118 I Can Hear But I Can’t Understand What is Being Said: Why?
Auditory Processing Disorder Test Auditory Processing Disorder in Adults

I Can Hear but I Can’t Understand What Is Being Said: Why?

Amanda Unrau
CCC-SLP
December 16, 2024
I Can Hear but I Can't Understand why

I can hear but can’t understand words. Why? It can be very frustrating to have seemingly normal hearing, yet be unable to understand what is being said. You may be able to hear sounds, but not be able to process them and interpret speech. This article will outline reasons for not comprehending what you hear, the difference between hearing and understanding, and what to do if you struggle to understand speech. 

Reasons for Hearing but Not Understanding Speech

Not comprehending what you hear can be caused by one of the possibilities described below. 

Auditory Processing Disorder

Auditory Processing Disorder (APD), or Central Auditory Processing Disorder (CAPD), impacts the ability to process incoming auditory information. Individuals with Auditory Processing Disorder can hear auditory information, but experience poor auditory discrimination skills. Symptoms include:

  • Difficulty localizing sound
  • Difficulty following multi-step directions
  • Difficulty understanding rapid speech or speech in noisy environments
  • Difficulty staying focused and avoiding distractions
  • Need for longer response time during conversation
  • Difficulty understanding sarcasm and jokes

High-Frequency Hearing Loss

High frequency hearing loss is the most common type of hearing loss, but it can often go undiagnosed. Sounds that are higher-pitched are harder for people to hear. These high frequency sounds are consonants, and these are the sounds that allow us to make distinctions between different words. For example, individuals with high frequency hearing loss may have trouble differentiating between “fair,” “there,” “chair,” “hair,” and “share.” Symptoms of high frequency hearing loss include:

  • Difficulty hearing speech in background noise
  • Unable to differentiate between similar words
  • Difficulty hearing consonants
  • Frequent misunderstandings in conversation

Hidden Hearing Loss

Individuals with normal hearing but trouble understanding speech in noisy backgrounds are described as having hidden hearing loss. It is believed that this is caused by damage to the nerve fibers, which is called cochlear synaptopathy. This damage interrupts communication with the brain. Causes of hidden hearing loss include certain medications, aging, or noise exposure. For example, you may find that sounds seem muffled after a concert. This is usually temporary, but it can cause damage along the auditory pathway. Over time, it can become more difficult to interpret certain sounds in noisy environments. Symptoms of hidden hearing loss include:

  • Straining to hear conversations in noisy environments
  • Preference for quiet environments
  • Frequent misinterpretation of speech
  • Difficulty focusing in loud environments

Language Delay or Disorder

A receptive language disorder is characterized by difficulty understanding incoming language. An individual may have a language disorder on its own, but it also coexists with many other conditions, such as cognitive impairments, autism, ADHD, and developmental delays. Symptoms of a language disorder include:

  • Difficulty following spoken instructions
  • Frequent need to ask for repetition
  • Difficulty participating appropriately in conversation
  • Limited vocabulary

ADHD

One of the major characteristics of ADHD is inattention. This lack of sustained attention can cause individuals with ADHD to miss auditory information. They may especially lose track of what is being said during longer or more complicated conversations. Symptoms of ADHD include:

  • Trouble taking turns during conversation
  • Topic changes
  • Often interrupts others 
  • Appear distracted when listening to others

Auditory Neuropathy

Auditory Neuropathy Spectrum Disorder (ANSD) affects how sound gets from the ear to the brain. Most types of hearing loss are due to a problem with the ear picking up sounds, but with ANSD, sound is detected by the inner ear, but the sound is not transmitted correctly to the brain. Symptoms include:

  • Normal hearing tests but difficulty understanding speech
  • Inconsistent hearing ability
  • Sounds seem distorted
  • Difficulty understanding speech in background noise
  • Tinnitus (ringing or buzzing in ears)

Hearing vs. Understanding: What’s the Difference?

Hearing and understanding are not the same thing. In order to understand auditory input, you must process what you hear. It takes much more effort and focus to understand auditory information than it does to hear a sound. Consider how we often tell others to stop what they are doing in order to listen when we want to tell them something important. We automatically know that someone won’t listen as well when they are on their phone because we need space to process one kind of information.

