Improve your communication skills
Phonak Canada Audiologist Janet Clark shares resources that empower you to improve your communication skills for the most comprehensive hearing solution.
Auditory skills training is a technique used to enhance listening skills and improve speech understanding. After a diagnosis of hearing loss, it is important to train the brain to interpret and understand auditory information. This training is commonly referred to as "auditory rehabilitation" in adults.
- Learn about the new HearingSuccess portal - a toolkit for auditory skills training
- Get the maximum benefit from the technology you already have
- Find out how auditory skills training (hearing re/habilitation) can benefit you!
The hearing loss journey
So firstly, in terms of your journey with your hearing, we do know that hearing loss challenges are not completely fitted or eliminated after fitting a hearing aid or a cochlear implant. And I'm sure you've either spoken to those or had personal experience where the hearing aid has certainly given you a lot more awareness of sound. But it can sometimes, especially in the early days of getting hearing technology be somewhat overwhelming. And what we know is that if we can offer some additional tools to help people maximize the benefit from the hearing aid technology, then there are actually spinoff effects in terms of how people manage with particularly challenging situations, like hearing and noise, which is often the main reason that people end up going to a hearing clinic in the first place because they're starting to have some trouble hearing in background noise.
Okay. So why is, especially if you've plucked up the courage, gone in to get an assessment, acknowledge that you could benefit from some amplification, you've got a hearing aid, why are we saying that it isn't always enough just to have done that? So I'm just seeing some people are saying they've got an echo problem. I wonder if my volume's too high, if I bring it down a bit, is that too quiet? Is that any better, we'll just see if that helps. But what we know from research is that the brain is plastic. And by that we mean that if you rehearse or practice or perform certain functions over and over again, the brain actually commits those neural pathways that get fired when you do that particular activity. It cements those.
Now, if for example, you've been able to hear high pitch sounds for a long time, and then you gradually lose some of your hearing in the high pitched sounds, what can happen is the brain takes the area that would have processed those high-pitched sounds and it uses it for something else. So, it might start using it for some of the mid-range sounds or sometimes even other things altogether, like feelings or perceptions. So what we need to do when the hearing aid is fitted, for example, a new hearing aid to someone that's never worn one before, is we need to give the brain lots and lots of practice of hearing these sounds again, which it hasn't heard for a long time. And by wearing the hearing aid more and practicing more with the amplified sound, the brain can actually reorganize itself to take advantage of that information. So, what we know from hearing aids in some folks is that when you fit the technology they're aware of sounds, but not necessarily aware of what those sounds mean or can make sense of them. They almost have to relearn to match some sounds to the source.
So we know that hearing aids help us pick up the sounds, but it doesn't address the understanding of sounds, or words, or picking speech out of background noise, because that's a function of the brain, not a function of the ear. So I think the one message I would take away from this is that this ability of the brain to learn and reorganize itself doesn't have an age limit on it. And I find that tremendously hopeful and a positive thing. So, it really doesn't matter how old you are, the brain is capable of this plasticity. You might just need to where the hearing aids a little bit longer to get more practice.
The benefits of stimulating your brain
Now, one other benefit of stimulating the brain is not only that it strengthens the pathways that are important for language and for listening and developing our thinking and our cognitive development, but it also refines our top down processing or understanding. And what I mean by that is top down, that means from the brain down. So as we get older and we've got a full rich life of full of experiences, we've got a well-developed language system at our fingertips, we can use that knowledge to fill in the gaps. So if we miss some information, we are using our experience of the world and our experience of language to fill in the gaps. A child that is learning language doesn't have that ability. So never let anyone say that aging is terrible. It actually has some benefits because you gather wisdom and knowledge, so that's all a good thing.
The other thing about stimulating the brain is it helps us improve the perception of speech and especially the perception of speech and noise, which can be very challenging. And also, anything that we use, to help us understand speech, any thinking processes like our focus or our attention or the speed at which we can process the information coming in, or our working memory. All these things with some practice or with some activities to strengthen them can actually help with this top down processing and help us develop the understanding side of speech and sound and music and language when we get our hearing loss addressed by a hearing aid, for example.
What is auditory skills training?
