How well do you understand your audiogram? Even for people who have lived with hearing loss for decades, it can be tricky to decipher. Xs and Ox signify your left and right ears. The high sounds are on the right side of the graph and the low sounds are to the left. Quiet is at the top and loud is at the bottom. Our audiologists try to explain it to us at each appointment, but because of the complexity, we often come away with a limited understanding that boils down to one thing: the degree of hearing loss we have. Yet, even that can be misleading since our hearing loss can vary widely across the frequency spectrum.
What if there was a better way? Jay Alan Zimmerman, a deaf musician and composer, believes he has created one. He calls it the Hearing Visualizer and it has three primary goals.
- Making the audiogram a picture of the hearing you do have, rather than how much your hearing deviates from “normal”
- Creating a more intuitive and user friendly format that helps people better understand the state of their hearing
- Allowing people to see how various hearing technologies could impact their potential field of hearing
Current Audiogram Framework Focuses on Loss Rather than Facts
The current audiogram format has been in use for over a century. It is likely overdue for an update. Jay describes the current audiogram as “not a picture of hearing, but a picture of loss.” From our very first visit to the audiologist, we spend time talking about what we can’t do rather than what we can. This may contribute to the stigma that often surrounds hearing loss.
Jay wants to update the language we use to describe hearing. Changing the audiogram may be the first step in doing so. “We understand seeing better because we use clear factual terms that describe the ability you have. In hearing we are still using sad ambiguous terms to describe the ability you don’t have,” Jay says. In vision, if you see near things better, you are called near-sighted. If you see better at distance, you are far-sighted. If at 20 feet, you can see what the average person sees at 20 feet, your vision is labeled 20/20.
Jay would like to use similar terms when describing hearing. If you need to be close to a certain sound to hear it, you would be deemed “near-hearing” for that tone. If you can hear it at distance, you would be “far-hearing.”
Hearing Visualizer Turns the Audiogram on its Head
The Hearing Visualizer takes the typical audiogram and turns it on its head, putting the person in the center and adjusting three main aspects of the standard audiogram format.
1. High pitches reside at the top of the page
Pitches are no longer shown across the bottom, but are arranged more logically, with high pitches at the top of the page and low pitches towards the bottom. In other words, high pitches are high and low pitches are low. The tones in speech are shown at mouth level.
2. Your right and left ear results are in their proper place
No longer two lines on a page, the hearing in your right and left ears form a hearing field that surrounds the central figure. The bottom scale is in decibels with louder sounds closer to the center. This depiction gives you an intuitive sense of loudness since we all know instinctively that sounds get louder as they move closer.
3. Your hearing field includes all tones
Because the audiogram was created with the invention of the telephone, it depicts only those tones needed to transmit speech over copper wire. It omits the highest and lowest tones, including the entire lower half of the piano. The Hearing Visualizer expands the spectrum of tones to include both very low and very high tones. This gives us a fuller sense of what we can hear that is less focused on speech.
The Hearing Field for Typical Hearing Looks Like this
Below we show the Hearing Visualizer for a person with typical hearing. The full range of sounds is shown up and down the page. The piano on the side gives you a sense of the tone depicted. How loud something needs to be in order for you to hear it (measured in decibels) runs across the bottom. The hearing field surrounds the central figure.
A person’s hearing field would be stored electronically so that it can be layered with information from various hearing technologies. What would this hearing aid do for my ability to hear speech tones? How would these headphones help me to understand conversation better on the phone? With the Hearing Visualizer, you can see your hearing field expand or contract under each scenario, giving you the power to make better technological decisions for your particular hearing.
To learn more about the Hearing Visualizer, watch Jay’s captioned video.
Readers, would you like to see a new format for the audiogram?
It’s refreshing to see an alternative approach to the traditional audiogram. What I don’t see in Jay’s video presentation is any mention of speech recognition measurement. Since Jay acknowledges that he is Deaf, perhaps others could build on his effort with a goal to add a visual speech and word recognition measure to The Hearing Visualizer. I look forward to seeing Jay’s effort further our ability to understand our hearing loss.
