Using Recorded or Other Materials in Self-Learning Rehabilitation
There are a number of recorded and written auditory rehabilitation programs that were developed specifically for rehabilitation post cochlear implantation. You may also use other general materials such as books on tape (in different lengths and linguistic levels but preferably with minimal background music or noise) or English as a Second Language teaching materials such as Rosetta Stone®.
• Using written materials will be more effective if you are able to be creative and adaptive in their use. In addition to repetition, be aware of the appropriate speech rate of the stimuli presentation. You can use the same stimuli in a more normal (higher) speech rate with time, as your speech perception skills improve. Similarly, you can use more speech-reading (lip-reading) cues during the first period of training, moving towards auditory-only perception with time. Another way to adjust the existing materials to your needs is to add stimuli that have specific relevance to your life. For example, you may include the names of your relatives and friends, common sentences from your everyday life and so on.
• Recorded materials are typically more difficult to understand than live voice and may pose greater auditory challenges. You may find recorded materials to be overly challenging during the early rehabilitation timeframe. If this is the case, try using them later when you are a more experienced CI user. Not every CI user has a positive experience with recorded materials so don’t feel that using them is a requirement. Adjust auditory training materials to your own auditory abilities.
• There are a number of interactive rehabilitation programs that run on one’s personal computer and are designed to help cochlear implant recipients practice and improve their listening skills. Some of these products are free including Angel Sound™ Tiger Speech available at http://angelsound.tigerspeech.com/.
• If you wish to develop your appreciation of music, practice listening while reading the lyrics for songs. These can typically be downloaded from music websites. You may wish to begin with children’s songs—which often have simple words, a strong beat and a limited number of instruments. When you feel you can move forward, build a hierarchical list of songs considering certain parameters. These parameters might include tempo, quantity and type of instruments, single vocalist songs versus multi-vocalist bands, etc. Even people with normal hearing are unable to understand every word in every song. Be selective about the songs you are choose and don't be surprised if you miss some words. It’s not a competition! You might also check out the websites of the CI companies for more tips and music listening products.
• When watching TV, try following some speakers without using captions.
• Talking on the phone presents special challenges and will be discussed separately in a future blog posting.
• Establishing and expanding auditory memory skills can have important implications for your ability to understand speech. The longer you had poor discrimination with your hearing aids, the longer and harder you must work on your auditory memory skills. This kind of work can be done using repetition tasks utilizing lists of words (e.g., repeating 2-5 words out of 10 word list). As your speech perception skills improve, you can use words from a given category (e.g., names of cars, football players) or a given topic (e.g., work, summer, vacation). For advanced CI users, you might repeat 2-3 sentences from a list of short sentences or work on perception of two-phase instructions (e.g., "Take your shirt and put it under the table") or listen to a short story and try to recall as many details as possible.
• Report specific difficulties in speech perception to your audiologist (e.g., the consonant /z/ perceived as /s/ and vice versa). Some difficulties may be resolved with mapping adjustments. Most will be resolved with CI usage and auditory practice. It is possible that you will not be able to identify all the consonants and vowels. However, it may not impede your communication interactions since people always use context combined with verbal information to understand speech.
In summary, there are many ways for you to improve your auditory skills outside of a formal rehabilitation program with a trained professional. The above is intended to give you ideas; your CI team may offer additional guidance. The world of sound surrounding us provides countless opportunities for auditory learning. It requires your attentiveness and dedication as well as constructive support from your family and friends. However, if there are emotional or other difficulties associated with adapting to your cochlear implant and the rehabilitation process, don’t try to do everything alone. Reach out to the appropriate professional for support in getting back on a positive track.
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