Beyond the Ear: Auditory Processing and Working Memory

Auditory Processing and Working Memory

“I can hear, I just can’t understand.”

Sound familiar? As an audiologist, I hear this complaint many times a day. It can be difficult, in the rush of a hearing appointment, to stop and talk about the importance of auditory processing. The focus of most of my time with patients is on the hearing aids or ear. Rarely do we have the luxury of talking about the complicated interaction between the ear and the brain. However, I am beginning to understand that this key information is what might make the difference for a lot of my patients when it comes to understanding and coping with hearing loss.

Working Memory and Speech Understanding

Think of working memory like a bunch of sticky-notes that help you keep track of very short-term ideas, thoughts, situations, and memories. The working memory is for things that are important to you now (a phone number or the set up of a joke before you hear the punch line). Even a good working memory can only store so many “chunks” of information before new information pushes its way in. Sometimes, our working memory slips a little; have you ever walked into a room and forgotten why? Our capacity for working memory is limited. When we struggle to hear or understand speech, we need to use more of our working memory to pay attention to the speech signal, which reduces out ability to pay attention to or remember other things.

It’s Complicated

Hearing and understanding speech are profoundly different. Whereas hearing is a relatively basic human function, there are many parts of the brain involved in understanding and processing speech and language. If you have a hearing loss, the auditory cortex is not receiving accurate information, so the brain must work much harder at decoding the intended message. Because of the additional strain on working memory, your brain much decide what is most important. If you are in a crowded room and trying to listen to someone tell a story, part of your brain is straining to understand the speech and trying to keep up with the story, while the rest of your brain is being used to stand upright, hold your beer, keep eye contact, and monitor the general environment for safety and security. The more difficult it is to hear, the more difficult (and exhausting!) it is to listen and stay engaged.

How To Make Listening Easier:

  • Reduce distractions. The less environmental information your brain must process, the better it can focus on understanding speech.
  • Make eye contact with the speaker.This will assist you with both speech recognition (those hard-to-hear sounds are usually visible) and assessing body language.
  • Don’t worry about the iron. Focus on the moment, and try not to think of unrelated information such as whether you unplugged the iron or fed the dog. Stay in the moment.
  • Stop what you’re doing. If you’re reading the paper or watching television, stop and listen to the person speaking to you. It is virtually impossible to process competing language inputs- even for folks with excellent hearing.
  • Advocate for yourself. Ask the speaker to slow down, introduce the topic, speak clearly, and to make eye contact. Teach those you love and respect how to communicate with you. This will significantly reduce frustration for everyone.
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