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How can I tell if I have a hearing loss?

Hearing loss is a very common chronic condition. There are some 28 million people in the USA with hearing loss and it is the single most common birth “defect”. Approximately one third of all seniors aged 75 years and older have significant hearing loss. About 14 percent of all people aged 45 to 64 years have demonstrable hearing loss. Hearing loss negatively impacts quality of life, personal relationships and of course, your ability to communicate Hearing loss can be due to aging, exposure to loud noise, medications, infections, head or ear trauma, congenital or hereditary factors, disease processes and many other causes. The vast majority of hearing problems do not require medical or surgical intervention. Some 90 to 95 percent of all cases of hearing loss can be corrected with hearing aids.It has been approximated that only 8 million of the 28 million hard of hearing individuals are using hearing aids.

I think I have a hearing loss, how do I get a hearing aid?

First you need to get your hearing tested. Then you can schedule a hearing aid consultation appointment with one of our audiologists.

Here are a few questions you can ask yourself to determine if you may have a hearing loss.

  • Do you frequently have to strain to hear people during conversation?
  • Do you often ask people to repeat words or sentences?
  • Do you miss punch lines in jokes?
  • Does it appear that people are mumbling?
  • Do you need the TV or stereo louder than other individuals in your home?
  • Do you have difficulty following conversations in meetings or restaurants?
  • Are you having difficulty understanding people over the telephone?
  • Can you hear the telephone or doorbell ring if you are not right next to them?

If you are concerned about your hearing and have answered yes to any of the above questions, schedule a hearing test. Hearing tests are simple painless procedures that require the patient to press a button whenever a tone or beeping sound is heard. Additionally, your ability to repeat words presented at various loudness levels is assessed. Following the procedures the results can be immediately discussed and recommendations will be made. A formal written report will be sent to physicians, referring agencies or professionals, at the patient’s request.

How old should my child be for a hearing test?

A child’s hearing can be assessed at any age. As a matter of fact, in California all the newborns at accredited hospitals have their hearing screened prior to leaving hospital. There are many testing techniques for assessing children’s hearing. If you or your pediatrician have concerns, a hearing test should most certainly be scheduled.

Do I need a hearing aid?

An accurate hearing test by a licensed audiologist is the first step in answering this question. The next step after obtaining a hearing test is a hearing aid consultation (this can be completed the same day). At that time the degree and implications of the hearing loss will be discussed. Options of implementing compensatory listening strategies, personal hearing aids and/or assistive listening devices are a few of the options available to the hard of hearing patient. These details will be covered in detail at the hearing aid consultation and mutually agreed upon plan will be initiated.

What is an audiologist?

An audiologist specializes in administering the tests necessary to diagnose hearing loss. As an expert in psychoacoustics (the study of human hearing and hearing loss) he or she has an extensive educational background including:

  • A four year college degree
  • A master’s degree (requires one or two more years of graduate work, depending on the institution)
  • May have a Doctor of Audiology (Au.D.) or Ph.D. degree in audiology
  • A one-year post-graduate, supervised fellowship
  • Must pass a national examination to become a certified audiologist

I have trouble understanding people on television. When I turn the volume up there is some improvement, but others in the room say that the volume is too loud. What can I do to make everyone happy?

This is a common problem among the hearing impaired and can have several causes. TV’s often have poor speakers and are placed on the side of the set, directing sound away from, not towards you. TV sound also can reverberate or bounce off of surrounding cabinet or room walls. To solve this problem:

Plug in an auxiliary speaker (if your TV allows for this) and set the speaker so that it is close to and facing you.
Place the TV less than 10 feet away from where you sit.
Adjust the bass and treble levels on your TV (if it has a sound menu) to find a balance that works for you. Maximizing treble and minimizing base seems to work best for most people.

I have an older hearing aid which helps me in most quiet situations, like when I’m speaking to one person. When I’m in noisy environments though, like a restaurant or business meeting, I have trouble understanding people. Are there now hearing aids that can help me hear better in a noisy situation?

