Publications by Year: 2016

OBJECTIVE: To examine the effectiveness of the Listening and Communication Enhancement (LACE) program as a supplement to standard-of-care hearing aid intervention in a Veteran population.

DESIGN: A multisite randomized controlled trial was conducted to compare outcomes following standard-of-care hearing aid intervention supplemented with (1) LACE training using the 10-session DVD format, (2) LACE training using the 20-session computer-based format, (3) placebo auditory training (AT) consisting of actively listening to 10 hr of digitized books on a computer, and (4) educational counseling-the control group. The study involved 3 VA sites and enrolled 279 veterans. Both new and experienced hearing aid users participated to determine if outcomes differed as a function of hearing aid user status. Data for five behavioral and two self-report measures were collected during three research visits: baseline, immediately following the intervention period, and at 6 months postintervention. The five behavioral measures were selected to determine whether the perceptual and cognitive skills targeted in LACE training generalized to untrained tasks that required similar underlying skills. The two self-report measures were completed to determine whether the training resulted in a lessening of activity limitations and participation restrictions. Outcomes were obtained from 263 participants immediately following the intervention period and from 243 participants 6 months postintervention. Analyses of covariance comparing performance on each outcome measure separately were conducted using intervention and hearing aid user status as between-subject factors, visit as a within-subject factor, and baseline performance as a covariate.

RESULTS: No statistically significant main effects or interactions were found for the use of LACE on any outcome measure.

CONCLUSIONS: Findings from this randomized controlled trial show that LACE training does not result in improved outcomes over standard-of-care hearing aid intervention alone. Potential benefits of AT may be different than those assessed by the performance and self-report measures utilized here. Individual differences not assessed in this study should be examined to evaluate whether AT with LACE has any benefits for particular individuals. Clinically, these findings suggest that audiologists may want to temper the expectations of their patients who embark on LACE training.

PURPOSE: The purpose of this study was to determine if patient characteristics or clinical variables could predict who benefits from individual auditory training.

METHOD: A retrospective series of analyses were performed using a data set from a large, multisite, randomized controlled clinical trial that compared the treatment effects of at-home auditory training programs in bilateral hearing aid users. The treatment arms were (a) use of the 20-day computerized Listening and Communication Enhancement program, (b) use of the 10-day digital versatile disc Listening and Communication Enhancement program, (c) use of a placebo "books-on-tape" training, and (d) educational counseling (active control). Multiple linear regression models using data from 263 participants were conducted to determine if patient and clinical variables predicted short-term improvement on word-recognition-in-noise abilities, self-reported hearing handicap, and self-reported hearing problems.

RESULTS: Baseline performance significantly predicted performance on each variable, explaining 11%-17% of the variance in improvement. The treatment arm failed to emerge as a significant predictor with other clinical variables explaining less than 9% of the variance.

CONCLUSION: These results suggest that hearing aid users who have poorer aided word-recognition-in-noise scores and greater residual activity limitations and participation restrictions will show the largest improvement in these areas.