Life With a Deaf Dog by Danica S. Billingsly, Au.D.

Rosebud (“Rosie”) is a one year old mixed breed dog, born into unknown conditions in rural Kentucky.  Sometime in her first six months she ended up at an animal shelter, and was placed on “death row”.  While in the pens, she was attacked viciously by a group of other dogs.  A no-kill shelter in McLean County picked her up, performed surgery on her wounds, nursed her back to health, and found her foster care.  A few months later, two little girls boarded the adoption bus in a Bloomington parking lot, spied the striking white dog with a pink nose and lots of scars, and fell in love. She was friendly to the girls, she didn’t lunge on the leash, she was happy to be petted. The adoption bus staff said cautiously, with hope in their eyes, “There’s just one thing.  She’s deaf.”

The word “deaf” didn’t scare Danica and Doug Billingsly, however.  Human hearing loss has been a part of their family identity since Danica chose a career in audiology.  Dr. Billingsly works every day with patients whose untreated hearing losses have affected their self-concepts, and acute hearing is so much a part of our concept of what makes a dog…a dog.  Rosie will never be trained as a guard dog, as she can’t hear a door open in the house.  She wouldn’t be a good sports dog as she doesn’t hear the approach of other animals at a distance.  She can’t be called in verbally from the backyard.  Rosie is also sometimes socially awkward with other dogs, as she doesn’t catch sound cues like low growls, and takes the sniffing “conversation” too far.

Living with a deaf dog takes a full shift in understanding of how we communicate.  Take away the usual verbal commands, and you have facial expression, stance, and gestures … body language.  Some trainers will suggest that deaf dogs be trained using a vibrating (not shock) collar, in order to get the dog’s attention at a distance.  Rosie’s new family found that she is attuned to floor vibration, and has made a language  of the interplay of light and shadow.  Her attention can be easily gained by stomping the floor and waving a hand or by flicking a light switch.  Her favorite play is to chase a flashlight beam.  She can be called from the backyard quickly (and silently) using a simple laser pointer shone on the ground.  Rosie learned the commands of “sit”, “stay”, “drop it”, “come” and “no” as well as the important “good dog” using gestures based in part on American Sign Language.  And because Rosie’s attention comes from her eyes, not her ears, she walks using a head halter instead of a collar-leash.

Rosie’s family has found some silver linings in her deafness.   A deaf dog doesn’t hear the doorbell or the garbage truck.  She doesn’t care if the “squeak” has been removed from her squeaky toys.  She doesn’t mind the mail carrier’s visits.  She doesn’t join in the neighborhood barkfests.  And she can sleep through the Fourth of July, as long as the blinds are down.  But for the most part, Rosie – like her millions of human counterparts with hearing loss – isn’t a “Deaf Dog”.  She’s just a dog with a family who loves her, and she happens to not hear.  If you see Rosie out walking in Bloomington with Dr. Billingsly and her family, feel free to stop and wave “hi”; Rosie loves to make new friends.

What you do with what you hear is often the term used to describe auditory processing, also known as central auditory processing.  It is what happens when your brain recognizes and interprets sounds around you.  Any disruption in this process results in an auditory processing disorder because the ears and brain do not fully coordinate.

Auditory processing is especially important for children because they are learning.  This is how they make sense of the world of sound around them.   Children with an auditory processing disorder cannot recognize subtle differences between sounds in words, even if the words are loud and clear enough, resulting in difficulty following directions or concentrating in the presence of background noise.  Auditory skills include:  telling which direction a sound is coming from (localization), telling the difference between two keys on a piano (discrimination), following a melody (ordering), understanding someone in a noisy restaurant (competing sounds), and understanding someone who does not speak clearly (degraded sounds).

The cause of an auditory processing disorder is often unknown.  It can occur as the result of head trauma, lead poisoning, or chronic ear infections.  Auditory processing disorders can also be associated with conditions such as dyslexia, attention deficit disorder, autism, language impairment, and developmental delays and/or disorders.  Diagnosing an auditory processing disorder is difficult when a child may also have a language, learning, or attention disorder.  It is impossible to completely differentiate among these disorders. Auditory processing disorders affect approximately 5% of school-aged children.

