American Abilities Program Guide

During this broadcast, the Sound Tips™ ticker connects brain, balance, and pain research to hearing health. The balance system lives in the inner ear, right beside the hearing system — so dizziness, vertigo, and unsteadiness often travel with hearing loss and tinnitus, and a balance problem is a good reason to ask for a hearing evaluation too. About one-third of U.S. adults experience an anxiety disorder at some point in their lives, and stress and anxiety can make tinnitus feel louder and harder to ignore; relaxation, good sleep, and talking with a health care provider all help. Depression research offers hope: NIH studies showed ketamine can lift major depression within hours, and that work has opened a new direction for treatment. Chronic pain affects tens of millions of American adults, and the NIH HEAL Initiative is funding research into better, safer ways to manage it — because pain, stress, poor sleep, and hearing problems often reinforce one another. Tips: tell your doctor about ringing, dizziness, or unsteadiness; protect your hearing in noise; and remember that mental health care is health care.

During this broadcast, the Sound Tips™ ticker focuses on the littlest ears: about 2 to 3 of every 1,000 babies in the United States are born with a detectable hearing loss in one or both ears, and more than 6,000 infants born in 2022 were identified with a permanent hearing loss. The ticker explains why every newborn should be screened before leaving the hospital — screened by 1 month of age, diagnosed by 3 months, and in early intervention by 6 months — and why early testing matters through infancy, childhood, and the teenage years: hearing loss that goes undetected can delay a child's speech, language, social, and emotional development. Parents will also hear the warning signs to watch for at home: a baby who does not startle at loud noises, a 6-month-old who does not turn toward sound, a 1-year-old who is not saying 'mama' or 'dada,' or a child who keeps turning the television volume up.

The Sound Tips™ ticker turns to the illnesses that can put a child's hearing at risk. Congenital CMV — cytomegalovirus — is the most common infectious cause of birth defects in the United States: about 1 in 200 babies is born with it, and about 1 in 5 of those will have long-term health problems, including hearing loss that can appear or worsen after a newborn hearing screen is passed. The ticker also covers bacterial meningitis, which can damage hearing permanently, and repeated middle-ear infections, one of the most common childhood causes of temporary — and sometimes lasting — hearing loss. And because good nourishment protects developing ears, the ticker shares how shortages of vitamins A, C, and E and of zinc, iron, and iodine are linked to poorer hearing and to ear infections that heal poorly — and what a hearing-healthy plate looks like for a growing child.

The Sound Tips™ ticker looks at children's hearing across communities. Nationally, about 14.9% of children ages 6 to 19 show some low- or high-frequency hearing loss, and about 15% of adolescents ages 12 to 19 are affected. The most recent national data show hearing in children is largely similar across racial and ethnic groups — white, Black, and Hispanic children alike — with family income, not ethnicity, among the strongest childhood risk factors; among adults, hearing loss is most common in non-Hispanic white adults and lowest in non-Hispanic Black adults. The ticker closes the series with a parent's checklist: keep well-child hearing checks, treat ear infections promptly, keep immunizations current, feed growing bodies well, and protect young ears from loud sound — because every child's hearing is worth protecting.

During this broadcast, the Sound Tips™ ticker explains that military noise, blasts, and traumatic brain injury can affect more than hearing thresholds: veterans may experience hearing loss, tinnitus, difficulty understanding speech in noise, sound sensitivity, dizziness, or other auditory-processing problems even when a standard hearing test does not tell the whole story. Research also shows that tinnitus commonly co-occurs with TBI, PTSD, anxiety, and depression; these are associations, not proof that one condition causes another. The ticker encourages veterans to report every hearing and communication symptom, protect their hearing from further hazardous noise, and seek a complete evaluation. Veterans enrolled in VA health care can contact VA Audiology directly without a referral for testing, hearing technology, rehabilitation, tinnitus education, and counseling. Because women remain underrepresented in much veteran hearing and TBI research, listening to their individual experiences is essential to better care and a stronger community.

