What's the economic cost to society for America's millions with hearing loss?  It's a whopping $56 billion a year – a number that's 50 percent higher than the cost of blindness.  It's measured in the price tags for treatment, specialized education and social services and in reduced work productivity.  But, until you or someone you're close to experiences it, it's hard to imagine the profound impact it can have on the day-to-day lives of a single individual and his or her family.

In children, hearing loss can lead to delayed social development and learning.  It can interfere with a child's language.  It can be mistaken as Attention-Deficit Disorder, mental retardation, behavioral problems, rudeness, or inattentiveness. Even a mild hearing loss can cause a child to miss as much as 50% of classroom discussion.

Those who lose their hearing later in life face their own challenges.  Many have difficulty in accepting their loss.  They may refuse to use hearing aids for fear of looking old.  They can feel lonely and isolated and those around them can feel the same.  Relationships suffer when family members feel as if their partner who has hearing loss doesn't care about them enough to make changes to make it easier to communicate.  Hearing problems make it difficult to hear doorbells, car horns, and alarms. It can make it hard to understand and follow a doctor's advice or respond to warnings, and can cause depression. Its effect on speech communication can reduce a person's professional and social well-being.

There are countless ways to compensate for hearing loss, but the first step is to acknowledge it – to psychologically and emotionally adjust.  With many people this includes working through the grieving process for their hearing loss.  The next step is to get an accurate diagnosis.  Hearing loss is said to be like fingerprints – with no two people having exactly the same circumstance.  To effectively help you, your doctor must understand the cause, type and severity of your loss.      

At first, your primary care doctor will conduct a general screening test to get an overall idea of how well you can hear.  If warranted, he or she may send you to an audiologist for further testing.  Tests in the audiologist's arsenal include (but are not limited to):

• Pure-tone audiometry (air and bone conduction) to determine the lowest intensity at which an individual "hears" a pure tone as a function of frequency (or pitch). Speech reception thresholds (SRTs) and speech discrimination are assessed

• Hearing in Noise Test (HINT) to measure an ability to understand speech in quiet and noisy environments

• Air conduction audiometry to test the condition of the external ear canal, middle ear, and inner ear.

• Bone conduction audiometry to evaluate the condition of the inner ear.

• Various physiologic tests to determine the functional status of the entire auditory system.

With test results in hand, doctors can recommend strategies and treatments tailored to the individual.

In some cases of conductive hearing loss, treatment can be simple.  Loss caused by wax buildup can be fixed with irrigation and suction.  Infection can be successfully treated with oral antibiotics or eardrops, fluid in the middle ear can be drained.  More complicated procedures may be needed to treat other conductive problems including: 

• Blocked Eustachian tubes (small tube connecting the back of the throat to the middle ear which neutralizes air pressure on both sides of the eardrum).  Sometimes tubes need to be inserted through the eardrum.

• Infected mastoid bone.  This infection of a bone behind the ear is usually treated with antibiotics, but occasionally needs to be treated surgically (mastoidectomy).

• Ruptured eardrums. These may heal on their own but sometimes surgery is necessary.

• Otosclerosis. This is often treated by an operation (stapedectomy) which replaces the damaged bones of the middle ear with tiny metal substitutes.

Other conductive hearing loss and sensorineural hearing loss (which involves permanent damage to the cochlea, the hair cells or the nerve) is permanent.  Loss can be mitigated with a combination of the following:

• Simple coping skills

• Assistive listening and alerting devices, such as TV-listening systems or telephone-amplifying devices, telecommunications devices for the deaf (TDD), flashing lights to signal events such as a ringing telephone, a doorbell, or a fire alarm

• Learning to lip read / speech read

• Hearing aids

• Cochlear implants

• Learning sign language

Coping Skills

• Face the person with whom you're having a conversation

• Get as close to the speaker as possible

• Choose quiet settings / turn down background noise like TV

• Tell the person you're talking to what they need to do so you can effectively communicate with them

• Use assistive devices

Lip Reading / Speech Reading
This is a technique used in understanding speech by watching the movements of the lips and mouth. It's sometimes referred to as speech reading, which technically also includes the reading of facial expressions and body language.  Only about 25 percent of the speech sounds we produce are visible on our lips.

Hearing Aids
While hearing aids can't help everyone with hearing loss, they're the mainstay of treatment for most people today.  Unfortunately, they can't restore hearing to normal – even the most advanced hearing aids don't correct hearing the way eyeglasses correct vision. 

The choice of hearing aid depends on the person's particular type of hearing loss. For example, people whose hearing loss affects mainly higher frequencies don't benefit from simple amplification.  That merely makes the garbled speech they hear sound louder.  Think of it in the context of listening to your radio.  If your volume is turned low, simply increasing it solves the problem.  However, if you have a reception problem, the sounds being transmitted won't be clear no matter how much you increase the volume. Hearing aids that selectively amplify the high frequencies markedly improve speech recognition. 

Hearing aids suffer from the bad reputation earned by models our grandparents used – those that produced annoying feedback and over-amplified background noise.  There's been tremendous improvement in today's models with many using digital sound processing with multiple frequency channels so the amplification can most precisely match the person's hearing loss.  When considering a hearing aid, expect to:

• Try more than one device before finding the one that works best for you.  Most states have laws requiring a trial period before you buy a hearing aid, making it easier for you to decide if the hearing aid helps.

• Use it consistently for weeks or months to give your brain a chance to adjust to the new sound information it now receives.

• Accept that there isn't a hearing aid made today that can cut out all background noise.  Background noise is made up of a lot of the same energy that speech is made up of – if you had a hearing aid that cut out all the background noise, you'd also cut holes in the speech. 

Cochlear Implants
An out-patient operation can provide a cochlear implant that can help restore partial hearing to some people with profound sensorineural deafness who do not benefit from even the highest-powered hearing aids. Unlike a hearing aid that amplifies sound and directs it into your ear canal, a cochlear implant compensates for damaged or nonworking parts of your inner ear. It consists of a small battery-operated speech processor and microphone worn outside the ear that converts sounds into electrical signals. The signals are transmitted to electrodes that are surgically implanted in the cochlea. The electrodes stimulate the nerve in the ear directly so that the sound can get to the brain.  The implants don't restore normal hearing. However, most people who have had the surgery can hear sounds. They also report that the implants help them read lips better, and in some cases, even use the telephone.

Learn more about Hearing Loss:

Key Point 1:  Normal hearing requires all components of the physical hearing chain to be functioning properly.  Any breakdown or impairment in that chain may result in a loss of hearing acuity.

Key Point 2:  Some types of hearing loss are preventable.  Avoidable hearing loss can be due to noise, toxins and injury.