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BetterCommunication Retraining the brain: Acclimatisation & hearing aids By Sharan Westcott, Principal Audiologist The brain plays an important role in not only receiving and processing sounds but also in assisting us to attend to relevant sounds and ignore those which are not important. Our world is a very noisy place. With the rapid development of technology many new sounds are being added to our environment. For example, mobile phones have introduced a whole new range of sounds with their different ring tones. When a mobile phone rings in a busy restaurant, have you ever been amused to see several people dive for their handbags and suit pockets only to discover that it was someone else’s phone? The calm mobile phone owner who did not reach for their pocket or handbag is the one that has learnt to recognise their personalised ring tone and knew that it wasn’t her phone. Her brain has heard the ringing mobile, processed the sound and discarded it as not relevant to her. Here’s another example of how clever our brain is. I rarely notice my refrigerator motor humming as it’s part of my everyday environment. I hear it but my brain processes and discards the information at the subconscious level as irrelevant. If my refrigerator starts to make a different sound however, my brain notes the altered noise as meaningful and alerts me to a problem. Part of hearing well is this ability to attend to meaningful sounds and ignore irrelevant sounds. The majority of us have learnt to do this over our lifetime and it has become automatic. When a new sound comes into our environment, the brain at the conscious level alerts us to it and we identify its source. If that sound becomes a familiar part of our environment we eventually learn to ignore it. This adaptation to new sounds is referred to as the acclimatisation effect. When our hearing starts to fade, particularly if we lose it gradually over many years, we are usually alerted to the problem because we notice we are missing out on conversation or hearing the TV. We are often unaware of how many other sounds we no longer hear, sounds that are both important and unimportant. What’s that noise? A common response from clients when their hearing aids are first turned on is “What’s that noise?” Welcome to our world. People with normal hearing cope with many potentially intrusive sounds by blocking awareness of them at the subconscious level. People who haven’t heard these sounds for some time must retrain their brain to notice them, then to ignore the ones they don’t need – like the refrigerator humming. The sophistication of technology available in hearing aids in recent years has made this less of a problem as they better mimic the clever amplification mechanisms of the ear. But the role that an individual’s brain plays in managing all the sounds they hear through their hearing aid has little to do with technology. The key factor in hearing well with your hearing aids is to retrain your brain to attend to meaningful sounds and ignore those that are irrelevant. Some individuals have learnt to do this very well when it comes to ignoring people who annoy them - children can be masters of this technique! How long does it take? Research studies have shown that acclimatising to new sounds with a hearing aid takes approximately six weeks for most people. Those with a 4 AustralianHearing
severe to profound hearing loss may adjust within four weeks. It’s important to note that acclimatisation to sound (retraining the brain) can occur only if the hearing aids are worn for several hours on a daily basis. The more a hearing aid is worn, the faster one can adapt to new sounds. This is probably why people with severe to profound hearing loss, who need to wear their aids all day, take less time to acclimatise. How do I retrain my brain? It doesn’t matter whether you’re getting hearing aids for the first time or upgrading, you will still have to acclimatise to the difference in speech and environmental sounds. The best place to do this is at home. Sit or walk around and listen with your hearing aids to all the sounds around your house. You can ask your audiologist for a Listening Check List to help you with this activity. Try to identify each sound. Do this every day until you can easily identify the sounds. Once they become familiar you’ll find them less and less intrusive until gradually your brain will ignore them and attend to more important sounds, such as the phone ring, the door-bell or a crash. Once you have developed the ability to cope with the environmental sounds around your home you will be less distracted by noise during social activities outside home. However, your brain can be retrained only if you wear your hearing aid for more than four hours each day around your home. Children or adults who are highly dependent upon their hearing aids can become very sensitive to changes in the signals they receive through them. They need to allow time to get used to the sound of a new hearing aid. They may not necessarily like how it sounds at first, even when the aid has features that should enhance speech understanding. That’s why it’s important to persevere with the hearing aids for several weeks in order to allow the brain enough time to acclimatise to the new sound. A very young child fitted with hearing aids or a cochlear implant needs to learn the meaning of sounds, especially the ones that are essential for speech, language and communication. This is a much slower process and involves more than simply acclimatisation. Children need to wear their amplification device (hearing aids or an implant) most of their waking hours to learn to identify the variety of sounds in our environment. My voice sounds funny Some hearing impaired people wearing hearing aids for the first time find their voice sounds quite different, which can be disturbing. The reason is simple. When our hearing is normal, we are used to hearing our voice louder than other peoples’ voices. However, when you have a hearing impairment, you are hearing your voice at reduced volume. Once you have switched your hearing aids on, you’ll hear it again at normal volume and the brain will need to be retrained to adapt to the new volume level. A useful activity to help you adapt to your own voice is to read aloud to yourself for five minutes each day in the first week or two after you are fitted with the hearing aid. Gradually you will be less distracted by the sound of your own voice. Patience and perseverance The aim of fitting hearing aids is to improve your ability to hear in listening situations that are important to you. Remember that hearing aids are hearing aids and to achieve good communication you’ll need to persevere and retrain your brain to discard less intrusive sounds. By consistently wearing your hearing aids and practising listening in different situations between your fitting and review appointment, you will assist the audiologist to decide whether any real adjustments are required to make your hearing aids even better. Hear&Now 5
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