Concurrent losses of hearing and vision function, or dual sensory loss, affect a large number of individuals of all ages and particularly older adults. Dual sensory loss may present at any age as a result of genetic defect, accident, injury, disease, or environmental insult; however, most persons develop this condition as a result of age-related disease processes that rarely result in total deafness or blindness. This condition has wide-ranging implications for physical and psychological functioning and quality of life. In this article, we review the prevalence and causes of dual impairment and its effects on functioning for both individuals affected and their families. We examine psychosocial coping and adaptation to this condition using biopsychosocial–spiritual and ecological models and discuss various strategies for coping and adaptation. The impact of larger societal forces on psychosocial adaptation is presented, followed by recommendations for how rehabilitation and other professionals can meet the challenge of dual sensory loss that awaits us with the aging of the population.

or to help with the psychosocial adaptation to hearing loss. 8,9 A survey of audiologists conducted in 1990 indicated that only 23% were providing communication training such as speech reading and auditory training: this was a decrease from 38% in 1980. A more recent survey of 275 American Speech Language Hearing Association (ASHA)-certified audiologists was conducted by Millington in 2001. 10 Although 92% of the respondents reported providing "general counseling" and 60% provided counseling that was described as "adjustment/support counseling," the nature of the counseling provided was not clear from the survey. Almost 92% of the respondents reported providing "general communication training"; however, only 23% of the sample said that they provided auditory training, and 12% reported providing speech-reading training.Carmen 11 recently described the results of an online survey of audiologists. Of 217 respondents, 85% reported dispensing hearing aids, but only 24% reported that they provided "AR classes." Sixty-five percent reported that they provided "therapeutic counseling," which was defined as "helping patients overcome the emotional influences caused by hearing loss." Another recent survey of audiologists 9 (110 respondents) about the frequency of provision of AR services revealed that although audiologists frequently provided information about assistive listening R oss's 1 definition of aural rehabilitation (AR) is "any device, procedure, information, interaction, or therapy which lessens the communicative and psychosocial consequences of a hearing loss." AR is available through most audiology clinics and other facilities where certified audiologists dispense hearing aids. Structured, formal AR programs have consistently been shown to be effective and beneficial for people with hearing loss, improving audio-visual speech recognition performance, psychosocial functioning, and reducing hearing aid returns [2][3][4][5][6][7] ; however, the scope of AR is often limited. The primary emphasis is usually on the use of technology and is predominantly informational, focusing on how a hearing aid works and troubleshooting simple problems with it. In most programs, far less support is provided for the development of communication skills and strategies 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...

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