Living with hearing aids

What is aural rehabilitation with hearing aids?

Last update on Mar, 17, 2025

Most hearing loss comes on gradually. It can be so subtle you may not even recognize the signs, like fatigue, mental strain or increased difficulty following conversations in noisy environments. Over time, as your brain works harder to fill in the blanks left by hearing loss, these seemingly small challenges can add up and lead to frustration, mental strain, social isolation and even cognitive decline.

Aural rehabilitation can be a powerful tool in helping your brain re-learn how to process, interpret and prioritize sounds effectively. When used in combination with hearing aids, it enhances not only your ability to hear but also your ability to understand speech, filter out background noise and adapt to different listening environments more comfortably.

Dr. Thomas Tedeschi, Au.D.

Chief Audiology Officer, Miracle-Ear

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Key takeaways

Aural rehabilitation helps retrain the brain. It improves speech understanding, reduces listening fatigue and enhances communication skills.
Hearing aids work best with aural rehabilitation. Combining hearing aids with auditory training and communication strategies maximizes benefits.
Auditory training, speech-reading and assistive listening devices like hearing aids help people adapt to various listening environments.
Hearing care professionals, along with audiologists and speech-language pathologists, provide guidance and support for aural rehabilitation.
Aural rehabilitation improves hearing aid performance. Training your brain to process sounds helps you adjust to hearing aids faster.

What is aural rehabilitation?

According to the American Academy of Audiology, “Aural rehabilitation uses strategies to improve communication of people with hearing loss.” ^[1]

Aural rehabilitation is a comprehensive program that includes auditory training and speech-reading methods with the ultimate goal of improving communication, reducing listening fatigue and enhancing the overall quality of life for people with hearing loss.

Components and foundations of aural rehabilitation

The foundations of aural rehabilitation and audiology as a profession expanded significantly during World War II,^[2]driven by the need to rehabilitate soldiers and sailors returning home with hearing loss.^[3]

In 1998, Dr. Nancy Tye-Murray emerged as a prominent voice in the discipline with her book, “Foundations of Aural Rehabilitation: Children, Adults, and Their Family Members.” Now in its sixth edition, the Tye-Murray foundations of aural rehabilitation method is considered a cornerstone in the field, providing a comprehensive, evidence-based approach to auditory training, speech-reading and counseling for individuals with hearing loss.^[4]

Modern components of aural rehabilitation can include auditory training, speech-reading techniques, counseling and assistive listening devices, including hearing aids, all designed to improve communication and quality of life for adults and children with hearing loss.

Aural rehabilitation with hearing aids

The first step in the process, after you’ve recognized the signs of hearing loss, is to seek out an evaluation from a hearing care professional (HCP). You may ask, when is the best time to use hearing aids? An audiologist or HCP can offer answers based on your unique hearing profile.

While aural rehabilitation includes more than hearing aids alone, they are a crucial component to the success of many aural rehabilitation programs.^[5]

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Types of aural rehabilitation

What are the goals of aural rehabilitation programs? Simply, the goal of any aural rehab program is to help those with hearing loss to hear, understand and communicate better in order to improve their quality of life.^[6]

Audiologists and patients work together to do this using a number of methods, technologies and strategies.

Communication strategies can be helpful in managing hearing loss as a chronic condition. Your audiologist or HCP can give you communication strategies, including^[7]:

Making direct requests of speakers when you don’t understand. Instead of a generic “huh?” ask the speaker to slow down or speak louder.
Reducing background noise when you can. Turn down music and the TV, or choose a quieter restaurant when dining out.
Facing the person you’re speaking with. Ask conversation partners to do the same.
Involving conversation partners in your efforts to hear and understand. Share strategies for speaking clearly and let them know you are making an effort to hear and understand.

Learn more about communication strategies for hearing loss here.

Some people benefit from specific exercises to aid in hearing rehabilitation. Auditory therapy involves real-world listening exercises that help participants understand and process sounds better. Exercises can include:

Structured listening activities, such as practicing conversations in different environments, to help retrain the brain.
- Example: The listener and a partner sit together. The partner reads two words from a list that are similar but have different vowel lengths (like “sleek” and “slick”), and repeats one of the words. The listener has to identify which word the partner repeated.

Training on how to improve communication in listening environments you are in often.
- Example: Learning how to cope with a communication breakdown. When a speaker and listener are having trouble, quickly coming up with a way to work through the breakdown, rather than giving up in frustration, becomes important. Asking questions like “Could you repeat the last part of that sentence?” or “Did you say [X]? I couldn’t understand” gives the speaker specific context about what the listener missed. That can help them adapt and modify what they are saying or the way they are saying it.

