Q: What is hidden hearing loss?

A: We often say, “hearing happens in the brain” because passively perceiving a sound is not the same as actively comprehending its meaning. Once a sound wave travels through the ear and along the auditory nerve, it’s up to the brain to process it. A hearing loss that occurs due to inadequate auditory processing — rather than damage to the inner ear — is often referred to as “hidden hearing loss” because it’s not uncommon for the patient to receive normal scores on standard hearing tests. This means hearing loss due to auditory processing difficulties is not diagnosed as often as it should be, and many people living with this type of hearing loss don’t even realize it.


Q: What are the symptoms?

A: The main symptom to watch for is struggling to hear or understand conversations in noisy environments. If you find yourself asking friends and family to repeat themselves while in a busy restaurant, shopping center, or sporting event, but can hear them just fine in quieter places, make an appointment with an audiologist. To get the most out of your evaluation, take some time beforehand to observe how well you hear in different listening situations and tell your hearing care provider which ones give you the most trouble.


Q: What if my audiogram is normal?

A: Standard audiograms often miss hidden hearing loss because it cannot be measured by playing sounds in isolation. Without competing noise to confuse the brain and slow down processing speeds, your hearing may appear normal. Speech-in-Noise (SIN) testing is usually required to uncover hidden hearing loss, and while this type of test should be a routine part of every hearing screening, surveys have shown that only 15–20% of audiologists are including it in their diagnostic evaluations. Choose your hearing care provider carefully and don’t hesitate to ask questions about the testing process!


Q: What is the treatment for hidden hearing loss?

A: Like other forms of hearing loss, hidden hearing loss is treated with hearing aids. Most current models have a built-in noise reduction feature that amplifies desirable sounds such as speech while minimizing distracting sounds like background noise and wind. Other better-hearing strategies such as active listening and lipreading are also beneficial. Your hearing care provider will explore the options with you and create a treatment plan that works for your individual hearing loss.

Are you having trouble hearing friends or family in crowded places? Schedule a hearing consultation so we can get you back to hearing clearly and enjoying the activities you love!

ASHAWIRE. Beyond the Audiogram: Whole-Brain Hearing and Listening. https://leader.pubs.asha.org/do/10.1044/leader.FTR2.27112022.aud-assessment-sin.44/full/. Accessed November 28, 2022.