HEARING DISORDERS

Health Alert

HEARING DISORDERS

Henry Wouk

Special thanks to Ren H. Gifford, PhD, director, Cochlear Implant Program in the Department of
Otorhinolaryngology at the Mayo Clinic, for his expert reading of this manuscript.
Copyright 2011 Marshall Cavendish Corporation
Published by Marshall Cavendish Benchmark
An imprint of Marshall Cavendish Corporation
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This publication represents the opinions and views of the author based on Henry Wouks personal experience, knowledge, and
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Library of Congress Cataloging-in-Publication Data
Wouk, Henry.
Hearing disorders / by Henry Wouk.
p. cm. (Health alert)
Summary: Provides comprehensive information on the causes, treatment, and
history of hearing disordersProvided by publisher.
Includes index.
ISBN 978-0-7614-4817-4
1. Hearing disordersJuvenile literature. I. Title.
RF291.37.W68 2011
617.8dc22
2009028905
Front Cover: An X-ray view of a cross-section of the ear.
Title page: A girl gets her ears examined by a nurse.
Editor: Joy Bean
Publisher: Michelle Bisson
Art Director: Anahid Hamparian
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Cover Photo: Oscar Burriel / Photo Researchers Inc.
The photographs in this book are used by permission and through the courtesy of:
Aaron Bean: 13. Getty Images: Jose Luis Pelaez, 3; DEA Picture Library, 5, 11; Matthew Ward, 7; Dr. Fred Hossler , 15; Dr. Fred
Hossler, 17; Brad Wilson, 26; 37, 39; Tara Moore, 49; AFP / Robyn Beck, 53. Alamy Images: Edward Moss, 9; Purestock, 20; Mary
Evans Picture Library, 31; Corbis RF, 44, 47; The National Trust Photolibrary, 51; Trinity Mirror / Mirrorpix, 42. Photo Researchers Inc.:
Chris Knapton, 21. AP Images: Barry Batchelor/PA Wire, 23; Tom Costello, 29. The Image Works: Mary Evans Picture Library, 33, 36.
Printed in Malaysia (T)
654321

Contents

Chapter 1

What Is It Like to Have a Hearing

Disorder?
Chapter 2

What Are Hearing Disorders?

10

Chapter 3

The History of Hearing Disorders

28

Chapter 4

Living with a Hearing Disorder

46

Glossary

56

Find Out More

59

Index

61

[1]

WHAT IS IT LIKE TO HAVE A

HEARING DISORDER?

Three-month-old Marie had a dangerously high fever. Her

parents rushed her to the hospital. After a number of tests,
doctors discovered that she had bacterial meningitis. The
fluid surrounding her brain had become infected and was full
of germs. After about a week and a half in the hospital, Marie
seemed fine. She went home.
One day, a couple of weeks later, the wind slammed a door
shut with a loud bang. Everyone jumped except Marie. She did
not even blink.
The doctors told Maries parents that Marie did not hear the
door slam because the infection had spread to her inner ear.
The infection had damaged the cochlea, a delicate part of the
bodys hearing system.

WHAT IS IT LIKE TO HAVE A HEARING DISORDER?

First, the doctors gave Marie hearing aids. Hearing aids have
tiny microphones and speakers that fit inside the ear and make
sounds louder. The hearing aids seemed to help Marie. Her
parents also enrolled her in a special school to learn American
Sign Language (ASL). Now Marie could talk to her family by
using hand gestures.

This is the alphabet as spelled out by the American Sign Language.

By the time she was three, Marie was frustrated. She could
communicate with children who had hearing problems, but
she could not talk to hearing children who did not know sign
language. Marie could make sounds but not words.
Maries parents heard about an electronic device called a
cochlear implant. They asked doctors if cochlear implants

Hearing Disorders

would be an option for Marie. The doctors said that cochlear

implants were an option. The devices could help Marie hear
better, and she could learn to speak. Marie would have to go
through surgery to get the implants inserted.
During the surgery, doctors drilled tiny holes in each side of
Maries skull. They used some wires to replace some damaged
nerves in her ear. The wires were connected to receiver disks
implanted under Maries scalp. Over each ear she wore sensors
which picked up sound and sent it to the disks.
After her surgery, Marie visited an audiologist who turned
on the cochlear implants. Marie wore special sound processors on each ear. They looked a little like her old hearing aids.
These sound processors were able to pick up sounds and deliver
them to her cochlear implants.
Before long, Marie was taking special classes from a speech
therapist. She learned how to speak more clearly and how to
understand the sounds she was hearing. The solution worked
well. One day Marie noticed for the first time that dogs have
different barks. By the time she was five, Marie could speak
clearly, and she did not have to rely only on sign language.
She was able to play and talk with hearing children. Best of
all, when her mother went away on business trips, she could
call home and talk to Marie on the telephone.
By the time she was nine, Marie had an interest in music.
Her singing was so good that she got a part in her school
musical, The Wiz.
8

WHAT IS IT LIKE TO HAVE A HEARING DISORDER?

This is a part of a cochlear implant. It relays sound signals into the inner ear.

[2]

WHAT ARE HEARING DISORDERS?

Our ability to detect sound relies on a system that is delicate, complex, and still a little mysterious. The human hearing
system has many parts. If one part of the system wears out or
breaks down, we can lose some or all of our ability to detect
sound. Instead of using the word deafness, doctors prefer the
term hearing loss because it is a more accurate way to describe
what happens.
There are two different kinds of hearing loss: complete
and partial. Complete hearing loss means a person cannot
hear anything at all. Partial hearing loss means a person can
detect some sound but cannot hear clearly with one or both
ears. Think about the volume control on a radio or television
set. If the radio is turned off and no sound is coming out of
the speakers, that is like complete hearing loss. If it is turned

10

WHAT ARE HEARING DISORDERS?

