Do hearing aids help maintain word recognition scores?

I brought this up in a previous post, but I’ll start fresh. It seems widely accepted that word recognition scores decrease with uncorrected hearing loss over time, regardless if adequate amplification is then used to make the words recognizable. Are there any studies that suggest that wearing hearing aids could slow or prevent this loss in word recognition scores?

I did some research and found a couple of studies. They’re done in kind of a weird way in my mind as they’re done with only one hearing aid and compare word recognition scores between ears. The first, which seems to be a classic is this one from 1993: Apparent auditory deprivation in children: implications of monaural versus binaural amplification. - PubMed - NCBI

It definitely suggests that a hearing aid can prevent decline in word recognition scores.

But then there’s this one from 2011: Long-term effects of hearing aids on word recognition scores. - PubMed - NCBI
which does not support that claim.

Anybody aware of any other studies? I’m sure to some this would seem similar to testing to see if parachutes save lives.

To me it’s an important question to answer. Perhaps word recognition scores just decrease with age and hearing aids don’t really help slow the decline. (That’s not what I believe, but my believing it does not make it so) If so, wearing hearing aids to preserve word recognition ability would be a fool’s errand. It wouldn’t mean wearing hearing aids was worthless as they obviously have benefits for improving communication in the here and now.


Interesting question. I don’t know about word recognition scores, per se, but after 1 1/2 years with my Signia’s I’ve noticed that I can avoid confusing more syllables with with some friends. But with other friends, there seems to be no difference, with vs without. Don’t know if it’s my HAs, my ears, or my brain… :wink:


I am working/researching this very subject right now. Talking to my audi. My word recognition is 75 in both ears. I am now tryng closed domes, to see if that makes a difference. Talking to my audi, I will have to go and get adjustments if I tolerate the difference between open vented domes and these closed. There is more bass I notice and maybe my brain will acclimate.

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I am not knowledgeable about the relationship between the hearing test slope and word recognition (Actually I don’t know much about HA or any other mechanism concerning HA and hearing), but this thread attracted my attention!

Today I went to the audio and ordered the molds for my OPN S1 because no matter what she has done, the sound has been echoey. When I asked her if I can no longer have social interactions, she told me that I won’t have normal hearing with HA, which I already knew, because of my low word recognition percentages, which I didn’t know. When I came home and looked at the old hearing tests, my word recognition dropped from 70% to68% (left) and from 75% to 52% (right). I noticed that there was significant drop on my right ear although I knew it while I was tested because the volume was too high. I told the audiologist (who is different from my current one) so. She went on testing while changing the test on right and lefty without telling me. The volume was good for left side but too loud for right side, and I didn’t have a chance to tell her so.

I have been wearing HA for more than 10 years. I haven’t been able to converse with people satisfactory for especially last 4-5 years (my Resound era). I am wondering if I lost the knack of hearing words especially English is my second language (as you can see from my writing). I wonder what is the relationship between hearing loss slope and word recognition percentages. Or there are no relationship?

Without my aids my word recognition in my right ear is under 40, with my ads it is over 90. I went without aids for over 20 years and I have been wearing aids for 15 years.

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That is encouraging to hear! Maybe it is possible for me to hear voices better.

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With correctly fitted aids you should, your hearing isn’t that bad. You just need the correct fit, and that takes you and your Audi working together the get that fit,it doesn’t happen over night it takes time and patience, for me almost 15 years of learning and trying different things. So many blame their aids for their hearing problems when it really is th fact that the person gives up and doesn’t keep working with their Audi to get the fit correctly done.
My saying is this you have to keep yours and your Audi’s feet to the fire until you get the best you can possibly get.


I just got back from a trip and it’s too late for me to go digging in pubmed, but you could also look at cochlear implant outcomes after auditory deprivation (typically they want people to be consistently aided before implantation). There’s other tangential stuff, off the top of my head: visual inputs invade the auditory areas of Deaf ASL users in fMRI, electrophysiology in cats shows abnormal organization in auditory areas after deprivation (reversible lesioning shows parital recovery after renewed auditory input but does not return to normal), phantom limb issues come from the neural co-opting of brain areas previously used for the lost limb. This is just what the brain does.

It would be nice to have something more direct, but keep in mind that WRS scores are a poor measure. People looking at changes in their own should use caution. If the words were presented live, you might as well dismiss the score completely. A drop from 70% to 68% isn’t actually significant. A drop from 75% to 52% might be, but presentation levels vary and clinicians don’t always take the time to hunt around for maximum performance.


From my experience I do know I lost speech recognition when I quit using aids for 4 years.
A couple years ago I realized my hearing was really getting bad so I got hearing aids going again. This time the word recognition has not come back as it did 10-11 years ago. It is a tuff battle to try and relearn understanding, frustrating.
The hearing appointment at Costco a few months ago showed I had 12% word recognition in each ear without aids. I am not sure what it is with aids but it is much better. Striving to have a comeback like cvkemp.
Only an opinion but I do believe hearing aids help maintain word recognition when used everyday.

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Thank you very much! Found some stuff on Cochlear implant outcomes and auditory deprivation. Seems clear that auditory deprivation makes outcomes worse, but there’s still a lot we don’t understand. Seems safe to say that hearing aids delay the progressive decline in word recognition. (I’m using “word recognition” in general, not word recognition scores. I agree they’re not a great measurement–I think largely because of so much inconsistency on how they’re administered.

Brain plasticity is fascinating: The Thinking Eye, the Seeing Brain is a great read and very counterintuitive.


