An increasing number of young people are being referred to audiology departments across the NHS due to hearing concerns. However, instead of finding impaired hearing, these individuals are often diagnosed with Auditory Processing Disorder (APD), a neurological condition that hinders sound comprehension. Five NHS audiology departments recently highlighted this trend, sparking questions about the potential link between the use of noise-cancelling headphones and the development of APD, particularly among the youth.
A YouGov survey reveals that a significant 61% of individuals aged 18-24 prefer watching television with subtitles, indicating a possible struggle with auditory processing. APD is prevalent among neurodiverse individuals, those with past brain injuries, and those who experienced middle-ear infections as children. Unlike typical hearing loss, APD involves difficulty in filtering and processing sounds, making background noise a significant challenge for those affected.
The brain's task of decoding numerous noises daily becomes particularly strenuous for individuals with APD. Sophie, a 25-year-old administration assistant, exemplifies this struggle. She was diagnosed with APD after experiencing difficulty identifying the source of sounds and feeling overwhelmed by noise. Her case underscores the challenges faced by many young individuals today.
"Even though I can hear that there are noises going on, I can't listen to where the noise is coming from. I know it's the person's voice, I just can't really compute it quick enough," – Sophie
Currently, the Royal National ENT and Eastman Hospital in England is the sole NHS provider offering comprehensive APD assessments. However, the waiting list extends up to nine months, reflecting a gap in resources and services available for diagnosing and treating this condition.
A UK-wide survey indicates that only 4% of audiologists consider themselves well-informed about APD. This lack of expertise may be attributed to the lengthy diagnostic process for APD, which requires extensive testing beyond standard audiograms. Prof Doris-Eva Bamiou highlights the complexity and cost of such services.
"It is a costly service because it is not just an audiogram, the test can take up to two hours and it requires additional assessments. In adults I also refer them for a cognitive assessment and in children I may also need to speak to an educational psychologist." – Prof Doris-Eva Bamiou
Despite these challenges, treatment for APD can significantly improve patients' lives. Microphones and low-gain hearing aids are sometimes provided to assist in specific situations, though adults outside the education system are not entitled to these aids through the NHS.
Dr. Angela Alexander advises reducing headphone usage time and utilizing transparency modes on devices to help improve auditory processing skills. She emphasizes the importance of auditory inputs for identifying environmental threats and managing anxiety levels related to auditory processing.
"Right now I can hear there is a fan above my head but my brain is telling me that is not something I need to worry about," – Dr Alexander
Claire Benton of the British Academy of Audiology echoes these concerns, suggesting that overuse of noise-cancelling headphones can create an artificial listening environment, potentially delaying the development of critical listening skills during adolescence.
"You have almost created this false environment by wearing those headphones of only listening to what you want to listen to. You are not having to work at it," – Claire Benton
Further research is required to fully understand the impact of noise-cancelling headphones on auditory processing abilities. Experts call for more studies to explore how these devices may contribute to APD development, especially in children whose brains are still maturing.
Renee Almeida underscores the distinction between hearing and listening, noting a decline in listening skills due to reduced exposure to diverse sounds.
"You have to hear a diversity of sounds so the brain can decide what is important to focus on." – Renee Almeida
