Auditory Training and Adult Rehabilitation: A Critical Review of the Evidence

  •  Kit Bronus    
  •  Amr El Refaie    
  •  Helen Pryce    


Auditory Training (AT) describes a regimen of varied listening exercises designed to improve an individual’s
ability to perceive speech. The theory of AT is based on brain plasticity (the capacity of neurones in the central
auditory system to alter their structure and function) in response to auditory stimulation. The practice of
repeatedly listening to the speech sounds included in AT exercises is believed to drive the development of more
efficient neuronal pathways, thereby improving auditory processing and speech discrimination. This critical
review aims to assess whether auditory training can improve speech discrimination in adults with mild-moderate
SNHL. The majority of patients attending Audiology services are adults with presbyacusis and it is therefore
important to evaluate evidence of any treatment effect of AT in aural rehabilitation. Ideally this review would
seek to appraise evidence of neurophysiological effects of AT so as to verify whether it does induce change in
the CAS. However, due to the absence of such studies on this particular patient group, the outcome measure of
speech discrimination, as a behavioural indicator of treatment effect is used instead. A review of available
research was used to inform an argument for or against using AT in rehabilitative clinical practice. Six studies
were identified and although the preliminary evidence indicates an improvement gained from a range of AT
paradigms, the treatment effect size was modest and there remains a lack of large-sample RCTs. Future
investigation into the efficacy of AT needs to employ neurophysiological studies using auditory evoked
potentials in hearing-impaired adults in order to explore effects of AT on the CAS.

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