Recently, an article was circulated through the UK media about "neurological issues affecting Gen Z", which were 'blamed' on "excessive reliance on noise-cancelling headphones". These 'neurological issues' are actually known as Auditory Processing Disorder, or APD.
What Is APD? Auditory Processing Disorder (APD) is a difficulty in the brain being able to distinguish background noise from speech, but with hearing tests returning "normal" results.
This is a tricky issue, because some people in the early stages of hearing loss will struggle in exactly this way, however their hearing test may come back as in a 'normal range'. As with all medicine, sometimes doctors fail to pick something up that could be managed or may be part of a wider issue.
However, where this is relevant to neurodiversity is that these issues combined with a normal result hearing test, are a hallmark for Auditory Processing Disorder (APD).
APD can occur for a variety of reasons, including things like brain injury or following an infection, but it is also highly common in people with autism and ADHD. At the same time however, it is not a defining feature of autism and ADHD. Neurodiversity just means 'brains which vary from the average norm' i.e. a certain brain profile is classed as 'neurotypical' and others are 'neurodivergent'.
Understanding that, this assertion that some outside cause is definitely causing these issues (as this article tried to imply) is a concern not just for neurodiversity training, but wider disability awareness as well.
Both Directors of The Productive Pessimist have APD. Neither of us has ever used noise-cancelling headphones. Morgana (who is writing this piece) is autistic and ADHD, while Ash also has a small amount of objective mechanical hearing loss, as well as tinnitus. Ash is currently exploring a possibly mitigation treatment, which involves listening to television documentaries, at normal volume, whilst reading a book; the premise is that this forces the brain to "practice" engaging with two distinct forms of focus simultaneously; for Ash, this is important, as he is legally blind, with his remaining sight deteriorating, and he finds APD interferes with effective use of screen readers, which are obviously going to be essential to him being able to maintain work long-term.
APD can and does occur independently of what could be termed mechanical hearing loss. However, a lot of the rhetoric related to both experiences is worryingly similar.
The Background
Historically, many Deaf people in the UK were confronted with the idea that they could just learn to 'overcome' their apparent disability, if they would only 'try harder'. This resulted in a lot of trauma surrounding attempting to force Deaf children to learn to speak.
I say apparent disability, because for centuries there has been a thriving Deaf community in the UK, and this is a space in which anyone with similar experiences is welcome (including those with APD). In actual fact, if we see APD as a neurological variation rather than deficit, it is possible that some peoples' brains are more primed for visual input (such as sign language) and thus their brains perhaps diminish the importance of speech as something worth separating from other sound. (It is important to take a moment to point out that a person can be deaf i.e. as a matter of medical fact, but that Deaf with a capital D, relates to people who are medically deaf and active in Deaf culture).
The concern from a training standpoint is that attempting to paint a possible neurological variation as 'caused' by an outside factor, presents a slippery slope for other disabled people. The language of a 'cure' for disability, is almost always underpinned by eugenicist ideas (the idea that genetics can give rise to 'good' vs 'bad' genes. 'eu' like in euphoria, positive feeling), and that is not acceptable.
(I allow for the fact that some disabled people may not wish to be disabled for a variety of reasons, but that must always be a personal choice, not one chosen or mandated by society).
It is a possibility, similar to how Ritalin will not have a calming effect on a non ADHD brain (the brain of someone without Attention Deficit Hyperactivity Disorder), that noise cancelling headphones in people with APD are providing a filter that the brain otherwise lacks. If this is the case, it is conceivable that for people without APD the prolonged use of such headphones is perhaps causing a greater dampening effect than just acting as a filter.
The issue here is that this entire premise is built upon the idea of neuroplasticity. Neuroplasticity is valid science, however what we see in cases of survivors of stroke is that the brain can take months if not years to relearn pathways it needs (such as walking, learning to eat again etc).
