University of Cambridge - hearing

Deaf opera singer welcomes new Cambridge-led cochlear implant trial

cjb250 — Wed, 06 May 2026 07:34:21 +0000

The UK trial will provide bilateral cochlear implants (cochlear implants on both sides) to some profoundly deaf adults. The results will be used to review NHS guidance for the provision of implants to adults.

Each year over 1,000 adults in the UK receive cochlear implants to restore their hearing. Under NHS guidance, adults currently only receive a single (unilateral) implant, yet evidence suggests having two could offer significant improvements in prospects and quality of life and may now be cost effective.

Janine said: “With bilateral implants, I no longer consider myself to be deaf. They have been utterly life changing and, for me, have broken a generational curse. I am excited that this trial will offer the same opportunity to others.”

Funded by the National Institute for Health and Care Research (NIHR), the trial is being co-led from Addenbrooke’s Hospital and the University of Cambridge. It will run in 14 hospitals and include over 250 adult participants, who will either receive one (unilateral) or two (bilateral) implants. Participants will be monitored for 12 months after surgery to assess the effects of the implants on wellbeing, ability to hear speech in noise, and quality of life. The study will also evaluate the economic benefits and cost of bilateral implants for the NHS.

Called LUCIA, the trial will be co-led by Dr Matthew Smith, an ear, nose and throat (ENT) surgeon at Addenbrooke’s Hospital, and Professor Debi Vickers, a speech and hearing scientist in the Department of Clinical Neurosciences, University of Cambridge, who leads the SOUND Lab.

Professor Debi Vickers, who also co-leads the Devices and Advanced Therapies theme at the NIHR Cambridge Biomedical Research Centre, said: “Children routinely receive bilateral cochlear implants. These can provide 3-dimensional hearing, enabling them to hear more naturally than unilateral, with improved access to sound and better engagement with society.

“Adults tell us, and I agree, that they should be given the same hearing opportunities as children. In turn these will result in reduced social isolation, enriched communication, improved mental health, and better overall quality of life.”

The trial, which is expected to begin recruiting patients in the autumn, has been designed in collaboration with Janine and other patients. By involving individuals with lived experience of cochlear implantation, the researchers aim to measure changes that patients consider to be most important.

The primary trial outcome will reflect participants’ own perceptions of their quality of hearing. The study will also measure common challenges faced by patients, such as listening effort and fatigue, a choice directly based on discussions with patient groups.

Dr Smith, who is also an academic surgeon at the University of Cambridge, said: “We know from giving bilateral implants to children that it can have a transformative effect on their quality of life and interactions with other people. Through this study, we can offer the same opportunity to adults who have become deaf, and understand the potential added value of bilateral cochlear implants, not just in terms of hearing, but also how they enrich quality of life.”

Janine was diagnosed as a teenager with a genetic condition that caused hearing loss and eventually led to her needing hearing aids. For over 30 years she hid her deteriorating hearing and became a well-known mezzo-soprano, performing in operas, operettas and musicals, including at the Royal Opera House in London.

It was only in 2019, after she had retired due to profound hearing loss, that she had cochlear implant surgery, and received bilateral implants partly through personal funding. She said: “Having two implants is lightyears away from just one. Sound quality is so much better, sounds are fuller, clearer, louder and more natural. It’s much easier to tell where sounds are coming from, especially in busy spaces.

“If you’re out in public, it can be hard to follow who is speaking, making joining in with conversations almost impossible. As a result, you have debilitating concentration fatigue at the end of every day.”

Just like at the cinema, multi-directional surround sound is a key part of creating an engaging immersive experience. By comparison, living with one implant can be like listening to life through a single, poor-quality speaker.

She explains: “Struggling to hear can be extremely isolating and many people experience anxiety or depression as a result. The implants are life changing. They reconnect you to the world and most importantly people. Communication is surely the longing of every human heart.

“I also feel safer and more secure having the two implants. I am more aware of and connected to what’s happening in the world around me. And, if anything goes wrong with one of the implants, I’m not suddenly plunged into a world of total silence.”

