How We Help Aswathy to Study and excel

How We Help Aswathy Study and Excel?

A TECHNOLOGY-DRIVEN SOLUTION FOR ANSD

Aswathy is a Grade 11 student at a government school in Tirupati. She hails from a working-class family that works hard to make ends meet. Her parents have always dreamed of providing a good education for their son and daughter, knowing that professional degrees can lead to good jobs and help end their family’s poverty. Both children are exceptionally bright and take their studies very seriously.

However, their dreams began to fade when their younger daughter, Aswathy, did not score as well as expected in her tenth-standard examinations, despite previously being one of the top students in her school. For the past year, she had been struggling with a quiet fear: she could no longer understand what her teachers were saying from a distance. She managed to pass her tenth board exams and joined the Biology, Physics, and Chemistry stream with the hope of studying medicine. Unfortunately, her first two weeks in class were a nightmare; unable to understand 90% of the conversations around her, she seriously considered abandoning her studies.

An ENT doctor advised the family to try a digital hearing aid, which can offer a partial, temporary solution. Fortunately, her physics teacher Dr. Mohan Reddy, reached out to Chakshumathi to report the case. We subsequently connected Aswathy with Dr. Yuginder, a world-renowned ENT specialist and speech-language pathology researcher to dragonise her and provide her a Hearing Aid as part of his charity. With years of research experience at the prestigious Johns Hopkins University in the USA, Dr. Yuginder now runs a specialized clinic in Guntur. He reviewed Aswathy's case and provided a definitive diagnosis. She is suffering with ANSD.

Understanding Auditory Neuropathy Spectrum Disorder (ANSD)

Aswathy was diagnosed with Auditory Neuropathy Spectrum Disorder (ANSD). This condition refers to a range of hearing dysfunctions characterized by compromised signal processing along the auditory nerve, or a deficient transmission of signals from the presynaptic inner hair cells (IHCs) to the auditory nerve.

In simpler terms, Aswathy can hear voices, but her nerves cannot successfully transmit those sounds to her brain to be processed into recognizable language. It is like standing outside a busy hall: you can hear that a lot of noise is happening, but you cannot clearly understand the words. All voices become noise without meaning.

• Medical History: ANSD was first described by A. Starr and colleagues in 1996 in ten patients who showed evidence of normal outer hair cell (OHC) function but impaired neural transmission in the peripheral auditory system.
• Terminology Evolution: Initially termed "auditory neuropathy," experts later proposed the more comprehensive terms "auditory neuropathy/auditory dys-synchrony" (AN/AD) or "auditory neuropathies" to highlight the loss of temporal coding caused by abnormal synchronization across the peripheral neural pathways.

Prof. Dr. Yugandhar Ramakrishna and Dr. Tejaswini Boreddy, examined Awathy at their RASYA Indo-American Clinic, Guntur

Recent Findings: Recent genetic and molecular biology studies on animal models show that the impairment can occur anywhere from the inner hair cell (IHC) synapses to the auditory neural fibers. Consequently, the term “auditory synaptopathy” is sometimes used to distinguish ANSD caused by IHC ribbon synapse dysfunction from issues caused by neural fiber dysfunction.

Exploring the Solutions

Medical Interventions

Unlike a heart bypass, surgical interventions in the brain carry significant risks. The current experimental methodology involves cochlear implants. While there have been some successful cases of cochlear implants in older patients, it is a highly expensive medical intervention; for ANSD, the cochlear unit requires a higher configuration tailored to the specific case, and the success rate sits between 30% and 70%.

Educational Interventions

For Aswathy, who is already in Grade 11 and possesses strong fast-reading skills, we implemented a practical, technology-driven solution:

• Classroom Setup: Aswathy is seated in the front row of the classroom and uses a Chromebook or an Android tablet.
• Real-Time Transcription: Her teacher wears a Bluetooth microphone. Using Gemini AI or the Google Transcribe app, the teacher's lecture is transcribed into text in real-time on Aswathy's monitor.
• Engagement: Combined with training in lip-reading, this setup allows Aswathy to read exactly what the teacher is saying, ensuring she remains fully engaged in the class without missing any educational content. Lip reading help her in her future life for social interactions too.

A cochlear implant consists of two main sections:

1. The External Components

• The Sound Processor: This part often looks similar to a slightly larger behind-the-ear hearing aid. It hooks comfortably over the top of the ear and sits behind it. It contains microscopic microphones that pick up environmental sounds and a microcomputer that processes those sounds into digital signals.
• The Cable: A very thin, durable wire connects the bottom of the sound processor to the transmitter coil.
• The Transmitter Coil (Headpiece): This is a small, flat, circular disk (about the size of a large coin) that rests against the side of the head, slightly above and behind the ear. It stays securely in place using a strong magnet that connects to the internal component through the skin.

2. The Internal Components

If you were viewing a close-up medical model of the surgically implanted parts, you would see:

• The Receiver/Stimulator: This is a thin, slightly curved medical-grade silicone and titanium disc that sits completely flat beneath the skin and against the skull. It contains the internal magnet that locks onto the external coil.
• The Electrode Array: Extending from the receiver is a hair-thin, flexible wire covered in microscopic metal contact points (electrodes). This delicate array is gently threaded deep into the spiraling, snail-shell shape of the inner ear (the cochlea) to directly stimulate the auditory nerve.

A cochlear implant device attached to the back of a person's head and ear.

Overcoming Speech Challenges

A major hurdle still stands in Aswathy's way: because she cannot clearly hear her own voice during conversations, she needs substantial training to trust her voice and speak face-to-face with others. In our experience, many students with ANSD eventually reduce how much they talk, which severely hampers their speech development.

To prevent this, Aswathy must commit to a simple, lifelong exercise: using her tablet or Chromebook's voice transcription tools (like Gemini AI or Google Transcribe), she must continuously read her study materials, newspapers, or magazines out loud. This practice will train her vocal cords, maintain her speaking instincts, and allow her to visually verify her speech.

This is how she will hone her unique abilities and overcome her disability. Chakshumathi wishes Aswathy all the best, confident that she will become a powerful role model for many other students facing similar challenges.

The Technology Solution for Aswathy simplified

• Teacher use a bluetooth Noise reduction mike to stream clear lectuer voice input to Aswathy’s Chromebook.
• Aswathy’s Chromebook transcript the voice of the teacher to text for Aswathy to read and understand.
• Aswathy also learn how to lip read the conversations of others with training and clear observations

Please download March issue of the Diversity Magazine to read how Dr. Mushrifa overcome her ANSD and become a role model.

To download past issues visit: https://differentlyabled.in/

Note: The student’s name is changed as Aswathy for her privacy