Is it time to visit the Audiologist for a Cochlear Implant Mapping?

Since starting telehealth therapy in the beginning of March, due to COVID-19 clinic closures, I started to notice difficulties with speech intelligibility in all of my patients, not just those with hearing aids or cochlear implants. 

Why was this the case?  

In virtual appointments we might have less context of the child’s story. We also can’t hear our patients as well-- it may be because of more background noise or even the sound quality from my microphone and the speaker quality on their end. After troubleshooting with each family to improve sound quality… I started to think about suprasegmentals!  What? Pitch, volume, tone, stress. 

After we tried to improve monotone, loudness etc. with different techniques it was time to refer to audiology to update/check their cochlear implant mappings. 

When else should you visit your audiologist? 

  • There’s a difference in responses to Ling-6 sounds. Your child typically imitates all sounds, but suddenly stops responding to certain sounds. 

  • Your child’s speech is monotoned. 

  • Your child is too loud or too soft.

  • You hear a nasal or breathy vocal quality

  • Voiced vs. voiceless speech sound errors (e.g., p vs. b, t vs. d etc.) 

  • Omitting unstressed syllables  or function words in sentences (e.g., is, a, the) 

  • High frequency sound confusions (e.g., sh, s, ch, z, v, th) 

  • Speech errors 

    • Manner errors (e.g

    • Vowel distortions/errors

    • Place of Articulation errors 

    • Omitting Plosive Sound (e.g., p, b, d) 

Follow your audiologist recommendations for regular checks (typically once a year once you’ve had your CI for at least a year). 

Speech Activities to Improve Suprasegmentals

  • Sing songs paying attention to the rhythm, melody, and pitch. (Focus on only one at a time). 

  • Practice saying words with different meaning (e.g., saying a word like you’re excited, bored, as a question etc.) 

  • As your child is learning to expand their phrases use word groupings versus having your child imitate each word in the sentence (e.g., The teddy bear is [on the table] vs. The teddy bear is [on] [the] [table]).  


References: Sylvia Rotfleisch M. Sc.A LSLS Cer. AVT at Hear to Talk; Soda Bottles & Submarines: Essential Speech Acousitcs. https://www.hear2talk.com/assets/presentations/soda-bottles.pdf

AVTChristiana Dcochlear implant, mapping, suprasegmentals, intonational phrases