There is a difference between hearing and understanding. For instance, you can hear French but not necessarily understand it. Why is this? The brain must interpret what it hears. But in order to do this, it must be given as complete a sound as possible. It is important that all vowels (mostly Low frequency sounds) and all consonants (mostly high frequency sounds) are loud enough to be heard and processed. If there are no other problems, then the sound should be recognized as a word and meaning associated with it. Interference with speech understanding can occur for many reasons.

• Words spoken too quickly
• Foreign accent
• Voice inflexion
• Interference from background sounds
• Loss of Hearing, especially in the high frequencies

The hearing-impaired person may say, "I hear fine, but I just don't understand." This means a person hears the low frequency vowels, but does not hear enough of the high frequency consonant sounds to understand. For instance, if the word is mat and he only hears the "ma", the options can be map, math, mask, match, or mash. Lip reading and the context in which the word was used are necessary to help understand. "Please lay down on the mat so the exercises can begin." By watching the speaker’s face, the final "t" would not be mistaken for "th" or "k" sound since they do not look alike when formed on the lips. The context would also, in most cases, eliminate map, math, and mask as the alternatives.

A hearing-impairment may start with a mild high frequency hearing loss. This means that occasionally some words would be misunderstood, such as misunderstanding when spoken to softly, a shy grandchild or when you go to dinner. But as the high frequency loss becomes more and more severe, a greater number of the speech sounds are affected. The problem then becomes more global, causing difficulty understanding television no matter how loud; or not understanding your spouse in face to face conversations.

Hearing devices can help the hearing impaired "understand". New technology hearing instruments are capable of amplifying only the frequencies that are impaired and thus improve "understanding". However, if there are problems with the central auditory system, hearing aids, no matter how good they are, may not be of significant benefit. To determine what type of hearing loss you have and whether you may be helped, see your local hearing healthcare professional for a hearing evaluation.

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