Speech must travel through your middle ear, inner ear, and auditory nerve before entering the brain, where these sounds are processed and interpreted. Any interruptions, such as background noise, can interfere with this process. For example, it is much harder for parents to comprehend a phone conversation when their kids are making noise in the background. 

What to Do If You Struggle to Understand Speech

If you suspect that you are hearing but not understanding speech, here are some actionable steps you can take:

  • Test for auditory processing disorder: The major characteristic of auditory processing disorder is the inability to process incoming auditory information, with normal hearing skills. Our free APD test is the perfect first step in determining if you should pursue further evaluation for APD. 
  • Have your hearing tested: An audiologist can administer and interpret a hearing test. They can also check your ears and ear canal for any physical disturbances. These results can help you narrow down the main issue and show you if you have a true hearing loss or not. 
  • Consult professionals: Professionals such as audiologists, ENTs/otolaryngologists, and speech language pathologists can all be helpful in determining why you are not comprehending what you hear. You may need to visit more than one professional in order to narrow down the underlying issue causing you to not understand words. Depending on what that is, they can recommend tools to help, such as hearing aids, speech therapy, or environmental modifications. 
  • Self-advocacy: If your difficulty understanding what is said impacts your daily life, you will need to learn to advocate for yourself in school, your workplace, and/or in social environments. You may need to ask others to speak slowly or more clearly, ask them to repeat what they said, sit close to the speaker, or choose to go to restaurants when they are less busy.
  • Therapies/training programs: It can be beneficial to work with a speech therapist or audiologist. During sessions with one of these professionals, you will learn strategies to help you improve your ability to understand speech. This may include writing things down, breaking down instructions into individual steps, and improving vocabulary skills. 

Using Forbrain to Help with Auditory Processing Disorder 

Another tool that can help those who have trouble understanding what they hear, such as those with auditory processing disorder, is Forbrain. Forbrain is an auditory feedback tool that individuals wear like a regular headset. Embedded with a microphone, this headset amplifies speech and incoming auditory information. This feedback improves attention to auditory input and helps people with APD understand speech better. Take the first step by taking our free APD test to identify your specific auditory challenges, possible solutions, and next steps.   

Final Words

If you struggle to comprehend what you hear, consider the possible reasons for this. Pursue further testing and consult with professionals in order to get the help you need. Parents, educators, and healthcare professionals, be sure to utilize the ideas presented in this article and share our free APD test with those who have difficulty understanding speech.

References

ASHA. (Accessed 2024, November 10). Central Auditory Processing Disorder. American Speech-Language-Hearing Association.  https://www.asha.org/Practice-Portal/Clinical-Topics/Central-Auditory-Processing-Disorder/#collapse_2

Childers, Linda. (2024, September 16). How Hearing Loss Affects Your Ability to Understand Words And Why Even Mild Hearing Loss Should Be Treated. Healthy Hearing. https://www.healthyhearing.com/report/53580-Speech-banana-speech-clarity-and-hearing-loss

Etudo, Margaret. (2023, September 3). Why You Can’t Hear in Some Situations. VeryWell Health. https://www.verywellhealth.com/hidden-hearing-loss-5218694

Lovering, Nancy. (2022, June 22). Does ADHD Affect Speech? PsychCentral. https://psychcentral.com/adhd/does-adhd-affect-speech

Melody Audiology. (Accessed 2024, December 14). How Does Auditory Neuropathy Affect Hearing: Frequently Asked Questions. Melody Hearing Clinic. https://melodyaudiology.com/faqs/how-does-auditory-neuropathy-affect-hearing/

Sarow, Amy. (2024, July 19). What is Hidden Hearing Loss? Soundly. https://www.soundly.com/blog/hidden-hearing-loss

Soft Hear. (2024, August 31). Auditory Neuropathy Spectrum Disorder: Understanding ANSD. Soft Hear. https://www.softhear.com/blog/auditory-neuropathy-spectrum-disorder-ansd/

Steele, Timothy. (2016, September 23). Hearing Vs. Understanding: A Complex Relationship. Widex. https://www.widex.com/en/blog/global/hearing-vs-understanding/  

Amanda Unrau

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Amanda is a speech language pathologist by day, and a freelance writer during the in between times. She has worked with children of all ages in a variety of private practice and school settings, as well as telepractice. She enjoys research and tries to make her speech therapy and writing as functional as possible.