Photo credit: Helena Lopes from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece in the Canadian edition of Psychology Today asks “Why can’t you hear?,” but a better title might be “Why can’t you understand speech in a noisy room?”

This problem is known in audiology circles as the “speech in noise” problem. People can understand what someone is saying just fine in a quiet room, but can’t follow a conversation in a noisy one. The problem has been known for decades, but now it is thought that the cause is cochlear synaptopathy, also called hidden hearing loss because hearing test results–technically known as pure tone audiometry–are normal despite the patient’s complaints of not being able to hear.

The problem can be assessed clinically by a number of tests, including the Hearing in Noise Test and the QuickSIN test. Now researchers at the Massachusetts Eye and Ear Infirmary have developed two tests, one measuring pupillary responses and the other recording electrical signals from the ear drum.

The inability to understand speech in noise is a frustrating one. Hearing aids usually don’t help much, although newer digital hearing aids with special features claim to do better.

Much better than any hearing aid, though, is preserved natural hearing. Protect your ears. If something sounds too loud, it is too loud. Turn down the volume, use hearing protection, leave the area, or you might have speech n noise difficulty later.