The Inquiring Mind; Hearing Without Understanding: Research on Post Lingually Impaired Adults

from the center for telecommunication services the university of texas at austin this use inquiring mind produced by public station kqed fm in association with a news and information service at ut austin these discussions examining ideas and activities of a major university community to introduce this week's guest your producer cathy glover here is the same the relatives arrive for a visit and papa sits in his favorite chair and begins complaining that everyone is murdering and there really should learn to speak at mom and says he isn't listening while others just smiled knowing that papa doesn't hear is well as he used to with me is punchy garrett of the ut news service and our guest is dr leonard koper a professor of speech communication at the university of texas at austin dr koh praise doing research on post label a hearing impaired adults those who have difficulty understanding speech dr coburn how you

distinguish between someone who is post lingle a hearing impaired first as someone who is deaf when the pows langley hearing impaired person as one who experiences hearing loss after having developed speech and language in contrast to them preliminary hearing impaired person who has hearing loss either at birth or immediately after birth such that they and the development of speech and language is significantly impaired and for whom a special type of educational opportunity is needed if they're going to develop to their potential intellectually academically socially and in a number of other ways is there a sizable number of the population in the united states you who would fall into this category of being post langley hearing impaired adults the post len were hearing impaired well it depends on the age range that we referred to

if we consider them the schoolchild who isn't in the feeling we're hearing impaired category we usually think about from three to five percent of schoolchildren having significant hearing impairment some of which is medically or otherwise treatable as we increase the age range half the incidents are hearing loss increases so that by the time we get into the sixties and older we have been incidents that's probably about one in four that is significant very much some estimates of individuals going and were in excess of seventy years of those estimates are in the neighborhood of thirty four forty percent with respect to older people in nursing homes that estimate of significant hearing impairment goes as high as eighty or

ninety percent so summarizing briefly there is a very significant age effect the older you get you aren't more likely to lose some hearing indeed true is your work many with people who have head of the traumatic loss are easy gradual it just you work with both hands well i don't know what the proportion that would be of those with traumatic hearing loss vs some gradual onset died i suspect that most of the people whom we see and with whom i worked have had hearing loss over a period of years and that kerry was usually is of gradual onset and there are some armed individuals who come to us after having had a very sudden onset about i'd say that that is a very small minority inside the impact of age what are some of the factors involved in

that the causes of hearing impairment or there is an awfully large number of causes of hearing loss with respect to children otitis media or middle ear information is the single largest cause of hearing loss otitis media by definition is an inflammation of the middle ear fortunately this kind of hearing loss is medically treatable and most children if they get medical attention can overcome this problem with respect to causes that are not that produce hearing loss that are not medically are reversible i would cite to the noise has a very significant one we we've learned much from experiences during the second war and following

the second war we learned much about the effects of noise as a cause of hearing loss and a good deal of research has been done on this topic obviously perhaps a final question answers haven't been there haven't been a ride another cause that i think needs to be mentioned is effective drugs like stripped to my son and my son have what we call the odor toxic drugs clearly in the treatment of tuberculosis it was determined that stripped the meyerson was a very good drug for it that it had its side effects and severe hearing loss was was found to be one of those effects so that the dosages were a reduced and more recently the incidence of hearing loss and tuberculosis patient isn't as large as

it was before however in terms of lifesaving measures an a minus and kana my assignment strip the mice and still is it cause of hearing rockets i might go so far as to say that perhaps even aspirant enter acting with her perhaps norris or some other noxious effects may indeed b a precipitating cause currently there's a good deal of research being conducted on the effects of asper in arm coupled with noise exposure and other kinds of summer things you touched on a phrase that their severity of the impairment and them i'm wondering if you can give us some kind of description of what we're adults that you work with what they might hear are they hearing in being able to distinguish most to the words in a sentence and exit for maybe one or two or do they hear sound without distinguishing words are one is that the

level of impairment well i think any to point out that there are two dimensions of hearing one has to do with the loudness loss terms of intensity as we measured in decibels with a calibrated to audio motor they have the machine that we test hearing with alonzo loudness losses one aspect of it many of the second dimension is what i would call clarity or in more technical terms of the effect of high frequency loss in the presence of a fairly good or pretty normal low frequency hearing this kind of situation causes wanted year low frequency sounds low pitched sounds like the walls quite well end high frequency sounds like some of the voiceless consonants like ensign and the states sound and the t h sound and some others causes the person not to hear these

