According to Dr. Emily Cooper, a clinical audiologist and audiology supervisor with OSF HealthCare Illinois Neurological Institute, the best treatment depends on the severity and type of hearing loss. An audiogram, or hearing test, can help audiologists determine the most appropriate option for each patient.

As hearing loss progresses, hearing aids may no longer provide enough benefit, especially when it comes to understanding speech.

When hearing becomes more severe, patients may still hear sounds but struggle to clearly understand conversations, even while wearing hearing aids.

"That's when we would consider someone for a cochlear implant," she adds.

Not just for children

Many people associate cochlear implants with children who are born with hearing loss. While cochlear implants can be life-changing for children, Dr. Cooper says adults should not overlook them as a treatment option.

"From nine months, all the way to 95. As long as you're healthy enough to undergo an outpatient surgery, you can get a cochlear implant," Dr. Cooper says.

Despite their effectiveness, cochlear implants remain underused.

"They're completely underutilized," Dr. Cooper stresses. "Only 6-13% of people who could benefit from a cochlear implant actually have one."

For adults experiencing hearing difficulties, the first step is making sure their current hearing aids are working as intended. Dr. Cooper recommends having hearing aids professionally evaluated and adjusted if necessary.

If hearing challenges persist, patients should schedule an appointment with an audiologist to discuss their concerns and determine whether a cochlear implant evaluation may be appropriate.

Who qualifies for a cochlear implant?

Many people are surprised to learn they may qualify for a cochlear implant sooner than they think.

According to Dr. Cooper, candidates may include individuals who:

• Have hearing levels of 60 decibels or poorer
• Score 60% or lower on word understanding testing

A comprehensive hearing evaluation can help determine whether a patient meets candidacy requirements and whether a cochlear implant could improve communication and quality of life.

What happens after implantation?

A cochlear implant works differently than a hearing aid. Rather than simply making sounds louder, the implant bypasses damaged parts of the inner ear and directly stimulates the hearing nerve.

After surgery, the device is activated and adjusted by an audiologist.

Dr. Cooper says patients should expect an adjustment period when the device is first turned on.

"Part of the process is doing listening therapy," Dr. Cooper says. "Over the first 1-3 months, people start to really notice their hearing a lot more than they used to, and understanding a lot more than they used to. So, it can be a slower process over the first couple of months as the brain relearns to hear with this implant."

Initially, sounds may seem robotic or static-like. Over time, however, the brain adapts to the new signals and learns to interpret them more naturally.

Hearing loss can affect anyone

Hearing loss is often associated with aging, but it can affect people at every stage of life.

"Hearing loss does not discriminate," Dr. Cooper says. It can impact infants, children, adults and older adults alike.

Some individuals are born with hearing loss, while others develop it later due to genetics, illness, injury or long-term noise exposure.

Certain genes can increase a person's susceptibility to hearing loss, and genetic forms of hearing loss often appear earlier in life. To identify hearing issues as soon as possible, every newborn receives a hearing screening before leaving the hospital.

Early identification is critical because untreated hearing loss can affect speech and language development.

The U.S. Food and Drug Administration recently lowered the minimum age for cochlear implant candidacy to seven months, allowing more infants with significant hearing loss to receive treatment earlier.

For children born with hearing loss, earlier intervention can help reduce the risk of speech delays and support language development during critical stages of growth.

Protecting your hearing throughout life

Not all hearing loss develops immediately after exposure to loud noise. In many cases, hearing damage accumulates over time.

Dr. Cooper notes that someone who attended loud concerts, worked around machinery or experienced other significant noise exposure years ago may not notice hearing loss until much later in life.

Because hearing changes often occur gradually, regular hearing evaluations can help identify problems early and connect patients with treatment options before hearing loss significantly impacts daily life.

Whether the solution is hearing aids, cochlear implants or another intervention, Dr. Cooper says people should not assume hearing loss is something they simply have to live with. Advances in hearing technology continue to provide opportunities for people of all ages to stay connected to the sounds and conversations that matter most.

Speaking with your primary care provider can help start the conversation, and figure out a plan that works for you.

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According to Emily Cooper, AuD, a clinical audiologist and audiology supervisor with OSF HealthCare Illinois Neurological Institute, researchers continue to learn more about the relationship between hearing loss and dementia.

"Over the last 10 years, there have been more and more studies linking hearing loss with dementia. There's a growing body of research showing that not only is there a link, but that untreated hearing loss is more of a risk for cognitive decline," Dr. Cooper says.

While researchers are still working to understand exactly why hearing loss and dementia appear to be connected, Dr. Cooper emphasizes that hearing loss alone does not cause dementia. Instead, untreated hearing loss may contribute to factors that increase the risk of cognitive decline over time.

One possible reason is the impact hearing loss can have on a person's social life. Individuals who struggle to hear often withdraw from conversations, social gatherings and activities they once enjoyed.

"Your brain needs to be active and used," Dr. Cooper stresses. "Hearing loss also takes a lot of brain power. Your brain is having to do a lot more processing to understand the world." Over time, that increased effort may contribute to cognitive decline.

Recognizing the signs of hearing loss

Hearing loss can develop gradually, making it difficult for people to recognize when their hearing has changed. Dr. Cooper says some common warning signs include:

• Turning up the television louder than usual
• Frequently asking others to repeat themselves
• Saying "what?" or "huh?" more often during conversations
• Having more difficulty hearing in noisy environments, such as restaurants or crowded events
• Experiencing ringing in the ears, known as tinnitus

Because these changes often happen slowly, family members are sometimes the first to notice them.

Dr. Cooper says loved ones can play an important role by encouraging hearing evaluations in a supportive way. Rather than focusing on the hearing loss itself, she recommends emphasizing quality of life and participation in important moments.

