Tuesday, February 14, 2012

The Importance of Aural (Auditory) Rehabilitation

While searching online, I found a really interesting article about the importance of aural (auditory) rehabilitation for adults with Cochlear Implants. I think that the topics and ideas presented in this article can be important for rehabilitation after any implant. The article is titled Making a Sound Connection: Rehabilitation for Adults with Cochlear Implants, was written by Mary Koch, MA, CED, and can be found on pg 6 of the following link: http://hearingjourney.com/userfiles/File/BionicBeat_Vol3Iss1_2006_1.pdf

What I found particularly interesting about this article is that we do not actually hear with our ears, we hear with our brains. [info from the rest of this paragraph did not come from this article. this was written by me based off my understanding of how we hear and how hearing loss affects the ear. i hope that it is portrayed accurately (in easy to understand laymen terms) but please refer to the professionals for more detailed information about these topics.] This actually makes sense when you think about how we hear. Sound enters our ears and the frequencies of sound are transformed into electrical signals as they pass through the middle ear to the Cochlea. The Cochlea stimulates thousands of tiny hair-like cells which send electrical signals to the brain to be interpreted. This is where our ability to understand what is being spoken comes into play. For most individuals with sensorineural hearing loss (like myself), the hair-like cells and/or parts of the Cochlea have been damaged which then affects how sound signals are converted into electrical signals and sent to brain. What is great about the Envoy Esteem Implant is that it, in theory, bypasses the damaged parts (i.e., Cochlea and hair like cells) and instead transforms and processes electrical signals through the Esteem processor. Each individuals processor is programed to meet the specific needs of each recipient based on their level of hearing loss. These "altered" and "improved" electrical signals are then send back through the system and to the brain for interpretation. 

As stated in this article, one of the biggest misconceptions of receiving a hearing implants is that the understanding piece of the puzzle will come immediately as we gain more sound and volume. However, while we can hear sound better because of the implant, our brain does not always immediately make sense of these signals right away. Additionally, this article also mentioned that the longer a person is hard or hearing, the more challenging it can be for them to be able to recall and form meaning of sound. In order to bring this understanding piece into play, we must form new auditory pathways as well as the memory skill to be able to retain the sounds. The purpose of Aural (auditory) therapy is to imprint this information in our brain so that these connections can be built more rapidly leading to greater success with the device.

The article also presents Norman Erber’s Heirarchy of Auditory Skill Development, which is essentially the process in which our brain learns to understand.
  • The first step in the process is Detection. This is the stage in which we become aware of our capacity to hear, as detected through an audiogram.
  • The second step is Discrimination. This is our ability to differentiate between the sounds that we are hearing. This is actually what I am currently practicing through my therapy. 
  • The third step is Identification. By going through the sound discrimination exercises, we are essentially imprinting our auditory memory with these sounds so that we are able to recognize and start putting meaning to these sounds.
  • The fourth and final step is Comprehension. This is our ability to hear by simply listening and at this level we are finally able to fully engage in conversation. 
These are just a few of the interesting things I found throughout this article. This article also provides some resources for getting yourself started on the aural rehabilitation track (and how those around you can help). Also, I have been exploring websites that provide free online practice tools so will be posting those soon for those who are interested. 

Monday, February 13, 2012

Life Since Adjustment

Since my adjustment in December, things got off to a slow start due to being sick and the fluids in my ear, but for the last couple of weeks, things have been getting progressively better! I thought I would take a moment to reflect on how things have generally been going since my readjustment.


Until about 3 weeks ago, I was not able to turn my volume past 7. Every time I tried, I would get high pitched feedback. However, in the last 3 weeks I have been able to make it all the way up to volume 10 and I have to say I am LOVING the volume gain (I want even more!) and cannot express what a difference it makes! After going a month without being able to change the settings, I never thought that I would actually make it to this level! This is very exciting not only because of the volume gain I am getting but also because it means that I am healing and the fluids are starting to drain!


I found that I spend most of my time on the "A" profile, which is considered my "Everyday" setting. I have tried the other settings but this is the most comfortable for me in almost all situations. I am not really crazy about my "C" profile ("Music/TV Watching" setting). I feel like the sound of swallowing is so distracting it is difficult to focus on anything else. When I am on this profile I feel like my ears are going to explode. I have this weird ear popping sensation. It is almost like there is too much base which is making my ear feel lots of pressure. I have not been out too much in the last month, but my "B" profile (i.e., background noise setting) has been pretty great! I found that it works better at bars/clubs where the the loud noise is more constant than when out to dinner at a restaurant. I have actually preferred to stay on the A setting when I am out to eat.


I found that I am finally starting to gain some of the distant noises I have been wanting. I actually attended a lecture for work which took place in a large classroom. I was seated towards the back right and heard every word except when I was thinking about how surprised I was to actually be hearing!  So, I guess I missed a few parts but more of an attention issue than a hearing issue. However, this is still not "perfect". At the end of the lecture, there was Q and A. I did have trouble understanding other peoples' questions. It is weird that some voices can sound so loud, while others are too quiet. I wonder if something like this can be addressed in my next adjustment or if this is just the nature of speech?

Since my readjustment, I feel that I take much more notice to the sound of walking. Shoes hitting the floor. Legs rubbing together. I feel like I make such a commotion when I am walking around my office that it makes me want to tiptoe sometimes. Since our production room is right by my office, I have found myself very distracted by the sound of the printer. I often get so distracted that I have to close my door. Also, I noticed that the heat vents in my office make a squeaky noise when they are on and running. Not to say that I am not grateful but it is crazy how I never noticed this before because it can be quite annoying...

I feel like the dishwasher in our home gets increasingly loud every time I turn up my Esteem device. Being on volume 10, I found the dishwasher so loud that one time, I started yelling at my husband to stop using his electric saw in the basement. I was so confused! The sound was so loud that I thought it sounded like someone using heavy machinery. haha. 


I haven't been able to wear sun glasses for almost 6 months since the side of my head is still a bit tender when I put pressure against it. When I tried them out this week, I realized that it doesn't hurt anymore!

Well, that is all I can think of at the moment!