Hearing is brain activity. Our ears pick up sound, but our brain makes sense of it. The auditory pathway that brings sound from our ears to our brain works similarly to the muscles in our arms. If we do not use those muscles consistently and put them to work, they become weak over time. More simply, if you don’t use it, you lose it! An untreated hearing loss causes a similar consequence in the auditory pathways of the brain leading to those pathways becoming weak and deteriorated over time. This occurs because our brains are plastic, meaning they are always rewiring to make connections for new signals. If a pathway is not being used, it will get rewired. This phenomenon was proven in a study looking at the effect of hearing aids on word-recognition scores over time for persons with an asymmetrical hearing loss. Word recognition is the ability to understand words that are loud enough to hear. They found that lack of properly fit amplification (hearing aids) leads to a decline in word-recognition performance over time in the worse ears of adults with asymmetric hearing loss (Silverman et al., 2006).
The good news is that our brains ARE plastic, so with new signals, such as sound through a hearing device, those pathways can be improved. Because the brain is plastic, the auditory nerve is never as usable as it is today. The longer it goes without stimulation, the less usable it becomes for future use, and the harder it is to maintain or rebuild the pathways. If you have a suspected hearing loss, it is best to get it diagnosed and treated sooner rather than later.
For persons with hearing loss who elect to try amplification, we expect an adjustment period for the reasons outlined above. An appropriately fit hearing device will provide a lot of new sounds. The first few weeks of wearing them, people play the “What is that?” game. The brain needs time to adjust to the new sounds and rebuild those auditory pathways. With consistent hearing device use, our brains perform better over time with the new sounds provided. In fact, in a recent study, researchers found that the brain’s response to similar speech sounds were more contrasted in persons who wore hearing aids versus those who did not, ultimately making the sound easier to differentiate (Miller & Zhang, 2020).
If you or a loved one suspects they have a hearing loss, consider this concept of auditory deprivation. The sooner hearing loss is addressed and treated, the better outcomes you or your loved one will have in the long run!
Miller, S. E., & Yang Zhang. (2020). Neural Coding of Syllable-Final Fricatives with and without Hearing Aid Amplification. Journal of the American Academy of Audiology, 31(8), 566–577. https://doi-org.usd.idm.oclc.org/10.1055/s-0040-1709448
Silverman CA, Silman S, Emmer MB, Schoepflin JR, & Lutolf JJ. (2006). Auditory deprivation in adults with asymmetric, sensorineural hearing impairment. Journal of the American Academy of Audiology, 17(10), 747–762. https://doi-org.usd.idm.oclc.org/10.3766/jaaa.17.10.6