Cochlear Implant Rehabilitation for Adults
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Self-Learning Tips: Part 1

Posted By Naama Tsach, PhD, Tuesday, April 12, 2016
Updated: Monday, April 11, 2016
Post surgical support for many adults consists mainly of appointments with their CI audiologist for the purpose of monitoring speech perception and mapping the sound processor. If you are one of many CI users who does not have access to a Speech Language Pathologist, this post will have special relevance for you.

Practical tips for self- learning auditory rehabilitation

• In the absence of speech language therapist to help manage the rehabilitation process, you are the case manager of your own rehabilitation. This is an important responsibility with many implications.

• First, you will need to pursue available professional resources yourself. Ask questions of your mapping audiologist and don't wait until your next meeting if you need answers. Immediate answers can be crucial. Report any changes in your hearing or other issues to your CI team.

• Ensure that you understand how to maintain and use your processor. The recipient kit comes with different accessories. You might not need them during the initial period of using your CI, but later on they can be very useful. Ask for professional guidance to enjoy the full benefits of your technology.

• Use your CI regularly throughout the day. If there are any restrictions or difficulties in your CI daily use, inform your audiologist and look for suitable solutions.

• Knowledge can be a great source of strength. In order to acquire this knowledge, participate in lectures and conferences, read professional papers and books, visit the online website for the company that manufactured your device, and stay abreast of technological improvements.

• Online CI users groups can provide you with many practical answers as well as emotional support.

• Document your hearing follow-up outcomes and ask your audiologist to explain any changes.

• Offer to participate in research at your CI center. This could provide you with additional knowledge as well as additional opportunities to meet and talk with the CI team.

• Be optimistic but realistic about your rehabilitation goals. Discuss your goals with your audiologist. Setting realistic rehabilitation goals is often the key to a sense of accomplishment and success.

• Be aware of the fact that spontaneous auditory learning during natural situations is not always possible. Typical everyday (noisy) acoustic conditions mask parts of the speech signal. In addition, natural communication interactions include a lot of inaccessible speech information (e.g. multiparty conversations, classroom situations, group meetings, and so on). Therefore, especially in the first period of your CI experience, you need to set aside time in a favorable setting to practice your hearing skills.

• Ask family members and friends to help clarify sounds. Choose one person to be your auditory trainer. If possible, this person should accompany you to as many meetings with your CI team as they can to help motivate you to acquire auditory skills. It may require lots of patience on their part for the repetitive practice required for success. They will also want to be there when you wish to share your concerns and frustrations. From my experience, these partners experience high levels of satisfaction and gratification for your trust and for the chance to be a part of such an important phase of your life.

• Know that auditory learning after cochlear implantation is a long-term process, characterized by changes in objectives and in the pace of progress along the way. We will discuss this issue in the future. However, for now, it is important to note that efficient auditory learning should become part of your daily life. This is not a short-term effort, but a long-term commitment.

In my next post, I will share information on specific recorded and other materials that you may find useful in your auditory self-learning rehabilitation program.

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Mary Beth Napoli says...
Posted Tuesday, April 12, 2016
Keep your posts coming! I look forward to reading your suggestions. Thank you.
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Janet Clarke Au.D. says...
Posted Tuesday, April 12, 2016
"spontaneous auditory learning during natural situations is not always possible." - this is a great phrase and one that many adults who lost hearing progressively do not "embrace." Since "neurons that fire together wire together" and the brain craves repetition to rewire those circuits that aid the eventual comprehension of speech, music, etc. the dedicated listening time with those "boring" auditory (re)habilitation tasks is so critical! Thank you for the great phrase I quoted at the top of this comment - it's a keeper!
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Administration says...
Posted Tuesday, April 12, 2016
I am happy to see that this adult AR blog is up and running. I feel that post-linguistically deafened adults are a misunderstood, and hence underserved, group. Though the CI team I am on at the Dallas Ear Institute has aural rehabilitation services for all children and adults who receive CIs, I have heard that many implant centers do not offer or recognize the high level of importance of aural rehab and counseling for the adult recipients. Many know of my 40 years of work with children with hearing loss including children with multiple disabilities: in the past I had my less experienced staff therapists work with the post-linguistically deafened adults. Since these CI recipients could already speak and had prior auditorily-based language, I thought their auditory needs were met by guiding them through a listening hierarchy. Over the past few years, I have had the opportunity to see many of the new adults in my practice myself: as a result, I have had my eyes and ears opened to the complex educational and counseling needs of this group and the same for people close to them.

I now see that the need for patient education and psychosocial support and counseling are in many cases greater than their need and desire for listening work each week. Due to the frankness of several men who come for therapy, I was educated that there is often a big gulf between the audiologist’s praise for improved speech recognition scores in the sound booth and the individuals’ communication function in daily life. As one gentleman put it, “I don’t live in a sound booth: my life does not reflect the improvement I show in the booth.”

As I have engaged in increasingly honest dialogue with my adult recipients, my work has changed quite dramatically. From their feedback, I started an adult support group six months ago and host in my office each month. We discuss/share on a new topic each meeting. The support and comradery they offer each other is heartfelt and they are so hungry to be together and share the joys and struggles of being a CI user. Typically the high performers do not feel a big need for the group and those who are really struggling don’t come because they cannot hear/understand the sharing (I am working on some ways to include them). Those in the range of performance between these extremes can’t wait till the next meeting. This has been a most gratifying expansion of my career. I am currently exploring means for online video therapy to assist those who do not have such services.

Linda Daniel, MS, MA, CCC, Lic. Aud.
Director, HEAR In Dallas
Cert. Auditory-Verbal Therapist
cell: 214.282.9238
fax: 214.350.3439
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The mission of the American Cochlear Implant (ACI) Alliance is to advance access to the gift of hearing provided by cochlear implantation through research, advocacy and awareness.