A New Chapter For Hearing Rehabilitation
Audiobooks help cochlear implant patients navigate a new world of language.
October 21, 2016
Laura Lowes was born with hearing loss. Her mother had contracted rubella while pregnant. At age 2, Lowes got a hearing aid. But at 27, she experienced sudden and dramatic hearing loss, losing all hearing in her right ear practically overnight.
A year later, she received a cochlear implant.
“On activation, it was very, very strange,” says Lowes, a London native, now 29. “Everyone sounded really high pitched and tinny … even my husband sounded like a little girl giggling. But I got used to it quickly.”
In some ways, Lowes was lucky: Her loss of hearing, while profound, had not been with her especially long. She could still remember being able to hear, so it came back somewhat quickly. But it was the aid of audiobooks that allowed Lowes to accelerate her recovery.
At the encouragement of her speech therapist, Lowes began listening to audiobooks six weeks after receiving her implants. She started, she says, with books that she had already read several times. “I bought books from Audible that were familiar to me so that I knew the story and didn’t have to concentrate too much and could follow along easily,” she says, describing a preference for “girly books”: the works of Katie Fforde and Sophie Kinsella, for example, and, of course, Bridget Jones’s Diary.
Experts suggest that audiobooks can serve as training wheels for cochlear implant recipients.
“In the beginning, I was following along with the text,” she says. “But I pushed myself so that further along the line I would get rid of the book and just listen to it.”
It turns out that Lowes was doing exactly the right thing. Experts suggest that audiobooks can serve as training wheels for cochlear implant recipients: Patients can follow along with the text of the book in front of them and monitor their own lapses — and improvements — in hearing.
“For cochlear implant recipients, listening to audiobooks provides a great way to help them adjust to their new way of hearing,” says Stu Sayers, a former executive at Audible who is now president of services at Cochlear Australia. “Choosing content that is familiar can also provide context and clues that help the listener identify and hear the words being spoken.”
Combining text with audio “is very helpful because [patients] can see where they made a mistake or didn’t understand something,” says Susan Waltzman, a professor of otolaryngology at the NYU School of Medicine and co-director of its affiliated Cochlear Implant Center. “It can get very frustrating, and the one thing you don’t want to have happen is that they get frustrated and fail.”
“We just finished a study that showed that [implant recipients] can continue to get better up to three, four, five years …”
First developed by American medical researcher Dr. William F. House in the 1960s, cochlear implant technology wasn’t approved in the U.S. by the Food and Drug Administration to treat hearing loss in adults until 1984. The implant works by converting acoustic sound into electrical pulses, bypassing the damaged part of the ear and stimulating the auditory nerve. It wouldn’t be until 2000, 16 years later, that the FDA would approve a type of cochlear implant for children as young as 12 months. By the end of 2012, more than 300,000 registered cochlear devices had been implanted in patients around the world.
The technology still continues to evolve, says Waltzman. “It used to be that 15, 20 years ago we thought that a patient plateaued after one year for an adult. But we just finished a study that showed that, actually, they can continue to get better up to three, four, five years — which was the length of our study — even if they’re long-term deafened,” she says. “It’s good to be able to counsel cochlear implant recipients and let them know, ‘Look, don’t give up. If you don’t like the way you’re hearing now, keep on with the therapy.’”
Archie Sturdivant III gave up — at first. When the Maryland salesman got his first cochlear implant two years ago, he went straight for the hard stuff: Tom Clancy novels. Sturdivant, 51, had been deaf for half his life when he decided to get an implant after he could no longer recognize speech with hearing aids — a big problem for a phone rep.
“I desperately wanted to be able to hear and understand speech,” he says. “I immediately purchased some 30 audiobooks to work with. At first, understanding these books was impossible. I was aggressive and went for books like Clear and Present Danger, Without Remorse, and The Hunt for Red October by Tom Clancy. I would listen to the same chapter every day for a month trying desperately to understand the words, and, by now, my vision was failing so reading along was not possible. So I actually gave up.”
Turns out he may have been too aggressive. Five months after his first implant, he decided to get a second one in the other ear. “My hearing took off,” he says. “Audiobooks and podcasts were the order of the day as my speech recognition increased to 80 percent.” Results will vary with each patient, depending how long he or she had been living with hearing loss and how severe that loss had been. A 50-year-old who had lost hearing two or three years ago might, after receiving a cochlear implant, say that they “hear the way they used to hear,” says Waltzman. A 30-year-old who had been deaf since birth, however, has no point of reference. They are more likely to say the implant “helps” them to hear, meaning it’s more of a sensory aid. “You can use it in conjunction with lip-reading — which we all do, but we don’t know that we’re doing it. So they’re watching somebody’s face and they’re using the input from the sound as well.”
“Aural rehab should be fun, not endured.”
Rowan Robinson, for example, was born profoundly deaf. The 47-year-old Worcestershire, U.K., resident had lived with hearing aids in both ears since the age of 11. She communicated through lip-reading and sign language. But when the little hearing she had deteriorated even further, she got cochlear implants in early 2015. Listening to audiobooks didn’t happen until three months after they were switched on (cochlear implants are often not turned on immediately, in order to give time for the patient to heal).
“I like to hear comedy-type books. To laugh out loud is great fun!” she says. It was slow going, though. “The first listening task was selecting the right word from a choice of four, then six, going up in difficulty. I selected books with female voices such as Barbra Annino’s Stacy Justice books, which I had already read so I had the gist of the story to help me follow it. Later, I tried Stephen Fry’s The Fry Chronicles: An Autobiography and was able to hear his voice well. For me, I needed to listen to UK voices.”
Indeed, every cochlear implant recipient interviewed for this article had a different severity — and length — of deafness. Yet all attest to the value of audiobooks in their recovery. They started slow, choosing books they were familiar with and enjoyed and didn’t mind hearing several times over with the text in front of them. While often frustrating, therapy works when it’s done in a spirit of self-interested enjoyment. “Aural rehab should be fun,” says Sturdivant, “not endured.”