What hearing and cochlear implants have to do with social intelligence.

In everyday social life, we need not only to hear and understand auditorily, but also to interpret, as well as to understand both content and emotions. CI therapy should include all this, demands special educator Katrien Timmerman, MSc. at the EURO-CIU symposium.

Today, we use the term artificial intelligence in connection with computers and often make the opposite conclusion: We compare the functioning of the human brain with the digital logic of conventional systems for electrical data processing. This does not do justice to the human ability to interpret, as Katrien Timmerman, MSc. pointed out in her presentation at the EURO-CIU symposium in Rotterdam in November 2022. She also explained the essential role of hearing in the thinking process and what happens when it is missing.

Timmerman is a special educator focusing on sensory impairments and a Flemish sign language interpreter. A Belgian national, she is an early intervention coordinator and special educator at the Brussels Region School and Boarding School for the Hard of Hearing, as well as at the KIDS Competence Center in Flanders, an institution for children and adults with hearing, speech and language disorders or autistic problems. Her work focuses on hearing-impaired children with additional impairments, Theory of Mind development, inclusion, and social awareness of diversity.

Computers think fast and correctly, but they don't understand anything

Conventional computers do exactly what they are told to do by means of program code. They follow the logical sequence: input - predefined processing - output. This strict logic is often advantageous: computers can complete instructions very quickly, especially if they are remotely similar to arithmetic tasks.
Within the framework of this strict logic, computers can even extrapolate - that is, predict a defined value. A computer, however, cannot understand or conjecture; nor can it make predictions in any real sense. These abilities distinguish humans and their way of thinking.

Human thinking is interpretation and prediction

"Our brain is not a computer!" emphasized Timmermann at the EURO-CIU congress, referring to the work of the Belgian Peter Vermeulen[1] on the human brain as a predictive organ. To explain, she showed the illustrated puzzle. If we would think according to the working model of conventional computers in the sequence "input - processing - output", we will treat the digits as a sequence of numbers. A matter of interpretation remains, perhaps, the sequence: 1-3-5-2-4-? or 1-2-3-4-5?

"To survive in modern society, however, we need a brain that predicts the world quickly and unconsciously, taking proper account of context," the summary of Vermeulen's book says. "The brain makes unconscious and super-fast predictions about the world. The brain asks for feedback from the senses about the predictions it has made."

This feedback from the senses also gives us additional information. With such additional information, our mind can reinterpret the digit image: When we see the "1-3-5/2-4-?" in a car, we almost automatically add "R" as in the digit picture on the stick of a gear shift.

Thus, for such interpretations we need additional information about the context of a statement or a question.

Sensory perceptions for correct interpretation

For our ancestors, foreseeing an action or situation was essential for survival: the more accurately a person could predict and thus act with foresight and anticipation, the better their chances of survival were. Today, these skills have a predominant influence on our business survival as well as on social and societal life.

We are constantly improving the quality of our predictions, learning and practicing our social interpretation: we compare the development we suspect with the actual event that follows. The perceptions of our senses - including those of hearing - are particularly important in this process: first, to gather in advance all the necessary information for a correct prediction; afterwards, to check how correct our interpretation was.

Interpretation with impaired acoustic perception

When information is incorrect or partially missing, both interpretation and prediction become strenuous and error-prone, as does verification of the same. This costs the person additional energy and time. The increasing frequency of errors is frustrating.

For successful communication, our mind also needs contextual information in addition to the wording of a communication that is understood as completely as possible: Facial expressions and gestures, but also prosody, word sound and speech melody. Particularly impressive is the tonal coloration we give to cynical word messages.

"We don't read emotions from the other person's face, but we connect their facial expressions with further contextual information," said Timmerman, explaining why misunderstandings and misinterpretations occur so easily when, for example, we cannot perceive the tone coloration in a conversation. Such misunderstandings cloud social and societal interaction for those affected, and for children they make social learning more difficult.

"We don't read emotions from the other person's face, but we connect their facial expressions with other contextual information, such as the tone color of a conversation."
Katrien Timmerman

How we develop social skills

In the first year of life, for instance, children respond to the smile of a caregiver. By the time they enter kindergarten, they can already sense the current mood of others and behave accordingly. By preschool age, they learn to distinguish their own opinions and thoughts from others'. They can classify the description of a situation as right or wrong.

The so-called Theory of Mind means exactly that:

  • Being able to take others' perspectives
  • being able to understand the thoughts, wishes, feelings of others
  • being able to take into account others' level of knowledge
  • being able to distinguish between reality and appearance

In order to develop these abilities, we need self-knowledge and self-perception as well as various contextual information.

In hearing-impaired children, the development of these social skills is usually delayed, even with age-appropriate language development: on the one hand, semantic information of language, nuances and sound variations are often difficult for hearing-impaired children to grasp; on the other hand, in situations observed "in the corner of their eye", they often cannot understand the related communication. Thus, they cannot use such accidentally witnessed situations for social learning.

An exception in this respect are children of deaf parents, for whom sign language is the general family language and thus all information is given non-auditively.

Consequences for the support of hearing impaired children

Hearing-language therapies must, of course, focus on vocabulary, grammar and the consolidation of knowledge transfer. For children in regular schools, this is still important at the higher school levels so that they can surely follow the lessons well.

In order to also support the development of social skills, we also need to work with the affected children concerning:

  • the practice self-awareness and expression of own feelings, wishes and needs.
  • the practice of feeling and thought conceptualization.
  • the encouragement of children to recognize the intentions of others and to empathically empathize with the feelings and thoughts of others.

However, it is not enough neither for the linguistic-communicative nor for the empathic skills to be learned exclusively in therapy situations. In order for these skills to be practiced and integrated into everyday life, parents must also learn to exemplify all of this themselves and encourage it in their children.

Last but not least, the overall development of the ability to act should also be strengthened in children with cochlear implants: "Delayed development of some organizational skills is often observed in hearing-impaired children," Timmerman explains. In this regard, he says, organization and flexibility are particularly important for hearing-impaired people: "In listening and preparing for listening situations - hiring interpreters, taking into account one's own fatigue, and so on."

Practicing inclusion requires conscious information

Even though speech understanding is generally improving with cochlear implants: Cochlear implant users, like all hearing-impaired people, need increased concentration and effort to correctly assess everyday situations in each case. Some of the contextual information will remain erroneous or be lost altogether despite all concentration. This leads to early fatigue and problems in communication and social interaction, and subsequently to increased risk of psychological problems.

Inclusion in this context also means that in the everyday life of hearing-impaired people, the respective hearing companions consciously and explicitly offer all possible additional information. "Sometimes it's about the situation itself. For example, there is a lot of background noise and hearing is therefore exhausting for everyone. Or you can hear in the intonation of a voice that the person speaking is annoyed," Timmerman explains.

If it is not possible in the situation, Timmerman asks to explain afterwards: "For example: 'I spoke to the doctor extra politely because that's the common way to do it.' I can't talk to him the way I talk to my friend. Or: This person reacted that way because someone else whispered something to a third person at that moment." This gives hearing-impaired people important information that they could not perceive themselves and helps them assess the situation. It helps children develop their social behavior.

Informational brochure about the relationship of language to social development and how to promote social development. Available at ZENTRUM HÖREN or as a free download at https://www.medel.com/support/rehab/rehabilitation-downloads.

[1] Peter Vermeulen, Autism and The Predictive Brain - Absolute Thinking in a Relative World, Routledge, 26. Oct 2022, London, doi:10.4324/9781003340447, ISBN: 9781003340447