Sound SHC Summer Newsletter

Hear it here first! Sound SHC has got a lot going on this summer, and we're catching you up on all the details in our Summer Newsletter! Learn more about our newly extended hours for audiology and speech therapy, our newest members of the team and upcoming events!

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Jody Vaynshtok

Jody is a California-licensed speech language pathologist with eight years of industry and clinical experience. She has worked with both adult and pediatric populations during her time at private practice, birth-to-three, and hospital facilities. She is experienced in the assessment and treatment of a variety of communication and cognitive disorders. In addition, Jody has a passion for working with adults looking to achieve clearer communication. Jody received her BS in Speech and Hearing Sciences and MS in Medical Speech-Language Pathology from the University of Washington. She was a part of the Lucile Packard Children’s Hospital at Stanford’s cleft and craniofacial clinic participating in the multidisciplinary assessment and treatment of children born with craniofacial abnormalities. She holds a staff position at UCSF and is the lead speech language pathologist for the department of Otolaryngology-Head and Neck Surgery’s Hearing Loss Clinic. When she's not busy having fun with her clients Jody enjoys spending time with her husband, Anton, friends and family. And if she's not headed out somewhere fun for dinner, you might find her at Bar Method working out!

Strategies for Easier, More Effective Communication

When you have a hearing loss communication can be difficult, even with appropriately fit amplification devices. Amplification alone often is not enough to help individuals hear clearly and understand speech in every environment. Things like distance from the speaker, background noise, reverberation, and communication partner characteristics (accent, dialect, etc.) can impede effective communication. It’s important for individuals with hearing loss to be proactive and let other people know what they need in order to communicate effectively.

Below are some helpful strategies to allow for more effective communication with less frustration.

Communication strategies for individuals with hearing loss:

1.     Always face the individual speaking to you. Often times communication partners try to talk to the individual with hearing loss from another room or with their back turned. Communication in this manner is difficult even for individuals with normal hearing. We use visual cues from the person’s face to help understand what is being said, so being able to clearly see your communication partner will go a long way toward helping communication and understanding.

2.     Decrease as much background noise as possible. If there is a television on or music/radio playing turn these off when trying to listen and communicate. Even the best amplification devices cannot completely eliminate all sources of noise, so be proactive about noise sources you have control over.

3.     Ask for clarification. And when you do so, make sure the other person understands you are hard of hearing, but you do not need them to yell at you. Simply ask them to re-state what they said in a different way. It’s also helpful to repeat what you heard them say so they know where the breakdown occurred.

4.     Change your position. If you are in a noisy area, try moving to a different location. If this is not possible, try positioning yourself so your back is toward the loudest noise source. This will allow your amplification devices to make the most effective use of their noise management features.

Communication strategies for friends and family members of individuals with hearing loss:

1.     Try to keep your mouth visible while you talk. Don’t cover your mouth with your hands and don’t turn your head away from your communication partner. If the listener is able to see your face and lips they can use visual cues more effectively to bridge the gap when they aren’t able to hear you clearly.

2.     Try not to communicate in areas with competing noise. Reduce background noise as much as possible when talking with an individual with hearing loss. This reduces the effort it takes for them to hear and understand.

3.     If the individual with hearing loss does not understand you, rephrase what you said rather than just repeating. This will provide a better chance for the individual to understand what you said if they are struggling with a few specific words.

4.     Be patient! Try not to get frustrated if you must repeat or rephrase what you said. Remember, the other individual is doing the best they can with the hearing they have. Even with hearing aids, they may not understand what is said 100% of the time. It’s just as frustrating for them to not understand as it is for you to be misunderstood.

Do I need a hearing evaluation?

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), approximately 15% of American adults (37.5 million) aged 18 and over report some trouble hearing. Furthermore, roughly 10 percent of the U.S. adult population, or about 25 million Americans, has experienced tinnitus lasting at least five minutes in the past year.

If you are among the millions of Americans who perceive difficulty hearing or understanding conversational speech or have experienced tinnitus, it might be time to get your hearing checked. Hearing loss and tinnitus are sometimes symptoms associated with medical conditions that may need treatment, so it's important to get a hearing health check up if you're experiencing tinnitus or difficulty hearing. An Audiologist can perform a thorough hearing evaluation and refer you to a physician if necessary.

