Today’s episode is a conversation with Dr. Ruth Reisman, https://www.urbanhearing.com/about-us

about the connections between auditory processing disorder (APD) and
Attention Deficit Hyperactivity Disorder (ADHD). We discuss the process of evaluation and how a tailored treatment plan can help people who are finding listening and processing spoken language to be challenging.

SHOW NOTES & TIME STAMPS:

• Introduction and background
  
  
• 2:19 – Becoming an audiologist. Advice for students.
  
  
• 4:57 – What is APD?
  
  
• 6:20 – Signs you may want to explore APD evaluation.
  
  
• 7:28 – The frustrations and misunderstandings surrounding under/misdiagnosed APD.
  
  
• 8:25 – Process of APD diagnosis.
  
  
• 12:00 – Every patient is unique! Overlaps between APD and ADHD.
  
  
• 18:00 – Multiple reasons why people interrupt?
  
  
• 19:42 – Developing a treatment plan for APD.
  
  
• 24:57 – The value of diagnosis/label.
  
  
• 28:13 – Overlap and similarities between APD therapy and aural rehabilitation following cochlear implantation/ hearing aid usage.
  
  
• 31:20 – Cautioning about generalized advice for patients, eg. “listen to audiobooks, listen to music while following the lyrics.
  
  
• 32:15 – Complexity of music.
  
  
• 33:30 – The diversity of patients and focusing on each individual’s story.
  
  
• 34:26 – Building a relationship with your audiologist.
  
  
• 34:39 – Ways to work with Dr. Reisman, in New York, Florida and Bermuda, virtually as well.
  

RELATED EPISODES:

ALL ABOUT AUDITORY PROCESSING DISORDER & SOUND SENSITIVITIES

PERSONAL EXPERIENCE WITH AUDITORY PROCESSING DISORDERS

https://www.podchaser.com/podcasts/thriving-in-the-midst-of-chaos-934874/episodes/auditory-processing-disorder-w-81682839

https://podcasts.apple.com/us/podcast/episode-18-auditory-processing-disorder-apd-crash-course/id1524865133?i=1000519524920

TRANSCRIPT:

[00:00:00] Dr. Lilach Saperstein: Welcome to the All About Audiology podcast. I’m your host, Dr. Lilach

Saperstein and I’m very excited today to be speaking with Dr. Ruth Reisman in New York. I know that many, many of you have questions about auditory processing disorder, the process of getting diagnosis, what the treatment is, what even is auditory processing disorder in kids and adults.

So, I’m really excited for a very informative conversation. First, let me welcome Dr. Ruth.

How are you? Welcome.

[00:00:34] Dr. Ruth Reisman: Thank you. Thank you so much. It’s a pleasure to be here and to have the opportunity to speak with you and present on this platform. I am, as you said, from New York. I support the audiology field in multiple aspects.

In addition to my private practice where I do work with individuals that have auditory processing disorders predominantly focusing on individuals that actually have. ADHD as a comorbid disorder. And I’ll explain as I go into that, as to why that became my area of focus or a specialty.

[00:01:06] Dr. Lilach Saperstein: I have to tell you right away that that Venn diagram I discussed that Venn diagram on the regular, so we’re going to go into that for sure.

[00:01:14] Dr. Ruth Reisman: Great. Great. I’m excited to talk about it and, and, and let you know how I got into that. And then in addition to that, I do work at a cochlear implant company or hearing implant company, I should say, cuz it’s not just cochlear implants called Medel. So, we support patients with their implants as well and, and aural rehabilitation, just like auditory processing comes into play in that arena as well. And then one of my favorite things to do is to teach at the university and I teach multiple classes on, on all of these wonderful things, aural rehab, hearing aids, so I’m happy to talk about anything always related to audiology.

[00:01:50] Dr. Lilach Saperstein: Same. Anytime we find someone who’s going to talk to me about these things, I’m like totally into it.

sign me up. These are my topics. So, I think a lot of people are curious as to how you got into audiology in the first place. You know, if you thought at the beginning when you got into it that you would be involved in all these other things down the line.