During this broadcast, the Sound Tips™ ticker explains that about 19% of U.S. students ages 12 to 18 reported being bullied at school in 2021–22, and that children and teenagers with disabilities face an elevated risk. Deaf and hard-of-hearing students may be targeted because of communication differences or social isolation, but hearing aids and cochlear implants are not the problem: safe, inclusive school environments and strong peer and adult support matter. Viewers learn warning signs — unexplained injuries, lost belongings, headaches or stomachaches, sleep changes, falling grades, avoiding school, lost friendships, or feelings of helplessness — and how to respond: listen without blame, document what happened, involve the school, and encourage witnesses to get a trusted adult rather than intervene unsafely. Daily, age-appropriate conversations help children know they can ask for help. Bullying is associated with anxiety, depression, isolation, and poorer learning; it does not by itself cause hearing loss. A blow to the head or ear, or an extremely loud sound used to harass someone, can injure hearing and needs prompt medical attention.

During this broadcast, the Sound Tips™ ticker follows hearing health across the lifespan. Loud noise can cause permanent hearing loss, and everyday sounds — lawn mowers, power tools, recreational vehicles, and loud music — contribute. According to CDC, about 1 in 4 U.S. adults who say their hearing is excellent or good already show signs of noise-induced hearing damage, and about 70% of people exposed to loud noise seldom or never wear hearing protection. The World Health Organization estimates that more than 1 billion young people are at risk from unsafe listening. Sounds at or above 85 decibels can damage hearing with long or repeated exposure. Tips: move away from loud sound, turn the volume down, limit listening time, and use earplugs or earmuffs. For pre-molded earplugs, choose the right size, reach over your head to pull the ear up and back, insert the plug until it seals, and check the fit — your own voice should sound deeper. Warning signs include ringing in the ears and trouble following conversations in noise. Hearing checks belong in routine health care at every age, and research supported by NIDCD continues to improve diagnosis, prevention, and treatment.

During this broadcast, the Sound Tips™ ticker explains how trauma and hearing health intersect. About 6 out of every 100 U.S. adults will experience PTSD in their lifetime; among veterans the rate is about 7 out of 100, rising to as many as 29 out of 100 for those who served in Iraq and Afghanistan. Roughly one in three veterans receiving care for tinnitus also carries a PTSD diagnosis, and veterans with PTSD report more sound-tolerance problems — ordinary sounds can feel startling or overwhelming. Blast exposure links the two conditions directly: service members exposed to blasts report twice the prevalence of hearing difficulty, and research shows much of that connection runs through PTSD itself. Injured personnel with hearing loss in both ears have nearly three times the odds of a PTSD diagnosis. PTSD can also heighten how burdensome hearing problems feel, even when a hearing test reads normal — hypervigilance changes the experience of sound. Tips: sudden loud sounds can trigger symptoms, so hearing care should be predictable and consent-based; treating PTSD often improves hearing outcomes too; and veterans can reach VA hearing and mental health care directly. If someone discloses trauma, listen without pressing for details, believe them, and help them connect to care.

During this broadcast, the Sound Tips™ ticker connects breast cancer care with hearing health. Some cancer treatments can harm hearing: platinum chemotherapy drugs such as cisplatin and carboplatin are known to be ototoxic, meaning they can damage the inner ear, and some patients report tinnitus (ringing) or hearing changes during or after treatment. Chemotherapy-related hearing loss often starts with high-pitched sounds, so it can go unnoticed at first. Tips: before treatment, ask your oncology team whether any of your medicines can affect hearing, and ask for a baseline hearing test; report ringing, fullness, dizziness, or trouble following conversation right away; and bring a trusted person to appointments, since stress and fatigue make hard-of-hearing listening even harder. Family history matters: having close blood relatives with breast or ovarian cancer can raise your risk, and genetic counseling can help you decide on testing. About 1 in every 100 breast cancers in the U.S. is found in a man. Black women are about as likely as white women to get breast cancer but are more likely to die from it, which is why early screening and equal access to care matter. Viewers with hearing loss have the right to ask for interpreters, captions, or assistive listening at medical visits.

