Recruitment

Recruitment: When Sound is Painful

December 2001

Editor: Ever heard the term "recruitment"? It affects many people with hearing loss, yet few really understand what it is. Here's a great article from NVRC News that explains it very well.

~~~~~~~~~~~~~~~~~~~

The condition of recruitment causes your perception of sound to be exaggerated. Even though there is only a small increase in the noise levels, sound may seem much louder and it can distort and cause discomfort. Someone with recruitment can have problems only with specific sounds and frequencies or may have problems with all sound in general.

The most common response you get from a person suffering from recruitment is that if you raise your voice slightly, the person will say, "Don't shout". Your voice may sound slightly louder than normal, but the person suffering from recruitment perceives it to be shouting.

What Causes Recruitment?

Recruitment is most commonly associated with hearing loss, but it can often happen before a hearing loss develops if there is damage within the inner ear - especially the cochlea. Recruitment occurs when there is an abnormally rapid growth within the area of the cochlea that deals with the sensation of loudness.

This condition also occurs in Meniere's disease. The three core symptoms a person with Meniere's disease would suffer are hearing loss with recruitment, tinnitus and pressure in the ear which results in the person getting vertiginous episodes for weeks, months or sometimes years.

Coping with Recruitment

There is no cure for recruitment. The only thing you can do is to accept and try to adapt to living with this frustrating condition. However, there is some help at hand. Firstly the audiological technician can perform a test to ascertain how limited your Most Comfortable Loudness level is above the Speech Reception Threshold. This helps to determine whether a hearing aid would be acceptable for you or not.

If a hearing aid is found suitable, it may be possible to have one which is fitted with 'peak clipping' facilities, or in some cases 'compression' circuits. The aim of these refinements is to prevent sudden loud noises being amplified and causing pain. Once the aid is issued there will probably be a period of trial and error while altering the setting of the aid before an acceptable sound level is found.