Some symptoms of an auditory processing disorder include:

• Difficulty paying attention to and remembering auditory information
• Problems carrying out multistep directions
• Poor listening skills
• Easily distracted by background noise
• Often asking “huh?” or “what?”
• Disorganized and forgetful
• Low academic performance
• Behavior problems
• Language difficulty
• Difficulty with reading, comprehension, spelling and vocabulary

If an auditory processing disorder is suspected, an auditory processing evaluation should be completed.  An Audiologist will perform a comprehensive hearing test to rule out any peripheral hearing loss.  Next, various listening tests are administered to assess various areas of auditory processing.  Each test is designed to assess specific auditory processing abilities.  An auditory processing evaluation is typically completed in children at least seven years of age.  Younger children’s brains have not matured enough to accept and process a multiplicity of information.  Auditory processing skills improve over time and are often not completely developed until age twelve.

Parents and teachers are often the first to notice auditory processing problems.  If an auditory processing deficit is suspected, there are several things that can be done at home or at school to assist the child in achieving his/her full potential.  Suggestions include:

• Reduce background noise as much as possible at home and at school when the child is working on homework.
• Have the child look at the person who is speaking.  Tap the child on the shoulder or call the child’s name before speaking in order to attain their attention first.
• Ask the child to repeat directions back to the parent or teacher and to keep repeating them aloud until the directions are completed.
• Use words such as first, next, and finally when giving multistep directions.

Treatment of auditory processing disorders is highly individualized.  There is no one treatment approach that is appropriate for all children with an auditory processing disorder.  A multidisciplinary approach is often best.  Members of this multidisciplinary team might include an Audiologist, Speech-Language Pathologist, School or Clinical Psychologist, Classroom Teachers, Parents, and Physicians.  Treatment involves three main approaches:  environmental modifications, compensatory strategies, and auditory training.  Treatment often includes a combination of these strategies, individualized for the student and their particular difficulties.

Adults may also have an unrecognized auditory processing disorder.  Because it is difficult to diagnose, it is crucial to have an evaluation done by an audiologist with the specialized skills necessary to properly test and interpret the results.  Many Audiologists do not perform this testing or have the physical set up to do so, such as speakers in the sound booth at different angles, specifically recorded test materials, and analysis capabilities.  Therefore, the importance of seeing an Audiologist with training in Auditory Processing testing, and appropriate testing tools, is of the utmost importance.

By: Arica Rock, M.S., CCC-A, Clinical Audiologist, Bloomington-Normal Audiology

Have you ever given much thought to your smoke alarm? For the majority of people, the answer is probably “no.” You may remember to change the battery in your smoke detector when you “spring forward” or “fall back” with daylight savings time, but other than that it is not something we often think about. For someone with hearing loss, this can pose a safety concern.

Currently in the United States, 36 million people over the age of three have some degree of hearing loss. Hearing loss affects approximately 10% of all adult men and women. The number of Americans with hearing loss has doubled in the past 30 years. And, three in 1000 infants are born with significant hearing loss each year.  With the number of individuals with hearing loss rising, assistance for those with hearing loss is important. Hearing assistance can go beyond the use of personal hearing aids. There are many Assistive Listening Devices (ALDs) on the market today. Some of these devices address safety concerns for those with hearing loss. And one of these safety concerns is the ability for individuals with hearing loss to effectively hear a standard smoke alarm in the event of a fire.

According to the Federal Emergency Management Agency, fires are the fourth leading cause of accidental fatalities. Most residential fires occur between 11 p.m. and 7 a.m., when the majority of people are sleeping. Individuals with hearing loss, even if they use hearing aids, typically remove them before going to bed at night, which makes them ineffective in assisting these patients in hearing a standard smoke alarm.

Most standard smoke alarms used in homes in the United States emit a high frequency signal. The majority of hearing losses occur in the high frequency range. This is alarming! Although with proper amplification, this signal should be heard by individuals with hearing loss while wearing their hearing aids, the concern remains for those times when the patient is not wearing their hearing aids or is sleeping. Although there are safety standards in place for smoke alarms, there are no requirements as to the frequency of the signal that is emitted. This high frequency signal emitted by standard smoke alarms has been shown to be ineffective in alerting individuals with hearing loss, particularly while sleeping. Even if the signal of your current smoke detector is audible while awake, it does not mean that the signal will be successful in awakening you while asleep. A recent study revealed that almost half of individuals studied, with a mild to moderately-severe hearing loss, did not awaken to a standard smoke alarm.

Several products are now available for individuals with hearing loss. Some of the devices use a louder signal, although this is not necessarily better in alerting patients with hearing loss. Even if the signal is sufficiently loud while awake, it does not mean that the signal will be effective in waking an individual from sleep. Others combine a visual (i.e. strobe light) or vibrotactile (i.e. bed shaker) signal in addition to the standard auditory signal. Devices emitting a lower frequency signal have proven to be the most effective in alerting people with hearing loss. Several new products are on the market today that use this low frequency signal. These products even include devices that work with your existing smoke alarm.

