You're having trouble understanding conversations, but when was the last time you had a hearing test? If you are one of the estimated 48 million Americans with impaired hearing, chances are you are often frustrated and embarrassed but suffering in silence.
"Statistics show that people with hearing loss wait an average of five to seven years before getting help," says Neil DiSarno, chief staff officer for audiology for the American Speech-Language-Hearing Association (ASHA) based in Rockville, Md. Denial is a big factor in the delay, while some people may suspect they have hearing loss but not think it's advanced enough to be evaluated.
There are alternatives, but if you are one of these procrastinators, one option may be the telephone-based National Hearing Test. Modeled on a test designed in the Netherlands, the National Hearing Test was developed by Communication Disorders Technology (CDT) in Bloomington, Ind., in conjunction with Indiana University and the VU University Medical Center in Amsterdam, with funding from the National Institutes of Health. It became available in the U.S. in 2014. "The National Hearing Test is making the public more aware that there is an inexpensive, fast and scientifically proven screening test for hearing loss," DiSarno says.
The test mimics one of the most challenging real-life situations: trying to hear in the midst of noise, notes James Miller, principal scientist at CDT and emeritus director of research at the Central Institute for the Deaf in St. Louis. Think family dinners, cocktail parties and crowded restaurants.
It effectively detects the changes in the inner ear caused by age or exposure to noise — the two most common causes of hearing loss. But the test has limits: The NHT website cautions it will not detect hearing problems caused by damage to the ear canal or the middle ear, or rare conditions caused by a tumor.
AARP has teamed with the National Hearing Test to provide free screening for its members annually. There are several ways to access the test. AARP members can start the test process by visiting the online AARP Hearing Center or you can also log on to the National Hearing Test website. You receive a code that activates the test when calling the toll-free National Hearing Test number, 800-299-9195. Nonmembers can take the hearing test for a small fee. No matter which avenue you choose, the test is the same. Listen to a series of three numbers spoken in a normal voice against a background of randomly generated noise, then tap what you hear into the telephone keypad. "Stick with your landline, because cellphone networks can be a bit unreliable," advises Alex Crowley, project manager at CDT.
Get the numbers right and the background noise increases. Stop responding and the background noise diminishes. "What the test is measuring is the signal-to-noise ratio," or SNR, says Miller. Finding the lowest SNR at which a person can successfully hear the digits is a good indication of how the ear is working, he says.
Results are immediate. Is your hearing within the normal range, slightly below normal or substantially below normal? Anything outside the normal range prompts a recommendation to get a more complete evaluation from a hearing specialist. Results are completely private, and no information is released to a third party, emphasizes Gary Kidd, senior scientist at Indiana University and CDT.
That confidentiality may not exist in some of the other screening options. Telephone hearing tests are available overseas, but "I think it's safe to say the National Hearing Test is the only one of any prominence in the U.S.," Crowley says.
Many hearing aid manufacturers provide online hearing tests, but "online tests have accuracy issues," says ASHA's DiSarno. This is in part due to ambient noise and the differences in headphones or speakers, he says. Self-administered questionnaires or quizzes offered by organizations such as ASHA and the National Institute for Deafness and Communication Disorders are also available.
The results of the National Hearing Test have been validated against the gold standard, the pure tone audiometry (PTA) test, a series of pure tones that change in volume. Earphones and a soundproof room are necessary for this test to be effective. The point at which you can no longer hear the tone indicates the degree of hearing loss. In a 2014 study of 693 veterans, results of the National Hearing Test were comparable to the results of the pure tone test in over 80 percent of cases. "Although not a substitute for a full diagnostic screening by a hearing health professional, the NHT turns out to be pretty reliable," Crowley says.
It also seems to be driving people to action. According to a 2015 phone and email survey of 619 people who showed hearing loss with the NHT screening test, 38 percent had seen a hearing professional afterward, and of these, 28 percent reported that they had bought hearing aids or planned to do so.
Even more encouraging for the scientists and developers: Of those respondents reached by telephone, 66 percent said the National Hearing Test had raised their awareness of hearing health. "That's one of the goals," James Miller says. "Even if people don't follow up with an audiologist, maybe at least they will be more protective about their hearing. That's real important."