Speech Therapy

Q: Can a Cochlear Implant user still improve the clarity of his speech through speech therapy, even though the CI surgery was done a long time ago? 

Answer: 

Yes, speech clarity can still be improved through speech therapy, even if cochlear implant (CI) surgery was done a long time ago and minimal speech therapy followed the surgery. While early and consistent post-implant therapy yields the best outcomes, neuroplasticity—the brain's ability to reorganize and adapt—can still support progress even years later, especially with consistent effort.

Here's what research and expert guidance say:

1. Neuroplasticity Is Lifelong:  

Although it's strongest in childhood, the brain retains a degree of plasticity throughout life.

Adults and late-therapy starters can still benefit from auditory and speech training, though progress may be slower or require more intensive work.

Source: Kral, A., & Sharma, A. (2012). Developmental neuroplasticity after cochlear implantation. Trends in Neurosciences, 35(2), 111–122.

2. Delayed Therapy Can Still Help:

A 2016 study showed that even late intervention with speech-language therapy in CI users led to measurable gains in speech intelligibility and auditory perception.

Motivation, daily practice, and therapist-guided strategies are key factors.

Source: Sarant, J. Z., Harris, D. C., & Bennet, L. A. (2014). Academic outcomes for school-aged children with severe–profound hearing loss and early unilateral and bilateral cochlear implants. Journal of Speech, Language, and Hearing Research, 57(5), 1831–1844.

3. Speech Clarity Can Be Trained:

A speech-language pathologist (SLP) can help with: 

• Articulation
• Voice modulation
• Prosody (intonation, rhythm)
• Auditory feedback training

Improvements have been observed even decades post-implant, especially when combined with auditory training tools and consistent practice.

Recommendations:

• Consult a certified speech-language pathologist (SLP) with experience in CI rehabilitation.
• Use apps or tools for auditory training, like Hearoes (in Android and iOS).
• Practice speaking in real contexts—record speech and review it with feedback.
• Combine therapy with listening activities (e.g., audiobooks, captioned videos).

Q: Speech and listening therapy exercises and tools for adult CI users. 

Answer:

Here’s a list of specific therapy exercises and tools for adult cochlear implant (CI) users to improve speech clarity and auditory skills, even years after CI implantation.  These can be part of your home therapy which you can do at our own pace. It is important to do these exercises with the help of a family member or friend.

These are backed by clinical use and research.

A. Therapy Exercises for Adult CI Users

1. Auditory Discrimination Exercises

• Goal: Differentiate between similar sounds, words, or sentences.
• How: Listen to pairs of words or sentences and identify if they’re the same or different.
• Example: "mat" vs. "bat" or "Did you see the cat?" vs. "Did you feed the cat?"
• Source: Tye-Murray, N. (2009). Foundations of Aural Rehabilitation: Children, Adults, and Their Family Members. 

2. Shadowing Practice

• Goal: Improve speech clarity, rhythm, and intonation.
• How: 
• Repeat phrases immediately after hearing them (like echoing).
• Start slow with clear speakers (e.g., listen to YouTube videos with transcripts).
• Record and compare your voice to the original.
• This technique is used in auditory training software like AngelSound and Hearoes.

3. Minimal Pairs Practice

• Goal: Improve articulation and fine listening skills.
• How: Practice saying and listening to minimal pairs. Minimal pairs are pairs of words that differ by one sound (e.g., “bit” vs. “pit”, "cold"vs "told").
• Compile your list of minimal pairs from online resources.

4. Lipreading + Listening

• Goal: Strengthen the ability to lip-read as well as the ability to understand spoken language.
• How: Watch videos of people talking and try to understand without sound, then watch the video again for the second time but add sound.

5. Reading Aloud + Recording

• Goal: Self-monitor articulation, fluency, and pitch.
• How: Read aloud daily (10–15 minutes), record yourself, and listen critically.

Other resources:

Cochlear.com's list of rehabilitation resources offer many therapy exercises which can be done at home.

B. Tools & Apps for Adult CI Users

1. AngelSound (by TigerSpeech Technology)

• Free auditory training software for CI/hearing aid users.
• Includes:
• Sound identification
•  Word recognition
•  Sentence comprehension
• Download AngelSound from http://angelsound.tigerspeech.com/

2. Hearoes

• Interactive app with gamified auditory training.
• Covers: Phonemes, Words, Everyday conversations
• Available on iOS & Android.
• See https://hearoes.com

3. AB Listening Adventures (by Advanced Bionics)

• Great for adults starting at beginner level.
• Free iPad app with auditory games and exercises.
• See Advanced Bionics Listening Tools 

4. Ling 6 Sound Test Practice

• Goal: Improve detection of key speech sounds across the frequency range.
• Practice sounds: /m/, /ah/, /oo/, /ee/, /sh/, /s/
• Use daily with recordings or partner assistance.
• See Cochlear.com's Ling 6 Sound Check guide