If you or a loved one has hearing loss, this information could be critical. Contact an audiologist today to discuss these products.

BLOOMINGTON — Is it getting louder in here? Perhaps.

Whether the volume has been pumped up in recent years at indoor arenas for games and concerts, at movie theaters and in aerobics studios is a subject of occasional discussion among audiologists who treat hearing and balance problems.

“Absolutely,” Kim Perkins, a doctor of audiology at Bloomington-Normal Ear, Nose & Throat, said when asked if it’s louder at large, indoor events and movies.

“Loud is cool,” she said. “They (some venue managers) literally want you to jump out of your seat.”

Natalie McKee, doctor of audiology at Bloomington-Normal Audiology, agreed. But Denise Lux, doctor of audiology and clinic director of audiology services at Illinois State University’s Eckelmann-Taylor Speech & Hearing Clinic, said people only think it’s louder because they’re more aware of the risk of being exposed to prolonged, loud noises.

Audiologists are concerned because sustained exposure to loud noises can cause progressive, irreversible hearing loss and most people don’t know they have a developing problem until they need hearing aids.

But there are things people can do to enjoy loud indoor events while reducing the risk of ear damage.

“Noise-induced hearing loss is 100 percent preventable,” McKee said.

Audiologists aren’t the only ones with noise levels on their radar screen. At two large Twin Cities arenas, balancing noise levels has been a recent priority.

“Regulating sound is pretty tough,” said Peyton Deterding, Illinois State University assistant athletic director for facilities and operations. For example, at basketball games at Redbird Arena in Normal, the diverse crowd includes people who prefer music quieter and those who want it pumped up.

“We’re trying to find a happy medium,” Deterding said.

Before August, ISU received occasional complaints about the sound levels in Redbird Arena. There were areas where some fans thought it was too quiet and other areas — such as parts of the upper bowl — where some fans thought it was too loud, Deterding said.

“In August, we (took decibel readings and) spent $60,000 to upgrade our audio system to even out the sound levels,” he said. “That helped.”

Deterding doesn’t know whether arenas are louder overall and said noise levels vary greatly.

“People strive for loud arenas to intimidate the competition,” he said.

At Redbird Arena, the Teflon roof and sound baffles that hang from the roof soak up a lot of sound, he said.

At U.S. Cellular Coliseum in Bloomington, a decibel meter (which measures units of loudness) was purchased in December and the manager on duty will monitor and record decibel levels for each event, including concerts, Bloomington PrairieThunder hockey games and Bloomington Extreme football games, said Bart Rogers, Coliseum vice president and general manager. Noise levels was a topic at the fall meeting of the International Alliance of Venue Managers, he said.

In addition, limiters on the sound system control how high the volume can go, he said.

“I’ve been in the sports business for over 20 years and I don’t think it’s louder,” Rogers said. “When the players are introduced, there is excitement and the music helps to get people excited for the face-off or the kickoff. We want to make sure that people are having a good time and music is a big part of it.”

In his three years at the Coliseum, Rogers said he’s received no more than five complaints from people who said it was too loud. All complaints were lodged before a game, when music was playing during team warm-ups, he said. No one has complained during a game or concert.

When a complaint is made, Coliseum management goes to the team and works with them to adjust and monitor the sound levels, Rogers said. In addition, most Coliseum ushers and guest services have ear plugs available free for customers who request them. Ushers also may work with customers to find a seat that isn’t as close to speakers.

“We want to make sure that all our customers have a good time,” he said. “But there are a lot of variables,” including the size of the crowd, the team and the type of band that is performing.

“The bands control the sound and fans of some of the performers we’ve had here — such as Alice Cooper — expect it to be loud,” he said. Kenny Chesney brought 20 semi-tractor-trailers of sound, light and video equipment.

What audiologists — and responsible venue managers — are trying to prevent is hearing loss. If you have to shout over background noise to be heard, if the noise is painful to your ears or makes your ears ring or if you have decreased or muffled hearing for several hours, the noise has been dangerously loud, according to the American Academy of Audiology.

When the ringing or muffled hearing stops, people think they’re OK. Actually, cells in their inner ear have been damaged, Lux said.

With more exposure to loud noises, more cells are damaged but the person might not know that’s happening until enough cells have been damaged to result in hearing loss, she said.

“Once those cells are dead, they’re dead,” she said. “You won’t notice it until you have measurable, irreversible hearing loss.”

