Episode #33 Show Notes

(Read the episode transcript below)

On Episode 33 of All Ears at Child’s Voice: A Hearing Loss Podcast, Wendy and Haley are joined by Dr. Candice Hicks. Dr. Hicks focuses her research work on listening effort and fatigue in children with hearing loss. Join us by listening to what Dr. Hicks has to say about the signs of listening fatigue, who is impacted most by effort, and some tips for parents and professionals to make listening easier for those with hearing loss!

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Episode Transcript:

Intro (Haley with music):

Welcome to All Ears at Child’s Voice, a podcast discussing all things hearing loss. We aim to connect parents of children with hearing loss with the professionals who serve them. And now, to start the show..

Haley:

Welcome to all ears at Child’s Voice, a podcast, discussing all things, hearing loss. We aim to connect parents of children with hearing loss, with the professionals who serve them. I’m Haley Gubbins.

Wendy:

And I’m Wendy Deters. Today on the show we talk to Dr. Candice Hicks. Dr. Hicks is the chair of the Department of Speech Language and Hearing Sciences at Texas Tech University Health Sciences Center. She is the director of the audiology program there, and the Associate Director for the PhD program. She received her BSE from Arkansas State University, her MS in audiology from Purdue University and a PhD in Speech and Hearing Science from Vanderbilt University. Her clinical research interests are pediatric and educational audiology. Today, we will talk with Dr. Hicks about her work and thoughts on listening effort and fatigue in children with hearing loss. And I’m sure many other topics as well. So Dr. Hicks, thank you so much for being here with us today. Welcome.

Candice:

Thank you for inviting me, looking forward to the discussion.

Haley:

Me too. So before we jump into our main discussion, we like asking all of our guests to share a little story from the past week. It can be anything to help the listeners learn something about you, so it can be funny or cute or heartwarming. Does anything come to mind?

Candice:

I don’t know if it’s in the past week, but the excitement at my house this summer is that we have it a newborn baby goat. So one of our goats had a baby and that’s our very first ever baby goat. So I might be spending a lot of time watching baby goat jumps and things going on in my backyard.

Haley:

That is adorable.

Candice:

The goats and chickens and dogs and kids, so at my house,

Wendy:

That’s a lot of action going on. How many do you have of each of those?

Candice:

We have 11 goats, 14 chickens, two dogs, um, and then an 18 and a 15 year old boy. So…

Haley:

Wow you’ve got your hands full and then you’re also an audiologist. I can’t imagine dealing with all that

Candice:

Makes life interesting.

Wendy:

Yeah. Oh, that’s amazing. Well, great. Well, it sounds like you’re not originally from Texas, is that correct?

New Speaker:

No, I’m not originally from Texas. My dad was military, so I moved around quite a bit when I was younger, but consider myself more from Arkansas. So I grew up, from third grade through undergrad in Arkansas. So consider that my home, most of my family is there.

Wendy:

So speaking of that, we wanted to kind of start with some of your history and what got you interested  in the field of audiology in the first place?

Candice:

I was one of those where I didn’t come in knowing, and to be completely honest, I didn’t even know about the field of audiology, until I was in college and my undergrad was the speech language pathology program. While in that took some classes in audiology and just realized that that really was what I wanted to do, what I liked and where I wanted to go and have never regretted it since then.

Haley:

Those were some of my favorite classes in my undergrad, the audiology classes, but I applaud you for going into it. There’s a lot of technical terms and a lot of things that I didn’t quite grasp. So that’s a really cool journey to start in one and then kind of take those classes and enter into a new interest. So what motivated you, I know you said taking classes kind of guided you in that direction to audiology, but what motivated you to pursue your PhD in audiology?

Candice:

I think I had thought about a PhD while in my masters, but it just didn’t work out right away. I went and worked for a year and I love clinic, but I like being able to do more than just clinic. So I’m getting to teach. I love the thought of teaching. I loved in clinic, you can see problems that then research is something that you could try to answer those problems. And that’s really what I thought in terms of the PhD, allowing me to do that clinical research and then also to allow me to give information to the generations coming after.

Wendy:

That’s wonderful. So after your PhD in Indiana at Purdue, you ended up, I think we, you mentioned this a little bit when we talked the first time, but then your journey somehow brought you to Texas.

