Understanding severe to profound hearing loss: A guide for audiologists and hearing care professionals

If you work in the hearing care industry, you may have noticed that each client's experience and journey with hearing loss is unique. The challenges are particularly daunting for those grappling with severe to profound hearing loss. This blog delves into the intricacies of severe to profound hearing loss, its impact on individuals, and how hearing care professionals (HCPs) and Audiologists can provide crucial support along the way. 

Additionally, it sheds light on an innovative hearing aid, the Motion Charge&Go SP X, tailored to address the needs of those with severe to profound hearing loss.

What is severe to profound hearing loss? 

Severe to profound hearing loss is characterized by significant damage to the ear's inner and outer hair cells, resulting in the loss of both audibility and frequency selectivity. This condition is often defined by audiometric thresholds, with values indicating severe loss ranging from 70 to 90 dB HL and values above 90 dB HL indicating profound loss. However, the inability to comprehend speech in challenging listening environments goes beyond these thresholds, emphasizing the complexity of this condition.

Factors contributing to hearing loss

According to the World Health Organization (WHO), over 1.5 billion individuals worldwide experience some form of hearing impairment, while 430 million of them have disabling hearing impairment. Hearing loss can happen at any age and can be caused by various factors, which are described below.

Noise pollution

In today's digital age, noise pollution is the primary culprit behind hearing loss. The widespread use of headphones, particularly among the younger generation, exposes individuals to prolonged periods of high-intensity sound, leading to potential hearing impairment. Moreover, occupations with loud environments, such as factory settings, pose a significant risk of noise-induced hearing loss.

According to a recent press release by the British Medical Journal, video gamers are at risk of developing irreversible hearing damage and tinnitus. A study involving over 50,000 gamers revealed that the sound levels they are exposed to often exceed permissible levels or are very close to them. The researchers have also noted that gamers tend to listen to high-intensity sounds for extended periods, which increases the risk of hearing impairment. Given the popularity of video games, greater public health efforts are needed to raise awareness about these potential hazards

Source : BMJ

Old age

As we age, certain parts of our ears lose elasticity, which can lead to a loss of hair cells, resulting in hearing impairment. The likelihood of experiencing disabling hearing loss increases significantly with age, ranging from 15.4% for 60-year-olds to 58.2% for those over 90. Moreover, if left untreated, hearing loss can dramatically increase the risk of dementia among the elderly.


Approximately half of all cases of hearing loss have a hereditary component. While newborn screenings may detect genetic hearing loss in some cases, signs may manifest later in life. Understanding one's genetic predisposition to hearing loss can inform early intervention strategies and personalized treatment plans.

Ear infection and tumors

Ear infections can cause fluid buildup in the middle ear, resulting in temporary or permanent hearing damage if left untreated. Similarly, noncancerous tumors such as acoustic neuromas can lead to hearing deficiency, with around 90% of people experiencing hearing loss on the affected side. Early detection and intervention are crucial in mitigating the impact of these conditions on hearing health.

Diseases and medications

Numerous diseases can cause mild to profound hearing loss, including chickenpox, mumps, meningitis, diabetes, rheumatoid arthritis, hypothyroidism, Lyme disease, and Meniere's disease. Additionally, certain prescription drugs used to treat severe infections, cancers, and heart issues can also lead to hearing loss. Some medications that fall under this category are antibiotics, large doses of aspirin, and chemotherapy medications such as carboplatin and cisplatin.

Ear wax

While earwax (or cerumen) serves a protective function in the ear canal, excessive production can lead to blockages and hearing loss. Improper cleaning methods, such as cotton swabs, may exacerbate the issue by pushing wax further into the ear canal. Safe and effective earwax removal techniques can help prevent hearing impairment associated with wax buildup.

Common challenges faced by individuals with hearing impairment

Hearing loss takes a profound toll on those affected, permeating both their physical and emotional well-being. It also significantly impacts society and the economy, leading to an annual global cost of $980 billion due to decreased productivity and social exclusion.
Let's delve into the physiological and emotional hurdles faced by those grappling with hearing impairment:

Social gatherings

People with hearing loss face difficulties in group conversations as they rely on visual cues and struggle to distinguish speakers among multiple voices. This can lead to isolation and withdrawal from social gatherings, especially for individuals with severe to profound hearing loss.

Noisy environments

Public places such as restaurants and shopping malls can be challenging for those who are hearing impaired. The constant background noise makes it difficult to communicate with others amid the unwanted chatter. Individuals with severe to profound hearing loss can easily pick up on low-frequency sounds, which travel better than high-frequency sounds. However, they may struggle to hear the high-clarity sounds of the person they are speaking with over competing noise.