Additionally, both hearing loss and tinnitus can make communication difficult which often leads individuals to limit the activities they participate in. Research has shown social isolation due to communication difficulties can lead to a poorer quality of life, depression, and even cognitive decline. Social isolation is a known risk factor for dementia, so staying connected with friends and family is important for older adults for many reasons.

Hearing loss taxes the brain in ways you may not realize. When someone has a hearing loss, they must work harder to hear and understand than individuals with normal hearing. When your brain is working overtime to understand speech this is often at the expense of memory. Essentially, to maintain optimal understanding the individual with hearing loss must allocate more “brain power” to the task of listening. Since cognitive resources are not unlimited, this means these individuals have fewer cognitive resources available for other tasks, such as visual processing or memorization. This can lead to what we call “listening fatigue” and can leave individuals with hearing loss feeling completely exhausted after communicating.

I find the reason many adults avoid getting their hearing checked is they feel the Audiologist will pressure them into purchasing hearing aids. As Audiologists, one aspect of our job is to diagnose and treat hearing loss, and at this time hearing aids are the primary treatment for most types of hearing loss. While I can’t speak for all Audiologists, I can say the majority of us discuss hearing aids as an option because we truly feel a patient would benefit from them. However, it is within your right to get a second opinion if you are unsure about the diagnosis or treatment plan proposed by an Audiologist or hearing instrument specialist.

So if you're worried an Audiologist might say you need hearing aids, please don't avoid having a hearing test for that reason alone. If we recommend hearing aids it is only because we genuinely care about your hearing health.

If you need help finding a trustworthy professional to work with, here are some resources:

American Speech Language & Hearing Association's Find a Professional

American Academy of Audiology's Find an Audiologist

This AARP article has good tips on finding an Audiologist

 

How loud is too loud?

As an Audiologist I often get asked to recommend safe listening levels for many different situations. There is no "one size fits all" rule, but I generally abide by the Occupational Safety & Health Administration (OSHA) guidelines when determining if a situation is noisy enough to warrant hearing protection. OSHA requires employers to provide hearing protection to any employee exposed to 85 decibels of continuous noise for an 8-hour work day. As the intensity of the workplace noise increases, OSHA further limits the amount of time that employee can be in that environment, even with hearing protection. For instance, employees are only allowed to be exposed to 95 decibels of noise for 4 hours.

Now, you may see decibels referenced as dBA, dBC, dBSPL, or dBHL. The algorithms that factor into each weighting system are too complex for this blog post. But suffice it to say, anything exceeding 85 dBHL on ANY decibel weighting scale CAN cause long lasting damage to the auditory system.

I have the National Institute for Occupational Safety & Health (NIOSH) sound level meter app downloaded on my iPhone and I use it frequently to decide if I should put in my earplugs or not. More information on this app can be found here. There are many other sound level meter apps available for free for both iOS and Android operating systems.

When listening to music via headphones I generally consider about 50% of the volume to be the loudest safe listening level. Studies have shown that more and more younger individuals are presenting with hearing loss related to unsafe headphone listening levels. My best tip for headphones is to get a good pair that makes a good seal in your ears to help block out ambient/environmental noise. When you can't hear your music or Podcast over the sound of public transportation or other environmental sounds the instinct is to increase the volume. Even though your PERCEPTION of what you're listening to may not be that loud, the sound pressure level in your ear canal may still be high enough to cause damage to the auditory system.

I also highly recommend anyone who enjoys listening to live music to invest in a good pair of earplugs. Now, I'm not talking about foam earplugs. Foam earplugs block more of the high frequency sounds, which can make live music sound muffled and generally leads to a less enjoyable experience. If you're looking for non-custom earplugs, Etymotic is a good place to start. If you're interested in custom earplugs, find an Audiologist to take ear impressions for you. It is possible to find websites that will send you an at-home ear impression kit, but I STRONGLY advise against trying this at home on yourself. Audiologists and hearing instrument specialists go through rigorous training to learn proper techniques for obtaining quality ear impressions SAFELY. Many things can go wrong, the least of which include an inadequate impression that would lead to a poor fitting product and ear canal bleeding and abrasions. Seriously, this is NOT a good thing to DIY. Westone Labs is a good resource for helping you find a professional who can take impressions for you. I have custom earplugs and I LOVE them.

