Hearing technology, such as hearing aids and cochlear implants, help us hear our best, but hearing technology alone is not enough. There is a misconception that wearing hearing aids or cochlear implants is just like wearing glasses. Put them on and you hear clearly!
This is just not the case. It is important to train the brain to hear better. Most of us would never consider running a marathon without any training to go the distance. It is the same with training the brain to hear. When people first get hearing technology, auditory skills training is needed to help make sense of new sounds.
Auditory skills training (AST) is the process of improving hearing skills through structured, repetitive listening exercises. In particular, it uses active listening exercises to train the brain to interpret sounds in order to understand spoken language.
The importance of rehabilitation was captured by Dr. Howard Rusk in his autobiography, A World to Care For, when he stated, “…once a person overcomes a disability through his own courage, determination and hard work, he has a depth of spirit you and I know little about… [this] is a branch of medicine in which the patient has more power than the doctor in setting the limits and possibilities…”
When I read this, I think of all the incredible people I have met through the years who have never let hearing loss slow them down in life. This quote is very empowering because it says that you – not your doctor, audiologist or therapist – can have the greatest impact on your ability to hear. In other words, you have the ultimate power and the ability to achieve your personal best!
…you have the ultimate power and the ability to achieve your personal best!
Making a commitment to use hearing technology opens the door to new possibilities. Using hearing technology such as hearing aids or cochlear implants does not mean the brain will immediately learn how to make sense of the sounds it hears. Hearing technology helps to pick up sounds and voices around you, but hearing challenges are not eliminated after you get a hearing aid and/or cochlear implant.
What can you do in order to be more successful with your hearing technology? Set goals early, wear your hearing aids and/or cochlear implant(s) during all waking hours, and make time to practice listening to support your everyday communication.
Some centers offer auditory skills training as part of an aural rehabilitation program. This training can take place one on one or in groups. Ask your audiologist to help identify a program or ask if there is a speech-language pathologist who offers this service. If you are at a teaching institution, there may be a student clinic run by the Speech and Hearing department that offers this service.
In the United States, auditory skills training is often covered by insurance under aural rehabilitation at hospitals or private practices. Typically, a speech-language pathologist provides this service, and an assessment is done, followed by therapy sessions. If you have ever been through physical therapy, it’s the same idea. Call your insurance provider to find out if it is a covered service in your plan and how many sessions are covered per year.
Even if your insurance does not cover this service with a professional, there is a lot you can do on your own. Besides programs and services offered by hearing care professionals, there are also online tools available such as the free HearingSuccess portal at hearingsuccess.com.
Inside the HearingSuccess portal, you will find auditory skills training activities as well as information and communities to support you. Two of the auditory skills training resources are specifically designed to practice everyday communication at home at your own pace.
WordSuccessTM is a mobile app available for iOS and Android designed to provide listening practice with words and phrases in quiet and noise. You can take a placement test and then work through exercises using the recorded voice or practice live voice. What’s really awesome is that the app can compare and track your scores.
SoundSuccessTM is an interactive online listening training program. You can practice getting used to how things sound with your new hearing technology, understanding different speakers, and listening in noisy environments. What’s unique is that you can use speech reading and listening, listening alone, or add different levels of noise and choose from six different speakers. It provides practice listening to phrases, sentences, paragraphs, stories, and conversations related to everyday things you do.
Taking an active role in the rehabilitative process is key. Just as training for a marathon requires you to get out there and run, you have to be an active participant in your hearing journey to make it to the finish line. You must put on your hearing aid and/or cochlear implants and commit time to practicing listening.
The goal of auditory skills training is to maximize the benefit received by using your hearing technology to help you better understand spoken language in order to meet your full communication potential. Take time to consider your personal hearing and communication goals.
You can plan for your hearing success even if you are still considering or being evaluated for a cochlear implant. Set personal communication goals early – before you receive or activate your cochlear implant. Your hearing health care provider, who may be an audiologist or speech-language pathologist, can be your coach and work with you to set hearing goals and set up an auditory skills training program to meet your hearing goals.
Set personal communication goals early – before you receive or activate your cochlear implant.
Share those goals with your family. Setting goals gives you something to work towards, motivates you, and can help you track how well you are doing. Telling others what your goals are helps you to stay committed and gain the support of other people. Training the brain to hear is a team process, and communication is important. Make sure you communicate with your hearing health care providers all along the way.
Motivation and confidence are the foundation for behavior change. Motivation drives our actions and behaviors. When we are excited and want to learn a new skill or improve an existing skill, we are more likely to set and commit to goals to make a change.
As we learn or improve our skills and achieve our goals, we become more confident. When we are confident, it changes our ideas of what we are capable of doing, and we become open to possibilities. Those possibilities may include your own ”WOW moments,” such as hearing a voice for the first time, the sound of your dog’s paws as he walks down the hallway, talking on the telephone to a loved one, listening to music for the first time, or enjoying music again.
Include family members or close friends. Training and running a marathon is much more fun when you have a fan club who has encouraged you and is there to see you cross the finish line. Including family members or other significant people in your life can not only be encouraging and supportive to you, but also will help them learn how to make communication more successful and less stressful for you.
Step 1. Write down your personal communication goals. There is a My Hearing Goals form in the SoundSuccessTM program that can be used for this purpose. Use these tips to help you think about your hearing goals:
· Choose a goal that is meaningful and important to you.
· Be specific. Example: “I want to be able to talk with my friends when we go out to eat.”
