Friday, August 27, 2010

Hearing loss hits 1 in 5 U.S. teens

By Liz Szabo, USA TODAY

One in five American teenagers now suffers from some type of hearing loss, an increase of 31% since the mid-'90s, new research shows.

Most cases of hearing loss are slight, affecting only one ear and involving mostly high-frequency sounds, according to a study in today's Journal of the American Medical Association. Many teens may not even notice the hearing change. About one in 20 have "mild or worsening" hearing loss, which can make them struggle to follow conversations or teachers at school.

"It's very concerning," says study author Josef Shargorodsky, an otolaryngology/head and neck surgery resident at the Massachusetts Eye and Ear Infirmary in Boston.

Other studies show that even a small hearing loss can harm a child's school performance, language development and social interactions, he says.

Parents may have trouble spotting the change as well, given that teens often tune their parents out, says Shargorodsky, whose research was conducted at the Channing Laboratory at Brigham and Women's Hospital, also in Boston.

Parents may notice other changes — such as an unexplained drop in grades — that could signal hearing loss, he says.

Because hearing loss is cumulative, these teens are at high risk for significant hearing problems as adults, says Brian Fligor, director of diagnostic audiology at Children's Hospital Boston, who wasn't involved in the study. Instead of developing noticeable hearing problems at age 50 or 60, these teens may have trouble hearing beginning at age 40.

Researchers based their findings on records of and interviews with nearly 4,700 kids ages 12-19, led by the Centers for Disease Control and Prevention.

They found no link between hearing loss and ear infections. Kids who reported being exposed to loud noise for at least five hours a week were no more likely to have hearing problems than others, says Shargorodsky, although he notes that teens usually aren't very good at accurately keeping track of their noise exposure.
Children living below the poverty level were much more likely to have hearing loss, possibly because poor kids have worse health in general, Fligor says.

Shargorodsky says his research doesn't explain why hearing loss is becoming more common. But doctors say the study points out the need to do more to protect children's hearing.

"Kids are growing up in a noisier world," Fligor notes.

An Australian study of kids with "mild to moderate" hearing loss found that using a portable music player, such as an iPod, was linked to 70% increased risk of hearing loss. And in a study of New York college students, Fligor found that more than half were listening to an MP3 player above the recommended exposure levels, which are 90 minutes a day at 80% of the maximum volume.

But iPods and rock concerts aren't the only source of noise in a child's world. Kids are also at risk if they fail to protect their ears when mowing the lawn, hunting with a rifle or attending noisy events, such as NASCAR races, Fligor says. Kids can protect their hearing by wearing headphones or inexpensive foam earplugs, Fligor says.

Other health trends also may be harming kids' hearing. Both high blood pressure and obesity can increase the risk of hearing problems, Fligor says. The number of children with diabetes has increased significantly in recent years, and a third of children are now overweight.

"What is scary is that these kids are setting themselves up for earlier hearing decline," says Mark Brown, an Austin otolaryngologist who treats a lot of children. "We will see the consequences of this down the road."

Originally published on USA today:

Tuesday, August 24, 2010

Even Minor Hearing Loss Puts Kids at Risk for Learning Problems, Better Hearing Institute Warns

Washington, DC, August 9, 2010 - Children with even a mild hearing loss are at risk for learning and other social, emotional, and behavioral problems, the Better Hearing Institute (BHI) warned today.

BHI is urging classroom teachers to be alert to the needs of children with unaddressed hearing loss, which is often overlooked or attributed to other learning and behavior-related issues, such as Attention Deficit Disorder (ADD/ADHD). BHI also is urging schools to incorporate hearing health education into the curriculum and to adopt hearing protection policies.

The warnings came as schools across the country are opening their doors for the start of the school year.

“Too many children with hearing loss aren't getting adequate help and are being put at risk”,   says Sergei Kochkin, PhD, executive director of BHI and co-author of the national study, Are 1 Million Dependents with Hearing Loss in America Being Left Behind?  “Educators, pediatricians, and other healthcare providers underestimate the impact of mild hearing loss. And sadly, it’s the kids who are suffering.”