While hearing aids help people with mild to moderate hearing loss by making sounds louder, they often provide very little benefit for people with severe or profound hearing loss. Cochlear implants bypass the outer, middle and inner ear and send electrical impulses directly to the hearing nerve which carries signals to the brain.

Participants in the trial will need to have become deaf later in life and cannot already have an implant.

People with cochlear implants will also be involved in delivering the trial. They will be specially trained to participate in interviewing trial participants that will be used to measure the impacts of the trial.

Professor Anthony Gordon, Programme Director for the NIHR Health Technology Assessment Programme, which funded the trial, said: "We fund innovative trials like the LUCIA study which explore how advances in technology can help make a positive difference to the day-to-day lives of those affected. This study offers real hope to people with severe hearing loss and the chance of a significant improvement in their quality of life."

Adapted from a press release from Cambridge University Hospitals NHS Foundation Trust

Janine Roebuck, a formerly deaf opera singer who regained her hearing thanks to cochlear implants, has described as ‘life changing’ an upcoming Cambridge-led trial in hearing loss.

We know from giving bilateral implants to children that it can have a transformative effect on their quality of life and interactions with other people. Through this study, we can offer the same opportunity to adults

Matthew Smith

Janine Roebuck

Janine Roebuck as Flora in La Traviata by Verdi at New Sadler's Wells Opera

The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

Significant gaps in NHS care for patients who are deaf or have hearing loss, study finds

sc604 — Wed, 07 May 2025 17:52:05 +0000

A team of patients, clinicians, researchers and charity representatives, led by the University of Cambridge and the British Society of Audiology, surveyed over 550 people who are deaf or have hearing loss about their experiences with the NHS – making it the largest study of its kind. Their findings, reported in the journal PLOS One, highlight systemic failures and suggest changes and recommendations for improving deaf-aware communication in the NHS.

View a version of this story in British Sign Language (BSL).

“The real power of this study lies in the stories people shared,” said lead author Dr Bhavisha Parmar from Cambridge’s Department of Clinical Neurosciences (Sound Lab) and UCL Ear Institute. “Patients weren’t just rating their experiences – they were telling us how these barriers affect every part of their healthcare journey, and in many cases, why they avoid healthcare altogether.”

The study found that despite being a legal requirement under the Accessible Information Standards, NHS patients have inadequate and inconsistent access to British Sign Language (BSL) interpreters and other accessibility accommodations such as hearing loop systems.

Nearly two-thirds (64.4%) of respondents reported missing at least half of the important information during appointments, and only a third (32%) expressed satisfaction with NHS staff communication skills. Respondents said they had to rely on family members or advocates to communicate with healthcare workers, raising privacy and consent concerns.

The research found that communication barriers extend across the entire patient journey – from booking appointments to receiving results. Simple actions, like calling a patient’s name in a waiting room or giving instructions during a scan, become anxiety-inducing when basic accommodations are lacking. Respondents noted that hearing aids often must be removed for X-rays or MRI scans, leaving them struggling or unable to follow verbal instructions.

“We heard over and over that patients fear missing their name being called, or avoid making appointments altogether,” said Parmar. “These aren’t isolated experiences – this is a systemic issue.”

The idea for the study was sparked by real-life experiences shared online by NHS patients, particularly audiology patients– a field Parmar believes should lead by example. “We’re audiologists: we see more patients with hearing loss than anyone else in the NHS,” she said. “If we’re not deaf-aware, then how can we expect other parts of the NHS to be?”

The research team included NHS patients with deafness or hearing loss, who contributed to study design, data analysis, and report writing. As part of the study, they received training in research methods, ensuring the work was grounded in and reflective of lived experiences.

Co-author Zara Musker, current England Deaf Women’s futsal captain and winner of deaf sports personality of the year 2023 said her disappointing experiences with the NHS in part motivated her to qualify as an audiologist.

“The research is extremely important as I have faced my own experiences of inadequate access, and lack of deaf awareness in NHS healthcare not just in the appointment room but the whole process of booking appointments, being in the waiting room, interacting with clinicians and receiving important healthcare information,” said Musker. “I really hope that the results will really highlight that NHS services are still not meeting the needs of patients. Despite this, the study also highlights ways that the NHS can improve, and recommendations are suggested by those who face these barriers within healthcare.”

