Auditory Training Software Programs for Adults

Question

I'm looking for auditory training software programs designed for use with hearing-impaired adults (and less importantly children). Could you give me the names of companies that offer such programs?

Answer

If we focus only on computer-assisted auditory training programs for adults, there are five programs available clinically. All of them are designed to take advantage of the plasticity of the auditory system. Even though none of these computer based programs may be routinely used by most dispensing professionals, I know of at least one systematic evidence-based review published in a special issue of JAAA a few years ago concluding that adult auditory training is effective (Sweetow & Palmer, 2005). Additionally, there are several anecdotal reports and a couple of studies from non-refereed publications showing that the consistent use of an auditory training program can lower returns for credit.

Although lower returns for credit don't necessarily equate to improved patient satisfaction, all of us can agree that lower returns are a good thing. Considering the clinical evidence of effectiveness for auditory training and its underutilization in most practices, it's obvious that the majority of audiologists are overlooking the value of computer-based auditory training programs.

1. Computer-Assisted Speech Perception Testing and Training at the Sentence Level, or CASPERSent. CASPERSent is a multimedia program designed by Dr. Arthur Boothroyd. The primary training target is perceptual skill. The program consists of 60 sets of CUNY sentences representing 12 topics and 3 sentence types. Sentences are presented by lipreading only, hearing only and a combination of the two. Patients are required to hear and/or see a spoken sentence, repeat as much as possible, view the text, click on the words correctly identified, see/hear the sentence again, and move on to the next sentence. The CASPERSent can be self-administered or administered with the aid of another person. For more information, visit: www.rohan.sdsu.edu/~aboothro/files/CASPERSENT/CasperSent_preprint.pdf
   
   
2. Computer Assisted Tracking Simulation and Computer Assisted Speech Training (CATS). The CATS program, which was developed at the Central Institute for the Deaf in St. Louis and subsequently updated by Dr. Harry Levitt, allows the patient and another person to interact. It works the following way: the talker says a sentence or phrase, and the listener repeats verbatim the sentence or phrase. If the sentence is correct, the talker goes on to another sentence or phrase. If it is incorrect, the talker repeats some variation of the utterance until the listener correctly repeats it. The computer-based tracking program makes it easier to score the results of each session and monitor progress. I do know some clinicians that offer tracking exercises as part of a more comprehensive aural rehabilitation program for their hearing aid wearers.
   
   
3. Computer-Assisted Speech Training (CAST). Like the previous auditory training programs mentioned, CAST was originally designed for adults with cochlear implants, but, like the other two, it can be adapted for use with adult hearing aid wearers. CAST uses more than 1000 novel words spoken by four different talkers. The CAST program is adaptive in that the level of difficulty is automatically adjusted according to the patients performance. To learn more about CAST, visit www.tigerspeech.com/tst_cast.html
   
   
4. Listening & Communication Enhancement (LACE). In my opinion, the LACE program is the most user-friendly computer-based program for both patients and clinicians. Patients are required to complete a series of short exercises that are intended to boost their auditory memory and speed of processing. LACE can be completed on any home computer and results can be tabulated and shared with the clinician using the Internet. Recently, Neurotone, the creators of LACE, introduced a DVD version to make it even more accessible. LACE was originally designed to be completed at home by the patient, however, I do know that many clinics around the country are seeing increased patient compliance when at least some of the exercises are completed in the clinic. For more information, visit www.neurotone.com
   
   
5. Siemens recently introduced a computer-based auditory training program called eARena. This training program is similar to LACE in that the level of difficulty of the exercises is automatically adjusted based on the skill level of the patient. Speech in noise perception and auditory memory are two of the skills eARena is designed to enhance. Also included in the eARena software is a basic hearing aid orientation, which helps reinforce the individual orientation the audiologist provides each patient during the fitting appointment. Although the data is unpublished, Siemens has presented data at conferences indicating that eARena contributes to better real world outcomes. For more information, visit www.hearing-siemens.com

Historically, auditory training programs have been viewed by some as largely academic exercises that are conducted in a university clinic. With the evolution of computer technology and the Internet over the past decade or so, audiologists need to reconsider the use of computer-based auditory training. Although an array of questions remain unresolved (e.g. which program is most effective for different adult populations), there is evidence supporting the efficacy of computer-based auditory training programs. Given the relatively steady in-the drawer and return for credit rates plaguing our industry, it is imperative that audiologists embrace computer-based auditory training programs. Without a doubt, computer-based auditory training needs to be part of a more comprehensive aural rehabilitation program that we offer our patients.

References

Sweetow, R. & Palmer, C. (2005). Efficacy of individual auditory training in adults: A systematic review of the evidence. JAAA, 16(8), 494-504.

Brian Taylor, Au.D, is currently the Professional Development Manager for Unitron Hearing in Plymouth, MN. He is a regular Contributing Editor for AudiologyOnline on a variety of topics including evidence-based practice and amplification. Dr. Taylor has 17 years of clinical management and teaching experience in the field of Audiology.