Noise-induced hearing loss can be caused by prolonged exposure to any noise more than 85 decibels. Those includes lawnmowers (90 decibels); MP3 players at full volume (100 decibels); concerts, car racing and sporting events (as high as 110 decibels).

Any noise 90 decibels or louder should be avoided for longer than 30 minutes without hearing protection. The louder the noise, the briefer the time before damage occurs.

For some people, prolonged exposure to noises more than 85 decibels can hurt their digestion, raise their blood pressure and heart rate and cause irritability, Perkins said.

The Illinois Telecommunications Access Corporation (ITAC) has been a provider of equipment for the Deaf, Hard of Hearing, Late Deafened, Speech-Disabled, and Deaf-Blind since 1988.  They recently launched a voucher program that provides amplified telephones to the hearing impaired AT NO CHARGE.  These phones have been designed with the hearing impaired in mind, providing levels of amplification that are difficult to find in regular phones.  Controls on the phone allow the user to adjust the volume of the speaker as well as the ringer.  The phones are hearing aid compatible, but can be used without hearing aids as well.

There are no age or income restrictions to take advantage of this service. The requirements are:

• Be a legal resident of the State of Illinois.
• Have working land line phone service in your home.
• Be certified by a physician, audiologist, speech-language pathologist, or DHS/DRS counselor.

The application can be downloaded directly from the ITAC website. For this, and more information, please click on the link: http://www.itactty.org/

Please feel free to contact our office with any questions regarding this program.  Applications are available in our office as well.  Many of our patients have taken advantage of this service and are very satisfied with their new phones!

So what is an Audiologist? When this question was posed to people walking in a busy shopping/business area, the responses included:

• “Someone who works at a TV Station”
• “I have no idea”
• “Someone who adjusts music for recordings”
• “Someone who sings”
• “Audio, audio, audiolo…geez I can’t even pronounce it!”

Audiologists are the licensed hearing healthcare professionals who diagnose and provide audiological treatment of hearing and balance disorders. These specialists are responsible for identifying and rehabilitating hearing loss in individuals of all ages, from newborns to seniors.

Audiologists may practice clinically in hospitals, physicians’ offices or in a private practice setting. Some Audiologists teach at universities and some work in the industrial world, helping employers comply with OSHA noise standards. Research Audiologists conduct research in all areas related to audiology and hearing science. Audiologists can sub-specialize and work exclusively with children or persons receiving a cochlear implant. A few Audiologists work only with professional musicians, for whom hearing preservation is very important to their profession. A select group of Audiologists practice “forensic audiology” and are called to assist law enforcement personnel with cases where knowledge of acoustics is needed.

The Americans With Disabilities Act (ADA) specifies hearing loss as a handicap; Audiologists often with work with employers to assist them in making accommodations for their hearing-impaired employees. There are also Audiologists who have special interest in the balance portion of the inner ear and devote themselves to evaluation and treatment of vestibular/dizziness disorders.

For many years the entry level academic requirements for becoming an Audiologist began with completing a Master’s Degree program in Audiology. Upon completing this degree, it was necessary to pass a national “Board type” written examination and then spend one year in a clinical fellowship. Those interested in teaching at the university level or conducting research would complete a Ph.D. Program in Audiology. Recently, academic requirements to become an Audiologist have changed. A doctoral level degree is now required. Au.D. programs accept persons with a Bachelor’s degree with a strong science emphasis. The Au.D. programs themselves typically include four years more of academic and clinical training. Upon graduation, a national competency examination must be passed. Audiologists who hold an existing Master’s Degree in Audiology may continue to practice. Many Master Degreed Audiologists have chosen to “return to the classroom” and earn their Au.D. degree.

The field of Audiology began in the late 1940’s. WW II servicemen and women returned home to find that the excessive noises to which they had been exposed during combat had damaged their hearing. The Veterans’ Administration was the first to train audiologists. During the 1950’s, the US experienced a rubella epidemic that left many children severely hearing- impaired. Audiologists were needed to serve these Veterans and to work with the children who needed assistance to overcome the effects of their hearing loss. Test equipment to assess hearing loss was very basic compared to today’s standards. Audiologists today have multiple types of instrumentation allowing for very detailed and specific results to be obtained. Certainly, examples include the auditory brainstem response test and the otoacoustic emissions test which allow Audiologists to accurately determine the hearing status of a newborn infant. In fact, legislation now exists nationwide which requires that all infants have a hearing assessment prior to discharge from the birthing hospital. The devices now available to assist hearing-impaired patients include high tech digital instruments, Bluetooth technology and the much improved cochlear implants that can offer tremendous help to the very severely hearing- impaired population.