Candice:

Right? So I was in Tennessee most recently. So I was looking for my first position after the PhD, and was offered here in Lubbock, Texas. So had never lived in Texas before I convinced my husband. I’m like, “we’ll move to Lubbock. We’ll live there five years. It’s great. Then we’ll move back home.” And then 20 years later, we’re still in Lubbock. And we travel back to visit family and talk about that this really is our home now.

Wendy:

And it sounds like you have a pretty big role there in the department. So you’re the chair of the department of Speech Language and Hearing Sciences, and then the director of the audiology program.

Candice:

Yes, I’ve been chair for only two years. I’ve been audiology program director for about 19. But we’ve just hired somebody who’s going to be taking over the audiology program director, which will allow me to focus on the chair duties while still teaching and doing clinic and being in research. So I’m excited about that.

Haley:

Well, I think that’s a really unique role to have in both because we know those two things, especially in relation to hearing loss are so interconnected. And I know you said you found somebody else to be the director, but I think it’s such a cool perspective for you to be able to work in both of those areas and that you’re also teaching. I think it just proves what we’re doing in the world of hearing loss. It’s not separated. Everything is just kind of integrated and that’s how things go,

Candice:

Right and even today, I’m walking down the hall and I caught the Speech Language pathologist and I’m going, “okay, I saw a kid Monday, I’m making the referral to you. This is what’s going on.” So working together is to me hugely important to best serve those kiddos who have hearing loss and the families.

Haley:

So today we wanted to learn from you about listening effort and fatigue, but can you tell us some other areas that you have interest in?

Candice:

Teaching wise, pediatric audiology, so more of like the assessing, hearing, seeing what the hearing loss is and then treating. Hearing aids in kids making sure that those are fit appropriately and really thinking through what that they’re getting, what they need and educational environments. In terms of some research, those areas, which lead into things like hearing assistive technology, types of things where teacher where’s the microphone and the kids listen. Like I have interest in those areas and started looking a little bit more into things like eye gaze patterns. So if there’s different levels of background noise, where do people look in the face? So that’s a newer area that I have interest in in terms of moving within the research realm.

Haley:

That is so interesting.

Wendy:

Yeah in preparation for this interview. I read some of your some of your work and read about those eye gaze paradigms and just the methods that you’ve used to collect your research is really interesting and above and beyond just observing behavior. So things like measuring cortisol levels and um it’s really interesting

Candice:

And it’s really trying to figure out because there are things that aren’t historically haven’t been researched. And so just trying to find new ways, because even the way that, that I’ve looked at effort  has evolved over time in terms of changing and, and looking for new ways to measure.

Wendy:

Yeah. So let’s get into that a bit since that was the original reason we wanted to, talk with you, before we talk about the impact, let’s define the difference between listening effort and listening fatigue. Can you help us with that?

Candice:

Definitely. It’s one of those things where technically, if you read some different things, there might be, some different definitions. So it’s not something that there’s necessarily concrete. This is exactly what it is. But,  the way I like to think about it is effort is more thinking through how much are you having to use your cognition and your brain to really understand what people are saying? So the listening effort side is, is really more thinking about how much effort, how much cognitive power am I having to use to really know what’s going on related to what I’m hearing. Most of the time understanding is what it’s talking about, but there can be other things you use hearing for. When I start thinking about fatigue, I think about that more as long-term. So if you exert effort over time, it’s going to start making you feel more tired. There are different ways to define fatigue, but it can be kind of a mental fatigue. So think about like when you’ve been listening all day and you’re going, okay I’m done with this zoom meetings for five hours a day. I’m just mentally tired. Can’t think about anything else. Or it could be physically tired, but it’s more to me when we’re start talking about listening. We’re talking about if you exert effort over time, then it’s going to start making it start impacting how you feel, and you have that tired feeling, which goes more into the fatigue part of it.

Haley:

That’s a really great analogy for us and our listeners because mental fatigue is such a real thing. And I feel like we all experienced that to the hundredth degree this year with doing zoom or having to sit for eight hours in a, an environment that we typically don’t work from. But especially our listeners, a lot of them don’t have a hearing loss. And so to put it in that perspective of you’re listening for so long, it’s that effort, it takes a lot more effort when you’re using that hearing technology and that how it does have an impact. I mean, it’s tiring for those kids and those adults, anyone that has hearing loss. I think that was a great way to put it so we can all understand what that means in terms of hearing fatigue. When did you start researching listening effort and fatigue, and why do you think that’s such a valuable area of research in our field?