clearly such that if i were to put my hand over my mouth and just simulate that problem you would hear words like noor noor noor noor and those are probably coming out very muffled and yet if you had seen me say those i would have said death death depth debt and deck and seeing me and hearing me you can you can tell it those final consonants are now we call this a problem of speech discrimination and this is particularly characteristic of the press of the problems that order individuals face not necessarily just order let this is a a specific problem that older people are frequently and say that they have i've heard literally thousands of times

that the state and i can hear you but i can understand it cocaine your research are you doing both with gladness and with the differentiation of the sands we'd we do indeed have to concern ourselves with both the loudness of theirs and then the discrimination or the clarity of speech the loudness loss can be taken care of at least in part by my inappropriate and hearing aid the hearing aid will will function as an amplifier obviously a hearing aid can be thought of as a um personnel public address system if you will have it increases the loudness now although the hearing aid isn't what we would consider a high fidelity amplifying system good for the person who has usable residual hearing in the higher frequencies in a higher pitched

tone that speech can be made sufficiently loud and clearer for them to profit significantly from amplification that in those cases where there is a discrimination problem and that loudness cannot a simple increase and loudness cannot accommodate that person then there is a great problem of hearing clearly even though the person wears suitable amplification in these cases we suggest that the person improve his ability to get meaning from the visual components of speech and that we call a pre most people have poked central to improving their ability to lip read so learning to listen learning to use the hearing aid and learning how to get meaning from the visual components of speech those are aspects of our car our rehabilitation and that we provide

hearing impaired individuals you're listening to be inquiring mind our guest is dr leonard copra from the speech communication department at ut austin speaking on his research concerning puzzlingly hearing impaired adults a plague touched on the lip reading aspect is this something that has by largely been left to say those children who are considered to be deaf from birth as opposed to teaching it to adults as is new on the history of lip reading goes back probably as long as it's as far back as three centuries on the early efforts on lip reading were geared toward the development of speech and deaf children and the history of lip reading instruction for adults doesn't go back more than about eighty years and ride around the turn of the century such major efforts were made to provide lip reading and for adults but the problem in those

in the early days was that methods appropriate for children were applied to adults and the adults is a different kind of person that is the post langley hearing impaired adult so the methods didn't work extremely well well during the last eighty years a number of individuals have examined what it is we can do to improve lip reading instruction for adults and it's only been in the last oh roughly twenty years that systematic research what i would call scientific research in visual communication have been carried out in the past ten years i'd say major progress has been made and lip reading and research the dough into a large degree i think it's a it has a large unknown component to it and other lot of unanswered

questions with respect to war what about what the best ways are to teach lip reading with the significant variables are why some people learned better than others and what the interaction is between hearing and lip reading and co host of other variables that that we might look and i know this is from my experience of seeing our young people but not children sort of teasing each other and learning to read each others' let's end i noticed that i have a very hard time trying to you know get in the way of their message to each other and i'm wondering if some people are just more iron i have a you know a predisposition to learn it as opposed to those of us who either not aware of has never had to learn a lot i think there are many aspects of human behavior in which there's a large

variability an inmate ability to perform some tests or other liberating as a particularly variable that is in terms of individuals ability to profit from from the visual components of speech but let me simply say that there is a high degree of variability in the innate ability to rule lip read across and the population at large i've been impressed though over the years in and the kinds of results i get from lip reading tests and administer them to students been partly for demonstration purposes and some individuals will get a ten percent and others may go as high as seventy or more percent on a rather formal test that has been developed and one might question well maybe there's a test the test's reliability there were there but there isn't because when we do it the second time it comes out very very close to the first

time so that yes some people are just innately very able to liberate well has something to do with visual perception how the way people at tandem concentrate the way people can see the hole from just a few of the parts at now this all goes on somehow miraculously in our in our brains i'm not prepared to say exactly why it is this would be one of those very important research question is that we need to pursue cokie you mentioned that the whole from gaining a whole from many the parks how much of speech is actually visible on the mathematics well surely just a small proportion of the total it if we look at all of the city speech sounds and we happen to have twenty five continents roughly and about