With the increased life expectancy of the US population, more and more individuals are finding themselves in need of hearing assistance. It is estimated that 33 million Americans experience hearing loss. As these persons look for care, it’s important that the distinction between hearing aid salespersons/dispensers and academically trained, State Licensed Audiologists be appreciated by the general public. AARP addressed this issue and stated,”more important than the specific hearing device that might be recommended, is the expertise of the person fitting the device.” Anyone seeking evaluation or treatment for their own hearing loss or for a family member or friend should not hesitate to ask if they will be seeing an Audiologist.

For over 20 years, Bloomington-Normal Audiology has been a healthcare provider that you can trust.  All of the audiologists in the practice are licensed by the State of Illinois, three have earned Au.D. degrees and one is working to finish her doctoral degree.  All staff members regularly attend continuing education courses to offer state of the art care right here in Central Illinois.

We pride ourselves in taking the extra time to answer questions and provide support to our patients and their families, giving them the information that they need in order to make their decisions.

Hearing aids have improved with the advent and progressive development of digital technologies.  High speed microprocessors have not only improved the responsiveness and sound quality, but the overall appearance as well.  Our patients report that the transition from analog to digital sound quality is remarkable and they enjoy being able to ‘hide’ their aids.  This acceptance of digital technology has been reflected in the average age of the new user and their satisfaction with the product.  More people are willing to wear hearing aids at an earlier age because they perform better and are more compact.

Because of the younger user, research and development demands increased.  Users wanted more than just a hearing aid that was worn by their grandparents.  They wanted better performance and versatility; a smarter amplification device that would “tune in” to other audio devices without sacrificing the discreet look.  Manufacturers responded by designing hearing aids that communicated with each other and additional electronic devices and learned the user’s preferences based on the communication environment.  This in turn improved the overall listening experience no matter the surroundings.

Wireless communication between the hearings aids has provided several improvements for the listener from basic to advanced operation in quiet and noisy situations.  On a more basic level, the communication allows for synchronized adjustments.  If one device is manually adjusted for volume or programming by the user, the other aid is adjusted at the same time.  The advanced, high-speed processing allows the hearing aids to create a continuous 360 degree analysis around the wearer much like a surround sound system.  Within that picture a primary speaker can be located, tracked, and focused on to separate the speech from the noise.  In the past, the hearing aids were programmed individually and responded as each was told to respond to that half of the picture.  With synchronized processing we have seen improvement in localizing sound and understanding speech.

Connecting to other devices was made possible by the invention of Bluetooth.  Bluetooth technology was conceived in 1998 and can be found in phones, wireless gaming devices (think Wii and Playstation), headphones, vehicles, mp3 players, computers, printers, and televisions with a range of up to 30 feet.  Most hearing aids require a gateway device that serves as a Bluetooth receiver to pair with the wireless devices and then in turn transmits wirelessly to the hearing aids.  And hearing aid wearers have an advantage over their normal hearing counterparts – the Bluetooth signal is transmitted to both ears in stereo giving a surround sound effect while listening or communicating.  Imagine hearing your telephone or television like the person is standing right there in the room talking to you.

Technology can be intimidating for users of any age.  It is important to note that these hearing aids and Bluetooth devices have been designed with the wearer in mind, no matter how young or how old.  So whether you are thinking about getting hearing aids for the first time or an experienced user, don’t assume that you can’t learn.  We have seen patients in their 90’s using this technology very successfully.  Everyone deserves the ability to tune in to their surroundings and this is a wonderful opportunity.

Do you have a child that spends most of his or her time wearing headphones to listen to music or a gaming device?

Are you worried that the constant bombardment of sound will cause hearing loss?

Are you constantly telling your child to turn down the volume of their music or gaming device?

If you answered yes to any of these questions then the KidzSafe Earbuds or Headphones may be the perfect solution to these problems.  These devices are compatible with standard headphone jacks and have a built in limiter to control the amount of volume pumped through them.  No matter how high the dial is turned on the device the output will not be louder than 85 dB, a level considered safe for listening for as long as 8 hours.

Your children will be none the wiser.  These stylish devices come as in-the-ear earbuds and over-the-ear headphones to comfortably fit ears of all sizes.  The limiter is hidden inside and no adjustments are required.  The earbuds are available in pink, green, or blue.

Contact our office for more details or stop in and take a look at them!