Candice:

I  started really within my PhD program. So my dissertation is actually on listening effort and fatigue. It’s interesting because some people do their dissertation and it it’s so stressful. They’re like, “okay, I’m done with that area.” But really when I did it, I’m going, “this is the area that, that I really like”. And t’s clinically important too, because I think it’s easier to say I can test you and see what percent of speech you understand. Right? I can, I can get your understanding. What’s a little harder to measure is how much effort did you have to expend to understand that amount? So we can have two people that you give them a task and they can understand 80% of it. You could have two people that do the same understanding ability, but it might take a lot more effort on one person than the other. And so it’s the thought of clinically do have we thought about like, not just that they can do okay, but it’s going to impact you longer term if you’re having to expend that effort. It’s important to consider effort. And in terms of these individuals with hearing loss, really with anybody, because we’re in a lot of poor environments now, in terms of a lot of noise around us, a lot of distractions. But think back to those noisy restaurants and even without a hearing loss, it’s really hard. Then we started adding on hearing loss in there. So it’s just the thought of, are there things we can do to help people? Is there a way that we can consider effort in terms of part of the impact of the hearing loss?

Wendy:

Yeah. I think like Haley mentioned, you know, anecdotally we see this. I work in early intervention and Haley works in our preschool. So we see this in kids. given that we are a school of just children with hearing loss, we don’t have those hearing peers to compare to, but we hear from parents that have, you know, one child without a hearing loss and one child with it, they feel that their child with hearing loss fatigues more quickly, it just seems to affect them a little bit differently. Do you hear anecdotally from parents and teachers that children with hearing loss do struggle more with fatigue at the end of the day and effort? Do we know what factors affect that?

Candice:

What I see clinically, sometimes as parents talking about their kids get home from school and it’s like, they take off devices because they’re tired, they’ve been trying to understand all day in most schools not great in terms of the amount of noise and echo and everything going on in that environment. They say they come home, they don’t want to do anything that requires them to really listen and have to, listen and learn or understand,  maybe play video games or something where they’re not really having to listen, but it’s like take off the devices and just not have that going on. So I think that that’s a lot of, of what I hear just parent-wise. The other thing that sometimes the report from schools or from parents that teachers are saying is that the kids at certain point just stopped paying attention. They start like looking out the window, they’re daydreaming. And I think a lot of that really isn’t them just daydreaming because they’re bored. It’s because they’re tired because they’ve just spent all this time trying to understand and it’s impacting them.

Haley:

I definitely see that in my classroom. I think especially working at a school for children, with hearing loss, every one of our students have hearing loss. We really do see a lot of that behavior. And I know like there’s a certain point where these little ones are so checked out because the tasks that we ask of them and we’re in an environment where we’re made for this, right? We don’t have that background noise. We have acoustically sound environments for them and they’re still struggling sometimes. And so I think it’s important to bring that up because it’s so easy for everybody to be like, oh, you know, they’re just, “they’re not paying attention”, but really it’s a lot of that listening fatigue. And actually, some of my parents have mentioned their kids go home and they want to take them off. They’ll tell them like all done and they’ll take them off for like an hour. It’s like a reset for them. So I think that’s a really important thing to talk about.

Wendy:

I know that this is an area that, we’re starting to see it come up a little bit in the literature, but it’s not, well-researched obviously, as you know, that’s why you work on it. But do we know anything about different types or degrees of hearing loss and how that affects effort?

Candice:

Um, I don’t know if we have a complete, clear picture of it, in terms of being able to answer the effort side of things. For example, I have some interest in those more mild losses, because I think those are the ones that, they come in and even the teacher or parent complaint is the kid just daydreams at school. They’re not interested. So they don’t necessarily know they have a problem because in quiet they probably do pretty decent. To me, I’m like, oh, can we catch those kids? Those kids are ones that are tougher, may not have been identified type of things. I think it’s easier to tell with, with greater amounts of hearing loss right, like you kind of expect that that’s, that’s more difficult for them. And I think that they’re probably even more accommodations and things done in school to help, um, you know, give them a little time to think, to process, try to figure out, can we decide where to put maybe heavier, listening things at beginning of the day or something like that. But some of those kiddos that are, that are the only one in their classroom, maybe a more mild boss doesn’t look very bad on an audiogram, or maybe they just have a hearing loss in one ear. I think it’s there. I just think that sometimes we just haven’t caught those kids. And we’re saying it’s maybe that they’re not interested or not paying attention to the teacher when it’s really that they’re struggling with trying to understand in those classrooms.