Inner ear

Outer ear

Middle ear

The ear is not one simple organ but is made of three parts which transform sound waves
into sound.

down so low that you can hear only a little sound, that is like
partial hearing loss.
HOW HEARING WORKS
Hearing starts with sound. If sound were visible, it would look
like waves of tiny particles called molecules flowing through

11

Hearing Disorders

the air. The ears gather up these waves and send them to the
brain. The ear is made up of three sections: the outer ear,
the middle ear, and the inner ear.
The Outer Ear
Much of the hearing system is out of sight, deep inside the
skull. What we usually think of as the ear is the soft, bendable
tissue with an earlobe at the bottom. This tissue is called the
pinna. The word pinna means wing in Latin. And, in fact, the
outer ears do look like little wings sticking out of either side
of the head.
Mammals are the only types of animals that have pinnae.
Many mammals have special muscles attached to their ears. The
muscles allow them to rotate their ears to hear sounds coming
from different directions. Dogs and cats, for example, can move
their ears without moving their heads.
People do not have these kinds of muscles, but their ears
have other special features. Every persons pair of ears, or
pinnae, has a unique shape. Ears are almost as individual as
fingerprints.
The pinna is shaped roughly like a funnel. It gathers up
sound waves and allows them to move into the ear canal.
This is a tube in each side of the head. It is about an inch
long and a quarter inch wide. The skin lining the canal has
glands that make a substance called cerumen, better known
as earwax. Cerumen serves many purposes. It coats the
12

WHAT ARE HEARING DISORDERS?

Some people may be able to wiggle their ears a little but no one can imitate
animals, such as this cat, that can rotate its ears in many directions without
moving its head.

13

Hearing Disorders

inside of the canal, traps dirt, and protects the ear canal from
harmful bacteria. The canal constantly sheds earwax, which
keeps the ear clean and clear.
The Middle Ear
Sound waves travel beyond the end of the ear canal to the next
section, which is called the middle ear. The middle ear begins
with the eardrum, also called the tympanic membrane. The
word tympanic comes from the Latin word for drum. The eardrum is a membrane made of a thin piece of skin that covers
the end of the ear canal. It is shaped like the top of a drum.
Sound bounces against the eardrum and makes the surface
vibrate.
On the other side of the eardrum is a tiny space called the
middle ear. The middle ear is about the size and shape of an
M&M candy. Inside the middle ear are three tiny bones called
ossicles, a word that means little bones. The ossicles are the
three smallest bones in the human body. They are hooked to
one another like links in a chain.
Each ossicle gets its name from its unique shape. The first
bone is the malleus, which is also called the hammer because
it looks like a little hammer. The malleus is connected to the
eardrum on one end. On the other end, it is linked to a second
bone called the incusnicknamed the anvil because it looks
like a tiny anvil. The incus connects the malleus to a third
bone called the stapes. Sometimes the stapes is called the
14

WHAT ARE HEARING DISORDERS?

The three smallest bones in the body are all in the ear. At the top is the malleus. The
stapes is at the bottom left and the incus is at the bottom right.

stirrup because it is U-shaped like the stirrup of a saddle.

The stapes is the smallest bone in the human body. All the
ossicles are inside a hollow area in each side of the skull
called the tympanic cavity.
15

Hearing Disorders

Moving downward from the middle ear to the back of the

throat is an airway called the eustachian tube. It was named
after an Italian doctor named Eustachius, who studied this part
of the hearing system. Eustachian tubes provide room for air
for the tympanic cavity and act as a drain for the middle ear.
Sometimes infections cause fluids to build up in the middle
ear. Eustachian tubes help keep the area clear by letting the
fluid drain down into the back of the throat.
The eustachian tube also provides ventilation for the inner
ear and helps the middle ear adjust to different amounts of air
pressure. That is why passengers in an airplane may feel their
ears pop. There is a difference in pressure between the air
outside their heads and the air inside the middle ear space.
The pop happens because the middle ear is adjusting to the
pressure difference as the eustachian tubes allow air to enter
the middle ear.
The Inner Ear
Sound travels from the middle ear to the third section of the
hearing system: the inner ear. The last bone in the middle ear,
the stapes, is attached to a thin membrane called the oval
window. This is part of a hollow, swirly bone structure called
the cochlea. It is part of the inner ear. The name cochlea
comes from the Latin word for snail because it has a shape
like a snail shell.

16

WHAT ARE HEARING DISORDERS?

The cochlea has fluid inside it. When sound vibrations jiggle
the three ossicles in the middle ear, the stapes pushes on the
oval window and sends ripples through the liquid. The ripples
tickle tiny hair cells located inside the cochlea. These cells
look like stubby little hairs under a microscope. They move
back and forth in the fluid. Different hairs respond to different
pitches of sound. At the base, or bottom, of each cell is a cluster of nerves. When a hair moves, it stimulates those nerves.

These are the inner ears hair cells as seen under a microscope. If they are damaged in
humans they will not grow back.

17

Hearing Disorders

This triggers an electrical signal that travels to the acoustic

nerve and then on to the brains auditory center, which sorts
out the sounds. It is actually the brain that senses the differences among music, speech, and birds singing. So, in a sense,
we hear with our brainsnot just our ears.
OUR AMAZING SENSE
Hearing develops before birth. Doctors believe that infants can
hear while they are still in their mothers wombs. Some experts
think that babies in the womb may even be able to recognize
their mothers voices. Pregnant mothers say they have felt their
babies kick or twitch in response to loud noises.
Why do people have two ears? There are many advantages
to having two instead of one. The first advantage is that it
makes it easier to tell where a sound is coming from. Because
ears are on opposite sides of the head, a sound will reach one
ear at a different time than the other. The brain takes this
information and can instantly figure out where a noise is
coming from.
Another advantage of two ears is that they collect more
information. This makes it easier to detect soft sounds and
even to sift through sounds so we can hear what we need to
hear. That is why you can hear your name called out in the
middle of a noisy room. Experiment with this advantage by
plugging one of your ears with your finger in a very noisy