[00:02:11] Dr. Ruth Reisman: Yeah, no, that’s a great question. I guess audiology kind of chose me, which I, which I always say as I go through the field, all of these areas kind of choose me.

Initially I had started actually in pharmacy, so I was doing a lot of science-based courses. I actually witnessed my mother suffer through hearing loss, so she had bilateral otosclerosis as she was having children and, and as we were growing up it got progressively worse. So, I’ve seen her go through the process of diagnosis, getting hearing aids and then getting surgery and her hearing actually going back to normal.

So, it was a really interesting, to witness her go through all of those stages and I became really very interested in the field of audiology. It started of course with, with speech therapy, like the majority of audiologists start, and I kind of got into the field that way, but I fell in love with audiology because of the diagnostic and the rehabilitative nature and how we can really see results with our patients.

[00:03:09] Dr. Lilach Saperstein: Yes, that first audiology course grabs a lot of people [laughs].

[00:03:14] Dr. Ruth Reisman: I would agree.

[00:03:16] Dr. Lilach Saperstein: Can you tell any advice for some of the students who listen? Cause we do have many students of communication disorders all around the world who message me on Instagram, always do that. Come say hi and ask for advice.

What should I do? Should this speech, should I do audiology? What advice would you have for students in general.

[00:03:35] Dr. Ruth Reisman: Yeah, I think both speech and audiology are very dynamic as fields. There’s a lot more to it than meets the eye. Right.

 I would encourage anyone who’s considering the field or who is enrolled in a speech and hearing program to go and speak to audiologists like myself and, and like you, to get a feel for what the field is about, what we’re able to do within the field, all of the options and opportunities because they’re really vast and I really think it’s such a rewarding field. Like, we really have the opportunity to do so much in terms of helping patients, diagnosing their issues, offering different rehabilitation options. And it’s not just about hearing loss and hearing aids. There’s balance, there’s tinnitus, there’s, aural rehab, auditory processing. So, it’s so, so dynamic and I think communicating or connecting with individuals that are in the field will give you a real sense of what’s available within the realm of audiology.

[00:04:34] Dr. Lilach Saperstein: That’s great advice. Connecting with actual people. You know, you can, you can Google search for a long time and listen to podcasts and you should do that, but the end of it, you know, find your local audiologist, the local community. And see if you can hop by for a day. Just watch and see what happened. That was so valuable to me when I was an undergrad.

I did that for a while.

[00:04:57] Dr. Ruth Reisman: Yeah, I would agree.

[00:04:58] Dr. Lilach Saperstein: So, let’s dive into auditory processing disorder

[00:05:01] Dr. Ruth Reisman: Sure. Mm-hmm. So, yeah, auditory processing is probably one of the more complex things that we work with in audiology. A lot of people, like I said, think of, okay, a patient has hearing loss, let’s give them hearing aids. But there are actual patients that it’s not hearing loss that is causing their hearing difficulty or causing their challenges.

Sometimes it can be in conjunction with hearing loss, but the majority of individuals that actually have auditory processing challenges usually have normal hearing. So, we test them on a hearing test. Their hearing is normal. But the way that they’re reporting their subjective responses sounds like they have a really significant hearing loss.

So, it’s this disconnect between what our hearing test is showing and what they’re actually reporting in terms of, how they function in their day-to-day life. So, it’s a very real, disorder and a way that we can kind of subjectively and objectively quantify it. And the way that we do that is we use a lot of questionnaires, subjective questionnaires.

So, we want to get insight from the patients, you know, where are they feeling like they’re having hearing challenges, what are their concerns? And then objectively actually doing testing to measure that if there is any deficit. Where does this deficit lie? So, some of the signs that you may experience that may indicate that you need this kind of evaluation is like I said, having normal hearing, but still feeling like you’re not hearing well in different environments.