Haley:

Yeah. That unilateral loss, especially I think it’s looked past and those kids fly under the radar a lot more. I taught at an a school district and I had third and fourth graders and I had a student with a unilateral loss. And there was a lot of that when he was in his general education classrooms, they’re saying he wasn’t paying attention, but when he’d come to our room, I understood that fatigue that he would have. So that unilateral loss is really easy for people to be like,  “it’s just one ear”. But then the effort you have to put in on the other ear, or if they have full hearing in the other ear, it just adds to that fatigue. So while we’re talking about listening fatigue and how you’re studying it, why do you think it hasn’t been studied more? And do you think it should be?

Candice:

It’s partly because it’s not easy to measure, because there are other factors, right? It’s not just what you’re hearing is it’s are you motivated? So that’s going to come in a little bit to play with it also. There’s these different factors that can come into play. And so it’s not like it’s really easy for me to say, I can test to your word, understanding. I can even do it noise to see how well you do with background noise. How am I going to measure effort though? Um, and so I think there’s a lot more research than there used to be the last 10, 15 years.  If you look at it, there’s so much more than there was when, when I started out, with that dissertation and kind of this, the starting point of looking at it. There’s still a lot to do. There are some things that can be done easily in the school. Like some things they do are subjective ratings, like have the teacher do a rating, do the kid do a rating, maybe a parent rating on scales, but the other things we’re doing, like measuring maybe eye dilation or something like that to measure effort, it’s not really in an actual school setting, right? So we need to do the research that eventually will connect of how can we measure this clinically so that we have an objective measure to be able to say, yes, this is what this person is doing. And this is how we could help them. So I think  that’s where we still need to go with that. There’s so much more and every time new articles come out, I want to look at it, read it, see how they’re testing, see what they’re using, but we still, we still have a ways to go to make sure that we’re really being able to use it the best way we can to help the kids.

Wendy:

Yeah because it’s so different for a nine month old who has cochlear implants. It can be so effortful, but then as they get older, it appears very effortless. So like, where does that balance come in? And our hearing aids different than cochlear implants. If you ask us, yes, we think it should be researched more because it would help parents understand their children even better and help teachers understand children and maybe put in some other, things throughout the day to decrease that so that when kids come home from school, they don’t just fall apart, which kids do. I mean, I have an eight and a half year old. He is just exhausted when he comes home from school. And I can imagine adding anything that makes it even more effortful for him to pay attention that can cause a lot of issues at home.

Candice:

And I think it’s helpful when we have some way to define it with some numbers or some things of saying it’s moderate difficult. Like, how difficult is it? I think that if we could get to the point that we can determine it because maybe like certain classes are a whole lot harder. So maybe we need to make some different recommendations for certain classes than others or things just to determine. But it’s getting to the point that it would, that we can, through out research, give the teachers and the parents and the families, something more to say this is yes, expending more effort. And this is kind of the amount of problems he’s having. So hopefullywe’ll get there. We’re further along than we were.

Haley:

I’m a Deaf education teacher, I’m very well aware that this is a real thing, listening fatigue. And I don’t even necessarily jump to that conclusion when I see certain behaviors. And so if there is more research and there are better practices that we can put in place that would help us  look at like, o”h, there is a reason they are tired. They have listening fatigue right now. They’ve put in a lot of effort today.” So that is really, really important for us educators in the deaf education field to be aware of.

Candice:

Because the teachers really do want to do the best for the kid, but it’s kind of figuring out the lines of everything that’s going on, the weaving of everything, the hearing loss, the language, the speech, the motivation, the effort, all of that together. And if we could help maybe pull one of those strings a little bit clearer to say this is what we think this part of the string is. Then hopefully it would help teachers to be able to better figure out how that we’ve all goes together.