That is a great idea and an important point. Thank you for sharing your thoughts.
I think Jay Alan Zimmerman’s new take on the audiogram is brilliant! Even though the traditional audiogram has been explained to me many times I still don’t get it, but this I understood immediately. And being a musician myself I love that he puts it into the context of music as well as speech. There are so many things about hearing tests that seem outdated to me and I love to see fresh thinking applied to it. When I get my hearing tested at the audiologist, it’s the same test I remember having in grade school, which was 65 years ago – even the words used are familiar – cupcake, baseball, airplane, etc. High time that hearing testing gets a fresh approach!
Thank you, Shari, for sharing this with us!
So glad you liked it. I agree it is time for a new approach. Thanks for sharing your thoughts.
Wow, I would love to see this instead of the old audiogram! Do you have any idea if/when this will be be used by our audiologists? Do they know of this??
Thanks, Shari, for spreading the word about this!
Jay is hoping to share the concept with the audiology community as well. So glad you found it helpful. Thank you for your comment.
Aahhhh it’s about time! THANK YOU FOR THIS MR. ZIMMERMAN. Absolutely incredible. So clear and logical. Looong overdue. Stellar job on the YouTube video too. I’ve shared this with my family and close friends already. Definitely going to share it far and wide. Thank you for sharing this on your blog, Shari!
So glad you liked it! Thanks for sharing your thoughts.
I think parents and other relatives of children with hearing loss would feel so much better if they got something like this that communicates to them what the child *can* hear. This would have practical information for them that they can actually use!
Good point! Thank you for your comment.
A while back, a few of us hard of hearing types were thinking about how the vision concept of explaining hearing loss could help others comprehend our limits, and now I am reading about it! Using music as a platform is a fabulous idea.
Thank you for sharing your ideas.
As someone with the rare reverse-slope hearing loss in both ears, I would welcome a new audiogram design if it helped audiologists figure out how to better program hearing aids for those of us who don’t have the conventional ski slope hearing loss (using current audiogram terminology). But the new audiogram will have to include a clear explanation on how to accurately read it, and what that means for an audiologist to accurately program hearing aids to fit that person’s hearing loss, however nuanced it is.
Now that my audiologist just retired last year during the pandemic, I’m not looking forward to when I have to get a new set of hearing aids and have to teach him about reverse slope hearing loss if he’s never had a client with it before.
Yes, a clear explanation that works for both the audiologist and the consumer is critical. Thank you for sharing your thoughts.
I love this take on the audiogram & Jay’s way of visulaising it as It makes so much more sense. I too have had audiograms explained to me over many years & I do “get it” but I think many more people would be able to more quickly understand what their hearing test results mean by looking at Jay’s representation. They would then be in a better position to explain it to communication partners so that a clearer understanding could be shared all round. More inclusive hearing management strategies could then be more easily developed & implemented.
Thanks for sharing your impressions.
It should be extended to -10 dB like on the current audiograms. Some people do score that well.
Thanks for sharing your thoughts.
I agree. I really like this different approach and would also like to see it developed to include speech recognition.
Speech recognition is an important component. Thanks for sharing your thoughts.
very interesting – thank you for sharing
Thanks for your comment!
I am grateful to you for sharing this. There are days when I agree that every profession is a conspiracy against lay people, including my own. We invent our own secret languages and symbols to mystify the uninitiated. It is a shame that audiologists have to sell hearing aids like aluminum siding salesmen to make a living in the U.S… Especially since the hearing loss community is among the most economically disadvantaged. But I suspect that this new audiogram would help audiologists sell more hearing aids. I also want to second the observation that including a speech recognition component is critical. I never was tested as rigorously for speech recognition when I was wearing hearing aids as I am regularly tested for my cochlear implants.
Yes, speech recognition is a critical factor. Thank you for raising these points.
I can see where this type of chart would be useful for many but as a technician in the field of audio, I am used to seeing the inverse of a normal audiogram with “normal” at the top and deficiencies toward the bottom. It’s just the way I have been indoctrinated over the years.
Thank you for sharing your perspective on this topic.