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The Need for and Development of an Adaptive Listening and Communication Enhancement (LACE™) Program

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Auditory training has long been advocated to enhance communication but has never been time or cost-effective. This article describes the concepts underlying the development of a home-based, interactive adaptive computer program designed to engage the adult hearing-impaired listener in the hearing-aid-fitting process, provide listening strategies, build confidence, and address cognitive changes characteristic of the aging process. An investigation using a between-group, within-subject design with pre- and post-test objective and subjective measures was conducted at five clinical sites. Sixty-five subjects were randomly placed into two groups, one receiving LACE™ (Listening and Communication Enhancement) immediately following baseline testing and one serving as a control for one month and then receiving training as a crossover group. Results showed statistically significant improvements for the trained subjects on all but one of the outcome measures. Barriers facing the widespread implementation of home-based aural rehabilitation are discussed.

Spanish
Se ha preconizado por largo tiempo que el entrenamiento auditivo mejora la comunicación, pero que nunca ha sido efectivo desde el punto de vista de tiempo o costo. Ese artículo describe los conceptos relacionados con el desarrollo de un programa hogareño de computadora, interactivo y adaptable diseñado para involucrar el adulto hipoacúsico en el proceso de adaptación de un auxiliar auditivo, aportarle estrategias para escuchar mejor, crear confianza, y manejar cambios cognitivos característicos del proceso de envejecimiento. Se condujo una investigación en cinco centros clínicos utilizando un diseño entre-grupos e intra-sujeto, y con medidas objetivas y subjetivas pre y post evaluación Se colocó a sesenta y cinco sujetos en dos grupos, uno recibiendo LACE™ (Mejoramiento Auditivo y Comunicativo) inmediatamente después de la evaluación basal y otro que sirvió como control durante un mes, para después recibir entrenamiento como grupo de cruzamiento. Los resultados mostraron mejorías estadísticamente significativas en los sujetos entrenados, en todas menos una de las medidas de resultado. Se discuten las barreras enfrentadas por la implementación cada vez más frecuente de rehabilitaciones aurales hogareñas.
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Keywords: ANALYTIC TRAINING; AUDITORY LEARNING; AURAL REHABILITATION; COGNITIVE CHANGES; COMPUTER ASSISTED THERAPY; INTERACTIVE COMMUNICATION STRATEGIES; LISTENER CONFIDENCE; NEURAL PLASTICITY; PERCEPTUAL LEARNING; REHABILITATION OF HEARING IMPAIRED; SPEED OF PROCESSING; SYNTHETIC TRAINING; WORKING MEMORY

Document Type: Research Article

Publication date: 01 September 2006

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