18

WHAT ARE HEARING DISORDERS?

place. Then you can tell how much harder it is to follow a

conversation with just one hearing ear.
The hearing system keeps the body balanced. In each side
of the skull, the inner ear has structures called semicircular
canals. These three bony hoops contain fluid and microscopic
hair cells. One loops straight out to the side. One goes upward.
The third loops downward.
When the head tilts, the fluid inside the ears moves. That
tickles the hair cells, which tell our brain if our head or body
is tilted. The brain uses that informationas well as sights
and other sensationsto keep the body balanced. This is called
the vestibular system. Everyone from a tightrope walker to a
person taking a stroll needs this system. Without it, we would
find it extremely difficultif not impossibleto run or even to
walk without falling over.
HARD OF HEARING
About 36 million Americans have some sort of hearing loss.
Experts say that the number of people with hearing problems
is growing. It may get as high as 78 million by 2030. Hearing
loss can fall into one of three general categories: conductive,
sensorineural, and mixed.
The term conductive hearing loss describes anything that
keeps sound from getting to the inner ear. Ear infections are
one of the most common causes of conductive problems in

19

Hearing Disorders

infants and children. Children have short eustachian tubes that

are not as vertical as an adults. When a child gets a cold and
germs move to the middle ear, the body reacts by building up
fluid. This fluid cannot drain easily through the childs eustachian tubes due to the tubes small size and orientation. The
extra fluid muffles the vibration of the small bones in the ear,
and makes it difficult to hear.

When the inner ear is fighting an infection, what can result is a build-up of fluid, shown
in this computer illustration in blue.

20

WHAT ARE HEARING DISORDERS?

Another common cause of

conductive hearing loss
is getting something stuck
in the ear canal. Children
sometimes poke things in the
ear canal. Other times, adults
and children may have too
much earwax. Sometimes
earwax builds up, forms a
plug, and blocks out sound.
Fortunately, conductive
hearing loss usually can be
solved easily. Doctors can
prescribe medicines or eardrops to clear up infections.
Where there is a buildup of
earwax, they can remove the
should never stick anything in their ears
wax with warm fluids or with People
even a cotton swab. A doctor can remove built up
earwax witha swab or other tools.
a small, hoop-shaped tool.
Sensorineural hearing loss
is more complex because it involves inner ear damage. People
can suffer from sensorineural hearing loss if they have been
exposed to loud noises or have had head injuries. Some people
are even born with sensorineural hearing loss. This is generally
the result of a genetic tendency for hearing loss. Diseases such

21

Buzz Off
One day the daughter of British inventor Howard Stapleton came home
very upset. Some teenage bullies hanging out near a local store had
been harassing her. Stapleton knew that the store owner had been
complaining about gangs bothering his customers. He had an idea.
When Stapleton was a boy visiting a factory with his father, he
complained about the high-pitched sound that some of the machinery
made. His father didnt know what he was talking about. Years later,
Stapleton learned why. Adults could not hear the high-pitched factory
noise because they had less sensitive hearing. All people start to lose
their ability to hear high-pitched sounds starting around age twenty.
Most people do not recognize this loss since it happens gradually.
Stapleton designed an electronic noisemaker. He called it the
Mosquito because it generated a high-pitched sound that only younger
peopleincluding teenage bulliescould hear. The store owner put
the Mosquito outside his shop and turned it on. Within minutes, the
teenagers left. The shrill noise bothered the teenagers, but the stores
adult customers did not even notice it. Soon other businesses began
ordering the Mosquito.
The Mosquito has been used for other purposes. Some imaginative
teenagers have downloaded the sound into their cell phones. They use
it as a special ring tone for text messages. They like it because they
can hear the ring, but their teachers cannot. They can check text
messages in class without getting caught.

22

The Mosquito device seen in the wire cage is used by some business
people in England to keep teenagers from gathering outside their
stores.

23

Hearing Disorders

as measles, mumps, and meningitis can interfere with hearing

if the infection spreads to the inner ear. High doses of some
drugs, such as antibiotics, can cause hearing loss by damaging
delicate hair cells.
A persons sex and age also make a difference. Men tend to
experience sensorineural hearing loss more often than women.
As people get older, their hearing starts to fade. Older people
are not as able to hear high-pitched sounds as they were when
they were younger. This condition of losing hearing as we age
is called presbycusis.
The third kind of hearing loss is called mixed hearing loss.
This type of loss involves both conductive and sensorineural
components. One example of a mixed hearing loss would be
someone who is born with a genetic type of sensorineural
hearing loss but also has a conductive hearing loss from an
ear infection.
PHANTOM NOISE
Another condition related to hearing is called tinnitus, which
comes from the Latin word for ringing. A person who has
tinnitus hears sounds like buzzing, ringing, whistling, or hissing in one or both ears. Only the person with tinnitus can hear
these noises. For that reason, tinnitus is sometimes called a
phantom noise.
Tinnitus can be present all the time, or it can come and go.

24

WHAT ARE HEARING DISORDERS?

For example, a person might experience tinnitus for a few

seconds if he or she stands too close to a loudspeaker at a
concert or if a firecracker goes off nearby.
Usually tinnitus is a problem for older adults. Most people
have experienced tinnitus at least once in their life. This is
considered normal. Doctors do not fully understand what causes
tinnitus, but they think it is caused by inner ear damage.
TESTS
There is no one test that can detect all hearing problems. One
of the most commonly performed tests, however, is called an
otoscopy. Otoscopy is the act of examining the ear canal, eardrum, and part of the inner ear. Doctors use an otoscope to
perform an otoscopy. An otoscope is a small, L-shaped flashlight.
It has a magnifying lens that allows doctors to look deeply into
the ear canal. With an otoscope, doctors first check to see if
the ear canal is blocked with wax or other foreign objects. Then
they check the color of the eardrum to see if it is infected.
Finally, they look at the eardrum and check for any tiny holes.
Doctors also test hearing with tuning forks. First, doctors
gently tap the tuning fork to make it vibrate and hum. Then
they hold the tuning fork close to the patients ear so the
patient can hear it hum. Next, doctors tap the fork again and
touch it to the skull behind the ear.
A person with normal hearing will hear the hum longer when

25

Hearing Disorders

By looking into a patients ear with a magnifier flashlight called an otoscope, doctors can
learn a lot about how healthy the ear is.