During this broadcast, the Sound Tips™ ticker connects hearing loss to work and benefits. Hearing loss is one of the most common disabilities among working-age adults, and Social Security's disability programs cover people whose hearing loss, alone or with other conditions, keeps them from substantial work. The Ticket to Work Help Line serves deaf and hard-of-hearing callers directly at 1-866-968-7842 (voice) or 1-866-833-2967 (TTY). Work Incentives can let you test a job while keeping Medicare or Medicaid and, in many cases, cash benefits — a myth says working ends benefits immediately, and it is not true. Tips: if hearing loss affects your work, ask about a hearing evaluation and workplace accommodations such as captioned phones, amplified headsets, and quiet meeting spaces; tell your employer what communication works best for you; talk with a benefits counselor before you start a job so there are no surprises; and remember that vocational rehabilitation agencies can help with hearing aids and other technology needed for employment.

During this broadcast, the Sound Tips™ ticker brings hearing into the Whole Health picture. Tinnitus and hearing loss are consistently among the most common service-connected disabilities in VA’s annual benefits reporting, so hearing belongs in every veteran’s personal health plan. Loud noise from weapons, aircraft, engines, and machinery can permanently damage the inner ear, and noise-induced hearing loss is preventable with proper hearing protection. Whole Health tips: add a hearing check to your health goals; tell your care team about ringing, muffled sound, or trouble following conversations; stress and poor sleep can make tinnitus feel worse, so mind-body practices like tai chi, mindful breathing, and good sleep habits can help you cope; protect your hearing at the range, at work, and at concerts; and bring a trusted person to appointments if listening is hard. Veterans enrolled in VA health care can reach VA audiology for hearing tests, hearing aids, and tinnitus care.

During this broadcast, the Sound Tips™ ticker connects Parkinson’s disease and hearing. A 2024 JAMA Neurology study of nearly 3.6 million U.S. veterans with hearing tests, led by researchers from OHSU and VA Portland, found that hearing loss was linked to a higher risk of later developing Parkinson’s, and the risk rose with more severe hearing loss. Veterans fitted with hearing aids within two years of a hearing-loss diagnosis appeared to have lower risk, though the study shows a link rather than proof of cause. Parkinson’s can also make a person’s voice softer and flatter, so conversations get harder on both sides when hearing loss is involved. Tips: get your hearing tested and wear hearing aids if they are recommended; ask about speech therapy for a soft voice; face each other and reduce background noise when talking; stay active, because exercise is part of Parkinson’s treatment; and talk openly with your care team and family about when it is time for a driving evaluation.

During this broadcast, the Sound Tips™ ticker focuses on hearing loss in the workplace. Under the Americans with Disabilities Act, employers with 15 or more employees generally cannot discriminate against qualified workers or job applicants because of hearing loss, and they must provide reasonable accommodations unless doing so would cause undue hardship. Common accommodations include sign language interpreters, captioning (CART) for meetings, written communication, amplified or captioned phones, visual or vibrating alarms, and quiet workspaces. You choose whether and when to tell an employer about your hearing loss. The Job Accommodation Network (askjan.org) offers free, confidential guidance for both workers and employers. Tips: know your rights before an interview; ask for accommodations in writing; and protect the hearing you have, because loud noise at work can cause permanent, preventable hearing loss, so wear hearing protection. Social Security beneficiaries can explore work without automatically losing benefits: Ticket to Work and work incentives are explained at choosework.ssa.gov.

