This is a concern we hear quite frequently expressed by patients and by other people we talk with. Background noise that occurs during conversation is a problem for all of us, but it is particularly problematic for people with reduced hearing ability. It is important that the speech signal is above the background noise level in terms of loudness to allow for improved clarity. People with reduced hearing ability, particularly when combined with ageing; require even more speech signal loudness in this type of situation compared with normal hearing people for a few reasons. Two of these reasons are inner ear nerve (hair cell) damage that reduces clarity for some speech sounds and longer processing times at levels of the brain beyond the ear. Other acoustic environment factors can add to speech signal smearing, for example, reverberant surfaces such as hard floors, walls, and windows, particularly in large rooms. Reverberation is reduced when hard surfaces are covered with carpeting and curtains. It can also help to create smaller areas within large spaces, for example, booths in restaurants can help to block sounds coming from sources outside of the booth area.

Two of the most common reasons that people of any age can experience problems hearing conversation in noisy environments are:

1. Background noise tends to be low-pitched (low frequency). This type of sound tends to interfere with or cover higher-pitched (high frequency) speech sounds, specifically consonants (e.g. "s," "f," "t," "p," etc.) that provide critical information and clarity for speech understanding. For example, if you were not able to hear the final consonant, you could not tell the difference between the words "cat" and "cap" or "sit" and "sip." Sometimes the consonants are visible on lips or it's possible to guess what the word is based on the context of the sentence or conversation. This is not always possible and misinterpretation results in frequent requests for repetition, embarrassment, or non-participation in conversation.

2. Hearing loss most commonly occurs in the higher pitches or frequencies rather than the lower frequencies. Again, high frequencies contain consonant sounds that are critical for speech clarity and comprehension and these are barely heard because of the dominating low-pitched noise in many public situations and even sometimes at home.

So, what can you do? There are three possible solutions:
1. Have your hearing checked by an audiologist. We can diagnose your hearing ability and make recommendations to help maximize your communication in all situations.
2. Enhance your communication environment by reducing the distance between the speech source and yourself and reducing the background noise where possible. For example, you can choose a quieter restaurant (this has become more difficult to accomplish) or pick a quieter time to go to a restaurant.
3. If you have some hearing loss, there is some very advanced technological assistance available in the form of hearing devices and assistive listening devices. The following hearing device features can improve hearing in noise:

-automatic volume changes
-adaptive noise suppression that detects the characteristics of the background noise and automatically changes the circuit response
-spectral enhancement, which automatically detects important speech sounds and gives more amplification to those frequency areas
-frequency transposition, which moves speech sounds from poor hearing areas of the inner ear nerves to better hearing areas

Regardless of whether your hearing ability is normal or if you have some reduced hearing ability, it is important to maximize your communication by following the recommendations below:
1. Get the individual's attention first before speaking to them. Even if they can hear you, if they're not paying attention, they won't process what you're saying.
2. Be in the same room. Distance reduces the loudness of the speech signal and walls can block sounds.
3. Allow the other person to see your face. That will provide facial cues and also body language. These things, along with the context of the conversation, can help someone "fill in the blanks" if they miss a word or words.
4. If a repetition is requested, try to rephrase what has been said. This second attempt may be more understandable.
5. It's more important to speak slower rather than louder. It may take some time to process what's being said.
6. Reduce the background noise where possible. Reduce the T.V. volume or even mute it during conversations, for example.

Communication is important to all of us! Everyone at Audiology and Hearing Aid Center consider assisting individuals with any needs in this area as one of our primary goals.

Please contact us and let us know how we can help you.