Hearing Aids and the Brain

At the heart of most rehabilitation programs for people with hearing loss is the use of amplification. The purpose of hearing aid amplification is to improve a person's access to sound. Depending on the degree and configuration of the individual's hearing loss, the hearing aid is tasked with increasing sound levels at different frequency regions to ensure that incoming speech frequencies are reaching the ear at sufficient levels to compensate for the individual's hearing loss. However, a perceptual event is dependent not only on the audibility of the signal at the level of the ear, but also on how that sound is biologically coded, integrated, and used. As described by Tremblay and Miller in this special issue, this complex ear-brain neural network system starts with sound leaving the hearing aid. At this stage the acoustics of the amplified signal has been altered by the hearing aid. It is this modified signal that is being encoded at subsequent stages of processing: the ear, brainstem, midbrain, and the cortex. The integrity of the signal, and the biological codes, are therefore assumed to contribute to the resultant perceptual event and it is for this reason that the brain can be considered an essential component to rehabilitation. Yet, little is known about how the brain processes amplified sound or how it contributes to perception and the successful use of hearing aid amplification (see Figure 1).