So, what is auditory skills training and why is it useful? I think we've already looked at some of the things, and what I would say is auditory skills training by itself isn't really as useful as if it supplements a well fitted hearing aid. So, it is supplemental to the hearing aid management. So what it can do is it can strengthen clinical outcomes, because if you are enhancing the skills from auditory skills training, it will improve the way that you make the best use out of your hearing aid devices. It also helps you adjust to the technology. And I would say in that instance what it would do is be able to give you some really targeted feedback to give to your audiologist so that they can fine tune that device for your very specific listening environments. And modern hearing aid technology has other things in it, in the devices that help clinicians with that as well.
And I put this last one, not likely. It can improve quality of life. It's a positive cycle. If you are experiencing success with your hearing aid, if you do some of this training, so you're taking ownership of managing your hearing loss and you come to a point where you can cope better in background noise, or you don't get as fatigued in background noise. That would mean that you'd want to wear your hearing aid more because it's a positive experience. And it may also prevent that slow withdrawal from social functions that sometimes happens to people with hearing loss. Because they find them so difficult to listen in that it's easier just to extract themselves from those social interactions. Now, I know that at present and over the last two and a half years social interactions maybe haven't been entirely face to face. But even if they're not, or even if you're still practicing physical distancing, masks can cause quite a lot of additional trouble in terms of using that top down processing. Because you're going to be missing some of the visual cues.
Speech perception:
So, anything we can do to make your response and your use of the hearing aid technology stronger will stand you in good stead. So, let's have a look at the clinical outcomes. As I said, it can help improve your speech recognition and speech perception. So speech perception means that you perceive someone's talking and speech recognition means that you then understand what they're saying. And these sorts of auditory skills training exercises can help improve speech perception in quiet and in noise, and it can reduce your listening effort. And if it reduces listening effort, it means you're going to be overall less fatigued if you're in social environments, which might encourage you to participate more, which can lead to a fuller, richer social life. Okay, the other thing that we've noted in some studies is that auditory skills training can not only increase people being willing to adopt hearing aid technology, but it can absolutely improve satisfaction with hearing aid technology. And as I said, the more satisfied you are, the more you're likely to wear the devices in a range of situations, and the more you are able to live your life as fully richly as possible with regards to communication.
Improved confidence:
It can also give you more confidence. It does take a lot of personal confidence to acknowledge that one has a hearing loss and to seek help to do something about it. For some people, they still feel very much a stigma of wearing a hearing aid, although nowadays a lot of the devices are very discreet and very small. But it can improve that confidence that allows you then, as I said, to go out and to do things that you either you used to do and you stopped doing because it was too difficult to hear. Or things that you've always wanted to try. That if you're feeling more confident in your ability to hear and understand in a range of listening environments, you're more likely to take part, which is fantastic. And that could reduce some of those limitations you might have in day-to-day life. Also, the improved confidence people pick that up, right? So people would be aware of the fact that you are appearing confident and would be more likely to engage or communicate with you as well.
Free online hearing portal
Now, one of the things that when we talk about auditory skills training, I am talking about a particular set of exercises and tools that are available online for free at www.hearingsuccess.com. I do have to say that this is the work of Audiologists that work for two companies that is owned by Phonak's parent company. So Advanced Bionics, who produce cochlear implants, and Phonak with the hearing aids. But the actual exercises themselves are not linked to a specific model of device. So it really doesn't matter what type of hearing technology you use, there are tools on this website for free that you can have full access to. But just to reinforce that these were not designed the tools by marketing people or our engineers, these were designed by Audiologists and speech language pathologists.
So, there are two aspects to what you will find on this online portal. You will find something called WordSuccess, which helps you deal with phrases and words and practices them in increasing levels of difficulty. And you can pick that in terms of background noise levels, the types of noise levels you hear. And then SoundSuccess, which is really interesting, because it goes beyond speech and looks at things like, can you train your hearing using some music as tools? So for example, it gives you very easy examples of listening to different types of guitar music, classical guitar music. And then it will give you a piece where that is embedded. The guitar music is embedded in say a full orchestra setup, and they ask you to focus on the guitar. So it's training your brain, not only in things like music, but also in auditory attention and focus, which is equally important in terms of learning to understand all the additional auditory input you're going to get with your hearing aids.