A lot of times it’s in noisy environments or environments that are less than ideal, like classroom settings, office settings where it’s large open spaces. There’s a lot of reverberation, so sounds bouncing off the walls and things like that. You find communication really difficult in those environments.

A lot of my patients complain, like now that they’re going back into work after being, on Zoom calls throughout Covid, that they’re starting to have a lot of difficulty in those types of settings, in social settings, in business meetings. The kids in the school environments now going back really into their day-to-day life, they find it even more challenging than before Covid. So, there is this kind of effect that they’re saying that even Covid enhanced or created some more auditory processing challenges for individuals.

[00:07:20] Dr. Lilach Saperstein: Yeah, and I, I think from the people I’ve worked with the biggest complaint they come in with and it’s very emotional. It’s very frustrating. And no one can really explain it because they can hear they’re hearing okay, for the most part, but then they’re having all these issues so it doesn’t match. And when they finally find that maybe there’s a reason for those difficulties, that it’s not them being disrespectful, rude, not paying attention, like all these other explanations that are given for it.

And I had one patient specifically who told me that they were, they were called manipulative. And it was even in a, a summary of their, you know, work related that they got, evaluated as being manipulative.

It really affects people’s lives in, in very significant ways, these communication breakdowns. It’s really amazing that we can then help people find out like, “wait a minute, there might be a reason why you’re having these issues.” And tell me a little more about what the diagnostic process is like for patients, once they’ve filled out all those questionnaires and they’re like, “yes, this is the problem,” then what happens?

[00:08:24] Dr. Ruth Reisman: For sure. And I always say oftentimes we’re like the last step. So, the patient has tried everything. They’ve gone all through all their testing, they’ve seen so many professionals, and then they’re like, they come across auditory processing and they say, well, I feel like this is what I have.

 So oftentimes we’re the last step. And we do want to rule out things like hearing loss as a confounding factor, things like ADHD autism, all of those things before we get to our actual evaluation.

When we’re doing the evaluation. So, there’s two ways that it can be done now with technology, it can be done in an office with the audiologist in a booth.

Or it can actually be done virtually these days, which is great, where we can actually get a calibrated, signal. So, all of our test materials are calibrated to be assessed, even virtually. And the patient will go through a series of tests and, and there’s a portion that’s done with the audiologist, at least in our practice.

And we also, give the patient an assessment via an iPad. And they go through a series of challenging their system under different conditions. So, we’ll get a baseline in quiet, see how they do in the most ideal situation, and then we’ll start to make it more and more difficult for them.

So, we’ll add noise, we’ll add competing words, competing sentences, competing numbers. And then we’ll also even degrade the signal to see if the brain is able to identify. What word is actually being presented. And after all of that, there is a pretty extensive evaluation or assessment that’s done on all of those results.

And from there we create a diagnosis based on the patient’s subjective responses, based on the objective testing, based on the case history. And then we’ll look at various areas of auditory processing including decoding, which is breaking down information, tolerance fading memory, which is like hearing in the presence of background noise. Integration, so integrating signals. Organization, being able to organize information. And we look at the different subcategories and identify where the patient has the most challenges so that we can really be very intentional in our therapy for.

[00:10:37] Dr. Lilach Saperstein: Mm-hmm. I find that one of the things that helps patients understand what all this is about is to first explain that we have all of these skills, auditory skills, that our brain is doing with all the sounds that come in, that we’re putting them in order, that we are hearing, you know, the right and left ear.

 The fact of getting two signals makes a lot of different information come in. How loud it’s, how far away, where it is in our environment. So, to first say that hearing is not, you hear or you don’t hear, it’s way, way, way, way more complicated. So, then we’re trying to break down all those parts, and with the testing we’re able to see which specific skills a person might be having trouble with.

[00:11:20] Dr. Ruth Reisman: Yeah, that’s, that’s definitely a great way to put it. And it makes it very clear to the patient in terms of why we’re testing them and why their results come out the way they do. More often than not, the patients are like, okay, yes, I knew this was the case, and I’m just glad that you’re able to test it and actually validate my feelings.

