Auditory Problems: An Audiologist’s Insight
November 16, 2016 by Michelle Reynard
A Conversation Between Michelle Reynard and Dr. Lynn Sirow
As providers of Fast ForWord, a program that focuses on memory, attention, auditory processing and sequencing skills, we are always interested in learning more about the field of audiology. I recently spoke with Dr. Sirow about the warning signs and causes associated with auditory problems, advances in technology, and the impact of interventions.
Dr. Lynn Sirow has a PHD in audiology and over thirty years of experience in the field. She is an adjunct professor at the City University of New York. Dr. Sirow is also a research assistant at the Hearing Aid Laboratory at Northwestern University. She founded the Port Washington Hearing Center in New York in 1984 and is the Center Director. The center provides routine audiological diagnostic services, central auditory processing diagnostic services, therapeutic services related to hearing aids and amplification, therapy, counseling, and anything else that is needed in the rehabilitation process.
On the indications that an adult or child may need to visit an audiologist:
Dr. Sirow explains that if you are noticing articulation problems in children, especially with high frequency consonants like /s/, /th/, and /f/, that may be a speech problem, but it can also be a sign of hearing loss. Another indicator is if the individual speaks very loudly. People with hearing loss don’t hear themselves as well as they should. So, they speak more loudly to hear themselves better. That’s sensorineural hearing loss. If an individual has a conductive hearing loss, which is a middle ear problem, the voice tends to resonate in the middle ear and skull, so you hear yourself louder than you normally would and end up lowering your voice. The main problem that we see in adults is hearing in noise: the inability to hear multiple speakers or hear speech in the presence of background noise.
On how early someone can visit an audiologist:
Hearing testing starts at birth. Screening is mandated in all 50 states and done in the hospital when the child is born. If any problem is noted during the screening, the child can be brought to the audiologist within a few months. You want to catch hearing loss very early, preferably before language development.
On the misconception that Central Auditory Processing Disorder (CAPD) doesn’t exist:
The difficulty (with CAPD) is in the transmission of sound of the brainstem. It certainly exists if there are difficulties with the brainstem itself. An accident or any kind of illness disrupting transmission certainly exists. I think the argument occurs sometimes when they’re looking at difficulty in language development, auditory attention, and so forth in children. Often times, what we think is an auditory processing disorder may well be a language disorder. I believe that auditory processing disorders occur in only about 2% of the population. I think, quite often, auditory processing disorders are language disorders that we misdiagnose or that we assume may be auditory processing disorders until you evaluate them.
On whether CAPD is something an individual has to be born with or if it develop later in life:
Auditory processing disorders can develop over time. These disorders are problems with the transmission of sound from the ear up to the auditory processing center of the brain. If there’s any kind of illness or accident which disrupts the flow of information of the auditory brainstem, an accident or any kind of a hemorrhage which might be a problem in the auditory brainstem, that’s going to affect the individual in terms of central auditory processing.
It’s really a combination of language and auditory processing when there’s any kind of middle ear problem in childhood. This is because you’re dealing with intermittent hearing loss. There may be hearing loss when a child is acquiring a particular kind of language rules or portions of language. The child is unable to take advantage of that smoother acquisition of language unlike those without intermittent hearing loss.
On devices that can benefit individuals with auditory processing difficulty:
An amplified telephone lets the individual converse on the phone in the presence of background noise. A captioning phone allows users to rely less heavily on the auditory signal. From what I understand, the computer listens to the input from the other party and types it out. So, you can read what the other individual is saying as well as hear it. There are supervisors who check over and see that the computers haven’t typed out gibberish.
Usually, FM devices are viewed as personal devices, where the individual wears some kind of receiver, hearing aid, or ear buds. However, FM devices can be used with the speaker on the wall which might be beneficial to the whole class. This is helpful because, usually, at any one time, especially in the elementary school grades, somewhere around 30-50% of the children have upper respiratory problems and may have conductive hearing loss as a result.
Hearing loss can accompany a number of upper respiratory infections. That’s when you have negative pressure or fluid in the middle part of the ear, because the Eustachian tube is not opening and closing and draining out the middle ear down to the nose and throat. So receiving the signal, the teacher’s voice and the surrounding background noise a little bit louder, may actually be helpful for the whole class.
More to Come
I was fortunate enough to speak with Dr. Sirow about a number of other topics. We also discussed hearing aids, research, and advancements in assisted listening devices. We will share her responses to those questions and more in our next blog post, coming soon.