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Dan's New Hearing: One Man's Success with ImpaCt Hearing Aids by Margie Littell Ulrich, CCC-A, Clinical Audiologist |
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Dan's eyes widened as he said, "Buy Low". He repeated it, "Buy Low" with a smile spreading over his face. "It sounds like Bi-Lo the grocery store's name!" he said with comprehension beginning to dawn. Dan's first introduction to puns began a remarkable auditory journey for us both as he began learning what the English language sounds like. Dan Powers, born 23 years ago with a severe to profound deafness, had worn strong hearing aids since two years old. But even when he wore his powerful behind- the-ear hearing aids, Dan's limited hearing ability only allowed him to tell when people began to speak and when they stopped speaking. The poor quality of his perceived speech signal consisted mostly of loud vowels and only a few consonants. He became an excellent speech reader by watching the movements of the mouth and he learned sign language in school. But his vocabulary and reading skills were low compared to Dan's high intelligence and abilities. Understanding speech is much like the game "Wheel of Fortune". When only the vowels are seen, it is much more difficult to solve the puzzle. As consonants are added, the ability to solve the puzzle increases. Speech listening with an impaired hearing system is the same: trying to guess what someone says by listening to the vowels with just a few consonants thrown in. As in the "Wheel of Fortune" game, some consonants are much more valuable than others, like the /s/ or /t/ because they take place with greater occurrence in written and spoken language besides adding so much more meaning to English. Dan's limited hearing ability did not allow him to hear most speech sounds. As a clinical audiologist, I am constantly watching the market place for new hearing aid technology to help different types of hearing loss. I knew if I could deliver to Dan's ears more high pitched speech sounds, the better he would understand speech. But Dan has no measurable hearing in the high frequency range in which these speech sounds are located. When I discovered a new computer programmable ImpaCt (TM) Dynamic Speech Re-Coding hearing aid at a hearing convention, I immediately thought about Dan. ImpaCt has the ability to actually "move" speech sounds like the s, k, t, sh, ch, which occur in Dan's inaudible range to a lower frequency area where Dan has hearing and could perceive them. This moving of the speech sounds is called proportional frequency compression. Think of this technology as a song being played on the piano. Speech is usually played in a high quiet key or range where, unfortunately, most severe hearing losses are, also, located. However, this hearing aid takes the song and moves it to a lower key where it is discernable. The song is the same; it is just lower, quieter, and more audible. Hearing these important speech sounds for the first time, Dan hears presence of sound where before there was an absence of sound. Remember the "Wheel of Fortune" game? Dan was receiving additional letters appearing in the puzzle, which allowed him to move one step further to solving the spoken message. To help him recognize these new audible sounds, a feature in this hearing aid, called the Dynamic Consonant Boost (DCB), is used to provide additional amplification (gain) to those new high frequency sounds alone. Remember the song on the piano? Certain notes on the piano are being hit just a bit harder. Think of it as a little man sitting inside the hearing aid. When the man hears a sound like s, k, th, f, th, he increases the volume but only for those sounds. Dan's first reaction to this new hearing aid was amazement at how "quiet" they sounded. He had been used to very "loud" sounds with his power hearing aids. He discovered that speech is a very quiet but rich sound. Louise Zelski, the factory representative who fitted Dan, had him raise his hand when he heard the new sounds she presented to him. He did not have to identify the sound; just listen for it. She stood about 6 feet behind Dan and said, "sh, s, k, t, and ch"; sounds which just shortly before had been completely inaudible to Dan. With a big smile on his face, he raised his hand each time she made one of the sounds. Then he turned around and asked, "What were they?" Now, Dan's listening task consists of learning a "foreign" language --oral English. He has to remember and use these new sounds when he hears them. Once a week, Dan comes to see me for listening exercises called auditory habilation. Sometimes, he finds it difficult to trust the signal which his hearing aids are providing him. Often he will close his eyes and repeat what I say accurately, but he will think he said something different. We are both discovering how oral English often does not make sense or follow common sense rules. He was practicing listening for the /sh/ sound in English one afternoon when I said the word: "Russian". He looked at me and said, "Is that the word Southerners use when they mean, "to go fast?" (Rushin'). ( A by-product to his better hearing has been an improvement in his own speaking. A native of Wisconsin, Dan has moved to Tennessee recently and is using his new hearing aid technology in order to learn how to listen for and speak with a Southern Drawl!). When I showed him the word Russian, he didn't realize that word had a /sh/ sound in it. So, I showed him some more words: "pressure, concussion, session, Russia" and