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Little ears, big challenges: navigating mild and unilateral deafness in children
Introduction
Amanda Hall
Hello and welcome back to Little ears, big challenges, where we're talking about mild and unilateral deafness in children. My name is Dr Amanda Hall.
Hannah Cooper
And I'm Dr Hannah Cooper. In this final episode, we're talking about what the future holds with Sophie, Mia, Rachel and Jonathan, who all have experience of having mild or unilateral deafness. Let's meet them.
Sophie
Hi, my name is Sophie. I'm 11. I like badminton, piano, reading and playing with friends in tennis and singing.
Mia
Hello, my name is Mia, I'm 13 and I enjoy sailing. I have two younger sisters. I also really enjoy books, cooking, baking, netball, music.
Rachel
My name is Rachel. I'm a paediatric audiologist. Outside of work, I do a lot of exercise and things. I'm tried to lose a bit of weight at the moment, so exercise is, at the moment, my life. So I do some gig rowing. So a gig boat is a 32 foot long wooden boat. It has six rowers in, one oar each rower, and you have a cox at the front who shouts at you constantly for an hour.
Jonathan
My name's Jonathan Gale. I'm a professor of auditory cell biology at University College London at the UCL Ear Institute. Interests outside I referee rugby. My kids, I coached them from rugby from when there was age seven up until just recently. And I like to get involved in lots of other things, including scuba diving.
Amanda Hall
We started by asking them to describe their deafness and talk about their experiences. Let's hear from them.
Jonathan
What I have is unilateral hearing loss or single sided deafness, which for me means that I have no hearing at all in my right ear. In practice what that means is that all the sounds in the environment that I'm exposed to sort of come in and in one ear, it feels like all at the same time. I live with this day to day and it's this inability to kind of separate out the sounds in a spatial way, which I think is quite difficult to come to terms with. But, you know, I've managed quite well so far. So I've been deaf since birth. Interestingly, I wasn't actually, it wasn't discovered till I was about five when I went to school and teachers at school realised that something was up. And then I went for a hearing test and then found that it was found that I had no hearing at all in in my right ear. And the assumption is that that was from birth, which I think for me makes sense because I really have no concept of sound or anything like that in that side. After many years, I've kind of learnt to deal with situations in the workplace, in social environments. The first thing I do is try to make sure I'm in the best place to hear people. You know, this often means asking people to move and saying, look, sorry, you know, explaining and can I sit at this end of the table because I have deafness in my right ear. As much as possible also being able to see people's faces, you use a lot of visual cues from mouth movements. And I think at the end of the day, it's been about not being afraid to tell people that I'm deaf in one ear. You know, once you're over that hurdle of doing that, I think it's an important one. It's our own built in hurdles, I don't think it's really out there in the world. One other interesting thing I think that it's worth thinking about is that it takes a lot more effort to listen and to hear when you have any deafness, you sort of find that you try to dominate conversations a little bit. I like to think that I'm a good listener and of course that's such an important skill to develop, of course, for everybody in any kind of roles. However, when it takes a lot of effort to listen, you know, and if the situation allows, you can sort of tend to dominate and talk a lot. So I have to try to watch out for that.
Hannah Cooper
And how do you get on at work?
Jonathan
I would say that the job that I do in science and academia is one that's kind of very doable in terms of that with hearing loss. Generally, people, it's not necessarily a very noisy situation for most of the time. If I'm giving lectures I have to again let the students know, you know, to make sure they put their hands up, don't just shout out, because I will not be able to locate where they are in a room. Sometimes there can be a thousand people in a big auditorium room talking all at the same time and that is a difficult situation to hear in. But I think, you know, if you talk to anybody again they find those situations difficult and it's really about the acoustics of the room and just the number of people.
Sophie
The audiologist would call it unilateral hearing loss but I call it deaf in one ear.
Hannah Cooper
And what does that mean for you that you're deaf in one ear? Can you hear a little bit in your deaf ear or nothing at all in that ear?
Sophie
I can't hear anything.
Hannah Cooper
And then in your hearing ear, is that fine on that side, would you say?
Sophie
Yeah.
Hannah Cooper
Can you tell me how that affects your everyday life.
Sophie
I have to turn when someone's on the wrong side and I have to tell them. And then when I'm in the car, I have sit on the right side and I always have to sit at the front of class. I have to strain my ear sometimes to hear.
