Thread by @sarahlovesears

I had my last auditory rehab appointment with my SLP today, and I have some thoughts on that. (TL;DR: it was a positive experience, but it came with high demands on my time/energy. I love my CIs, but what I love more is having options for communication in 2 languages.)

I began auditory rehab immediately after my 2nd CI was activated in January. The day after I finished editing and sharing my activation video with commentary in ASL, which was about 3 days post-activation, I had my first session.

I’m lucky that my insurance paid for 4 months of sessions. I’m also lucky that because I’m an Au.D. student and know where to look to find SLP services in my area, I was able to see a SLP who knows ASL and is accepting of the fact that I communicate daily in both English and ASL.

The entire reason I got CIs in the first place is that I want to communicate effectively with the children I see in clinic who are English speakers and do not sign. So my focus in auditory rehab was on that goal: hearing well enough to understand small children better in clinic.

I decided that I would work hard toward that goal until my move for my 4th year clinical experience, be satisfied with however I progressed, then give myself a break and do only what is needed for maintenance after that. And gosh, I worked hard these past 4 months.

Doing auditory rehab is not just going for a SLP appointment once a week. It involves regular practice- daily, if possible. It involves listening to vowel/consonant combinations repeated over and over again while straining to figure out how one sounds different from another.

I did a lot of listening to my SLP behind a speech hoop as she tried to imitate the voice of a child so that I could get more goal-specific practice. I did okay with that in quiet, but even after 4 months I struggled when environmental noises (like the air conditioner) began.

I listened to audiobooks read by children, and I never got to a point of understanding the full message...although I did notice improvements over time. I was also encouraged to seek out conversations in spoken English with children during my free time.

During the couple of weeks when I had less time to practice, that would show at my next appointment. I would have more trouble with glides and nasals especially if I took a week off my dedicated daily practice time. Keeping up the skills after a therapy session isn’t automatic.

Auditory rehab is different for each person because needs vary. Due to my having been hearing before becoming deaf progressively, my brain already knew how to hear and make sense of speech. Some of the skills I worked on would not be realistic for some CI users.

In any case, auditory rehab is hard work. That’s true even for someone like me who had fully developed spoken language before becoming deaf. AR for CIs requires not only a time commitment w/ the SLP appointments/daily practice, but it also requires significant cognitive effort.

Tbh, I’ve been more exhausted than usual these past 4 months, and nothing else in my life changed before I started feeling that. Nothing new has come up medically either. The only thing that’s different is the adjustment to the second CI and commitment to intensive rehab for it.

Has it been worth the effort? Absolutely. I’ve made more progress toward my goal of hearing small children in clinic than I ever thought possible. My 2nd CI has also had a much better overall outcome than my first. But is what I’ve been doing the past 4 months sustainable?

For some people, it might be. For me, it isn’t. I was ready for my AR to come to an end today because I’m worn out. I’ve promised myself more ears-off time outside of clinic after my move next week. I say this at the same time as I’m grateful to my SLP and glad I did this work.

Hearing friends have asked, “Why wouldn’t you want to hear as well as possible 24/7?” The answer is simple. Relying on my ears all the time isn’t worth sacrificing my mental health. Could I focus on listening to spoken language for everything? Probably, but the cost is too high.

I saw someone say on Twitter recently that ability to do something does not automatically make that task accessible. That’s so true in this situation. I *could* listen with my ears almost 24/7 and do more AR, but I’d also end up depressed and unproductive. Not worth it.

Hearing people: think about that next time you interact with a deaf CI user. It may seem that we are listening effortlessly, but I promise you that isn’t true. The ability to hear with technology is nice, but if I do it for extended periods I have less energy for other things.

If I had to go back to January and decide again whether to do intensive auditory rehab for my 2nd CI, I’d still do it...but I’d probably be a bit gentler with myself. For now, I am so looking forward to some great ASL socialization when I move to my new city next week.