A Randomized Control Trial: Supplementing Hearing Aid Use with Listening and Communication Enhancement (LACE) Auditory Training

Abstract

Findings from this randomized controlled trial show that LACE training does not result in improved outcomes over standard-of-care hearing aid intervention alone. Potential benefits of AT may be different than those assessed by the performance and self-report measures utilized here. Individual differences not assessed in this study should be examined to evaluate whether AT with LACE has any benefits for particular individuals. Clinically, these findings suggest that audiologists may want to temper the expectations of their patients who embark on LACE training.

Audiomotor Perceptual Training Enhances Speech Intelligibility in Background Noise

“…In these cases, interpreting the basis for change before and after training is difficult, as subjects’ expectations for benefit and motivation to participate would also be expected to differ systematically between the treatment and control groups. Several recent studies have used an “active control” group, where subjects are assigned an activity during the training period [13,15]. Even active controls fall short of the mark because there is no explicit demonstration that the control group is matched for factors that are not directly relevant for driving speech processing improvements [42].…”

“…We focused on training older hearing aid users, a demographic that often struggles to follow conversations in noise and for whom neither hearing aids, nor currently available auditory training software offer reliable assistance [13,38]. Our training interface empowered subjects to control the frequency spectrum, envelope modulation rate, and level of dynamic sounds while closely monitoring errors between actual and predicted changes in sensory feedback.…”

“…Work in these disciplines have embraced the “curse of specificity” by training animal models and human subjects on various derivations of psychoacoustic tasks to gain deeper insight into the biological and psychological factors that constrain the transfer and consolidation of learning [3–10]. Given that learning specificity is effectively baked into these tasks, it should come as no surprise that well-designed randomized control trials using derivations of perceptual training tasks find minimal evidence for a transfer of learning to untrained speech materials in hearing impaired subjects [13,17]. In the visual training literature, clinically oriented rehabilitation studies are increasingly turning towards tasks that promote a desire to learn by allowing the subject to navigate engaging, multi-layered training challenges built from diverse underlying stimulus sets [11,19,22,23].…”

“…We tested whether training on this CL audiomotor task was associated with generalized benefits in auditory perception and whether these gains, once learned, remained in the absence of ongoing practice. We performed our training in hearing-impaired older adults because they are often the target of marketing efforts for brain training software and because neither existing training software nor their hearing aids offer reliable assistance with “real world” communication signals, such as understanding speech in a crowded room [13,38]. We carried out our study as a double-blind, randomized, placebo-controlled trial.…”

Investigating the Impact of Hearing Aid Use and Auditory Training on Cognition, Depressive Symptoms, and Social Interaction in Adults With Hearing Loss: Protocol for a Crossover Trial

“…The results of these studies have often demonstrated the efficacy of auditory training, despite the computerized method of auditory training perhaps resulting in lower compliance with training protocols [ 32 ]. In addition, Saunders et al [ 35 ] found that LACE training did not result in improved outcomes over a standard-care hearing aid intervention on its own. Furthermore, according to research studies [ 36 , 37 ], there are still a large number of outstanding questions on the benefits of auditory training, such as which aspects of auditory training protocols contribute to learning, how auditory training generalizes to benefits in everyday communication, how individual characteristics interact with training outcomes to identify candidacy for auditory training, and the identification of outcome measures that are appropriate and sufficiently sensitive.…”