Hannah Cooper
And what about the other children in your class or your friends, or when other people are speaking? How's that?
Sophie
I mean, like, background noise is quite hard when I'm talking to a person it's hard to, like, hear them sometimes. I just listen carefully.
Hannah Cooper
Ah, okay. So is that when you were saying about having to strain?
Sophie
Yeah.
Hannah Cooper
To hear a bit more. Yeah. Interesting. Okay. And you sort of talked about quite a lot of hobbies that you did. How do you find your hearing in terms of hobbies?
Sophie
I guess, like in the sports hall in badminton at school it's quite echoey, it's quite hard then sometimes.
Hannah Cooper
Do you ever have to ask people to repeat things or anything like that?
Sophie
And sometimes I do.
Hannah Cooper
And is that okay? Do you feel confident doing that?
Sophie
Yes.
Hannah Cooper
Great. That's brilliant.
Rachel
My hearing is actually a mild hearing loss. And what that means is that some of the sounds that I hear will be loud enough for me to hear absolutely fine. So conversational voice I can hear generally well but anything quiet, a sort of whispered voice maybe, distance type of sounds that are coming at me a bit quieter, those are the types of things that I would probably struggle to hear. With my hearing it's one of those levels that it really depends on the voice as well, so I do better with sort of high pitched squeaky sounds than I do with low bassy notes. So if someone has a lower bassier voice, I do tend to struggle a little bit if they're speaking softly. Day to day conversations like we are right now, 1 to 1, absolutely fine. If I add in a bit of background noise, that's when it starts to get a little bit more tricky, because I have that conflicting noise then, so I still need the face to face conversation, but it depends on the level of the background noise as to how much that impacts me. So say we go to somewhere, café, restaurant where there's still lots of hubbub around you, but it's not overly loud, I can still have a conversation as long as someone's within a close distance to me. If it's getting louder and louder, say I went to a concert with my friend, that level is so difficult for me to hear, and I might not get what most people say during those things, as probably people with normal hearing will probably struggle in those environments as well.
Hannah Cooper
And Rachel, can you tell us how long you've been deaf?
Rachel
So this is one of the questions that I struggle to answer because I don't actually know. So as a child, I had glue ear and a few surgeries to try and correct that. In and out of the normal range after I had a surgery and then when the grommets fell out, that's the surgery for glue ear, when they fell out, the glue returned so then my here would go up and down. So I spent a lot of my childhood when I was about 3 to 7 going in and out of the normal to moderate range, so on average, probably about a mild level but then sort of as I've come into adulthood, it's become more of a permanent mild level.
Mia
So I have EVA, enlarged vestibular aqueduct, which basically just means my hearing goes down over time, and it's because of my cochlea and stuff like that. I've got severe deafness in my left ear and mild deafness in my right ear, but because only one of them severe, I only have one hearing aid. I usually have my door shut because my family can be quite loud, but usually people have to go up and knock on my door and come in and speak to me like that. If they're like yelling from downstairs, unless for some reason they’re yelling really, really loudly I can’t hear them. Sometimes I do hear them, but I'm usually listening to music in my bedroom because I love music, and who doesn't? But for most classes I sit at the front or near the front. Usually I sit near the teacher's desk and I sit with my right ear facing them because my hearing aid, it picks up on a lot of different sounds, and it doesn't always pick up on the teacher, so I'd rather that would be facing other students or people I don't have to listen to as much because I can ignore it and I find it easier if I'm focusing on the teacher. Obviously everyone has their own needs of how they learn, and my needs are that I'm close so I can hear better, otherwise I just struggle to learn. For me to learn to my fullest, I've got to be able to hear what they're saying. When I’m around my friends we’re in quite a close area together, we’re usually like in a bit like a circle or a square or something and we’re usually all chatting. I can usually hear them fine because my friends are quite loud to say the least. But if I don't hear anything, I'm like, oh, can you just repeat that, please, and they understand because two of them have glasses actually so they also, they struggle to see and so we all struggle together I guess. I have had times when people have thought I was ignoring them when I really wasn't, I just couldn't hear them. People are honestly forgiving because it's not my fault I have a hearing aid, it's not my fault I can't always hear, and it's not their fault either, it's just we've got to make it so we can communicate. And if we ever have any problems, it's usually good parties communicating and talking to people about what's happened and how to improve. I'm really grateful because I've had some really great and supportive friends over the years. So if people do struggle with like confidence and stuff, you can always probably ask people who choose classes to be like, oh, can I have a friend in my class because friends boost your confidence quite a lot.
