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An artist tackles the challenges of navigating dense urban areas with hearing loss.

The multimedia artist Trish Adams began losing her hearing in her mid-twenties. She now wears high-end hearing aids in both ears and continues to communicate through speech. But living in a big city—in her case, Melbourne, Australia—can still be frustrating.

After moving to Melbourne, Adams started noticing how intrusive various urban sounds could be: traffic roaring, car horns honking, music blasting, jackhammers drilling. Cities also give rise to chance social interactions, a large part of their appeal, but a source of stress for those with hearing loss.

To help others understand how she experiences her city, Adams created the exhibit

Disconnections. Working with a psychologist who specializes in sensory processing and with the Creative interventions, Art and Rehabilitative Technology (CiART) lab at the Royal Melbourne Institute of Technology (RMIT), she made two video works, which debuted at the University of Melbourne in April.

The first, “Inaudible City,” is a projection of everyday scenes from Melbourne’s urban landscape. When it was exhibited, four soundtracks played on four sets of headphones, each representing the city’s sounds through a different auditory condition: low pitch removed, high pitch removed, raised ambient noise, and tinnitus.

The second, “Fractured_Message,” portrays a young man on the street talking to the viewer, presumably asking for help or directions, but in words the soundtrack renders incomprehensible. Watching the video, you feel a rising sense of unease at not being able to grasp what this man—right in front of you and now visibly annoyed at your silence—is saying.

Hearing impairment* isn’t a straightforward matter of all sounds being muffled or fading out. It’s a broad spectrum, from slight impairment (when hearing aids may be recommended) to profound deafness (when signing may be essential). Often, it’s surprisingly noisy. “Different noises override one another, and in fact, you can hear too much noise or distortion of noise,” Adams says.

Permanent hearing loss is usually sensorineural, caused by damage to the delicate hair cells in the cochlea, the inner ear. When those cells have been damaged, the ear “filters sound so it’s distorted,” explains Anne Oyler, an audiologist who works for the American Speech-Language-Hearing Association. “So no matter how loud we make [a sound], it would never be as crystal-clear as it was before. That’s why people will say, ‘Talking louder doesn’t help me.’”

Following a conversation in a noisy setting is difficult for anyone with sensorineural hearing loss. Sometimes even moderate noise can cause pain, because of a perceived increase in loudness called “recruitment.” Adams says the effort to compensate for her hearing impairment is mentally draining, so much so that she gets tinnitus when overtired.

Adams’ experience is as common as it is dispiriting. The World Health Organization estimates that 5 percent of the global population has a disabling hearing loss, and one-third of people 65 and over do. (Above age 75, it’s one-half, Oyler says.)

In the United States, the cusp of the vast Baby Boom generation is turning 70, which means tens of millions of Americans will be struggling with hearing loss in years to come. Most will delay getting help for it: Only 20 percent of people who need treatment for hearing loss seek it promptly. The rest hold out for years as their hearing deteriorates, until they can’t function or just can’t stand it any longer.

Fortunately, hearing-aid technology has made huge advances. Digital hearing aids can switch settings depending on background noise and often have directional microphones for focusing on the right sounds. There are even new devices you can control from your iPhone. The problem is cost. A single low-end hearing aid runs about $2,000, and most insurance plans don’t cover it. Oyler says audiologists are talking about ways to make treatment more affordable.

Design unquestionably has a role to play in making cities more sensitive to the hearing impaired. The features suggested by Adams seem like common sense: pedestrian areas separated from traffic, abundant green spaces, soft furnishings in restaurants that can absorb noise. Social awareness can help, too. If a person is struggling to hear you, face them when you speak and consider your environment; moving to another table or crossing the room can make a big difference.

Adams—who is looking for new opportunities to exhibit Disconnections, by the way—has one last piece of advice. If you’re talking to someone and can tell they didn’t understand what you just said, don’t brush it off and say, “It doesn’t matter.” It does.

*Note: Many people with hearing loss avoid using the audiological term “hearing impairment” and prefer to use “hearing loss,” and describe themselves as “hard of hearing” rather than “hearing impaired.”

Top image: aerogondo2 /

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