Change the Game, Change the Focus
Beck (2015) notes that hearing care professionals (HCPs) should consider a philosophical change from simply correcting hearing loss to maximal hearing and listening. He reports that hearing is the perception of sound, whereas listening is applying meaning to sound. Beck advocates that for the brain to listen maximally, technology must preserve the natural acoustic information the brain needs to make sense of sound.
Specifically, he notes preservation of natural acoustic information includes the maintenance and delivery of interaural loudness differences (ILDs) and interaural timing differences (ITDs)—as these cues help the brain orient, separate, focus and recognize sounds. Beck reports listening requires unique personal cognitive abilities and processes working in tandem and in real time, such as working memory, processing speed, attention and the ability to integrate multiple sensory systems and most importantly (for speech-in-noise), the ability to compare and contrast sounds from the left and right ears—to know where to attend, and to better appreciate spatial information, so the brain has key information from which it can de-code the acoustic information and so the brain knows where (in space) to focus listening effort.
Beck reports that “adaptive compression” is a new concept (Pittman, 2014), which provides variable fast or slow compression release times based on the demands of the specific acoustic environment, at a given moment in time.
He concludes, as we move beyond correcting hearing loss to an approach that emphasizes the preservation and delivery of maximal acoustic information, to support maximal listening, it is likely our patients will better appreciate the world of natural sounds.
For More Information, References, and Recommendations
Beck DL. (2015) Brain hearing: maximizing hearing and listening. Hear Rev March 2015.
Pittman AL, Pederson AJ, Rash MA. (2014) Effects of fast, slow, and adaptive amplitude compression on children’s and adults’ perception of meaningful acoustic information. J Am Acad Audiol 25:834-847.