One of the most common complaints expressed by patients to their audiologists concerns the difficulty they have when attempting to listen in the presence of background noise. This difficulty includes, but is not limited to, situations where one tries to carry on a conversation in a restaurant, while a TV is on, while water is running, or when attending a cocktail or dinner party. The added noise present in all of these situations can have a significant negative impact on one’s ability to understand and follow a conversation.
For many years, hearing aid manufacturers have focused on (and continue to invest in) improving hearing aid technology to help achieve better hearing in the presence of frustrating and distracting background noise. While hearing aids have certainly come a long way as far as the development of “hearing in noise” programs, many people with hearing loss continue to have significant difficulty hearing and understanding conversation in noise. Why is this so?
When an individual has a conversation with one other person in a quiet setting the most important factor in their ability to hear is audibility. In other words, can the listener hear the sounds of the other person’s voice in order to understand them? If you have a hearing loss, and are using hearing aids, then yes, in a quiet setting the hearing aids do provide audibility. However, when a conversation takes place in a crowded restaurant, audibility is only a part of being able to understand the conversation. When distracting background noise is present your brain has to perform a more complex processing task in order to understand what it hears. This portion of hearing is known as auditory processing.
It is known that an individual’s auditory processing ability changes throughout his or her life. At approximately 40 years of age, our auditory processing slowly begins to become less effective, but each person’s auditory processing changes differently. And of course, such changes are compounded when hearing loss is present. This is why it is so important for people with hearing loss to be aware of exactly what auditory processing is, and the approaches they can take to try to improve their own auditory processing skills.
Just as physical therapy can help muscles rebuild strength to regain or improve mobility, exercises in listening can improve auditory processing resulting in better understanding in difficult listening environments. Listening and Communication Enhancement or LACE, is a computer-based instructional tool designed to help individuals practice their auditory processing skills. The LACE program consists of a series of exercises developed by audiologists and engineers specifically to target those skills that can help adults improve their auditory processing.
LACE utilizes practice exercises in four specific categories: speech in noise, fast talkers, competing voices, and auditory memory. Within each of these categories the exercises become more difficult or easy depending on your performance and progress. So, as your improve your auditory processing skills, the tasks become more difficult. LACE also includes numerous pop-up “tips” designed to provide the user with helpful strategies and informational tidbits to improve your communication skills as well as provide additional information about hearing loss and hearing loss prevention.
The professional audiologists at Audiological Consultants of Atlanta encourage all of our patients to take an active role in their hearing rehabilitative process by visiting the LACE website at: http://www.neurotone.com/. When you visit this website you can learn about the LACE instructional program and download a free demonstration. The demonstration will allow you to sample some of the practice exercises in each of the four training categories noted above.
Research shows that auditory processing can significantly improve with the use of LACE. If you have hearing loss, LACE is most effective if used in conjunction with hearing aids. Don’t hesitate to ask our audiologists at Audiological Consultants of Atlanta about auditory processing and LACE.



You “misunderheard” me.
That’s what my 6 year old son told me the other day when I fussed at him for something I thought he said to his sister. My husband and I laughed at the funny things kids say, and I knew this new word would be remembered for a long time. As I got to thinking, though, I came to the realization that “misunderhearing” happens every day, especially for the people who walk through an Audiologist’s office door.
Here are some active listening strategies to help you “misunderhear” less.
• Look at the person speaking to you, making sure you are in good lighting, seeing their face clearly and fully. (This might mean you need to put your glasses on.)
• If you have a “better” ear, make sure it is closer to the speaker, and try to be within 3 to 5 feet of a speaker.
• Be assertive. If you can’t hear what someone is saying, let them know. Don’t bluff and nod. Ask for clarification if you need it.
• Ask for written directions or instructions.
• Don’t get frustrated if you can’t hear every word, especially in a noisy environment. Remember that everyone struggles in noise.
• Be aware of the topic of conversation.
• Use visual and contextual clues to help fill in what you may miss.
• Let those around you know how they can help you hear better. For example, ask them not to put their hands in front of their mouth and to speak more slowly.
• Minimize distractions. Close the car window, shut the door at home if your neighbor is mowing their grass, turn the t.v. or radio down if you are trying to have a conversation.
• Use assistive listening devices, FM systems, or streamers when they are available. Many public places have devices that will help the hearing impaired.
• Chose wisely. Consider the restaurant’s noise rating before you make plans to dine out. If your favorite restaurant is noisy, try to go when it is not as busy, and ask for a booth versus a table.
• Don’t lose your sense of humor. If you are at ease with yourself, it will help those around you feel more comfortable.
These are just some strategies that will make it easier to interact with those around you. Rest assured that those around you want to be heard and will do what they can to make it easier for you to hear. No one likes to be “misunderheard.”