2: Unilateral Hearing Loss
Deanna and Kimmy answer common questions about unilateral hearing loss and discuss strategies for supporting these students in the classroom.
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episode 2: unilateral hearing loss
Transcript
Intro: Welcome to the TOD Podcast, or as we like to say, the “TOD POD.” We chat about all things Deaf Education while you drive around. I’m Kimmy from The Hard of Hearing Teacher and I’m Deanna from Listening Fun, and let’s get started!
D: Welcome back! Denna here. So when I was finishing up today's episode I dropped the outline in me and Kimmy's shared doc, and it was way too long. Um, so we're going to get straight into it today because unilateral hearing loss is one of those topics that gets so overlooked, and we have a lot to say about it. We're mostly focusing in this episode on some commonly asked questions and how we explain the impacts of unilateral hearing loss to teachers and strategies they can use to support the students. I had a whole section on strategies that I teach to unilateral listeners in my sessions, different compensatory strategies and such, but we're going to save that for a part 2 episode because I don't think anyone, like not even TODs wants to hear us talk about unilateral hearing loss for 45 minutes straight so [chuckle]...
K: So true [chuckle]. So now we're going to go over some of the questions that come up often when working with unilateral listeners, the teachers usually ask some version of: "Since they have typical hearing in one ear, they should be fine. Right?" What do you usually say to that, Deanna?
D: So I usually explain that unilateral listening impacts 2 main things: localizing sound and understanding speech in background noise. The reason we have 2 ears is because 2 ears is better than one for these skills specifically. Listening to speech in background noise is disproportionately harder when you're only listening through 1 ear. So I have them imagine: you're in the classroom, and it's noisy, which is not that hard to imagine because many classrooms are noisy, and the student with hearing loss is facing the teacher and the teacher calls on someone to give an answer. The student with hearing loss first has to localize and turn to the student who's talking. Part of the reason they have to turn to the speaker is because it's harder to hear in background noise; so they might need to lipread or they might need to look at them to understand what they're saying clearly. And because it's hard to localize, It takes them an extra second to find the speaker because they have to visually scan the classroom. And by the time they figure out who is speaking, and focus on them, they're already done talking, and they've missed the entire comment. So having perfect hearing in one ear doesn't help you if you're struggling to locate the speaker and struggling to hear that speaker in background noise, once they start talking. So that's kind of my go-to example.
K: I really like that example. I like the visualization part of it. That really helps teachers understand, and put themselves in the student's shoes. I Also want to say localization is definitely an important classroom skill and one that can be challenging for students with single-sided deafness or even with uneven hearing loss. For me, even with my hearing aids, I can rarely localize sound sources because my hearing loss is worse in my left ear than my right ear, so it still makes it really hard for me to find a sound source as quickly as someone who has even hearing. The other thing that seems obvious but gets overlooked all time is that the student may struggle to hear people on their poor side even if the student has preferential seating, kids get up and move throughout the day; and if someone is standing on their poor side, they can be missing a big chunk of information.
D: Yeah, and that means- when are they going to struggle? In like social situations or group speaking situations where it's noisy, several people are talking at once, maybe they're moving around - so like hallways, lunch, group projects - Those situations are going to be harder.
K: Plus they may experience higher levels of listening fatigue because they need to work so much harder to focus to listen. They need to constantly monitor the speaker to see if they're on their better side. They need to maintain visual access and all of that can be really draining.
D: And what that all adds up to for a student with unilateral hearing loss is sometimes it can look like they're “selectively listening”, and I'm doing that in air quotes because that's like not a thing.