26

WHAT ARE HEARING DISORDERS?

the fork is near his or her ear than when it touches the skull.
But if the patient has conductive hearing problems, he or she
will hear the sound more clearly when the tuning fork touches
the head than when it is next to the ear.
In another test, doctors tap the tuning fork and touch it to
the middle of a patients forehead. Normally, both ears should
detect the sound at about the same volume. If this does not
happen, there might be a problem with the inner ear, or there
might be fluid behind one of the eardrums.
To test how well a person can hear different pitches, the
patient has an audilogic (hearing) evaluation. The patient sits
in a soundproof room, puts on a set of headphones, and listens
to different tones played at different volumes in each ear. This
test allows doctors to determine the seriousness of a hearing
problem. It also reveals which ear has the problem.
When children are too young to turn their heads in response
to sound, doctors check their hearing systems by using an
auditory brain stem response test. A machine sends clicks or
tones to each ear through headphones or earphones. Doctors
place electrodes on the childs scalp and ear lobes to record
brain waves in response to the sounds. Doctors compare these
to the brain waves of people with normal hearing. If the childs
pattern is different, he or she might have hearing loss.

27

[3]

THE HISTORY OF HEARING DISORDERS

For years, people with serious hearing loss had to live an

isolated life, cut off from the rest of the world. Now that is
no longer true. Just as we have different ways of discovering
hearing problems, we now have amazing ways of fixing them.
In 1995, the Miss America Pageant crowned its winner:
Heather Whitestone of Alabama. Whitestone had trouble
hearing the announcement, but it was not because she was
nervous. It was because she had been almost totally deaf
since she was an infant. For the first time in its seventy-fiveyear history, the famous pageant had crowned a winner with
a disability.
Had Heather Whitestone lived in another century, her life
would have been much different. Instead of being applauded
and receiving a crown, she would have been an outcast.
For centuries, deaf people suffered terrible discrimination.
28

THE HISTORY OF HEARING DISORDERS

Heather Whitestone became the first deaf winner of the Miss

America pagent in 1994. Here she signs I love you to the crowd
after she wins the crown.

29

Hearing Disorders

More than two thousand years ago, the Greek philosophers

Aristotle and Plato said that if people could not hear, they
could not be taught. In ancient Rome, deaf people did not
have the full rights of citizens. They could not own property.
One religious writer, St. Augustine, declared that parents who
had a deaf child were being punished by God.
THE SIXTEENTH AND SEVENTEENTH CENTURIES
It took centuries before these ideas changed. In the 1500s,
an Italian doctor and mathematical genius named Girolamo
Cardano became interested in deafness because his oldest son
had no hearing in one ear. Cardano experimented with a series
of images that he thought could be used to teach the deaf. He
called the images visual codes. Cardano was the first person to
say that Plato and Aristotle were wrong. Being unable to hear,
he said, does not prevent a person from learning.
About a century later, a British doctor named John Bulwer
agreed with Cardano. Bulwer thought people could communicate with their hands. Since people already used gestures to
communicate some of the time, he thought it would be natural
for deaf people to use a system of hand movements to express
their thoughts. He suggested an alphabet sign language.
Different hand and finger movements would represent letters.
With these hand movements, a deaf person could spell out
words.

30

THE HISTORY OF HEARING DISORDERS

Girolamo Cardano was an Italian doctor who believed in the rights of

deaf people.

31

Hearing Disorders

Around the same time in Spain, a monk named Pedro Ponce

de Leon had a similar idea. His fellow monks had taken a vow
of silence, so they did not speak. Even so, sometimes they had
to tell each other something. He noticed that they used a system of hand signals to communicate. De Leon thought it might
be possible to use similar signals to teach the deaf. He got his
chance to try out the idea when a wealthy Spanish family asked
him to teach their two deaf sons.
The laws in Spain said that a person had to be able to read
and write in order to inherit family property. Without these
skills, the two children would get nothing. De Leon used
alphabet signs that had been developed by another Spanish
monk, Melchor de Yebra. De Leon successfully taught the two
boys how to read and write. He also worked with deaf children
from other wealthy families.
THE NINETEENTH CENTURY
For years, only the children of the rich got this kind of education. That changed in the 1800s. One day a French priest, Abbe
Charles-Michel de LEpee, met two girls from a poor family. At
first he thought they were rude because they did not answer
when he spoke to them. Then he found out they had been deaf
since birth.
De LEpee discovered that deaf people in Paris had developed their own sign language. He learned those signs and

32

THE HISTORY OF HEARING DISORDERS

began teaching the two girls how to communicate using them.

The girls were bright, and they learned quickly. De LEpee
thought other deaf children should be taught as well. Gradually
he developed his own system of hand signals. He produced a
dictionary of his sign language.
De LEpee showed how accurate his language was by using
special theater demonstrations. He would give a speech, and

In the nineteenth century, the French priest Abbe Charles-Michel de LEpee, shown standing, developed methods to teach deaf children which are still used today.

33

Island of the Deaf

Six miles off the coast of Massachusetts is a small island called
Marthas Vineyard. In the 1600s, a group of English settlers moved
there. Over the years their families married one another. Many of
the settlers carried an inherited tendency for deafness. As a result,
about one of every four children was born deaf. But the people
adjusted. Over time, the island residents developed their own sign
languagethe first ever used in the United States.
Many of the deaf families settled in a Marthas Vineyard
town called Chilmark. Deafness was so common there that town
meetings were conducted in sign language. Hearing people who
moved there were outnumbered. They had to learn sign language
to communicate with their neighbors.
Eventually the deaf children married people outside their
communities. The number of deaf people on the island dropped.
By the 1950s, the last deaf person born on Marthas Vineyard died.

