HHF Board of Directors Elects Elizabeth Keithley, Ph.D. as its new Board Chair

By Elizabeth Keithley, Ph.D.

Elizabeth Keithley, Ph.D., Chairman, HHF Board of Directors                                            Professor Emeritus, Department of Surgery and Otolaryngology

University of California at San Diego

I have been a scientist who does research on mechanisms of inflammation and aging on the inner ear for more than 30 years. Growing up with a mother who had a hearing loss, I understood of the impact that hearing loss can have on a person’s life. It was quite natural that while in college I became interested in neuroscience and specifically the study of sensory perception. A professor asked me to work in his lab on hearing mechanisms and I have been studying them ever since.

In the 1990s I was asked to review the Emerging Research Grant (ERG) applications and that began my association with Hearing Health Foundation (HHF, and formerly known as Deafness Research Foundation). Soon afterward I was asked to join the Board of Directors. I have remained on the Board since that time.

The ERG program is a very valuable asset for the research community by enabling early-stage researchers to get their careers started. This program allows them to write a proposal describing a series of experiments to test a hypothesis that will increase our understanding of auditory or vestibular (hearing or balance) mechanisms. With data generated during the ERG funding period, the researcher can write an expanded, plausible proposal to address a larger issue. This becomes a proposal for funding from the National Institutes of Health.

In some ways the ERG program is a “dress rehearsal” for a career as an academic scientist. When these scientists receive funding from HHF, they have the opportunity to develop their own ideas. They begin to have some independence from a more senior investigator. The best path to achieving a world where everyone can hear is to continue bringing new people with their innovative ideas into the field of hearing and balance research. A review of the names of HHF-funded researchers over the past half century reveals the American leaders in the fields of hearing and balance research from the mid-1980s on.

As of October 1, 2015, I am the Chair of the HHF Board. I am very pleased to be involved with this important organization. HHF was created almost 60 years ago by a woman who was steadfast in her support of funding for new technologies and treatments for hearing loss. I will do whatever I can to ensure we are able to continue to make a meaningful impact through hearing research. 

It is a goal to see HHF raise enough money to fund the Hearing Restoration Project. The consortium model is a wonderful way to focus the attention of scientists to work together collaboratively and get meaningful results. If we can get to the level of funding $5 million to $6 million for research annually, it will give the scientists the resources to further accelerate the pace of the research and produce advances to prevent, treat, and cure hearing loss. Another goal that is equally as important to me is to be able to return our funding levels for the ERG program to $1 million a year. This was the level of funding when I started 20 years ago and I don’t think it is unreasonable to recommit to that amount in the future.

Hearing and balance research and advancements in hearing devices and technology have come a long way over the past 50 years. Significant outcomes have been achieved, but we still have a lot of work to do. The number of people with hearing loss and other hearing-related conditions is increasing and we need to continue to fund the most cutting-edge research until there is a day when every person can enjoy life without a hearing loss or tinnitus.  

I am interested in getting to know the members of our Hearing Health community.  If you have questions or comments, please don’t hesitate to reach out to me via email.  

I look forward to hearing from you.

World Heart Day

By the Better Hearing Institute

World Heart Day is today, September 29th. In response to a growing body of research showing a link between cardiovascular and hearing health, Hearing Health Foundation and Better Hearing Institute (BHI) are urging you to check your hearing.

Raymond Hull, PhD, professor of communication sciences and disorders in audiology and neurosciences at Wichita State University, recently completed research analyzing 84 years of work from scientists worldwide on the connection between cardiovascular health and the ability to hear and understand what others are saying. Hull’s work, which reviewed 70 scientific studies, confirmed a direct link.
 
According to Hull, “Our entire auditory system, especially the blood vessels of the inner ear, needs an oxygen-rich nutrient supply. If it doesn't get it due to cardiovascular health problems, then hearing can be affected."  
 
While there are many possible causes of hearing loss, cardiovascular disease appears to exaggerate the impact of those causes and intensify the degree of hearing decline, says Hull. This compounded effect not only increases the difficulty a person experiences in perceiving what has been said, but also diminishes their ability to make sense of what they hear with speed and accuracy.

Could hearing loss be an early sign of cardiovascular disease?

