Between the two extremes of hearing well and hearing nothing, there are many degrees of impairment. The terms used to describe the degree of hearing loss are mild, moderate, severe, and profound. Most hearing losses are mild to moderate.
Mild hearing loss: Unable to hear soft sounds, difficulty perceiving speech in noisy environments.
Moderate hearing loss: Unable to hear soft and moderately loud sounds, considerable difficulty in perceiving speech, particularly with background noise.
Severe hearing loss: Speakers must raise their voice. Group conversation is possible only with considerable effort.
Profound hearing loss: Some very loud sounds are audible but hearing conversation without a hearing instrument is impossible.
The Impact of Hearing Loss on Speech Perception
Hearing loss in the inner ear (sensorineural hearing loss) mainly affects high frequency sounds. These high-pitched sounds such as “s,” “f,” “sh,” “t” play a key role in our ability to understand speech clearly. This is why a person with this type of hearing loss will often say, “I can hear but I don’t understand what’s being said.” Hearing loss drastically reduces the ability to understand speech.
The Hearing Test

The performance of the ear is tested with a special measuring instrument, the audiometer. The object of the test is to precisely register the extent of the hearing loss. This can only be done when there is no background noise to distort the result. Since the extent of the damage may be different in each ear, they need to be tested separately. In order to do this the sound signals are transmitted via headphones. Both the perception of the sound and the understanding of speech are tested. The key observations are “when do I begin to hear the sound” and “when does the sound become unpleasantly loud.” This test is usually carried out for several frequencies (or pitches), at a range of different loudness levels. The result is presented in the form of a sound-audiogram. The audiogram is a special graphic representation of the evaluation of a person’s hearing ability. The audiogram enables us to establish the degree, type, and progression of a loss of hear. Regular checks give a clear picture of any changes in the hearing system.
What do the horizontal numbers in the audiogram mean?
The frequencies (pitches), measured in Hertz (Hz) are marked on the horizontal axis. The pitch of the sound increases from left to right. Lower numbers mean lower-pitched sounds (e.g. bass voices, drums) and high numbers correspond to higher-pitched sounds (e.g. birdsong, soprano voices).
What do the digits on the left-hand side of the audiogram mean?
The hearing loss for each frequency measured can be seen on the vertical axis. The higher the number, the louder the sounds. The level is measured in decibels (dB). 0dB indicates the softest sound normally heard by the healthy ear. 120 dB is the loudest sound usually considered tolerable by human beings.
Analog, Digitally Programmable, Digital?
Every hearing instrument has at least one microphone which picks up sound from the environment, an amplifier which transforms the signal to compensate for hearing loss and a receiver that directs the signal, which is adapted for the hearing loss, into the auditory canal. This is similar to a hi-fi system although these hearing systems are much smaller and adapted specifically to the needs of the hearing-impaired individual. Thanks to increasingly small micro-processors, digital technology has been introduced in to the most modern hearing systems. Digital hearing instruments are programmed by a hearingcare professional via computer. Acoustic signals are transformed into a binary code at high speed and with great precision. Complex calculations provide the ultimate flexibility in providing individualized solutions to hearing loss. Additional hearing system features can be offered: e.g. various hearing programs, automatic program selection, noise cancellers, and adaptive directionality. Remote control operation is also possible.