Even the most sophisticated hearing aids basically amplify sound. This is very problematic for children who are born profoundly deaf, as I was, because hearing loss can occur from prolonged loud noise exposure even at relatively non-loud levels-- and that is for healthy ears. I was born with around 90 db hearing loss, well into the threshold for noise-induced hearing loss. My audiogram looked like a usual one, turned inside down, almost. I had most hearing (if that) in the highest and lowest frequencies; in fact I was testing at 60 db or better for the lowest sounds. Digital hearing aids are programmable to amplify sound in useful frequencies only and to dampen out background noise, but they are expensive. I can't speak for their effectiveness because these didn't exist when I was a child.
My hearing was worst at the speech frequencies themselves. So, my hearing aids were squealing sound at me at 90 dbs or better just for me to hear fragments of speech-- the vowels alone. If I wanted to hear any consonants, I'd have to hike my hearing aids to dangerously high levels, and suffer auditory shock, causing tinnitis and increased, temporary deafness. I had to wear hearing aids until I was twelve for school, for classrooms and speech therapy. Eventually, I turned mine low or off as much as I could, because they hurt. By my teens I was in torture just walking past loudspeakers which were too loud (at this time I had 95 dB hearing loss, but my pain threshold was lower than usual-- at around 110 dB instead of 120--a nearly 10-fold difference in sound intensity.)
When I say it hurt, I don't mean a nasty buzz. Nails on a blackboard isn't even quite it. I'm talking intense, pure pain delivered through the ears. Not a jab, agony. My heartbeat would skyrocket as I fought the urge to break the source of the painful sound. As usual, nobody around me seemed to notice.The pain and arousal would last for a long time after the sound had stopped; I'd have ringing. If this is not torture, then people don't know what torture means. Getting my wisdom teeth pulled was far less painful. There are very few things that hurt remotely as much as sound itself hurts the wounded ear.
Parents are often told that "deaf children want it easy" and that they won't listen and speak unless forced to. That's nonsense. Deaf children are like any other children, they want to talk to people around them. They want to know what's going on. I learned about "recruitment hearing" (recruitment means here "to increase manyfold") only when I was 16. An audiologist told me that deaf people had been called liars for decades when they complained of pain from sounds that hearing people didn't find painful. Then finally audiologists "discovered" recruitment hearing and deaf people were finally believed.
Recruitment hearing essentially occurs from a mix of both sensorineural damage and conductive issues. The cochlea has a membrane over it (the basiliar membrane) that helps transmit sound from the eardrum, and which also serves as a filter and pump to clear away the ions released by the hair cells. If this membrane doesn't work right-- too slack, let us say, sound may not be transmitted until it's very intense and then it's painful because the membrane is moving too much and actually injuring the cochlea itself. If the pump doesn't work right, then the hair cells will actually ring themselves to death from a single sound exposure-- this is called excitotoxicity.
I was not very sociable in high school. I had to avoid public events and parties because of loud music suddenly causing me pain out of nowhere. I joined clubs to do things, not party. Atfer college, I even considered the possiblity of getting cochlear implants, not to make me hear better, but because they'd cut off all sound except when I had the cochlear implants on. I could simply turn the cochlear implant off and be in blessed silence anywhere.
Then a decade or so later, nature eventually gave me what I wanted-- absolute deafness thanks to the slow suicide of my existing hair cells, frequency by frequency. Strange, remarkable. This excitotoxicity process was very specific. First a single high frequency ringing nonstop (I'd count as much as 100 rings a second. I'm not joking.) for a few minutes, and then it'd stop. I'd never hear that frequency again. Then another day, a second, lower frequency. And so on. When I realized my ears were ringing in very low pitches, I knew my ears were approaching total eclipse of sound.
As a kid, I didn't tell my parents my hearing aids hurt. I didn't have to wear them at home all the time. It was school I had to wear them for, and the school didn't care if I hurt or not. I tried my best to hear with them. I remember listening for cars and learning about the Doppler effect from the change in pitch; that was when I tuned them so they weren't loud. It was at speech therapy time that I was pushed to amplify so I could hear speech at all. The jump from silence to unbearably loud was tiny. Quantum, even. It'd be silence, faint, then pain, often in a single word. So I turned it down and couldn't hear anything at all.
No speech therapist or audiologist until I was sixteen even asked me if I hurt at all from being deaf. I didn't say anything. If I complained, I'd be treated like a crybaby, a liar. and they'd tell me to keep trying. They wouldn't change the rules. Those adults were not my friends. As a child I understood they only cared about making me do what they wanted. If I complained, they'd label me a troublemaker and lie to my parents in a heartbeat, and my parents might believe them.
It's easy for the general public to think deafness means numb ears. Untrue. In conductive deafness, the cochlea is intact; the sound is simply not travelling through to it correctly. Bone conduction hearing aids can help. In sensorineural hearing loss, the cochlea itself is damaged, right where sound meets nerves.
The ears in sensorineural hearing loss ARE wounded and may be continually wounded by auditory overload. This is why we must understand that deaf children who don't like wearing hearing aids are not rebels, but reacting as anybody would to a wound repeatedly being ripped apart, no matter how minor or major the pain might be.
This is just my own story. But I know I am not alone in having endured this sort of pain. This is why I am very interested in alternative sensory technology; why try force-feeding sensory information through damaged nerves, when you could bypass them altogether? For many deaf children nowadays, cochlear implants solve this issue. But not all can benefit from cochlear implants, simply because the auditory nerve is itself damaged, unrepairable, and painful.