The Penny

Example is not the main thing in influencing others. It is the only thing.

[Friday, April 3, 2009]

Listening Laynie

Laynie has decided that she doesn't care who knows, so it's alright for me to talk about her cochlear implant.

Laynie's cochlear implant was activated on February 13, 2009, so her "ear" is 7 weeks old now. The first week was pretty overwhelming for her. A few sounds still really bother her (plastic packaging is killer), but she has mostly gotten used to it. In fact, she acts just like regular old Laynie, and it's easy to forget that she is listening.

The first three or four weeks involved a lot of "What's that?" and "I think I heard something." Now she hears few novel sounds (birds singing and rain on the roof of her car, recently), but she is beginning to respond "normally" to sounds. Instead of saying "I heard the toaster oven beep!" she just goes and gets what she was cooking.  Sound is being integrated into her life.

Her auditory processing is improving, and the sound quality is improving. A month ago, she asked me why anyone would write music for the upper third of the piano ("It's so plinky!"). Last week, she commented that those notes sound like music now. I think she was hearing it similarly to high sounds on a xylophone, or the very top piano note. Those sound plinky to me. Now she hears the slight reverberation of the notes and goes, OK, that sounds like music, I can see why people like that.

One benefit of Laynie's implant for ME is that we can watch the TV at a normal volume. With her hearing aid, she turned it up loud. Actually, now she likes it quieter than I do, because she doesn't quite have a realistic perception of loudness yet. It will come. For now, everything sounds a bit loud to her, because she's not used to that much input. Sometimes she asks me how loud something is, so she can compare her perception with mine.

It's difficult to imagine what her experience is like. When hearing adults become deaf and receive a cochlear implant, they very quickly (often on activation day) are able to understand speech. At first, they describe the sound quality as robotic, machine-like, high-pitched, or monotone. But within a few weeks, it sounds normal, just like natural hearing. This indicates that the cochlear implant mimics normal hearing fairly well. But hearing is only half of auditory comprehension. Maybe less than half.

Laynie has been deaf since birth. Before birth, I suppose. Her brain has never learned to make sense of sounds, since she was not exposed to normal sound. Hearing aids did not provide her much benefit, because she was missing so many cells in her inner ear. The hearing aids amplified the sound, but her inner ear distorted it beyond all recognition. Because of that, she didn't use her aids much as she got older. People don't use things that don't benefit them. At any rate, her brain did not receive enough usable input to make sense of things, and the auditory processing area of her brain probably did not develop well. fMRI scans of deaf people have shown that the visual processing areas of the brain are larger than those of typical people. In fact, the visual processing areas wrap around into where the auditory processing areas should be. It's not a myth that deaf people have superior visual skills.

With blind people, it's just the opposite. Their auditory processing areas extend into the usual visual processing areas. Here is a journal written by a man who was blinded at age three and regained some sight as an adult, following stem cell therapy and corneal transplant.

It's wonderful that Laynie has excellent visual processing skills, but what brain "real estate" is left for auditory processing? The reason that she can't understand what she hears is not because she's not getting usable input now. It's because her brain doesn't know what to do with that input. But it's learning. 

Laynie and I were just talking about how we had a reasonable phone conversation last week, even though she doesn't understand spoken language yet. We had practiced once at home. I told her that all she needs to be able to do is recognize yes vs. no (which she can do!), and then she can ask me yes/no questions. Also, she can tell me things, and I can say yes if I understand. So we had a conversation that went something like this:

Me: Hello?
Laynie: Hi. I am here safe.
Me: Yes.
Laynie: I love you.
Me: What?
Laynie: Thank you for helping me.
Me: Yes.
Laynie: I love you.
Me: I love you.
Laynie: I better go now.
Me: What?
Laynie: Bye.
Me: Bye.

OK, so I didn't follow the yes/no thing very well. It's just so natural to say, "What?" when you don't understand. We'll have to refine that. But the interesting thing is that we were talking about it today, and Laynie said she doesn't understand yes and no because of the /s/ in yes, which is how I thought she did it. She hears the shape of the word. She described it visually, so it's hard to write down, but basically "yes" looks like a steep hill and "no" looks like a shallow hill. She concluded that she doesn't really understand those words, because she doesn't hear each speech sound separately. I had to tell her that she's wrong, she does understand the words. It's normal not to hear each speech sound separately! We hear the shape of the word. A baby can't tell you that "mommy" is "m" "ah" "m" "ee," but she can produce and understand the word. In fact, it's not until preschool or kindergarten that kids learn to parse words into sounds, as part of the reading/writing process. It's often hard for them to learn.. and they've been hearing and understanding the language for years! It gave both of us something to think about.

Yeah, this is nerdy stuff.

Laynie's audiologist, Steve, said that, based on auditory nerve response, she has the potential to comprehend spoken language. It would certainly make life easier for her, particularly with employment options. I know she wants to be able to talk to her mom on the phone, which her mother would certainly love, as well. She'll need to improve her speech a little, though. So we'll keep plugging away at therapy, and Laynie will do great.


Megs | April 3, 2009 at 9:06 PM

This is probably the most interesting thing i have ever read. seriously. maybe that makes me a dork but this is all so exciting! it truly is amazing how the mind works.

Anne Hasting | April 3, 2009 at 9:22 PM

Thanks, Meg. I think it's all really interesting. I guess I'm a nerdy academic at heart. I belong tucked away in a book-filled office at some university.

Funny, I didn't think anyone read my blog.

Post a Comment