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Enhancing Auditory Skills through Technology and Intentional Listening Practice Virgi Mills, M.E.D. MED-EL Consumer Outreach Manager, Southeast region, Enhancing Auditory Skills through Technology and Intentional Listening Practice Thank you for attending this presentation! Phone on vibrate, please. (We all live busy lives! If necessary, please feel free to step out to take a call.) Disclosures Financial: Salaried employee of MED-EL Corporation as a Consumer Outreach Manager in the southeast region Nonfinancial: Bilateral cochlear implant recipient of MED-EL Enhancing Auditory Skills through Technology and Intentional Listening Practice Learner Objectives: 1) Participants will be able to list at least three programs and organizations that promote awareness and treatment of hearing loss. 2) Participants will be able to describe the criteria of hearing aids and cochlear implants. 3) Participants will be able to outline one auditory skills assessment and three aural rehabilitation tools. The Ear and Hearing ear ear canal/ear drum 3 bones cochlea auditory nerve brain How Hearing Aids Work Hearing aids make sounds louder Hearing aids can not correct the damage to the inner ear Hearing Aids Use in Adults Only 10-20% of people with hearing loss have ever used a hearing aid(s). 20-29% of patients who have used hearing aids at some point, stop using them. SOURCES: US Census, Hearing Health Foundation, National Institute of Health, Hearing Loss Association of America MED-EL’s SYNCHRONY System How a cochlear implant works Inside the Cochlea Facts about Hearing Loss Here are some general guidelines regarding the incidence of hearing loss: 3 in 10 people over age 60 have hearing loss 1 in 6 baby boomers (ages 41-59), or 14.6%, have a hearing problem SOURCE: http://www.linresearch.org/ Facts about Hearing Loss -1 in 14 Generation Xers (ages 29-40), or 7.4%, already have hearing loss At least 1.4 million children (18 or younger) have hearing problems SOURCE: http://www.linresearch.org/ Facts about Hearing Loss It is estimated that 3 in 1,000 infants are born with severe to profound hearing loss SOURCE: http://www.linresearch.org/ Documented Diagnostic Status of Infants Not Passing Hearing Screening (national) National Data from Centers for Disease Control and Prevention SOURCE: http://www.cdc.gov/ncbddd/hearingloss/2013data/2013_ehdi_hsfs_summary_b.pdf Documented Intervention Status of Infants with Hearing Loss (national) Documented Intervention Status of Infants with Hearing Loss SOURCE: http://www.cdc.gov/ncbddd/hearingloss/2013data/2013_ehdi_hsfs_summary_b.pdf South Carolina South Carolina - 2013 Hearing Screening Summary SOURCE: http://www.cdc.gov/ncbddd/hearingloss/2013data/screen_2013_web-b.pdf Resources in SC – pediatric hearing loss First Sound Program, SC Dept. of Health Newborn Hearing – Identifying Problems Early SOURCE: http://www.scdhec.gov/Health/ChildTeenHealth/EarlyChildho od/NewbornHearingScreening/ Resources in SC – pediatric hearing loss “BabyNet is South Carolina’s interagency early intervention system for infants and toddlers under three years of age with developmental delays, or who have conditions associated with developmental delays.” SC First Steps - Baby Net SOURCE: http://scfirststeps.com/babynet/ Resources in SC – pediatric hearing loss SC BEGINNINGS “An expanding nonprofit providing professional expertise, education and guidance to anyone in South Carolina with the ability to impact deaf or hard of hearing families.” SOURCE: http://scbegin.org/ Resources in SC – pediatric hearing loss Carter Hears! “Our Vision: We believe that all children, specifically children with hearing loss, reach their potential in academic, social, emotional, functional, and spiritual avenues through conducive learning environments.” SOURCE: http://www.carterhears.com/ Resources in SC – pediatric hearing loss This list was not meant to be comprehensive by any means MED-EL’s BRIDGE Program Four Levels of Auditory Skills DETECTION: “can you hear this?” DISCRIMINATION: “does this sound different from that?” IDENTIFICATION: “what did you hear?” COMPREHENSION: “what does it mean?” Adapted from: Erber, N. (1982). Auditory Training. Washington DC: Alexander Graham Bell Association, pp. 9294. Strategies for all levels of auditory On all waking hours Come close to me Talk more Expansion/extension Thinking place Listening first Signal to noise ratio Pause-wait Auditory feedback loop My voice matters Music Books Parent as model MED-EL’s BRIDGE program for Aural Rehabilitation for all ages Pediatric Habilitation Pediatric Assessment Teen Rehabilitation & Assessment Adult Habilitation Adult Assessment Resources Pediatric Auditory Assessments LittlEARS® Parent Questionnaire Auditory Skills Checklist Pediatric Auditory Skills Assessment The LittlEARS® Auditory Questionnaire Only standardized auditory skills assessment on the market for birth to 24 months Or Hearing age up to 24 months LittlEARS® Parent Questionnaire