Conversation: 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 the screening notes any problem, 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 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 can disrupt transmission. I think this argument comes up sometimes when they’re looking at difficulties in language development, auditory attention, and so forth in children.

Oftentimes, 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 auditory processing disorders are often language disorders that we misdiagnose, or that we assume are auditory processing disorders until we evaluate them.

On whether CAPD is something an individual has to be born with or if it develops later in life:

Auditory processing disorders can develop over time. These disorders involve problems transmitting sound from the ear to the brain’s auditory processing center. If any illness or accident disrupts the flow of information in the auditory brainstem, or if a hemorrhage affects it, it can impair 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. A child may experience hearing loss while acquiring particular language rules or parts of language. The child can’t take advantage of the smoother language acquisition that those without intermittent hearing loss experience.

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 lets users rely less on the auditory signal. From what I understand, the computer listens to the other party’s input and types it out. So, you can read what the other individual is saying as well as hear it. Supervisors check that the computers haven’t typed out gibberish.

Usually, FM devices are viewed as personal devices, where the individual wears a receiver, hearing aid, or earbuds. However, FM devices can be used with a speaker on the wall, which might benefit 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 many upper respiratory infections. That’s when you have negative pressure or fluid in the middle part of the ear because the Eustachian tube isn’t opening and closing to drain the middle ear to the nose and throat. So, receiving the signal, the teacher’s voice, and the surrounding background noise a little louder may actually help the whole class.