Research is ongoing, but a number of findings suggest that keeping track of your hearing may help you monitor your cardiovascular health as well.

“The inner ear is so sensitive to blood flow that it is possible that abnormalities in the cardiovascular system could be noted here earlier than in other less sensitive parts of the body,” according to David R. Friedland, MD, PhD, Professor and Vice-Chair of Otolaryngology and Communication Sciences at the Medical College of Wisconsin in Milwaukee.

In Dr. Friedland’s own 2009 study, published in The Laryngoscope, he and fellow researchers found that audiogram pattern correlates strongly with cerebrovascular and peripheral arterial disease and may represent a screening test for those at risk. They even concluded that patients with low-frequency hearing loss should be regarded as at risk for cardiovascular events, and appropriate referrals should be considered.

More recently, a 2014-published study by researchers at the University of Wisconsin in Madison found that the risk of hearing impairment was significantly greater in people with underlying atherosclerosis, or hardening of the arteries, than in those without vessel abnormalities, suggesting that hearing loss may be an early sign of cardiovascular disease in apparently healthy people, according to an article in The Wall Street Journal. The study involved a large cohort of middle-aged participants and showed that hearing loss is common in people in their forties. 

3 Heart-Healthy Reasons to Get a Hearing Test

1. Six decades of research points to heart-hearing health link: Specifically, the study authors concluded that the negative influence of impaired cardiovascular health on both the peripheral and central auditory system—and the potential positive influence of improved cardiovascular health on these same systems—have been found through a sizable body of research.
   

2. The ear may be a window to the heart: Some experts find the evidence showing a link between cardiovascular and hearing health so compelling that they say the ear may be a window to the heart. They encourage collaboration between hearing care providers, cardiologists, and other healthcare professionals. Some even call on hearing care professionals to include cardiovascular health in patient case history and to measure their patients’ blood pressure.
   

3. The same lifestyle behaviors that affect the heart impact hearing. A higher level of physical activity is associated with a lower risk of hearing loss in women. Another revealed that smokers and passive smokers are more likely to suffer hearing loss. And a third found that regular fish consumption and higher intake of long-chain omega-3 polyunsaturated fatty acids are associated with a lower risk of hearing loss in women. Coincidence? Or does it all come back to blood flow to the inner ear? Research is ongoing.

The content for this blog post originated in a press release issued by The Better Hearing Institute on September 15, 2015.

Meet the Researcher: Samira Anderson, Au.D., Ph.D.

By Tine Aakerlund Pollard

Samira Anderson, Au.D., Ph.D.  received her Ph.D. from Northwestern University, and also holds an Au.D. from the University of Florida. Anderson is an assistant professor in the Department of Hearing and Speech Sciences at the University of Maryland and is a 2014 Emerging Research Grant recipient.

My experience as a clinical audiologist inspired my research. I worked for 26 years as an audiologist before deciding to pursue a Ph.D. Part of my motivation came from working with patients who struggled with their hearing aids. I was frustrated that I was unable to predict who would benefit from hearing aids based on the results of audiological evaluations.

Two people who have identical audiograms and who are fit with the same advanced hearing aids may experience vastly different results when hearing in the presence of noise. I wanted to study the way the brain processes sound, and how deficits in this process may impact the accuracy of the auditory signal reaching the brain.

To examine the neural processing of auditory input across the life span, I study the development of speech sound differentiation in infants, and the relationship between speech encoding and later language development. This information may lead to earlier identification and treatment of language-based learning impairments. 

In older adults, I am looking at the effects of aging and hearing loss on the ability to understand speech in complex environments. As we age, we begin to notice a gradual decrease in our ability to process incoming stimuli, in part due to slower speed of processing. These changes are exacerbated by hearing loss and deficits in cognitive abilities, such as memory and attention. 

Specifically in the future, I hope to determine the effects of manipulating hearing aid settings on the ability of the brain to accurately encode speech. Understanding the effects of amplification on the brain’s processing of speech means that better hearing aid processing algorithms can be developed. I would also like to compare changes in the brain’s processing of sound after wearing hearing aids alone vs. wearing hearing aids and using auditory training.

Studying language development made me interested in hearing science. My mother immigrated to the U.S. from Lebanon just before I was born, and I grew up hearing both English and Arabic. This exposure led to an interest in languages and how we first acquire spoken language as children. I was born in Southern California but grew up all over the U.S. as my father was a career Marine.