So that ends up, like you said, being the most rewarding thing for them is that we’re actually able to quantify it and, and identify what it is, and then offer options for help.

[00:11:46] Dr. Lilach Saperstein: Mm-hmm. Do you feel that you see one specific type of APD most commonly or all different skills?

[00:11:55] Dr. Ruth Reisman: So, I think every patient is unique and they’ll all have a different, mix of challenges.

I think the most common challenges are probably decoding, tolerance, fading memory, and then maybe organization. Right? So especially in the population that I deal with, with the ADHD population, A lot of them, it’s the organization aspect. So not being able to stay on task, not being able to organize themselves at work or at school or feeling very flustered and things like that. So, it’s a little biased in my practice cuz that’s the, that’s the population that I deal with.

[00:12:30] Dr. Lilach Saperstein: Can you talk a little bit about the overlap, the differences? People who have a comorbid at the same time they have ADHD and APD or when you’re making a distinction between one or the other

[00:12:42] Dr. Ruth Reisman: yeah. Sometimes it’s difficult to separate the two. Oftentimes when these individuals with ADHD make it to our office, it’s when they’ve been dealing with symptoms of ADHD, like distraction, hyperactivity inability to focus, things like that.

And they’ve dealt with that for a long time, and it’s been diagnosed by their psychotherapist and, and by their psychiatrist, and they’re getting treatment for it, but they still feel like they’re having difficulty hearing and processing. So, we try to make the testing more palatable to those types of patients who let’s say, can’t, focus for a really long period of time.

So, if we need to break up the testing to make it more reliable, that we’re actually testing the auditory processing and not the lack of focus. Or make things more engaging, so more interactive for, for the children and things like that. If they have that type of disorder. The reason why I got into it is I did a lot of my doctoral research in ADHD. I have two children that have ADHD, and their father had it as well.

So, it became kind of an area of interest for me, and like I said, with my kids, Similar to a lot of my patients. We’ve done everything. We went to the psychiatrist; we went to the psychologist. They were receiving every service under the sun. I would pay a lot, a lot of money for various specialists for reading and things like that.

Not realizing that a lot of their inability to actually grasp information was their difficulty with decoding. So actually, breaking down the information and allowing their brain to process it. And I made a lot of mistakes with my older one who I first identified, and then my, my youngest one who I knew early on had it, I was able to do all of the, the same, obviously the same types of therapies, but working with auditory processing from the beginning, and he was able to really overcome the disorder at a much faster pace when he was younger. And his reading skills and writing skills and language learning skills are at a much higher level than even for his own age range. And that’s because we worked on it early on. It is difficult sometimes to make that distinction, but oftentimes, they’re going through everything and there’s still this disconnect between what is being said and what the brain is understanding.

And the rehab with APD really helps them to focus and really work on their reading and language, development skills in a very intentional way.

[00:15:15] Dr. Lilach Saperstein: I want to ask you if you can give us a little more information on decoding is, and what it looks like when someone’s having issues with decoding, whether that’s in reading or in their auditory processing.

[00:15:27] Dr. Ruth Reisman: Yes. So, in terms of decoding, what that means, is it’s really breaking down, speech information or language information to the individual sounds or the individual phonemes.

The reason why we work on that is because a lot of individuals with auditory processing challenges or decoding, concern often will mix up words or mix up letters and sounds, and that will show up in a number of ways.

 Building those pathways within the brain to understand that when you hear the sound /d/ or “D”, that you know that that is the letter D and that that pathway gets reinforced throughout the whole auditory system. And the reason why we work on that, it almost seems elementary sometimes when we’re doing that, that we’re working on the ABCs from a very basic standpoint, but a lot of the times we work on that because when the speech information is degraded, either due to background noise or due to fast, rapid speech, an individual who has auditory processing disorders will not be able to differentiate between various sounds or various speech information. And so, what ends up happening is they’ll mistake one word for another and the whole comprehension of what’s being said is very much off or impaired, which leads them to have this, seemingly have a hearing loss even though their hearing is normal.

