What Is Aural Rehabilitation (AR) and Why Is It Important?

The purpose of Aural Rehabilitation (AR) is to help patients learn how to optimize their hearing experience through adaptive strategies and technology. It is patient-centered and designed to reduce negative impacts of hearing loss, which can include a decrease in attending social gatherings, communication ability, and overall quality of life. Many providers believe AR is a critical step in obtaining the best outcomes for people with hearing loss.

The process can be a combination of formalized questionnaires to gather information about how the hearing loss is impacting the patient, as well as informal counseling and technology recommendations. Preliminary discussions with and without the use of formal questionnaires will show the provider how they will best be able to support you.

Some providers use standardized questionnaires to better understand where you can use support. Others are able to talk informally with you and understand your hearing journey without the use of a specialized questionaire. In either case, they will tailor your care based on your responses.

What are the benefits for the patient of aural rehab?

Aural rehab is actually at the foundational origins of audiology, and among its key goals are:

• Greater patient ability to manage hearing difficulties;
• Improved patient quality of life;
• Patient self-empowerment, and
• Better patient outcomes.

Who provides aural rehab?

• Audiologist: Typically the hearing care provider who you receive your hearing aids from has built-in aural rehabilitation concepts and practices within the process of being fit with a hearing aid. Learning about how the hearing loss effects you is the first step they need to ensure they are able to help you. 
•  Speech Language Pathologist (SLP): The specialty of an SLP will enhance speech and language communication, when applicable.  They can also discuss communication strategies that are important for daily life.
• Online options: You can choose to take online courses to assist in auditory training without the need of an office visit to a provider.  One example is the LACE program, which is web-based and adaptive to each individual depending on their progress (more details below).

Components of aural rehabilitation

Many great providers already incorporate AR into their daily clinics. Through counseling conversations during an evaluation, to explaining the hearing test results to patients and loved ones, many of the verbiage and techniques are incorporated naturally. The best clinicians have already implemented many steps along the way to ensure their patients achieve optimal results.

Some providers have a formalized class to teach patients about many aspects of AR. This is often a complementary class with the purchase of hearing aids, or it can be fee-based. It is not something that is typically covered by health insurance.

• Anatomy & physiology of hearing: It is helpful to understand the mechanisms of hearing. Without realizing how the auditpry system is designed and how it works, you may not realize the limitations and capabilities of hearing and therefore not have realistic expectations—good, bad, or otherwise.
• Hearing aids: Learning how a hearing aid is designed and the various types that are available is helpful. The provider can walk through generalizations about the technology, touching on the most popular types.  Pros/cons are listed, but which hearing aid is right for an individual will depend on a lot of variables.
• Accessories: Modern hearing aids are self-adjusting and make decisions for your hearing based on the environment around you. However, hearing aids sometimes need some extra support. Accessories can help patients who need that added support— whether it be everyday, for the TV, or for specific environments, like places of worship. Specialized remote microphones, chargers, smoke alarms and alerting devices, captioned telephones, and transmitters are examples of some common accessory options.
• Communication strategies: Arguably the most important aspect of AR is learning how to better interact with the world around you. A hearing aid is just that: an aid, not a cure. It is important for you and your loved ones to understand how to optimize your communication for optimal quality of life.

What can I do at home to help optimize my hearing?

There are online forums for those with hearing loss, as well as programs in which you can enroll to strengthen your auditory listening skills, that ensure you are making the most of your hearing levels. Below are 2 programs designed by audiologists that you can do from your own computer:

• Amptify (formerly clEAR) is a computer-based and mobile program that will have you playing games while strengthening your auditory skills. It addresses hearing health with coaching, an interactive curriculum, auditory training video games, and a peer support community. Pricing: Monthly subscription fee of $24.99/month.
• LACE is a self-guided computer-based program will build your listening skills while adapting to your strength and weaknesses.  This makes sure you focus on skills important for you! Pricing: One time fee of $119.

Some clinics provide these computer-based programs in the clinic environment for patients who do not feel comfortable using the computer at home; other clinics refer their patients to this site to do on their own time. Ask your provider if you’re interested.

There are also some great consumer groups available for people with hearing loss, such as the Hearing Loss Association of America, the AG Bell Association (for parents of children with hearing loss), and the American Tinnitus Association, to name only a few. Some of these have state and local chapters that host online activities and get-togethers where members share tips and “life hacks” for better hearing and communication.

As with anything in life, the more information you can gather, generally the better outcomes. AR is an important step in the process of learning about hearing loss, and the impacts it may have on you is crucial in success. Your hearing care provider will be able to help you in understanding this impact by guiding you through simple discussions during your journey to better hearing.