If you can hear sounds and make out some words but not others, or you can’t distinguish between someone’s voice and surrounding noise, your hearing issue could be in your ear’s ability to conduct sound or in your brain’s ability to process hearing signals–or both.
Age, overall wellness, brain function, and the physical makeup of your ear all contribute to your ability to process sound. If you have the frustrating experience of hearing a person’s voice but not processing or understanding what that person is saying you may be experiencing one or more of the following types of hearing loss.
Conductive Hearing Loss
When we tug on our ears, repeatedly swallow, jump up and down on one leg, and say repeatedly to ourselves with growing annoyance, “There’s something in my ear,” we may be experiencing conductive hearing loss. Issues with the outer and middle ear such as fluid in the ear, a buildup of wax, ear infections, or damage to your eardrum all diminish the ear’s ability to conduct sound to the brain. Depending on the severity of issues going on in your ear, you may be able to still make out some people, with louder voices, versus catching partial words from others speaking in normal or lower tones.
Sensorineural Hearing Loss
Where conductive hearing loss can be caused by outer- and middle-ear issues, Sensorineural hearing loss affects the inner ear. Damage to the inner ear’s hair-like cells or the auditory nerve itself can block sound signals to the brain. Voices may sound slurred or muddy to you, and sounds can come across as either too low or too high. If you cannot distinguish voices from background noise or have difficulty hearing women and children’s voices in particular, then you may be experiencing high-frequency hearing loss.
High-Frequency Hearing Loss
With age we often lose the ability to hear high-frequency sounds. High-frequency hearing loss occurs when you can still make out low-frequency sounds but cannot make out high pitched sounds. Vowel sounds (A, E, I, O, U) are low-frequency sounds and consonants (S, F, H, V, P, Sh, Th, and K sounds for example) are high-frequency sounds. The ability to make out vowel sounds and not consonant sounds contributes to the experience of hearing sounds, but being able to discern words. Many words like “know” and “foe” or “hat” and “vat” can be difficult to distinguish from each other simply because you can’t hear consonant sounds clearly.
Mixed Hearing Loss
When you experience conductive hearing loss and sensorineural hearing loss it’s called mixed hearing loss. A hearing test or exam will first address middle ear issues (removal of wax buildup) before assessing the conditions surrounding your inner ear, and if there are long periods between hearing checkups, you may find yourself in this category.
Understanding the difference between hearing sounds and understanding sounds is a big help in managing your hearing health. If you see a pattern of words you consistently miss, or particular friends you can’t understand in conversations take note of that. Also, note places and situations that make it particularly hard to understand what people are saying or where sounds are coming from. For example, it’s common for people with high-frequency hearing loss to find it difficult to understand women and children whose voices trend towards the higher frequency range.
Auditory Processing Disorder
Auditory processing disorder is another possible reason you can’t “hear” words. In a noisy environment, you cannot distinguish the words in a conversation from the background noise. Where high-frequency hearing loss is a hearing issue, Auditory Processing Disorder is an issue with how well the brain processes sound by distinguishing sounds from each other and where sounds are coming from relative to the listener.
The more specific you can be with your hearing specialist about your symptoms, the better your chances of pinpointing the origins of your hearing loss and seeking appropriate treatment. Together, regular hearing check-ups and the assistance of hearing aid technology can help you put sounds and words back together again.