beth_leonard

A long-time reader asked if I have any wisdom to share about getting one's first set of hearing aids, and I don't. Maybe some of you do?

He just had a hearing test showing hearing loss – almost perfectly the same in both ears, IIRC starting around 1000 Hz and tanking in a straight line on the audiogram as pitch rises – so he's been referred to an audiologist consult on hearing aids. He'd like to know more about whatever there is to know about hearing aids before talking with someone with a financial interest in selling him something. Definitely interested to hear from any hearing aid users who have strong and informed opinions about the market.

Also – this being the US – he's still working and has excellent health insurance coverage for hearing aids through his present employer, but hopes to retire in about a year, at which point he'll be on Medicare, and doesn't know how good his hearing aid coverage will be. So if there are decisions to be made that might make the most of his present insurance situation, he'd like to know about it.

I also have some questions of my own. I was surprised to learn that standard hearing tests don't go below 250 Hz and go up to 8000 Hz, and the justification is that that covers the range of human speech. Which:

1) The hell it does? You know what 250 Hz is? Middle C on a bad day in the Baroque. That is: a slightly sharp B3 under A440 tuning. Middle C is so-called because it is in the middle of human sung vocal production ranges, where below it is the bass clef, traditionally for men's voices, and above it is treble clef, traditionally for women's and boy's voices. The standard audiogram starts above any note a bass singer ever typically sings, and above 2/3rds of what tenors sing.

1a) Worse, sung vocal production is usually (always?) higher than spoken vocal production in the same person – that is, speech is lower than song. According to this at VoiceScience.org, the typical men's speaking range is ~93–135 Hz with a mean of ~116 Hz and the typical women's speaking range is ~162–238 Hz with a mean of ~205 Hz. There are no human beings whose speech production pitch range is typically above 250 hz. A hearing test that starts at 250 Hz and goes up starts higher than the entirety of typical human speech production, all genders.

2) The C above middle C is only 523 Hz. Who talks at 8000 Hz? Dolphins? Bats? Hell, 1000 Hz is just under the second C above middle C.

3) You know what's even lower than human speech? Traffic. Garbage disposals. Engines. Thunder. Rushing water. Tornadoes. Why are we pretending to only care about hearing correction for understanding human speech when hearing is also necessary for safety, and the pitches of things you might want to hear in the environment can be low?

4) No, really, they triaged everything below middle C? Like fuck music entirely? Doesn't matter if you can enjoy a rock band or a symphony orchestra any more, that's not a medical problem?

Is there some way any of this makes any sense? This all seems completely insane to me.

I had a hearing test back in 2005 because I noticed I was having trouble parsing speech at my internship. I got an audiogram, but at the time I didn't even notice what the starting pitch on the chart was. I was told that my hearing was fine – better than average for my age, actually – and that it showed no reason I would be having trouble. But in retrospect, they... never actually tested my hearing in the range of speech? WTH?

ETA: A picture's worth a thousand pitches. Here's my understanding of the situation:



Note that the ranges I specified for sung voice types is the typical choral expectations; virtuousic soloists can and are often expected to exceed these.