· Be realistic.
Think about your own personal interests, hobbies and other things you like to do. List three things that you enjoy. Finish the sentences below:
· I like to …
· I like to …
· I like to …
Think about your daily activities. List three daily activities that are important to you to be able to hear better:
· I want to hear better when I’m…
· I want to hear better when I’m…
· I want to hear better when I’m…
Review what you wrote above. Now, write three specific hearing goals you want to achieve. For example, “I want to go back to playing cards with my friends.” Or “I want to talk with my grandchildren on the phone.” Or “I want to be able to hear what my friends are talking about during lunch.”
· I want to …
· I want to …
· I want to …
Step 2. Share your goals. Who do you want to support you and see you to the finish line? Think about the most important people you want on your ”team.” List two or three people who might be willing to work with you regularly on some listening activities.
Now, share your hearing goals with your team listed above. Remember to bring or email your hearing goals to your hearing healthcare specialist (audiologist, speech-language pathologist, auditory verbal therapist, etc.) so they can help you work towards achieving your personal communication goals.
Step 3. Begin auditory skills training, either with a professional one on one or in a group, or by using online resources such as HearingSuccess.
The brain learns through repetition, so make some time for your listening practice daily. A research study shows the huge impact that auditory skills training can have on understanding speech. After participating in a training program, the study found that the greatest improvements in the ability to understand speech happened in the first three to eight months post-implantation, but improvements continued to be seen as much as five years later.1 This is incredible! This study shows the lasting impact that auditory skills training can have as much as five years later.
Plan for your success. Set goals early, wear your hearing aids and/or cochlear implant(s) during all waking hours, and make time to practice listening to support your everyday communication.
Don’t overwhelm yourself. Remember, you are in it for the long game. Hearing is a journey. A daily practice plan can be incorporated into your daily activities, but don’t expect that you will be talking on the phone right away. Using some of the apps mentioned above will help prepare you to do harder tasks, such as listening in noise and on the phone. Think of your hearing technology like your clothes. Best practice is to wear them every day, during all waking hours.
Now think of your everyday activities. Most often, the listening environment or situation causes communication difficulty. You can practice auditory skills training in your everyday listening situations. Ask a family member or friend to be your listening coach. Practice listening around the house, in the car, while dining out, on the phone, at public events (concerts, meetings, etc.). Ask questions about what you hear. Your family member or friend will be your listening coach. They will tell you what you are hearing when you can’t identify it. This will help your brain make the connection to the sounds, voices, and music around you. The brain learns through repetition, so repeat these experiences often.
You can practice auditory skills training in your everyday listening situations.
Keep a hearing diary. Make notes about the situation: environment, speaker, listener, technology. Note what was a success and what was challenging. Note the communication partners involved. Share these notes with your hearing health care providers. This is valuable information to guide programming your devices and also to work towards your personal communication goals.
Your auditory skills practice can be done in everyday situations, but focused, repetitive drills will be beneficial. The research supports this. While the auditory training programs mentioned in the literature differ and outcomes cannot be generalized, the evidence suggests that auditory skills training is beneficial.2,3
Don’t wait to start; start now. Start with something that is easy. For example, in SoundSuccess, start with the “Getting Started” exercises. The first activity, “Listening to Paragraphs” is a great place to start. You can listen to the speaker and read along in the printed paragraph.
When you get most of the answers correct, try something a little harder. Look at the HearingSuccess Listening Practice Tips and Resources to learn tips on how to progress your listening practice from easy to challenging.
It is okay to use visual cues such as lipreading, body posture, facial expressions, hand gestures, print, and captions to help you understand. As you gain more experience and confidence hearing with your hearing aids and/or cochlear implant(s) and have success, take away some of the visual cues, add noise as you are ready, and try harder exercises. You can do all these things using the WordSuccess app and doing the, “Up and Running” exercises in SoundSuccess.
Consider using the Bluetooth streaming capabilities on your hearing aids and/or cochlear implants or a Roger system to make your listening practice less tiring. Just like training for a marathon or participating in physical therapy, daily practice will help you meet your goal. Starting auditory skills training early in your hearing journey will have a positive impact. Be patient and be persistent. You will make it to the finish line!
With your newfound self-determination, support team, and access to free auditory skills training tools in the HearingSuccess portal, you’re well on your way to achieving hearing success!
Special thanks to Julia Biedenstein, M.S., LSLS Cert AVEd, and Krista Heavner, MS, CCC-SLP; LSLS Cert AVT, for their contribution to the article.
Oba, S. I., Fu, Q. J., & Galvin, J. J. (2011). Digit training in noise can improve cochlear implant users' speech understanding in noise. Ear and hearing, 32(5), 573-81.
Henshaw H. & Ferguson, M.A. (2013). Efficacy of individual computer-based auditory training for people with hearing loss: a systematic review of the evidence. PLoS One, 10;8(5):e62836.
Stropahl, M., Besser, J. & Launer, S. (2019). Auditory training supports auditory rehabilitation: A state-of-the-art-review. Ear and Hearing, 41(4), 697-704.
Valeri Le Beau, Senior Rehab Manager at Advanced Bionics, lives in Lake Forest, Illinois with her husband Marc, who is a lifelong user of Phonak hearing aids, and puppy, Sandor. Valeri has expertise in hearing loss, cochlear implants and re/habilitation for individuals with hearing loss. Her personal interests are travel, food, wine, fitness and tennis.