To Hear, or Not to Hear? The Mental Gymnastics of Hearing Device Use

A word cloud showing the most common appearing words in the post in different colors.
Alt text. A word cloud showing the most common appearing words in the post in different colors.

-Sarah Sparks

I had planned to write this post about listening fatigue, but as I began writing I realized that a related yet rarely discussed topic resonated more in the moment. This post is my attempt at addressing the complexity of that topic.

The mental gymnastics involved in deciding whether and/or when to use hearing devices is not discussed often—at least publicly. This can be an uncomfortable topic because the decisions about amplification use made by deaf and hard of hearing people have an impact on how we are viewed within our professions, the willingness of other people to take our accommodation needs seriously, and the assumptions made by others about our communication needs and preferences. Ideally, decisions about amplification use should be made freely. That doesn’t always happen in the context of an audist society. Some might argue that because of audism (the belief that hearing and speaking are superior to deafness and signing, and the consequent discrimination), none of these decisions are ever truly free.

I am against audism in all its forms, and I also believe it is possible to genuinely like and want amplified sound for its own sake, not because of attempts to assimilate to the hearing world. But perhaps more often than we would like to admit, deaf and hard of hearing (HoH) professionals who use hearing devices make decisions about device use based on what others expect rather than what feels best to us as individuals. 

I identify as deaf. I am a full-time, bilateral cochlear implant (CI) user who also communicates in and loves both American Sign Language (ASL) and English. In times past I would wear my CI processors from the moment I woke up in the morning until about an hour before going to bed at night, sometimes topping 18 hours of device use in a day. That was exhausting, and I’m glad that I have since found a CI use pattern more suited to my needs. These days I am still a full-time CI user in that my device use averages approximately 8 hours per day, but rarely do I use my processors outside of professional situations. I’m a pediatric audiologist, and I work with many hearing children and their parents as well as the hearing parents of deaf and hard of hearing children. I care about communicating with all of them in their native language whenever possible. Because of this, my processors go on as soon as I walk into clinic in the morning and they come off as soon as I’m on my way home in the evening. If I have class or a meeting in the evening, generally I will keep them on for that purpose. 

Mostly, I’m comfortable with my current CI usage. But my choices come with unique kinds of personal and professional costs that affect neither hearing professionals nor deaf professionals who don’t use devices. The decision to use my CIs as frequently (or infrequently) as I do has a downside that I don’t discuss often: the constant need to evaluate why I use them (or not). Every day, I notice how my decisions interact with others’ conscious and subconscious expectations for me not just as a deaf person, but also as a person with auditory access. Confident as I am in my decisions to switch up my communication—ASL, spoken English, or written English depending on the situation—often I find myself wondering about my CI use pattern and messages that others may infer, independent of anything I say directly.

Does using my CIs full time lead others to believe that I value spoken language over signed language? Maybe I need to clarify every other day that I love ASL and that spoken-language access isn’t the only reason I use my CIs…

Do my coworkers and other acquaintances see my CIs and assume that if my processors are on, they should always speak instead of sign? Maybe I should use my processors only when I want people to speak to me, but then I wouldn’t get to use them for many of the sounds I genuinely want to hear…

How does my CI use impact the willingness of employers and conference/event organizers to fulfill requests for accommodations? In the past, people have heard the clarity of my speech and thought I was exaggerating when I described the limits of my CI hearing. Maybe I’ll have to explain for the thousandth time that my speech is so clear because I wasn’t born deaf, lost my hearing progressively, and don’t hear nearly as well as I speak. Maybe this is why some deaf professionals who can hear and speak choose not to…

If I prefer to speechread my way through certain kinds of interactions, am I leading others to believe that I don’t need visual language? Maybe the access problems I experience are my own fault for opting to communicate in two languages…

If I remove my CI processors for a few hours while among colleagues in my profession, will they see me as irresponsible and make wrong assumptions about how I counsel my own CI patients? Maybe they’ll lose trust in me as a clinician or researcher and assume that I’m recommending lackadaisical or capricious device use…

My signing is clearly non-native: if I’m around other deaf professionals, is wearing my processors (even without batteries) necessary to remind them that I’m not a hearing person? Maybe they’ll see me as just another hearing audiologist if I’m not wearing them… or despite my wearing them…

Are my CIs sending the message that deaf/HoH people can be audiologists and hearing scientists only if we use CIs? Maybe I’m hurting someone else’s opportunities unintentionally just by trying to be deaf in the way that feels most okay for me…

What message does my observable CI use pattern send about deaf/HoH professionals who don’t use hearing devices at all or use their devices differently than I do? Maybe my own decisions affect whether they can get their access needs met…These are just a few of the questions that come to mind when I’m deciding whether to turn on my artificial, electronic auditory access. Needing to think through these and other costs of my CI use pattern is almost as exhausting as listening fatigue itself. Multiple times a day, I have to decide which is more important: using my CIs in the ways that feel best to me, or using them in ways that are least likely to result in negative consequences for me and other deaf/HoH professionals. Every day, I have to decide which battles I’m willing to fight and how my choices about CI use affect my ability to do so. I know that I can’t be the only deaf CI user who struggles with navigating these concerns both inside and outside of academia.

A dark haired woman, with hair pulled back and dark-framed glasses is smiling. She wears a dark colored blazer and has a cochlear implant.
Alt text. A dark haired woman, with hair pulled back and dark-framed glasses is smiling. She wears a dark colored blazer and has a cochlear implant.

Dr. Sarah Sparks: Dr. Sparks holds a clinical Doctorate in Audiology (Au.D.) from Gallaudet University. She has experience in a variety of clinical settings, including a university clinic, private practice, school for the deaf, and two pediatric hospitals. She completed her final year of clinical education at Boston Children’s Hospital where she also held a fellowship in the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program. She is currently studying at Gallaudet for a Ph.D. in Hearing, Speech, and Language Sciences. Her clinical and research interests include pediatrics, vestibular assessment and rehabilitation, cochlear implants, the audiologist’s role in counseling and self-advocacy skill development, and audiology services provided in American Sign Language. Her Ph.D. dissertation research will focus on vestibular dysfunction and its impact on deaf/HoH children.

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