Cochlear Implant Rehab for SSD: How to Improve Your Understanding of Speech in Noise

If you have single-sided deafness (SSD) and are one of the increasing number of adults around the world who’ve decided to receive a cochlear implant (CI), you’re probably looking for ways to get your listening up to speed! In this post, we share a couple of activities to improve your listening with your CI and understanding of speech in noise.

Whether at work or out and about, we spend much of our time in noisy environments, or at least in places with noise humming along in the background. Being able to communicate in these environments is so important in our daily lives. Speech understanding in noise is helped when the brain can interpret and understand speech information arriving from both ears—or in people with SSD and a CI, speech information arriving from the typically hearing ear and the CI.

To understand speech in noise, the brain must interpret the signals coming from either side and focus in on the better signal (the one with less noise, or a clearer message), or integrate information from both sides to fill in the gaps in the message. Building your listening skills with your cochlear implant alone in quiet is the first step to then being able to understand speech in noise.

How to Set up Listening Practice

Listening activities that target the CI side alone can be difficult to set up with one typically hearing ear. This may be done using what CI rehabilitation specialists call the “free field technique” or with direct audio input.

• The free field technique involves the typically-hearing ear being blocked during listening tasks with an occluding earmold, earplug or earphones so that the CI receives the stronger auditory signal (in this condition, the typically-hearing ear may still receive some auditory input). Have a friend or family member provide the spoken information in your listening activities.
• Direct audio input involves listening materials being sent directly to the CI audio processor via a device (computer, phone, tablet) using a cable or wireless. Using a cable is better as it achieves the most consistent input. Consult with your audiologist if planning to use direct audio input, as a dedicated MAP may be required.

How Can I Improve My Listening With My CI?

• Take a look at the activities we’ve shared on the blog in early articles for adult cochlear implant rehab, such as this activity and handout for listening practice using maps. Although written for standard CI rehab, the same activities and materials can be used. Use the free field technique explained above. Ask a friend or family member to provide the spoken instructions and sentences. Block your typically-hearing ear, so that you listen with and exercise your auditory brain pathways on your CI side.
• Further activities can be found in the MED-EL Adult Rehabilitation Kits. Although the Adult Rehabilitation Kits are aimed at rehabilitation specialists, the activities and materials can also be used by recipients at home. Use the materials included in the Adult Rehabilitation Kits with the free field technique.
• Listen to podcasts and audiobooks with direct audio input to your CI. If you are not sure where to start, read our guide to using audiobooks and podcasts to develop your listening skills.

How Can I Improve My Understanding of Speech in Noise?

Once you can follow instructions of increasing length and complexity and simple conversations with your cochlear implant alone, add background noise to your listening practice.

• Start by playing white noise or orchestral music (sound or music without speech) at low volumes in the background while you work through listening activities with both ears together, or if this is too easy with your CI alone through DAI.
• Remember, the addition of noise will make listening more difficult and you will need to move back to easier, early activities.
• If this becomes easy, add background noise such as ‘multi-speaker babble’ or slowly increase the volume to continue challenging yourself!

Finally, the best way to improve your understanding of speech in noise is to reduce or remove the noise! Wherever possible, try the following:

• Position yourself away from noise sources (loudspeaker, open windows, restaurant kitchen).
• Reduce the distance between you and the person you are speaking with.
• Use assistive listening devices.
• Use and share strategies with your family and friends to promote successful communication exchanges.

Looking for more rehab activities? The popular Rehab for Adults series offers you a variety of resources available for you to print and use at home.