Frequently Asked Questions

What is a hearing instrument specialist (HIS)?

A hearing instrument specialist (HIS) is a professional trained to conduct basic hearing tests in order to determine candidacy for hearing aids.  They also fit hearing aids and assistive listening devices as well as provide counseling on those devices. In addition to a certification program and state requirements, a hearing instrument specialist has extensive supervised on-the-job training prior to being licensed. The HIS is also required to fulfill annual continuing education requirements.


What types of tests and treatments do hearing instrument specialists perform?

Hearing instrument specialists are experts in hearing technology and assistive listening devices. Common services and treatments provided by a hearing instrument specialist include:

  • Hearing aid fitting
  • Hearing tests and evaluation
  • Hearing aid repair
  • Hearing aid counseling and selection
  • Assistive listening devices

How do I know if I have hearing loss?

If you’re concerned you or a loved one may be experiencing hearing loss, you are not alone. Because hearing loss can come on gradually, it’s often the people around you who notice your hearing problems before you do. Typically, it takes people an average of seven years to seek treatment. If you exhibit the following symptoms, consider visiting a hearing instrument specialist:

  • You hear mumbling when people are speaking to you
  • You have to ask people to repeat what they said
  • You laugh at jokes even though you may not have heard the details
  • You frequently complain that people mumble
  • You need to ask others about the details of a meeting you just attended
  • You play the TV or radio louder than your friends, spouse or relatives
  • You cannot hear the doorbell or the telephone
  • You find that looking at people when they speak to you makes it easier to understand
  • You miss environmental sounds, such as birds chirping or leaves blowing
  • You find yourself avoiding certain restaurants because they are too noisy

What causes hearing loss?

Hearing loss can be due to several factors such as the aging process, exposure to loud noise, medications, infections, head or ear trauma, congenital (birth) or genetic factors, diseases, as well as a number of other causes. It is estimated that nearly 20 percent of adults in the United States (48 million) report some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime.


How is hearing loss diagnosed?

If you have any symptoms of hearing loss, you should see a hearing instrument specialist to have a formal hearing evaluation. This hearing test allows the hearing instrument specialist to recommend the best hearing aid for your specific needs.

Your hearing instrument specialist may ask for a list of symptoms you have been experiencing and will use this information, in addition to the hearing test results, to determine which device would be the right fit for you.

Results of the hearing evaluation are plotted on a graph called an audiogram. The audiogram provides a visual view of your hearing test results across various pitches or frequencies, especially the ones necessary for understanding speech.


What are the different degrees of hearing loss?

The results of your hearing test are plotted on a chart called an audiogram. Loudness is plotted from top to bottom. The top of the graph is very quiet and the bottom of the graph is very loud. Frequency, or pitch, from low to high, is plotted from left to right. Hearing level (HL) is measured in decibels (dB) and is described in general categories. The general hearing loss categories used by most hearing professionals are as follows:

  • Normal hearing (0-20 dB HL)
  • Mild hearing loss (21-40 dB HL)
  • Moderate hearing loss (41-70dB HL)
  • Severe hearing loss (71-90 dB HL)
  • Profound hearing loss (greater than 91 dB HL)

What are the different types of hearing loss?

There are three main types of hearing loss and each can be caused by different factors and require different hearing aid technology and features to have the best listening experience. The three types of hearing loss include:

1. Sensorineural hearing loss: When the problem is in the inner ear or a problem with the auditory nerve, a sensorineural hearing loss is the result. This commonly occurs from damage to the small hair cells, or nerve fibers, in the auditory system. Sensorineural hearing loss is the most common type of hearing loss in adults and accounts for more than 90 percent of hearing loss in all hearing aid wearers. The most common causes of this hearing loss are age-related changes and noise exposure. Loss may also result from disturbance of inner ear circulation, increased inner ear fluid pressure, or from disturbances of nerve transmission. There are many excellent options for the patient with sensorineural hearing loss.

2. Conductive hearing loss: When there is a problem in the external or middle ear, a conductive hearing loss occurs. Conductive hearing loss develops when sound is not conducted efficiently through the ear canal, eardrum, or tiny bones of the middle ear, resulting in a reduction of the loudness of sound that is heard. Conductive losses may result from earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstruction of the ear canal, perforation (hole) in the eardrum membrane or disease of any of the three middle ear bones. Individuals with conductive hearing loss can benefit from hearing aids, medical implants, medication or surgical options.

3. Mixed hearing loss: When there are problems in the middle and inner ear, a mixed hearing impairment is the result. Because mixed hearing loss involves both sensorineural and conductive hearing loss, treatment options from hearing aids to surgery depends on the nature of the impairment and the symptoms experienced.


What are the signs of hearing loss in children?

Hearing loss in children can be present from birth or may be caused by acquired factors in life such as ear infections, head trauma, certain medication and genetic factors. You may suspect your child has a hearing loss if you observe any of the following:

  • Failed newborn hearing screening
  • Delays in speech and language acquisition, including baby babbling
  • Frequent ear infections
  • Not startling to loud sounds
  • Not turning to the location of sounds after six months of age
  • Difficulty following verbal directions
  • Daydreaming in many situations
  • Concerns by school teachers or failed school hearing screening
  • Loud volume on the TV or radio
  • Complaints from the child that they cannot hear

What style of hearing aid do I need?

There are many types of hearing aids today and the style or device depends on your lifestyle, budget and hearing loss needs. There are in-the-ear styles as well as behind-the-ear styles. In addition to selecting the right style of device, it’s also important to consider what features would be most beneficial to you. From directional microphones to waterproof options, there are numerous varieties to meet everyone’s personal needs. Today’s hearing aids are even equipped with Bluetooth connectivity to work with wireless technology like a cell phone or television.

Hearing aids are available in many different sizes and styles, thanks to advancements in digital technology and miniaturization of the internal components. Many of today’s hearing aids are considered sleek, compact and innovative – offering solutions to a wide range of hearing aid users. When selecting a style of hearing aid, the following should be considered:

  • The type/degree of the hearing loss
  • Power requirements
  • Manual dexterity and visual abilities
  • Budget
  • Cosmetics and aesthetics
  • Anatomical and medical considerations
  • Lifestyle requirements

What are assistive listening devices (ALDs)?

People with all types and degrees of hearing loss can benefit from an assistive listening device (ALD). Since the microphone of a typical hearing aid is worn on or behind your ear, its ability to enhance the talker-to-background-noise ratio can be limited. However, ALDs are designed to increase the loudness of a desired sound, such as a radio, television or a public speaker, without increasing the background noise. This is because the microphone of the assistive listening device is placed close to the talker or device being used, while the microphone of the hearing aid is always close to the listener.

ALDs include alarm clocks, TV listening systems, telephone amplifying devices and auditorium-type assistive listening systems. Many newer devices are small, wireless and compatible with a person’s digital hearing aids. Alarms and other home ALDs may be small devices that are placed discreetly on tables, next to the TV or on the wall.