THE HISTORY OF HEARING DISORDERS

at the same time he would say it in sign language. One of

de LEpees students would sit on the other side of the stage
and write down what de LEpee signed. The audience was
always amazed when the student reproduced an exact copy of
de LEpees dictation in perfect French.
De LEpee believed that all hearing impaired children, not
just those with rich parents, should be educated. He was from
a wealthy family himself, and he used all his money to open
the worlds first free school for deaf children in Paris.
Similar events were happening in other parts of Europe.
In England, a wealthy man asked a teacher named Thomas
Braidwood to teach his deaf son mathematics. Braidwood
found he had a talent for teaching. In 1783, he started the
first school for the deaf in England.
In Germany a teacher named Samuel Heinicke thought it
might even be possible to teach deaf children to speak. His
method was to put the hand of a deaf person on his throat
and have the student feel the vibrations that his voice box
made when he said different words. In this way, some of
Heinickes students learned to speak.
In the 1800s, the idea of special schools for the deaf spread
to the United States. It began in Hartford, Connecticut, with
a nine-year-old girl named Alice Cogswell. She was born a
healthy baby. As a little girl, however, she caught scarlet fever,
and the infection destroyed her hearing. Her father, a wealthy

35

Hearing Disorders

doctor, tried different ways

to help her learn, but nothing seemed to work well.
After his neighbors son
Thomas Hopkins Gallaudet
stopped by, Dr. Cogswell
had an idea.
Gallaudet was impressed
by how smart Alice was.
During one of his visits he
taught Alice to write the
word hat. He taught her a
few more words on later
visits. Dr. Cogswell had
read about Abbe de LEpees
school in Paris. He knew
there were several hundred
deaf children on the East
Coast, and he thought
they could benefit from
Thomas Gallaudet was an American educator who
helped set up teacher training institutions for deaf
a similar school in the
people.
United States.
Dr. Cogswell convinced Gallaudet to travel to Europe and
learn about the French system. Gallaudet did better than that.
He brought back one of the teachers, a French man named

36

THE HISTORY OF HEARING DISORDERS

Laurent Clerc, who had been a deaf student at de LEppes

school. In 1815, Clerc traveled to Hartford and helped Gallaudet
set up the American School for the Deaf in Hartford. It was the
first of its kind in the United States. The schools first student
was Alice Cogswell.
The school was so successful that others like it began
appearing all over the countryin New York, Pennsylvania, and
Kentucky. In the 1860s, the worlds first college for the deaf
was established in Washington DC. It was called the National

Gallaudet University is the only university exclusively for deaf students.

37

Silent Signals in Sports

Shortly before the beginning of the twentieth century, a man
named William Dummy Hoy made headlines in sports. He was
the first deaf man to play Major League Baseball. Hoy changed
the way the game was played. The story goes that when Hoy
was up at bat, he could not hear the umpire call out strikes and
balls. So he devised a system of hand signs and asked his teams
third base coach to tell him which pitches were balls and which
were strikes. Eventually home plate umpires adopted the same
signals. Today, umpires use all kinds of hand signals when they
make their calls.
Deaf players also changed the game of football. In the
1890s, Gallaudet University had a football team. Its quarterback,
Paul Hubbard, used sign language to tell his team what the next
play would be. He was worried that players on the other team
would read his signs, so he gathered his team around him in a
circle. Other football teams copied the idea, and the football
huddle was born.

This major-league umpire signals a strike during a baseball game. This is just
one of the signals umpires use to communicate during a game.

Hearing Disorders

Deaf Mute College. Its president was Edward M. Gallaudet, the

youngest son of Thomas Gallaudet. Later it changed its name
to Gallaudet University, in honor of Alices teacher, Thomas
Gallaudet.
The 1800s was an era of disagreement about the best ways
to teach the deaf. There were two approaches. Some thought
it was better to use sign language. Others thought it was
better for hearing impaired people to learn to communicate
by reading lips and speaking. This second technique was called
vocalizing.
Alexander Graham Bell, the inventor of the telephone, was
one of the people who believed vocalizing was better than sign
language. Deafness had been a part of his life since he was a
child. His mother was deaf, and as a boy Bell had talked to her
in sign language. Bell also worked as a teacher of the deaf at a
school in Boston. His wife had been one of his students.
Bell and others believed that relying only on sign language
restricted a person to communicating only with other deaf
people. By learning to vocalize, a deaf person could talk to
everyone.
In 1880, educators who worked with the deaf met at a
world convention. They decided to stop teaching sign language
and teach only vocalizing. Deaf students were forbidden to use
sign language. In some schools, teachers tied the hands of
students caught signing.

40

THE HISTORY OF HEARING DISORDERS

Not everyone agreed with this.

Teachers in the United States continued to teach sign language.
The controversy went on for years.
Eventually schools became less
rigid about their methods. Today
most schools now teach a combination of techniques: lip reading,
vocalizing, and sign language.
THE TWENTIETH CENTURY
For centuries, schools helped deaf
people learn and communicate
but could do nothing to improve
their physical disabilities. It was
not until the twentieth century
that this began to change.
Over the years, there were all
kinds of folk remedies to cure
deafness. Most were strange or
silly. For example, one cure
was to stick a twig in the peoples
ears and leave it there for a day
and a night. Another was to put
pepper in the peoples mouths

Royal Hearing
Device
The king of Portugal, Goa
IV, was hard of hearing. In
1819, furniture makers built
him a special throne with
openings in each arm of the
chair. When people needed
to speak to the king, they
talked into the openings.
Speaking tubes inside the
arms magnified peoples
voices. The king listened
through a rubber hose connected to the hollow arms.