Wendy:

So which environments are tasks make listening more effortful?

Candice:

The, the environments usually are just gonna be the more difficult environments. So most, most people will, you’ll have to expend a lot more effort if there’s background noise present, or if you’re in a really reverberant room. So a lot of echoes. I think about gyms and things like that in terms of, of that type of environments, where you’re also not being able to get other cues. If you can’t see the person talking, thinking through just another problem that that can add onto it. Cause a lot of people but a lot of people use those visual cues to really help them understand. Problem, as most environments are not just one thing, that’s a problem. So usually, it’s not seeing the person talking and it’s a really noisy environment, those types of things in terms of adding onto it.

Wendy:

Do we know anything about what kinds of tasks are more challenging and, and produce more effort and fatigue?

Candice:

I think that that’s one thing that I don’t know at this stage, if it’s completely answered on research and Iin my head thinking through, and the way that I’ve kind of gone in terms of trying to find new ways to look at things is a lot of what we do are like word or sentence repetition tasks, and that can be cognitively like a load, right? Cognitive load makes you think. But if I have an unfamiliar story and I know that I’m going to have to be asking and answering questions at the end of that, so the comprehension side of itt to me, it’s a different what you’re listening for and what you’re going to have to do with it. Because if you think about the system having kind of a limited capacity, so you can only do so much, right? Your brain can only think so I can be working and listening to somebody coming into my office. But if you then add in the phone ringing and some emails that I have to deal with right then I can’t handle it all. If I just ask a kid to repeat words, they’re going to use a part of that system. But if I ask them, “I’m going to be telling you this story. And then I’m going to ask you questions”. And they know you’re grading it, right? So now it’s like that limited capacity system is using more of it. And the problem is, as you get distractions, there’s not as much leeway to be able to handle the distractions. So that’s where that effort can, can get more because your system can’t handle it anymore. It’s in an overload. At which point it’s either work really hard or turn it off and be the kid that’s distracted and not paying attention. And it actually is a whole lot easier to turn it off and not listen then to keep working so hard.

Haley:

We do so many activities like that at Child’s Voice, where it’s directed, where it’s, they have to tell us the word they have to listen for it. And then we gradually build up to that, three sentences answer questions. And even then when it’s a very controlled environment, very short amount of work for a three or a four or five-year-old, or even Wendy, you do tasks like this all the time. We still see some of that. It’s so hard. You see them shut down and they’re over here. And we sometimes think maybe, “okay, they just don’t want to do it” but just we’re asking them to listen to the most minute pieces of information and then asking them to repeat it or remember it. So I sometimes look at that. I’m like, I can’t even do that. Like, I’m a grown adult with hearing and I still can’t remember everything I just told you. So to kind of go off of that, what are some ways that we can work through all of these tasks or environment for children, with hearing loss, you know, you mentioned the difficult tasks or the difficult environment. So what can we do as speech, language pathologists, parents, teachers, to kind of help these children through these tasks that might require more effort or listening?

Candice:

I really think some of it is just understanding that it is going to be tougher for them. If we’re talking about a full day type of thing, if you can do some of the more heavily loaded listening and a lot of new vocabulary things earlier on so that they haven’t been listening all day. I would say anytime you can have some listening and a little break to kind of process that, that can be helpful because it, their processing time can be longer anyway and so if you can work on that, just some checks every now and then. I tend to think even in a college class, I started doing brain breaks where it’s like, okay, we’re going to do a short Kahoot on movies or something that, really heavy thinking type of thing. I do think we have to think through the environments, right? So if I’m a parent and I’m going to be working on homework with my kid, let’s have it in as quiet as a place that we can, so we don’t have the TV going. And if we can get away from siblings that are fighting in the other room, um, you know, think through, let’s try to make it a better environment in the school. That’s a really have those devices on. So things like the hearing assistive technology  use that type of technology. Have a check of making sure it’s working every day, because the, the more we can improve what they’re hearing  at least we can, we can help some with that.

Wendy:

Those are super helpful. And you mentioned hearing assistive technology. We have a whole episode on remote mic systems, but how do you think those play in and do you feel like at this point we’ve made the case that every child should have a remote mic system if possible, and when do we start them, we’ve had some differing opinions over the years of, do you start them at three years old? Do you start them in toddlerhood? So what are your thoughts on that? About the use of remote mics?

