Harp Center 

Soridity, blindness, hearing implant and cochlear implant

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Soreness and music (hearing aid or deafness)

Music therapy is a powerful way to improve the communicative sphere and to initiate or deepen a therapeutic and rehabilitative path, both with people with hearing loss and with deaf people.

We all perceive sounds with the body: vibrations affect our tissues, bones, muscles, the nervous system ..

However, we are used to perceiving only those vibrations that are very powerful, such as the low frequency ones that "hit" the stomach. In reality our natural resonators are always active, the fact is that having shifted our attention almost exclusively to the ears, which allow us to have a more precise and detailed listening, we are almost unable to "hear" with the body.

And it is precisely in this capacity of ours that all the work of the Music Therapist with deaf patients begins.

Our first sensory experiences were tactile-auditory, the sense of hearing is the first to be formed and our most archaic and primitive experiences are in fact tactile-sound.

Think of a child still in the amniotic fluid, in this sea that protects and still isolates from the world, sounds arrive both from the inside (the mother's body with the beating of the heart, the intestinal noises, the voice of the mother, etc.) and from the 'external.

All the sounds that the child perceives are filtered by the liquid in which he is inserted and it is thanks to the vibrations that he can experience them, he has two stimuli therefore the auditory and the sensory one that occur simultaneously.

When it is born, in addition to light, sound will be the most important element that will connect it to reality. All the stimuli we receive are fixed in our deep memory and form our musical heritage, the so-called ISO .

The sounds and the maternal voice (but also that of the father, albeit with different beneficial "functions") are therefore fundamental for the child in this early evolutionary period.

In the case of children who are born deaf or with severe hearing problems, then we can ask ourselves how to intervene, how to create a therapeutic alliance in order to improve their quality of life.

As mentioned above, the starting point is body perception and the use of the body as a tool; through this the subject can hear the sound vibrations and therefore all the musical parameters: rhythm, accentuation, pitch, intensity and duration.

Music therapy becomes the way to put the person in contact with a world  expanded sound that goes beyond listening with the ears; 

Through music we will try to connect to those vital states lived in the womb, we will contact those more ancestral and archaic parts formed by the fundamental pre and post natal experiences, then we will implement tactile-sound "performances" that leveraging the emotional sphere will use the non-verbal communication that having been developed before language is more profound and effective.

Furthermore, all those that Stern (world-renowned psychiatrist and psychoanalyst) defines as "vital affects" will be implemented, or those non-verbal affective categories that we already perceive in the womb, but of which we do not have a clear definition even at a linguistic level given their nature purely non-verbal.

We are talking about emotional gestures such as: floating, fading, passing, exploding, crescendo, decrescendo, swollen, exhausted etc ..

Vital affects affect the entire span of human existence but in the first years of life they are of fundamental importance for the formation of identity. (the topic is obviously much more extensive and complex but this is not the place to talk about it).

Add to this the ability inherent in human beings, but more developed in children, to transpose information from one sensory channel to another, (from touch to sight, from hearing to touch, etc.) this is a excellent resource as it allows us to use musical parameters making them perceive through channels other than the auditory one.

Of course we are not talking exclusively about receptive music therapy but also about active one and therefore the person will be able to act on the instrument and play according to their preferences and how they perceive sounds, so everything will take place within the framework of clinical improvisation, and dialogue. sound .

We will try to give the person a “new” harmonic sense, make him experience rhythm, give him the opportunity to find new means of expression and to discover his own deep inner musicality and harmony.

Helping her to improve her gestures and to deal with the social and mental discomfort that her particular condition entails, in short, improving the quality of her life in many respects.

COCHLEAR IMPLANT

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One of the challenges that remain in the audiological sector, which nevertheless appears increasingly refined and technologically advanced, is the achievement of high quality of life standards for prosthetic or implanted patients. For example, listening to music is still a goal to be crossed.

If you think about the rehabilitation of a hearing deficit, the first benefit that comes to the mind of trying to conquer is undoubtedly communication with others, or the acquisition of the ability to hear words and participate in a conversation. The second, however, is already something that is destined to significantly improve the quality of life of the prosthetic or implanted hearing aid: that is, to learn or relearn to enjoy the sounds that enrich life, among which music undoubtedly stands out.

It is for this reason that scientific and technological research still works deeply on the details necessary to perfect the nuances of listening that allow a hearing aid or cochlear implant wearer to adequately appreciate a concert or a piece on the radio. This kind of listening, in fact, still presents evident difficulties in current daily practice.

Conferences, analysis laboratories, hospital departments and development and research departments continue to deal with the subject as one of the future commitments on which to concentrate efforts. Because musical perception with various types of hearing aids - confirmed in clinical rehabilitation circles - is still lacking, despite the evident progress made to date.

In particular, it is in patients who have undergone cochlear implant that this ability is impractical: the reason lies in the low number of electrodes, equal to twenty-two, which are inserted into the inner ear during this type of surgery; very few, if compared with the high number of pitches, equal to eighty-eight, attributed instead to a piece of music. Scientists who have studied the subject affirm that it is therefore impossible today for a single electrode to discriminate and recognize a melody based on different notes.

Another interesting aspect to evaluate, in this regard, is the concept of auditory memory: in the case of an adult who has experienced normal hearing in part of his life, the so-called auditory memory can help him to benefit from music later on. to a rehabilitation with technological aids; the most important problem concerns children, who have no auditory memory of the musical experience and therefore cannot even benefit from help in this sense. Rehabilitation training, therefore, must also take these factors into consideration.

In conclusion, however, and pending new developments in technological research, it only remains to admit that music remains, unfortunately, the great limitation of cochlear implants.