fifteen balls for a total of forty about a third this speech sounds that we hear from which we get meaning are visible or have some degree of visibility so let me simply say that a small proportion of the total sounds have some visible component a large discrepancy vary depending on the speaker that the local ninety eight it can then ncaa can be more easily red banana and so yes the speaker variability here is an important thing to consider without naming names if you'll consider some other news casters and television whose lips don't move at all and some of our past presidents whose mobility of the mouth is as is very small these individuals would be very difficult and to liberate and i might

add that the females tend to be more easily lipper it than males let's talk about the use of computer based instruction has that fit into your work and this is an aspect of some research that we're doing we're engaged and i'm a research project for the veterans administration for the development of the first in a series of lip reading lessons and secondly the development of some droll and practice exercises of that can be used in computer assisted instruction liberating the apparatus for this has been and developed or at least a prototype of that are bred a city and national technical institute for the deaf and we've been fortunate in getting instrumentation for use in a research project where we will use computer assisted instructional a breeding we see this computer as their

program is or visual element to it as well is this is the messy the keyboard in this quiet most readily is their visual element also in this training program yes and the visual element is in a videotaped recordings that we have a bum and so there's a television monitor that lip reading students were observed there will be a stimulus for example the question how have you been will appear on that on the television monitor without sound and the student their response on the keyboard that if he gets a portion of that he's given credit for taking this is part of that very same is played again and some clue words are given on the screen so that he gets now he has more information in another condition that we will

use very low levels of sound the person will be wearing earphones and if he misses the first stimulus clip bring stimulus that the next time it comes on and there will be a little bit of sound in the ear phones demas is that the computer automatically increases the sound a few decibels so more so that we have two kinds of clues here or what i would call a rebalancing one is linguistic in the form of two words the other is auditory in the form of increased loudness and is the point of this kind of exercise to determine which is the most beneficial if a person can understand what is being said through only visual cues and then lean into whatever degree the volume increase makes it easier for then understand what other research questions that i'm interested in pursuing as the effect of the auditory cues are

clues races linguistic core word clothes we really don't know which of these is better in terms of drill and practice so we we hope to get some information on what kind of clues are better in promoting lip reading skill in for the hearing impaired person for those averse you are engaged with dealing with people who might have some minor hearing impairment in the meantime when this kind of thing is not available other things that we can do just one on one during our conversation that will enable that person to understand this more clearly i think there are number of things that all of us can do but one doesn't have to be technically trained to do to be able to help lead hearing impaired person understand better for example if every kid didn't speak slightly louder than than normal without shouting because shouting exaggerates this would help most of his tend to talk too

fast it would slow down just a little bit that would help most of us mumble at times because so we can mumble and still be understood by the normal hearing personally if we would pay just a little attention to be what i would call the precision of articulation house clearly we form our sounds and words that would help we frequently have had it so of putting her chin on her elbows as i am now and that could be disturbing so i'd say keep the hands away from a mouse acquit don't bumps the head don't to go and take the pipe cigar a cigarette out onto one pencils and entering else that it might be tragic week we have and a number of other things usually about juan the things that occurs to me is that before we talk to the hearing impaired person we should get their attention somehow

instead of calling from one room to another and then getting upset because someone didn't respond well while i think that there's one thing we need to try to be and it's difficult really to be a patient listener every person doesn't understand we should try to seek ways to help the communication situation and we need to be patient with me too except we need to have self control our guest is conductor leonard koper professor of speech communication at the university of texas at austin speaking on his research concerning puzzlingly hearing impaired adults those who are here without understanding i'm kathy glover for an inquiring mind yeah yeah i know you've been listening to the inquiry line a series of programs about the members of the major university community their ideas and opinions expressed in this programme

do not necessarily reflect the views of the university of texas at austin inquiring mind is produced by public station in association with the news and information service and distributed by the center for telecommunication services all at the university of texas at austin matter who would misuse the longhorn radio network