Yes. The many of the newer hearing aids have two microphones. One faces forward and the other backward. In a quiet environment, the forward facing microphone is active. In a noisy environment, both are activated and can either automatically or manually switch, depending on the manufacturer and model. When both microphones are active, the sound behind you is not amplified. With the background noise reduced, you should receive a much clearer signal from the direction you are facing. A member of our Premier Practice Network can explain the advantages and indications for dual microphone hearing aid systems.

I have two hearing aids that are working well. They are few years old. How long can I expect them to last?

The first questions you should ask is, am I pleased with the aids and are they working reliably and consistently? If so, you probably don’t need a new hearing aid regardless of their age. However, hearing aids are like automobiles in that they have an average lifespan. Typically, Behind the ear (BTE) hearing aids last 6 – 7 years. In the ear (ITE) hearing aids have a life of approximately 4 – 5 years, with the smallest completely in the ear (CIC) aids lasting 3 to 4 years. There are always exceptions, with some people having successfully worn their hearing aid for up to 7 to 10 years, while others need replacement in two years.

What can I do to extend the life of my hearing aids?

Just like your car, routine checkups and maintenance of your hearing aid will assure longer life and better performance. Wiping off the hearing aid, clearing wax out of the receiver port, placing them in a hearing aid dehumidifier are a few of the steps you can take to increase the lifespan of your instruments. Your audiologist will go over these issues carefully at the time of the fitting and hearing aid check appointments. The maintenance varies from instrument to instrument. If you have questions please contact us.

Are digital hearing aids the best instruments?

At one time, there use to be extensive discussions as to whether one should purchase an analog (traditional) or a digital system. This question is no longer relevant, in that essentially all of the hearing aids dispensed at our facility are digital systems. The advantages of digital processing are now available in all cost ranges and the entry level digital aids are the same price as analog (traditional) instruments. Except in a few circumstances, it is better to choose digital amplification.

How much do hearing aids cost?

The cost of a hearing aid at our facility can range from $1,200 per aid for the basic digital system to $3,400 for the most advanced completely in the ear (CIC) hearing aid.

Do I need one or two hearing aids?

Numerous research articles and our years of experience have convincingly determined that in the vast majority of cases, two hearing aids are better than one. The use of two hearing aids improves one’s ability to hear in the presence of noise, localize the direction of a sound with better accuracy and to hear softer sounds. A trial with two hearing aids is almost always recommended.

How long does it take to get my hearing aid?

There are some hearing aids that are available in our office for you to take home today. However, most hearing aids are custom fit and take around 3 weeks for the manufacturer to make.

Does my hearing aid come with a warranty?

All manufacturers give at least a one-year warranty on the hearing aid that includes repair, loss, and damage.

Can I return my hearing aid if I don’t like it?

Yes within 30 days of the time you received it as long as it was not damaged.

How much does it cost to repair a hearing aid?

Once a hearing aid is out of warranty the minimum repair charge is $150. Charges for a digital hearing aid can be up to $275.

How long does it take to get my hearing aid repaired?

It takes between 2 and 3 weeks to have a manufacturer repair.

Does my health insurance cover any of the above services?

Most insurance covers hearing tests. Occasionally they cover new hearing aids. Always check with your insurance company before coming in for your appointment.

What if I can not afford a hearing aid?

There are services, like California Children Services and Medi-Cal, who will purchase hearing aids for you. The timeline for a new hearing aid order through them usually takes 2 to 3 months.

If my hearing aid is already out of warranty, can I take out insurance on it?

Yes, there are companies who insure hearing aids. We can give you the applications in our office. You can also check out their website at:

Can prescription drugs cause me to have a hearing loss?

Drugs that can cause hearing loss are called ototoxic drugs. Those drugs known to cause permanent damage are the aminoglycoside antibiotics and the cancer chemotherapeutic agents, cisplatin and carboplatin.

