PROFESSIONAL COUNSELLING

Providing information about hearing loss and management, and very little information about feelings and emotions, is the basis of informational counseling.

NATURE OF HEARING LOSS

Conductive hearing loss: Any condition interfering with the transmission of sound through the outer and middle ear to the inner ear. Affected Mobility of ear drum, fluid filled, dislocation of small bones in middle ear etc, leads to conductive pathology.
Sensorineural hearing loss: Damage lies in the inner ear , auditory nerve or both. In adults, causes include ageing and prolonged exposure to loud noise. In children and infants, causes include congenital abnormalities or infections. In this type of hearing loss, higher-pitched tones may sound muffled. It may become difficult to pick out words against background noise.
Mixed hearing loss: When both conductive and sensorineural hearing losses are present in the same ear. There may be a problem in the outer or middle ear and in the inner ear or auditory nerve. It can happen after a head injury, long-term infection, or because of a disorder that runs in your family. Hearing loss can affect one or both ears.
Central hearing loss: Involvement of central nervous system leading to hearing problems especially associated with interpreting or understanding speech. Patients with central hearing loss typically have inconsistent auditory behavior, that may cause them to be misdiagnosed as having “functional” or psychogenic hearing disturbances. Cortically “deaf” patients may have reactions to environmental sounds, despite absence of reaction to loud noises. As in patients with cortical visual disturbances, patients may consider themselves “deaf” in spite of having reactions to sounds in the room.

DEGREE OF HEARING LOSS

DEGREE OF HEARING LOSS	HEARING TRESHOLD (dB)	ABILITY TO HEAR SPEECH
None	0-25 dB	No difficulty.
Minimal Hearing Loss	16-25 dB	Very soft speech is difficult to hear, especially from far away, Background noise can worsen comprehension.
Mild	26-40 dB	Soft speech is muffled but comprehensible in quiet environments. Noise and reverb can further complicate speech
Moderate	41-55 dB	Speech is difficult to understand even in quiet situations, and background noise is highly distracting. Audio must be at a high volume to be heard.
Moderate to severe	56-70 dB	Speech is muddy and requires amplification. Communicating with a group is difficult.
Severe	71-90 dB	Conversations at regular volume cannot be heard, and even loud speech is difficult to understand. Amplification offers little help.
Profound	91+ dB	Most speech is inaudible, even with significant amplification

Hearing loss can have a range of consequences that depends on the individual and their unique type of hearing loss. The most common experience is a reduced ability to understand other people,particularly in noisy situations.

The person withdraws from his/her surroundings
The ‘personality’ changes
Conversations become shorter, less frequent, less spontaneous and less personal
The person has become less attentive and/or avoids social gatherings and noisy
surroundings
Reduced social contact and less social and physical activity
Loss of intimacy
Problems at work
Shame, guilt and anger
Embarrassment
Lack of concentration
Sadness or depression
Worry and frustration
Anxiety and suspiciousness
Insecurity
Self-criticism and low self-confidence
Alzheimer’s disease and dementia. (Hearing loss includes peripheral hearing impairment and central auditory dysfunction; both are associated with accelerated cognitive decline or impaired memory)
Auditory deprivation. (when the brain gradually loses some of its ability to process information from the unaided ear(s) due to continued lack of auditory stimulation)

IMPORTANCE OF HEARING MANAGEMENT

Many causes of hearing loss have no cure. In these cases, treatment involves compensating for the hearing loss as much as possible. Most people with moderate to severe loss use hearing aids. People with severe to profound loss are greatly helped by a cochlear implant. Sound amplification with a hearing aid helps people who have hearing loss.Untreated hearing loss can also make the person irritable and less tolerant towards other people. Some may even become paranoid.

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COUNSELLING

PROFESSIONAL COUNSELLING

NATURE OF HEARING LOSS

DEGREE OF HEARING LOSS

EFFECT OF HEARING LOSS

IMPORTANCE OF HEARING MANAGEMENT

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