What Writers Need To Know About Hearing Loss

(Cupped ear image taken from Google Images. Credit to rightful owner.)

(Cupped ear image taken from Google Images. Credit to rightful owner.)

So, you want to write a hearing impaired character? You came to the right place, because if I have authority to speak about anything, it’s hearing loss. I happen to have extended experience with it.

Here’s a quick run-down: I’ve been wearing hearing aids in both ears for what will be 3 years come the end of October. I have a condition called LVAS (or sometimes EVA), which stands for enLarged Vestibular Aqueduct Syndrome. That basically means that the tube that connects my inner ear to my skull is bigger than normal, and for some reason that causes hearing loss.

Since I’m up close and personal with hearing loss every single day, I figured that I’m just the person that can speak from experience and help writers know how to correctly portray it in fiction. I’ll give you an inside look at what it’s like to be hearing impaired, and I’ll tell you some things that you may not have known.

NOTE: Most facts are given with congenital hearing loss (present from birth) in mind. I am not familiar with hearing loss that has been brought on by elderly age or by an outside source (such as a concussion). I am also not familiar with cochlear implants and how they work, although I do know people who have them. Additionally, there are different rules for each condition that cause hearing loss, so be sure to research what kind you’re using. Also, I can only speak for those who are only hearing impaired. If you wish to write a completely deaf character, I cannot speak from experience with that.

Here’s what you need to know about hearing loss:

  • There are different kinds of hearing aids. They all are meant to help you hear, but each kind looks a little different.
    (Credit: NIH Medical Arts)

    (Credit: NIH Medical Arts)

    There’s a nifty little chart to help ya out. I, for one, wear the “Mini BTE”, and that seems to be the most common, though the regular BTE isn’t rare to see. Be sure to know which kind of hearing aid your character wears. Just for fun, here’s a pic of the hearing aids I wear now (right down to the same color I have):

    (From Google Images. Credit probably goes to Unitron. Thanks for making the hearing aids I wear, guys. 🙂 )

  • Hearing aids have batteries that need to be changed. This is something you don’t really think about. I know I sure didn’t before I got hearing aids. But hearing aids DO take batteries, just like other electronics do. Now, they’re special kinds of batteries, so you can’t just slap in any ol’ double A’s, mind you. They’re small button batteries made specifically for hearing aids, and there are different kinds of hearing aid batteries that fit different hearing aids. Hearing aid batteries are sold at stores like Wal-Mart, so as long as you get the right kind, store brands will work. In my experience, with the kinds of batteries I use, they last about a week or a little longer before they die and need replaced. You know the batteries are dying, because your hearing aid will beep twice in your ear. If not changed, it’ll beep twice a few minutes later to warn you again, then after that, it’ll usually die. How do you put batteries into hearing aids, you might be wondering? With BTEs, there is a compartment that you pull open, put the battery in, then close it again. Here’s an example of what that looks like when it’s open:

    (Image taken from Google Images. Credit goes to rightful owner – again, probably Unitron.)

    That little circular area is pulled out. Plop the battery in, then push it closed, and voila. You’re done.

