Action on Hearing Loss Logo
    Total results:
    Search
      Total results:

      Scientifically speaking...

      We funded Dr Helen Willis’s PhD research assessing ‘listening effort’ for people using a cochlear implant. It’s a subject close to Helen’s heart, as she’s an implant user.

      By: Dr Helen Willis | 13 December 2018

      I lost all my hearing after contracting meningitis when I was 19 months old. When I was three, I was lucky enough to be one of the first 50 children in the UK to receive a unilateral cochlear implant. By the time I was eight, I could speak fluently and had caught up with my hearing peers. That was when I decided that, when I was older, I wanted to be able to study at the best universities, so that I could do my bit for cochlear implant research one day.

      I graduated from Oxford University with a First Class Honours degree in Physiology and Psychology, and also an MSc in Neuroscience. Now, thanks to funding from Action on Hearing Loss and Cochlear Ltd, I’ve just successfully completed my PhD at UCL (University College London). I’ve been working with Professor Stuart Rosen and Dr Tim Green to research the best way to develop an accurate tool to assess listening effort.

      A common (often underestimated) problem for people with hearing loss – even when it’s mild – is that listening can be hard work. This is because their listening effort has increased. Listening effort is a natural consequence of hearing, and is the amount of brain processing required to pick out what we want to hear from the noisy world of sound. If listening becomes difficult, then listening effort increases.

      This problem applies to cochlear implant users, too. However, this fact often takes people by surprise, because they may have gained the impression that, as soon as the implant is well established, the patient has few major listening problems. This is not actually true. Although cochlear implant users’ audiograms can become very similar to that seen in someone with only minimal hearing loss, the cochlear implant produces an artificial sound that’s different to what’s normally heard. This can increase their listening effort.

      Clinical assessments following an implant mainly focus on speech understanding (particularly when noise is present in the background), with no actual measurement of the listening effort required for that individual.

      This lack of objective measurement of listening effort is worrying because, although the cochlear implant is fantastic technology, it is not a cure for deafness. So, there are still gaps in the sound information provided by the cochlear implant, which the brain has to compensate for. As a result, the brain is having to put in ‘overtime’ to ensure that the cochlear implant user can understand what they’re hearing. This creates a greater ‘cognitive load’ for the brain. Now, the brain can cope with the missing information very well (which is why we have all the success stories), but this extra cognitive load can become a burden. This is especially true if the cognitive load is greater than usual for a sustained period of time.

      What’s particularly concerning is that this extra cognitive load (caused by increased listening effort) can increase the risk of debilitating, long-term health consequences, both physical and mental, including tiredness (even to the point of exhaustion) and depression. This is because the brain is more likely to become so overloaded with the extra processing that it ends up beingoverwhelmed.

      It’s important to understand that cochlear implant users, even when they’re performing well (in terms of speech perception), may still be experiencing stress because of the extra listening effort involved. This is why a clinical test should be developed, so that we can keep a careful eye on listening effort levels.

      As part of my research, I used a behavioural test where the participant had to multi-task by simultaneously listening to spoken sentences (with or without noise in the background) and counting numbers (which flashed up on a computer screen). By asking the participant to multi-task, you can measure how the brain is managing the cognitive load. From this, you can calculate the listening effort.

      The results suggest that cochlear implant users are, indeed, experiencing extra listening effort compared to normal hearing controls. Not only this, but the cochlear implant users’ listening effort is significantly higher even when the listening conditions are as good as they can be (such as a quiet room with no background noise whatsoever).

      It was previously assumed that implant users only really experience difficulty in noisy situations. But this may only be part of the story: it seems possible, from my results, that their brains are working harder from the moment they switch on the implant, even when there is no noise present at all.

      Cochlear implant users should not only hear well, they should also hear healthily. Listening effort needs to be monitored, by clinicians and also by the cochlear implant users themselves. Schools and workplaces, too, need to be more aware of the extra burden a cochlear implant user is having to cope with. They also need to support the cochlear implant users in finding ways to control their listening effort levels. Every cochlear implant user is unique in how they process sound, how they’re affected by listening effort, and also how they cope with listening effort.

      Potential ways to keep listening effort manageable could include taking more breaks (during a meeting, for instance), having short periods of quiet during the day, or finding time each day to carry out an activity which is relaxing (such as ‘mindfulness’ exercises, ‘mindful’ colouring, or a craft such as knitting). Essentially, the brain just needs the opportunity each day to relax, recover and generally de-stress.