Both of my parents have hearing loss, so I have witnessed firsthand their struggles with hearing. My mother’s father was an agronomist and had a large farm in Damascus, Syria. When visiting him in Syria I would hear street vendors calling out that they had “Miqdadi cucumbers”—Miqdadi was his last name. I believe that my interest in the scientific field came from him as well as from my mother.

Read Anderson’s first-person account of her switch from the clinic to the lab and details about her research in “A Closer Look,” in the Winter 2014 issue of Hearing Health.

Samira Anderson, Au.D., Ph.D., is a General Grand Chapter Royal Arch Masons International award recipient. Hearing Health Foundation would like to thank the Royal Arch Masons for their generous contributions to Emerging Research Grantees working in the area of central auditory processing disorders (CAPD). We appreciate their ongoing commitment to funding CAPD research.

We need your help supporting innovative hearing and balance science through our Emerging Research Grants program. Please make a contribution today.

Go for It, Live It, Experience It

By Nina Poersch

Have you ever wanted to do something so badly, fulfilling a dream, but the next minute you’re terrified? Then back to feeling like you’re ready, but then again thinking, “What have I gotten myself into?” And finally settling with: If I don’t do this now, I may never get a chance again, so you go for it.

That was me when I was chosen for Season 30 of the reality TV show “Survivor.”

I was not the first person with a disability on the show. But then, being deaf and a cochlear implant recipient wasn’t always who I was. I was born with typical hearing and didn’t lose it until I was 44. I call it a “gradual sudden hearing loss” that took place over the span of about five years. The doctors are not sure why I lost my hearing. All I wanted was to get my hearing back.

After two months of wearing hearing aids that were not helping, I knew I wanted cochlear implants and got one in my right ear. I am not one to sit back and wonder why something has happened to me, or to worry about the future, but instead I embraced my situation and began a journey of educating others about cochlear implants. It’s what I talk about with every new person I meet. I also volunteer for Cochlear Americas as a mentor with the company.

After the implant, I didn’t need a captioned phone anymore. I also threw away my note pad, which had become my ears for people to write on when I couldn’t understand what they were saying to me. Driving became less horrifying. It’s amazing what you hear in your everyday life that you didn’t realize you were hearing.

But all of this didn’t come easily. I struggled with my family. It took time for everyone in my life to understand that while I do use hearing technology, there are limitations to how well I hear.

For six years I only had one implant. It wasn’t until I was called for a possible chance to be on “Survivor” that I considered going bilateral. It was a definite life-changer and I still kick myself for waiting so long.

I’m not sure whether these challenges prepared me for “Survivor,” but I believe everything happens for a reason. “Survivor” is very much a social game, one that I could have mastered before I lost my hearing. Even with cochlear implants, people with hearing loss don’t always catch everything and in the game, you can’t always ask people to repeat themselves. Nighttime was especially hard because I had to take off my sound processor.

“Survivor” finished airing in May 2015. Looking back, I know that being on the show was a learning experience as well as a teaching experience.

I learned that not everyone knows how to react to someone who has hearing loss. It can make people feel uneasy and create misunderstandings. When I look in the mirror, I don’t see a person who is deaf, or a person who wears cochlear implants. People I meet don’t see that either. They just need to be taught how I hear and how to talk to me—and that it’s okay. It’s very simple and I find most people are very interested.

Playing the game gave me insight and a voice to teach people what it was like for me to lose my hearing and what it means to have a cochlear implant. The challenges on the show that I participated in were not ones that required a lot of hearing, but I felt 100 percent confident that my implants would not have failed me had I had the chance to compete in more challenges. Instead, because of a combination of reasons—my hearing loss, my age, maybe being in the wrong tribe—I was voted off on day eight.

“Survivor” remains one of the most amazing things I have ever done. But it’s not the only thing. The biggest lesson I have learned since losing my hearing is to never let your hearing loss hold you back. Always go for your dreams. And remember that going for your dreams doesn’t always mean that you’ll succeed, but if you don’t try then you’ve failed yourself. In the end you’ll be happy that you did and you’ll find that you’ve inspired others to go for their dreams.