The LittlEARS® Auditory Questionnaire is normed and acceptable for reimbursement Reliability? “Studies show that parent evaluation is a suitable method to assess development in early childhood and to reflect the children’s everyday behavior.” (Bates et al, 1988) LittlEARS® Auditory Questionnaire Auditory Skills Checklist Developed by Nancy S. Caleffe-Schenck Purpose: 1) Establish auditory goals 2) Track progress made in auditory areas related to spoken communication Auditory Skills Checklist To track progress, check the appropriate answer for each item Skills should be noted if the child responded using auditory cues only, without any visual information such as speech reading or sign language Teens and Adults with Hearing Loss 3 in 10 people over age 60 have hearing loss 1 in 6 baby boomers (ages 41-59), or 14.6%, have a hearing problem SOURCE: http://www.linresearch.org/ Teens and Adults with Hearing Loss 1 in 14 Generation Xers (ages 29-40), or 7.4%, already have hearing loss At least 1.4 million children (18 or younger) have hearing problems SOURCE: http://www.linresearch.org/ Hearing Well Contributes to Healthy Aging ~John Briggs Educational Audiologist Head of CI Program, Cambridge Other Age-Related Facts about Hearing Loss HL is independently linked to cognitive decline Older adults with hearing loss demonstrate: a 30-40% increase in cognitive decline compared to those with normal hearing a 24% increased risk of cognitive impairment after a medical incident (stroke, etc.) Why? We aren’t sure…but possible reasons could be: Increased social isolation Increased cognitive load • The effort of listening reduces other cognitive task processes like working memory SOURCE: Frank Lin (2010, 2011, 2013) Johns Hopkins, NIH funded research Impact of Hearing Loss Cognitive Overload Trying so hard to hear that it makes it hard to actually absorb what is being said. Constant expending of mental energy decoding what is heard. “The brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.” Dr. Frank Lin Say What? BETTER HEARING TAKES PRACTICE Science Magazine February 2013 AAAS (American Association of the Advancement of Science) Results Participants understood 20% more words and could process about 15% more items on a timed test and showed a 50% increase in neural timing Those in the non-training group showed no improvements in any area Assessment for teens and adults Hearing Implant Sound Quality Index (HISQUI₁₉) HISQUI Description Questionnaire used to determine an individual’s perception of sound quality in daily life 19 questions and individual checks appropriate box Always Almost Frequently Mostly Occasionally Rarely Never NA Always 99% 87% 75% 50% 25% 12% 1% HISQUI Description Converts to a score Indicates how poorly or good individual finds sound quality in everyday listening situations Complete questionnaire over time to determine progress and help identify next steps in hearing loss treatment and/or AR HISQU Sample Questions 3. When listening to music, can you effortlessly distinguish whether one or multiple instruments are being played simultaneously? 4. When background noise is present, can you effortlessly participate in a conversation with friends or family members (e.g. at a party/in a restaurant)? Aural Rehabilitation for Pediatrics and Adults MED-EL Soundscape Listening Activities SoundScape for Children 6 Years + Fun shopping game with fruits and vegetables at the MED-EL Mart 5 levels of increasing difficulty Choice for listening w/background music Choice of male/female speakers PDF file for additional listening practice SoundScape for Teens Explore the worlds continents and oceans with this game 3 levels of increasing difficulty Choice of speakers, male or female A time score with fun facts provided after each game Colorful pictures and additional activities for download SoundScape for Adults Designed for adult users for independent listening practice Offers a variety of listening conditions Provides percentage correct score Repeat button allows as many repetitions as needed PDF file for additional listening practice What Else Can We Do? Read-a-louds • With a communication partner • Following an audiobook • Read aloud to yourself Card Games Sentence Repetition/Conversations with Contextual Support Encourage the use of ALD’s Listening to Music and Television Websites/Apps Bluetooth Connectivity Audio Cable Resources for Professionals and Recipients re: Aural Rehabilitation American Cochlear Implant Alliance SOURCE: http://acialliance.site-ym.com/ Hearing Loss Association of America SOURCE: http://www.hearingloss.org/ Aural Rehabilitation Stations First Station: Free Audio Books http://www.openculture.com/freeaudiobooks Second Station: SOUNDSCAPE and free app from MED-EL called Oceans and Continents Third Station: live read-a-louds and playing cards Enhancing Auditory Skills through Technology and Intentional Listening Practice Thank you for your time and attention! Any questions, please visit the MED-EL table [email protected] 407-617-7719