Climate change is a health story, and some of its effects reach the ears. Extreme heat is among the deadliest weather hazards — the World Health Organization estimates roughly 489,000 heat-related deaths worldwide each year — and heat-related deaths among people over 65 rose about 85 percent between the early 2000s and 2021. Severe dehydration can reduce blood flow to the inner ear and has been linked to sudden sensorineural hearing loss, so drink water and take heat warnings seriously. Long-term exposure to air pollutants such as nitrogen dioxide and carbon monoxide is associated with a higher risk of sensorineural hearing loss, and wildfire smoke carries fine particles and chemicals recognized as environmental ototoxicants. Climate shifts are also expanding the range of infectious diseases; bacterial meningitis, which leaves 1 in 5 survivors with severe complications including permanent hearing loss, spreads more easily during disasters. And noise itself is an environmental health burden — traffic noise alone costs Western Europe at least one million healthy life years every year. If you or someone you love has hearing loss, prepare before the emergency: use a NOAA Weather Radio with strobe light or bed-shaker alerts, keep hearing aids and cochlear implant processors in one easy-to-find place, and carry paper, pens, or communication cards in your emergency kit.

PTSD is treatable, and the treatments with the strongest evidence are trauma-focused psychotherapies. The VA/DoD Clinical Practice Guideline recommends Cognitive Processing Therapy, Prolonged Exposure, and EMDR as the most effective PTSD treatments — they produce greater improvement than medications, and the improvement lasts longer. For those who prefer medication, paroxetine, sertraline, and venlafaxine have the strongest support. Sleep is often the first casualty: insomnia is reported by 90 to 100 percent of Vietnam-era veterans with PTSD, and 92 percent of active duty personnel with PTSD report clinically significant insomnia, compared with 28 percent without PTSD. Nearly half of people with lifetime PTSD — 44.6 percent — also meet criteria for an alcohol or substance use disorder; veterans with PTSD are twice as likely to have an alcohol use disorder and three times as likely to have a drug use disorder. Free help is close at hand: the PTSD Coach app offers symptom tracking and coping tools, AboutFace shares unscripted veteran stories, and the PTSD Family Coach app supports loved ones. Families can help by learning about PTSD, offering to join doctor visits, and planning low-stress time together. Recreation counts too — PGA HOPE, the only adaptive golf program with a formal VA agreement, serves more than 4,500 veterans a year. And if you have a VA claim exam coming, know that it is based on DSM-5 criteria and conducted by board-certified psychiatrists or licensed psychologists — go prepared to describe your symptoms honestly.

Life in space is loud — and astronauts can't walk away from it. The International Space Station hums with ventilation fans, pumps, and machinery around the clock; measured background levels inside its modules run about 56 to 69 decibels, and crews live with that sound every hour of every day for missions lasting six months or more, because the life-support systems that keep them breathing never shut off. Close quarters make it worse — there is no quiet room, and NASA reports that since 2008 more than a third of crew noise measurements have exceeded the agency's strict flight-rule limits. NASA fights back: every piece of equipment is acoustically tested before it flies, quiet fans and sound-absorbing barriers dampen the noisiest hardware, alarms must stand out at least 20 decibels above the cabin noise, crew members wear acoustic monitors to track their daily exposure, and they even take hearing tests aboard the station. Weightlessness adds a quieter challenge: without gravity pulling body fluids toward the legs, blood and fluid shift toward the head, and NASA studies have found low-frequency hearing shifts of up to 10 decibels in some crew members — possibly linked to pressure changes in the inner ear. On the ground, the same physics applies: sound at or above 85 decibels — about the level of heavy city traffic — can damage hearing with long or repeated exposure, and noise-induced hearing loss is permanent but almost entirely preventable. The World Health Organization estimates more than a billion young people worldwide risk hearing damage from unsafe listening, especially through earbuds and headphones. A few habits protect your hearing for a lifetime: keep personal audio at no more than 60 percent of maximum volume for no more than 60 minutes at a time, move away from loud sound sources when you can, and carry earplugs for concerts, power tools, and loud events. If you notice ringing in your ears or trouble following conversation in a noisy room, treat it as an early warning and ask for a hearing check — the same vigilance NASA applies 250 miles above the Earth works just as well in your living room.

