Degrees of hearing loss and speech scores!

[deafdude1]

Deafdude, people are different. They respond differently to you. Just because they have a less hearing loss than you doesnt mean they should have better hearing. There might be other factors into it. Or just because YOU think someone should do this or that, it's not YOUR right to tell people what to do!!

Also stop going on and on about Miss Kat, she is a child, her responses will be totally different

So you basically think I could hear great if I try different HAs? After all, you think everyones different so you think hearing loss doesn't matter that much? I discussed this with my dad and I plan to try different HAs soon. I only want to help Miss Kat, maybe her responses will be great for certain HAs, no one knows till she tries them! Maybe my response will be great to the right HA, I never know till I try!

Only 20% of spoken language is visible on the mouth. That is why lipreading is so difficult and unreliable.

How do you explain the fact I understand over 80% effortlessly of what my dad says lipreading(even when I don't wear HAs) even my dad agrees and he rarely has to repeat himself? I can read stranger's lips almost as well as my dad's.

But what do you understand? Can you walk up to a stranger and carry on a conversation. Just speaking clearly does not lead to understanding as well. I would much rather my daughter hear and understand speech than be able to say words clearly and not understand

I do that all the time lipreading. They think I am hearing and act surprised when they see I wear hearing aids! They then think my HAs give me 100% hearing! I don't bother arguing with them and just say im hearing impaired.

$0 Medicaid paid 100% They believe it is a valid surgery.

My dad doesn't believe that CI is covered by any insurance(he's wrong on that one) He also doesn't believe CI is worth $50,000 for anyone that can get sound awareness with powerful HAs(that I agree) since he considers CI risky surgery and is scared about the surgeons cutting your head open to insert CI. He's a huge fan of stem cells however and is excited to see the day I become less deaf with stem cells. All my family is hearing so this could have something to do with it.

Again with DB! Why is more important to hear extremly soft enviromental sounds than understand speech and COMMUNICATE???

My dad does consider speech understanding to be important but he knows I simply read his lips to understand and communicate. I often talk to him without my HAs. With stem cells ill get both improved speech and improved hearing soft sounds.

86% was the overall test. "Gun" and "gum" were just 2 examples of the words on the test. And it wasn't just between those two words, each word said had 6 choices. So the audiologist says "gum" you have to know if it was "gum", "gun", "comb", or 4 other words which all sound very similar, but I don't remember what they were.

Many words sound very similar to me, even dad admits this. With lipreading, very few words are similar on the lips.

You hear at 10 db at ONE frequency! That will not lead to good speech understanding.

Still an improvement regardless and better than nothing. I also hear more sounds as well. I need stem cells that can give me more residual hearing before I hear 10db(or better) aided at several frequencies or even across the entire audiogram. Very few get to 10db with CI. At 30db with CI, I would still understand more speech reading lips than listening. Ive shown that a 30db loss causes someone to miss at least 25% of speech. I miss less than 20% speech reading lips.

Did you know that for vowel discrimination you have to hear both the first AND second formant? The first formant of "u" and "i" are both at 250 hz, so if you don't hear the second formant for "i" at over 2000 hz, you can't hear the difference.

Well, you stand correct! Proof here and here I discussed this with dad and he does agree that even vowels aren't puretones but can range from below 250Hz to over 1500Hz depending on the vowel and that I am only hearing the lower frequency componants. But with lipreading, I understand them all anyway with little confusion. My dad says that hearing up to 2000Hz is important, anything above that isn't. He's correct since he himself has a high frequency hearing loss and can hear at least 90% speech anyway. I am going to be trying different HAs, one that can transport 2000Hz down to below 1000Hz so I hear all the higher frequency speech. I may have cochlear dead regions above 1000Hz so transporting to below 1000Hz should help alot. I never know till I try!

That is just one example of why hearing across ALL frequencies is important to speech understanding.

