Maximizing Cochlear Implant Outcomes with Short-Term Aural Rehabilitation.

BACKGROUND: Increasing numbers of adults are receiving cochlear implants (CIs) and many achieve high levels of speech perception and improved quality of life. However, a proportion of implant recipients still struggle due to limited speech recognition and/or greater communication demands in their daily lives. For these individuals a program of aural rehabilitation (AR) has the potential to improve outcomes. PURPOSE: The study investigated the effects of a short-term AR intervention on speech recognition, functional communication, and psychosocial outcomes in post lingually deafened adult CI users. RESEARCH DESIGN: The experimental design was a multisite clinical study with participants randomized to either an AR treatment or active control group. Each group completed 6 weekly 90-minute individual treatment sessions. Assessments were completed pretreatment, 1 week and 2 months post-treatment. STUDY SAMPLE: Twenty-five post lingually deafened adult CI recipients participated. AR group: mean age 66.2 (48-80); nine females, four males; months postactivation 7.7 (3-16); mean years severe to profound deafness 18.4 (2-40). Active control group: mean age 62.8 (47-85); eight females, four males; months postactivation 7.0 (3-13); mean years severe to profound deafness 18.8 (1-55). INTERVENTION: The AR protocol consisted of auditory training (words, sentences, speech tracking), and psychosocial counseling (informational and communication strategies). Active control group participants engaged in cognitive stimulation activities (e.g., crosswords, sudoku, etc.). DATA COLLECTION AND ANALYSIS: Repeated measures ANOVA or analysis of variance, MANOVA or multivariate analysis of variance, and planned contrasts were used to compare group performance on the following measures: CasperSent; Hearing Handicap Inventory; Nijmegen Cochlear Implant Questionnaire; Client Oriented Scale of Improvement; Glasgow Benefit Inventory. RESULTS: The AR group showed statistically significant improvements on speech recognition performance, psychosocial function, and communication goals with no significant improvement seen in the control group. The two groups were statistically equivalent on all outcome measures at preassessment. The robust improvements for the AR group were maintained at 2 months post-treatment. CONCLUSION: Results of this clinical study provide evidence that a short-term AR intervention protocol can maximize outcomes for adult post lingually deafened CI users. The impact of this brief multidimensional AR intervention to extend CI benefit is compelling, and may serve as a template for best practices with adult CI users.

A peer mentor training program for aural rehabilitation.

This article describes a new training program at Gallaudet University that aims to prepare peer mentors to work under the supervision of hearing-health professionals in the area of aural rehabilitation (AR). The paucity of AR programs for consumers with hearing loss in the United States has been documented. The peer mentor training program is an attempt to harness the energies, skills, and knowledge of people with hearing loss; to expand them through a program of academic and experiential learning; and to put them to work in audiologic practices and other hearing-health care settings in order to improve the quality and quantity of AR available to consumers. A peer mentor training curriculum is described, and the current status of the educational program is reported. Initial anecdotal evidence suggests that the program has the potential to contribute to the development of a more comprehensive model of AR service delivery.