Candice:

So any of that hearing assistant, remote mic type of thing, it really is thinking through getting teacher’s voice or parents’ voice if you use it at home more directly to the kid, cause it sends it through device to the ear, right? So it’s kind of like you’re standing right next to them, even though you’re 10 feet away. So that impact of the background noise is not as bad because you have the way that that system works. I will say in terms of everybody using them, I think probably almost all people with hearing loss could benefit from them. I will say from my clinical perspective, I always do some kind of testing because I do think when you’re talking about schools, purchasing the devices and how many you have and what they’re using, and sometimes kids not wanting to wear them that the more we can have some kind of information to say, no, this kid really has difficulty in background noise. Or this is going to be the trial period of that type of system. Even if there’s not big changes. I still usually am going to say, let’s have a trial period. We’re going to do things like teacher ratings and parent ratings and word understanding what them without and see how school is going because I really think anybody with hearing loss, almost everybody is impacted by background noise with a hearing loss. You have some people that can handle it pretty well, and you have some people where they totally can’t do anything when they’re in background noise. I’ve had those mild loss kids that didn’t end up getting hearing aids, but use that device. And like parents emailing me going, this made the biggest difference in the classroom, because they’re saying it’s so much easier to listen now to the teacher. Does absolutely everyone need it? I think it probably could benefit. I think it’s the cost benefit type of thing. And looking at me and me kind of going, I’m going to do some testing. So I have numbers that go behind it to say, this is why I’m recommending it. So it’s not the school thinking that I’m recommending for absolutely every kid, no matter what. And then still doing things in the schools to make sure that it’s helping them.

Haley:

That’s like my favorite part of the IEP when you’re going through the reports and you do the testing without the microphone, and then with the microphone, just in a quiet environment. And then my favorite is when it’s background noise, because putting those numbers to that child and their listening just puts it in perspective. They’ll go from 60% and background noise with hearing, but then once you put that microphone in it’s 94% and wow, is that such a jump. So I think using a remote microphone or an FM system, I am all for it because I think every kid with a hearing loss can definitely benefit from that.

Candice:

It’s pretty much on most of my recommendations, I do testing as much as possible. And then if I can’t, if it’s like a three-year-old, then I can’t get some testing and noise on because they’re not doing it. Then I go back to the research and say, research shows that these kids are impacted by background noise. So it’s usually in my recommendations, but let’s add in some testing if at all possible so that I can say this is why it’s recommended.

Wendy:

I can imagine that that’s really helpful for parents to hear. If they are in the mainstream, they have older kids, they have less professional support because their kid is doing so well, which is great. But your team goes from like seven people when you’re early intervention. And as the child progresses and is doing so well, your team gets smaller and the parent has to take on a bigger role. So that’s really helpful.

Candice:

And the material they’re learning gets harder and harder and the requirements of them now, now it’s like that whole like cognitive effort thing, they’re having to really take notes or type their notes, or write their notes depending on kind of how old school they are and listen, and write. And they’re getting all this vocabulary they don’t know about. So you get, less on the team as they get older and the needs change. It’s really important even with those middle schoolers that’s where it’s like, you really need to look again at where they’re at in school and what kind of needs they have and where they’re having having problems, because it has that stage. It might even be where they have problems is in band. They need to use their device, but they’re not hearing this, so just the differences and how it changes over time.

Wendy:

Yeah. And hopefully as kids get older as well, they’re part of the team and can tell parents and educators. That’s something I think really important for us to think about, even in these younger ages is to instill in kids really young to say, it’s too loud. I can’t hear, really trying to push that when they’re young. So it becomes part of their vocabulary and they can advocate for themselves.

Candice:

And then I really think it’s important by the time you get to middle school, upper elementary, middle school,  when we’re in appointments or if you’re in class with them, it’s a discussion with them as part of it. Because even the, I don’t want to wear this system cause teacher wearing the mic makes me different. In addition to my hearing aids, you’re talking through, it’s like, okay, you’re a part of this conversation. Let’s talk through what it’s really like when you’re in class. What parts are hard? What parts are easy. And then being able to show them test results too. It’simportant too, to have them as part of the conversation, because by the time they get out of high school, they’re not going to have anybody trying to find what problems they have. Right. They need to already have some skills so that when they go either work or college, they’re like, I already know these are the things I need to do to help myself related to it.