The scientific literature is clear that untreated hearing loss affects nearly all dimensions of the human experience. And the pediatric literature demonstrates that even children with "minimal" hearing loss are at risk academically compared to their normal hearing peers.

Hearing loss of any type or degree in a child can present a barrier to “incidental learning.” Up to  90 percent of a young child's knowledge is attributed to incidental reception of conversations around him or her. Hearing loss poses a barrier to the child's ability to overhear and to learn from the environment, as well as miss a significant portion of classroom instruction.

Hearing loss also frequently causes a child to miss social cues. Not surprisingly, many of the symptoms of unaddressed hearing loss in children overlap those of Attention Deficit Disorder (ADD/ADHD).

A large part of the problem is that many parents today either don't recognize their child's hearing problem, minimize it, or have been given misinformation regarding the ability to treat it.  At least 50 percent of parents don't seek additional professional testing when their infant fails an initial hearing screening.

According to Eileen Rall, AuD CCC-A, an audiologist from the The Center for Childhood Communication of The Children's Hospital of Philadelphia, teachers can help children with undiagnosed hearing loss.  She said:

"First and foremost, teachers can pay attention to the listening environment of the classroom and how the students are functioning in it. There are many low cost, creative ways to improve the acoustics of a classroom including something as simple as teaching children to create good listening environments—make eye contact, reduce distance, taking turns speaking and reducing the noise the students are making themselves. Some schools install sound field systems in their classrooms. Sound field systems amplify the teacher's voice and deliver his/her voice through speakers placed strategically in the classroom. Most importantly, teachers who suspect that a child is having difficulty hearing should bring it to the attention of the child's parents and school administrators so the child can undergo a thorough hearing assessment by an audiologist."

Some basic steps that teachers can take on their own to help a child with a confirmed or suspected hearing loss include the following:
  • Arrange the child's seating away from the heating and cooling system, hallways, playground, and other sources of noise. If the child's hearing loss affects only one ear; if it's greater in one ear, seat the child in front of the room with his better ear toward the teacher.
  • Allow the child to move around in the classroom to clearly see the speaker.
  • Assign a helper, or notetaker, for the child.
  • Try to speak clearly and not too fast.
  • While you are speaking, don't turn away to write on the board or cover your mouth.
  • Write key words or visual aids for the lesson on the board.
  • Write assignments on the board so the child can copy them down into a specific notebook used for this purpose.
  • If the child does not understand something, rephrase what you have said rather than repeat the same words again and again.
"Children need to be able to hear, not just in the classroom, but also because hearing affects language competence, cognitive development, social and emotional well-being, and academic achievement" says Kochkin. "Children who cannot hear well—that is, when their hearing loss is untreated or under-treated—could face a life of underperformance and broken dreams."

According to Kochkin:
  • Only 12 percent of children under the age of 18 with hearing loss use hearing aids; yet an estimated 1.5 million youth (including adult dependents) under the age of 21 have hearing loss that may be improved with amplification.
  • The study found no evidence of the use of any form of hearing assistance in the classroom (e.g. FM systems, hearing aids, speakers), other than front-row seating.
  • Hearing loss leaves children vulnerable to other problems, according to three out of four parents of children with hearing loss. Common problem areas include:
    • Social skills (52%)
    • Speech and language development (51%)
    • Grades in school (50%)
    • Emotional health (42%)
    • Relationships with peers (38%)
    • Self-esteem (37%)
    • Relationships with family (36%)
Compounding the problem is the increased use of portable media devices such as MP3 players, which children are listening to at high volume levels for long periods and putting their hearing at risk. According to the Centers for Disease Control, an estimated 12.5 percent of children and adolescents aged 6 to 19 years—or approximately 5.2 million youth—have permanent hearing damage from excessive exposure to noise.