Hannah Cooper
Next, we ask them to describe how they navigate the world with their deafness. Let's hear from them again.
Mia
From my school actually is doing a junior musical, which my year group will be involved in, and I would like to try because, the last year they did that I was backstage team but this time I do want to maybe see if I'm part of the acting team for it.
Hannah Cooper
Can you anticipate any problems? Do you think there might be any problems with your hearing with that kind of thing, or do you think it'll be fine?
Mia
The only problems I think I'll ever find a like cues for instance, I don’t know, there's like a big bang or something and you've got to move for that. But I think for the last plays I've been in at my primary school and stuff, I've always just found it easier if there are other people on stage, I can go with the flow and I can always like see what they're doing. I do have a hearing aid so I can hear. I can usually hear, I can usually count on it, but if I don't, I've become a lot more observant using my eyes and stuff, looking around a lot more, and I guess I'm subconsciously just focusing quite a lot more.
Hannah Cooper
That leads us on to the next thing actually, lots of parents, I think, worry about things like road safety. So can you tell us about how you make sure that you're safe if you're crossing the road or riding a bike or things like that.
Mia
So I actually got my hearing aid in year three, so when I was a lot younger, I was just used to being like, oh, I can hear a car, but now I guess I've just become a lot more observant, I always look when I cross the road, not really an exception. If I'm walking with other people and they're looking, I don't look sometimes, but unless I'm focussed on something else and I forget, but usually it's just like also subconsciously you look anyway – road safety, it's natural, you always take kids to look because electric cars, no one can hear them, you can't hear them at all. And I guess like riding a bike, for instance I haven't ridden in quite a long time because it got quite muddy around here, but I guess just being careful, looking out for things, make sure no one's going to, like, maybe like check behind really quickly, but always look in front because that's where you're heading.
Rachel
So with my hobbies, as I said, I row in a gig boat as my hobby, I sometimes sit at the back of the boat which is furthest away from the cox, o sometimes if the cox says something a bit too quietly, they haven't quite got a powerful voice, I don't always pick that up. Luckily, I just ask the person sitting in front of me, what did they say, and most of the time they relay it. I don't feel like there's any sort of security issues with my hearing. I don't think it impacts me in terms of safety. I don't rely just on my hearing when I'm doing things like crossing the road and things like that. I always make sure that I look as well before I cross, whereas I know some people might not technically look before they cross the road. But I suppose with the introduction of more and more electric cars, you can't hear them coming anyway, so you're going to have to start looking.
Hannah Cooper
You feel about your deafness as a child?
Rachel
I don't know how conscious of it I was when I was a child. I think it was just my way of life, I suppose. And so there's definitely times I can think of where I remember struggling to hear certain things. And so there was times where, I don't think they'd do this, but mental maths and things where they used to have the recorded voice on the tape player saying, do this math question, and then, you know, and I had to be like, I can't hear in this echoey hall, I need to be in a smaller room where I can hear what they said, so they made those arrangements for me, obviously and I did those listening exams in a smaller room, there were probably about 3 or 4 of us that needed that help. Yeah, so I think as a child I think it was just my way of life, I didn't notice it too much, but I think I'm just more aware of it as I'm older and sort of I think I get apprehensive about the person speaking, like, am I going to be able to hear and understand everything they say. Oh, well, this environment's a little bit more noisy, I might struggle a little bit to hear what they say. I don't want to, I suppose sometimes if you mishear people, people then can think you're rude in some way. You often hear that said quite often, and I'm not being rude, I just didn't hear what you said. And I think it depends on the person I'm talking to as to whether I’ll just come out with it and say, you know, I've got a mild hearing loss, I'm not going to hear everything you say, and sometimes I will say that straight away, other times I won't. I think it’s, I don't know, it really depends on the situation as to whether I would or not.
Hannah Cooper
Lots of parents want to know about things like safety as well, so especially when riding a bike or crossing the road. Can you tell me about how you make sure you stay safe when you're doing those things?