My motto is “go for it, live it, experience it.” It’s how I live my life and it has never failed me.

Nina Poersch lives in California. For more, see ninapoersch.com.

Have a story like Nina's that your would like to share? If so, please email info@hhf.org! 

Distilling the Data

By Michael Lovett, Ph.D.

The burgeoning field of bioinformatics allows the Hearing Restoration Project to analyze and compare large genomics datasets and identify the best genes for more testing. This sophisticated data analysis will help speed the way toward a cure for hearing loss and tinnitus.

Since its launch in 2011, the Hearing Restoration Project (HRP) is focused on identifying new therapies that will restore inner ear hair cell function, and hence hearing. Within the consortium, smaller research groups engage in separate projects over the course of the year, to move the science along more quickly.

Over the past decade my group, and the group led by my collaborator Mark Warchol, Ph.D., have worked to identify genes that are potential targets for drug development or for gene therapies to cure hearing loss. Our approach has been to determine the exact mechanisms that some vertebrates—in our case, birds—use to regenerate their hair cells and thus spontaneously restore their hearing. We have been comparing this genetic “tool kit” with the mechanisms that mammals normally use to make hair cells.

Unlike birds, mammals cannot regenerate adult hair cells when they are damaged, which is a leading cause of human hearing and balance disorders. Our working hypothesis is that birds have regeneration mechanisms that mammals are missing—or that mammals have developed a repressive mechanism that prevents hair cell regeneration.

In either case, our strategy has been to get a detailed picture of what transpires during hair cell regeneration in birds by using cutting-edge technologies developed during the Human Genome Project (the international research collaboration whose goal was the complete mapping of all the nuclear DNA in humans). These next-generation (NextGen) DNA sequencing methods have allowed us to accurately measure changes in every single gene as chick sensory hair cells regenerate.

The good news is that this gives us, for the first time, an exquisitely detailed and accurate description of all of the genes that are potential players in the process. The bad news is that this is an enormous amount of information; thousands of genes change over the course of seven days of regeneration.

Some of these will be the crucially important—and possibly game-changing—genes that we want to explore in potential therapies, but most will be downstream effects of those upstream formative events. The challenge is to correctly identify the important causative needles in the haystack of later consequences.

We already know some important genetic players, but we are still far from understanding the genetic wiring of hair cell development or regeneration. For example, after decades of basic research, we know that certain signaling pathways, such as those termed Notch and Wnt, are important in specifying how hair cells develop. These chemical signaling pathways are made of multiple protein molecules, each of which is encoded by a single gene.

However, the Notch and Wnt pathways together comprise fewer than 100 genes and, despite being intensively studied for years, we do not completely understand every nuance of how they fit together.

It also may seem surprising that—more than a decade after the completion of the Human Genome Project and projects sequencing mouse, chick, and many other species’ genomic DNA—we still do not know the exact functions of many of the roughly 20,000 genes, mostly shared, that are found in each organism. This is partly because teasing out all of their interactions and biochemical properties is a painstaking process, and some of the genes exert subtly different effects in different organs. It is also because the genetic wiring diagram in different cells is a lot more complicated than a simple set of “on/off” switches.

All of this sounds a bit dire. Fortunately, we do have some tools for filtering the data deluge into groups of genes that are more likely to be top candidates. The first is to extract all of the information on “known” pathways, such as the Notch and Wnt mentioned earlier. That is relatively trivial and can be accomplished by someone reasonably well versed in Microsoft Excel.

That leaves us with the vast “unknown” world. Analyzing this requires computational, mathematical, and statistical methods that are collectively called bioinformatics. This burgeoning field has been in existence for a couple of decades and covers the computational analysis of very large datasets in all its forms. For example, we routinely use well-established bioinformatic methods to assemble and identify all of the gene sequences from our NextGen DNA sequence reads. These tasks would take many years if done by hand, but a matter of hours by computational methods.

In the case of our hair cell regeneration data, our major bioinformatic task is to identify the best genes for further experimental testing. One method is to computationally search the vast biological literature to see if any of them can be connected into new networks or pathways. There are now numerous software tools for conducting these types of searches. However, this really is not very helpful when searching through several thousand genes at once. The data must be filtered another way to be more useful.