So that’s why decoding is, is the bulk of what we do to really reinforce the pathways of all of the speech and language sounds so that this way, once it reaches the level of the brain, it’s, well organized, and then it gets integrated properly so that comprehension is not impaired for the patient.

[00:17:21] Dr. Lilach Saperstein: Think people don’t realize how so many of the sounds are so similar from an acoustic perspective. They sound so alike. Like the letter S and the letter s h and like the ends of words that we, we tend to swallow the end of the word and it’s not as loud or clear if the word ended in a ED or a T, so then that makes a lot of sense that you go down to that base level of the input.

And then, this is an example I often give to people about differentiating things- back to our Venn diagram. Is it ADHD? Is it auditory processing? Is it something else? I talk a lot about interrupting. That you might have three different people who the complaint that’s coming through is that they interrupt a lot, that they’re not holding conversation appropriately.

So, for one kid it might be because they have an impulsivity issue and it’s part of the ADHD part that, they can’t control themselves or hold themselves back once they have something to say, they’re going to say it. But for someone else, it would be the same behavior, but it might be because they don’t want to forget what they’re going to say.

They’re trying to hold onto it. And that’s, it’s more of an internal, anxiety that they won’t remember what the question was or what their answer. And that’s more, I think on the auditory processing side and then a third kid. Well, that might be cultural because there are in some cultures that over- talking and you know, there is less of this quiet, formal reciprocity, back and forth and it’s more like, you know, that might be not even disordered at all if we look at their cultural background.

So that’s something I always like to bring in, that everything we’re looking at is so multifactorial, like who you are, where you came from, what your life is like. And if there’s issues, are these issues that we want to address and can address for this part of your life, you know,

[00:19:10] Dr. Ruth Reisman: Yeah.

I would add one more characteristic to that, and it’s similar with individuals that have hearing loss, that they interrupt because they want to dominate the conversation so that no one knows they have a hearing loss or an auditory processing issue. So that’s another, yeah, I, I usually find that more, more the most common reason why individuals try to dominate the conversation.

[00:19:33] Dr. Lilach Saperstein: Right, because then they don’t need to be hearing and decoding what everyone else is saying cuz they’re the ones speaking. That makes a lot of sense.

[00:19:40] Dr. Ruth Reisman: Exactly Right.

[00:19:42] Dr. Lilach Saperstein: So then once you do have the diagnosis, what is the treatment plan like? You mentioned your son getting very targeted and specific therapy, so what were some of those?

[00:19:53] Dr. Ruth Reisman: Yeah, once we have the evaluation and we really identify what categories the individual is having challenges with, then we come up with a therapy plan, and therapy usually lasts, as long as there’s no major compounding factors or like I say, things like very traumatic brain injuries and things like that, often times the therapy would last about 12 to 14 weeks and many times at that point, the patient has overcome a lot of their challenges with the auditory processing.

 Each week we work towards building upon the skillset that we worked on the previous week. So, if, like we said it is a decoding issue, then we will work on a certain few sound that the patient, let’s say, often will, mix up or confuse. And then the following week we’ll review those sounds and then work on new sounds.

And then the week after that we’ll go back and revisit all of the sounds and then work on new sounds and, and learn on integrating all of that information and build up each week until they have a full repertoire of the phonemes and the various, linguistic sounds.

In things like tolerance, fading memory or difficulty hearing in background noise, we’ll work on desensitizing the patient to hearing in background noise. So, we’ll work at their level, what level can they tolerate in terms of background noise and at each, appointment or each therapy session we’ll make it more challenging and more and more aggressive to a degree to really tax the system.

