As CJB stated, the numbers are just that, numbers, and can only give a person guidelines, and do not give real life situations. When my speech comprehension is tested the volume is jacked up loud enough so it doesn't cause pain and my tests scores are around 46%. But this in no way can be used in real life situations where distractions are numerous and can be coming from different directions. Increasing volume, for me at least, does not improve speech comprehension. My hearing loss starts at about 85 decibels in both ears and rapidly falls off the table. So we are already looking at extreme amplification, and speech comprehension is poor at best. Maybe amplification helps comprehension for those with a less severe loss, I wouldn't know.
If someone can be aided to 15db with HAs, why consider CI?
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First - not everyone can tolerate maximum amplification. I for one cannot. It makes me dizzy and gives me intense headaches. My hearing aids are not programed to be as loud as they should be for that reason.
Second - I had my transposition turned down and heard BETTER than I did before.
Third - Cranking a hearing aid up to maximum gain doesn't equal better hearing. When it gets that loud you get distortion and while some can use and understand the distortion many cannot. The loudness is there but the clarity is not.
I am sure some super gain HA could aid me up to 20 or 15 dB but I would never be able to tolerate it, walk in a straight line, or do anything from the head aches. Let alone understand speech under those conditions. Blasting someone with sound is not practical or comfortable and that is why it isn't done.
john57
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You take Ph4sius for example and he does the opposite of transposition. He has a new hearing aid that since it has a better feedback reduction system that allows him to her the higher frequncies, 2000 extra Hz of amplifiable frequencies as he was saying. If I was in the market for new hearing aids I may look at the model he is currently using.
somedeafdudefromPNW
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Yay! Someone else who understand amplification isn't everything. My audiologists alway try to get me to turn them up, but I get headaches. I remember someone changed the gain on mine. I got ticked off that the person didn't do it with my explicit permission and threw them at the person.
Exactly. What good is having speech loud enough to hear if you still can't understand it? Or having the car noise amplified so much it makes your head throb?
sr171soars
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Some good comments and other comments were just headscratchers...made me wonder what planet I was on.
Just wanted to reiterate the fact that understanding speech is a difficult endeavor when your hearing isn't up to snuff. Doesn't matter what DB loss or type of loss one has. There are too many variables for it to be a straight forward prediction exactly how one should do.
Just wanted to reiterate the fact that understanding speech is a difficult endeavor when your hearing isn't up to snuff. Doesn't matter what DB loss or type of loss one has. There are too many variables for it to be a straight forward prediction exactly how one should do.
Which speech test was that and do you have any unaided/aided audiograms? That's pretty good for a profound loss. What volume was required for 46% scores? It may be at a volume much higher than normal converstation. For you, what is optimal volume and at what volume point does your speech scores stop increasing? Why is this the case for you? This would be interesting for me to learn.
Do you have any aided audiograms? It would be interesting to learn. As for your HA, is it the gain or is it the SPL/MPO that's causing the problem? For me, it's always the SPL/MPO, never the gain. The purpose of the SPL/MPO is to put a limit on how loud sounds can become. That way with maximum gain, the faint sounds become audible but the loud sounds don't become too loud. You may want to have the SPL/MPO on your HAs reduced. I am having the SPL/MPO on my HAs reduced as 125db is too much, even in the frequencies where my loss is over 110db.
I would like to learn and understand why max gains causes distortion. I notice no additional distortion but I can hear alot more sounds and speech. You are right that HAs don't improve clarity but I havent noticed increased distortion either. How much gain are you getting at what frequency and you have any aided audiograms?
How well do you score on speech using what test? People have asked me this before and I never had an official test such as HINT, CUNY, CNC, etc. I honestly am not overly concerned about speech since I get over 80% from lipreading. I am more concerned about hearing lots of sounds and why music doesn't sound anything special to me. There's no super HA. I posted a thread months ago asking if a gain of 100db would ever be possible and was told nope due to physical limitations. Youd need a huge body worn HA for any chance at 100db gain. I guess if someone had a hearing loss of 100db or more to require a gain of 100db, CI would honestly and likley be a better option or you can wait for stem cells or just accept the limitations of HAs, it's all a choice. Aren't you still blasted with alot of sound due to your 110-120db HL? How were HAs before your progressive HL? This is another thing I can learn.
He doesn't need transposition since he still has high frequency hearing to 3500Hz before cochlear dead zone. That's enough to hear consonants like "S" "F" and "th"
So you mean hearing 0db at 250Hz would overwhelm the higher frequencies? Maybe so, but what about 0db at every frequency?
Teach me more! You got unaided/aided audiograms? How much gain are you getting currently? Was what he turned up the MPO/SPL or just gain? The two are not the same.
Exactly. What good is having speech loud enough to hear if you still can't understand it? Or having the car noise amplified so much it makes your head throb?
