Tag Archives: listening fatigue

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

advocacy, daily grind, job searches, meetings, networking, , ,
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.

How much listening is too much?

daily grind, meetings, teaching, , , ,

– Michele

Listening is hard work. At the end of a long day of meetings I’m exhausted. When I share this with my hearing colleagues they’ll say “Oh, I know—me too!” But is it the same? Really? 

Studies have shown that users of hearing aids like me, who rely on speech reading along with amplification, experience listening fatigue as much higher rates than hearing people (e.g., Bess and Hornsby, 2014). We are working much harder than everyone around us to piece things together and make sense from what we are able to hear. Most listening fatigue studies are on school-aged children and the few studies of adults show that “Adults with hearing loss require more time to recover from fatigue after work, and have more work absences.” (Hornsby et al., 2016). As academics, our jobs require us to listen to others all the time—in our classes, in faculty meetings, in seminars, and when meeting with students. How do we recognize cognitive fatigue due to too much listening and mitigate this fatigue so that we can manage our work responsibilities? This is a tremendous challenge for deaf/HoH academics and The Mind Hears will explore this topic in several blog posts. 

In this post I share how I figured out my daily listening limit, which turns out to be 3 hours with good amplification and clear speech reading. For many years, I pushed through my day not paying attention to how much time I was spending in meetings and classes. Some days I felt okay while other days I ended up utterly exhausted. The kind of exhausted where I can’t track conversation and even have trouble putting my own sentences together. When this happens, I can’t converse with my family and exercise class is out of the question because I can’t follow the instructor. I just take my hearing aids out and lie on the floor with the dog— I don’ need to speech read him and he gets me. Yay dogs!  

When I explain to my listening fatigue to non-native English speakers, they get it right away. They recognize that this listening fatigue is just like when they first moved to a country with a new language; while they had good command of the new language, following it all day exhausted them. Exactly! Except I’m not going to get any better at my native language.

After a while—actually a really long while because for many years I tried to work as if I was a hearing person due to internalized ableism, which really is a whole different blog topic—and now this sentence has really gotten off track so I’m going to start over. After a while, I started to realize that for my own health I needed to avoid becoming so exhausted that several times a week, I could only commune with the dog.

undefinedIt turns out that my fancy new Garmin watch that tells me to “MOVE” every hour also detects my stress level. This image at left is from a day at a conference. All I did that day was sit in one room listening to talks with occasional breaks for coffee and meals. My heart rate stayed elevated all day due to the work of following the conversation and the anxiety of constantly deciding whether I should ask for clarification on something I may have missed or just let it go. When even my watch is telling me ‘enough is enough’ or more specifically “You’ve had very few restful moments on this day. Remember to slow down and relax to keep yourself going”, it might be time to figure out how much listening is too much

So last February I tracked both my hours each day spent listening and my evening exhaustion level in my bullet journal. 

Actually, I didn’t track this much detail—I just made marks in my bullet journal for each hour and then noted whether this was manageable. Below are two example pages. For the day on the left, the 3 Xs represent 3 hours of listening and this was an OK day. The image on the right is from another day that month. The horizontal line below the Xs means that I was on the floor with the dog that evening after 5 hours of listening. 

Yes, I know that my handwriting is messy and I tend to kick a lot of tasks to the next day. But this blog post is not about my untidiness and unreliability. What I learned from this exercise was that any day including more than 3 hours of listening would be a tough an unmanageable day. Armed with this knowledge, I could start to try to rearrange my schedule to avoid having days with more than 3 hours of listening. 

Interestingly, this goes against the advice that many academics give each other. Early career researchers are encouraged to push all meetings to one day so that you have a day free for research. This is great advice… for a hearing person. For many deaf/HoH, we may do better with two free mornings a week rather than 1 full day so that no one day is overloaded with listening.

So how successful have I been? Moderately. While I have control over some aspects of my schedule, I don’t over others. I schedule my one-on-one meetings with my research assistants on days that I don’t have a lot of other meetings. If I’m teaching a 3-hour lab, sometimes it’s just impossible for me to have no other teaching or meetings that day. But I am considering restructuring my lab activities so that I don’t need to be ‘on’ the whole time. I’ve also started talking with my department head about my effort to limit my daily meetings; this involves educating him on why listening fatigue is different for me than for hearing faculty. Had I been more savvy, I might have negotiated a listening limit when I was hired. Take note of this, future academics! 

I’m still sorting out how to manage my day and eager to learn more from others on how they successfully manage listening fatigue. As I mentioned at the start of this post, The Mind Hears wants to have a series of posts about listening fatigue. Tell us how has this fatigue affected your work day and your health. What solutions have you found?

References cited

  • Bess, F.H., & Hornsby, B.W. (2014). Commentary: Listening can be exhausting—Fatigue in children and adults with hearing loss. Ear and hearing, 35(6), 592.
  • Hornsby, B.W., Naylor, G., & and Bess, F.H. (2016). A taxonomy of fatigue concepts and their relation to hearing loss. Ear and hearing, 37(Suppl 1), 136S.