"Parents, healthcare providers, and educators need to come together to thoroughly address a child's hearing loss if we are to allow that child a fair and equitable opportunity for success," says Kochkin. "As schools gear up for the start of the new academic year, I strongly encourage all educators to do their part to recognize the problem of unaddressed hearing loss in the classroom and to advocate for these children.”

Republished at

Wednesday, August 18, 2010

MP3s 'to blame' for hearing loss

Up to six and a half million teenagers in America struggle to hear whispered conversations or leaves rustling in the wind.

That's according to researchers in Boston, Massachusetts who say a growing number of 12 to 19 year olds have suffered slight hearing loss.

Doctors are putting the blame on MP3 players causing damage to the hearing of young people.
The study used data from a nationwide health survey.

It compared hearing loss in 3,000 teenagers from 1988-94 and then compared it with similar data from 2005-06.

The researchers say hearing loss has increased by 19% during that time, meaning one in five teenagers now has some sort of hearing damage.

Listen carefully

Some experts say it means teenagers should turn down the volume on their MP3 players and listen for less time.

But there's no absolute proof that the apparent hearing loss is a direct result of MP3 players or earphones.
"Our hope is we can encourage people to be careful", said the study's senior author, Dr. Gary Curhan of Brigham and Women's Hospital in Boston.
Most of the hearing loss was "slight", defined as inability to hear at 16 to 24 decibels.

A teenager with slight hearing loss might not be able to hear a tap dripping or their partner whispering "good night."

Those with slight hearing loss "will hear all of the vowel sounds clearly, but might miss some of the consonant sounds" such as t, k and s, according to Doctor Curhan.

He added: "I think the evidence is out there that prolonged exposure to loud noise is likely to be harmful to hearing, but that doesn't mean kids can't listen to MP3 players".

Each new generation of teenagers has found new ways to listen to loud music.

Brian Fligor, an audiologist at Children's Hospital Boston, said: "Today's young people are listening longer, more than twice as long as previous generations".

Tuesday, August 17, 2010

New Hearing Loss Forum

BHI Launches Discussion Forum

July 23, 2010

testThe Better Hearing Institute (BHI) announced today that it has launched a discussion forum to help people and their families cope with hearing loss.

This unique online forum covers a wide range of hearing health topics. It is designed as the go-to place for people with mild-to-severe hearing loss who are looking for a peer support community where they can chat and exchange information on hearing loss, treatments, tinnitus, hearing loss prevention, and other related topics.

To participate in the discussion forum, visit, click on “Discussion Forum,” and go to “Welcome!” to register.

Moderated by BHI, the free discussion forum will have quick and convenient access to a wealth of accurate and valuable hearing health information found on the BHI web site.

“Hearing loss is challenging for many people to deal with because it can be so isolating,” says Sergei Kochkin, PhD, BHI’s executive director.  “Unaddressed hearing loss can affect virtually every aspect of a person’s life. Even when someone with unaddressed hearing loss is surrounded by loved ones, the impaired ability to hear and actively participate in conversation can leave the individual feeling cut off.”

Kochkin said that connecting with others with hearing loss grappling with the same issues can provide great comfort and support.

The BHI discussion forum index includes topics such as Hearing Loss 101; Hearing Loss Treatment: Hearing Aids; Hearing Loss Treatment: Alternative/Supplementary Options; Tinnitus (Ringing in the Ears); Financial Assistance; Hearing Loss Prevention; Childhood Hearing Loss; Family and Relationships; and Hearing Loss Technology.

According to a BHI study, the number of Americans with hearing loss has grown to more than 34 million—roughly 11 percent of the U.S. population. Over the past generation, hearing loss has increased at a rate of 160 percent of U.S. population growth and has remained one of the nation’s most commonly unaddressed health conditions.

