You might not know about it, but hidden hearing loss is a crucial – and relatively recent – subject of study in audiology and healthcare circles.

“The more technical term for the condition is cochlear synaptopathy, and it is associated with difficulty understanding speech in noisy environments,” a recent ASHA article says. It’s termed “hidden” because standard tone audiometry doesn’t pick up its presence.

According to hear-it.org: “A hidden hearing loss doesn’t normally affect a person’s ability to hear quiet sounds, but it makes it harder to hear sounds when there is competing background noise.” A major cause of concern is that this type of hearing loss is possibly widely under-diagnosed, and without treatment or further preventative measures, one could see their hearing easily get worse over time.

The definitive cause is unknown, but evidence may point to loud noise (concerts, power tools, everyday above average sound levels) as the main culprit. Some scientists believe causes may also be due to genetics.

Hidden hearing loss may appear daunting, but there are steps to combat it, and we’re learning more about its characteristics every day.

REM can determine the presence of a “hidden hearing loss” during a diagnostic audiometric assessment. A speech in noise hearing test will determine a potential signal to noise hearing loss. People who have this loss are prime candidates for assistive listening devices that will help with enhanced comprehension.


According to a recent ASHA blog, “approximately two-thirds of children get at least one middle ear infection (otitis media) by age 3.” And with ear infections, especially at a young age, hearing loss may not be so far behind.

If your child has an ear infection is there any cause for concern?

It’s definitely something that should be looked at by a doctor or doctor of audiology as soon as possible. The younger the child is, there great the chance of future hearing problems. Under age 3, children with hearing loss are more susceptible to recurrent infections down the line, and recurrent ear infections are a big contributor to hearing problems.

How can you tell if your child has an ear infection?

There are many reasons why children might get or be prone to ear infections, including family history, allergies, asthma, or bottle feeding while an infant is on her back.

Symptoms include (according to the NIDCD):

  • Tugging or pulling at the ears
  • fussiness and crying
  • fluid draining from the ear
  • clumsiness or problems with balance
  • and more

How do ear infections cause hearing loss? Is is permanent?

Chronic otitis media can affect the middle ear for a long period of time, and the position of the Estachian tube – different in infants and children than adults – can inflame and swell due to a buildup of fluid.

“All types of middle ear infection can cause some degree or temporary hearing loss. In most cases, the loss is mild and doesn’t result in any long term damage to hearing ability,” says healthy hearing. But there’s one big caveat: “…infants and toddlers who suffer from chronic otitis media experience stretches of mild hearing loss during a crucial learning period for speech and language.”

For these reasons, among others, a middle ear infection should bet taken care of as soon as possible.


June is Aphasia Awareness month, and we at REM want to do our part to help spread awareness.

Aphasia is a communication disorder stemming from damage to the part of the brain containing language. Those afflicted usually have difficulty with speech. Though aphasia does not directly affect one’s hearing, hearing loss in combination with aphasia can add to the “language deficits” that make comprehending speech in noise difficult.

How should I approach those with Aphasia and Hearing Loss?

It may not be a wide ranging issue, but for the person who has both, it’s a big one. Being understanding is always important. Be patient, avoid extra noise where possible, and keep your speech as simple as possible.

Though not hearing loss specific, ASHA has an article about a family coping with aphasia that may be a good starting point with those who are going through something similar.

How can an audiologist help with Hearing Loss and Aphasia?

Patients diagnosed with aphasia need to have a comprehensive diagnostic audiometric assessment performed by an audiologist. The audiologist’s test battery consists of objective measures of auditory function. When these objective measures are analyzed in conjunction with behavior testing, the audiologist can begin to help with the patient’s comprehension problems.

The best results would come from working closely with both an audiologist and a speech language pathologist.

What can you do for Aphasia Awareness Month?

The National Aphasia Asociation (Aphasia.org) is a great resource full of articles and helpful tips.

First step — to help spread the word about apahsia, it’s important to understand what aphasia is beyond its clinical definition.

Aphasia.org reports that the 2 million people in the US who have aphasia have “lost all or some ability to use words.” They often have trouble speaking and understanding the speech of others. Despite these difficulties, aphasia does not “affect a person’s intellect.”

Second step — tell as many people as you can. Close to 90 percent of people don’t know what Aphasia is. And the more people who know, the more they can help in turn.

Third step — if you have a few extra bucks, you can always donate to the National Aphasia Association (NAA).

June and Aphasia Awareness month are almost over, but even beyond, there’s still lots you can do and people you can tell.


Summer vacation doesn’t mean a vacation from your hearing aids. Whether you’re traveling in the next few months or staying close to home, there is lots you can do to keep your hearing aids and your hearing health in tip top shape.

