I was born with hearing loss myself, and I did not hear much in my left ear for the first 20+ years of my life, until I got a hearing aid.
When the brain has been deprived of certain sounds (sometimes for decades), it’s going to take time to learn how to hear and process again. We cannot just fit a set hearing aids or a cochlear implant and call it a day. I believe focusing on aural rehabilitation means that our clinic is working to treat the whole person. If a patient is in front of me with a complaint, then I will work with them to find a solution to their problem! How does an aural rehab program impact your practice? For some patients, their challenge may have more to do with auditory processing than anatomy and physiology, but that does not mean that their struggles are not real, and do not need to be addressed. Even patients whose test results fall into the “normal” range may not be performing as optimally as they would like. I listen carefully to their symptoms and concerns. They have acknowledged that there is an issue, and they want to get to the bottom of it. In private practice, if patients are at my office, it is because they notice they are struggling. I bring up aural rehab from just about day one. At what point in the treatment process do you bring up rehab? For whom?
So during this time, I have focused on working with patients individually, and having them complete homework by themselves or with family members. COVID-19 certainly changed our plans and brought an additional level of complexity as masks hamper lipreading and distort speech signals while quality degrades over distance. Group therapy would also give patients the opportunity to listen to lots of different voices (male and female, accent variations, loud and softer talkers, etc.). I think that patients can learn so much from each other, knowing there are others in the same boat.
Pre-COVID, we were working on developing a weekly in-person group therapy session. Data shows that aural rehab is important for adult patients – how do you implement into practice? I use certain speech in noise tests (such as the QuickSIN or AzBio), as well as questionnaires such as COSI, APHAB, HHIA, HHIE, as benchmarks, to track their progress. I explain that aural rehab is like “physical therapy for the brain.” Whichever skills the patient wants to strengthen or develop, we create a treatment plan and a goal to work towards. I recommend it to patients at just about every stage in their hearing wellness journey. What is the value of aural rehabilitation for your adult patients?Īural rehabilitation is immensely valuable.
Laura Pratesi, AuD, discusses the importance of aural rehabilitation and how she puts it into practice.