"Unaddressed hearing loss silently erodes one's quality of life, undermining family relationships, interfering with short-term memory, and creeping into virtually every aspect of daily living," says Kochkin. "But hearing loss can be easily diagnosed, and there are modern-day solutions that can help people hear better—so they don’t need to draw back in silence.

“BHI is offering this forum so we can better help the large numbers of people with mild to severe hearing loss. We urge anyone with hearing loss—or anyone who cares about another with hearing loss—to join the online forum and share their questions and experiences. We want anyone with hearing loss or other hearing health issues, no matter how mild or severe, to find the support and help they need.”

Friday, August 13, 2010

Are You Aware of Your Hearing Loss?

Patricia B. Kricos, Ph.D. - University of Florida, Gainesville, Florida
PiggybackGrandpa“What? You think I have a hearing loss?” If you are like many people, you may be surprised when friends and family suggest that you have a hearing problem. You may think to yourself “I hear what people say. I don’t know why they think I have a hearing loss.” Many times, you probably do hear them when they are talking, but you may be missing some of their conversation with you, or you may not realize that what you think you heard is not exactly what they were saying. This can lead to your loved ones accusing you of not listening or of not paying attention. There may actually be times when you do not realize that someone is speaking. In this case, you may appear to be ignoring the person, or you may start talking, causing your communication partner to view you as quite rude. Faux pas such as this can lead to annoyance, resentment, and/or exasperation on the part of your communication partner.

You are not alone! Many people experience this, because hearing loss usually comes on very gradually. If you woke up one morning and suddenly could not hear your alarm clock, or the coffee brewing, or your neighbor’s lawnmower, you would probably know right away that you had a hearing problem. The hearing loss experienced by most people is not sudden, but instead comes on little by little. Even when people’s hearing losses have advanced to the point where they are missing the punch line during a joke, or failing to hear the tea pot whistle, they still are likely to know when someone is talking and to understand much of what is said, especially in an ideal listening situation where there is only one talker and no background noise.

Although your spouse, children, coworkers, and friends may nag you to do something about your hearing difficulties, you yourself may not realize how much you are missing in every day conversations. Even if a full hearing evaluation confirms that you have a significant hearing loss, you still may insist that even if you do, it is not causing any problems.

If this sounds like you, it may be helpful to start consciously monitoring situations in which you may be experiencing communication problems due to hearing loss. It is importance to realize that hearing loss not only affects your ability to understand what people are saying, it can also have other consequences. For example, you may not realize that lately you feel tense in social situations, that you become tired more easily, especially after a busy day at work or during a social situation, and that you want to bow out of previously enjoyed activities such as bowling. These changes may be occurring because, without realizing it fully, you may be straining to understand your communication partners and experiencing communication situations as stressful. Again, these experiences may happen so slowly over time that you do not even realize the connection between hearing difficulties and your emotional response to these difficulties.

Let’s say that your family and friends have suggested that you have a hearing loss, and a hearing health professional has confirmed that test results indicate a significant hearing loss. You, however, are still doubtful. Try monitoring your hearing for a few weeks so that you may become more aware of how your hearing loss may be affecting you, as well as your family and friends. When you realize not just that you have a hearing loss, but that it is affecting your family, social, and work place, you may be a better candidate for hearing assistive technology. When you monitor your conversational experiences, you will probably become more aware of everyday communication problems that you are experiencing. Your awareness of difficulties, such as hearing female voices, understanding in background noise, and participating in conversations when multiple speakers are talking, may help your hearing health care provider choose hearing assistive technology that would be most helpful for your particular problems.

To increase your awareness of how hearing loss might be affecting you, try periodically (e.g., every week) looking at the sample communication situations below and answering the question “How often does this happen to you?” using one of the following answers:
  1. Never
  2. Once or twice a week
  3. Several times each week
  4. Many times
  5. All the time
none none
none none
none none
none none

Self-monitoring may help you realize that your family and friends are not just picking on you, but rather, that you do have hearing difficulties. These difficulties can cause problems not only for you, but also for family members, coworkers, and friends. If you scored 3 or more on these items you may have a hearing loss. For further information about your treatment options, go to the Edison Stanford Hearing Center web link titled Hearing Solutions or take the online hearing check by clicking here.