If someone can understand speech at 30db, I would like to know what reasons that hearing at 20db or even 10db wouldn't improve it? As for car noise making head throb, this should be addressed by reducing the SPL/MPO.
jillio
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Because it does not automatically transfer to greater clarity. Particularly in the case of certain types of nerve damage in which particular sounds are not transmitted to the auditory centers in the brain. Those sounds are absent, no matter the dB level. You consistently fail to include the variable of discrimination in your assessments. Discrimination is independent of dB level.
Watermelon
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Yes, that's true. Hearing sounds is way different from understanding sounds. Amplification isn't everything. Sometimes too much amplification becomes just noise, and turning down the volume helps. If life was easy enough to just amplify things to 10dB loss up from 70-80 dB loss (we'll assume a flat (no curve), across the board, 70-80dB loss), and understanding sound was easy, then wearing hearing aids would be great.
Understanding sound is a monumental task for the brain to chug through, and requires a lot of training. There's a lot of different methods to go through training. My preference is total communication (sound + sign + speech reading) as no single method is best.
There are also varying types of hearing losses, so hearing aids wouldn't work for everybody. Same with cochlear implants not working for everybody. There is no silver bullet solution, where one common answer works for everyone. People have to understand and choose what works best for them.
Understanding sound is a monumental task for the brain to chug through, and requires a lot of training. There's a lot of different methods to go through training. My preference is total communication (sound + sign + speech reading) as no single method is best.
There are also varying types of hearing losses, so hearing aids wouldn't work for everybody. Same with cochlear implants not working for everybody. There is no silver bullet solution, where one common answer works for everyone. People have to understand and choose what works best for them.
I have never done an aided audiogram. My audiologist doesn't have the things required to do one. Quite frankly I don't care that much either.
Both gain and MPO had to be reduced for me. I have sensory sensitivity anyway from having autism. That could also be linked to why I understand speech better. My brain processes things weird so maybe my brain is able to process the incomplete speech differently than someone else. I don't know.
Distortion can be caused by not enough power to support the volume and therefore the sound gets distorted. Since we can't walk around with AA batteries in our BTEs....
And if the sound just gets too loud for the speaker to handle then the sound gets distorted. Turn on your computer speakers, put on music, and turn your speakers on as loud as they go. You should be able to feel the distortion at a certain point with your fingers.
My speech test scores have been between 0% and 10% with the standard 2 syllable word lists. Hot dog, ice cream, sailboat, baseball, blah blah blah. If I am having a conversation with someone I know well (I can only do this with like 3 or 4 people in total) and they are using my FM and I can't see their lips and they speak slowly, clearly, and I know what we are talking about I don't need to lip read. They need to repeat some things and if the topic changes I am screwed.
I am still blasted with sound and I need to take breaks from my hearing aids several times throughout the day if I wear them.
Hearing aids when I was moderate-profound were still annoying. I could tolerate them better though.
Then a CI won't improve clarity either as all a CI does is take the job of the missing hair cells but you still need a healthy nerve to carry the signals. Are there any tests that can detect the health of the nerve? If the problem is the nerve, then one must wait for stem cells that can repair the nerve. A low discrimination score with a working CI or for someone with alot of residual hearing wearing properly fitted HAs points out a such problem with the nerve and/or auditory processing centers.
I was never told that too much gain reduces sound to noise! Perhaps a better HA can handle more gain with clarity? Phi4sius was aided to 20db from a 70db loss with his old HAs. He say he could be hearing at 10db with his new HAs!
Guess she doesn't have a soundproof booth/soundfield? For me, an aided test makes sure im getting the proper amplification, if not then ill be getting my HAs reprogrammed or trying a different HA so I hear more.
You mean Asperger's? It's not the same as autism, although they share some similarities. Asperger's isn't really a disorder. The person with Asperger's is just as capable, but simply thinks differently and for him/her self and doesn't follow the "herd mentality"
Didn't know this! Does this have to do with gain or with SPL/MPO? One can have a gain of 70db but keep the SPL/MPO at only 110db instead of 130db to reduce distortion. Of course if your hearing loss is above 100db, the SPL/MPO must be higher than 110db.
Makes sense(regarding computer speakers), couldn't one just limit the SPL/MPO so sounds never become too loud? Say you can get clear sound up to 110db SPL/MPO, then set the SPL/MPO to 110db. The HA will start reducing the gain when you hit the SPL/MPO limit. Say you set the gain to 70db. A 20db sound will be amplified to 90db. A 40db sound will be 110db, so will a 50, 60, 70....110db sound still be 110db since that's the SPL/MPO limit! You can use compression to increase your perception of loudness. Someone with a HL of 90db will just barely hear that 20db sound. With a SPL/MPO limit of 110db, nothing will become uncomfortably loud due to recruitment or just pain threshold.
Were you able to understand a high percentage of speech back then? Im also guessing there was a big difference in clarity and amount of sounds you hear. Do you still hear sounds or just experience vibrotactile? Phi4sius has a 100db+ loss in his bad ear and he says everything is just vibrotactile in nature.
faire_jour
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Deafdude,
The CI does provide better clarity because you are no longer using the part of your ear that is "broken". You are completely bypassing the hairs that are missing or damaged. It won't help if the nerve is bad, but if it is the hair cells, you get clarity not loudness.