During this broadcast, Sound Tips™ shares what sickle cell disease can mean for hearing — a connection few families ever hear about. Sickle cell disease affects about 100,000 Americans, occurring in roughly 1 in 365 Black or African-American births and 1 in 16,300 Hispanic-American births, and about 1 in 13 Black babies is born with sickle cell trait. Research shows adults with sickle cell face about six times the risk of sensorineural hearing loss, and children about three times — the same vaso-occlusion that causes pain crises can starve the cochlea of oxygen, sometimes causing sudden hearing loss that doctors describe as an inner ear stroke. Some treatments carry their own risk: the iron chelator deferoxamine has been linked to hearing loss in a substantial share of transfusion-dependent patients, so regular hearing tests belong in every sickle cell care plan. The ticker also shares daily management guidance: drink plenty of water, avoid extreme heat and cold, keep vaccinations current, wash hands often to prevent infection, and see a hematologist regularly. Newborn screening for sickle cell now happens in every state — early diagnosis saves lives. And because sickle cell has many faces, families of every background should know the signs.

During this broadcast, Sound Tips™ shares the hearing connection hiding inside attention problems. About 11.4% of U.S. children — 7.1 million — have received an ADHD diagnosis, and an estimated 15.5 million adults live with one. But the CDC cautions that a child who seems not to listen, ignores their name, or doesn't follow directions may actually have an undetected hearing loss — behaviors easily mistaken for not paying attention. Auditory processing disorder, where the ears hear but the brain struggles to make sense of speech, can also look exactly like ADHD, and the two can occur together. That's why a hearing evaluation belongs in every attention or behavior workup before a diagnosis is finalized. The ticker also notes that adults with tinnitus report anxiety at nearly three times the rate of those without it — ringing ears and an anxious mind often travel together, and treating one can ease the other. Parents are offered simple signs to watch: a child who constantly says "huh?", struggles most in background noise, or turns the TV up loud may need their hearing checked, while attention that falters even in quiet points a different direction. And for viewers whose children use Jane the Brain's calming skills, the message is the same: understanding what a child is really experiencing is the first step to helping them.

Military service is loud. Jet engines, flight lines, weapons, generators, and vehicles expose Airmen to hazardous noise, and deployments add dust and debris that make hearing protection harder to wear well. According to the Department of Defense, hearing loss and tinnitus — a ringing, buzzing, or whistling in the ears — are among the top three reasons for VA disability compensation claims. Noise is the main cause: years of repeated unprotected exposure, or even one unprotected blast of extremely loud sound. The Air Force runs a Hearing Conservation Program with regular hearing tests for Airmen in noisy jobs, and Defense Department policy now requires hearing-protector fit testing for personnel with high noise exposure, because protection only works when it fits. Sound Tips™ for service members, veterans, and families: wear earplugs or earmuffs every time around loud equipment, on or off duty; ask for a fit test; get hearing checked regularly and report ringing or muffled hearing right away; and veterans with hearing loss or tinnitus can seek care and benefits through the VA.

Every newborn should have a hearing screening before leaving the hospital. About 2 to 3 of every 1,000 U.S. babies are born with detectable hearing loss, and follow the 1-3-6 guideline: screen by 1 month, complete a diagnosis by 3 months, and begin early intervention by 6 months. If a baby does not pass the screening, go to the follow-up test — a missed screen is not a diagnosis, but it should never be skipped. Heart defects are the most common birth defect, affecting nearly 1 in 100 births, about 40,000 babies a year; about 1 in 4 of them is critical. A simple, painless pulse-oximetry test after 24 hours of age can find critical heart defects, and mandated screening has cut early infant deaths from them by about a third. Birth defects affect about 1 in 33 U.S. babies. Some can be prevented: there is no known safe amount of alcohol during pregnancy, and fetal alcohol spectrum disorders last a lifetime and can include hearing problems. Tips for families: ask for your baby's screening results before discharge, keep every follow-up appointment, watch whether your baby startles at loud sounds and turns toward voices, and treat repeated ear infections promptly.