From some research it is clear that word recognition is not in one’s ears but in one’s brain. Having said that, it is perfectly logical that when one stops stimulating the parts of the brain that do word recognition for extended periods the functionality will deteriorate just like any other neurologically based sense in the body. This is the reason why doctors don’t want to put hard inflexible solid casts on breaks if it can be avoided. The positional sensors in the joints start to atrophy in a matter of a few days of non-stimulation and one’s body quickly becomes “untrained” by disuse. There are some therapies for reversing some of this but most treatment of word recoginition problems are targeted at children, not functional adults. However, here is one item I did find that seems to target this condition: Auditory Therapy Program | Americans for Better Hearing Foundation


Personally I find it difficult to determine what keeps my word recognition scores low. One important factor is that th native language of person speaking single words is not same as mine. Another is that, even with HAs, I do not hear many sounds (frequencies) used in speach. Another is something in my brain, what ever that might be.

Earlier this year we were in Norway again and, much to my surprise, I started understanding more and more of our host’s Norwegian. This continued in Sweden and has persisted in USA with most speakers. Also, my ability to understand phone conversations has been improving. All of this with NO CHANGE in settings on my HAs – SO, seems logical to attribute this to my brain.

However, there is another major factor, ambient noise, including echos. In a quiet room, with only one person talking, I often can carry on a conversation “normally”, but, it requires my full attention and that speakers look at me when speaking. Speaker’s volume needs to be adequate but too loud results in decreased understanding, often totally. I am soon 80 years old and my hearing has been degrading for about 30 years. Hearing aids are, indeed, aids, but apparently nothing more.

Well “fitted” HAs are essential, but, that is something that requires good interactions between audiologist and patient, not a simple matter for my situation.

In closing, I consider well fitted HAs essential but, for me, quite inadequate to full return to previous ability to understand speach.


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My feeling is that HA’s help a lot in speech recognition and do keep the brain trained. On the other hand, I am very noise sensitive and I notice my HA’s also trigger tinnitus and possibly may have an adverse effect on my inner ear. So the question to me is: May there be a trade off between inner ear preservation and brain training?
Of course HA’s should be set such that they do not stress the ear too much. But on the other hand, everyone with healthy ears is advised not to wear HA’s due to potential damage of the ears. Why should my ears be less vulnarable? In fact they seem to be more vulnarable than the ears of people around me, as I can tolerate much less ambient noise (without HA’s). So I am hesitating wearing HA’s all the time even though I should to train my brain.
Is anyone aware of any literature / studies on such a trade off?


Your question recalls a question I had some months ago: What is difference between Noise Recruitment and Hyperacusis? I suggest you look them up on Google, etc and see which you think applies to you – and then ask your audiologist to run hearing test on your ears that can determine which you perhaps have. For me the answer was “Hyperacusis”.

Your question causes me to wonder how valid is your concern about HAs damaging the hearing of us wearers. I do know that my HAs supposedly have an adjustable upper limit for how loud a sound can be transmitted to my ears – I understand that all safe HAs have such limits and that these limits are adjustable. Suggest you query your audiologist about this for your HAs.

It is clear to me that my ears are quite sensitive to ambient noise and especially to sudden loud noises, which I experience every time some one speaks quite loudly so this old man can hear them – does NOT work!! I cringe and ask them to "Please! Just speak clearly, a bit slower and perhaps only a bit louder than “normal”.

What is origin of my Hyperacusis?? Donno, hope to remember to ask my audiologist next visit.

Thanks for asking!

When the hearing aids are in, or when you take them out again?

I have no clear diagnosis. Personally I suspect it is recruitement, as even in UCL testing it changes from quite OK loudness to painful very fast.
Thanks for your comment. I think I will discuss this with a specialist. So far my ear doctor has pointed out what recruitment is how that could correlate with my perception, but he neither made a clear diagnosis nor did he explain what other reasons may be.

I’d say both. Just more in general compared to periods where I do not wear HA’s at all.
I have different kind of tinnitus. One is a constant high frequency (it seems even in the range where I do not hear sound anymore) non sinusoidal noise / ringing. Some times, lower frequency more sinusoidal sounds appear and disappear. Luckily they have not stayed so far. I also have clicking sounds every now and then. My perception is that the more sound power my ears get, the more clicking sounds and the more single frequency tinnitus I have.

Do you wear them consistently? That is, any chance this is an onset effect that would go away over time?

My tinnitus does so strongly the oppozite that I am always interested by people whose tinnitus is aggravated my their hearing aids. Hearing aids take my tinnitus right down.

To understand the problem a little better I suggest folks take a look at the “speech banana” chart which is like an audiogram. Look for a marked up one that shows where various vowels and consonants are located. You will see that many consonants are a higher frequency sound whereas vowels are low frequency.
As our hearing deteriorates it is the high frequencies that go first and so we don’t even “hear” the sh, st, ch sounds as the condition worsens. We do best with people whose voices we are used to but those that have a different first language than English are very tough to understand. If you switch to a CI you will get back the ability to hear sounds in the 8000 frequency range so you have a chance to relearn and recognize these sounds. Lots of folks with a HA still can’t hear at 4000 or 5000 frequency. I have worn a CI as well as a HA for over a year now. And with learning with a CI comes lots of word recognition testing to see how you are doing. If you are lucky you can get back up to 90% again.
There’s a tone tester available on-line. That will run on your laptop. Check it out. Run up from say 200 frequency to 8000 and see how you do with your HA’s, as a pair or individually. It can be a bit of an eye opener.

Problems I see with the online tone test is that we don’t really know how loud we’re playing it and also I think many hearing aid feedback suppressors work on pure tones, so that may also come into play.