Challenge it, to expand itself and, and work towards the next level of understanding speech in a more challenging environment. Things like organization will work on small sequences or a few steps. And once the patient can master working on a, very limited amount of, directions or steps, then we’ll increase that and, and see how much we can task the system until we can get them sequencing multiple, directions and things like.

So, it tends to be very elementary in the beginning, gets more challenging as time goes on. I think the key is to really keep the patient engaged, make it fun, and really do the maintenance from appointment to appointment.

[00:22:20] Dr. Lilach Saperstein: And does therapy also do remotely or in person?

[00:22:24] Dr. Ruth Reisman: There’s two models. You can either do it in person or you can do it remotely. We’ve found great ways to really work on the therapy remotely for adults and children, to really make it very engaging and, intentional in what we want to do in terms of improving their skillsets. And there’s been a lot of success with that, even in the virtual realm.

[00:22:46] Dr. Lilach Saperstein: something that so many people, have all the different barriers to healthcare that we always talk about, and if we can do this, it seems also like maybe a short time that someone might be surprised by just, you know, 3 to four months and then, all my auditory processing issues will be finished.

How might you respond to?

[00:23:06] Dr. Ruth Reisman: I know it. And sometimes I’ll tell patients that it almost seems like unrealistic, right? For the most part, a lot of these patients have been dealing with these challenges their whole life. But we’ll typically counsel them and say, if we are very intentional in targeting the challenges that you have. We’re working towards building the skillset and they do what they need to do on their part, in terms of their maintenance activities, their homeworks that we give them in between sessions. So, it’s like a workout program to a degree, or a nutritional program. Right.

They’ll monitor themselves or we’ll give them tools to know how to eat healthy, know how to exercise. but the work comes from both sides. We’ll give them the information and work with them during the therapy sessions. But the patient also has to do their part in terms of the maintenance.

and I think what ends up happening is that once they see that they’re able to function so much better, with the therapy that they’re unintentionally doing their own therapy in real world settings and we’ll always reevaluate the patient six months after therapy. This way we’ve given it time to actually use their skills in their real life, in their day-to-day setting, and then see how much we were able to actually decrease their concerns, or their areas of weaknesses with auditory processing.

And like we said, the majority of patients will do really well and for the most part will almost or nearly, get rid of all of their challenges. But from time to time, there’s always still some residual because again, it is, in some ways, especially if there’s a global comorbid disorder, there’s always going to be potentially some residual weakness.

But we can, we can work towards giving additional exercises and things like that to, to make it more seamless in their day-to-day.

[00:24:59] Dr. Lilach Saperstein: So, would you say that people after, let’s say, after that six-month appointment, where you can see a big difference from when they first came in to how they’re doing now, that, that they drop the diagnosis, the label, is that something that happens?

[00:25:15] Dr. Ruth Reisman: So. I guess it really depends on their needs. So, for children in the classroom setting, we definitely want to do the therapy, but also still want to give them any support that they would continue to need. Once we do the. reevaluation, we’ll see if there’s any residual effects and if they still need, some maintenance or continued ongoing support.

For adults. Oftentimes we can kind of say that, it’s been rehabilitated, but just to be mindful of the fact that they still have those symptoms. If they still have those symptoms, they should work towards, using the strategies that we discussed in therapy or work on, some of the maintenance activities.

I don’t think it can always fully go away. In some ways we are working with an impaired system just like hearing loss. So yes, we’re giving a lot of tools. We’re doing a lot of therapy, we’re giving a lot of support, and they can be functioning in a normal, setting in those environments where they find that they’re having challenges, but we probably have to always keep this awareness that it was there or that it is there so that we can so that they can get accommodations or support, when needed.

[00:26:24] Dr. Lilach Saperstein: That sounds amazing and I, I just hope that’s something that a lot of people can take away from this conversation is that there’s hope and there’s help and there’s resources. And that so many people feel that they’re dealing with these challenges and that’s it. This is going to be like this forever.

you also don’t want to give false promise, but you do want to say, let’s get specifically your case. Go see someone who knows what’s going on, and even if you have one or two or 10 other professionals tell you something about what’s going on, that doesn’t mean that there isn’t, that, you know, another person who might say, I know exactly what’s going on and help you out.