And all you would do when you log into www.hearingsuccess.com is you have to register, there's no charge for that. And then you would in the right hand up a corner there's a little dropdown menu, and you would select that you're an adult with a hearing aid. So it would pull up the tools that are appropriate for people with hearing aids versus say, people with cochlear implants. The lovely thing about this being online is that you don't have to travel anywhere to get to it. It's not going to cost you anything. And because it's online, you can access it whenever you feel you have the time, so you're not set to a certain appointment time. So really if you are having relatively quiet day or afternoon at home, you could choose to do this.
The other thing is that, as I said, it doesn't just give you speech or picking out words or phrases in background noise, it also allows you to practice listening to someone and focusing in on someone without needing another communication partner to help you. So you can do this totally under your own steam, in your own time, in your own home, even in your PJs if you wanted to.
And I think you would get the satisfaction because it's graded in difficulty where you can go at your own pace. And you can go back if you're having particular difficulties with something. And you can do as much or as little as you want to. So it is customizable. The WordSuccess can actually also be an app. The SoundSuccess is usually something that you would use your tablet or your computer to access. But as I said, everything's first loaded on one page. You select the fact that you wear a hearing aid and you're an adult, because you will see some tools that are specifically for teens or specifically for young children. And then as I said, you can access that whenever or whatever attire you're wearing at the time, that's fine, because you don't have to physically go anywhere.
Share your results with your clinician:
The other thing too is you can share the results or you can discuss your results with your clinician if that's something that you would like to do. And it will hold your place as to where you got to, the level that you got to in a particular area or function. And then you can pick up where you left off when you come back into the portal. So really, as I said, very easy way to practice. And as I said, there's also some rehabilitation support. It can give you some speech, reading skills, some communication tips. And one of the other nice things about the webpage is it actually also has a sort of a blog, number one, that you can read input from people that wear hearing aids and some of their experiences, but it also gives you a place where you could chat with others that share the fact that they have hearing loss and have chosen to do something about it.
And often there's no one that's really going to understand you and some of the challenges that you might have faced as much as someone that's having some of the same difficulties, number one. And number two, it can be a way of kind of motivating or sort of encouraging you to do a bit more on this training site, if you've got a competitive spirit, for example.
Communication tips & strategies
Okay, so as I said, there's some tips and strategies for communicating that you can share with those whom you talk with regularly. There's some generic information on hearing technology. There are some exercises to practice listening skills. And one of the lovely ones that I liked was it's a song that plays, and it's got the lyrics in front of you, but it leaves some words out. And so, as you are listening, you're anticipating that line that's got a word missing and then waiting for it and listening for it and filling in those gaps. So, it's really trying to find lots of interesting ways to focus your attention and to pay attention to what's being said accurately. And then, as I said, also this online community of people that have the same challenges.
So let's take Noah here as an example. He says, "I need to follow conversations at my large family dinner table every night. I want to be able to carry on a conversation at a crowded local cafe with my buddies. And I want to be able to hear the speaker at my local community lecture each month." So what additional actions can you take to address his expectations and make them realistic expectations for hearing in those three communicative environments that he's identified?
So, certainly one of them is getting seen by an Audiologist, having hearing assessed and based on the hearing loss setting, appropriate technology and measuring that that's providing the right balance of sound for him. You can also remind him that the brain needs to practice to learn how to make sense of sounds that it hasn't heard for quite a while in the same balance. You can also remind Noah that, "Hey, if you do some structured, repetitive auditory skills training that is very carefully graded in levels of difficulty at your own pace at your own home." This could help you train so that in those environments he identified he won't be as fatigued, and he'll actually have more success.
You could also say that, "There's this wonderful website, hearingsuccess.com." And he can sign up there for free and get some of these skills trainings. Or you could tell him all of the above. And I think if you have been able to join us for this talk so far, you'll realize that the correct answer for that was all of the above. And that's how you could support Noah. So I would say, give hearing success a try. It's really, it's going to cost you nothing, only a little bit of time. And you might actually find it's a lot of fun. And before you know it, you're so busy focusing on your hearing and your understanding and listening that the focus on the actual physical device behind your ear or inside your ear is not as great as it was when you first got your hearing aids.
If you’re ready to improve your communication, schedule a Hearing Evaluation with an Audiologist, please call: Broadmead Hearing Clinic: 250-479-2969 or Oak Bay Hearing Clinic: 250-479-2921.