Here's the truth about hearing tests: they aren't perfect, and they don't give us a complete view of your entire auditory (hearing) system. They are, however, still important because it shows us the very softest sounds you can hear across a range of pitches in both ears to classify your hearing ability in the most ideal setting. We do this in a very controlled manner in a soundproof booth with calibrated equipment to eliminate any other variables and to make it possible to compare results year to year, clinic to clinic, provider to provider.
But what does the hearing test miss? Well, a whole lot! Our standardized hearing test focuses on one's ability to hear or detect that sound is present. It does not do a very good job at measuring one's listening or ability to attend to or focus on what you are hearing. With this, we can miss something called Auditory Processing Disorder, a disorder that can impact one's ability to listen even if one's hearing test shows normal hearing sensitivity.
Let me explain: the auditory system, or the hearing system, requires sound to go through the ear canal of the outer ear through the ear drum and the three tiny bones of the middle ear to the cochlea, or the hearing organ, in the inner ear. This is the part our traditional hearing test best evaluates. BUT from the cochlea, the signal then goes through about 7 structures in your central auditory nervous system, ending with the auditory cortex in the brain. We really listen from our brain, not our ears!
Auditory Processing Disorder is when something doesn't quite go right from the cochlea up to the brain. Its classic presentation is someone who has totally normal hearing on a hearing test, but then falls apart in background noise. It can also cause issues with auditory memory and even manifest in writing, reading, or spelling issues. With more research, we now understand that people can have both a hearing loss and an auditory processing disorder- it isn't an either/or. We also understand that this doesn't just affect children, although that tends to be when people are first diagnosed.
For people that think they have an Auditory Processing Disorder, the first step is to get a baseline hearing test and an auditory processing evaluation that will classify exactly what type of disorder it is. From there, the recommended intervention is auditory training, or a program of weekly sessions that improve your listening ability and address your specific auditory processing deficits You can think of it as physical therapy for your brain and ears.
I offer virtual auditory training programs for people with auditory processing disorders, as well as those who feel they aren't hearing as well as they should be despite use of a hearing aid or cochlear implant.