Cause I think you and I have both seen that many times where people say, wow, “I wish I would’ve met you five years ago. Where were you when this or that was going on?” And that’s, – yeah, you’re nodding along, so

[00:27:11] Dr. Ruth Reisman: Yeah, exactly. Exactly. Exactly. Right. and the beauty of it also is that it’s, although it’s extremely helpful, it’s also extremely non-invasive, so it’s like, it could only help. that’s the real takeaway aways. Like it could really only help. We’re not doing anything in any way to harm the system. We’re not giving any, invasive technologies or anything like that.

A patient today was telling me about, you know, shock therapy for tinnitus, and in my mind, why would we start there if there are other non-invasive things that we could try before we, we get to that point, you know?

So that’s the beauty of this. And, and it’s just, so in some ways when there’s a diagnosis and we identify the weaknesses, there’s treatment options. Like you said, there’s help, there’s a way to get help. And it’s so non-invasive and it’s just so helpful in any way. Like you said, any improvement is really a win.

 I don’t think anyone should hesitate to try if they’re having those challenges.

[00:28:12] Dr. Lilach Saperstein: I’d like to ask you a little about what’s the overlap with this kind of treatment, protocols and the work that you do with people who get cochlear implants in the auditory and aural rehab that they go through.

[00:28:25] Dr. Ruth Reisman: Yeah, the amazing thing is that we do have wonderful technology to help individuals with hearing loss, like hearing aids, middle ear implants, cochlear implants. Those are for individuals that really have, significant hearing loss or have a lot of challenges with their speech understanding and maybe weren’t successful with hearing aids and things like that.

But what patients really need to learn and understand is that yes, the technology is amazing and the options that patients have to treat their hearing loss is so expansive as compared to what it was, let’s say, when my mother was suffering with hearing loss back in the day. But we, like I had said earlier, we have to understand that we’re always still working with an impaired system and that the aural rehabilitation or the therapy, the hearing therapy that we do for individuals with auditory processing holds true for individuals who also get hearing aids or get cochlear implants because in many, many ways their brain is learning how to hear again, right?

They haven’t been hearing for so long because of their hearing loss. Or the technology is such a different way of hearing than the brain is used to. So, let’s say with the cochlear implant, we’re used to hearing acoustic sound, and now with the implant, it’s electrical sound. So, it really takes a lot for the brain to relearn, to hear again, and to make the patient as successful as they can be.

So yes, the technology is the first step, but I’m a huge proponent of aural rehabilitation, really taking the patient to that extra mile and making them as close to a normal functioning hearing individual as we can with all of the tools that are available to us as an audiologist.

[00:30:10] Dr. Lilach Saperstein: That is phenomenal. I think a big part of our job is educating the public.

On the fact that these devices and these technologies are not glasses and they’re not a light switch. There’s a lot that goes into it. A lot of patients they’ll say like, what’s the rehab time? And it’s can really vary. For many people, it could be a year, a few months, it could be many years, depends on

what their progress is and so many other factors, like you said, how long they had hearing loss for before, did they hear before as in did they lose their hearing or were they born with hearing loss? These are all factors that, that go into it. But again, it’s really important to stress that, there is a possibility of training and working out the system.

It’s something that people can be aware of that exists.

[00:31:00] Dr. Ruth Reisman: I would agree. And yes, like you said, with hearing impairment, the therapy will be individual. It could be an ongoing thing that they’re always going to be learning new ways to compensate for the challenge. But where there’s a will, there’s a way.

I think if, if we’re willing to all work together and work hard, that they can be extremely successful.

[00:31:19] Dr. Lilach Saperstein: Mm-hmm. I hear this thing that’s thrown out a lot that people say, oh, you have to listen to audiobooks, or you have to listen to music and follow the lyrics. And even though those are really good strategies, we certainly use them.