Is There Tinnitus Relief Through Herbal Treatments?

Richard E. Carmen, Au.D. – Auricle Ink Publishers, Sedona, AZ

In the past many years there have been a number of herbal remedies claiming benefit for tinnitus. As a clinical and research audiologist, I reviewed the literature on herbal treatments in 2004 and was unable to substantiate that any of the product manufacturers’ claims were backed by U.S. evidence-based research. As a former human studies researcher in the area of tinnitus during the 1980s, I’ve remained interested in this subject matter. In that it had been six years since I last looked at the literature, in June-July/2010 I ran a Medscape search that revealed 174 articles mentioning the word tinnitus. However, none of them were scientific studies on herbal treatments for tinnitus. On a Medline search for “tinnitus,” 7,078 articles were cited. But when I refined the search to “herbal treatment for tinnitus,” 24 articles were cited, almost all of which were useless because they only mentioned the word tinnitus or herbal treatment, but were not related to a study. Only one was an actual study (article in Chinese), and based on the abstract in English, there are serious flaws in the design of the study, not the least of which was the study lasted only 5 days.

I think Enrico and his research team in 20071 aptly sum things up regarding herbal treatments and tinnitus. It “ . . . lacks substantial scientific support, and . . . these substances are probably not clinically effective either.” Furthermore, they stated that, “. . . in view of the potential harm that may occur from inappropriate use of CAM products [complementary and alternative medicines, such as herbs], physicians need to be aware of their principal characteristics with particular emphasis on toxicity and possibilities of interaction with prescription drugs.”

In addition, in June-July/2010, I contacted two companies with over-the-counter tinnitus remedies using herbs, nutrients or a combination, for treatment of tinnitus. My inquiry to them was, “What U.S. evidence-based research is your claim based on?”

One company’s representative claiming tinnitus relief through their product (now seen all over television and print media) replied, “We’ve done extensive research over five years and the product works!”

I asked, “Where can I find this published study?”

She replied, “It’s not for public viewing.”

It defies common sense. If you have a proven relief for tinnitus, you’d want to be sharing this news with the world. Yet, they could provide nothing to me other than a claim and their word. The other company I contacted basically said the same thing – admitting there was no tinnitus research the company conducted to back the claim - BUT – I was told that the ingredients in the bottle were effective for a variety of things related to increasing blood flow, maintaining cognitive health, or relaxing the body.

On July 7, 2010, I ran an online search, “herbal treatment for tinnitus,” at The New England Journal of Medicine and the search turned up only one result, unrelated to the question. The same search at The Journal of the American Medical Association cited many articles isolating the word tinnitus in an article, but in the top 100 results, not a single article reported conducting such a study.

Here are the conclusions from an abstract that Morris and Avorn3 offer: “Consumers may be misled by vendors' claims that herbal products can treat, prevent, diagnose, or cure specific diseases, despite regulations prohibiting such statements. Physicians should be aware of this widespread and easily accessible information. More effective regulation is required to put this class of therapeutics on the same evidence-based footing as other medicinal products.”

It’s probably worth noting that the single most touted ingredient in some of these purported remedies is Ginkgo biloba. My general review of the literature in 2004, and again in June/2010, failed to uncover a single U.S. scientific study that supported the notion that any herbal treatment, including Ginkgo biloba, was of any more benefit for tinnitus than a placebo (sugar pill). Even company executives of tinnitus relief companies could not provide the data. What’s more, researchers can’t even agree that Ginkgo biloba is of benefit to health unrelated to tinnitus (see a December/2009 report on Medscape regarding a study on Ginkgo in Journal of the American Medical Association:

Now then, in fairness as a reporter and quite in contrast to U.S. studies, some European research showed there was a link between herbal treatment and tinnitus. This is the basis for U.S. product claims. The problem is, as I said earlier, that results from these foreign studies have not been replicated in U.S. studies, so the methodologies in these foreign studies should be challenged. The reason there may be no studies conducted on herbal treatment for tinnitus is because there are far stricter guidelines in the U.S. than most other countries. We cannot know the flaws in research without knowing how the studies were designed, and exactly what the data showed. Here are only a few examples how tinnitus research can be so flawed and biased as to make the study itself worthless:

  • scant case history details and “fact gathering” make for unreliable or biased results;
  • not isolating and identifying variables (those things that could contaminate a study like having one patient privately taking a prescribed drug for stress or depression, for example, at the same time being assessed for the value of the test herb);
  • not considering duration of tinnitus may be an influential factor (someone who just developed tinnitus last week versus a subject suffering for 20 years);
  • not objectifying rating scale questions (how a researcher measures relief can influence outcome);
  • not using standardized scales and measures in order to determine what comprises improvement or relief;
  • failing to use randomized, blind or double-blind, placebo-controlled methodology;
  • not taking into consideration the “unknowns,” for example, if most subjects report subjective tinnitus loudness about 1-4 (on a scale of 1–10 where 10 is loudest tinnitus), it may well be easier to shift tinnitus from 4 to 1 than from 8 to 5;
  • failing to perform a physical exam at baseline to rule out potential factors that could influence the test result;
  • failing to rule out obvious causes of tinnitus that could result in spontaneous recovery from tinnitus even after many months or years – and there are such known recoveries with cause and effect (for example, tinnitus caused by pressure or fluid in the middle ear can be resolved when the medical cause is treated; or something as simple as an ear canal hair touching the eardrum can set off a sound emission through conductance, with tinnitus immediately gone upon removal of the hair).
Linde2 and a group of researchers in 2003 reviewed clinical trials on herbal medicines including their effects on tinnitus, requiring what they felt were specific stringent methodology, and concluded, “From a total of 79 potentially relevant reviews pre-selected in the screening process, 58 met the inclusion criteria. Thirty of the reports reviewed Ginkgo (for dementia, intermittent claudication, tinnitus, and macular degeneration), hypericum (for depression) or garlic preparations (for cardiovascular risk factors and lower limb atherosclerosis). The quality of primary studies was criticized in the majority of the reviews.”

If you’re a person who regardless of the evidence seeks to try anything, then it should at least be done under medical supervision. It’s worth mentioning that in most people there are apparently few side effects using Ginkgo biloba (oral administration of Ginkgo special extract EGb 761, typically 24% ginkgo-flavonol glycosides, 6% terpene lactones). However, there can be side effects including gastrointestinal disturbances, headaches, dizziness, intracerebral hemorrhage, and allergic skin reactions. Most importantly perhaps is that it does function as a vasodilator (opens the blood vessels more). For people already on vasodilators it can increase the risk of bleeding; for example, when used in conjunction with histamines, anticoagulants (like Coumadin or Warfarin), vitamin B3 (variations of niacin), Alpha blockers (such as Phenoxybenzamine), antiplatelet agents (like aspirin), and even other herbs.

I would suggest to anyone searching for tinnitus relief no matter the treatment: be vigilant, discerning, demand to see the evidence that the product works, and don’t throw good money away on testimonials alone. That’s not science.

  1. Enrico P, Sirca D, Mereu M., Antioxidants, minerals, vitamins, and herbal remedies in tinnitus therapy. Prog Brain Res. 2007;166:323-30.
  2. Linde K, ter Riet G, Hondras M, Vickers A, Saller R, Melchart D; Systematic reviews of herbal medicines—an annotated bibliography. Forsch Komplementarmed Klass Naturheilkd 2003; Apr,10 Suppl. 1:17-27.
  3. Morris CA and Avorn J. Internet marketing of herbal products. JAMA 2003;290:1505-1509.
Republished from