The CI does provide better clarity because you are no longer using the part of your ear that is "broken". You are completely bypassing the hairs that are missing or damaged. It won't help if the nerve is bad, but if it is the hair cells, you get clarity not loudness.
sr171soars
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Exactly!
That is what I was missing with my HA before I got my CI. Now, clarity is not a problem. That is also why I don't read lips much anymore (this is for DD1) as it is not necessary.
If I can hear then I am happy, if I am not satisfied with what I am hearing we try again. My audiologist does REM to verify the fittings which is more reliable than an aided audiogram. That's why many audiologists don't do an aided audiogram.
No, I mean autism. I have "high-function autism". Are you trying to tell me that because I have autism I am not "just as capable" and I am in some way disordered or defective? You need to back off in your judgments.
I have had some fluctuation so my speech understanding changed by the day. I am also a strong speech reader. Obviously I hear sound if I can understand some speech. It is not the same experience for everyone.
Transposition can bypass the broken part or cochlear dead region as well. I admit that transposition doesn't have a 100% success rate but it's risk free. If it works, people are experiencing as much as 30% improvement in speech by being able to hear the highs and more of the mid frequencies. No one can tell you that transposition won't work unless you try and find out for yourself. If transposition works for you, then you may have saved yourself or insurance over $50,000 and the risks of CI as well as your residual hearing!
Have you given transposition a try before CI? You mention that your hearing in the lows is much better than in the highs where you may have no hearing at all.
Does real ear measure tell you how well you are hearing aided? For me, an aided audiogram is an objective way to determine if my gains are meeting targets or if it's possible to get more access to sounds which have and do improve my ability to hear speech and faint sounds.
Show me where did I say "less capable" If you re-read what I said:
You mean Asperger's? It's not the same as autism, although they share some similarities. Asperger's isn't really a disorder. The person with Asperger's is just as capable, but simply thinks differently and for him/her self and doesn't follow the "herd mentality"
There's alot of good articles on Asperger's which you can Google. If you want to discuss this, start a thread and ill post in that thread.
Some unanswered questions:
Were you able to understand a high percentage of speech back then before your progressive loss?
Regarding distortion, didn't know this! Does this have to do with gain or with SPL/MPO? One can have a gain of 70db but keep the SPL/MPO at only 110db instead of 130db to reduce distortion. Of course if your hearing loss is above 100db, the SPL/MPO must be higher than 110db.
Makes sense(regarding computer speakers), couldn't one just limit the SPL/MPO so sounds never become too loud? Say you can get clear sound up to 110db SPL/MPO, then set the SPL/MPO to 110db. The HA will start reducing the gain when you hit the SPL/MPO limit. Say you set the gain to 70db. A 20db sound will be amplified to 90db. A 40db sound will be 110db, so will a 50, 60, 70....110db sound still be 110db since that's the SPL/MPO limit! You can use compression to increase your perception of loudness. Someone with a HL of 90db will just barely hear that 20db sound. With a SPL/MPO limit of 110db, nothing will become uncomfortably loud due to recruitment or just pain threshold.
It tells you that the hearing aids are matching the gain they should be giving at the level of the ear drum, so yes.
I know what Aspegers is. I don't have it. I have Autism. High Functioning Autism and Aspergers are different diagnoses. Different criteria to diagnose them and everything. Some people will call Aspergers high-functioning autism but that is mostly when they don't know what they are talking about or trying to explain it to someone who doesn't understand. They are different.
I did answer this. My speech understanding fluctuated. It depended on the person and I am strong speech reader so it didn't matter. On average I was between 40% and 60%.
Gain.
No. If it is too loud it is too loud. With so much hearing loss we have virtually no dynamic range. There isn't a lot of different between quite and loud for us.
sr171soars
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As for transposition, no I didn't try that. Er...I never mentioned anything about hearing in the lows as being better in the highs where one may have no hearing at all. I assume somebody else said that and you attributed it to me.
I merely was pointing out that I had a big problem with clarity toward the end prior to getting my CI. They indicated given my audiogram and history that I would probably lose all my useful hearing in five years or less. With that prospect looming before me, I didn't want to spend big bucks for a HA only to have to go to a CI in any case. Thus, I simply decided not to mess around and be done with it. It was strictly a cost benefit move.
Hear Again
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This was certainly the case for me. I had severe-profound hearing loss for 10 years before deciding to receive CIs. My left ear unaided began at 95 dB with NR at 1000 Hz and above. My right ear unaided started at 90 dB with NR at 1000 Hz and above. My aided hearing began at 60 dB with NR at 1000 Hz and above. I tried to function with HAs and a Comtek FM system using DAI for as long as I could, but after being locked inside a building because I didn't hear anyone leave as well as a family emergency that involved my late mother, I knew I had to do something for my own personal safety as a deafblind person. Mind you, there are many, many deafblind people living independently, but in my case, I thought getting CIs was the right decision for me. None of us (whether we are hearing, HoH, D/deaf) have the right to tell another what kind of hearing "device" (for lack of a better word) to use.