Hearing Loss, Conversation and the Brain

Listening can be defined as an active or intentional behavior involving the brain’s ability to focus its attention to decode and process conversation. The impact of hearing loss can have many negative social affects on verbal communication between partners and family members. There are a number of social, relational, and cognitive challenges which can occur during interrupted social exchanges.

According to Tjornhoj-Thomsen, Ph.D. and Philipsen, Ph.D. 2018¹, the majority of the studies presented in the literature have focused on the effects of hearing loss on close or intimate relationships, whether explained from the perspective of the hearing-impaired individual, the significant other or both. Feelings of frustration, embarrassment, intolerance, insecurity, and dismay may be felt by all the individuals participating in a failed communication event.

Because hearing loss can disturb the smooth “give-and-take” exchange described by Hallam, R., Ashton, P., Sherbourne, K., Gailey, L., 2008², the social situation is altered and disturbed. Tjornhoj-Thomsen, Ph.D. and Philipsen, Ph.D. 2018³ further argue that the social complication resulting from hearing loss affect the “timing aspects” of conversation. The challenge from the hearing-impaired individual and significant other is that things are often repeated. Additional time is also needed to process and make sense of the message. This delay or temporal disruption explained by Tjornhoj-Thomsen, Ph.D. and Philipsen, Ph.D. 2018⁴, breaks down the ease and flow of communication causing negative feelings and distress to be added to the social exchange. Hearing impairment therefore creates a loss in everyday communication spontaneity. This disruption of shared experiences according to Dahl Mo, in an unpublished dissertation, 1995⁵ “disturbs the basic elements of relatedness” between close partners, family members and friends. Furthermore “not listening or wanting to hear is an intentional act, and is viewed as antisocial, unacceptable and distressing”.

Johns Hopkins University Otolaryngologist and researcher, Dr. Frank Lin in 2013⁶ suggested that hearing impaired people tend to “withdraw socially and the lack of regular interaction leads to mental stagnation”. He added that. “The effort it takes those with hearing loss to hear and comprehend creates a regular strain that interferes with normal cognition”. He concluded that “A combination of all these factors contributed to cognitive decline”. Dr. Lin’s MRI studies conducted over a 10 year period suggested that, “declines in hearing abilities may accelerate gray matter atrophy”. He added that seniors with hearing loss are significantly more likely to develop dementia and Alzheimer’s disease than those who retain their hearing. Dr. Lin also noted that hearing aids not only improve hearing but may indeed “preserve the brain”.⁶

Decades of multi-disciplinary research suggests that coping and managing communication are often linked to the distinguishing of speech in noise. Technical advancements in hearing aids, cell phones and assistive listening device systems can potentially improve residual hearing sensitivity levels and enhance word recognition abilities with environmental mapping and real-time processing. Hearing aids can now provide inter-ear synchronization utilizing advances wireless Bluetooth technologies. Cycling processors can also maximize speech audibility and comfort by actively controlling ambient noise levels in a variety of listening environments.

Integrating back to “social context” as discussed by Tjornhoj-Thomsen, Ph.D. and Philipsen, Ph.D. 2018⁷ requires a number of necessary disciplines to facilitate and “to restore spontaneous exchanges and sharing intimacy with close partners”, Smith, M., 2007.⁸ Careful diagnostic and medical evaluation of a hearing-impaired patient’s deficits includes a collaborative team effort between physician, audiologist, patient and family members. The cause and degree of the hearing loss, associated disease health risk factors, potential medical treatments and hearing aid options must all be considered when the goals are to “preserve brain function”, Johns Hopkins Dr. Lin, 2013⁹ and to “manage the interactional and social complications associated with hearing loss” Tjornhoj-Thomsen, Ph.D. and Philipsen, Ph.D. 2018.¹⁰

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