When hearing healthcare professionals start their medical training, they often begin by learning about the basic concepts of hearing loss. Usually, this starts with a discussion about the different degrees of hearing loss and how to identify them using audiograms or other tests.
This, of course, makes sense as a good starting point for a hearing healthcare professional’s education because people vary widely in terms of their ability to hear – from having minor hearing loss at high frequencies to being profoundly deaf. Treatments for these different population groups are vastly different, so knowing how to identify different degrees of hearing loss is the first step in helping someone as a hearing healthcare provider.
But what about hearing access? How do we take into account the “human factor” of hearing when we just look at someone’s hearing loss as a factor of the frequencies of sounds they’re able to hear?
Hearing Access: The Basics
The problem with thinking about someone’s hearing only in terms of their degree of hearing loss is that it ignores all of the external and internal factors at play. These factors, like the acoustics of a building, the amount of background noise, or how someone feels during a given situation, can all affect someone’s ability to hear, in conjunction with their hearing loss.
Thus, the concept of “hearing access” is really one that takes into account all of the different factors that can make someone with moderate to severe hearing loss feel like their degree of hearing loss in a given situation is either moderate or severe. On a noisy, dimly lit subway, this person might feel like their hearing is severe, but during a quiet night, at home when talking to just one other person, this same person might feel like their hearing loss is moderate.
Hearing access is a decidedly and purposefully nebulous concept because it can be difficult to for someone with hearing loss to articulate how they experience their hearing loss in different environments and situations. Luckily, the World Health Organization (WHO) has actually created a model, known as the International Classification of Functioning, Disability, and Health (ICF) that can evaluate the impact of a condition, like hearing loss on someone’s life. This model can be useful for understanding and evaluating this concept of hearing access in people with hearing loss.
The ICF Model And Hearing Access
To evaluate and determine someone’s degree of hearing access using the ICF model, one needs to look at the following four factors:
Ultimately, hearing access is a complex metric that is perhaps best left to qualitative and not quantitative approaches. Although the four factors that make up hearing access can’t really be displayed or modeled like the degree of hearing loss can be mapped out on an audiogram, understanding an individual’s degree of hearing access can make a substantial difference in someone’s overall quality of life.