60% of speech information takes place at 500Hz and below(That's why I can understand more than half of what my dad says without reading lips) Another 30% takes place at 500Hz to 2000Hz. The last 10% takes place at 2000Hz and above. My dad's outside the speech banana at frequencies above 2000Hz, yet he hears 90% speech!

Does deafdude really think that people & insurance companies would spend up to $50,000 a pop for something that works as bad as he claims CI's do?

My dad doesn't even believe that CI is covered by most insurance.

I don't think deafdude really truly knows all the facts and info on implants, to tell you the truth. But then again, what do I know? All I know is I'm tired of his BS posts (and of his little groupie doing the same).

See my reply to you here: AllDeaf.com - View Single Post - Degrees of hearing loss and speech scores!
Also do you claim to be an expert on CI? You keep saying everyone hears and processes sounds differently so how do you know CI will work for you or anyone who hasn't tried CI yet? I am not gonna stop you from trying CI, it's your choice, ear(s) and money. I choose to try different HAs, maybe there will be one that works even better than the Phonak Naida V UP(which didn't work so well for you) You bet I will be trying many different HAs. How many different HAs have you tried so far?

I don't think he has a remote understanding of how amplification and CI's work or even a small understanding of we hear speech, and discriminate the different sounds

Well, I am here to learn! You can teach me what you know(even though you don't know what it's like to be deaf/hoh/hearing impaired) You taught me about 2nd formants of vowels. People say audiogram isn't everything so do you think someone with my audiogram has any chance of hearing decent if I find the right HA and have it programmed correctly? Do you think me or Miss Kat could benefit more from a different HA she and I haven't yet tried? If the answer is no, then why do people go saying audiograms aren't everything?

Then you don't have to read the posts or participate in the discussions if you're tired of them. No one's forcing you to do so. Others choose to stir lively debate about the various treatments involved for hearing loss, including hearing aids, cochlear implants, and appropriate amplification. That's what a "discussion forum" is for, is it not?

I find it ironic she wants me to stay out of her threads but then she goes into my threads and makes rude remarks. When I ask her perfectly valid questions, she doesn't have any answers! If she wants me to learn, teach me please! She goes on saying that everyone is different but can't explain when I ask her questions about this! See my questions in my earlier posts!

 

[faire_jour]

IS your dad an audiologist or speech language pathologist? If not, why on earth are you taking his word as gospel??

Do you understand formants? They are why different sounds are able to be discriminated. Some initial formants are the same in the low frequencies, so if you do not have high frequency hearing you won't be able to discriminate.

So, if I block my lips and say "oooo", will you be able to tell it from "eee" and "mmm"? Can you hear "ssss" and "shhh"? If not, you do not have access to all of the sounds of speech.

 

[faire_jour]

Deafdude,

By the way, I don't know what it is like to be deaf, but I do know what it is like to hear well. I have also had many classes on spoken language, and how we hear and understand it.

As for hearing aids, no, I don't think you can do "better". I think you have bullied your audiologist into aiding you completely wrong, and if you want to understand spoken language, you need a CI.

 

[AlleyCat]

As for hearing aids, no, I don't think you can do "better". I think you have bullied your audiologist into aiding you completely wrong, and if you want to understand spoken language, you need a CI.

The bolded part - I'm not sure if I'm interpreting that correctly as part of the first part of the sentence, or if it's a secondary part. At any rate, when I looked into a CI last year and met with a CI audi (my whole family and SO went with me so I could ensure I didn't misunderstand anything), she strongly felt I would not benefit from a CI for understanding spoken language. That my primary and pretty much only gain would be in hearing environmental sounds. That was very disappointing, and the very reason I opted not to get a CI.

 

[faire_jour]

The bolded part - I'm not sure if I'm interpreting that correctly as part of the first part of the sentence, or if it's a secondary part. At any rate, when I looked into a CI last year and met with a CI audi (my whole family and SO went with me so I could ensure I didn't misunderstand anything), she strongly felt I would not benefit from a CI for understanding spoken language. That my primary and pretty much only gain would be in hearing environmental sounds. That was very disappointing, and the very reason I opted not to get a CI.