We have used statistical pattern matching tools called self-organizing maps to analyze all of our data across every time point of hair cell regeneration. In this way we can detect genes that show similar patterns of changes and then drill down deeper into whether these genes are connected. This has provided us with an interesting “hit list” of genes that have strong supporting evidence of being good candidates for follow-up.

An additional approach is to compare our chick data to other datasets that the HRP consortium is collecting. The logic here is that we expect key genetic components to be shared across species. For example, we now know a great deal about what genes are used in zebrafish hair cell regeneration and the genes that specify mouse hair cells during normal development. We can conduct computational comparisons across these big datasets to identify what is similar and what is different. Again, this has yielded a small and interesting collection of genes that is being experimentally tested. 

Our final strategy has been to extract classes of genes that act as important switches in development. These transcription factors control other genetic circuits. We have identified all of these that change during chick hair cell regeneration. As a consortium the HRP now has a collection of about 200 very good candidate genes for follow-up. However, software and high-speed computation are not going to do it all for us. We still need biologists to ask and answer the important questions and to direct the correct bioinformatics comparisons.

Hair cell regeneration is a plausible goal for the treatment of hearing and balance disorders. The question is not if we will regenerate hair cells in humans, but when. Your financial support will help to ensure we can continue this vital research and find a cure in our lifetime! Please help us accelerate the pace of hearing and balance research and donate today. Your HELP is OUR hope!

If you have any questions about this research or our progress toward a cure for hearing loss and tinnitus, please contact Hearing Health Foundation at info@hhf.org.

Michael Lovett, Ph.D., is a professor at the National Lung & Heart Institute in London and the chair in systems biology at Imperial College London.

Getting a Hearing Test May Be Good for Your Memory

By the Better Hearing Institute

If you want to help your memory and cognitive performance, you may want to get a hearing test and treat hearing loss. In response to a growing body of research that shows a link between unaddressed hearing loss and cognitive function, the Hearing Health Foundation (HHF) and the Better Hearing Institute (BHI) are encouraging people to get their hearing checked by a healthcare professional in recognition of World Alzheimer’s Month in September.

According to Brandeis University Professor of Neuroscience, Dr. Arthur Wingfield, who has been studying cognitive aging and the relationship between memory and hearing acuity for many years, effortful listening due to unaddressed hearing loss is associated with increased stress and poorer performance on memory tests.
 
His research shows that even when people with unaddressed hearing loss perceive the words that are being spoken, their ability to remember the information suffers—likely because of the draw on their cognitive resources that might otherwise be used to store what has been heard in memory. This is especially true for the comprehension of quick, informationally complex speech that is part of everyday life.
 
“Even if you have just a mild hearing loss that is not being treated, cognitive load increases significantly,” Wingfield said. “You have to put in so much effort just to perceive and understand what is being said that you divert resources away from storing what you have heard into your memory.”
 
How hearing loss affects cognitive function
Our ears and auditory system bring sound to the brain. But we actually “hear” with our brain, not with our ears.
 
According to Wingfield, unaddressed hearing loss not only affects the listener’s ability to perceive the sound accurately, but it also affects higher-level cognitive function. Specifically, it interferes with the listener’s ability to accurately process the auditory information and make sense of it.
 
In one study, Wingfield and his co-investigators found that older adults with mild to moderate hearing loss performed poorer on cognitive tests of memory than those of the same age who had good hearing.
 
In another study, Wingfield and colleagues at the University of Pennsylvania and Washington University in St. Louis used MRI to look at the effect that hearing loss has on both brain activity and structure. The study found that people with poorer hearing had less gray matter in the auditory cortex, a region of the brain that is necessary to support speech comprehension.
 
Wingfield has suggested the possibility that the participant’s hearing loss had a causal role. He and his co-investigators hypothesize that when the sensory stimulation is reduced due to hearing loss, corresponding areas of the brain reorganize their activity as a result.
 
“The sharpness of an individual’s hearing has cascading consequences for various aspects of cognitive function,” said Wingfield. “We’re only just beginning to understand how far-reaching these consequences are.”
 
As people move through middle age and their later years, Wingfield suggested, it is reasonable for them to get their hearing tested annually. If there is a hearing loss, it is best to take it seriously and treat it.
 