Subtle sounds or lack of visual cues

When an individual is diagnosed with bilateral profound hearing loss, they might not be able to detect if someone is speaking softly without any visual cues. Moreover, individuals with severe to profound hearing loss usually depend on lip reading. This becomes impossible when the speaker is facing away, leading to missing out on the entire conversation.

Long-range listening

For the hard of hearing, it is easier to miss sounds that come from a faraway source, such as when someone speaks from the next room or a large hall. This is because the sound becomes quieter as it travels farther, making it more difficult for people with hearing issues to hear.

Telephone conversations

People with severe to profound hearing loss often struggle to follow phone conversations due to the absence of visual cues and overall loss of sound. However, with the help of a smart hearing aid that connects calls directly to the device, they can improve their ability to communicate over the phone.

Alarms and alerts

Individuals with hearing loss may miss sounds like phones, doorbells, and alarms, such as smoke detectors when the source of the sound is far away.

Mental health issues

The challenges discussed above can significantly impact a person’s self-confidence. Those with severe to profound hearing loss may opt to isolate themselves due to the fear of misunderstanding or mishearing others. This kind of social exclusion often results in feelings of loneliness and episodes of depression. 

Managing clients with severe to profound hearing loss 

People with severe to profound hearing loss might be a smaller group among your clientele. However, they have complex needs that require extra attention and expertise during fittings. 
Here are some tips based on the real-life experiences of a hearing rehabilitation specialist who has suffered severe to profound hearing loss. 

Focus on communication rehab along with hearing rehab

Restoring communication is not the same as restoring damaged hearing, especially for clients with severe to profound hearing loss. When hearing loss occurs over a prolonged period, it can cause significant damage to one's social communication skills, self-image, personality and ability to interpret social norms correctly. Therefore, it is essential to take personalized remedial action to assist clients in optimizing their communication function and selecting the best hearing aid for severe to profound hearing loss.

Reliance on visual cues

People with severe to profound hearing loss rely heavily on vision for communication, much like those who are prelingually hearing impaired. Even though this group may not identify as part of the deaf-signing community, audiologists could emphasize visual input as part of the rehabilitation process. Since amplification can't provide audibility across the entire speech spectrum in severe to profound cases, visual information from facial expressions and body language is crucial for effective communication. 
When fitting such clients, audiologists must face them and use clear speech without exaggerated lip movements. Furthermore, whenever culturally appropriate, male audiologists can ensure that facial hair does not affect lip movements and that hands and objects are kept away from the mouth while speaking.

Fluency in sign language

In most cases, post-lingual hearing-impaired people are somewhat familiar with sign language, if their hearing loss occurred in childhood. There are chances they were exposed to it at school or in social activities involving sign language users. Therefore, it is helpful if the hearing care specialist is proficient in sign language when working with these clients. However, caution should be exercised when using sign language, and it should not be used as the sole mode of communication when treating such cases.

Now that we have explored a few helpful measures to help clients with severe to profound hearing loss, let's explore a hearing aid designed specifically for this purpose.

Introducing Motion Charge&Go SP X: A super power solution for severe to profound hearing loss 

Fitting hearing aids for people with severe to profound hearing loss is challenging for audiologists or HCPs. These individuals rely heavily on their hearing aids and are sensitive to their performance. Complex hearing loss cases require a superpower hearing aid with superpower features.

Bonus material: Guide to fitting hearing aids for severe to profound hearing loss

The Signia Xperience platform with the Motion C&G SP device is an excellent option for wearers of power devices. The Signia Xperience fitting strategy (XFit) lets users choose between relevant gain and compression settings. Additionally, the Dynamic Soundscape Processing slider and the Signia Assistant help the wearer find a preferred sound balance for the best performance.

Motion C&G SP is the world’s first rechargeable SP device, with a wearing time of up to 61 hours. This ensures users can wear it throughout the day without worrying about running out of power.

Learn more about Motion Charge&Go SP X 

Final thoughts

Severe to profound hearing loss presents multifaceted challenges that demand tailored solutions and unwavering support from hearing care professionals. Results from one of our latest studies indicate that smart fitting decisions, along with advanced hearing instrument technology, are the key to assisting people with such extreme degrees of hearing impairment. By understanding the nuances of this condition and embracing innovative technologies like the Motion Charge&Go SP X, we can enhance the quality of life for individuals with severe to profound hearing loss. 

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