Healthy hearing – as always – has a good, practical breakdown on taking care of your devices away from home. Among their tips:

  1. Store your hearing aids and batteries in cool, dry locations
  2. Don’t allow your devices to get wet (especially moisture buildup via humidity)
  3. When traveling, don’t forget your “back-up supples” (extra hearing aids, cleaning tools, etc)

Summer is also a good time to strengthen your hearing. Among REM’s recommendations:

  1. Whether at the beach or outside a cafe with a cool drink under an umbrella, summer is a good time to read. And while you’re reading, why not grab the audio book and listen along? Auditory stimulation is important, especially for developing children.
  2. Wear your hearing aids in all social settings. You’ll probably be going out more. That doesn’t mean you should leave your aids at home. We’ve written about this before — relearning how to understand speech in noise is brain training, and you don’t want to be skipping sessions.

If you’re looking for more information, we just released our summer education newsletter. It’s full of helpful tips for both educators and students. You can sign up for any of our newsletters on our website.

Enjoy your summer!


Communication disorders are wide ranging and can affect everything from comprehension to speech and language development. Sometimes their causes are unknown, sometimes they’re neurological, but sometimes they’re due to hearing loss.

According to ASHA, “a communication disorder is an impairment in the ability to receive, send, process, and comprehend concepts of verbal…systems”. A hearing disorder – often understood as a type of communication disorder – may “limit the development, comprehension, production and/or maintenance of speech and language.”

It’s important to be able to identify the signs of hearing loss, especially in regards to children. If hearing loss is caught early, more effective intervention is possible. If caught early enough, children with hearing loss can “develop speech and language skills on schedule with their peers.”

For adults, unaddressed onset hearing loss can result in a decline in cognitive skills. Such a decline can result in speech comprehension problems.

No matter what your age, however, prompt attention is always recommended. A lot of hearing related communication disorders are very manageable.


Hearing loss is a wide ranging concern that affects everyone from newborns to senior citizens. Communication disorders are health issues sometimes dependent on early intervention. Better Hearing and Speech Month (BHSM) raises awareness of both.

BHSM addresses everything from autism and strokes to bilingual speech and language development. It’s a month that helps spread the word about the relationship and specifics of hearing loss and speech problems, as well as how to best combat their negative effects.

Why is Better Hearing and Speech Month important?

According to Johns Hopkins medicine, about “two to three of every 1,000 newborns in the U.S.” will have some level of hearing loss. The National Institute on Deafness and Other Communication Disorders reports “approximately 15% of American adults…aged 18 and over report some trouble hearing” and “nearly 25 percent of those aged 65 to 74” have some form of rehabilitating hearing loss.

With hearing loss, communication disorders are more likely to occur, especially in children. That’s why early intervention is so important (why any intervention is, really), and why helping get the word out about BHSM is crucial.

What can you do?

1. Social media is the quickest – and often most effective – way to let everyone know about BHSM.

2. If you have kids, let their school or the school’s counselor know.

3. Reach out to your local legislators.

The American Speech-Language Hearing Association has a helpful rundown as well as a document pageoffering press releases, web banners, and printouts.


“In recent years, scientists searching for ways to restore hearing have made a number of promising discoveries,” writes David Brooks in the New Yorker. “The natural human tendency, though, is to do nothing and hope for the best, usually while pretending that nothing is wrong.”

The article, focusing on hearing technology and it’s increasingly tangible benefits, is personal, funny, and hits on a number of important points:

1. New technology is not only helping to manage hearing loss, but also helping prevention techniques (such as more advanced hearing protection).

2. Medical and genetic breakthroughs are just as important as technical milestones.

3. “If I could relive my adolescence, I wouldn’t listen to Steppenwolf with loudspeakers leaning against my head, and I wouldn’t have cherry bomb fights with my friends unless I was wearing ear protection.”

Brooke goes on to describe several new products, such as the Hearphones from Bose, the Starkey Halo, and the Starkey Soundlens. These devices not only include clever ways to hide (or make fashionable) the hearing aid, but they are also able to integrate into one’s daily, technological lifestyle. The Halo, for instance, is able to stream audio from certain devices right to the hearing aid.

Through the article, David Owens focuses on a point we all know to be sure: rapid inventions in hearing health technology are capable of transforming one’s lifestyle in pretty meaningful ways.


Sleep and hearing are not often though about together, but their relationship may be more important than you think. It’s safe to assume that hearing loss or a hearing related problem can affect the amount of sleep one gets at night. But can the amount of sleep affect the way you hear?

“Research indicates people who are well rested have active temporal lobes, which is the area of the brain that processes sound and interprets it as language,” says a recent healthy hearing article. In other words, the more rested you are, the better your brain functions. This could have a direct affect on your hearing.

Specific disorders can also cause problems. Take, for example, a disorder like sleep apnea. Some researchers believe that sleep apnea can lead to hearing loss due to reduced blood vessel function. “Auditory hair cells of the inner ear depend upon good blood flow,” says that healthy hearing article. Slow blood flow may damage certain parts of the ear.

Sleep can also affect other hearing related problem, such as tinnitus. A sleepless night (in addition to maybe an overindulgence of alcohol or caffeine) can often temporarily increase tinnitus’s effects. Many sufferers often report more pronounced pulsing or whooshing after a poor rest.