I am talking to Deafdude, sorry for the confusion, I'll edit.

 

[deafdude1]

So, if I block my lips and say "oooo", will you be able to tell it from "eee" and "mmm"? Can you hear "ssss" and "shhh"? If not, you do not have access to all of the sounds of speech.

I have a program that gives me exactly that and I hear all except the SSSSSSS.

Deafdude,
By the way, I don't know what it is like to be deaf, but I do know what it is like to hear well. I have also had many classes on spoken language, and how we hear and understand it.

Got any links to articles so I can learn how others hear and understand it?

The bolded part - I'm not sure if I'm interpreting that correctly as part of the first part of the sentence, or if it's a secondary part. At any rate, when I looked into a CI last year and met with a CI audi (my whole family and SO went with me so I could ensure I didn't misunderstand anything), she strongly felt I would not benefit from a CI for understanding spoken language. That my primary and pretty much only gain would be in hearing environmental sounds. That was very disappointing, and the very reason I opted not to get a CI.

I wonder what is your audiogram exactly like? You mention 100db loss but at what frequencies? Maybe you have a ton of hearing at 250Hz, that would make a huge difference and partially explain why you hear so well. I read of people with precipitously sloping audiograms where they have a ton of low frequency hearing that quickly whittles down to 100db+ losses(probably cochlear dead zone in reality) 60% of speech takes place in the lows and people who have alot of the lows, even with no high frequency hearing can in fact understand 60% speech, some can even hear on the phone! So yea a CI might help with your high frequencies and give you the ability to hear a few more environmental sounds. But then transposition could achieve good results.

Why are you disappointed that your hearing is too good for a CI? I wish I had your good hearing so I could hear more environmental sounds and understand speech better(without reading lips) like you do! You save the $50,000 cost, you avoid the risks of surgery and you save your residual hearing for stem cells! That's where you stand to achieve serious benefit above and beyond a possible small benefit with CI. It's also why I stand by the fact that the cutoff for CI should be 100db hearing loss(without cochlear dead regions) because 100db is still able to be aided to 30db with the best HAs. I had only 100db loss in 1998 and was aided to 35db and could understand more speech back then than today as well as being able to hear high frequencies which I lost a few years later.

CI technology back in 1998 probably would have only matched what I heard with HAs. Besides that, to be a candidate in 1998, you needed at least 110db loss and a speech score of zero! If you could understand even a few words, CI wasn't likley to be any better. Today CI requirements are unusually lax even though CI is better, it still doesn't justify the lax requirements. I think they have started to realize this and tightened the requirements somewhat. HA technology has also improved alot and my audiologist said if I still had only 100db loss today, I would hear decently with my current HAs. You are living proof of this! Can you use the phone? How much speech do you understand in the real world without lipreading?

 

[AlleyCat]

Why are you disappointed that your hearing is too good for a CI? Can you use the phone? How much speech do you understand in the real world without lipreading?

I'm not disappointed that my hearing is too good for a CI. It isn't. The CI audi did qualify me. My speech discrimination score was only 6%. I understand maybe 1 word out of 15 without lipreading, so no, I can't realistically use the phone or have an in-person conversation without lipreading. She still felt strongly that the 6% would not improve by much at all. I didn't want to justify a surgery if that was going to be the case. My whole family and SO went with me to this 3-hour appt so it's clear I didn't misunderstand because they all heard the same thing.

 

[ref74]

I'm not disappointed that my hearing is too good for a CI. It isn't. The CI audi did qualify me. My speech discrimination score was only 6%. I understand maybe 1 word out of 15 without lipreading, so no, I can't realistically use the phone or have an in-person conversation without lipreading. She still felt strongly that the 6% would not improve by much at all. I didn't want to justify a surgery if that was going to be the case. My whole family and SO went with me to this 3-hour appt so it's clear I didn't misunderstand because they all heard the same thing.