D: Or that they're not paying attention or they may be accused of only paying attention like quote unquote when they feel like it. The reality is that in certain situations they're hearing better than others because that's the situation they truly are hearing differently in different situations based on their location, the background noise, the speaker. All of those factors. And sometimes that can look kind of like ADHD, like students may zone out if they're experiencing listening fatigue. They might miss important directions or be distracted because they don't know what they're supposed to be doing. Or you know someone was sharpening a pencil when you were talking and they they didn't filter that out so they missed what you said. It's hard to predict what the problem is going to be, but it all adds up to that kind of looking distracted, looking confused, because they missed little bits and pieces of information. I've heard of some teachers they give out like ear plugs during inservices and let the teacher listen with 1 ear plug in, for like part of their day, and let them truly experience how disorienting it can be to only listen through 1 ear. And I think that although I've never personally done that, I think I should. I think it's a great idea.
K: Yeah, I love that idea for an in-service. I think simulations of hearing loss like that or even Youtube videos can be so beneficial to help people and teachers to understand what the student is experiencing. Because it's not something that people often think about or really get to dive deep into understanding how even little bits of hearing loss can affect you.
D: That reminds me, there's actually a really good simulation, I'll link it in the show notes because I can't remember the name off the top of my head, but it's basically where they simulate a unilateral hearing loss it works best with headphones but you can do it through speakers. It like has the listener try to localize like there was a crash. "What direction did the crash come from?". Or you're in like a situation with speakers and the person turns their head, and says something to someone else and all of a sudden you can't hear it. It just shows like in real life the intermittence of unilateral hearing loss. And I'll link it because it's ah it's a really good one if you have the time to go into it. It's a really good simulation.
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K: This episode is brought to you by the Itinerant Caseload Planner from The Hard of Hearing Teacher. If you're looking for a way to manage your crazy caseload, I have a time-saving, auto-calculating, all-in-one solution just for you. My digital planner will help streamline your planning process and simplify your data collection. With all of the student's sheets linked together, you can find information quickly. Get started organizing your caseload at the link in the show notes and at listentotodpod.com . Now let's get back to the show.
[Music]
K: Next question, How would you explain teachers what they can do to support the student that has a unilateral hearing loss?
D: So if they use technology, and particularly if they are very young, I make sure that they keep the technology a priority. Wearing the device consistently when they're young can help them develop stronger listening skills and language skills, and they can still experience listening fatigue like any hearing aid user, but it can help with localizing, listening in background noise, etc. It's easy to fall into the trap of they can -they don't have to - wear it because they can hear fine in 1 ear. So right from the beginning with young students, I try to prioritize like this will set them up for success in the future. If they have better access now when they're younger and there's not time for those delays to develop.
K: Yeah, also reducing background noise in the class as much as possible. There are sometimes sources of noise we don't think about like the hallway, the pencil sharpener, like you mentioned, the HVAC system. You'll want to look around the room, listen, and see what makes sense for the space. This is why I always visit a student's classroom within the first couple days of school or during in-service to make sure I can help point out those things to the teacher because if you're not trained to notice them, they can really easily go overlooked.
D: Can I tell you something funny I was in a school a really really old building like truly the worst acoustics I've ever experienced. It's like a hundred year old building. And they can't turn off I don't know I think it's that they can't turn off the heat. So the heat is just on all of the time like the teachers don't have control over it. But then, even when it's warm, the heat is still on so then they also turn on the window AC unit and a fan.
K: Oh no.
D: So, it's like all of the HVAC system going at once. Plus there's like the tall ceilings and the cinder block like it's literally the worst acoustic environment I've ever been in my entire life. And the teachers know that so they use a bunch of the accommodations we're about to talk about, but it was like truly wild. I was like, "This is literally worst case scenario".
K: Well, I bet that you work on a lot of advocacy skills with those students.
D: Let's just say the FM is very consistently used for that child.
K: I hope so.
D: But even if they're not that obvious, like there's usually during an in-service, like, a source of background noise that I try to point out to teachers. You know, like I listen and I'm like, "Ok, I hear beeping. I hear shuffling in the hallway." And I try to like point them out that like even that level of background noise can be distracting. I also talk about gaining auditory attention prior to giving important directions or visual attention. I also mention trying not to give directions during transitions because that's like the noisiest time of the day, and a lot of teachers do that like the bell rings or whatever and everyone start shuffling getting their stuff, and they're like, "Oh by the way, test on Friday, homework due Thursday, blah blah blah blah". And it's like wow, they just missed all that because they weren't looking at you, and it's noisy, and maybe let's do that before the bell rings, or even better have it written down somewhere else that they don't have to rely on you verbally saying it when everyone's shuffling around.