Have you ever left a concert or other noisy event and felt like your hearing was muffled or you experienced tinnitus (ringing in the ears) afterward? If so, then you should have been wearing hearing protection! Lesson learned for next time, hopefully!

Finally, here are some additional resources regarding safe listening levels and hearing protection:

Turn it to the left

NIH's Noisy Planet website

OSHA Occupational Noise Exposure Standards

American Academy of Audiology Fact Sheet on Noise Induced Hearing Loss

 American Speech/Language and Hearing Association (ASHA) Loud Noise Dangers

 

Keeping hearing aids on little ears can be difficult, but isn't impossible!

When a child is diagnosed with hearing loss, the most frequent recommendation is to utilize hearing aids. However, children are very curious and keeping hearing aids on their ears (and not in their mouths!) can often be challenging. Many parents struggle with keeping hearing aids on their children, so if you are a parent of a hearing-impaired child who likes to remove their hearing aids, remember you are not alone. As frustrating as it can be to continually replace hearing aids on a squirmy toddler’s ears, it is important to keep trying as consistent auditory input is crucial for language learning and development. Here are some tips that may be helpful for encouraging your child to wear their hearing aids.

1.     Make listening fun! Sing songs, read their favorite book, experiment with different sounds around the house. Help your child associate their hearing aids with positive experiences. Point out all the interesting sounds they can hear when wearing their hearing aids.

2.     Try a timer. It might just start with 30 seconds, but gradually you can increase the duration of time your child wears the hearing aids before being allowed to remove them.

3.     Try rewards to keep your child motivated. Snacks, stickers, or inexpensive toys can be strong motivators for children. Try a calendar and place a sticker for each day your child wears their hearing aids for a pre-determined amount of time. At the end of the week take them for a special treat or adventure.

4.     Decorate the hearing aids. This can help your child have fun with their hearing aids and take ownership of them. Most pediatric hearing aid care kits include fun stickers your child can use to decorate their hearing aids. There are also many options for hearing aid charms and stickers online. Some options are: Hayleigh’s Cherished Charms, Tubetastic Pimp, and Tube Riders.

5.     Praise your child for hearing aid use. Try to focus on even small victories to keep your child motivated to use their hearing aids.

 

If you happen to have a child who is particularly resistant to the hearing aids, no matter what, there are also retention devices that can help prevent your child from removing the hearing aids.

1.     Tie, clip, or pin the hearing aids onto your child’s clothing to ensure they are not lost if your child removes them. You can use string, floss, or an eyeglass cord and a safety pin for a DIY version. Commercially available options include: EarGear, Safe-N-Sound, and oto/critter clips.

2.     Secure aids behind the ears with adhesive. The easiest option for this is to use double-sided wig/toupee tape.

3.     Try headbands or hats to cover the devices and keep your child from removing them. There are many options available online, most of which were created by other parents looking for options to keep hearing aids on their children. Some options include pilot caps (available on Etsy) and headbands.

Karen Anderson has a thorough list of retention accessories with pros and cons of each, which can be found here.

Does my child need a hearing evaluation?

As a pediatric Audiologist one of the most common concerns I hear from parents is that their child doesn’t always respond consistently to voices and other auditory stimuli. It’s often hard for parents to discern whether their child did not hear them or simply was not listening or attending to what was said. More often than not it is the latter, especially if you've got a toddler or teenager at home. However, even if your child passed a newborn hearing screening, that does not mean they will never have difficulty hearing in their lifetime. Hearing can change over time, and children especially are prone to fluctuating hearing loss due to ear infections.

Just like with speech and language and motor development, there are auditory milestones every typically developing child should achieve by a certain age. If you have concerns regarding your child’s hearing, referring to these milestones may help you and your child’s pediatrician decide whether a referral to an Audiologist is warranted.

The American Speech Language and Hearing Association (ASHA) has an excellent guide to both auditory and speech/language milestones here.

It’s important to remember these milestones are guidelines and not hard and fast rules. Every child is different and may not achieve every milestone by that exact age. Many factors can influence auditory and speech/language development, including language exposure. One of the best ways to foster auditory skills and language development is to talk with your child as much as possible. Reading with your child is also an excellent way to help with auditory and language development.