“I can hear you. I just cannot understand you.”
It is one of the most common things people say when they first wonder whether their hearing has changed. Voices are there, but the words seem soft around the edges. Conversations take more concentration than they used to, especially in busy places.
If you have been wondering why speech sounds unclear, this article answers some of the most common questions we hear, using information from Canadian and international health sources.
Is it normal to hear voices but not understand the words?
It is a commonly reported experience. According to Johns Hopkins Medicine, common symptoms of age related hearing loss include other people’s speech sounding mumbled or slurred and trouble understanding conversations, often when there is background noise.
Hearing that someone is speaking and understanding each word are two different tasks. A person may still hear voices at a comfortable volume while missing some of the smaller sounds that make words distinct.
Why would speech sound loud enough but still unclear?
Speech is made up of lower pitched sounds, like many vowels, and higher pitched sounds, like s, th, and f. A U.S. Food and Drug Administration consumer article explains that understanding consonant sounds depends on the ability to hear high pitches, and that when high pitched sounds cannot be heard, speech becomes less intelligible.
Johns Hopkins Medicine notes that age related hearing loss most often affects the ability to hear high pitched sounds, while the ability to hear low pitched sounds is often not affected. Because vowels carry much of the loudness in speech, a person may feel that speech is loud enough while still missing details that help separate one word from another.
Can the problem be in the hearing nerve, not just the ear?
In some cases, yes. Cleveland Clinic describes a type of age related hearing loss called neural presbycusis, which involves the loss of nerve cells in the inner ear or along the pathway to the brain and can affect a person’s ability to understand speech.
This is one reason why speech testing, and not only tone testing, can be a useful part of a hearing assessment.
Why is it harder in restaurants and at gatherings?
Background noise can mask the soft, high pitched sounds in speech. Cleveland Clinic notes that people with age related hearing loss may have trouble understanding what people are saying in noisy places, like crowded rooms and restaurants.
In a quiet room, the brain can often use context to fill in a missed sound. In a busy room, that context is harder to access.
How common is this kind of hearing change in Canada?
More common than many people expect. According to Statistics Canada, an estimated 54 percent of Canadians aged 40 to 79 have at least mild hearing loss in the high frequency range. The same report found that 77 percent of those individuals had not perceived any loss of hearing.
Globally, the World Health Organization reports that the prevalence of hearing loss increases with age, and that more than 25 percent of people over 60 are affected by disabling hearing loss.
Why do so many people wait to have their hearing checked?
Gradual changes can be easy to adapt to without noticing. Statistics Canada’s Health Reports notes that people and their communication partners may adjust to slow changes in hearing, and that once hearing loss is suspected, there is often an average delay of seven years or more before someone seeks help.
What are some signs it may be time for a hearing assessment?
You may wish to book an assessment if you notice:
- Speech often sounds mumbled or unclear
- Some voices are noticeably harder to follow than others
- You regularly ask people to repeat themselves
- Busy places make conversations difficult
- Family members comment on the TV volume
- You feel tired after social events
These signs do not confirm a hearing change on their own, but an assessment can provide more information.
What happens during a hearing assessment?
A hearing assessment with an Audiologist at Bluewater Hearing and Balance may include:
- A discussion about your hearing concerns and daily listening situations
- An examination of your ears
- Pure tone testing to measure how you hear across a range of pitches
- Speech testing to look at how well you understand words, which may include background noise
- A review of your results and a conversation about possible next steps
Cleveland Clinic describes pure tone testing as a common test used to assess age related hearing loss.
What options may be available?
Options depend on each person’s results and needs. For some people, hearing aids may be recommended. Today’s hearing aids can be adjusted to support specific pitches, rather than making all sounds louder. Communication strategies may also help, such as:
- Facing the person who is speaking
- Reducing background noise when possible
- Choosing quieter seating in restaurants
- Using captions on TV and video calls
Your Audiologist can talk through which approaches may suit your situation.
Book an Appointment With an Audiologist in Sarnia
If you have been wondering why speech sounds unclear, a hearing assessment may help you better understand what is happening. Bluewater Hearing and Balance serves patients in Sarnia and across Lambton County, and our team is here to answer your questions.
Visit our Contact page to book an appointment with an Audiologist.
Sources
- Statistics Canada: Unperceived Hearing Loss Among Canadians Aged 40 to 79 (The Daily, 2019)
- Statistics Canada, Health Reports: Unperceived Hearing Loss Among Canadians Aged 40 to 79
- U.S. Food and Drug Administration: Sound Advice About Age Related Hearing Loss
- Johns Hopkins Medicine: Age Related Hearing Loss (Presbycusis)
- Cleveland Clinic: Presbycusis (Age Related Hearing Loss)
- World Health Organization: Deafness and Hearing Loss Fact Sheet