Technologic advances in aural rehabilitation: applications and innovative methods of service delivery

Abstract

The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described.

Figure 1.

Percent correct on vowel identification (n = 10), consonant identification (n = 7), gender identification (n = 7), and Hearing-in-Noise Test sentence identification (n = 3) for subjects before (gray bars) and after (black bars) training on the Computer-Assisted Speech Training program. Significance (paired Student t test): ∗P < .05; ∗∗P < .01; ∗∗∗P < .001. Figure was redrawn from data presented in Fu et al.

Figure 2.

Mean improvement on training task scores for each quarter of the training relative to the first quarter of training, for all subjects completing Listening and Communication Enhancement (LACE) training. (A) Group mean change on speech in babble performance. A decrease in decibels of signal-to-noise ratio (dB SNR) score indicates improvement. (B) Group mean improvement on speech with a competing speaker performance. A decrease in dB SNR score indicates improvement. (C) Group mean improvement on time-compressed speech performance. A decrease in score indicates improvement. (D) Group mean improvement on auditory memory performance. An increase in score indicates improvement. Error bars indicate 95% confidence interval of the mean.

Figure 3.

Mean change in scores for all outcome measures. Circles indicate changes in control group scores, and squares indicate changes in the trained group scores. Increase in score indicates improvement on all measures. Error bars indicate the standard error of the mean. HHIE = Hearing Handicap Inventory for the Elderly; CSOA-S = Communication Scale for Older Adults; CSOA-A = Communication Scale for Older Adults attitudes subscale; SPAN = Listening Span; STROOP = Stroop Color Word Test; Quick SIN 45 = Quick Speech-in-noise at 45 dB HL; Quick SIN 70 = Quick Speech-in-noise at 70 dB HL; HINT = Hearing-in-Noise Test.