Obviously you audi have all the data to make the judge, but it sounds very strange not to expect any improvement over your 6% by CI...

 

[sr171soars]

Obviously you audi have all the data to make the judge, but it sounds very strange not to expect any improvement over your 6% by CI...

This is not surprising to me in the least. Not everybody has developed the ability to listen and comprehend speech. They can hear the sounds of the words and sentences but that is not the same as comprehension. Just because one can "hear" sounds better with a CI won't necessarily translate into better speech discrimination. That ability is best developed early in life (roughly the first 5-7 years).

I have a good friend who wore HAs all his life and had gotten a CI about 2-3 years ago. He never developed that ability and still needs to lipread and use sign to understand those who speak. It was still worth it to him to get his CI as he can hear things he couldn't as well before.

 

[deafdude1]

I'm not disappointed that my hearing is too good for a CI. It isn't. The CI audi did qualify me. My speech discrimination score was only 6%. I understand maybe 1 word out of 15 without lipreading, so no, I can't realistically use the phone or have an in-person conversation without lipreading. She still felt strongly that the 6% would not improve by much at all. I didn't want to justify a surgery if that was going to be the case. My whole family and SO went with me to this 3-hour appt so it's clear I didn't misunderstand because they all heard the same thing.

We have never seen what your audiogram is like, do you have any copies with you? Are you able to hear anything unaided? Is your hearing much better at 250Hz? As to the 6% score, didn't you get like 18/20 on other speech tests? That would be way too high for CI! May I ask why she felt your 6% wouldn't improve much? Do you have some other problem besides profound HL?

Obviously you audi have all the data to make the judge, but it sounds very strange not to expect any improvement over your 6% by CI...

Yea, I was wondering the same. If she has some other problem, she wouldn't even be a CI candidate if CI isn't going to be better than HAs.

This is not surprising to me in the least. Not everybody has developed the ability to listen and comprehend speech. They can hear the sounds of the words and sentences but that is not the same as comprehension. Just because one can "hear" sounds better with a CI won't necessarily translate into better speech discrimination. That ability is best developed early in life (roughly the first 5-7 years).

I have a good friend who wore HAs all his life and had gotten a CI about 2-3 years ago. He never developed that ability and still needs to lipread and use sign to understand those who speak. It was still worth it to him to get his CI as he can hear things he couldn't as well before.

I have developed the ability to understand speech, it's far from perfect though. Ill need lots of auditory training after I get stem cells. Even then, I don't expect to score as high as a hearing person nor do I expect stem cells to cure my loss. My friend emailed the stem cell center and they said to expect up to 30db improvement. They also said stem cells doesn't cure any disease, including blindness, but does give an improvement to varying extents. Ill just be happy to have my hearing improved to the point that I am getting equal or better aided hearing with proper HAs than CI.

Those with good hearing unaided or aided who score poor on speech have auditory processing disorder. I know this 40 year old who struggles to understand what others say. She needs close captions on TV. Her hearing is actually better than my dad's and my dad can understand like 90% speech which is normal for someone with a high frequency loss. She seems to understand closer to 70%. Even with HAs, she doesn't seem to get much improvement and her HAs overamplify her lows and mids. Many people with a mild or high frequency loss don't bother with HAs as they hear good enough unaided already and don't need the world to be so loud.

 

[AlleyCat]

I understand speech surprising well, but only in individual words. It is odd because most people need the context of a whole sentence to understand speech, but I scored way better on those tests with individual words. She said I pick out phonemes really well. I do not have any other health issues other than being profoundly deaf and no, I don't hear anything unaided. Anyways this thread isn't about me, I was only pointing out that I wasn't a good candidate for a CI so I'm choosing not to do that just to gain environmental sounds, primarily.