Hearing loss and dementia

A number of studies have come to light over the last few years showing a link between hearing loss and dementia.  Specifically, a pair of studies out of Johns Hopkins found that hearing loss is associated with accelerated cognitive decline in older adults and that seniors with hearing loss are significantly more likely to develop dementia over time than those who retain their hearing. 
 
A third Johns Hopkins study revealed a link between hearing loss and accelerated brain tissue loss. The researchers found that for older adults with hearing loss, brain tissue loss happens faster than it does for those with normal hearing.
 
Some experts believe that interventions, like hearing aids, could potentially delay or prevent dementia. Research is ongoing. 
 
Staying connected

A number of studies indicate that maintaining strong social connections and keeping mentally active as we age might lower the risk of cognitive decline and Alzheimer's disease, according to the Alzheimer’s Association website.
 
Interestingly, BHI research shows that people with hearing difficulty who use hearing aids are more likely to have a strong support network of family and friends, feel engaged in life, and meet up with friends to socialize. They even say that using hearing aids has a positive effect on their relationships.

For more information about hearing health and finding a healthcare professional, please visit: http://hearinghealthfoundation.org/find-a-hearing-health-professional.

The content for this blog post originated in a press release issued by The Better Hearing Institute on September 8, 2015.

Emerging Research Grants: 2016 Application Period is Now Open

By Laura Friedman

We are excited to inform you that the application period for Hearing Health Foundation's 2016 Emerging Research Grants program is now open. 

Through ERG, HHF, the largest non-profit funder of hearing and balance research, awards emerging researchers grants to conduct novel investigations of auditory and vestibular function and dysfunction. HHF wishes to stimulate research that leads to a continuing and independently fundable line of research. Only research proposals in the topic areas listed in our announcement, including basic, translational, and applied clinical research, will be considered:

We encourage you to review our announcement and Policy on Emerging Research Grants. If you are eligible to apply for this program, please make note of the deadlines below and review the instructions for submitting a letter of intent (LOI).

2016 HHF-ERG Timeline for Applicants:

• LOI deadline: October 26, 2015 by 5pm ET

• Full Application opens: Early November, 2015

• Full Application deadline: December 7, 2015 by 5pm ET

If you have any questions about the ERG program and process, please contact us at grants@hhf.org. 

Please forward and share this information with your colleagues. 

Noise Annoys

By Kathi Mestayer

There I was, pumping gas into my car outside a convenience store, lost in thought. Then, the harsh yammering started. “Come inside for pizza and chicken wings! You can pick up candy and evil-carb junk food! Diet soda for a caffeine fix! Whaddya waiting for?”

The moot mute button

It was hard to pinpoint the noise at first, since I have an asymmetrical hearing loss. But I quickly located the source… a speaker on the gas pump. It had a mutilated “MUTE” button on the right side, which looked like it had been pressed about a hundred thousand times. So I optimistically joined the ghosts of muters past, pressing hard, harder, again, one more time, trying to make it shut up. No dice.

My peace of mind had been hijacked! If I’d had the option of swiping my card again to make it stop, I would have!

I glanced around, stressed, helpless, and furious. I got into my car, opened the glove box hoping for an ice pick to drive into the heart of the speaker, and saw a tube of sunscreen. As I headed back to the pump, my brain worked out a plan:

“Squirt the sunscreen into the speaker!”

“But they can see you from inside the convenience store! You’ll get arrested!”

“Actually, that could be an interesting adventure. Imagine the headlines!

‘Woman arrested for trying to get silence a gas-station speaker.’”

I could blog about it!

So, I took that tube of sunscreen, aimed it into the middle of the speaker, and squeezed until it was empty. Haha! The speaker was still shouting at me, but I could picture the sunscreen working its way into the speaker, choking it into silence.

Everybody Hates Noise!

When I emailed Seth Horowitz, author of “The Universal Sense: How Hearing Shapes the Mind,” about my ice pick idea, he replied that it would have been a waste of a perfectly good ice pick.

I had to agree. In his book, Horowitz writes, “The targeted use [of noise], from louder ads to deafening store music, is an important and often misused sales and marketing tool.” It can backfire, creating strong negative impressions of the business, product, or space. In fact, the only time I ever visited that gas station again was to take the photo for this article. And I didn’t buy any gas.

