Aural rehabilitation helps people with hearing loss optimize their hearing so that they can communicate successfully. ‘Aural’ has to do with the ear or hearing. ‘Rehabilitation’ is the process of helping a person get back abilities or skills lost because of illness or injury. It is any assistance that reduces the communication and psychological consequences of hearing loss and improves how people function with hearing loss in their daily lives.  

Why is aural rehabilitation necessary?

Many people with hearing loss wear hearing aids. The fitting of hearing aids is a part of aural rehabilitation as they restore, or at least improve, hearing. Even with hearing aids, people with hearing loss may struggle to understand speech and communicate successfully. Aural rehabilitation is most successful when used together with hearing aids as it helps people get the maximum benefit out of them. 

What does aural rehabilitation involve?

Every person with hearing loss has different communication environments, situations, and communication partners and, therefore, unique communication needs. In addition to fitting hearing aids, aural rehabilitation includes a wide range of services that are recommended based on your specific needs. Aural rehabilitation can be completed with a hearing healthcare provider, in groups,  or by yourself at home. Aural rehabilitation services include the following:

Counseling

Counseling is one of the most critical activities involved in aural rehabilitation. Informational counseling involves sharing information to help you and your family better understand and manage your hearing loss. For new hearing aid users, counseling would include information about the use and maintenance of your hearing aids, and how to adapt to them. Personal adjustment counseling involves discussing feelings and thoughts about hearing loss to help you and your family adjust to the social and emotional effects of hearing loss.

Communication strategies training

Communication is not a straightforward process- even people with normal hearing may misunderstand what people are saying from time to time. Often people and their loved ones don’t know how to improve the communication situation or what to do when they don’t understand what is spoken. A crucial part of aural rehabilitation is learning some of the many strategies that can help you better communicate in specific environments or with individual speakers. 

With communication strategies training, you would learn to plan for difficult communication situations. For example, if you will be attending a meeting, anticipate what questions you may be asked. Or if you are meeting with someone, choose a venue that you know isn’t noisy. You would also learn how to successfully repair communication breakdowns when they occur. This would include asking the speaker to speak louder or slower, or to repeat a specific word or part of the sentence, or rephrase the sentence, depending on what you need from them.  

Training would also help you identify how your environment affects your communication and how to adjust your environment to be able to communicate successfully. Examples include reducing or moving away from background noise, decreasing your distance from the speaker, and ensuring you can see the speaker clearly. Through communication strategies training, you learn to ask for what you need from your communication partners and how to improve your environment to make conversation smoother and less frustrating for both you and others.

Assistive technology

Assistive technology forms an integral part of aural rehabilitation for people who struggle to hear in specific situations. For example, you may find that you hear well with hearing aids in most cases, but struggle on the telephone or in noisy environments. Several assistive devices work with hearing aids to help in such cases. If you struggle to hear the television or on the phone, adapters can be used to transmit sound from the source into your hearing aids. If you have difficulty hearing on your mobile phone, a device can be worn to send sound from your phone into your hearing aid.  Sound can be sent directly from iPhones to most of the latest hearing aids without using a different device.  If you struggle to hear in background noise, a speaker’s voice can be transmitted into your hearing aids by using an FM system or remote microphone. Some public places such as cinemas or auditoriums may have loop systems which send sound from the source into hearing aids that have a telecoil.  For non-hearing aid users, devices such as amplified telephones and earphones connected to the television can help.  

Auditory training

We hear with our ears, but we listen with our brains. Auditory training is the process of teaching the brain to listen. Auditory training improves listening skills and speech understanding. People who benefit the most from auditory training are; children and adults after receiving cochlear implants, children with hearing aids, adults who have to understand a lot of auditory information (for example, people who regularly communicate over the phone or radio, or who have vision problems), and adults who struggle to hear with well-fitted hearing aids. Auditory training is done through exercises that involve listening to sounds, words, or sentences, usually without lip movements or visual information to help.  Some activities introduce background noise to improve your listening in challenging listening environments. There are Smartphone Apps, which can help improve auditory skills such as Hear Coach and i-Angel Sound (in App Store only). There are also computer and web-based programs such as Listening and Communication Enhancement (LACE) and Angel Sound. 

Speechreading/lipreading

We don’t only use our hearing to understand speech- we also use visual information: Speechreading and lipreading training help you better use visual information to improve speech understanding. Speechreading involves learning to use a speaker’s lips, facial expressions, body language, and gestures to understand better what they are saying. Lipreading involves learning what sounds look like when they are said by looking at a speaker’s mouth and lips. 

Group sessions

Many aural rehabilitation services, such as counseling, information-sharing, and communication strategies training, can be done in a group setting. Group sessions introduce you to people who share similar challenges and allow you to discuss how to overcome them.  

Aural rehabilitation is important as it helps people with hearing loss regain their ability to hear and communicate successfully, which can increase your quality of life. If one believes they have a hearing loss or diminished hearing, seek help from a hearing health professional immediately in order to start treatment and rehabilitation early.