Getting a good night’s rest is important, for both preventative and hearing maintenance reasons. It also never hurts to have a positive outlook.


Traumatic Brain Injury (TBI) and School Treatment

According to the published report “Mild traumatic brain injury: a neuropsychiatric approach to diagnosis, evaluation, and treatment”, Traumatic Brain Injury, or TBI, “…is a common occurrence in the United States, with an estimated incidence exceeding 1 million injuries a year.” TBI is a big topic. It’s getting a lot of play in the news, in medical journals, in sports related discussions. It’s something that has been, historically, treated when severe and ignored when mild. And in both cases, the effect of withholding treatment can manifest in long term problems. From the published report:

“Given the large number of persons that experience mild TBI each year, it is indeed fortunate that the majority or these individuals recover fully within the first year following TBI. However, a nontrivial minority of persons with mild TBI, with estimates raining between 1% and 20%…will develop persistent cognitive, emotional, behavioral, and physical impairments that extend well into the late (> 1 year) following TBI.”

TBI Diagnosis

TBI can be diagnosed through a variety of tests. The Glasgow Coma Scale (measuring a person’s ability to speak, ability to open eyes, and ability to move) is one. There are also cognition and neurophsychological tests, as well as imaging tests such as CT or MRI scans.

TBI is classified as either mild, moderate, or severe.

TBI and Children

Whether during a game (organized or otherwise), or during an accident, if a child hits their head, they need to get tested. According to an article from the ASHA Leader by Roberta DePompei, the “effects of a TBI in childhood are not fully realized right away and, in fact, new challenges can emerge after the individual has become an adult.” As we said earlier, there are immediate effects, and there are long term effects. Each have their challenges, and each can inhibit progress, development, and growth.

An article on Brainline.org, a website dealing with “preventing, treating, and living with Traumatic Brain Injury(TBI)”, has a parents’ guide. Though focusing on rehabilitation from a moderate or severe injury, author Cynthia H. Bonner taps into the heart of the matter:

“Your child’s ability to cope with or develop strategies for dealing with these changes will vary depending on many factors. Some of these may include your child’s previous coping skills, her intellect and personality, the support available from friends and family, her emotional health, the strength of her relationships, the stage of development she was in when injured, and the extent of the injury.”

Returning to School with TBI.

Say your child is diagnosed with a traumatic brain injury. Treatment is in place, the prospects are good, and you’ve done everything you can do. What’s the next step? If your child is out of school, how can you prepare for their return?

According to an article on msktc.org, “school personnel should be contacted as soon as possible after the injury to plan for the student’s return to school. School personnel can also connect the student with services they need while they are not in school.”

Each school will be different, and each school district will have their own plans in place. So it’s important you coordinate with your physicians and your educators. Ask a lot of questions and do a lot of research. Contact your school district, look into your school’s IEP and 504 plan. There’s lots you can do to prepare, and a good amount of resources out there to help you do it.


Location Services for the Hard of Hearing: Philadelphia Theaters

Every few months, REM Audiology will be releasing installments of what we’re calling our Location Hearing Blogs. In these installments we will discuss the options the hard of hearing have at certain local attractions. Options such as available FM or hearing amplification devices, and how those devices interact with their current aids.

This month: the Walnut Street Theater and the Landmark Ritz Theaters, both located in Philadelphia.

Walnut Street Theater

The other month we reached out to the Walnut Street Theater and got a quick response from Joel Markus, their production manager. Coming soon, Walnut Street Theater will have:

  1. 6 new Sennheiser emitter panels (transmitters) strategically located in the theater for optimal reception
  2. New Sennheiser headset receivers
  3. 10 to 20 personal loops for individuals with induction coils in their aids. (Side note: If you’re thinking of purchasing new hearing aids, be sure to purchase those that have induction or telephone coil technology. This is not a new technology, but it is a rapidly growing one).

According to the FAQ on their website: “The Walnut offers devices to assist the hearing impaired for MainStage performances. Infrared hearing enhancers are available in the lobby on a first-come, first-served basis; quantities are limited. ASL-interpreated, audio-described and open-captioned performances are available for certain performances.”

Keep in mind: it’s always a good idea to call ahead and see what devices any location currently has operational before attending. Their Walnut Street Theater box office can be reached at 215-574-3550.

Ritz Theaters

The Ritz Theaters (Ritz East, Ritz Five, Ritz at the Bourse) offer closed captioning devices and wireless audio systems.

The closed captioning viewing system is a CaptiView, which is a “personal closed captioning device that transmits dialogue to a small easy to read personal screen which attaches right to your seat.”

The wireless audio system, the Fidelio, is an audio receiver with a plug-in headset for the visually impaired, and provides descriptive narrations.

You can request devices from the box office cashiers, which they will program for you.

The Landmark website has more info.


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If you have t-coil interactive hearing aids, remember to always look for this logo.