How to Check for Hidden Hearing Loss / CAPD

For some individuals, significant hearing loss may be suspected because of greater than normal difficulty understanding speech in noisy environments, BUT... when standard hearing tests are performed, all testing comes back normal or better than expected. What's going on?

It's possible that such individuals may be suffering from "hidden hearing loss" or some type of central auditory processing disorder (CAPD). The ears can hear just fine which is why hearing tests come back normal... but the brain is having a hard time processing the sound information it receives from the ears. The greater than normal difficulty understanding speech in a noisy environment, for example a loud restaurant… is due to the brain having difficulty separating out relevant speech from other competing sounds whether random noise versus multiple speakers. There is nothing wrong with ear itself and its ability to hear the sounds. The problem is the brain. The analogous engineering concept is that the brain’s signal to noise processor is not working very well.

That said, there IS a type of hearing test called word-in-noise (WIN) or speech-in-noise (SIN) tests that can suggest possible hidden hearing loss if the standard hearing test battery comes back normal. To see if you may be suffering from hidden hearing loss, WIN testing is available on this website.

Please note that any online hearing test is not nearly as good or as reliable as one performed by a professional audiologist in a sound-proof booth. Results of any online hearing test is meant to only be a guide!

Here are the steps recommended to check for hidden hearing loss.

STEP 1: Take the online standard hearing test. If it comes back showing significant hearing loss, by definition, you do NOT have hidden hearing loss. Hearing aids are the next appropriate step to resolve your hearing loss. HOWEVER, if the hearing test comes back normal, or better than expected, go to step 2.

STEP 2: Take the online word-in-noise (WIN) test. If you do poorly on this test (assuming normal hearing on the standard test), you may be suffering from hidden hearing loss or CAPD! Do keep in mind that if you DO have significant hearing loss, then you will also do poorly on this test as well.

There is no medication to treat this condition, but music ear training has been found helpful for some patients. The best music to utilize for such ear training are songs that vary in pitch and melody. When listening to such songs, it is very important to really focus and work on isolating a single voice or melody while ignoring the other parts. Ideally, sing or hum each individual part to reinforce the sound isolation and improve its perception. Over time, the brain slowly rewires itself to improve the auditory processing centers of the brain to better "hear" speech in noisy environments. This improvement is no different from musicians who train their ears to achieve perfect pitch (or close to it) or detect if something sounds out of tune.

Another strategy is to listen to an audiobook at normal loudness levels while playing music in the background. Turn the music volume up just loud enough that it is a struggle to understand the audiobook. Over time, as it becomes easier to understand the audiobook, keep increasing the volume of the background music. Eventually, hidden hearing loss should slowly resolve.

Any information provided on this website should not be considered medical advice or a substitute for a consultation with a physician. If you have a medical problem, contact your local physician for diagnosis and treatment. Advertisements present are clearly labelled and in no way support the website or influence the contents. Please note that as an Amazon Associate, we may earn small commissions from qualifying purchases from Amazon.com.