Sophie
I often like cross that the safest part, even if it means walking a bit further. I, like, always look, I use my eyes a lot instead of my ears, and like I always turn sometimes to hear a car, if they’re coming.
Hannah Cooper
And what about, do you ever ride your bike or anything like that? Do you have a bike?
Sophie
Yeah so crossing is quite like hard sometimes. Like if I'm riding on the road and then I need to be really safe, but if I'm riding, like, on a canal in the park, it's fine.
Hannah Cooper
That's good. And what do you do on a road to make sure that you're safe?
Sophie
I always look behind me. I always just like make sure I’m listening extra carefully and stuff.
Hannah Cooper
Sounds very sensible. Excellent. And did you say about playing a musical instrument, Sophie?
Sophie
Yeah, I play piano and guitar.
Hannah Cooper
Oh, lovely, so tell me how you get on with that.
Sophie
Well, sometimes if I'm playing it too loudly I sometimes don't know, and if I’m playing too quietly I sometimes don’t know, so that's quite hard.
Hannah Cooper
Tell me about your singing experiences, Inderstand that you've done some solo performances. Can you tell me all about it?
Sophie
I did two solos in the abbey. And then, like, in my school play, I got one of the main parts, and I did two solos at the theatre with my school. It was really fun. I actually like rehearsals with my choir and stuff. It was Charlie and the Chocolate Factory and I got Mrs. Buckets, but my teacher said that I had a really good singing voice so I could have two singing parts instead of one.
Hannah Cooper
Do you think it's giving you confidence?
Sophie
Mm, yeah.
Jonathan
Kind of the worst situations I've kind of had, I would say, through my single sided deafness from is in really noisy environments where someone might be calling, particularly as a kid calling to me and, you know, just no way you're going to be able to locate in a noisy, crowded environment that sound. So I think the people who know you need to, you know, understand that's not going to happen and you need to do that. Oh, and another one, I've just thought about this one, I had a thought, people talking from other rooms at you, even though, you know, they've known me for, you know, a long time, shouting at me and talking to me from another room, it's just like, no, you can't do that, I need more, I need more visual information about you, where you are.
Hannah Cooper
Can you tell us about how you negotiate road safety, driving, cycling.
Jonathan
So, I mean, I think, as I say it, highly dominated by my visual system in terms of being super careful about that. I think I was about seven or something like that, my mum and dad bought me a new bike and they decided it should have like 15 mirrors on it or something like that, and it was like, no, this isn't happening I am not going out with 15 mirrors on! So, you know, for parents, yes, look after the kids, but don't, you know, don't be over the top, that doesn't help particularly. But yeah, making sure that I was comfortable and I was aware of my own inability to locate the sound and that I needed to compensate for that. Driving, I feel no kind of issue with that generally, sounds like that. It's pretty noisy in environments, very few people locate sounds apart from the important ones to locate, you know, ambulances and police cars and where they might be coming from and, and actually, the way that those are set up, it's a little bit easier to do that, but not easy.
Hannah Cooper
How did you feel about your deafness as a child? Were there any interactions that you had with people? Did you talk about it as a child?
Jonathan
There were times when there was probably a bit of bullying or something like that, but it was never too major that it was raised above a certain level, and primary school was quite a small single class kind of primary school, that possibly helped a little bit with that. You know, I was pretty much put at the front of the class, as it were, so that was something I guess I had to deal with. There were times perhaps when it was a little bit, you know, made you feel a little bit different, I suppose. But looking back, I have no concerns about being in that position at all, right and to some extent, as I said, I do that now myself. That's an active thing that I will do, it won't necessarily be the front, but it'll be in the right position. So one of the things perhaps we haven't touched on is the social side of it, which is, aside from this scenario of, and which has happened, where you're in a very crowded place, like a funfair situation, lots of people, and then someone's trying to, you know, you're lost as a kid and then told, you know, I was shouting at you. Well, yeah. I'm not going to hear you, I'm not going to locate it all that noise and when I can't see very well. The other thing is, in a sort of social environment, when there are a larger crowd of people talking, and this happens a lot when you're younger, generally. As you get older, people tend to lose their hearing a bit, so they actually tend to have more discreet little conversations rather than great big group conversations, I've found. But in those situations, yeah, there are many times, and actually I still have groups of friends that we go out with or, you know, have dinner with them, it can be quite lively and a lot of people talking and that's where you struggle, that's really hard to keep with those things. And so, you know, you become a people watcher a bit then, which is no mean thing either to watch people and understand what they do, kind of, you learn a little, a few things there, so I'm turning it into a positive. But I mean, there have been times, you know, as a youngster and going out to a pub or something, asocial environment, you feel quite isolated from that, but you end up having a conversation with somebody very close to you, you know, next to you on my good side in that sort of scenario and try to work that one. You know, you end up having more 1 to 1 conversation, perhaps in situations that actually allow friendships to develop in that way. Don't be held back by your deafness because there's no reason why you should be. As far as I'm concerned, I've done everything I've ever wanted to in terms of in terms of sports and musical instruments, have played many sports, team sports, racquet sports. My parents were kind of proactive in trying to avoid me getting into certain, well, so rugby, at one point I was going to be in the front row of the rugby and that my parents were like, no, no, we don't want this to happen just in case something happens. But I mean, it's not common that something would happen to your ear in that situation, but they were proactive about that, but it’s not stopped me from playing, playing rugby at school for a long period. And who knows with sound localisation what, you know, what level of kind of sports player I really could have been. You know, I always think about that.
