American Speech-Language-Hearing Association

Audiologic (Hearing) Rehabilitation

Audiologic (hearing) rehabilitation (also known as auditory or audiologic rehab) is the process of providing training and treatment to improve hearing for those who are hearing impaired. Hearing rehabilitation services focus on adjusting to hearing loss, making the best use of hearing aids, exploring assistive devices, managing conversations, and taking charge of communication. Services can be individualized, in small groups, or a combination of both.

Audiology Information Series
More information on this topic can be found in our Audiology Information Series [PDF].

Topics typically discussed include the following:

Nature of the hearing loss. It is important to understand the specific nature of the hearing loss. Sometimes it takes several discussions with your audiologist and your family for things to “click.” By better understanding your hearing loss, you will gain new insights into:

  • Why it seems that people are mumbling
  • Why you “hear” but cannot “understand”
  • Why you have trouble with female voices
  • Other questions that may have been troubling you for so long.

Your family's understanding of your hearing loss. Your family does not know how you hear. What they do know is that you do not hear well! They know they use lots of energy trying to communicate with you. Sometimes, the audiologist will play a recording that simulates your hearing loss so that your family can understand better what you are experiencing.

The hearing aid. What will the hearing aid do, and what will it not do? When people have realistic expectations, it is easier to adjust to the hearing aid. Also, the audiologist should review how to take care of the hearing aid, explain how to troubleshoot problems, and answer any questions. So much information is given to you at the time of the hearing aid fitting that it is difficult to absorb everything. Also, more questions will come to mind after the hearing aid has been used for some time.

Many audiologists take this opportunity to review different types of hearing aids and how they work. This helps to explain why the specific style of hearing aid was recommended by the audiologist.

This review also helps family members understand that the hearing aid was a specialized prescription. Often, well-meaning family members and friends mention ads for other kinds of hearing aids or talk about other friends who have “better” hearing aids. They simply do not understand that the hearing aid was chosen because it best addressed the hearing loss.

In addition, hearing rehabilitation services will often cover the following topics:

Managing hearing aids and hearing assistive devices. A hearing aid or hearing assistive device is effective only when properly used. Issues that must be covered include proper positioning/wearing of the device, adjustment of controls, and use of special features.

Improving speech. Sometimes a person with a hearing loss needs help in saying words more clearly and keeping his or her voice quality and level pleasant.

Using visual/visible clues. People use their eyes to get clues about what others are saying. For people with hearing loss, this visual information is even more important to make up for what they cannot hear. This involves more than lipreading. Visible cues include the speaker's facial expression, body language, and the context and environment in which the communication is taking place. All of these factors provide meaning and help to make conversations easier to understand and enjoy.

Managing communication. The focus here is to help those with a hearing loss understand their hearing loss and develop skills to improve communication when listening becomes difficult. Some situations that pose a problem for people with hearing loss include understanding speech in background noise, when they cannot see the speaker’s face, or when the sound or speech is soft or distant. Audiologists and speech-language pathologists can help teach ways to improve communication in these difficult listening situations. Examples include:

Dealing with background noise outside the home. In a noisy restaurant, for example, request a table away from the kitchen and clattering dishes. Seat yourself directly in front of your dining companion. Choose quiet times to dine out, and choose restaurants with linen table cloths, carpeting, and drapery; these improve the room’s acoustics and decrease reverberation.

Handling conversation. By learning to take charge of your communication assertively (not aggressively!), you can become a more effective communicator. There are many ways to be assertive. You can ask people to get your attention before speaking to you, suggest that they face you, and ask them not to shout. Another way to be assertive is to learn to use strategies for handling communication breakdowns. You must know when to ask for a “rephrase” instead of a “repeat,” know how to apply a clarification strategy, and learn how to ask questions.

Hearing assistive devices. A hearing aid won't wake you up when you are sleeping. A hearing aid may not help you in a theater or when you are far away from the sound source. But there are many other devices that can help, such as TV listening devices, personal FM systems to use in lectures, conference microphones, and telephone amplifiers. You can become acquainted with these devices and see how they can improve your social, family, and work life.

Rearranging your home. Now that you've learned more about your hearing loss, you may want to rearrange your furniture at home to promote easier conversation (and that full-face view mentioned above). You might wish to change lighting so you can better see your conversation partner's face. Perhaps carpeting can be strategically placed to absorb noise. Also, consider using alerting devices that can help to identify when the doorbell rings.

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