Aural rehabilitation

Aural rehabilitation, also known as aural rehab or simply AR,refers to a method of assessing and managing hearing loss that focuses on the individual and the aspects of hearing loss most important to them. It combines the input of the person with hearing loss, their family, and medical professionals to develop a comprehensive plan for addressing the impact hearing loss has on communication and everyday life activities. The process can include the use of mechanical hearing aids. However, it also incorporates a wide range of other activities to help the person minimize the impact of hearing loss and live life as fully as possible.

Background

People can be born with hearing loss or acquire it later in life. Hearing loss can be complete or partial, with the person retaining some ability to hear. Symptoms of hearing loss include hearing voices and sounds as muffled, difficulty telling the difference between similar words and consonants, having a hard time understanding in crowds, needing to ask people to repeat themselves, and needing to turn up the volume on televisions. Loud noises from explosions, machinery, music, and other sources are a significant cause of acquired hearing impairment. These sounds cause damage to the nerve cells and small hairs in the ear that help transmit sounds to the brain for interpretation. Other causes of hearing impairment include illnesses and infections, tumors, abnormal bone growths, damage to the ear that ruptures the ear drum, and earwax buildup. Most forms of hearing loss cannot be reversed.

The impact on hearing of loud noises associated with weapons and war machinery was noted as early as the sixteenth century. While some soldiers began wearing earplugs as early as 1884, the mechanics behind hearing loss were not well understood and many soldiers did little to protect their hearing. Modern aural rehabilitation began as physicians treated returning World War II veterans whose hearing was affected by the sounds of battle.

Overview

As World War II veterans came home eager to resume their lives, physicians realized they needed help coping with the damage done to their hearing, which included chronic conditions such as tinnitus. Early hearing aids existed but were bulky and unattractive to wear. They also did not fully restore hearing. Physicians began looking at other ways to help patients with limited or no hearing adjust to living a fuller life.

The answer came in a combination of techniques that address the aspects of hearing loss that most impact each individual. This can include the use of a hearing aid or cochlear implant, which is a surgically implanted sound processor that bypasses the damaged areas causing hearing loss. However, an aural rehabilitation plan goes beyond the use of mechanical aids to include teaching the person communication strategies, relaxation and self-care techniques, and other means of coping with the challenges of hearing impairment, such as participation in support groups.

An aural rehabilitation plan begins with an assessment of the degree of hearing loss. This assessment will also include determining what aspects of hearing loss are most challenging and/or impact the person’s life the most. For example, one person might be most concerned about hearing a crying baby while another might be most interested in understanding instructions from their work supervisor. These situations will be analyzed for the specific challenges they present, such as the presence of background noise.

Following this assessment, the person and the hearing professional will determine ideal outcomes, set goals, and determine what methods will work best for overcoming the person’s specific hearing challenges. This process will usually involve family members and close friends who will be part of the plan’s implementation.

Hearing loss management plans for aural rehabilitation can include training the person in the use of devices to assist with communication, such as hearing aids, captioning devices for television, and wireless microphones to amplify the voices of teachers, clergy, coaches, or others. Training in the use of visual cues such as the position of a speaker’s lips (lip reading) and other visible signs that give clues to context of spoken words may also be incorporated. The plan could also include the addition of online auditory training programs that help a person improve their ability to use any remaining hearing through techniques such as focusing their attention and avoiding listening fatigue. Listening fatigue is a collection of symptoms such as tiredness, headaches, discomfort, and loss of focus that can occur in situations that require intensive and continuous attention to auditory information.

In addition, the aural rehab plan will often include other steps to help the person deal with hearing loss. This can include efforts to prevent or minimize challenges, such as identifying restaurants with quieter environments that make it easier for the person to engage in conversation. It can also emphasize methods of limiting stress, such as creating a plan in advance for leaving loud events that can be emotionally and physically draining. Breathing exercises and regular relaxation through meditation, exercise, and yoga to reduce overall stress might also be incorporated.

Peer support groups are often important elements of aural rehabilitation plans because they help reduce the sense of isolation people have when others cannot fully understand their situation. Group members also share information on techniques and devices that are helpful to people with hearing loss.

Aural rehabilitation plans have many benefits for people affected by hearing loss. In addition to improving the person’s ability to communicate with others, aural rehab plans help people to feel better about themselves and their hearing loss. The plans improve the overall sense of quality of life. They can also help people adjust to living with hearing loss, especially when it has come after life without a hearing impairment.

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