Hannah Cooper
What do you think you're hearing influenced your career choice?
Jonathan
Undoubtedly, undoubtedly. I mean, it wasn't necessarily a direct line to where I got to, right, but my interest in how the body works has no doubt come from the fact that I have something that's not quite right with one bit of my body kind of thing, right.
Amanda Hall
We also asked them about their experiences of hearing devices. Let's hear what they had to say.
Sophie
I used to, so I had them since year three in primary, and then when I was in year six I decided not to wear them at my audiology appointment because I found them too confusing with the cross aid. It works for other people, but it only worked for me when someone was like right close up to my right ear. I didn't really find it that helpful.
Hannah Cooper
So can you explain a little bit about what the cross aid is?
Sophie
It like transmits the sound from my bad ear to my good ear.
Hannah Cooper
And what happened when you said you didn't want to wear it anymore?
Sophie
The audiologist gave me if it was working or not, like, if it was helping me. And then she said I could choose not to wear them or I could choose to wear them.
Hannah Cooper
So it was your choice.
Sophie
Yes, she was really nice about it.
Hannah Cooper
Great. And did anybody ever comment on your hearing aids or say anything about them?
Sophie
Some people said ‘what are the for’ and stuff, but I just said they’re to help me hear.
Hannah Cooper
Did anyone say anything else or was that about it?
Sophie
That was about it because when I was in year 3, I made a video about it, and then, like, I showed the class. Yeah.
Hannah Cooper
Oh, brilliant. And what was in your video?
Sophie
It was, like, how they used what they're for, and like, answering questions basically.
Mia
I got it in year three so I was really used to it when I first got it. It was very difficult and I forgot about it quite a lot. Like at the start, yes, it obviously is going to be weird, but it's been about six years from now. I'm very used to it, I sometimes forget it's in. It feels like a part of me now. Because my hearing aid isn't waterproof is splash proof, but when it rains, I sometimes do have to take out, which does make me struggle a bit more than usual. And also, I love sailing a lot, but I don't wear my hearing aid out on the water because, just you have a chance to fall in, and then I'd rather not wear it for sailing and then be able to use my hearing aid in the classroom and for my learning and stuff.
Hannah Cooper
And do you use your hearing aid to stream the music?
Mia
Sometimes, so if I'm just out and about and I don't have headphones available, then I will use my hearing aid, but obviously it drains the battery quite a lot, and I’m part of my school’s student council, so I'm a bit concerned about the environment, so I don't want to waste too many batteries.
Hannah Cooper
And can you describe it, like what colour is it, what colour is the mould, how do you choose the colours? What's your decision making process?