      I owe a debt to the incredible, life-changing cochlear implant technology. I wouldn’t be where I am today, with the opportunities I’ve had and my academic achievements, without it. I believe my debt is best repaid (at least, in part) by finding ways of further improving the outcomes for other cochlear implant users. I hope that, with my personal experience of living with the implant, I’ll be able to use my additional insight and understanding to make a positive contribution. Ultimately, I want to help other cochlear implant users gain maximum benefit from the technology so that they can fulfil their own true potential.

      Find out more

      We depend on your donations so we can fund the best hearing and tinnitus research around the world. Donate today and help us continue our vital work into hearing treatments, so that people can live life to the full again.

      You can find out more about the research we’re funding in our biomedical research section.

      If you’re interested in finding out more about our research, sign up to receive our Soundbite e-newsletter. It’s a monthly email, filled with the latest news about hearing and tinnitus research.

      Dr Helen Willis
      Dr Helen Willis
      Helen working in her lab at UCL
      Helen working in her lab at UCL

      Recent Posts

      Protecting a lifeline in Parliament

      Over 700 of you have written to your MP, asking them to protect your local NHS audiology service. We held an event in Parliament on 26 June and MPs from constituencies across England dropped by to hear why hearing aids are a lifeline – and should be protected on the NHS.

      By: Jess McNulty
      28 June 2019

      Five steps to a more deaf-friendly workplace

      Is hearing loss affecting you at work? Do you sometimes feel stressed and isolated? Our Working for Change campaign aims to change attitudes in the workplace, so that people who are deaf or have hearing loss can thrive. Follow our five steps to a more deaf-friendly workplace. Then check out our products and services to help you focus on your job, not your hearing.

      By: Sally Bromham
      20 June 2019

      Our top five smoke alarms

      Would you hear a smoke alarm in the event of a fire? People with hearing loss may not be woken by an audible alarm. Plus, if you use hearing aids, you’re less likely to hear your smoke alarm when you take them out to sleep. Our smoke alarms are designed to work in a ‘system’, providing additional visual and vibrating alerts. Here’s a roundup of our top five smoke alarms to protect your home and family, with 10% off from 25 – 31 July 2019.

      By: Sally Bromham
      20 June 2019

      Bring your Dog to Work Day

      This 21 June is national ‘Bring Your Dog To Work Day’, but for people with assistance dogs, this is an everyday occurrence. James, one of our profoundly deaf supporters, was partnered with his hearing dog, Cracker, in October 2018 after applying for assistance through the UK based charity Hearing Dogs for Deaf People. Read about his story and his tips for working with deaf people.

      By: James
      19 June 2019

      Recent Posts

      Protecting a lifeline in Parliament

      Over 700 of you have written to your MP, asking them to protect your local NHS audiology service. We held an event in Parliament on 26 June and MPs from constituencies across England dropped by to hear why hearing aids are a lifeline – and should be protected on the NHS.

      By: Jess McNulty
      28 June 2019

      Five steps to a more deaf-friendly workplace

      Is hearing loss affecting you at work? Do you sometimes feel stressed and isolated? Our Working for Change campaign aims to change attitudes in the workplace, so that people who are deaf or have hearing loss can thrive. Follow our five steps to a more deaf-friendly workplace. Then check out our products and services to help you focus on your job, not your hearing.

      By: Sally Bromham
      20 June 2019

      Our top five smoke alarms

      Would you hear a smoke alarm in the event of a fire? People with hearing loss may not be woken by an audible alarm. Plus, if you use hearing aids, you’re less likely to hear your smoke alarm when you take them out to sleep. Our smoke alarms are designed to work in a ‘system’, providing additional visual and vibrating alerts. Here’s a roundup of our top five smoke alarms to protect your home and family, with 10% off from 25 – 31 July 2019.

      By: Sally Bromham
      20 June 2019

      Bring your Dog to Work Day

      This 21 June is national ‘Bring Your Dog To Work Day’, but for people with assistance dogs, this is an everyday occurrence. James, one of our profoundly deaf supporters, was partnered with his hearing dog, Cracker, in October 2018 after applying for assistance through the UK based charity Hearing Dogs for Deaf People. Read about his story and his tips for working with deaf people.

      By: James
      19 June 2019

      More like this

      We're really proud of everyone who's a part of Action on Hearing Loss, and hope you'll feel inspired to become a part of our community.​

      We campaign for changes that make life better for people who are confronting deafness, tinnitus and hearing loss.

      Our ears are our organs of hearing and balance. They have three parts: the outer, middle and inner ear.