  • Not all hearing aids have manual volume control and on/off settings. This seems to be very popular in the movies. Hearing impaired character is frustrated with what another character is saying, so they cheekily turn off their hearing aids or turn them down, and now they can’t hear a single thing their friend/coworker/sibling/etc. is saying. (A good example of this is in Spy Kids 4: All The Time In The World). There are several things wrong with this scenario. First, not all hearing aids even have the aforementioned features. I have worn two sets of hearing aids thus far. The first set had no volume control whatsoever. The ones I wear now do have buttons on each that I can use to turn them louder or softer, but it depends on the type of hearing aid. In the same vein, I have never come across any hearing aids that have manual on/off switches. Both sets of hearing aids I have had always turn on when you push the battery compartment in (you pull it out to turn them off) and put it in your ear. I can’t just reach up and push a button and they’re turned off. It doesn’t work that way. One last faux pas of that stereotypical movie situation is that it’s a bit unrealistic to have the character turn off their hearing aids and not be able to hear anything. It is possible, but it depends on how severe of a hearing loss your character has. I have mild to moderate hearing loss, so if I take out my hearing aids or have them turned down, I will still hear people (not as well, but I’ll still hear them). However, someone with severe hearing loss might hear little to nothing if they take out their hearing aids. Consider the severity of your character’s hearing loss before you go and make the joke of them taking out their hearing aids so they can’t hear their comrades.
  • Your ear gets used to hearing aids. They feel really weird at first, and your ear is like, “THIS IS SOMETHING FOREIGN. GET IT OUT.”, but it won’t always be that way. After a little while, your ear realizes that it’s here to stay, and you get used to it. After wearing hearing aids for nearly three years, I don’t really even feel them anymore – sometimes I forget I even have them in!
  • Hearing aids cannot help a hearing impaired person hear perfectly. I think some people see it as, “Well, you have hearing aids, so you can hear normally now”. Actually, no, I can’t. Hearing aids help a person hear better than they would without them, but they can’t make a hearing impaired person hear as well as non-hearing impaired people can. I wear my hearing aids every day, but even with them in, I still mishear or don’t hear things. I still need to ask people to repeat things. I still have all the problems my hearing loss brings, just a little less often than without them in.
  • There are two main types of hearing loss: sensorineural and conductive. Sensorineural is when your hearing loss is caused by the nerves in your ear. For one reason or another, they aren’t processing sounds correctly. People with sensorineural hearing loss often struggle with headaches, dizziness, and feeling off-balanced. They also tend to endure a lot of tinnitus (a persistent ringing sound in the ears). Conductive is when the outer or middle ear is the cause of hearing loss. It has nothing to do with your nerves. Many sites describe it as a “mechanical” problem, because it has something to with one of the ear’s parts not doing its work (for example, the eardrum not vibrating correctly, or the three little bones called the ossicles not transferring sound like they should). I have a mix of both conductive and sensorineural hearing loss, ’cause I’m just that lucky. When conductive and sensorineural hearing losses are present together, it is referred to as a third type of hearing loss: mixed hearing loss.
  • People with hearing loss can have trouble hearing either high or low frequencies. I was talking to someone about my hearing loss a little while ago, and they assumed that hearing impaired people only can’t hear low sounds. They were very surprised to learn that people can have trouble hearing high-pitched sounds too. Mine is a low-frequency hearing loss, so I have trouble hearing soft, deep sounds. I have a hard time hearing my dad, because he happens to have a deeper, very quiet voice. However, those with high-frequency hearing loss might not be able to hear, say, a woman’s voice as well. The sounds you want your character to hear (or to miss) will depend on what frequencies they can hear.
  • Hearing loss can be present at birth, but not realized until later in life. Take me, for example. My hearing loss has been with me since the day I was born, but I didn’t know that I even had a hearing impairment until three days before I turned thirteen (I’m sixteen as of the time of writing this). If you want your character to know about their hearing loss and be wearing hearing aids from a young age, by all means, go for it! Just know that it is perfectly plausible to say that they’ve had it their whole life and haven’t found out about it until the time of the events in your book.
  • If hearing loss has been present from birth and a character gets hearing aids later on in life, they will hear new sounds you take for granted. You know how when your wear jeans, there’s a little swish swish sound as the fabric rubs together when you walk? How about when you hear the whirrr of the refrigerator running? And your computer’s fan makes a whoosh noise as it keeps the electronics at a proper temperature? Imagine hearing none of that. Not a single one of those sounds. I mean, you don’t pay much attention to those sounds now, right? They’re just there, in the background of your daily routine. But when you haven’t heard those sounds your whole life, you definitely notice them when you get hearing aids and you suddenly do hear them! As I walked out of the audiologist’s with my new hearing aids, I said something really intelligent like, “Whoa, Mom, my pants are making noises!” She never even thought twice about hearing jean fabric rubbing together, but to me it was an astonishing new revelation because I had never heard it before. Another person with LVAS told me that for the first time, she heard herself walking! So, if you happen to make your character get hearing aids during the course of your book (or if they have just recently gotten them when your novel begins), show that transition between not hearing and hearing by making a few remarks about the commonplace sounds he/she is now hearing.
  • Sounds are very loud when you first wear hearing aids. I remember driving home from the audiologist’s, and even just a potato chip bag crinkling was really loud! Hearing aids are essentially amplifiers of sounds, so at first every single little noise seems deafening (that’s a bit of an exaggeration). Again, that’s something that the hearing aid wearer will get used to after a few days, and things won’t sound as loud anymore.

You might be wondering, after all those facts, how do you effectively write the experience of being hearing impaired? You’ll never get it perfect if you’re not hard of hearing yourself, but you can still make it believable if you try your hardest to understand what it’s like. I have a few last tips on writing the atmosphere of being hearing impaired.

Making sure your character’s hearing impairment is prominent in their lives doesn’t mean you need to make it the topic of every paragraph. Subtle comments about putting their hearing aids in or them not hearing things is communicative enough to your readers without forcing the fact into their faces. Also, I’ve found that there are two ways that I don’t hear people: I either completely don’t hear them, or I hear their voices, and not their words. The former is your typical, run-of-the-mill “I didn’t hear them say anything at all”. It could be that someone said my name, and I’m not aware that they spoke at all. The latter is a bit different. That’s when I hear someone talking, but they’re too far away, too quiet, etc., and I can’t make out what they’re saying. It’s really hard to explain, but I hear their voice and certain sounds, but I can’t figure out the words. LIke, if someone might say, “I was once in the army”, I might only pick up the “s” sound, something that sounds like “unce”, and “are-ee” (“army” without the “m”). Based on the context of our conversation and the sounds I pick up, I might be able to roughly figure out what the person was saying. Sometimes I can, sometimes I can’t. It depends. I’ll briefly rehash what I mentioned above: what sounds your character can or can’t hear will depend on the severity of their hearing impairment and whether they have high or low frequency hearing loss (for example, if you want them to mishear their best friend who is male a lot, they might need to have low-frequency hearing loss). And one last thing: the character’s personality will determine how they react to having to ask people to repeat themselves. Asking for repetition is inevitable in a hearing impaired person’s life, but not everyone is willing to do it. I will ask as many times as I can, but after six or seven times, I might just act like I heard it, even if I didn’t. Some people won’t even ask someone to repeat themselves once. It all depends how forward your character is.

Finally, since I dumped a LOT of info on you today, here is a brief, simplified list of factors that might change certain facts I have given here.

  • The condition which instigates hearing loss (Born with it? Concussion? Something else? Find out the facts)
  • Severity of hearing loss
  • High or low frequency hearing loss
  • Type of hearing aid
  • Kind of hearing loss: sensorineural or conductive
  • The disease/syndrome/affliction that is at the source of hearing loss (LVAS like me? Another kind? Find out the symptoms and facts that are unique to each kind)

Now that you know the facts, go get started!

It’s your turn! Do you have any hearing impaired characters? What else do you want to know about hearing aids and having hearing loss? Do tell!


One thought on “What Writers Need To Know About Hearing Loss

  1. Pingback: If I Had A Million Dollars – Writer’s Tag – Maggie's Musings

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