41

Hearing Disorders

while they yawned to make them sneeze. The sneeze was supposed to take away the deafness.
One of the oldest methods is something called candling.
A person lies on his or her side while a healer places a small
candle in one ear and lights
it. The flame is somehow supposed to draw out impurities
from the ear and take care
of ailments, from earaches to
hearing problems.
After the twentieth century
began, inventors created more
useful tools for deaf people.
One strategy was to make
sounds louder. The first hearing aid was something called
an ear trumpet. It was basically a tube shaped like a horn.
The small end was placed in
his ear, and the large end was
In the early 1900s hearing aid devices were very
aimed at the sound.
large and cumbersome. This woman shows how an
Later researchers discovear trumpet from 1911 was used.
ered that they could make
sound louder by adapting parts of the telephone invented by
Alexander Graham Bell. In these early models of a hearing aid,

42

THE HISTORY OF HEARING DISORDERS

a person used a microphone copied from the mouthpiece of the

telephone. The microphone was connected to a headphone like
the telephones earpiece.
The first electric hearing aids were clumsy. The batteries
powering them were very big, and the microphone was in a
large box that the user would set on the table. As batteries
got smaller, so did the hearing aids.
By the 1950s, scientists managed to miniaturize the wiring
of a hearing aid into tiny electronics packages. Hearing aids
were so small that they could be hidden in eyeglasses or worn
hooked over the ear. Todays hearing aids are tiny enough to
fit completely inside the ear. Whatever the size, all these hearing aids worked the same way: they made faint sounds louder.
Another invention made a big difference in the lives of deaf
people. It was a machine called the telephone typewriter
(TTY). In 1964, a deaf scientist named Robert Weitbrecht
decided to take a machine called a radio teletypewriter and
change it to help the deaf.
Using a radio teletypewriter, a sender would type a message
on a keyboard. That message would travel over radio waves
to a receiving unit, which printed out the message. Weitbrecht
changed this machine so it could send and receive typed
messages over telephone lines. Using the TTY, two deaf
people could call each other. They typed their conversation
the way people do now with texting. Today there are special

43

Hearing Disorders

There are many devices to help the hearing impaired. This is a telephone
at an airport for those who are hard of hearing.

44

THE HISTORY OF HEARING DISORDERS

TTY translation services that allow a deaf person to call a

hearing person. A specially trained operator reads the TTY
message to the hearing person and types the answer to the
deaf caller.
In the 1970s, television networks started broadcasting
shows with closed captions. These are typed versions of the
words that are being spoken. A whole world of entertainment
opened up to hearing impaired people. Then, in the 1980s,
doctors made the first step toward developing a bionic ear with
the cochlear implant. This is an electronic device that feeds
sound to the brain through the cochlea and the acoustic nerve.
Cochlear implants are for people who have lost most or all
of their hearing and can hear very little with hearing aids.
It gives the ability to hear to people who could hear little or
nothing before. One deaf person who has cochlear implants is
former Miss America Heather Whitestone.

45

[4]

LIVING WITH A HEARING DISORDER

ife has gotten better for people with hearing loss. It has
also gotten more complicated because of the many choices
they have. For example, hearing aids are now smarter. For
years, they were basically tiny microphones that picked up
sound and made it louder. That was fine in a quiet room,
but it did not help if a person was in a noisy restaurant.
Everything, including background noise, became louder.
Many people stopped using hearing aids for this reason.
Today there are newer, digital hearing aids. Built into
them are tiny computers that turn sound into bits of data.
The computer can keep loud background noise softer and
bring out the softer sounds of the nearest voice.
Digital hearing aids are more complicated than older
models. Each one has to be programmed for a specific users

46

LIVING WITH A HEARING DISORDER

As electronic circuits got smaller, so did the size of hearing aids which fit behind or even
inside the ear canal.

hearing needs. But they are smaller and sturdier, and they use
less battery power. And if a persons hearing gets worse, he
doesnt have to get a new hearing aid. He can just have his
digital model adjusted.

47

How Loud Is Too Loud?

More than one out of every ten Americans has a condition called noiseinduced hearing loss. This is caused by loud noise.
Hearing experts measure the loudness of sound with units called decibels
(dB for short). The louder the sound, the higher the number of decibels.
Sounds of 75 decibels or less are safe, but exposure to noise above 85
decibels can be damaging. Time is also a factor. Exposure to sounds that are
100 decibels or louder for more than 15 minutesor to sounds louder than
110 decibels for more than one minutecan seriously damage a persons
hearing. Here are some typical decibel measurements and the level of danger:
SAFE
Silence
A whisper
Normal conversation

0 dB
15 to 30 dB
60 dB

RISKY (more than 85 dB)

Lawn mower
Motorcycle or snowmobile
Personal music player at max volume
Chain saw or rock concert

90 dB
100 dB
105 dB
110 dB

DANGEROUS
Ambulance siren
A gunshot or firecracker

120 dB
140 dB

Hearing experts warn that people who play their music so loudly that they cannot hear
any other sounds around them are putting their hearing at serious risk.

Hearing Disorders

ELECTRONIC HELPERS
Several other new gadgets also help make life easier. People
with hearing problems can use special electric alarm clocks
connected to wake-up vibrators. The user sets the alarm and
puts a vibrating disk under the pillow. When the alarm goes off
in the morning, the shaking disk wakes the person. There are
special digital watches that use the same system. The user sets
the alarm, and the watch vibrates at the chosen time.
Many deaf households have a system of warning lights. If
someone rings the doorbell, a specific light goes on. When the
phone rings, a light marked Telephone flashes. Special smoke
detectors have superbright strobe lights that go off when they
detect a fire.
ANIMAL HELPERS
Just as blind people have seeing eye dogs, some deaf people
have special hearing dogs. The dogs are trained to recognize
specific sounds and signals such as a baby crying, fire alarms,
smoke alarms, oven timers, ringing telephones, doorbells, and
knocks at the door. When they hear one of these sounds, the
dogs go to the owners, paw them to get their attention, and
lead them to the source of the sound.
PROTECT YOUR EARS
One of the scary facts about hearing is that once it is damaged, it does not recover. That is why hearing experts urge
50

LIVING WITH A HEARING DISORDER

Dogs can now be trained to act as a persons ears by learning to recognize the important
sounds in a persons life from doorbells and telephones to smoke alarms.

