Q: When someone speaks, I often miss nuances, like tone. Could this be hearing loss?

A: That’s an interesting question! Hearing loss shares symptoms with other conditions, though. Let’s look at what hearing loss is and consider another possible culprit.

Hearing Basics

Hearing is complex. It’s more than just your ears taking in sound. Your nerves and brain actively partner with your ear in a delicate dance to accomplish hearing. Here’s how it happens.

Area 1: The Ear-Your outer ear collects sound waves, which travel down your ear canal and cause your eardrum to vibrate. The vibrations are passed to your middle ear, where three tiny bones amplify the vibrations and send them to your inner ear. In your inner ear, the vibrations become waves in a fluid-filled cavity. The waves jostle tiny hair-like cells, which convert the wave information into electric impulses.

Area 2: The Auditory Nerve-Your auditory (hearing) nerve carries all those electrical impulses as nerve signals to the part of your brain that processes what you hear.

Area 3: The Brain-Your brain pinpoints where the sound is coming from, focuses on it, separates out background noise, determines whether it recognizes the sound, and identifies whether it’s speech, music, or something else.

Hearing Loss

Hearing loss is anything that does go wrong in that first area-your ears-such as earwax buildup, an ear infection, or damage to any of the tiny structures.

A standard hearing test from a hearing care professional will determine whether you have hearing loss. Common symptoms are:

 

• Trouble understanding people on the telephone
• Difficulty following conversations with two or more people
• Asking people to repeat themselves
• Turning up the TV so loud that others complain
• Problems understanding speech in background noise
• Thinking others mumble
• Trouble understanding children and people with higher-pitched voices

 

But the symptom you mentioned-missing nuances like the tone of people’s speech-is more often a symptom of something else.

Auditory Processing Disorder

Auditory processing disorder (APD) has a lot in common with hearing loss-but many (not all) people with APD pass a hearing evaluation with flying colors! What’s going on here?

This is where that third area you use for hearing, the brain, comes in. With APD, something interferes with the way your ears and brain coordinate. You might hear sounds loud and clear-your ears are doing their job-but something keeps your brain from processing the sounds effectively.

How common it is? It’s hard to even pin down an estimate because providers use different diagnostic standards. We don’t understand the causes of APD very well, either, but it tends to be linked with ADHD and dyslexia.

Symptoms of APD

Certain symptoms point more strongly to APD than to hearing loss, for example:

 

• Difficulty remembering directions spoken aloud
• Mishearing words or sentences
• Sensory overload in noisy environments
• Problems picking up nuances in speech
• Inability to appreciate music

It’s not about intelligence-someone might remember written directions very well but misremember spoken ones them. It’s about how the sounds are received and processed.

If you’re an adult with APD, you may well have had it your entire life, but it went under the radar. Many adults with APD don’t even realize they’ve developed coping strategies.

An audiologist diagnoses APD in adults through a series of listening tasks, then develops a treatment plan that could include:

 

• Speech-language therapy, especially auditory training
• Brain-training techniques to improve processing skills
• Computer-assisted-programs
• Counseling or art/music therapy

There’s No Easy Answer

As you can see, a lot must happen for you to successfully hear and understand a sound. Your symptom-missing nuances in speech-is just one symptom to consider.

Audiopedics, LLC focuses on delivering effective results with compassion, education, and integrity while providing a complete range of diagnostic hearing services and treatment for communication disorders as well as preventative options. Contact us to get a hearing evaluation on the books today: 908.388.1064 or audiopedics.com.