 

[Hask12]

All any of this proves is that amplification and comprehension work hand in hand for deaf dude.

 

[sr171soars]

I understand speech surprising well, but only in individual words. It is odd because most people need the context of a whole sentence to understand speech, but I scored way better on those tests with individual words. She said I pick out phonemes really well. I do not have any other health issues other than being profoundly deaf and no, I don't hear anything unaided. Anyways this thread isn't about me, I was only pointing out that I wasn't a good candidate for a CI so I'm choosing not to do that just to gain environmental sounds, primarily.

Fascinating. Learn something new everyday. You are correct that in general, it is much easier to comprehend speech if one has a "sentence" to work with. I never sweat the sentence tests and always get close to 100% and even with "noise" I do almost as well. It is a little tougher to do the individual words. I think I do 85-90% on those.

 

[AlleyCat]

Fascinating. Learn something new everyday. You are correct that in general, it is much easier to comprehend speech if one has a "sentence" to work with. I never sweat the sentence tests and always get close to 100% and even with "noise" I do almost as well. It is a little tougher to do the individual words. I think I do 85-90% on those.

You must have pretty good hearing! Or at least better than I, anyway. In the sentence tests, I had to listen to 20 sentences. I could only pick up certain words out of 3 sentences, total. I did miserably there! Yet the individual words test I did so well.

 

[Hear Again]

From what my CI audi told me, sentences are easier to understand due to context -- I know they always have for me. Individual words have always been very difficult for me even when I had moderately-severe hearing loss. The only exceptions are the same words they ask you to repeat (ice cream, baseball, etc.) Fortunately, I was able to find two audis when I was still wearing hearing aids who changed the word list so that I couldn't memorize them and it was a more accurate reflection of what I could and couldn't hear. Now that I have CIs, I hear sentences in quiet and noise at 100% while I hear words at around 95%. Of course, this doesn't reflect real life, but as my audi explained, it allows her to know what frequencies I'm not hearing so that can be added to my maps. Being a hearing aid user since 1985, I know the same is true for those who wear aids.

 

[deafdude1]

I understand speech surprising well, but only in individual words. It is odd because most people need the context of a whole sentence to understand speech, but I scored way better on those tests with individual words. She said I pick out phonemes really well. I do not have any other health issues other than being profoundly deaf and no, I don't hear anything unaided. Anyways this thread isn't about me, I was only pointing out that I wasn't a good candidate for a CI so I'm choosing not to do that just to gain environmental sounds, primarily.

Maybe sentences are spoken too fast for you to understand? When a single word is spoken, you have time to interpret that word. If you aren't missing the high frequencies, the only problem is a decrease in clarity that follows a 100db loss. Back in 1998 I could understand some speech too, but not enough to forgo lipreading. Today my speech is worse but I have always done great reading lips. Depending on your audiogram, type of HA you wear, how much gain you get, a CI might give you up to 10db improvement in environmental sounds. I can get up to 30db improvement today with stem cells but am waiting 2-5 years for even more improvement/reliability/safety.

There is alot I have learned from your replies. I learned that speech isn't just what you hear but how your brain processes the sounds. I also learned that a CI doesn't always improve speech, AlleyCat's audiologist didn't think a CI would improve her speech. My own audiologist said a CI might benefit me but no guarantee and that I can never go back to HA. This is why im waiting for stem cells among many other reasons.

 

[deafdude1]

For those who say I have no clue what im talking about, I am going to defend myself.

A deaf dude's life: Try every HA before CI! This guy now scores 80% speech with HA!

Why get CI when the right HAs programmed correctly can get you from 20% to 80% speech? He has the same HAs I have. If I had a little more residual hearing, id be scoring 80% speech too!

A deaf dude's life: Profoundly deaf man scores over 90% speech recognition with hearing aids!