The researchers have also released a set of recommendations that could improve accessibility in the NHS, such as:

Mandatory deaf awareness and communication training for NHS staff
Consistent provision of interpreters and alert systems across all NHS sites
Infrastructure improvements, such as text-based appointment systems and visual waiting room alerts
The creation of walk-through assessments at hospitals to ensure accessibility across the full patient journey

“This is a legal obligation, not a luxury,” said Parmar. “No one should have to write down their symptoms in a GP appointment or worry they’ll miss their name being called in a waiting room. These are simple, solvable issues.”

A practice guidance resource – developed in consultation with patients and driven by this research – is open for feedback until 15 June and will be made publicly available as a free tool to help clinicians and NHS services improve deaf awareness. People can submit feedback at the British Society of Audiology website.

“Ultimately, better communication for deaf patients benefits everyone,” Parmar said. “We’re not just pointing out problems – we’re providing practical solutions.”

Reference:
Bhavisha Parmar et al. ‘“I always feel like I’m the first deaf person they have ever met.” Deaf Awareness, Accessibility and Communication in the United Kingdom's National Health Service (NHS): How can we do better?’ PLOS One (2025). DOI: 10.1371/journal.pone.0322850

A majority of individuals who are deaf or have hearing loss face significant communication barriers when accessing care through the National Health Service (NHS), with nearly two-thirds of patients missing half or more of vital information shared during appointments.

Better communication for deaf patients benefits everyone. We’re not just pointing out problems – we’re providing practical solutions.

Bhavisha Parmar

sturti via Getty Images

A male doctor sits next to a male patient in a waiting room while holding a digital tablet.

Yes

Make Indian Sign Language official language and open more schools for deaf and hard-of-hearing students, study advises

ta385 — Mon, 17 Mar 2025 09:00:00 +0000

“Many thousands of children who are deaf or hard-of-hearing are missing out on school in India,” said Dr Abhimanyu Sharma, from Cambridge’s Faculty of Modern & Medieval Languages & Linguistics, the study’s author. “This has a huge impact on their wellbeing and life chances.”

“One of the main reasons for this very high dropout rate is that their schools do not offer education in sign language.”

Dr Sharma’s study, published today in Language Policy, explains that sign language continues to be ‘shunned’ in most Indian schools because it is still stigmatised as a visible marker of deafness. But, he argues, the alternative preferred by many schools, ‘oralism’ harms the school attainment of deaf students.

“Outside of India, ‘oralism’ is widely criticised but the majority of schools in India continue to use it,” Dr Sharma says. “Gesturing is not sign language, sign language is a language in its own right and these children need it.”

“When I was in primary school in Patna, one of my fellow students was deaf. Sign language was not taught in our school and it was very difficult for him. I would like to support the charities, teachers and policymakers in India who are working hard to improve education for such students today.”

Dr Sharma acknowledges that the Indian Government has taken important steps to make education more inclusive and welcomes measures such as the establishment of the Indian Sign Language Research and Training Centre in 2015. But, he argues, far more work is needed to ensure that DHH students receive the education which they need and to which they are legally entitled.

Sharma calls for constitutional recognition for Indian Sign Language (ISL) as well as recognition of ISL users as a linguistic minority. Being added to India’s de facto list of official languages would direct more Government financial support to Indian Sign Language.

“Central and state governments need to open more schools and higher education institutes for deaf and hard-of-hearing students,” Sharma also argues.

“In the whole of India, there are only 387 schools for deaf and hard-of-hearing children. The Government urgently needs to open many more specialist schools to support the actual number of deaf and hard-of-hearing children, which has been underestimated.”

He points out that deaf and hard-of-hearing people were undercounted in India’s last census because of the use of problematic terminology. The 2011 census reported around 5 million deaf and hard-of-hearing people in the country but in 2016, the National Association of the Deaf estimated that the true figure was closer to 18 million people.

Sharma also highlights the need for more higher education institutions for these students as there are very few special colleges for them, such as the St. Louis Institute for Deaf and Blind (Chennai, Tamil Nadu). He also calls for an increase in the number of interpreter training programs available across Indian universities.

