills is important in helping you to understand conversation. These skills can be damaged by acquiring hearing loss and by the “accumulation of birthdays.”

So, if hearing instruments aren’t the only answer, what can you do? If you ask most audiologists that question, they’ll tell you Aural Rehabilitation is the key, which generally consists of group classes where new skills for better listening are practiced. But “rehab” tends to have a negative connotation that can stir up bad memories of lip reading classes or long and tedious courses that sometimes have little benefit. What if there was another option? What if there was a way to help yourself better understand what you are hearing with very little time or effort? Sound too good to be true? Well, there is such a program. It is a training program that can help those with hearing loss listen more effectively. It’s called LACE – Listening and Communication Enhancement and you can think about it like a Physical Therapy for your brain.

Just as physical therapy is necessary after an injury, training to improve your listening skills is necessary if you have had a hearing loss for any length of time. And, even more incredible is the fact that even people with normal hearing have found this program helpful in the difficult situation of listening in background noise. If you don’t have any trouble hearing in quiet, but notice that you strain to understand in a noisy situation, this program may be for you!

Of the patients that have completed the program nationally, most have shown at least a 30% increase in their listening abilities in noise and many are above 40% improvement! That’s incredible! More importantly is what I have been hearing from patients in our practice. One person told me, “I notice I’m more confident when I’m out with friends.” Another told me, “LACE taught me to pay attention better, which takes the pressure to HEAR off of me.”

The greatest thing about LACE is that it is a home-based program. You can do it at home on your computer at your own pace. There is even a DVD version for the not-so-computer-saavy. The program will take you step-by-step through individualized training sessions. Each 30-minute session is designed to provide a variety of interactive and adaptive tasks that will help train your brain to listen and communicate more effectively. Even better is the fact that each session is tracked via the internet and scores are provided to your audiologist. This allows her to review your progress and review with you where your struggles are or what you might need to focus on more intently.

LACE has truly been a great addition to our clinic and for our patients. If you’d like more information, check out or make an appointment to talk with us about LACE training. I think you’ll like what you hear.

10 Tips for Caring for Your Hearing Aids

May 11, 2015

Hearing aids are a big investment. Having a regular cleaning regimen in place is the best way to make sure your investment lasts as long as possible. Here are some easy-to-remember tips for caring for your hearing aids on a daily basis:

1. Clean and disinfect your hearing aids daily with a disinfectant spray that can be purchased from your hearing healthcare professional. Or, in the least, wipe the hearing aids with a tissue or Kleenex to remove any debris or wax from the outside of the hearing aid. Be sure to clean the openings of the hearing aid with the proper cleaning tool, which were provided to you when you received your hearing aids.

2. Turn the hearing aids off when not in use or for overnight storage by opening the battery door. Leaving the battery door open will also allow any accumulated moisture to dry. It is best to store the hearing aids in the box provided by your hearing healthcare provider or in a dry-n-store dehumidifying box. If you use a dehumidifying box, remember to remove the battery from the instrument first.

3. Remove the hearing aids before using hair spray. Hairspray can gum up the microphone and keep sound from entering the hearing aid or decreasing the amount of sound coming to the hearing aids internal circuitry.

4. Do not expose your hearing aids to excessive heat, moisture or humidity. Doing so may damage the hearing aid casing that requires the hearing aid to be sent away for repair.

5. Do not wear your hearing aids while bathing, showering, or swimming. Water and moisture are not your hearing aid’s friend.

6. Keep your hearing aids away from heat sources such as stoves, heat registers, hair dryers, or open flame. Excessive heat can damage the vital internal components.

7. Do not drop your hearing aids or allow the instrument to be subjected to rugged handling. Even a fall from a short distance can cause damage to a hearing aid. If you drop your hearing aid, don’t worry. Check for any cracks and, if you are concerned, feel free to have your hearing healthcare provider check the hearing aid to make sure it is in good working condition.

8. Keep hearing aids away from pets. Dogs, in particular, are curious about feedback sounds that are sometimes produced by hearing aids. Using a box or case to keep the hearing aids in over-night is a good idea in order to keep them away from our furry family members.

9. Keep fresh batteries in your hearing aids. Most new technology hearing aids will notify you when it is time to change batteries. If the signal is ignored, be aware that it will stop functioning when the battery dies. This is of particular importance as you drive in traffic or are in other situations where you may rely on warning sounds for safety. It may be easier to change your batteries on a routine basis – say every Monday – in order to make sure the batteries are fresh and so you don’t have to worry about a hearing aid going dead during an inopportune time.

10. Keep in touch! Maintaining regular contact with your hearing healthcare provider will increase the life expectancy of your hearing aid. A regularly scheduled check of your hearing aids will enhance long lasting reliability of your hearing aids as well. Biannual testing of your hearing is also crucial to assure that the product you purchased is delivering the performance needed to match any changing hearing conditions.