51

Hearing Disorders

us to take special care of our ears. Doing that is not complicated or difficult. Here are some recommendations:
Limit the time you are exposed to loud noise. People can
become used to high levels of loudness. When you use
headphones, do not listen to music at a louder volume
than is healthy.
Wear ear protection, such as earplugs or soundproof
headphones, when you are near loud sounds such as live
rock music, leaf blowers, lawn mowers, and power tools.
Set the volume on your stereo or MP3 player no higher
than 50 percent of the loudest setting.
Never turn up the volume on personal music players high
enough to block out noisy surroundings. If you cannot
hear people speaking, the music is probably too loud.
Keep track of how much time you spend listening to
music.
Take quiet breaks from a noisy situation.
HOPE FOR THE FUTURE
Computer technology is making a huge difference in the world
of hearing loss. One recent technological breakthrough is called
automatic speech recognition (ASR). This is a program
that can listen to a persons spoken words and turn them
into print.

52

LIVING WITH A HEARING DISORDER

There is a special telephone that uses ASR. When a speaking

person calls someone with a hearing disability, the call is sent
to an electronic translation service. The translator displays the
spoken words on a small screen.
Today deaf students at the Rochester Institute of Technology
in Rochester, New York, can attend regular college classes

A gadget called VPAD+ is a videophone developed for deaf and hard-of-hearing people.
Through the video screen, callers can communicate via sign language. If the caller does
not know sign language, a third party sign interpreters services are offered.

53

Hearing Disorders

because of ASR. As the teacher talks, a person watching the

class repeats the professors words into a computer, which displays the words on a screen. This process is faster and
simpler than having an interpreter or a stenographer.
Right now ASR programs are limited. They can translate
most but not all spoken words. The programs can only be
trained to understand one speaker at a time. In addition, there
is a short time lag between when a word is spoken and when
it is displayed. The reason for the delay is that the computer
has to find the word in its memory sound bank and then print
it out.
Scientists think that people with hearing loss might someday carry a small listening machine with a microphone hooked
to an ASR computer. They could aim the microphone at someone talking and see what the person is saying on a screen.
Other improvements are being made for people with hearing loss. Doctors at Ohio State University Medical Center have
two electronic devices that they say work better than hearing
aids. One is called a middle ear implant. To use a middle ear
implant, doctors attach a tiny magnet to the stirrup bone of
the middle ear. On the outside of the persons head they place
a small receiver and transmitter that takes sound and sends
it as a magnetic pulse into the head and to the magnet. This
makes the bones vibrate and send sound to the cochlea. It
produces a clearer sound than any hearing aid.

54

LIVING WITH A HEARING DISORDER

The other device uses bone as a sound magnifier. It is

called BAHA, short for bone-anchored hearing aid. Bone
is an excellent conductor of sound. With the BAHA system, a
surgeon screws a small metal post into the skull behind the
ear. He or she attaches to it a sound processor about the size of
a half-dollar coin. This sound processor turns sound into
vibrations. The metal post picks up the vibrations and sends
them to the cochlea. Unlike a cochlear implant, this does
not destroy the delicate hair cells in the inner ear, and it
requires a simpler surgery.
Someday, doctors hope, a true cure for deafness will come
when scientists learn how to grow new hair cells in the ear.
One of the great mysteries of science is why the hair cells of
some animals, such as birds, grow back while this does not
happen in humans. Right now researchers at the University of
Oregon are trying to grow replacement hair cells in deaf mice.
One scientist at Stanford University in California thinks there
could even come a time when doctors will treat damaged hair
cells with special ear drops. This is good news for all of us who
live in a world that gets noisier by the day.

55

Hearing Disorders

Glossary

acoustic nerveThe connection between the inner ear and the

brain.
American Sign Language (ASL)A language of hand signals
and facial expressions used by deaf people in the United
States and Canada.
antibioticsMedications that either kill germs or stop them
from spreading.
audiologistA person who studies hearing disorders.
auditory brain stem response testA test that measures the
brains response to sounds.
auditory centerThe part of the brain that receives sound
from the ears and analyzes them.
automatic speech recognition (ASR)The digital transformation of spoken words into text.
bacterial meningitisAn infection of tissue in the brain.
cerumenEarwax.
cochleaA spiral cavity inside the head where sound vibrations
are turned into nerve impulses.
cochlear implantAn electronic hearing device implanted in
the head to send sound directly to the cochlea.
conductive hearing lossDifficulty hearing caused by problems
in the outer or inner ear.

56

GLOSSARY

decibelsUnits that measure the loudness of a sound.

ear canalA tube running from the outer ear to the middle
ear.
eardrumThe thin membrane of skin at the inner end of the
ear canal.
eustachian tubeA narrow tube that goes from the back of
the throat up to the middle ear.
hair cellsMicroscopic cells that convert sound into electrical
signals inside the cochlea.
incus (anvil)One of three tiny bones of the inner ear. It
is shaped like an anvil and sits between the other two
ossicles.
inner earThe most complex section of the ear. It is connected to the brain by the auditory nerve.
malleus (hammer)One of the three tiny bones of the ear. It
is shaped like a hammer and is connected to the eardrum.
middle earThe portion of the ear that includes the eardrum
and the cavity inside the head.
middle ear implantA hearing aid in which a listening unit
outside the head sends magnetic signals to a receiving unit
attached to the bones of the inner ear.
ossiclesThree tiny bones of the middle ear that relay sound
vibrations to the inner ear.
outer earThe part of the ear that is outside the head, as
well as the ear canal.

