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Ear, Nose, and Throat Disorders

Exceptional hearing is a problem at school

10/16/2002

Question:

My 7 year old daughter went for hearing tests after her 2nd grade teacher commented that she is having difficulty hearing instructions at school. I took her to an Audiologist who informed me that my daughter "suffers" from exceptional hearing. She is able to hear sound at -10 dc. Her problem in the classroom is that she hears too much. She has the ability to hear other classrooms and traffic outside. It is difficult for her to focus on the teacher`s voice. I would like to know how other parents and doctors have handled this situation. I have heard there is no treatment for this condition. Is this true? At this point homeschooling seems like my only solution.

Answer:

This is a very unusual "problem" in that most hearing professionals are usually dealing with the opposite scenario of poor hearing. As an FYI - hearing levels in decibels are based on a populational norm. For example, 0 decibel hearing does not mean that a person can hear a tone presented with no sound. Instead, 0 decibels was defined as the sound level at which 50% of the tested population could just barely detect the sound being presented. Being able to detect sounds at -10 dB means that your daughter can hear very soft sounds that most people cannot consistently identify. At first glance, home schooling seems like an extreme option. While this is not a criticism of home schooling at all, to base that decision solely upon your daughter`s hearing seems premature. There are other options to consider. Initially, I do feel that it is worthwhile to have your daughter evaluated by an ear specialist. A thorough eval will make sure that your daughter`s auditory system and overall health are fine. A comprehensive audiologic evaluation is also worthwhile. Occasionally we see children who have normal hearing on testing, yet continue to show signs and behaviors consistent with hearing loss because they are unable to focus on the specific listening task or cannot process the sounds/speech that they are listening to. Central auditory processing disorders are an example of such a scenario. Routine audiologic testing will not usually pick this up, and specific CAP (central auditory processing ) testing is necessary. As one consideration, I would consider discussing the options of an FM system with your physician and school educational professionals. An FM system involves the teacher wearing a microphone which then transmits her voice directly to a student who is using either a personal speaker at her desk or perhaps a headset with earphones (it can also be used as a sound field system in which the teacher`s voice is transmitted to speakers placed in the room). While we routinely use these for children who have a hearing impairment, it could also be of potential benefit to your child`s situation. The reason for this is that it greatly improves the signal-to-noise ratio. In simple terms, with an FM system, the child hears primarily what the teacher is saying and competing background noise is greatly reduced. Incidentally, studies have shown that if you implement an FM system in a classroom with normal hearing children, these children will perform signficantly better. So for your daughter, an FM system might be able to reduce the distracting noise from other classrooms, children, etc. An FM system does not have to amplify or make the teacher`s voice louder. It can simply make her voice stand out more with respect to the other noise in the classroom. It would be worthwhile discussing this option with your physician, teachers, etc to see if they consider this a worthwhile trial. 

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Response by:

Daniel   Choo, MD Daniel Choo, MD
Associate Professor and Director, Division of Otology/Neurotology
College of Medicine
University of Cincinnati