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Articles - Hearing Health

Why Can I Hear But Not Understand?

When most patients walk through the front door for their first hearing test, it is typically because a spouse or family member has lovingly coaxed them into “finally coming in.” Patients often do not feel that their hearing is impaired. The most common statement that patients utter is, “ I can hear. I just can’t understand what people are saying” When patients state this one simple expression, they are completely correct, in most cases.

Presbycusis is the name for hearing loss that occurs slowly over time in most of the population, which affects our high-pitch hearing yet leaves, our low-pitch hearing intact or less impaired. This high-pitched hearing loss hinders our ability to hear consonant sounds, which are higher in pitch. Consonant sounds are critical for the discrimination of speech; our ability to discern one word from another. This reduced audibility of consonant sounds will adversely affect our ability to understand speech or mistake words in a conversation. However, because our low-pitch hearing is better or possibly normal, the ability to “hear” is still there; people are audible but not necessarily intelligible.

New hearing aid technology has improved drastically over the years in a multitude of ways. One of which is in the fidelity and clarity of the sound reproduction being put into the ear for processing. One challenge in the past was in the hearing aid fitting of patients whose hearing was drastically worse in the high-pitches versus the low. The reason why this was a challenge is because when hearing falls below a certain point, the integrity of the auditory (hearing) nerve is also greatly diminished. When the nerve is impaired, distortion of sounds may occur even when the appropriate amount of amplification is provided for the severity of hearing loss present.

New technology, known as frequency (pitch) transposition or frequency shifting has made it possible to provide the appropriate amount of correction for high-pitch hearing loss without causing the distortion of speech that occurred in the past. This new technology alters where in the hearing organ specific sounds are being presented for processing. This allows areas of better neural integrity to process the high-pitched sounds instead of the damaged areas. Frequency transposition technology has been shown to greatly improve patient’s abilities to discriminate and understand speech in typical presbycusis type hearing losses of certain severities.  

If you or someone you love suffers from any of the symptoms described above, please take the time consult a Doctor of Audiology, Au.D. or a Doctor of Philosophy in Audiology, Ph.D., who is specifically trained to identify, diagnose, rehabilitate and monitor disorders of the hearing and balance system.

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