Today I would like to share some thoughts about learning to listen, which is not the same as learning to hear.

When people come across the phrase “auditory training,” one often associates this term with computer-based listening practice. Alternatively, one might have an image of someone sitting in front of a speech-language pathologist covering his/her her mouth and asking the person to repeat words and sentences or answer questions.

However, when I work with my patients as part of their auditory rehab program, my goal is to help them become better listeners. Listening is more than being able to hear and repeat auditory stimuli. Who are the ones who will eventually benefit the most from their CIs? I believe it is those with congenital hearing loss who have been transformed into active listeners as well as those who lost their hearing later in life and then managed to recover their listening skills.

Why is it that adults who can hear with their cochlear implant(s) don’t necessarily listen?

People, especially those who have never heard before, may be accustomed to the option of living largely in a quiet world. They may prefer to not use their hearing technology in noisy environments, especially when it is unlikely to that they will be having any significant verbal communication (e.g., when using public transportation). Before cochlear implantation, some people have removed (or turned off) their hearing aids in uncomfortable auditory situations so their tendency is to do the same thing with their cochlear implant. Although their audiologist may encourage them to use their CI throughout their day, they may retain old habits and not  use their hearing device(s) for a few hours each day.

Other people will use their CIs throughout the day but will listen only to what they perceive as directed to them, as they used to do before. That is, they would listen to people who are talking to them and would ignore any other auditory stimuli. Therefore, they would miss a lot of significant information. 

What types of auditory stimuli may be missed by CI users?

·         Side or background conversations: if these conversations occur in proximity to you, the speakers may assume that you could (or even should) understand what has been said. Or, when two people at your place of work are talking about their preferences regarding the New Year’s party date, they might expect you to express your opinion or at least to be aware of their view.  

·         A comment or a question that is not directed to someone specifically, but can be significant, such as: “Does everybody know they are going to close the parking lot earlier today?”

·         Information provided during over public announcement systems at work, in transit stations (airports, train stations)

·         Background music anywhere (and everywhere)

These examples demonstrate huge challenges in terms of auditory perception and speech understanding. However, being aware of these situations and trying to get the most out of them would result in more attentive listening; active attempts to resolve insufficient understanding; better sense of orientation and inclusion; and Improved ability to apply your auditory skills into your everyday life.

What can an adult CI recipient do to improve their listening skills?

·         Strive to actively use your cochlear implant(s) throughout the day. If you have difficulty doing that, share your experience with your professional team (audiologist, speech pathologist). Many issues can be resolved with mapping, use of assistive listening devices, and/or a clinically-guided auditory rehabilitation program.

·         Know that indirect communication is significant and try to make use of any opportunity to listen during your daily routines. Think about the gain you may derive by being more attentive and more involved.

·         Examine how you might Improve acoustic conditions in your workplace and home.

·         Adjust your location at work that so you maximize visual access to as many people as possible. Try not to sit with your back turned into the center of the room which may prevent you from being able to make eye contact with co-workers.

·         Attempt dual tasking by practicing speech perception and auditory understanding skills while undertaking other (quiet) tasks (i.e., cooking, painting). This may help improve ability to react to speech even when you are busy with another activity.

·         Develop personal weekly listening goals.  These might include listening to public announcements at one’s workplace or when using public transportation (possibly with a co-worker or friend helping), listening to conversations between two other people when this occurs behind you, or listening to the GPS navigator in your car. (Try this last one when driving a known route so as not to be dependent on 100% speech understanding.)

Mastering Learning to Listen

It is not trivial to expect someone with hearing loss, who has been accustomed to attending only to speech that is directed at them, to start listening to a surge of auditory input from all directions. Even some people who had nearly normal hearing in the past but have been deaf for many years sometimes become selective listeners—focusing on speech that is addressed to them. Nonetheless, ongoing listening is a challenge worth taking on.

A few days ago, when I asked one of my patients how he did during the prior week, he told me that he surprisingly understood a short conversation between two people in his workplace without seeing them. I was thrilled! I knew he had made an amazing breakthrough. He has become more attentive to spoken communication occurring around him and is now more involved and oriented. The benefits for a CI user who becomes a good listener is not limited to his/her auditory rehab sessions because (s)he can use their "auditory training" in so many situations every day. I know that from now on my patient will progress at a faster rate and will better enjoy to a much greater degree the contribution that his cochlear implants make to his quality of life. And that is the point of it all!