K: Right? Or the door's already open and you can hear a hundred other kids in the hallway because so much is going on.
D: Yeah, oh my gosh so much.
K: Group work - group work is another time where there's a lot of noise. Um, one way to help the student during this is just allow the student to work at the back table or just somewhere that's a little quieter. If they're directly in the middle of the room surrounded by noise, it's going to be really hard for them to hear their group mates and if you're giving directions, while group work is going on, there's way too much to follow auditorily and it's definitely getting lost in all that noise.
D: Yeah. I feel about talking about group work specifically with teachers is really helpful. I usually say something like, "I'm not here to change the way you teach like rather help make what you already do more accessible for the student", and I use group work as an example since a lot of teachers like to do group work. The other important factor I bring up is just generally being aware of listening fatigue, like you mentioned earlier, and providing listening breaks when needed. I usually give the example of just like walking to the water fountain or spending a few minutes in a quiet location - just generally being aware that the student might need a break. And explain it, don't they don't really have to take their devices off, like that's not what I'm saying. It's just giving them a few minutes of quiet where they can take a beat, and you know, take an opportunity to relax so that they can resume listening more strongly after that.
K: Yeah, as someone who uses hearing aids and knows that that's like that little bit of reset can be invaluable, and really help you get back into the swing of things once you return back to the room or whatever situation you're in.
D: Yeah, and I feel like if you just let teachers know that that might be a thing then like they see it more readily as opposed to just thinking that like the student is just tired or they're just not paying attention. And it kind of goes back to that unilateral listeners look like ADHD sometimes because they just look like they're not paying attention. So if you notice a change in them, give a listening break. Like, always assume that's the issue first, and then trickle down from there if it persists.
K: Yeah, I think these are all great tips. Are there any other helpful tidbits of information that you think might be helpful for our listeners?
D: I do like to tell teachers the fun fact that we gain about 6 decibels at conversation level when listening through 2 ears instead of 1, even if the hearing loss is the same. And the reason is that the brain takes information from both ears and it's more than the sum of its parts so to speak. It particularly helps with clarity of speech in background noise and that's really helpful because if you're trying to just be a little bit louder to be heard those 6 decibels can really help with clarity, and comprehension. So I like to bring that up. Another interesting thing is that more and more I'm seeing children with single sided deafness, sensorineural hearing loss of 1 ear. As of this recording the FDA has approved cochlear implants for single-sided deafness for children starting at age 5. However, it's not uncommon for children to get implanted younger than that depending on the center and the family. And auditory training for those children is uniquely challenging. Um. because you need to isolate the new implant from the typical ear at least some of the time to monitor its audition skills. I took a training on this a couple of years ago when a student like this showed up on my caseload. And long story short, you can use a HAT or bluetooth to isolate that year, but it's it's very interesting. If people are interested in that we could do a whole episode on it because now that single-sided deafness, well not that the deafness is more common, but getting implants for single-sided deafness is more common, it might be something that TODs are going to have to do more and more going forward.
K: For sure! So all this has been a very useful information and I know that we have so much more to share because we can go and on for a very long time about this topic, but I am very interested to see the feedback and questions from this episode because like you said unilateral hearing loss is often overlooked and misunderstood. And I've gotten a few questions on it from our audience, so I'm looking forward to seeing what everyone has to say.
D: As always, we welcome your feedback on this week's topic you can DM us on Instagram. I'm @listeningfun and Kimmy's @thehardofhearingteacher. Plus if you enjoy this episode, we would really appreciate it if you left a review on Apple Podcasts because that would help us a lot. Full transcript and show notes are available at listentotodpod.com . We'll talk to you next week!