When to Refer

Diagnosing and treating early onset hearing loss can prevent and reduce further hearing loss.

Onset of Hearing Loss

Age related hearing loss is typically a gradual decrease in hearing ability over a period of time. The onset of hearing loss predominantly affects high frequency hearing region (high pitch sounds and consonants) first and gradually progresses towards low frequency hearing region (low pitch sounds such as male voices and vowels) of inner ear.

The high frequency sounds are most important for speech clarity and low frequency sounds are important for the loudness aspects of the speech. As you know now that the age related hearing loss and many other types of hearing losses start at the higher frequency regions of the inner ear, these individuals typically experience troubles with speech clarity and have no apparent difficulty hearing sounds around them. The background noise situations make conversation even more difficult to hear.

If you or someone you know has no apparent hearing difficulties but tend to have difficulty with speech clarity or following the speech in presence of background noise, you must get hearing checked. There is very good chance that you or your loved one might have an early stage hearing loss. The treatment solutions are most effective if the hearing loss is managed in early stages.

Just like routine general health checkup, periodic hearing check up should be part of every individual’s annual health plan.

Indicators of Early Onset Hearing Loss

  • No significant hearing difficulties but trouble with speech understanding
  • Increased hearing difficulties in presence of background noise
  • Unable to hear certain beeps, bells and high pitch noises such as air leak
  • Dementia and cognitive decline
  • History of recreational or occupational noise exposure
  • Ringing in the ears or tinnitus

When to Refer?

  • Complaints with ear and hearing
  • Suspected hearing loss
  • History of ear infections
  • History of occupational or recreational noise exposure
  • Constant or intermittent tinnitus
  • Vertigo or dizziness complaints


  • Family history of hearing impairment
  • Unusual intolerance to sounds
  • Impacted cerumen
  • Signs of dementia, depression and cognitive decline
  • Musicians and singers
  • Hearing aid users