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.

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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!