Ivy Yang’s research is helping shape the future of cochlear implant care

For Master of Audiology student Ivy Yang, the opportunity to combine science, technology and clinical care has led her to The Hearing House, where she is undertaking research that could help audiologists better understand how children and adults with cochlear implants access speech sounds.

Ivy is in the second year of her Master of Audiology programme at the University of Auckland and is working with The Hearing House paediatric team to establish local normative data for the organisation’s new Eclipse auditory cortical evoked response equipment.

Her research focuses on cortical auditory evoked potentials (CAEPs) – measurements of the brain’s natural electrical response to sound. She is being supervised in her research by The Hearing House’s Clinical Director Holly Teagle and Professor Suzanne Purdy.

“In simple terms, my research looks at how the brain responds to speech sounds in children and adults who use cochlear implants,” Ivy explains. “By recording the brain’s natural responses to sound, we hope to gain a more objective picture of whether speech sounds are reaching the central auditory system effectively through cochlear implants.”

The research addresses an important challenge in audiology -- determining how well a hearing aid or cochlear implant is providing access to sound, particularly when conventional behavioural testing is difficult.

“This is particularly challenging for infants and young children, or for anyone who may not be able to reliably tell us what they can hear,” Ivy says.

CAEP testing offers a potential additional source of information by measuring the brain’s response directly. A key part of Ivy’s project is establishing reference data from people with typical hearing, providing a local comparison that can help clinicians understand what responses might be expected at different ages.

Ultimately, she hopes her research will help make CAEP testing a more useful and practical tool in clinical audiology.

“In the future, it could provide clinicians with an additional objective measure of auditory access and cortical auditory function, particularly for infants or young children when behavioural information is limited or difficult to obtain.”

Learning together at The Hearing House

Ivy’s research has also provided an opportunity for her to work closely with the paediatric clinical team at The Hearing House. Rather than conducting her research in isolation, she has been working alongside clinicians as the team develops and refines the testing protocol.

The clinicians have contributed to decisions around aspects of the research, including stimulus intensity levels and recording environment settings. Ivy has also led regular CAEP training sessions with the team every two weeks.

“We tested each other and developed the recording procedure together,” she says.

The collaboration has been an important part of Ivy’s learning, while also supporting the team at The Hearing House to build its knowledge and confidence in using the new technology.

For the research itself, Ivy plans to recruit between 40 and 80 children and adults, including people who use cochlear implants and a comparison group of people without hearing differences.

Each participant attends a session of approximately 60 minutes at The Hearing House. Following a review of their hearing and device history, participants with typical hearing complete an age-appropriate hearing assessment to confirm their hearing is within the expected range.

The CAEP recording itself is straightforward and non-invasive. Participants sit comfortably in a sound-proofed room while short speech-like sounds are played through a loudspeaker. Small sensors placed on the forehead and scalp record the brain’s natural electrical responses.

“The sensors do not send any electrical stimulation into the person, they just record the responses,” Ivy explains.

Participants can watch a silent video during the recording and take breaks whenever they need to, while parents or caregivers can remain with children throughout the session. Ivy is also asking participants and caregivers about their experience of the procedure, recognising that a test needs to be not only scientifically valuable but practical and acceptable in a real clinical environment.

A different path into audiology

Ivy’s journey into audiology has not been a conventional one. Before beginning her studies, she trained in Traditional Chinese Medicine and acupuncture and worked in healthcare for several years.

“I have always enjoyed working directly with people, but I was also looking for an area that combined healthcare with science, technology, and engineering,” she says.

Audiology offered that combination, while also addressing something she considers fundamental to people’s wellbeing: communication.

“I really enjoy working with people and supporting them to achieve the communication outcomes that are important to them,” Ivy says.

“I also enjoy the combination of clinical problem-solving and technology involved in areas such as electrophysiology, hearing aids and cochlear implants.”

Ivy became increasingly interested in hearing healthcare as she learned more about the field and the many ways hearing services can support people to make informed choices about their hearing and communication.

She sees a growing need for hearing healthcare services both in New Zealand and internationally, including in China.

Now studying full-time, Ivy has stepped away from her previous part-time job to devote herself to her studies, clinical training and research.

Her ambition is to work as a clinical audiologist, with a particular interest in cochlear implants, while continuing to be involved in research that can contribute to clinical practice and the care provided to cochlear implant users.

For now, Ivy is focused on completing her thesis and exploring how CAEP testing could provide clinicians with additional information to help guide assessment and care.

“It has been a great opportunity to learn from the clinicians at The Hearing House and to see how research can be applied in a clinical setting,” Ivy says. “I’ve really enjoyed being able to contribute to work that may help clinicians better understand and respond to the individual needs of cochlear implant users.”

Away from her studies, Ivy enjoys keeping active at the gym and playing squash. She is also a keen gardener and grows many of her own vegetables at home.

Having immigrated to New Zealand in 2017, Ivy remains closely connected with her family in China, visiting whenever she can.

As the oldest student in her class, Ivy brings a wealth of life and healthcare experience to her second career. Her research at The Hearing House is now adding another dimension – helping explore how listening can be measured not just by what a person can tell us they hear, but by how the brain responds.

Ivy Yang (pictured right) with Hearing House Clinical Director, Holly Teagle