Mia
So I was very lucky for my hearing aid because I got quite a versatile, I think that's the word, a big range of colours and options. For the mould, I prefer something not very easy to see so I got mother of pearl, I think it was called. So it's a bit see-through and it's white and it's a bit glittery, it's quite nice. The tube is obviously see through, and then my actual hearing aid I’ve gone for blue because at my school that's my house colour, so, you know, a bit of pride in that. But I prefer it because I can hide it with my hair, and I guess, especially I was younger was very self-conscious about it because, I mean, I had just got it, nobody else I knew had it. But now I've grown up I can see a lot of people my age, younger, older, who do have hearing aids. And when you're looking for them they’re easy to spot, but when you're not looking for them, they're not easy to spot because no one particularly cares if you have one or not. So sometimes people do make jokes about deafness but they never say it to me, they never actually mean it to be mean. They're just like, oh, why didn't your hear me, are you deaf? And then they realise, oh yes, you are a bit deaf. And it's, sometimes people just don't usually mean it in a mean way. I guess, I haven't been bullied because of my hearing aid, which I am really grateful for. If someone is bullied for their hearing aid, I would be a bit surprised because it's usually they are a lot harder to see them, for instance, glasses. People don't know them as much, and the only people who have ever really talked to me about them or see me with them are like five year olds and they have got no filter. I usually just say, oh, it's a hearing aid, it helps me hear, it's like, some people have glasses, some people have a wheelchair. It's just a disability and people just learn how to live with it.
Rachel
Day to day I actually don't use hearing aids very often. There are specific times that I will use hearing aids, so when I'm congested, so when I've got a heavy cold, my hearing actually drops out of the mild range into the moderate range, I really, really struggle at that time, so that's when I tend to use hearing aids. So winter months I tend to wear my hearing aids quite frequently, and then in the summer months, I don't feel like I need them as much. If I was to try and wear the hearing aids, which I have tried hearing aids for my mild hearing loss, I find it gives me a bit too much sound. I'm very aware of a lot of environmental sounds when I've got my hearing aids in at my mild level. I don't notice it as much when I'm ill. I think it's, I don't know whether it's more of a significant hearing loss that then the benefits kind of outweigh the negatives of the hearing aids at that point, I think, it gives me back that level of sound that I require. Whereas with my mild hearing loss, because the majority of the time I'm hearing things, actually, when I put the hearing aids in, it just gives me everything and sometimes it's a bit overwhelming.
Hannah Cooper
And have you ever worn any hearing devices, hearing aids, anything like that?
Jonathan
No, I haven't actually to date. But, you know, I've been thinking about this, it's probably about time I tried a kind of crossover device or something, in order to see how they work, actually. But the reality for me is that I've managed to deal with my hearing loss reasonably well. I'm lucky that the hearing in my good ear is good and has been good, but as you get older, you begin to worry about that more, and particularly if you have a single sided deafness. So I'd like to try some out actually.
Hannah Cooper
Finally, we asked what advice they would give to parents of a child with mild or unilateral deafness.
What would you say to a parent of a new baby that has just been diagnosed with deafness in one ear? What do you think they should know?
Sophie
Well, research as much as possible, speak to other parents about it and research into that. Look for support on National Children's Deaf Society. Talk to healthcare professionals. You can still be great even if you have a hearing disability.
Mia
Well, I say, don't worry about it too much because if you worry about it and your child grows up stressed in that environment it will cause them to affect and maybe even really dislike their hearing loss, and it might make them think how difficult their life is and how they wish they didn't have it. I do sometimes wish that sometimes. My parents are very supportive, but I'd say a hearing aid’s definitely very useful for school and stuff so you can actually hear in classes. And obviously it's your child's norm, your child will never really experience another way unless the future of science beholds a cure for hearing, which hopefully it will. But it's a child's norm, the child would be well accustomed and used to it, and they shouldn't struggle too much in life as long as you support them. The most important thing I find is support and making sure they have the confidence to speak out if something bad happened, they're being bullied or if they just can't hear properly.
Rachel
Technology is such a big part of our world now so, you know, utilise it. And generally I feel absolutely fine with my hearing, it doesn't impact me very much at all. The majority of my day I don't think about my hearing.
Jonathan
The first thing I would say, and I've sort of alluded to this, is that I understand that you would be really want to be very protective of them, but you know, yes, be protective, but don't be overprotective. There is nothing to stop them achieving anything they want to in this world. Don't hold them back from that by being overly protective. Give them support, but just don't hold them back from anything.
Amanda Hall
Oh, that's such great advice from everyone. Many thanks to Sophie, Mia, Rachel and Jonathan for sharing their experiences with us.
Hannah Cooper
That's it for this series. Thanks so much for listening and thanks again to all our amazing contributors. You've been listening Little ears, big challenges: navigating mild and unilateral deafness on UCL Minds.
