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Why Do People with Hearing Loss Still Often Struggle to Follow Group Conversations?

Brian Taylor, AuD

August 9, 2023

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Question

Why do people with hearing loss still often struggle to follow group conversations?  

Answer

As a hearing care professional, I appreciate stories of patients whose hearing aids have made dinner out with their spouse (or friend, or child) a happier, healthier, more enjoyable experience. They can better hear the conversation across the table, and all the background noise, while not diminishing one altogether, and fading to the point of undistracting.

In fact, they’re usually so pleased with their newfound ability to hear their companion in noisy settings that they almost loathe to begin tackling the next challenge: listening to others in noise at the same time, as more people join the conversation. Maybe it’s a family dinner; a business dinner; or no dinner at all, but rather a meeting, conference, book club, class discussion, or cocktail party. Listening is hearing plus engagement. It entails following, comprehending, and reacting to what people say, especially in groups.

Studies have shown that people with hearing loss often struggle to follow group conversations. And even those who’ve already adopted hearing aids report frustration when trying to engage with several people at once, especially in noisy conditions. As a result, they become fatigued. Some withdraw from social situations, risking their physical and cognitive health.

Today’s hearing aids can absolutely help — to a point.

Hearing aid technology has come a long way in addressing focused hearing — the ability to pick up and enhance the voice of someone in front us while diminishing the noise all around. The next step — and the one that will truly help support healthy engagement for those with hearing loss — is to broaden the focus. It’s to improve a hearing aid wearer’s ability to have a conversation with the person in front of them and with others around them. Because it’s one thing to hear better; it’s another to listen in a group, grasp what’s being said, and actively contribute.

The Importance of ‘Conversation Success’

A 2022 article in the International Journal of Audiology sought to explore the concept of “conversation success,” both in one-to-one and group settings and among adults with normal and impaired hearing. The authors concluded that for all study participants, “being able to listen easily, being spoken to in a helpful way and sharing information as desired are significantly more important in group…conversations.” They described communication success as “multifaceted,” encompassing various elements of speaker, listener, and communication channel.

In practical terms, listening easily means not only hearing what’s spoken, but also perceiving who’s speaking, when, and from which direction. And it entails sensing how the conversational soundscape changes as people approach, leave, or simply move around the room. For those with hearing loss, this requires a more advanced approach to soundscape processing.

It begins with split processing, which enables a class of hearing aids that can split a soundscape into two channels — a focus channel and a background channel, each handled separately by dedicated processors. Split processing, as implemented in Signia’s unique Augmented Focus technology, analyzes the two sound channels to determine if they contain information the wearer wants to hear (like the voice of a companion), background information that’s important for understanding the soundscape, or background noise that’s irrelevant and can be suppressed. The streams are then processed appropriately and the wearer experiences far greater speech clarity despite the surrounding noise.

In addition, a split-processing platform constantly analyzes the conversation setting through sensors and directional microphones to adjust as necessary. Based on this capability and the ability to split sound inputs into separate channels, we’re in a technological position to do what hasn’t yet been possible: improve hearing aid wearers’ engagement in group conversations.

It’s clear that future generations of hearing technology must create a split-processing platform that handles multiple streams, identifying primary and secondary speakers, sensing the proximity and importance of their speech, and adjusting in real time as people enter or leave the conversation. All while preserving the background channel, a hallmark of split-processing technology, to improve situational awareness even as it tones down noisy distractions.

The result is a listening experience that adapts to conversation itself, as well as to the acoustic environment – the future of hearing technology will ensure wearers remain fully engaged and ready to contribute.

Listening Care as Healthcare

Ultimately, clearer conversation benefits all involved because it minimizes the gaps that occur when those with hearing loss contribute. Researchers in The Journal of Cognition estimate “turn-taking” in a conversation happens in milliseconds, a process that can be taxing for people with hearing loss, especially in noisy situations. Hearing aids help improve these “turn starts,” thereby improving healthy, conversational dynamics. In this way, the hearing aid becomes a true listening aid.

Research continues to find that hearing loss can lead to social isolation and cognitive decline because sufferers struggle to communicate with others in everyday, immersive acoustic environments. Amplification isn’t enough to overcome this challenge.

We’ve seen scientific evidence that split processing improves hearing in background noise, setting the stage for healthier overall communication and the future of hearing technology.  


brian taylor

Brian Taylor, AuD

Brian Taylor is a Doctor of Audiology and Senior Director of Audiology for Signia. He is also the editor of Audiology Practices, a quarterly journal of the Academy of Doctors of Audiology, editor-at-large for Hearing Health and Technology Matters and adjunct instructor at the University of Wisconsin. Dr. Taylor has authored several peer reviewed articles and textbooks and is a highly sought out lecturer. Brian has nearly 30 years of experience as both a clinician, business manager and university instructor.


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