While I concede that, especially if a person is using noise cancelling headphones every day, maybe this could have an unwelcome effect on the brain, I am more concerned that the medical establishment is doing something it often does. That is to say, placing blame on patients who are struggling, rather than looking for an actual root cause. This placing of blame is a direct result of systemic ableism, and ties back to the historical (similarly ableist) belief, that D/deaf people could just 'overcome' their state of being if they just tried harder.
Concerns were also raised in this article, that people were becoming 'overly reliant' on use of subtitles.
As I have already mentioned, from a training perspective this whole angle is worrying. When we are talking about what provisions to make to include disabled people in jobs etc, a number of social provisions are already there and subtitles are one of these.
There is already an unfortunate trend among some able bodied people to view subtitles as 'annoying' and 'detracting from their viewing experience'. If a branch of the government (which the NHS technically is), are subtly suggesting that a literal disability provision is something people should use less and simply 'train themselves better', that should be cause for concern.
Not least, because this comes in the wake of attempted cuts (now shelved at least for the time being), focused on disability related welfare provision. Part of training is making people think carefully about their daily lives, and we must be wary of ways in which systemic biases become apparent. At this present moment in time, systemic ableism is still a major issue for all disabled people.
Has the Problem Been Accurately Identified?
I cannot be certain of course, but I would strongly question whether noise cancelling headphones are definitively causing hearing related issues. After all, in a closer space, people in certain professions may have cause to wear them for safety purposes. At that point, where hearing loss occurs, we are far more likely to put the blame on heavy machinery which makes a lot of noise and so on. Not the safety gear that those people wear to actually help prevent hearing loss.
I would question whether the people presenting for treatment are actually in high noise environments, but perhaps this is being dismissed. Even outside of construction, factory work and so on, we are bombarded with a lot of noise every single day. Cars, music, machinery, people shouting and screaming and so forth. Is it therefore possible that modern living itself is having a deleterious effect that is not being acknowledged?
One other issue this article raised was the idea of the vital importance of being able to distinguish speech from other sounds. Once again, from a training perspective and from my own lived experience as someone with APD and who uses alternative communication (mainly sign language), I feel it is even more vitally important to counter this assertion with the acknowledgement of systemic ableism. Why do we place such high emphasis on speech? Why do we force people to exist in high noise environments and then seemingly blame the individual rather than the environment?
What this assertion of the importance of speech does, is to privilege speaking as superior to all other forms of communication. Historically this has harmed D/deaf people, for example use of phrases such as 'deaf and dumb' i.e. medically deaf, but also unable to speak. This unequivocally associates a lack of speech with lessened intelligence, with dumb having become a synonym for stupid.
Similarly, this goes on (even now) to have disastrous consequences for people who are long term non speaking and/or non verbal. (Non speaking being the state of not speaking. Non verbal being in a state of not thinking in words, but for example images, sensations etc). Many people who are long term non speaking and/or non verbal, when they have access to communication devices, will report that they are treated with absolute contempt by people supposedly providing care for them. Setting a certain standard of 'normal’, which disabled people will never meet by definition, and punishing us for not meeting it, is ableism. People without APD are framing the problem as "these people can't engage around all the general noise of life." Here at The Productive Pessimist, we begin all our work by looking for the real problem. The real problem of "a rise in APD" (and many other no-clinical-evidence conditions) isn't "people are claiming they have a condition, and expecting accommodations"); the real problem is people are not being supported to live with their condition, so that it becomes something, like non-sight-loss-condition poor eyesight, which "just is" - people don't need to be derailed by it, it doesn't have to "become their whole personality", they don't have to "go on about it all the time"; they simply identify and acquire the most relevant accessibility aids (ie, in the non-clinical poor eyesight scenario, glasses or contact lenses), and, with those in place, and unremarked by their teachers, peers, or employers, get on with meeting the expectations placed upon them, and navigating challenges that stretch their understanding of their competencies and capabilities. Not seeing accessibility aids and accommodations as a "burden" on abled people, not dismissing them as "unnecessary" simply because you don't need them, is vital to people being able to live with conditions, including "non-clinical" or sub-clinical conditions, which do not show any anomalies on objective testing. No one is trying to claim that "glasses and contact lenses cause low vision!", or that "hearing aids are making people deaf!" - we have simply accepted that people with poor eyesight, or mechanical hearing loss, require glasses/contact lenses, and/or hearing aids, to engage fully with work, family, leisure, and social life; we should be aiming to reach a position where we see all accessibility aids the same way, and give as little reaction to people presenting with them. How Can I Be More Inclusive?