By using these ten simple tips, you can ensure a long and happy life for your hearing aids. And, you can feel confident that your hearing aids will be working optimally at all times, as well. If you have any questions about how your hearing aid is working or would like us to take a look at your hearing aids, please call our office for an appointment. We’d be glad to help!

9 Tips for Adjusting to New Hearing Aids

May 4, 2015

Learning to use your new hearing aids optimally and enjoyably will depend on many factors: your age and physical health; severity of hearing loss; how long you have had a hearing loss; and, your level of motivation to improve your hearing. Learning to hear again requires patience, practice and establishing reasonable hearing expectations. It will take a while for your ears, as well as your brain, to adjust to hearing through your hearing aids and to their physical presence. Your ear has a built-in “alarm system” that is meant to tell you that you have an intruder in your ear. It takes a while for the ear to get used to the idea of something residing in there for twelve hours a day. But don’t worry, after a few short weeks, wearing your hearing aids will be like second nature. Here are some simple tips to help you make the most of the first few weeks of wearing new hearing aids:

1. Begin with easier hearing situations: Start off slowly by wearing your hearing aids in familiar surroundings, such as around your home. After you have familiarized yourself with the operation of your hearing aids, put them on and start talking with one or two familiar people. Unless it cannot be avoided, don’t attempt to wear your hearing aids in noisy places like the supermarket, the airport or a noisy restaurant for the first day or so. Take it slow and easy. Getting used to your aids is like training for a marathon, not deciding to run a sprint race tomorrow.

2. After the “breaking-in” period: It’s important that you increase your wearing time from 5 or 6 hours the first day to using your hearing aids most of the “waking hours.” Soon, wearing them will become routine. Using your hearing aids regularly under varying conditions will teach you how to fully exploit your hearing potential and enjoy optimum benefits from your new investment.

3. Learn to observe yourself: Adapting to hearing aids will take some time. For some, it’s 6 weeks while others may need upward of 6 months. Ideally, your hearing aids should become “part of your body”, similar to glasses. To achieve this, make sure your hearing aids are fitting comfortably. Should you experience any discomfort or “pressure points” please call us right away. Wearing hearing aids and hearing a greater range of sounds may make you tired at first. Take a break if the sound seems over stimulating. Be happy with a little progress each day.

4. Learn to be an effective listener: With your new hearing aids it’s now easier to hear well and communicate effectively in both quiet and noisy situations. It is still necessary, however, for you to be an effective listener. Even people with good hearing often have to concentrate on what they want to hear and ignore or suppress the things they don’t. Try to identify any sounds you don’t recognize when you first start wearing your hearing aids. Practice concentrating on the sounds and voices you want to hear, ignoring those that are less important. When there are a number of different sounds occurring around you, practice shifting your attention from one to the other.

5. Adjust to your own voice: At first, you may not recognize the sound of your own voice. This is because you are now hearing yourself more clearly with the help of your hearing aids. Hearing yourself better means you’ll have the opportunity to adjust the volume of your voice and the way you pronounce words more easily. It’s good practice to read aloud to yourself when you’re getting used to hearing aids.

6. Learn to hear again in difficult situations: Living with noise can be unnerving when you first start out with hearing aids. The world is a noisy place. People with normal hearing are able to suppress noise to some degree by concentrating on the sounds they wish to hear. If, however, you have had hearing loss for a while, you may have lost this ability. Your mission is to live with both unpleasant and pleasant sounds. Practice concentrating on what you want to hear. If you have multi-program hearing aids, practice choosing the best program for the situation.

7. Be An Active Participant in Group Conversions: Even people who hear well can have problems understanding speech if several people are talking at the same time. So, it’s understandable if you feel overwhelmed when you are first trying to hear in large groups. It will help if you move closer to the person you want to hear and watch his/her lips. Don’t listen to the group but focus on a single speaker at a time. Experienced hearing aid wearers manage astonishing results in this type of situation with practice.

8. Listen to the radio or television: Electronically produced speech may be difficult to understand. By focusing on the general meaning the speaker is trying to convey instead of trying to decipher each word, your ability to use your hearing aids should improve. If television continues to be a problem, talk to your audiologist about accessories that might be available for your hearing aid that allow for hands-free ear-level connectivity to your TV or other audio equipment.

9. Try using the telephone with a hearing aid: There are a number of options available for improving how you can hear on the phone. Remember where the microphones are on your instrument and try to place the receiver over the microphone. This will ensure the best possible pick-up of the sound and by doing so, improve the likelihood of your being able to hear on the phone.

While not an inclusive list, we hope that this short list of tips will help you be successful with your new hearing aids. If you have any questions or concerns, please feel free to call our office at any time. We’d love to work with you through the first months on your journey to better hearing. Call us anytime!
That’s why we’re here!