Tools for Improving Listening Skills
The success of your rehabilitation process depends on your follow through. A professional can help you set a course, but it is important for you to set aside time each day to use tools that can help make maximum use of your new access to sound. When practicing and working with tools, remember:
- Practice makes perfect—just as it does with golf, tennis, skiing, and dancing.
- Repetition and redundancy provide opportunity for the brain to learn new sounds.
- Working with a rehabilitation professional can help ensure you are practicing correctly and not reinforcing bad habits.
- Be sure to report back to your rehabilitation therapist and audiologist about how you are doing. If you consistently miss the same sounds or words, let them know.
All of the suggested tools should be used repeatedly and, if possible, every day over a designated period of time.
Side-by-side tracking is a good practice tool for those who have been newly implanted—either with a first or second cochlear implant. This exercise is done with a partner who sits beside the recipient and reads while the recipient follows along looking at the text. The partner then stops and the recipient picks up at the appropriate place. The task can be made more difficult by picking up the speed or even substituting selected words. Some general guidelines:
- Involve family and friends who are supportive.
- Start with easy materials and work up to harder materials.
- Have the person assisting sit beside you on the side of the implanted ear.
- Use regular volume (do not use a raised voice).
- Minimize background noise.
- Use speech that is full of expression and natural rhythm.
Books on Tape or Audio Books
Books on tape or audio books are an accessible and enjoyable form of rehabilitation. Some people prefer to begin practicing with familiar children’s books while others prefer adult books from the outset. To get the most out of these resources:
- Start out easy with speakers who are comfortable to listen to and have a clear voice.
- Look for tapes that have no background music or noise effects.
- If there is a gender preference, consider this in the selection.
- Begin by listening to tape + book initially and work up to listening to the tape alone.
Check out audio books at the library to see what selections work best for you. You can also purchase audio books of interest online at www.audible.com, and other websites. Some MP3 players have controls allowing the listener to slow down or speed up the speaker reading speed. Be sure to choose audio books that are unabridged so that you can track along with the book if you wish.
Additional tips on using audio books can be found in Cochlear Implant Rehabilitation: It's Not Just for Kids!.
Listening exercises can be tailored to your needs. Cochlear offers a number of products that can be introduced by your therapist and used in a therapy session or at home. A therapist will be able to determine where you are in the hierarchy of performance and then recommend appropriate exercises.
Nucleus Hear We Go! is a CD providing exercises for therapists working with teens. The exercises allow for selection of interests (e.g., sports, fashion, travel) and level.
Analytic Training is based on the assumption that speech is understood by recognizing the smallest distinguishing linguistic features and applying these to higher-level units of speech. It is a widely held view that analytic training alone is of limited value. (from Pedlez, K. et al. 2006, Adult Aural Rehabilitation: A Guide for CI Professionals, Cochlear, Ltd., page 11). Typically, analytic training is administered as part of a treatment plan that incorporates analytic and synthetic training with communication therapy.
Examples of analytic training exercises include:
- Syllable counting
- Word stress
- Vowel and consonant phonemes
- High-and low frequency identification
- Over-learned speech tasks
- Text following.
Synthetic Training provides an approximation of the speech perception tasks found in everyday communication. Clarification strategies are incorporated into these training exercises.
Examples of synthetic training exercises included in the guide include:
- Continuous discourse tracking for speech and in noise
- Topic of conversation using word, phrase, related sentence and unrelated sentence clues
- Context cues
- Information transfer activities
- Variations on open-set tasks
- Sentence predictability
- Seeking information
- Open-set sentences
- Comprehension tasks
- Scripted conversation
- Games and interactive activities.
Communication Therapy deals with ways in which cochlear implant recipients develop skills to establish and maintain successful conversations. It employs a conversational approach to rehabilitation and includes exercises such as: talking about talking, speech perception in conversational context, predictability, shaping conversational turns, confirming, clarifying, and repairing conversation and telephone training.
While not a specific tool, the HOPE Online seminar, Adult Cochlear Implant Rehabilitation: What and Why, is helpful for recipients to refine their approaches for clarification when speaking with others. The seminar reviews these objectives:
- Learn/re-learn strategies you used before cochlear implantation.
- Develop strategies to increase access to everyday conversation.
- Recognize when communication has failed and why and develop skills to re-establish communication.
- Emphasize turn taking, talking, listening.
- Bring aspects of communication under your control (without being controlling).
Some of your objectives might include:
- Anticipate elements of the setting so you can develop strategies that will work for you.
- Identify skills that help you maintain communication.
- Recognize when communication has failed so you can re-establish it.
- Select strategies that increase fluency and ease of conversation.
- Evaluate success and whether the strategies you chose were appropriate.
Interactive Computer Software
Interactive software products allow you to build listening skills at home and at your own pace. Research has shown that moderate training on targeted phonemes with computer assisted rehabilitation products may improve consonant and vowel recognition by as much as 15% (Fu, Q.J. et al. Moderate auditory training can improve speech perception of adult cochlear implant patients, ARLO 6(3), July 2005, pages 106-111).
Sound and WAY Beyond is a comprehensive computer software product available only from Cochlear. It provides a range of listening exercises that are appropriate for newly activated recipients as well as those who have had a cochlear implant for some time and wish to improve their listening skills in specific areas like hearing in noise and music appreciation. The software:
- is designed to improve vowel, consonant and sentence hearing.
- is designed to enhance telephone use and music enjoyment.
- features interactive, self-directed modules for adults and teens at all skill levels.
- features 10,000 sounds, words and sentences.
- allows user to print out reports and share results with their audiologist and therapist.