And sudden, loud, unexpected noises are likely to cause a hardwired stress response in our brains. In a recent essay in The New York Times, “The Cost of Paying Attention,” Matthew B. Crawford asks himself, from the noisy chaos of an airport, “Why am I so angry?”

Volume Optional

Noise doesn’t have to be loud to be disconcerting. Last year, in my art class, two fellow students were chatting quietly at the next easel. I couldn’t make out what they were saying, but they were just close enough, and just audible enough, that my brain would not quit trying. My brain, which often gives me feedback in this kind of situation, said, “You sure you want me to give up? It might be something interesting! I know I’m going to get it in the next couple of words!”

I was just starting to feel the frustration of trying, and failing, to understand the conversation, as I turned off my hearing aids. My own personal “mute” button.

There’s More of Us Out There

Lots of smart people are recognizing public-space noise, and attention piracy, as a real problem. In “Ambient Commons: Attention in the Age of Embodied Information,” author Malcolm McCullough writes, “Silence remains necessary for individual and especially cultural sanity. This is why modern cities enforce noise ordinances. You have a right to free speech, but not to amplify it from the rooftops all night, as if the air were an inconsequential void.”

And in his book, “The Unwanted Sound of Everything We Want,” author Garret Keizer chimes in: “In the end, after all the physicists, musicologists, and social theorists have had their say, there are only two kinds of human noise in the world: the noise that says, ‘The world is mine,’ and the noise that says, ‘It’s my world too.’ We need to quiet the first and make more of the second.”

And those who don’t take note of those wise words could end up with sunscreen in their speakers.

This is adapted from Hearing Health magazine staff writer Kathi Mestayer’s work on BeaconReader.com. 

Using Words Carefully

By Jane Madell, Au.D.

We are all influenced by words. Some have easy, uncomplicated meanings (book, tree, house) and others carry a lot of emotional baggage (disabled, slow, delayed, etc.). When audiologists talk with families and children we are working with, we need to think carefully about how we describe children and test results. We do not want our words to interfere with our message.

Normal vs. Abnormal

What does it mean to say that a child’s behavior or test results are “abnormal”? Is there another way we can discuss this? Can we talk about what we expect to see and compare it to what we are seeing? We need to be sure we are talking about a specific test or behavior and not making a statement about the whole child. We need to be sure we are not saying, “Your child is abnormal.” We are saying, “Your child’s hearing is abnormal.” In audiology we might say, “Children with typical hearing have responses above this line on the audiogram. Your child’s hearing is below this line.” When describing speech perception testing, we can talk about what typical children can understand and what we may need to do to help this child understand speech better. A speech-language pathologist or listening and spoken language specialist might say, “Children with typical language development have a vocabulary of XX words at this age, your child has a vocabulary of XX words.”

Describing strengths and weaknesses

It is more useful to describe a child’s strength and weaknesses than to describe a child as having a disability (unless you are trying to get a school district to agree to services in an Individualized Education Program (IEP) meeting). Labeling a child as “disabled” does nothing to plan remediation. It is much more useful to make a list of strengths and areas of weakness. The areas of weakness, carefully defined, can result in a treatment plan. If testing identifies a hearing loss, it provides an opportunity to discuss possibilities for remediation such as selecting technology or determining therapy options. If a speech-language evaluation indicates specific areas of weakness (e.g, vocabulary, auditory memory, etc.), the report should discuss how these areas of weakness will affect language and literacy, and the therapy plan should specifically list areas to be worked on to improve skills.

When discussing test results with a child we need to remember that this is likely going to be distressing and we need remind the child that everyone has areas of strength and weakness, and we need to be sure to remind her what her strengths are.

Giving criticism or suggestions

Kids with hearing loss and other disabilities that affect access to academic information find it difficult to deal with the constant need for extra help, etc. They spend hours a week in therapy of one kind or another where they are working on areas of weakness and things that are difficult. They may be receiving preview and review services in school to help them keep up. The very fact that they need to go to see the teacher of the deaf for these services is an indication to the child that he is different than the other kids in his classroom. We need to be sure we are providing positive feedback along with areas needing improvement. If we need to give criticism, sandwich it between positive statements. While we need to give kids honest information, we need to be careful how we explain it. There is no value in telling kids that their work is “bad” or “poor,” or that “if they worked harder they would be able to do better.” We need to encourage them to work hard, but we will accomplish it more easily by being positive.

