Assessment of Impaired Hearing

Abstract

<p><b>The meaning of 'normal'</b><br/>In this text the term <i>normal</i> has been used as a shorthand way of describing levels at threshold for tones or speech that are not elevated beyond certain recognized limits. Where possible I have avoided use of the term altogether for two major reasons. First, the term has connotations of 'proper', 'correct', etc., and its use in place of <i>hearing</i> (as opposed to deaf or <i>partially deaf</i>) perpetuates the evaluative labelling that adheres to the latter states. It is only hearing people who are 'normal'; deaf people are thus 'abnormal'. It is time such evaluative descriptions were done away with, so that 'hearing' can be recognized as having a different but no lesser or greater status than 'deaf'.</p> <p>The other reason for trying to avoid the use of <i>normal</i> is because the term refers to a person's response on tests. One's hearing is 'normal' if the level at threshold is at or around 0 dB on an audiogram. The bulk of this [article] is taken up with a rather convoluted exploration of this state of affairs. Let me point out from the start that application of the term normal to the audiogram trace begs the question about that trace's validity in differentiating hearing from partially hearing listeners ... Traditionally, <i>normal</i> refers to zero level at tonal threshold, hence it applies as a label not broadly to people who hear but quite narrowly to people who hear tones at very low output levels. If we bracket, for the moment, the issue of validity and take it that this capability (hearing acuteness) is a sufficient measure of hearing capacity in general, then it follows that <i>normal</i> applies only to people with highly acute hearing. This application of the term is fitting, in that <i>normal</i> means <i>not deviating from a standard</i>. But the term <i>normal</i> also means <i>ordinary</i> or <i>as a rule</i>. The question then is, can audiometric zero function as a 'normal standard'? Does it represent <i>ordinary</i> hearing? I will show, after a necessarily circuitous critique, that a certain zero level no longer in use can be taken to represent an 'ordinary standard' for hearing, but that the currently used zero represents highly acute and hence non­ normal hearing.</p>