Weight and hearing are connected. About 4 in 10 U.S. adults and about 1 in 5 children and teens have obesity. Studies of U.S. teenagers found that teens with obesity were about twice as likely to show signs of hearing loss, including early signs of noise damage. A large meta-analysis of adult studies linked obesity with higher odds of hearing loss. These are associations, not proof that weight causes hearing loss; one explanation researchers are studying is that the inner ear depends on healthy blood flow. Diabetes matters too: hearing loss is about twice as common in adults with diabetes, so anyone with diabetes should get hearing checked regularly. Overweight and obesity are also linked to a higher risk of 13 types of cancer. Sound Tips™ for families: eat more vegetables, fruits, and whole grains; choose water over sugary drinks; aim for 60 minutes of activity a day for kids and 150 minutes a week for adults; limit screen time and turn down the headphones while you exercise; and ask your doctor for a hearing check along with your blood sugar and blood pressure.

Hearing health is an equity issue too. Hearing loss can affect anyone, but access to hearing care is not equal. National studies of older Americans found that Black adults were more likely than white adults to have had a recent hearing test, yet were not more likely to use hearing aids; white adults and people with higher incomes and more education were more likely to use them. Research among Hispanic and Latino older adults has also found low hearing aid use. Cost, insurance coverage, transportation, language, and trust all play a role. The good news: since 2022, the FDA has allowed hearing aids to be sold over the counter without a prescription or exam for adults 18 and older with perceived mild to moderate hearing loss, which can lower cost and make them easier to get. REACH-style solutions apply to hearing too: bring hearing screening to churches, health fairs, and community centers; offer information in people's own languages; train community health workers to recognize hearing loss; and make captions and interpreters standard at every health event. Sound Tips™ for families: get a hearing test, ask about lower-cost options, and remember that treating hearing loss helps you stay connected at work, at home, and in your community.

Blasts that injure the brain often injure hearing too. Service members exposed to blasts can develop hearing loss, tinnitus (ringing in the ears), and dizziness or balance problems, and some have trouble understanding speech in noisy places even when a standard hearing test looks normal, because the brain's ability to process sound can be affected. Tinnitus in veterans is closely tied to mental health, and more severe tinnitus goes along with more symptoms of depression, anxiety, and PTSD. Sound Tips™ for veterans and families: after any blast or head injury, ask for a full hearing and balance evaluation, not just a quick screening; tell the care team about ringing, dizziness, or trouble following conversations; reduce background noise, face the speaker, and use captions to make conversations easier; include family members in appointments; and contact VA Audiology to get started with hearing care.

Sound Tips™ for this Columbus Day broadcast looks at hearing health among Indigenous Peoples — Native Americans, Alaska Natives, and tribal communities, from children to adults, including members of the Tongva tribe. Research shows hearing loss affects American Indian and Alaska Native adults more often than non-Hispanic white adults — roughly 6.5% to 10.4% versus 3.7% to 6.7% of adults 45 and older — and hearing loss in these communities often travels with other health concerns. Ear infections and middle-ear disease are a major reason: studies of Native children, from mass surveys on the Navajo Nation to research in rural Alaska and among First Nations school children, have repeatedly found high rates of middle-ear disease and hearing loss — in one First Nations school study, more than 20% of children. Tips for families and tribal communities: treat ear infections early and completely, keep up regular hearing screenings for children and adults, and ask a school, clinic, or Indian Health Service provider for a full hearing evaluation if a child or elder seems to struggle to hear.