Learning to Listen Again: The Role of Compliance in Auditory Training for Adults With Hearing Loss

Purpose: To examine the role of compliance in the outcomes of computer-based auditory training with the Listening and Communication Enhancement (LACE) program in Veterans using hearing aids. Method: The authors examined available LACE training data for 5 tasks (i.e., speech-in-babble, time compression, competing speaker, auditory memory, missing word) from 50 hearing-aid users who participated in a larger, randomized controlled trial designed to examine the efficacy of LACE training. The goals were to determine: (a) whether there were changes in performance over 20 training sessions on trained tasks (i.e., on-task outcomes); and (b) whether compliance, defined as completing all 20 sessions, vs. noncompliance, defined as completing less than 20 sessions, influenced performance on parallel untrained tasks (i.e., off-task outcomes). Results: The majority, 84% of participants, completed 20 sessions, with maximum outcome occurring with at least 10 sessions of training for some tasks and up to 20 sessions of training for others. Comparison of baseline to posttest performance revealed statistically significant improvements for 4 of 7 off-task outcome measures for the compliant group, with at least small (0.2 \u3c d \u3c 0.3) Cohen\u27s d effect sizes for 3 of the 4. There were no statistically significant improvements observed for the noncompliant group. Conclusion: The high level of compliance in the present study may be attributable to use of systematized verbal and written instructions with telephone follow-up. Compliance, as expected, appears important for optimizing the outcomes of auditory training. Methods to improve compliance in clinical populations need to be developed, and compliance data are important to report in future studies of auditory training

Learning to Listen Again: The Role of Compliance in Auditory Training for Adults With Hearing Loss

Purpose: To examine the role of compliance in the outcomes of computer-based auditory training with the Listening and Communication Enhancement (LACE) program in Veterans using hearing aids. Method: The authors examined available LACE training data for 5 tasks (i.e., speech-in-babble, time compression, competing speaker, auditory memory, missing word) from 50 hearing-aid users who participated in a larger, randomized controlled trial designed to examine the efficacy of LACE training. The goals were to determine: (a) whether there were changes in performance over 20 training sessions on trained tasks (i.e., on-task outcomes); and (b) whether compliance, defined as completing all 20 sessions, vs. noncompliance, defined as completing less than 20 sessions, influenced performance on parallel untrained tasks (i.e., off-task outcomes). Results: The majority, 84% of participants, completed 20 sessions, with maximum outcome occurring with at least 10 sessions of training for some tasks and up to 20 sessions of training for others. Comparison of baseline to posttest performance revealed statistically significant improvements for 4 of 7 off-task outcome measures for the compliant group, with at least small (0.2 \u3c d \u3c 0.3) Cohen\u27s d effect sizes for 3 of the 4. There were no statistically significant improvements observed for the noncompliant group. Conclusion: The high level of compliance in the present study may be attributable to use of systematized verbal and written instructions with telephone follow-up. Compliance, as expected, appears important for optimizing the outcomes of auditory training. Methods to improve compliance in clinical populations need to be developed, and compliance data are important to report in future studies of auditory training

Electro-Tactile Stimulation Enhances Cochlear Implant Speech Recognition in Noise

For cochlear implant users, combined electro-acoustic stimulation (EAS) significantly improves the performance. However, there are many more users who do not have any functional residual acoustic hearing at low frequencies. Because tactile sensation also operates in the same low frequencies (<500 Hz) as the acoustic hearing in EAS, we propose electro-tactile stimulation (ETS) to improve cochlear implant performance. In ten cochlear implant users, a tactile aid was applied to the index finger that converted voice fundamental frequency into tactile vibrations. Speech recognition in noise was compared for cochlear implants alone and for the bimodal ETS condition. On average, ETS improved speech reception thresholds by 2.2 dB over cochlear implants alone. Nine of the ten subjects showed a positive ETS effect ranging from 0.3 to 7.0 dB, which was similar to the amount of the previously-reported EAS benefit. The comparable results indicate similar neural mechanisms that underlie both the ETS and EAS effects. The positive results suggest that the complementary auditory and tactile modes also be used to enhance performance for normal hearing listeners and automatic speech recognition for machines