The most common complaint from some one with hearing loss is "I can hear but I cannot understand". This is because hearing loss leads to three kinds of communication difficulties.

1. Difficulty hearing soft speech (loss of sensitivity)
Most people think that hearing loss is simply a reduction in loudness - something that makes speech and other sounds difficult to hear at 'normal' loudness levels.

When someone loses their sensitivity to soft sounds, these sounds need to be amplified to make them loud enough to hear. Simply turning up the volume (on a TV) or speaking a bit louder may be enough to compensate for a mild loss of sensitivity.

2. Difficulty hearing consonants (high-frequency loss)
People with high-frequency hearing loss usually have problems hearing and understanding soft, high-frequency (high pitch) consonants, such as t, sh, f , p, s, th.

When this happens, it become difficult to distinguish between words such as cap, cat, and catch. This can make it particularly hard to follow a conversation and can sometimes result in inappropriate answers to questions.

3. Difficulty understanding speech in noise (focus loss)
Some people who seem to have no problems understanding speech in quieter and one-to-one situations suddenly experience much greater problems when background noise is present.

The noise may not even be as loud as the level of speech, but it can still 'mask' or cover the speech sounds you need to hear to understand.

A person with normal hearing can generally separate the speech from the background sounds. But for someone with a hearing loss, background music, other people talking in a restaurant or even the noise of a car can make it very difficult to distinguish speech from the other sounds.

Usually a person with hearing loss experiences all these problems to varying degrees. Depending on the nature and severity of the hearing loss, some people have difficulties in only certain situations, whereas others might have problems hearing and understanding almost all the time.

While it might appear that some people practise 'selective listening' (he/she hears what they want to hear) a mild or high frequency hearing loss might be the true culprit.