The TFI should be useful in both clinical and research settings because of its responsiveness to treatment-related change, validity for scaling the overall severity of tinnitus, and comprehensive coverage of multiple domains of tinnitus severity.

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.

A systematic review of the literature was conducted addressing the following question, "Is there evidence of improvement in communication skills through individual auditory training in an adult hearing-impaired population?" Keywords and authors were used as search terms in eight major indexes, and seven textbooks were reviewed for related references. The level of evidence that was accepted included randomized controlled trials, nonrandomized controlled trials, cohort, and before/after designs with or without control groups. Two hundred thirteen articles were identified during the preliminary search with 171 of these eliminated by review of abstracts because they did not meet the search criteria. Forty-two manuscripts were reviewed, with six meeting the evidence and search criteria. The strengths and weaknesses of these studies are high-lighted, and the systematic review question is answered in light of these studies. In addition, elements critical to the future of auditory training research and clinical practice are offered.

The results suggest that use of acoustic stimuli, particularly fractal tones, delivered though hearing aids can provide amplification while allowing for relief for some tinnitus sufferers. It is important to recognize, however, that tinnitus management procedures need to be supplemented with appropriate counseling.

Only a small portion of audiologists (fewer than 10%) offer auditory training to patients with hearing impairment, even though auditory training appears to lower the rate of hearing aid returns for credit. Patients to whom auditory training programs are recommended often do not complete the training, however. Compliance for a cohort of home-based auditory therapy trainees was less than 30%. Activities to increase patient compliance to auditory training protocols are proposed.