You don’t miss your water, ‘til the well runs dry
-William Bell-
You don’t know what you’ve got ‘til it’s gone
-Joni Mitchell-
Round about age fifty, everybody in my family with patrilineal (Powsner) DNA enters the world of progressive higher frequency hearing loss. At first, the progression is so incremental as to be insidious. The drip-by-drip decay of consonant discriminations gradually renders comprehension of others’ speaker behaviors challenging, particularly in environments where there is a lot going on. Crowded social events, or even more formal meeting settings where people forget to take turns talking, become an overwhelming sound soup where one can see peoples’ mouths moving, but messages are lost. Busy outdoor environments frequently bewilder with a cacophony of auditory events that compete for focused attention and discrimination of importance, sometimes with basic safety implications. There’s a crucial reason for “Deaf Child at Play” signs.
Of necessity, vision must take on an outsized share of environmental awareness and it’s all very exhausting. In the absence of sensory disability, hearing and vision work together seamlessly to support effective responses to the world around us, but that partnership goes unnoticed until one of the partners in perception begins to falter.
‘Tis a gift to be simple, but life only affords such gifts when the responsibilities of communal living abate for the day and one can retreat into the relative serenity of space and activity that one can control. I remember my father, after a busy day of speaking and listening, taking out his (in his day blunt instrument) hearing aids and settling into his favorite chair with a book and heaving a sigh of relief. My hearing aids are much higher tech, with five different channels that can be adjusted for frequency response and discrimination of ‘what’s important to hear’ in a variety of settings. They are still, however, prostheses… not the real deal, and are one more thing to attend to and manage. I find myself, in conversations, running through the five channels for best effect, or more aptly stated: which one will help me hear the least badly.
So why am I sharing my personal tale of disability challenge?… not so you’ll know I have a hard time hearing you (I’ll deal with that on the spot). I’m reporting here in the service of applied behavior analysis. We work hard to support people with a wide range of disabilities: sensory challenges, motoric challenges, communication challenges, intellectual challenges… by themselves and in endless combinations. I’ve described the impact of sensory challenge in my own life. To people with motoric challenges, a curb looms like a hard to scale cliff. People with communication challenges struggle to both impart and receive information. People with intellectual challenges struggle constantly to make sense of the world around them.
Behavior analysts teach through targeted applications of positive reinforcement. To be effective, the reinforcement provided must surpass the effort required to produce a response. While I struggle with hearing loss, the reinforcement of successful communication makes the fatigue I feel at the end of the day worth it… but my disability is adventitious. For most of my life, listener behavior was easy and highly reinforcing. People with lifelong disabilities do not have the advantage that a rich adaptive learning history affords. For them, we must ensure two things. First, challenges must be accommodated so that response effort (as we behavior analysts call it) is never so great that the learner is discouraged. Secondly, we must always offer sufficient positive reinforcement to make the effort worthwhile.