Dr Sharma advises central and state governments to conduct regular impact assessments of new policy measures to ensure that they are improving inclusion for deaf and hard-of-hearing people.

He also calls on the government to invest in research to support more targeted approaches to teaching and learning for DHH students, and to support public awareness campaigns to tackle biases and negative social attitudes towards deafness.

Dr Sharma’s study examines developments in Indian legislation and policy relating to DHH people since the 1950s. He highlights the fact that parliamentary debates in the Upper House about DHH people declined from 17 in the 1950s, to just 7 in the 1990s, before rising to 96 in the 2010s.

India’s language policy requires pupils to learn three languages at the secondary stage of schooling. Given the problematic nature of the three-language formula for deaf students, the 1995 Persons with Disabilities Act rescinds this requirement for these learners and decrees that they should learn only one language.

The drawback of the 1995 Act, however, is that it does not mention the use of sign language and does not specify how language learning for such learners will be realised. Dr Sharma recognises that the Rights of Persons with Disabilities Act 2016 brought significant improvements but highlights the gap between decrees and implementation. The 2016 Act decrees that the Government and local authorities shall take measures to train and employ teachers who are qualified in sign language and to promote the use of sign language.

“In practice, India does not have enough teachers trained to support deaf and hard-of-hearing students, but I am positive that the country can achieve this,” Dr Sharma said.

References

A Sharma, ‘India’s language policy for deaf and hard-of-hearing people’, Language Policy (2025). DOI: 10.1007/s10993-025-09729-7

For the % of India’s deaf and hard-of-hearing children out-of-school in 2014, see National Sample Survey of Estimation of Out-of-School Children in the Age 6–13, Social and Rural Research Institute 2014

Around one in five (over 19%) of India’s deaf and hard-of-hearing children were out-of-school in 2014, according to a survey conducted for the Indian Government. A new study calls on the Government to address this ongoing educational crisis by recognising Indian Sign Language as an official language; rejecting ‘oralism’, the belief that deaf people can and should communicate exclusively by lipreading and speech; and opening more schools and higher education institutes for deaf and hard-of-hearing (DHH) students.

India does not have enough teachers trained to support deaf and hard-of-hearing students

Abhimanyu Sharma

Yogendra Singh via Unsplash

Female students in an Indian classroom. Photo: Yogendra Singh via Unsplash

Yes

Licence type:

Attribution

Mild-to-moderate hearing loss in children leads to changes in how brain processes sound

cjb250 — Tue, 01 Oct 2019 14:04:43 +0000

Researchers say that the findings may have implications for how babies are screened for hearing loss and how mild-to-moderate hearing loss in children is managed by healthcare providers.

The structure and function of the auditory system, which processes sounds in the brain, develops throughout childhood in response to exposure to sounds. In profoundly deaf children, the auditory system undergoes a functional reorganisation, repurposing itself to respond more to visual stimuli, for example. However, until now relatively little was known about the effects of mild-to-moderate hearing loss during childhood.

A research team led by Dr Lorna Halliday, now at the MRC Cognition and Brain Sciences Unit, University of Cambridge, used an electroencephalogram (EEG) technique to measure the brain responses of 46 children who had been diagnosed with permanent mild-to-moderate hearing loss while they were listening to sounds.

Dividing the children into two groups – younger children (8-12 years) and older children (12-16 years) – the team found that the younger children with hearing loss showed relatively typical brain responses – in other words, similar to those of children with normal hearing. However, the brain responses of older children with hearing loss were smaller than those of their normally hearing peers.

To confirm these findings, the researchers re-tested a subset of the group of younger children from the original study, six years later. In the follow-up study, the researchers confirmed that as the children with hearing loss grew older, their brain responses changed. Responses that were present when the children were younger had either disappeared or grown smaller by the time the children were older. There was no evidence that the children’s hearing loss had worsened over this time, suggesting instead that a functional reorganisation was occurring.

“We know that children’s brains develop in response to exposure to sounds, so it should not be too surprising that even mild-to-moderate levels of hearing loss can lead to changes in the brain,” says Dr Axelle Calcus, lead author of the paper, from PSL University, Paris. “However, this does suggest that we need to identify these problems at an earlier stage than is currently the case.”