Aural rehabilitation speech therapy can include strategies to help people process and visualize speech more clearly, such as^[8]:

Analytic training focused on recognizing speech sounds based on how the mouth moves, like identifying similar-looking sounds.
Synthetic training to help understand whole words and sentences by combining speech reading with context and meaning.

Aural rehabilitation activities and goals for adults

Adult aural rehabilitation starts with an assessment of a person’s unique goals and goes on to focus on improving communication skills, reducing listening fatigue and enhancing overall quality of life. Common goals within aural rehabilitation for adults include understanding speech more clearly (especially in noisy environments), improving confidence in conversations and reducing reliance on visual cues such as lip-reading.

To reach these goals, practitioners and patients work together on aural rehabilitation speech therapy activities, communication training, auditory training and even counseling.

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Who provides aural rehabilitation with hearing aids?

Aural rehabilitation is typically provided by trained professionals such as audiologists or speech-language pathologists (SLPs). Other providers, like otolaryngologists (ear, nose and throat doctors) and psychologists, may also be involved in offering aural rehabilitation.

Hearing aid wearers should start with their HCP, who can help you find the correct professional for your needs. You can also consult the American Speech-Language-Hearing Association (ASHA) for resources and support for aural rehabilitation.

Looking for support for aural rehabilitation?

If you’re exploring hearing aid options to maximize the benefits of aural rehabilitation strategies, visit a Miracle-Ear hearing aid center to speak with a hearing expert. We can help you find the devices that match your needs. Schedule an appointment at a location near you to get started.

Aural Rehabilitation as part of Miracle-Ear aftercare

Aural rehabilitation is part of Miracle-Ear’s complimentary lifetime aftercare, ensuring you get the most out of your hearing aids. Your HCP at Miracle-Ear can support you with personalized aural rehabilitation plans and make recommendations in the following areas:

Counseling and expectations. HCPs can offer guidance on adjusting to hearing aids, managing background noise and setting realistic expectations about how your brain and ears will adjust to ongoing hearing aid use.
Custom fit and adjustments. Your HCP can fine-tune your hearing aids based on your feedback and real-world use, ensuring your hearing aids are providing the appropriate amplification for your hearing loss and the listening environments you find yourself in regularly.
Listening and communication training. Together, you and your HCP can work on exercises to help retrain your brain and improve conversations in different listening situations.
Family involvement. Your HCP can share tips for partners and loved ones to help with aural rehabilitation and improved communication.
Bluetooth and device support. An HCP can offer guidance and help with pairing hearing aids to phones, TVs and other devices to maximize usability.
Follow-up care. With regular check-ins, your HCP can address any concerns you might have, adjust settings and help you adjust comfortably.

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Sources

^{^[1]} American Academy of Audiology. "Aural Rehabilitation for Adults." American Academy of Audiology, https://www.audiology.org/consumers-and-patients/managing-hearing-loss/aural-rehabilitation-for-adults/. Accessed 9 Feb. 2025.

^{^[2]} Lessons from the Past: Two Influential Articles on the Early History of Audiology." The Hearing Review, 14 May 2015, https://hearingreview.com/hearing-loss/hearing-loss-prevention/industrial-military/lessons-past-two-influential-articles-early-history-audiology. Accessed 9 Feb. 2025.

^{^[3]} Gase, Jacqueline. "Artifacts Recall the History of Military Hearing and Speech Health." National Museum of Health and Medicine, 2 May 2019, https://medicalmuseum.health.mil/micrograph/index.cfm/posts/2019/artifacts_military_hearing_speech_health. Accessed 9 Feb. 2025.

^{^[4]} Tye-Murray, Nancy. Foundations of Aural Rehabilitation: Children, Adults, and Their Family Members. 6th ed., Plural Publishing, 2022.

^{^[5]} American Academy of Audiology. "Aural Rehabilitation for Adults." American Academy of Audiology, https://www.audiology.org/consumers-and-patients/managing-hearing-loss/aural-rehabilitation-for-adults/. Accessed 9 Feb. 2025.

^{^[6]} Boothroyd, Arthur. "Adult Aural Rehabilitation: What Is It and Does It Work?" Trends in Amplification, vol. 11, no. 2, 2007, pp. 63–71. https://doi.org/10.1177/1084713807301073.

^{^[7]} American Academy of Audiology. "Aural Rehabilitation for Adults." American Academy of Audiology, https://www.audiology.org/consumers-and-patients/managing-hearing-loss/aural-rehabilitation-for-adults/. Accessed 12 Feb. 2025.

^{^[8]} Gallaudet University Hearing and Speech Center. "Aural Rehabilitation/Communication Therapy." Gallaudet University, n.d., https://gallaudet.edu/hearing-speech-center/speech-and-language/aural-rehabilitation-communication-therapy/. Accessed 12 Feb. 2025.