Those known to cause temporary damage are salicylate analgesics, quinine, and loop diuretics. In some instances, exposure to damaging noise while taking certain drugs will increase their ototoxicity.

There are other categories of drugs known to be ototoxic including anesthetics, cardiac medications, glucocortico-steroids (cortisone, steroids), mood-altering drugs, and some vapors and solvents. Did you know that common drugs can cause hearing loss? It is important to discuss the potential for ototoxicity of any drug you are taking with your physician and/or pharmacist.



What is Tinnitus?

It refers to any auditory perception not directly produced by an external sound. Tinnitus is commonly described as a “hissing, roaring, or ringing”. It can range from high pitch to low pitch, consist of multiple tones, or sound like noise (having no tonal quality at all). Tinnitus may be constant, pulsed, or intermittent. It may begin suddenly, or may come on gradually. It can be perceived in one ear, both ears, or in the head.

What causes tinnitus?

The exact physiological cause or causes of tinnitus are not known. It is likely that there are many mechanisms. A few of the potential causes are:

Disorders in the outer ear such as: ear wax (cerumen), hair or a foreign body touching the eardrum, a perforated eardrum;
Disorders in the middle ear such as: infection, otosclerosis, Eustachian tube dysfunction, benign tumors;
Disorders in the inner ear such as: sensorineural (nerve) damage due to noise exposure, presbycusis (hearing loss from aging), labyrinthitis (inner ear infection), Meniere’s disease (associated with hearing loss and dizziness);
Temporary effects of medications such as anti-inflamatories (including aspirin, ibuprofen, and quinine), sedatives and antidepressants; possible permanent effects from certain antibiotics and chemotherapeutic agents;
Systemic disorders such as high or low blood pressure, anemia, diabetes, thyroid dysfunction, glucose metabolism abnormalities, vascular disorders, growth on the jugular vein, acoustic tumors, head or neck aneurisms, Lyme Disease, hormonal changes.
Non-auditory disorders such as trauma to the head or neck, temporomandibular (jaw joint misalignment), cervical (neck) problems.

Although tinnitus may initially be caused by an injury to the ear, an auditory pattern is ultimately established in the brain. Thus, many management approaches are directed at retraining the focus of the brain, rather than the ear. While the majority of tinnitus sufferers also have hearing loss, the presence of tinnitus does NOT mean that one is losing hearing.

What can you do to minimize Tinnitus?

  • Avoid loud noises, or wear proper ear protection
  • Maintain good nutrition; certain disorders may be helped by lowering salt intake. Some people find their tinnitus is reduced following reduction or elimination of stimulants such as caffeine and nicotine
  • Exercise
  • Control stress; learn to relax, avoid fatigue
  • Educate yourself


What Are Speech and Language Developmental Milestones?

HEARING & SPEECH AGES AND STAGES (Taken from California Newborn Hearing Screening Program, Department of Health Services)

Birth to 3 Months

Quiets to familiar voices or sounds
Reacts to loud sounds, e.g., baby startles, blinks, stops sucking, cries or wakes up. Makes soft sounds when awake, e.g., baby gurgles.

3 to 6 Months

Turns eyes or head towards sounds, e.g., voices, dog barking
Starts to make speech like sounds, e.g., “ga,” “ooh,” “ba,” and p, b, m sounds Reacts to changes in your tone of voice

6 to 9 Months

Responds to own name and looks when called
Understands simple words, “no,” “bye-bye,” “juice”
Babbles, “da da da,” “ma ma ma”

9 to 12 Months

Responds to both soft or loud sounds
Repeats single words and imitates animal sounds
Points to favorite toy or foods when asked

12 to 18 Month

Uses 10 or more words
Follows simple spoken directions, “get the ball”
Points to people, body parts or toys when asked
“Bounces” to music 18 to 24 Months
Uses 20 or more words
Combines 2 or more words, “more juice,” “what’s that?”
Uses many different consonant sounds at beginning of words, m b, g, m
Listens to simple stories and songs