“Current screening programmes for newborn babies are good at picking up moderate-to-profound levels of hearing loss, but not at detecting mild hearing loss. This means that children with mild hearing impairment might not be detected until later in childhood, if at all,” says Dr Lorna Halliday from the University of Cambridge.

“Children with hearing problems tend to do less well than their peers in terms of language development and academic performance. Detecting even mild degrees of hearing impairment earlier could lead to earlier intervention that would limit these brain changes, and improve children’s chances of developing normal language.”

The research was funded by the Economic and Social Research Council and the European Union Horizon 2020 Programme. The research was carried out at University College London (UCL).

Reference

Calcus, A et al. Functional Brain Alterations Following Mild-to-Moderate Sensorineural Hearing Loss in Children. eLife; 1 October 2019; DOI: 10.7554/eLife.46965

Deafness in early childhood is known to lead to lasting changes in how sounds are processed in the brain, but new research published today in eLife shows that even mild-to-moderate levels of hearing loss in young children can lead to similar changes.

Detecting even mild degrees of hearing impairment earlier could lead to earlier intervention that would limit these brain changes, and improve children’s chances of developing normal language

Lorna Halliday

WikiCommons

Kind, Hinter-Ohr-Gerät-Anpassung

Researcher Profile: Dr Lorna Halliday

Dr Lorna Halliday was recently awarded one of three MRC Senior Fellowships in Hearing Research, enabling her to undertake a programme of research into childhood hearing loss at the MRC Cognition and Brain Sciences Unit (CBU).

She has been interested in hearing loss ever since studying Experimental Psychology at the University of Bristol. She is particularly interested in how hearing difficulties impact upon the development of language and literacy in children, studying what aspects of hearing are important for language acquisition, and also those factors that contribute to the poor language outcomes that some children with hearing loss experience.

“I work with children with normal hearing, as well as those with a range of different hearing and language difficulties,” she explains. “Ultimately, the goal is to find out how we might improve outcomes for children with hearing difficulties, so that they no longer experience barriers to achieving their full potential.”

Lorna will shortly begin a longitudinal cohort study looking at outcomes of children with hearing loss who were identified as part of the NHS Newborn Hearing Screening Programme. This will involve visiting over 100 children with early-identified hearing loss in their schools and homes, in and around Cambridgeshire and the South-East of England.

“I hope that my research will lead to changes to the way in which we detect, diagnose, and treat hearing loss in children in the future,” she says. “This could be through changes to the NHS Newborn Hearing Screening Programme or the school-entry hearing screen, improvements in hearing aid and cochlear implant technology, and the introduction of targeted interventions for those at risk of future difficulties, ideally before those difficulties occur.”

Cambridge is the ideal place to carry out such research, she explains, as it is rapidly becoming a centre for research into hearing with links across the university, Cambridge University Hospitals, and beyond. “It is a particularly exciting time to be part of the research community here, with lots of opportunities for collaborations and new ideas.”

Lorna has two children of her own, and describes herself as “one of a rare but growing breed of part-time scientists, full-time parents”. She is passionate about promoting equality within the sciences, and addressing issues relating to the “leaky pipeline” within STEM subjects, which sees the number of women in STEM fall dramatically at more senior levels.

The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

Licence type:

Attribution-ShareAlike

Noises off: the machine that rubs out noise

lw355 — Wed, 02 Oct 2013 16:20:50 +0000

A noisy restaurant, a busy road, a windy day – all situations that can be intensely frustrating for the hearing impaired when trying to pick out speech in a noisy environment. Some 10 million people in the UK suffer from hearing difficulties and, as helpful as hearing aids are, those who wear them often complain that background noise continues to be a problem.

What if hearing device wearers could choose to filter out all the troublesome sounds and focus on the voices they want to hear? Engineer Dr Richard Turner believes that this is fast becoming a possibility. He is developing a system that identifies the corrupting noise and “rubs it out”.

“The poor performance of current hearing devices in noise is a major reason why six million people in the UK who would benefit from a hearing aid do not use them,” he said. Moreover, as the population ages, a greater number of people will be hindered by the inability to hear clearly. In addition, patients fitted with cochlear implants – devices implanted into the brain to help those whose auditory hair cells have died – suffer from similar limitations.

