By Christina M. Roup, Jodi Baxter, and Gail M. Whitelaw

This article is a part of the July/August 2025, Volume 37, Number 4, Audiology Today issue.

It is common for adults to present to audiology clinics with hearing- and/or listening-related complaints, yet have clinically normal pure-tone hearing (air-conduction thresholds ≤25 dB HL). These individuals report struggling to hear and communicate in complex acoustic environments (that is background noise and reverberation). It is estimated that approximately 25.3 million adults in the United States (Edwards, 2020) experience these functional hearing difficulties (FHD). Although many cases are idiopathic, FHDs are commonly reported by patients with known damage to the auditory system, including a history of noise exposure (Kamerer et al, 2022) or traumatic brain injury (Roup et al, 2023). Importantly, individuals with untreated FHD are more likely to experience co-morbid conditions such as depressive symptoms (Golub et al, 2020a), anxiety (Saunders & Haggard, 1989), and reduced cognitive functioning (Golub et al, 2020b).

This content is an exclusive benefit for American Academy of Audiology members.

If you're a member, log in and you'll get immediate access.

Member Login

If you're not yet a member, you'll be interested to know that joining not only gives you access to top-notch resources like this one, but also invitations to member-only events, inclusion in the member directory, participation in professional forums, and access to patient resources, tools, and continuing education. Join today!