Aural Rehab

Aural Rehabilitation can be defined as maximizing your residual communication abilities. This involves not only hearing improvement provided by hearing aids but also includes understanding how we hear, improved communication strategies, and setting realistic expectations about outcomes.

In the Musician’s and Hearing Loss section we reviewed the basic anatomy and physiology of human hearing. An important message is that we actually “hear” with our brain. We use our brains to process what we hear. Throughout our day we make assessments of the speech we hear and our sound environment. As long as what we hear continues to make sense to us we are fine and this is called top down processing. Problems arise when, due to a number of factors, we miss or misinterpret important bits and pieces of the conversation. To repair or get back into the conversation we use bottom up processing, looking for meaning and rebuilding our knowledge of the important parts of the conversation.

Background Noise is one of the most difficult obstacles to overcome when you have a hearing loss. In fact, even people with normal hearing are complaining about overall levels of noise in restaurants and other public places. Common high frequency hearing loss becomes very evident in background noise because the noise fills up the low frequency range where hearing is best, leaving the listener frustrated and confused. Obviously management of this noise can provide improved understanding.

Some tips to improve hearing in noise:

  • Move closer together while talking in noise
  • Face to face conversation helps
  • Mute T.V. commercials while talking
  • Roll up windows while talking in the car
  • Choosing quieter restaurants for intimate conversations
  • Select tables away from noise sources such as kitchen, front entrance, etc.

Communication Strategies are ways to improve how we interact with each other. Remember that communication is a two way street. During a conversation or other verbal exchange we alternately send and receive information. While reviewing the following suggestions think of how you and the important people in your life might apply them to your daily interactions.

  • Speak at a normal rate. Speaking fast increases the risk of missing important points and puts strain on the listener.
  • Speak clearly and at a normal level. Loud or exaggerated speech can be just as difficult to understand as soft speech.
  • If you are not understood try rephrasing rather than repeating the same word(s) over and over. Rephrasing gives a new opportunity to pick up on the missing information.
  • Talking while chewing, smoking, or eating makes it very difficult to read lips.
  • Good lighting and speaking face to face allows the best opportunity to read lips and pick up important visual cues from facial expressions.
  • Speaking from one room to another or one end of the house to the other stacks the cards against good communication.

Hearing Aid Technology has improved dramatically recently. Directional microphones are improving speech understanding and comfort in noisy environments. Multiple programs and automatic adjusting programs provide more opportunities to increase speech understanding. Telecoil technology is available for using traditional telephones. Wireless solutions for use with cell phones are now available. We are in the midst one of the most exciting eras in digital hearing aid technology.

That said we have to set realistic expectations for ourselves when it comes to aural rehabilitation. Better hearing is not a destination but a journey. Discover for yourself how far you can go. Be. Hear. Now.

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