Haley:

So we’ve talked a lot about, you know, what listening fatigue is, but we really haven’t talked about what are signs of listening fatigue. So what are some signs that we can look for as families or teachers to notice listening fatigue, and then what can we do to give these kids a break?

Speaker 3:

I really think it’s some of the things that we’ve talked about in terms of like those kids that come home and are just not wanting like that are like completely going to sleep or taking off their devices. For the parents probably really seeing some of those things. For the teachers, they may really see some actions of them being tired. Like usually they’re not going to be able to take off their devices because they’ve already learned that they wear the devices in school. So they’re not going to do that. But starting starting by the end of the day, them not paying attention, then looking out the window a lot, them putting their head down, those types of things, to  me, are things that you’re gonna look for. And then going from there, it’s, it’s just having the discussions, with everybody on the team, really. It’s having the discussions with, you know, what, what does our day look like? How are they listening? What are things that we can do? Because everybody’s day, every kid’s day is different, um, depending on age and what school they’re in. Is there anything they can do? Are there ways to work in some breaks? when then talking to the audiologist, can you do testing to recommend that remote my cat system type of thing. Then talking to the speech language pathologist. Does it seem like it’s more effort with this new vocabulary? Are there things you can work on in therapy to get them? Right. So it’s, it’s talking to the different people on the team because each one will give different tidbits to help and then being able to pull it together to help the child the best possible way.

Haley:

I think it’s really important to to bring up that each kid is going to be different. So what works for one kid for giving them a break so they don’t have listening fatigue is not always going to be the same. So really collaborating with that team and every member on that team is going to benefit that child.

Wendy:

Yeah. And thank you for mentioning, like when kids get home, they want to take off their devices and just kind of being okay with that for some time I think, um, we drill so much, eyes open, devices on, but you know, we’ve really got to listen to the kids. I think it’s harder with toddlers because often taking devices off comes with behavior,

Candice:

And then they know that they can take it off. When they’re old enough to realize that it’s a little bit of a break and then it goes back on.

Wendy:

That’s great to be able to talk about it like this and give parents the space to like be okay with that. I know some, sometimes kids do in the morning when they first wake up, they’re not ready for them right away. They need a good 15, 20 minutes of just eating breakfast and hanging out and then they’ll be ready to put their devices on. So Dr. Hicks, thank you so much for everything that you’ve shared with us, it’s been really informative and helpful. We like to ask everybody for one kind of final piece of advice or anything that we didn’t talk about that you’d like to share with us to wrap up.

Candice:

The only other thing that kind of comes to my mind is, is a few cases of kiddos where, um, they’re doing okay in school, but they have some struggles. And then when I do testing, everything comes up the same. Like parents are like, I think the hearing’s worse. Nope, it’s not. Everything’s the same hearing. Aids are still working. It’s kind of pulling together to think is there something else that maybe isn’t typical things that we measure? Is it effort or like sometimes like with some of my kiddos, I’ve had ones where it’s going, “let’s get them into speech path and do theory of mind, executive function, higher order thinking”. Because some of these times it’s like, I think we’re just used to looking at this is what all kids are and if everything’s staying the same, then no, there’s not really a problem. Let’s make sure that we look at the well-rounded and know that there are some kids that there are other things that could impacting how they’re doing and let’s optimize those two and test them in different areas that might not be the typical area to test.

Haley:

I love that. Look at the whole child and there might be other reasons for certain behaviors. So, well, thank you so much for talking with us, Dr. Hicks, you are a wealth of knowledge and I’m so glad we got to have this conversation. So thank you. And thank you all for joining us on another episode of All Ears at Child’s Voice, be sure to join us for our next episode. We release episodes once monthly,

Wendy:

You can follow us and this podcast on Instagram with the handle at child’s voice podcast,

Haley:

We’d love to hear from you. So please send us an email at podcast@child’s voice.org, and you can find episode show notes and archived episodes at our Child’s Voice Website, childsvoice.org.

Wendy:

If you’re interested in learning more about child’s voice, where on Facebook as well as Twitter with the handle at Childs underscore voice. No apostrophe,

 

Haley

Thanks for listening. Bye.

 

Wendy:

Bye!