Cochlear Implant Rehabilitation for Adults
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Audio Books

Posted By Naama Tsach, PhD, Thursday, November 2, 2017
Updated: Thursday, November 2, 2017

Favorite Home Practice Tools to Improve Speech Understanding:
Audio Books, Speech Sounds, and More


Audio Books: Why people like them for auditory practice

Audio books are widespread and accessible. They include wide-ranging topics and are available for non-fiction, biography and fiction and span many different languages and personal interests. Many adult CI recipients use audio books as a home practice tool to improve their speech understanding skills. Usually the narrator is a clear speaker who is reading at a normal speech pace (meaning not too fast). While listening to audio books, you can read along with the written text if you wish. These are significant positives, making the use of audio books the most common self-practice tool for adult CI recipients.

Audio Books: What’s their downside as a practice tool?

Anyone who has used audio books knows that there are also some negatives associated with their use as a practice tool. First, recorded speech sounds different from natural speech because the acoustic signal is restricted (contains fewer auditory cues) and therefore might be more difficult to process. Secondly, the content is sometimes recorded at a pace which may be too fast and overly challenging for a CI recipient—depending upon where they are in their rehab process. It may be technically impossible to slow down the narrator’s reading speed. (And if it is possible to slow the pace, this could cause distortion of the speech signal.) Some audio books have background music that make the speech even more difficult to understand. In addition, listening to audio books requires more than just good speech perception of everyday language as book text may use less frequently used vocabulary, longer sentences, and more complex syntax.

One can look at the use of audio books from two perspectives:

  • On the one hand, for many people, they are too difficult to use, especially during the early rehabilitation timeframe (when the motivation to practice is the highest but auditory skills are still limited).
  • On the other hand, they provide challenging practice. For individuals who are able to cope with the complexity they provide, audio books can be an effective and engaging practice tool.

More ways to practice your auditory skills

Speech sounds can be presented either solitary (/s/), as part of a syllable (/sa/), or in a single word context (bus). Good speech understanding does not always indicate that someone has excellent perception of speech sounds. For example, the last word in the following sentence can be perceived—regardless of one’s access to all of the acoustic information: "I bought a new _a_"(car).” If the CI user knew that the person talking had an old car that was always breaking down, he would have contextual knowledge that supports speech understanding even when all of the words heard were not understood.

So if words can be understood based on context cues, why is it so important to improve the accuracy of speech sound perception? In order to capture new words with minimal linguistic redundancy, you must be able to perceive the word's components. This is also true in cases of single word presentations or proper names when there is no context to enable someone to fill in the gaps. In addition, knowing which sounds you perceive less well, or which sounds tend to get mixed up with others (e.g., /b/ with /p/, /k/ with /t/) will help your audiologist fine tune and to monitor your CI.

Practicing understanding simple greetings, questions and simple sentences is easy to do and can be very rewarding when you implement these skills into your everyday life.

  • You might practice recognizing the names of friends, co-workers and relatives.
  • You may find it useful to practice single letters, numbers and other words that may help ("c like Charley") clarify words that you are having difficulty with.

Improving auditory memory skills and capacity may make it easier for you to follow sentences, conversations, and even lectures. You can use word lists that contain letters, numbers, and words related to different topics (i.e., shopping, food ingredients, packing for travel, city and country names) and practice different repetition tasks. Start with two words and gradually increase the number. You can also practice auditory memory by using sentences, such as understanding instructions with ascending complexity (1) take the book and put it on the table, (2) take the pencil and put it on the table, (3) take the pencil and put it on the book. More advanced practice could include recall of details from a short story or recipe, or how to get from your home to another location with specific directions.

Comprehensive practice of hearing skills might include the activities above and more. Many of these suggested activities rely upon the assistance of another person. In the next post, we will discuss some guidelines and tips for relatives or friends who assist you with your home training.

Good luck.


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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.