57

Hearing Disorders

otoscopyA doctors examination of the ear canal and

eardrum with a special light.
oval windowA tiny membrane of skin in the cochlea that
helps send sound from the middle ear to the inner ear.
pinnaThe flap of skin and cartilage that sticks out on
either side of the head. This is what most people call
an ear.
presbycusisA type of hearing loss that occurs as people
get older.
semicircular canalsThree half circles of hollow loops inside
the head that help maintain balance.
sensorineural hearing lossHearing problems that result
from damage to nerve tissue.
speech therapistAn expert who treats speech problems.
stapes (stirrup)The smallest of the three bones of the
middle ear.
telephone typewriter (TTY)A special device that allows a
deaf or hard-of-hearing person to send and receive typed
messages over a phone line.
tinnitusA ringing or buzzing sound in the ears that is not
caused by an outside source.
tympanic cavityA small space, located inside either side of
the head, that surrounds the bones of the middle ear.
tympanic membraneAnother name for the eardrum.
vestibular systemA system that keeps the body balanced.

58

FIND OUT MORE

FIND OUT MORE

Books
Landau, Elaine. The Sense of Hearing. New York: Childrens
Press, 2009.
Van Cleve, John Vickrey. The Deaf History Reader. Washington
DC: Gallaudet University Press, 2007.
Yost, William A. Fundamentals of Hearing. Burlington, MA:
Elsevier, 2007.
Websites
American Speech-Language-Hearing Association
www.asha.org/public/hearing/disorders/types.htm
Centers for Disease Control and Prevention: Hearing Loss
www.cdc.gov/ncbddd/dd/ddhi.htm
Hearing Loss Association of America
www.hearingloss.org/
Mayo Clinic: Hearing Loss
www.mayoclinic.com/health/hearing-loss/DS00172

59

Hearing Disorders

National Institute on Deafness and Other Communication

Disorders
www.nidcd.nih.gov/index.asp
New York Online Access to Health: The Ear and Hearing/Balance
Disorders
www.noah-health.org/en/ear/

60

INDEX

Index
Page numbers for illustrations are
in boldface.
acoustic nerves, 18, 45
age, hearing loss and, 2223, 24, 25
animals, 12, 13, 50, 51, 55
audilogic (hearing) evaluations, 27
auditory brain stem response test, 27
automatic speech recognition (ASR),
5254
babies, 18, 20
bacterial meningitis, 6
balance, 19
Bell, Alexander Graham, 40, 42
bone-anchored hearing aid (BAHA), 55
Braidwood, Thomas, 35
brains, 6, 18, 19, 27, 45
Bulwer, John, 30
candling, 42
Cardano, Girolamo, 30, 31
cats, 12, 13
cerumen. See earwax
children, 20, 22
see also teaching deaf children
Clerc, Laurent, 37
closed captions, 45
cochlea, 6, 1617, 5455
cochlear implants, 78, 9, 45, 55
Cogswell, Alice, 3536, 37
complete hearing loss, 1011
conductive hearing loss, 1921, 24, 27
deafness. See hearing loss
de Leon, Pedro Ponce, 32
de LEpee, Charles-Michel, 3233, 33, 35,
36

discrimination against deaf people, 28,

30
dogs, 12, 50, 51
ear canals, 12, 14, 21, 25
eardrums, 14, 25, 27
ears, 11, 1218, 13, 21
protecting, 4849, 49, 50, 52
ear trumpets, 42, 42
earwax, 12, 14, 21, 21, 25
Eustachian tubes, 16, 20
fluid, 6, 19, 20, 20
Gallaudet, Thomas Hopkins, 36, 3637,
40
Gallaudet University, 37, 38, 40
Goa IV (king, Portugal), 41
hair cells, 17, 17, 19, 24, 55
hearing, description of, 1119
hearing aids, 7, 42, 4243, 4647, 47,
5455
hearing loss
description of, 1011, 1921, 2425,
27
hereditary, 21, 24, 34
history of, 2845
living with, 4647, 5255
treatments for, 21, 4142, 5455
Heinicke, Samuel, 35
Hoy, William Dummy, 38
Hubbard, Paul, 38
incus bones, 14, 15
infections, 6, 1920, 20, 24, 25, 42
inner ears, 11, 1618, 17, 1920, 20,
21, 24, 25, 27
lip reading, 40, 41

61

Hearing Disorders

malleus bones, 14, 15

Marthas Vineyard, hearing loss on,
34
middle ears, 11, 1416, 20, 5455
mixed hearing loss, 24
Mosquito device, 22, 23
nerves, auditory, 1718
noise-induced hearing loss, 4849,
49
ossicles, 1415, 15, 1617, 20
otoscopy, 25, 26
outer ears, 11, 12, 14
oval window membranes, 16
partial hearing loss, 1011
pinna, 12
presbycusis. See age, hearing loss and
semicircular canals, 19
sensorineural hearing loss, 21, 24
sign language, 7, 7, 8, 30, 3235,
3839, 39, 40, 53
sound, 10, 1112, 14, 1618
speaking tubes, 41
speech, learning, 8, 35
sports, sign language in, 3839, 39
stapes bones, 1415, 15, 1617
Stapleton, Howard, 22
teaching deaf children, 30, 3233, 33,
3537, 4041
telephone typewriter (TTY), 4345, 44
tests for hearing loss, 2527, 26
tinnitus, 2425
tuning forks, 25, 27
tympanic cavities, 15, 16
tympanic membranes. See eardrums
vestibular systems, 19
vocalizing, 35, 4041

62

VPAD+ (videophone), 53
Weitbrecht, Robert, 43
Whitestone, Heather, 28, 29, 45

About the Author

Henry Wouk is a writer who lives in Western Massachussetts. He
has authored more than a dozen books on health and science
and has written articles for a variety of national magazines.

63