I wonder if you have specific thoughts on that just being given out as a blanket recommendation.

[00:31:40] Dr. Ruth Reisman: Yeah. I think oftentimes it’s our nature as audiologists to want to help and to want to give solutions to patients, especially when they’ve gone through something as challenging or traumatic as a cochlear implant.

audiology is so expansive and people don’t realize that. So much that there are various areas of specialty, right? So, I think definitely giving patients some sort of a tool is great, but also giving them information of what else is out there to be able to help them. So, it’s a great starting point, and like you said, integrating that into their, let’s say, everyday life, using an audiobook or listening to music and, and listening to the lyrics is great.

But we have to also remember that that is in some ways, a complex speech input especially music, right? That’s a complex auditory input that we’re giving to the patient where it may not be the case that their brain is at that level to actually break all of that information down. So, if we think about music, right, there’s the melody overlaid with the words.

So, the brain really has to filter out the melody and the words, and, and by doing that without actually breaking things down into much more smaller packets may take a longer time for the patient to actually adapt or overcome. So, I think using it as one strategy is great, but I think we also have to be more intentional in what we’re offering the patient in order to make them successful.

Yeah.

[00:33:12] Dr. Lilach Saperstein: I would like to ask you about what is your favorite part of this?

[00:33:16] Dr. Ruth Reisman: Yeah, I, I think my favorite part of auditory processing is actually working with all the different types of patients. What I find so interesting and every time I meet a new patient, I’m always shocked by, it’s not one mold of patients that really fit into this category. There are younger individuals, there’s children, there’s older individuals. It just spans across the age range, across gender, across different cultures, different backgrounds different races. It’s just so, so interesting and fascinating to me. And everyone has a story, which I always enjoy hearing about and learning about and being able to be part of their story and their journey is a very rewarding aspect to what we do as audiologists.

[00:34:06] Dr. Lilach Saperstein: That’s really very special and good for people to know that their audiologists actually cares about them and what’s going on in their life.

And I think that’s true for most of us in this profession.

[00:34:17] Dr. Ruth Reisman: Oh, for sure, for sure. Sometimes that’s part of the most interesting aspect of what we do, is really learning about, people’s lives and, getting to know them, especially doing the therapy. We’re going to build a relationship whether you like it or not, so we’re going to get to know each other well.

[00:34:30] Dr. Lilach Saperstein: So is there anything else you’d like our listeners to know about you and how they can find you and work with you, where you’re located, et c.

[00:34:38] Dr. Ruth Reisman: Sure, of course. So, I’m actually located in New York, as we discussed. So, I live in New York. I service because we’re virtual, like we service the whole entire state.

So, anyone in New York is able to reach out. We have a website called Urban Hearing, so urbanhearing.com. And on there, there’s ways for professionals to connect with us, for patients to connect with us, for family members. And there’s a lot of information on there about auditory processing and what we do.

But we also service actually Florida and we are essentially the only audiologist on Bermuda offering this service too. So, we can support patients in all of those areas. And feel free to touch base and reach out. And if you’re not sure if scheduling an appointment or evaluation is the next step, just send us a message or send us an email and we’re happy to respond right away and, and answer all your questions.

Perfect.

[00:35:32] Dr. Lilach Saperstein: Thank you so much. We’ll absolutely have all your information in the show notes and a full transcript of today’s conversation as well on the All About Audiology podcast. So, thank you so much to Dr. Ruth Reisman for all the information and this fun conversation about how our brains do so much with everything that we hear.

[00:35:51] Dr. Ruth Reisman: Thank you so much for the opportunity and I’m always happy to connect with anyone, including the students that are listening, patients, professionals. If anyone has any questions, I’m always happy to, to, to connect and, and discuss further.

[00:36:05] Dr. Lilach Saperstein: Awesome. Thank you so much.

[00:36:07] Dr. Ruth Reisman: Thank you.

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