For example, family members might say they want their loved one to fully participate in family gatherings or clearly hear conversations during medical appointments.

Don't wait to get your hearing checked

Many people postpone hearing evaluations for years, assuming hearing loss is inevitable or waiting until their golden years.

"Getting treated early is going to be the most beneficial in preventing cognitive decline as it relates to hearing loss," Dr. Cooper says. "That means getting your hearing tested early, not waiting until you're 65 and on Medicare to do so. Even in your 40s and 50s, there's research that shows even mild hearing loss in your 40s and 50s can lead to cognitive decline later in life."

She encourages adults to establish baseline hearing assessments as they age, just as they monitor other aspects of their health.

A good first step is discussing hearing concerns with a primary care provider, who can then provide a referral to an audiologist for a comprehensive hearing evaluation.

A growing concern for an aging population

The importance of hearing health is becoming even more significant as the nation's population ages.

By 2030, all Baby Boomers will be over the age of 65 according to the United States Census Bureau. Dr. Cooper says this creates a larger risk for both hearing loss and dementia.

"We're looking at massive numbers of an aging population and people who could be at a risk for dementia and hearing loss," Dr. Cooper says. "As a field, we are looking at educating people to get their hearing tested early and getting treated early."

Research in Oxford Academic’s Age and Ageing journal suggests that individuals who receive treatment for hearing loss may have a lower risk of cognitive decline than those who leave hearing loss untreated.

Treatment options vary based on the severity of hearing loss and may include hearing aids or cochlear implants. While Medicare does not currently cover hearing aids, cochlear implants are covered by Medicare and many other insurance plans.

For Dr. Cooper, the message is straightforward: hearing loss should not be viewed as something people simply have to accept. Identifying hearing loss early and seeking treatment may help individuals stay engaged, connected and cognitively healthy as they age.

If you have concerns about your hearing, speak with your primary care provider who can help talk through options with you.

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As parents, it’s easy to sometimes think our children are ignoring us. But it’s a real possibility they could have a hearing problem.

According to the World Health Organization, about 95.1 million children age 5-19 live with hearing loss. And more than 1 billion young adults are at risk of permanent, avoidable hearing loss due to unsafe listening practices. May is national Speech-Language-Hearing month and is a good time to raise the importance of staying on top of our children’s hearing.

Krista Irmeger, AuD, an audiologist with OSF HealthCare, says congenital hearing loss starts at birth. 

“It can be genetic. It can be a factor in pregnancy with the mom; it can be acquired later with different viruses and illnesses,” says Irmeger.

There are plenty of signs to look out for, Irmeger adds. In babies, it starts when they don’t get startled at loud noises. They don’t use signal words by the time they turn 1. Signal words are basic words and gestures toddlers use to communicate basic needs, regulate their emotions or express preferences before they develop full sentences. In older children, speech and language development is delayed. They don’t follow directions or often turn the TV volume up.

As children age, there are several contributing factors that could lead to hearing loss. The biggest one is noise exposure. That can include repeated exposure to loud music or attending concerts or fireworks displays. Another potentially bad habit is overusing ear buds and headphones.

“Kids nowadays are using earbuds and headphones like crazy,” says Irmeger. “So, monitoring the volume of that; the rule that we go with is 60% or less of the max volume, never greater than that. And then monitor how much time they're using headphones and earbuds. Wearing hearing protection when you're around loud noises, concerts, sporting events, fireworks...”

Children should be receiving hearing exams in school through middle school. But if parents have any concerns or notice any issues such as speech and language delays or frequent ear infections, Irmeger encourages parents to make an appointment to see an audiologist to set up a hearing exam. Ear tubes are an effective way at treating hearing loss caused by chronic fluid buildup or repeated infections in the middle ear.

“If there's an underlying medical condition like an ear infection or a structural abnormality, first we would get that treated,” Irmeger says. “And if the hearing loss is still there, then it would be a hearing aid, and if it's more severe, it'd be a surgical treatment, like a Bone Anchored Hearing aid (BAHA) or a cochlear implant.” BAHA is a surgically implanted device that uses bone conduction to transfer sound directly to the inner ear, bypassing the outer and middle ear. A cochlear implant is a small electronic device that can provide a sense of sound to a person who is deaf or severely hard-of-hearing. 

Getting the news that hearing aids are needed can be unsettling to anyone. Irmeger says children typically react in one of two ways. “Some children are excited to have hearing aids because the kids in their classroom are like, ‘Whoa, that's really cool that you have that.’ And others are more reserved and they're hesitant to get them. I think the big factor that really helps is how the parents respond. If they're super excited and they make it seem like a cool thing that they get to do.”

Preserving your child’s hearing starts with good habits developed in the home. “If you're in a situation and it's loud for you, it's going to be loud for your kids too,” says Irmeger. 

For more information on children and hearing, visit the OSF HealthCare website. 

 

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John Greinwald Jr., MD, otolaryngologist at OSF Children’s Hospital, performed the first implants this month, giving local children access to the latest technology sooner than patients at other hospitals in the region.

The Cochlear Nucleus Nexa System features upgradable firmware, internal rewritable memory, and dynamic power management. These innovations allow patients to receive software updates and future improvements without the need for additional surgery. The system also securely stores a user’s unique hearing information, or MAPs, so it can be transferred to a new sound processor if needed. The system includes the smallest and lightest sound processors with all-day battery life, adaptive sound processing for clearer hearing in different environments, and a connected ecosystem for ongoing care and support.

OSF Children’s Hospital continues to establish itself as a surgical destination for pediatric care, providing access to the latest medical technology and specialized expertise for children and families throughout Central Illinois.

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