he was amazed that the /sh/ sound was in the middle of these words too. He learned that the flower's name, "rose", had a z sound instead of an s sound. He discovered puns, an auditory play on words which is used so much in jokes. One afternoon, he came into my office for his weekly learning to listen lesson with a sneaky grin on his face. "Margie," he said. "Do you know what the little fish said when he swam into a concrete wall?" "No, what?" I answered, happy to hear Dan's first joke. "Dam!" Dan turned off the captions on his television in order to practice listening and understanding. He told me that English sounds like a "foreign language" but he is getting better at "picking out words" in a constant stream of spoken English. Dan used to watch me carefully when I spoke to him and I would often have to sign to him when he misunderstood. But as he becomes more proficient in listening to English, he will look away or I will hide my mouth and he uses his ears as they were intended--to be omnidirectional. Sitting around a recent family campfire one evening, Dan laughed and talked with his family where previously he would go inside because it was too dark for him to lip read. Dan is hearing other new sounds, too, besides speech sounds. Another afternoon, he stopped by my office and asked me to drive with him to Wal-Mart, a short distance away. "There is some new sound in my car which is driving me crazy," he said. "I need you to tell me what I am hearing." I hopped into his car and when we drove over a bump in the road, I heard something rattle in the trunk. "There," he said looking over at me. "Did you hear it?" I told him he had something loose in the truck which was banging when he drove. He stopped the car and moved the tire jack. Another time when his brother was visiting, Dan heard a strange sound repeated in the bathroom. He stood by the door trying to determine what that funny noise was. Later, when his brother came out, Dan asked him. His brother had to think for a few minutes and then began to laugh, "I was blowing my nose," he told Dan. Dan was delighted to hear birds singing, wind rattling the leaves, some pesky, loud insects called Cicadas, and his dog whining to be let out the door. One of Dan's goals with his new hearing is to operate the telephone "like other people do" by talking and listening to the person speaking. In the past, he has had to use a text telephone called a TDD or TTY and apply a relay system of telephone operators to make his phone calls for him. Telephone usage, therefore, is clumsy, inefficient, and intimidating. One recent Friday when he arrived at the office, I told Dan we were going to practice utilizing the telephone. He was very reluctant but agreed to try. I sat him down by a regular telephone with a speaker attached and told him that I would call him and say, "Hi Dan" and "How are you". I would then ask him some questions of which he had no previous knowledge. He would not be able to see me but would have to rely completely on his new hearing aids. "Hi Dan, " I spoke into a portable phone from a back office. "Hi Margie," he answered. "How are you?" I asked. "I am fine, he answered again with his voice quaking a little. He knew the unknown English questions would be coming up. "Is it raining?" I asked with my fingers crossed. "Yes, it is raining!" he answered giggling slightly. "Are you hungry?" I asked with joy bubbling up in my voice. "Yes, I am hungry. I haven't had lunch yet!" he replied with happiness radiating in his voice. By this time, I was leaping around the back office crying, "Yes! Yes!" Dan, who could hear me clearly on the phone, said, "I hear you celebrating, Margie!" Then, he quietly requested, "Could we call my dad?" I told him that we would try but it might not work on long distance calls as well as the inter-office call functioned. He dialed his father's work number in Wisconsin and his step-mother, Susan, answered the phone. I explained to her what we were going to attempt. She replied, "Hi Dan. I will go get your father." Dan looked and me and grinned, "I heard say she was going to get my dad!" Then, Dan's father, Roger, came on the line. "Hi Son," he said, "This is your dad". Dan's eyes filled as he spoke into the telephone, "Dad, I can hear you. I am talking to you on the phone just like other people do. Margie is not telling me what you are saying." There was a long silence, then Dan and I heard his father's choked voice replying, "Sorry, Dan, but I am crying and it is hard to talk. I can't believe it. For the first time in my life, my son is talking to me on the telephone. Dan and his father and his step mother talked a long time. Occasionally, when the topic shifted, Dan would get lost and look to me for help. But I would simply tell his parents to say it again or to speak a bit more slowly and Dan would pick up the flow of the conversation again. I watched, so happy and so proud of Dan. He continues to make extraordinary progress in understanding English and now makes it a habit to call me on the telephone about once a week in order to "practice". For more information on the ImpaCt (TM) hearing aids, visit http://www.avrsono.com. © Copyright 2001 Margie Littell Ulrich. All rights reserved. Printed with permission. Margie Littell Ulrich, CCC-A is a clinical audiologist and a contributing writer at HearingExchange. She practices audiology at the Mid-East Tennessee Regional Speech and Hearing Center in Dayton. She is also the chairman of the Children's Wellness Council of Tennessee. |
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