Hearing Aids

Hearing aids are small devices that are worn in or behind one or both ears to make sounds louder. A hearing aid may correct a conductive hearing loss to a normal or near-normal level if it is caused by a malformation of the middle or outer ear. For a significant sensorineural hearing loss, a hearing aid may help but will not bring hearing back completely.

Hearing aids come in many sizes, shapes, and styles. Some fit in the outer ear or ear canal and are for mild to severe hearing loss. Others fit behind the ear and are attached to a plastic ear mold that goes inside the outer ear. These hearing aids are for people with mild to profound hearing loss. Some people with profound hearing loss use a body aid. This is a larger hearing aid that is attached to a belt or put in a pocket and connected by a wire to the ear.

A hearing aid is made up of:

  • A microphone to bring in sounds
  • An amplifier to increase the volume of sounds
  • A speaker or earpiece to send the sounds to the ear
  • A battery for power

The electronic mechanisms in hearing aids can be analog or digital. More advanced analog aids can be programmed by the wearer to accommodate different sound environments. Digital aids use a computer chip and provide even more flexibility in different environments. However, they are the most expensive type of hearing aid.

It can take time and patience to get used to a hearing aid because things sound different. Some people need to try more than one hearing aid to find one that works well for them.

Assistive Devices

An assistive listening device (ALD) is any kind of device that can help you in your communication activities. It can be used with or without hearing aids to deal with problems of background noise, distance, or poor room acoustics.

Some examples of ALDs include:

  • Personal frequency modulation (FM) systems—The system has a transmitter microphone that the speaker uses and a receiver that you, the listener, use. If you use a hearing aid, the receiver sends the sound to it. This type of system is useful in many settings, such as classroom lectures, meetings, or restaurants. In large group settings, such as auditoriums, movie theaters, and places of worship, the transmitter may be built into the main sound system.
  • Infrared systems—These are often used in your home with TV sets, but can also be used in large settings like meeting halls. Sound is sent by infrared light waves.
  • Many other types of equipment are made with amplifying devices for people with hearing loss. They include telephones, cell phones, answering machines, computers, and wake-up alarms.
  • There are also different types of alerting devices that can give you a visual signal or a vibration you can feel. These are made for things like doorbells, telephones, alarm clocks, smoke detectors, and paging systems. Other systems that work visually are text telephones, which enable conversations to be typed and read, and captions on TV and movies.

Implanted Devices

Cochlear Implant

A cochlear implant is a small electronic device that can help provide sound to a child or adult with a severe hearing loss. It is surgically implanted under the skin behind the ear. This device picks up sounds through a microphone, processes them, converts them into electrical impulses, and transmits them past the damaged or nonworking parts of the inner ear to the brain. The microphone and transmitter are worn in a headpiece just behind the ear, and the sound processor is placed in a pocket or on a belt. The receiver and electrode system are implanted.

A cochlear implant does not create or bring back normal hearing. However, it can help many people understand their environment and speech and communicate fully in person and over the telephone. The amount a cochlear can help depends on a number of factors, including:

  • How long you have had hearing loss
  • The age at hearing loss
  • The age at implant
  • How quickly you learn
  • The health and structure of your cochlea

The decision to have an implant should be made with medical specialists, such as an otolaryngologist, which is a surgeon specializing in ear, nose, and throat conditions. The procedure involves some risk of complications, as does any surgery, and is expensive. It also takes time and patience to learn to understand sounds from the implant.

Implanted Hearing System Attached to Middle Ear Bones

The Esteem system is used to treat sensorineural hearing loss in adults. It attaches to the middle ear bones. Like the cochlear implant, this is another type of device that is implanted behind the ear. Esteem consists of 3 parts:

  • Sensor—senses vibrations and changes them into electric signals
  • Processor—amplifies the signals
  • Driver—changes the electric signals back into vibrations and amplifies the vibrations, allowing the person to hear the sound

Communication Techniques

General Tips for Communicating

  • Face the person with whom you are talking so that you can see their facial expressions and lips moving.
  • Ask other people to speak louder and more clearly.
  • Turn off background noise, such as from a TV or radio.
  • In public places such as restaurants, choose a place to sit that is away from noise.

Lip Reading

Lip reading, also called speech reading, involves paying close attention to how a person’s mouth and body are moving when they talk to help you understand what they are saying. Special trainers can assist you in learning how to do this.

Sign Language

American Sign Language (ASL) is the most common form of sign language used in the United States. It uses signs made with the hands, facial expressions, and other body movements. ASL is a separate language from English with different rules for grammar, punctuation, and sentence order. There are other types of sign language that are based on English, such as spelling out English words with hand signs.


American sign language. National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at: https://www.nidcd.nih.gov/health/american-sign-language. Updated June 24, 2015. Accessed August 17, 2017.

Cochlear implants. National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at: https://www.nidcd.nih.gov/health/cochlear-implants. Updated May 3, 2016. Accessed August 17, 2017.

FDA clears Envoy's Esteem hearing aid. Mass Device website. Available at: https://www.massdevice.com/fda-clears-envoys-esteem-hearing-aid. Accessed August 17, 2017.

Hearing aids. National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at: https://www.nidcd.nih.gov/health/hearing-aids. Updated May 11, 2016. Accessed August 17, 2017.

Hearing assistive technology. American Speech-Language-Hearing Association website. Available at: https://www.asha.org/public/hearing/treatment/assist_tech.htm?print=1. Accessed August 17, 2017.

Hearing loss. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Hearing-Loss.aspx. Updated November 21, 2015. Accessed August 17, 2017.

Hearing loss and older adults. National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at: https://www.nidcd.nih.gov/health/hearing-loss-older-adults. Updated June 3, 2016. Accessed August 17, 2017.

What is a cochlear implant? US Food & Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/CochlearImplants/ucm062823.htm. Updated June 6, 2014. Accessed August 17, 2017.

Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP  Last Updated: 11/8/2017