Most people who live with the challenges of hearing loss are able to benefit from technology, such as a hearing aid, cochlear implant, or an assistive listening device of some sort. The degree to which that person benefits will vary. Their success depends on the severity of the loss and the length of time that person has gone untreated.
Aural rehabilitation (AR) encompasses a wide set of practices aimed at optimizing a person’s ability to participate in activities that have been limited as a result of hearing loss. AR provides an opportunity to further explore how hearing loss impacts a person’s ability to communicate. You and your audiologist can create a rehabilitation plan to meet your specific needs.
What does aural rehabilitation involve?
The first step is a comprehensive needs assessment. This helps identify specific situations that are valuable but at risk for being compromised by difficulty hearing. Most commonly this is in background noise, where maintaining attention and focus is harder. Listening fatigue can therefore set in quickly.
Once the needs assessment is complete, the patient and audiologist create a management plan together. Each plan is unique to the person, but would often contain one or several of the following:
- Behavioral strategies: learning how to ask speakers to modify their speech, creating a meditation or relaxation practice, asking others to face you when talking, getting one another’s attention before speaking, and writing down critical information.
- Technology: using an assistive listening device (ALD) for various situations and hearing needs.
- Prevention: discussing the use of hearing protection or creating a list of quieter restaurants for social gatherings.
- Restorative habits: agreeing to leave a noisy environment early in order to rest and recover.
- Online auditory training: programs designed to improve listening stamina and the ability to sustain attention in challenging situations. We believe the most accessible and cost-effective route is a well-designed online program. We have partnered with LACE AI, and we also review several other online auditory training apps worth considering.
In addition, peer support groups can be an invaluable tool. No matter how supportive loved ones can be, no one can fully appreciate all a person with hearing loss deals with daily. Talking to others can help you feel less alone. A worksite assessment can also help identify where and why communication breakdowns occur and how to address them.
Why aural rehabilitation matters more than ever
The benefits of aural rehabilitation are significant. Aural rehabilitation can reduce one’s perception of hearing difficulty, improve quality of life, and help a person become a more effective user of hearing technology and communication strategies. Research documents these benefits consistently, including a landmark finding by the 2024 Lancet Commission on Dementia identifying hearing loss as the single largest modifiable risk factor for dementia in midlife. Treating hearing loss and actively retraining the brain through programs like aural rehabilitation is one of the most meaningful steps a person can take for long-term brain health. We explore this research in depth in our blog Hearing Loss, Aural Rehabilitation, and Dementia: What the Research Shows.
A note on Medicare coverage
This is one of the most common questions we hear. Medicare does not cover aural rehabilitation services when provided by an audiologist. Under current Medicare rules, audiology services are classified as diagnostic only, meaning Medicare pays for hearing tests but not for treatment or rehabilitation provided by an audiologist.
However, aural rehabilitation may be covered by Medicare when provided by a speech-language pathologist (SLP), if services are deemed medically necessary and a physician approves the plan of care. We encourage every patient to check with their specific Medicare Advantage plan as well, since some Part C plans offer broader hearing benefits. Legislation is currently moving through Congress (the Medicare Audiology Access Improvement Act) that may change this in the future; we will keep our patients informed.
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As always, Happy Hearing, Karen and Kim
