Aural Rehabilitation/Cochlear Implant Collaboration

The School of Communication Sciences and Disorders offers diverse opportunities for students and faculty to explore their interests through clinical work and research. As part of the curriculum, audiology and speech-language pathology students complete a research project with an academic faculty member. This partnership between clinicians and academic faculty is not only reserved for students. Many tenure-track academic faculty members collaborate with clinical faculty members to develop projects that will benefit the populations we serve. 

One such interprofessional collaboration is the expansion of the MSHC Cochlear Implant team, between Dr. Sarah Warren, a tenure-track Assistant Professor, and JoClaire Merrill, a clinical speech-language pathology Associate Professor. Dr. Warren, the head of the Cochlear Implant Research Lab, approached Professor Merrill with the idea for this program. When asked about her motivation, Dr. Warren explained, “Team-based care is critical to success in cochlear implant patients. I like to tell my patients, ‘You wouldn’t have a knee replacement without seeing a physical therapist.’ Speech-language pathologists provide training on listening and show them how to use their newly implanted devices.”  Dr. Warren plans to investigate the effects of aural (re)habilitation on people with cochlear implants. 

Patients begin in the cochlear implant clinic with Dr. Jordan Alyse Coffelt, who identifies cochlear implant candidates and guides them through surgery and device activation, which is a process which spans multiple appointments. Once the activation process has been completed, these patients are referred for aural rehabilitation with Professor Merrill. Aural rehabilitation includes patient training in listening skills, speech perception, articulation, music appreciation, telephone use, and communication strategies for use with others. 

While aural rehabilitation is within the scope of practice for both audiologists and speech-language pathologists, patients with cochlear implants have unique communication struggles and needs. To prepare for the special considerations for implanted patients, Professor Merrill completed a listening and spoken language course through the Institute of Cochlear Implant Training. The treatment progression for this program is based on the hierarchy of auditory skills: detection, discrimination, and identification. Each patient will move through these three stages with a variety of auditory stimuli, including environmental sounds, suprasegmental aspects of speech, speech with context, and speech without context. Patients also move towards comprehending paragraphs in quiet, in noise, and on the telephone. In addition to honing these auditory skills, patients are counseled on how to explain their hearing needs and areas of difficulty, as well as learning compensatory strategies for areas in which they are not progressing. For children with cochlear implants, aural habilitation includes training in articulation, play, early literacy, listening skills, and expressive communication. Caregiver coaching is a critical part of this therapy so that the training can continue outside of the clinic. 

While this collaboration is still in its early stages, Professor Merrill is already seeing great improvements with her patients. Two of her patients have reported improved listening abilities, and another said, “This is exactly what I need.” The addition of aural rehabilitation on the MSHC Cochlear Implant team is an excellent example of how partnerships between academic and clinical faculty can have significant impacts on the clinical services at the Memphis Speech and Hearing Center. Students are always encouraged to put research evidence into practice in the clinic, and collaborations such as this are a great reminder of how research and clinical outcomes are so closely interconnected.

Thank you to JoClaire Merrill and Dr. Sarah Warren for contributing to this story!