Father and Son

Are You Listening?

By: J. Nikki Gaylord, MA, CCC-SLP

Capital Region Medical Center

“I like to listen.  I have learned a great deal from listening carefully.  Most people never listen.” -- Ernest Hemingway

How many times have you been talking to your spouse or your children and realize they aren’t listening to a thing you have said?  They may have heard you but did they listen to you?  Hearing is passive, involuntary and never shuts off while listening is active, voluntary and connects our inner world to our outer world.  Listening requires motivation!

Active listening is made up of five main components: 

  1. Orienting to the sound – this skill helps us answer these questions:  What is this sound? Do I need to pay attention to this?  Is this dangerous?  If orientation cannot occur with a sound, the foundation for attention to the sound is lost. 
  2. Locating the sound - This skill helps us to locate the time of arrival of the sound.  If we walk into a busy street, our locating ability helps us to know if we can get across the street before the approaching car is upon us. 
  3. Selecting the sound - This skill is our filtering system that helps us to block out the sounds that are unimportant and enrich the sounds that are meaningful to us.  The inability to select the sound to attend to can impact communication skills.  If we can’t select the sound of the person that is speaking to us, we cannot block out other unimportant sounds, therefore not comprehending what the person is saying.
  4. Attending to the sound – This skill requires persistence and motivation.  We will only attend to a sound that motivates us.
  5. Interpreting and discriminating sound – This is the last step of the listening process and plays a large role in social skills.  This skill helps us to understand the small nuances of language that indicate emotion and feeling such as changes in intonation and inflection. 

Children or adults that suffer from chronic ear infections, sensory integration disorders, hearing loss, or genetic syndromes may have a breakdown in one or all of the components of listening, therefore impacting their ability to pay attention in a noisy classroom, have a conversation in a loud restaurant, understand specific instructions, or communicate with clear speech.

The middle ear is made up of three tiny bones and two striated muscles.  These structures must work with the outer and inner ears to send sound to the brain to be interpreted.  Because the muscles of the middle ear are striated, this means that they can contract and relax just like other larger muscles in the body.  Also, just like other muscles in the body, they can become weak and out of shape when they are not made to work because of fluid in the middle ear or in the case of hearing loss.  When this occurs, the sound that is sent to the brain to be interpreted may be a different sound that actually entered the outer ear.  If those striated muscles of the middle ear are unable to contract to dampen out unimportant sounds (background noise) and interpret the important sounds (speech), those sent to the brain will not be the same as those initially heard.  A child will imitate only what they hear – therefore, if a child hears a sound a certain way, he will repeat that sound the way he heard it.  For example, when talking to a one-year old and trying to get him to imitate “dada,” if all he heard was “uhuh,” then he will eventually say “uhuh” because that is what his brain is interpreting.

When a breakdown in active listening occurs, the result may be a child with speech that is hard to understand, an adult that doesn’t process information in noisy environments, or a toddler who doesn’t put words together to communicate.  These breakdowns in listening are often seen in children or adults with autism spectrum disorders.  Frequently, sensory issues that these individuals may experience take away from their ability to listen and attend therefore impacting how they communicate and socialize with others.     

At Capital Region’s Sam B. Cook Healthplex, the Pediatric Speech Therapy Department has the ability to help with listening skills.  Through the use of traditional therapy techniques and alternative therapy techniques such as Therapeutic Listening, the therapists are able to assess what part of listening is not working properly and provide exercises during therapy sessions and for use at home.

Therapeutic Listening is a program developed by Vital Links to facilitate the components of listening as well as build the middle ear muscles.  It is comprised of modulated music CDs that are listened to through headphones or on a CD player.  The music is formulated so that it addresses the components of listening and works the middle ear muscles while making it enjoyable for the listener.   An example of a treatment session might include listening to the modulated music while completing some other task such as swinging, walking, playing with toys, coloring, or playing a game.  The listening therapy is completed secondary to other therapy tasks to facilitate the patient’s overall listening capabilities.