Auditory Training – Brain Training That May Help You Hear Better
Hearing loss can feel like the end of one’s life. A resignation to an inevitable and diminished hearing experience that will forever change everything – and that may never get better. Yet those who wear hearing aids and cochlear implants know that there is life after hearing loss and that technology plays a critical role in hearing rehabilitation. In addition to hearing devices, there are a number of apps, tools, toys, and gear that can enhance one’s hearing experience across a variety of environments. One often-overlooked hearing enhancement tool is auditory training, a “brain training” technique for the ears, that is often used to improve listening skills for hearing aid wearers.
What is auditory training?
Auditory training is a technique used to enhance listening skills and improve speech understanding. It involves formal (focused) listening activities designed to optimize speech perception through training the cognitive processes that play a role in listening. Improvements in speech understanding can often be seen for hearing aid wearers, even when listening in difficult noisy environments.
Procedures and techniques used in auditory training are continually evolving, and advances in technology have increased the range of services available for those with hearing devices. Now, computers and training programs have made auditory training possible in your own home.
How Does It Work?
Cortical areas of the brain go through a kind of reorganization when a sound-deprived brain is given access to sound again (through the use of hearing aids). It is thought that during this reorganization process, the auditory system is especially sensitive to the positive effects of auditory training. Computer-based auditory training exercises usually involve a number of watching and listening activities that may be performed to improve speech comprehension over time.
Who Does It Work For?
Auditory training is generally practiced by those who have experienced a recent change in their hearing function. For example, recent cochlear implant (CI) recipients may benefit from intensive auditory training along with the initial activation of the CI. Other auditory training candidates include adults with sudden hearing loss, people who have switched to different hearing aid signal processing schemes, and individuals who are beginning a new job or training program that is auditorily demanding. Patients who have not made reasonable improvements in hearing function and speech comprehension after a hearing aid fitting are also reasonable candidates, as are those who have adjusted to their aids but wish to use auditory training to further enhance their speech comprehension.
Despite this, most adults receiving audiologic services are not aware of auditory training as a treatment option. Moreover, few adult patients are referred for auditory training because this type of rehabilitation is not usually reimbursed and because many audiologists simply do not go beyond the fitting and servicing of hearing devices.
Formal Vs Informal Listening Activities
“Formal listening activities” in auditory training differs from the auditory “learning” that takes place whenever hearing aid users are simply listening to speech. The new amplified signals often sound a bit different, even strange. Audiologists and hearing instrument specialists have always counseled new hearing aid users that it may take some time for them to “get used to” the new sounds the hearing aids are providing to their ears and their brains.
In fact, a great deal of informal “auditory training” takes place during the initial hearing aid (and cochlear implant) adjustment phase. Hearing-impaired people are constantly trying to make sense of speech signals that are distorted in some fashion. Listening to speech is always a bit of a guessing game in which people use their knowledge of the language and the context to fill in the acoustic gaps and distortions of the incoming speech signals. The good news is that people do get better at this over time.
A formal listening program of auditory training assumes that hearing aid users have completed this initial adjustment stage, i.e., that they have reached a plateau in their listening skills and are now ready to attempt to further improve their performance through explicit training.
Auditory training was rarely used clinically for several reasons. One, it does not lend itself to group lessons – it must be practiced on a one-to-one basis. The other reason was that supporting research attesting to its value was relatively sparse and did not appear to justify the time and expense that the activity required. This view has been changing in the last decade or so, thanks to developments in three areas.
The Cochlear Implant
The auditory sensations that the first generation of CI users received was so different from what they had been used to that they needed help in adjusting to, and learning to comprehend these new and strange sound sensations. This is similar to orthopedic patients who receive physical therapy after some sort of surgery (hip, knee, shoulder, etc.). In other words, if physical therapy helped people with post-surgical physical issues, why wouldn’t auditory therapy (training) be similarly helpful for people with hearing problems? And why limit therapy only to CI users, why not people wearing hearing aids as well?
The second of these developments was the emerging appreciation of the neuroplasticity of the brain – once viewed as immutable – now beginning to be seen as malleable and subject to modification. It now appears that changes take place in the central nervous system as a result of repeated exposure to meaningful auditory stimuli in a training situation. In other words, it seems that old dogs can learn new tricks.
The Computer and the Internet
The third development is the widespread use of the personal computer and familiarity with the internet. Before this, it simply was not economically practical for clinicians to offer this service. To be effective, therapy has to be conducted frequently and over a relatively long period of time. Any practice or agency concerned with the bottom line simply couldn’t afford to offer it as a routine clinical procedure. With personal computers and/or online training, it’s now possible for people to conduct frequent training sessions at home, at a great savings in cost and time. The most effective model is a combination clinical and home activity where the professionals can interact with the clients to monitor and provide assistance when needed.
Does It Help Improve Listening Skills?
The short answer is “Yes” provided the program is appropriate and sufficiently intensive. The best results were obtained with the more intensive programs (longer duration and more sessions per week). Recent research on auditory training has focused on home-based training programs, with results that are even more promising than the early studies.
Online Training Programs
Ask your audiologist to recommend an auditory trainer in your area. At home, get acquainted with these remarkable online listening training programs:
- LACE® Listening and Communication Enhancement
- clEAR – customized learning: Exercises for Aural Rehabilitation
- Angel Sound
- Postit Science: Brain Fitness Program
Listening Programs for Cochlear Implants
Stu Nunnery is a writer, speaker, recording artist and hearing activist. He has recently returned to making music after a 35-year hiatus and presents workshops and performances about his journey with bilateral hearing loss.
Last modified: December 14, 2017