What are some ways that people and companies can be more inclusive and welcoming of those who are D/deaf, hard of hearing and so on?
Subtitles: It is a small thing, but always ensure that audio/video presentations contain subtitles wherever possible. If this is something you yourself can't do easily, please do consider asking someone to help you set them up, or at the very least acknowledge in your video that you don't have the capacity for subtitles.
Transcripts: These are separate to subtitles, but can serve as an excellent method of conveying information if a person can't hear you. Some Youtube videos now provide transcript-like subtitles as a separate box (as sometimes the white text on black box subtitles can leave something to be desired). Or you can include a transcript or detailed summary in the description box.
Lip-reading: At bare minimum, try wherever possible to hold meetings or do videos in lighting that makes it possible for people to lip-read. If this is not possible for whatever reason, handouts about the topics being discussed and/or a transcript or subtitles on a video are really important. Alongside bright enough lighting, please try to ensure that you speak at a steady pace so that mouth shape is not distorted, and that you don't unnecessarily cover your mouth (if you are anxious, or have a speech impediment which makes speaking steadily difficult, please do mention this. People will be understanding you are making the effort to include them).
Sign Language: This is more so for companies, however individuals can get involved too. For companies who have the budget, you absolutely should include sign language interpreters when you know someone who needs them will be present.
For smaller companies with less budget, please do reach out to people who may be able to help. While interpreters are not free by any means, sign language interpretation is such a lacking accommodation in the UK that sometimes interpreters are willing to step in to help if they know their work will prove to be of vital assistance.
For individuals, it's not mandatory that you know sign language, however it can really help D/deaf people feel included. There is such a shortage of sign language provision, that many D/deaf children do not actually have the equivalent vocabulary of their Hearing peers of a similar age. This gulf can widen if the D/deaf child in question does not have family who seek to learn sign language, and this is a painful experience of isolation that many D/deaf adults report having endured.
While there is a British Sign Language GCSE upcoming, it is still a way off. As such, people in the Deaf community really appreciate it when others take time to learn sign language.
There are a variety of sign languages across the world, however in the UK (alongside regional sign languages), these are typically BSL and Makaton. BSL is its own language with its own grammar. Makaton is a sign language that uses similar signs to BSL, but it employs an English language word order. Technically, Makaton would be considered a form of Sign Supported English (SSE).
Get involved in Deaf culture: This is more individual, but there are plenty of events you can attend that focus on Deaf culture. In various places across the country there are Deaf centres, where people meet for coffee and to catch up with friends, and a number of towns and cities now have signing choirs.
Whatever your situation, whether deaf or hard of hearing, you will be very readily welcomed. If you are trying to learn sign language for your own use, others who know sign are likely to do their best to help you. Please be aware however, and this goes doubly so for Hearing people, these are Deaf cultural spaces. Ideally if you have need of sign language, people will assist you in learning, but much like you wouldn't go to an event for people from another country and pester them to learn their language, please be respectful of peoples' time and energy. If you are going to an event with the intention of learning, please consider attending having learnt at least something beforehand. Often local Deaf centres will run taster sessions to give you a very basic grounding in how sign language works. Allow people to use the accessibility aids they know help them. Treat noise-cancelling headphones the same way you do hearing aids, or glasses/contact lenses. Treat someone needing subtitles as you would treat someone like Ash needing to use a screen reader.
If you would like to get in contact with The Productive Pessimist, to discuss training or business consultancy we can be contacted at theproductivepessimist@yahoo.com .
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