2 Years to 3 Years

Uses 2 to 3 word sentences
At 2 years, people can understand what the child says some of the time (25-50%) At 3 years, people can understand what the child says most of the time (50-75%) Follows 2 step directions, “get the ball and put it on the table”

3 to 4 Years

Can tell a story or relay an idea to someone using sentences of 3 to 4 words.
Can use all vowel sounds in speech and is understood much of the time by main family members
Can follow simple two-step directions, for example: Go to your room and get your jacket.
Understands some concepts of when things happen, like yesterday, lunchtime, “little-big”

4 to 5 Years

Asks many questions, for example,”who?” and “why?”, and is more interested in how the answers fit his/her thoughts than with the explanation given
Uses sentences of 4 to 5 words
Is able to use most consonant sounds correctly in his speech, and is understood by most people much of the time
Uses “I” for self, and is using other pronouns correctly some of the time.

What Is Speech and Language?

Speech refers to:

  • How the sounds in spoken words are pronounced
  • How easily others understand the words spoken
    How easily or fluently the person talks
  • Whether the rate and timing sound like adult speech and includes the quality of the voice used in speaking
  • Is it too loud or soft, low or high, or does it sound like they are talking through their nose.

Language refers to:

  • Vocabulary used and understood
  • Sentence length and complexity
  • Word and sentence structures that can be understood and used
  • Knowledge of concepts e.g. hot, bottom, alike
  • Ability to understand and follow age-level directions
  • Ability to answer age-appropriate questions
  • The sequential accuracy of what is said; social relevance and situational appropriateness or pragmatic content of the remarks made and of the non-verbal cues used such as gaze, gestures and body language

What should I do if my child’s speech or language appears to be delayed?

If you are concerned about your child’s speech/language development you should contact your pediatrician and request a referral for a speech and language evaluation. Remember that every child is different and that speech/language develops at varying rates even amongst siblings. Make sure that you or your child is evaluated by a qualified Speech/Language Pathologist. Typically a Speech/Language Pathologist will have the letters SLP-CCC after his/her name. He/She will determine the need for therapy based on a comprehensive evaluation.

What can I do to help my child if he/she presents with a language delay?

Make language part of every day experiences in a fun and natural way. Set time aside daily to play with your child, talk about what you and he/she are doing, and try to read to him/her daily. If possible find opportunities for him/her to socialize with other children. Avoid comparisons between your child’s speech and other children’s.

If my child has a speech delay will he/she have learning difficulties?

There is no way of knowing for sure when a child is very young if he/she will have learning difficulties later one. Depending on the type of language issues the child has and his/her age, there is frequently a correlation between expressive and receptive language difficulties and later difficulties in school with reading, writing, comprehending classroom content material, focus and attention. However, each case is individual and generalizations are not necessarily useful.

Is it a problem if we speak another language?

Young children who are exposed to more than one language may demonstrate language skills that are below those expected of children who are exposed to only one language. This delay in language development does not necessarily indicate a language disorder. An evaluation by a licensed speech-language pathologist can help differentiate a language disorder from normal bilingual language development. A child with a language disorder may have difficulty learning two languages at one time. When more than one language is spoken at home, it is not necessary to speak to your child only in English, but it is important to keep the two languages separate. This can be done by saying complete sentences in only one language, or better yet, one parent speaks to the child in one language and the other parent speaks the other language.

What is the difference between a speech/language pathologist, a speech therapist, speech teacher?

A speech language pathologist is a licensed professional with the following minimum qualification: 1) possesses a master’s degree in communicative disorders with a concentration in speech-language pathology; 2) has passed a national exam in speech-language pathology; and 3) has completed a 9 month clinical fellowship year under a qualified supervisor and possesses the Certificate of Clinical Competence. The other titles do not require any specific education or clinical training.


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