Teaching self-advocacy

An important part of success is helping kids advocate for themselves. It is very tempting as parents and professionals to advocate for our children. But we are not always there, so we need to help kids learn to advocate for themselves. They need to understand that they have a disability, and while this is not a statement about who they are as a person, it is a statement about what is needed to help them hear or learn. Talk about how to, recognize when you have missed something, and how to ask for help. If you do not know what page the teacher said to go to, raise your hand and ask for repetition, or look at your neighbor’s book. If you do not hear the answers of other kids to a teacher’s questions, ask the teacher to repeat. If you miss a friend’s comment, ask what was said. Practicing how to ask is very useful with parents or therapists modeling how to ask.

Introducing kids to others with the same disability

Kids need to know that they are not alone. When working with a child with hearing loss, it is useful to introduce them to other kids and to adults who have hearing loss. If there are celebrities who have hearing loss, it will make kids feel terrific to know about them. It helps them to understand that hearing loss is not going to interfere with being who they want to be. When it became public that Derrick Coleman has a hearing loss, it gave a boost to a lot of kids with hearing loss. I personally loved the commercial that Duracell put out with him saying something like, “They told me I couldn’t do this, but I was deaf so I didn’t listen.” What a powerful statement for kids!! Meeting physicians, audiologists, or teachers with hearing loss opens doors for kids. Audiologists, speech-language pathologists, listening and spoken language specialists, teachers of the deaf, and families can seek out adults with hearing loss for kids and parents to meet. It will help everyone feel stronger.

This post originally appeared on Hearing Health @ Hearing Health & Technology Matters’ blog on June 16, 2015. The author, Jane Madell, Au.D., is an audiologist, speech-language pathologist, and auditory verbal therapist with 40-plus years of experience in the greater New York City area.  

New Beginnings

By Margaret

Like many of you, after a fun-filled, active summer, my children are looking forward to their first day of school. With my first child, now entering the 1st grade, things were pretty seamless when she started big girl school.

This year my second child is starting Pre-K and while I have the same excitement (and anxiousness), I also have an extra set of challenges to prepare for; Emmy has hearing loss and will be in a mainstream classroom.

I compiled the below list for how to handle the beginning of the school year for parents of children with hearing loss. Some are my ideas and others were passed on from other parents. I hope by sharing this list I can help anyone else who has a child with hearing that is starting school.

1. Speak Up: Before the school year begins, schedule meetings with teachers and administrators to discuss accommodations, such as classroom seating arraignments, note-taker services, in-class participation (i.e. repeating an answer of a classmate seated behind your child that s/he may not hear), and handling emergency situations, such as fire drills. If your child has an FM unit, this is a great time to teach teachers how to use it. It's just as important for them to know how to turn it on, as well as turn it off when they take bathroom breaks!

2. Teacher-Student Communications: It's important that your child feels comfortable and encouraged to communicate with their teachers when they feel they missed something said. Include your child in these meetings to help build that relationship, and as they get older, your child likely will have the best advice (and stories) to share.

3. Reinforce Good Practices, Politely: Kindly ask teachers to face your child when addressing the classroom. When writing on the chalkboard and talking at the same time, the teacher's voice is bouncing off the board instead of going forward, making it harder for your child to hear as well as lip-read.

4. Buddies, Not Bullies: Bullying should never be tolerated, however it sometimes comes up. Talk with teachers and administrators about how to mitigate tough situations and protect your child, without having your child feeling victimized and ostracized for having hearing loss.

5. Practice Makes Perfect: Develop a scripted answer for your child (and their siblings) when asked about his/her hearing aids and hearing loss. Not only does it put the parents at ease, but helps your child confidently self-advocate.

6. Show and Tell:  If your child mentions s/he received a lot of questions during the first week of school, ask their teacher to take five minutes in the beginning of class for your child to "show and tell" their hearing aids. Not only does it promote tolerance, but it teaches your child public speaking skills. 

If you have additional tips and suggestions for managing the start of school, please add share them in the comment box below or by e-mailing us at info@hhf.org.