The solution lies in the statistics of sound, as Turner explained: “Many interfering noises are immediately recognisable. Raindrops patter on a surface, a fire crackles, talkers babble at a party and the wind howls. But what makes these so-called auditory textures sound the way they do? No two rain sounds are identical because the precise arrangement of falling water droplets is never repeated. Nonetheless, there must be a statistical similarity in the sounds compared with say the crackle of a fire.

“For this reason, we think the brain groups together different aspects of sounds using prior experience of their characteristic statistical structure. We can model this mathematically using a form of statistical reasoning called Bayesian inference and then develop computer algorithms that mimic what the brain is doing.”

The mathematical system that he and colleagues have developed is capable of being “trained” – a process that uses new methods from the field of machine learning – so that it can recognise sounds. “Rather surprisingly, it seems that a relatively small set of statistics is sufficient to describe a large number of sounds.”

Crucially, the system is capable of telling the difference between speech and audio textures. “What we can now do in an adaptive way is to remove background noise and pass these cleaned up sounds to a listener to improve their perception in a difficult environment,” said Turner, who is working with hearing experts Professor Brian Moore at the Department of Experimental Psychology and Dr Robert Carlyon at the Medical Research Council Cognition and Brain Sciences Unit, with funding from the Engineering and Physical Sciences Research Council.

The idea is that future devices will have several different modes in which they can operate. These might include a mode for travelling in a car or on a train, a mode for environments like a party or a noisy restaurant, a mode for outdoor environments that are windy, and so on. The device might intelligently select an appropriate mode based on the characteristics of the incoming sound. Alternatively, the user could override this and select a processing mode based upon what sorts of noise they wish to erase.

“In a sense we are developing the technology to underpin intelligent hearing devices,” he added. “One possibility would be for users to control their device using an interface on a mobile phone through wireless communication. This would allow users to guide the processing as they wish.”

Turner anticipates a further two years of simulating the effect of modifications that clean up sound before they start to work with device specialists. “If these preliminary tests go well, then we’ll be looking to work with hearing device companies to try to adapt their processing to incorporate these machine learning techniques. If all goes well, we would hope that this technology will be available in consumer devices within 10 years.”

Tinnitus sufferers could also benefit from the technology. Plagued by a constant ringing in the ears, people with tinnitus sometimes use environmental sound generators as a distraction. Such generators offer a limited selection of sounds – a babbling brook, waves lapping, leaves rustling – but, with the new technology, “patients could traverse the entire space of audio textures and figure out where in this enormous spectrum is the best sound for relieving their tinnitus,” added Turner.

The technology not only holds promise for helping the hearing impaired, but it also has the potential to improve mobile phone communication – anyone who has ever tried to hold a conversation with someone phoning from a crowded room will recognise the possible benefits of such a facility.

Moreover, with 100 hours of video now being uploaded to YouTube every minute, Google has recognised the potential for systems that can recognise audio content and is funding part of Turner’s research. “As an example, a YouTube video containing a conversation that takes place by a busyroadside on a windy day could be automatically categorised based on the speech, traffic and wind noises present in the soundtrack, allowing users to search videos for these categories. In addition, the soundtrack could also be made more intelligible by isolating the speech from the noises – one can imagine users being offered the chance to de-noise their video during the upload process.

“We think this new framework will form a foundation of the emerging field of ‘machine hearing’. In the future, machine hearing will be standard in a vast range of applications from hearing devices, which is a market worth £18 billion per annum, to audio searching, and from music processing tasks to augmented reality systems. We believe this research project will kick-start this proliferation.”

For more information, please contact Louise Walsh (lw355@admin.cam.ac.uk).

Inset image: Dr Richard Turner

Future hearing aids could be adjusted by the wearer to remove background noise using new technology that could also be used to clean up and search YouTube videos.

We are developing the technology to underpin intelligent hearing devices

Richard Turner

The Machine that Rubs Out Noise

Video of The Machine that Rubs Out Noise

The District

This work is licensed under a Creative Commons Licence. If you use this content on your site please link back to this page.

Yes