Listening and Communication Enhancement

Many people who experience hearing loss turn to hearing aids for help. Sometimes, hearing aids alone are not sufficient. Listening and Communication Enhancement (LACE) is an interactive computerized training program that's self-paced, individualized and can be completed at home. It improves listening and communication skills by involving patients in the hearing-aid fitting process, building confidence and providing effective listening strategies.

While hearing aids can help to detect sounds, they don't affect other important factors in the brain's ability to understand — listening, communication and comprehension. Enhanced listening skills lead to better comprehension and communication and vice versa.

Typically when patients receive a therapeutic device, such as an artificial limb, they undergo physical therapy to learn to adjust. The same is needed for hearing aids. If patients don't learn to use their brains to listen and "fill in the gaps," the benefits of hearing aids are minimized. LACE can develop skills to offset those limitations.

How does LACE work?

For four weeks, a user spends a half-hour, five days each week working with a computer program at home to help enhance listening skills. The user gets immediate feedback regarding correct comprehension and can monitor improvement.

LACE provides interactive and adaptive tasks that are divided into three main categories:

  • Cognitive skills
  • Communication strategies
  • Degraded speech.

For degraded speech exercises, speech is either time compressed to simulate rapid speech or presented with background babble noise or a single competing speaker. The difficulty level of the task is based on the accuracy of the person's response to the previous task. The patient listens to and identifies the signal, then sees the correct response on the screen. If he or she understands correctly, the next sentence will be a little more difficult, or if he or she was incorrect, the next sentence will be easier. For rapid speech, the ratio of time compression changes in a similar adaptive manner, minimizing boredom and frustration.

LACE also gives stimulating training exercises to enhance auditory memory and speed of processing, two elements of listening that are particularly important in noisy environments. Also, LACE presents interactive communication strategies.

In addition to the immediate feedback for each task, LACE provides the patient with a graph depicting daily progress and improvement from the start of the training. Furthermore, the results of the training are tracked and electronically transmitted to a secure Web site accessible by the audiologist so that the progress and any needed modifications in training can be implemented.

LACE objectives

  • Get patient involved
  • Make the patient recognize difference between hearing and listening
  • Build confidence
  • Provide communication strategies
  • Reduce unnecessary patient visits

LACE was created by Robert Sweetow, professor of otolaryngology and former director of audiology at UCSF Medical Center. Sweetow developed it with researchers Jennifer Henderson Sabes and Monica Miller of UCSF, and Gerry Kearby, Earl Levine and Rob Modeste at NeuroTone, Inc.