Profoundly deaf man scores over 90% speech recognition with hearing aids! It just goes to show if you put enough time and effort into getting properly fitted with HAs, you can score as well as a CI!

 

[ref74]

Having a look to the studies, it appears evident that CI gives a substantial benefit also to people with usable residual hearing. The final results are not dependent on the quantity and quality of the pre-implant hearing, but apparently all the CIers perform better than with HAs after a certain period of time. Nevertheless it must be underlined that people with substantial residual hearing will probably face an initial decline of their performances and need efforts to overcome the difficulties before getting significant improvement.
This is an interesting piece of work dealing with that:


The Laryngoscope (2008) Volume 118 Issue 11 Pages 2044-9

Effect of preoperative residual hearing on speech perception after cochlear implantation
Adunka Oliver F; Buss Emily; Clark Marcia S; Pillsbury Harold C; Buchman Craig A

Abstract:
OBJECTIVE: To assess the effect of substantial preoperative residual hearing on speech perception outcomes in adult cochlear implant recipients. SETTING: Tertiary care academic referral center. METHODS: Twenty-nine patients with substantial preoperative residual hearing underwent cochlear implantation. Twenty-one implant recipients matched for age and duration of hearing loss, but without preoperative residual hearing, served as controls. Postoperative speech perception was assessed using City University of New York sentence, consonant-nucleus-consonant, and hearing in noise test in quiet and in noise (+10 dB signal to noise ratio) tests at 1, 3, 6, and 12 months after fitting. RESULTS: After implantation, there were no significant differences between groups for any of the tests administered. The mean change in speech perception abilities from baseline was significantly greater for the control patients than those with substantial preoperative residual hearing at a number of the test intervals across the various conditions. Moreover, at both 1 and 3 months, some patients in the residual hearing group had speech perception scores that were worse than their preoperative values. Ultimately, all of the patients with substantial residual hearing surpassed their preoperative performance. DISCUSSION: Patients with substantial preoperative residual hearing can gain significant benefit from cochlear implantation. Although the degree of improvement in these individuals is somewhat more modest than for those patients without preoperative residual hearing, the outcomes are still excellent. That there were no significant differences between the patient groups suggests that having substantial residual hearing before implantation does not provide a measurable performance advantage for electrical stimulation. Patients with substantial residual hearing who are contemplating cochlear implantation should be counseled regarding a possible initial decline in speech perception performance.

 

[deafdude1]

From your study, it doesn't matter how much residual hearing you have, you will lose it anyway with CI and even if not, CI doesn't care about residual hearing. Youll still score the same as someone with no residual hearing. Those with residual hearing sometimes scored worse than CI at 1-3 months but your study does show that they all eventually did better than with HAs. I want to know what type of HAs they had, how many different HAs did they try and were their HAs correctly programmed? All this proves is that CI is better than the one type of HAs they wore but tells me nothing how well they could have done with different HAs. Furthermore, I posted above of this guy who went from 20% speech to 80% speech with proper HAs. I would not be surprised if 25% of those getting CI who have plenty of residual hearing get way up there in speech with better HAs and especially HAs with transposition. See the audiograms in my earlier posts. I can show more case studies of transposition giving hearing as good as CI.

 

[faire_jour]

From your study, it doesn't matter how much residual hearing you have, you will lose it anyway with CI and even if not, CI doesn't care about residual hearing. Youll still score the same as someone with no residual hearing. Those with residual hearing sometimes scored worse than CI at 1-3 months but your study does show that they all eventually did better than with HAs. I want to know what type of HAs they had, how many different HAs did they try and were their HAs correctly programmed? All this proves is that CI is better than the one type of HAs they wore but tells me nothing how well they could have done with different HAs. Furthermore, I posted above of this guy who went from 20% speech to 80% speech with proper HAs. I would not be surprised if 25% of those getting CI who have plenty of residual hearing get way up there in speech with better HAs.

So they do better with the different hearing aids....then they still do better with the CI!