Overview of Current Approaches to Aural Rehabilitation for Adults With Cochlear Implants

Abstract

Purpose This clinical focus article provides an overview of clinical models currently being used for the provision of comprehensive aural rehabilitation (AR) for adults with cochlear implants (CIs) in the Unites States. Method Clinical AR models utilized by hearing health care providers from nine clinics across the United States were discussed with regard to interprofessional AR practice patterns in the adult CI population. The clinical models were presented in the context of existing knowledge and gaps in the literature. Future directions were proposed for optimizing the provision of AR for the adult CI patient population. Findings/Conclusions There is a general agreement that AR is an integral part of hearing health care for adults with CIs. While the provision of AR is feasible in different clinical practice settings, service delivery models are variable across hearing health care professionals and settings. AR may include interprofessional collaboration among surgeons, audiologists, and speech-language pathologists with varying roles based on the characteristics of a particular setting. Despite various existing barriers, the clinical practice patterns identified here provide a starting point toward a more standard approach to comprehensive AR for adults with CIs.

Designing and Implementing a Comprehensive Telehealth Aural Rehabilitation Program for Adult Cochlear Implant Recipients

“…Existing evidence supports the benefits of AR on the auditory experience for adult CI recipients (e.g., Cohen et al, 2004;Dubno, 2013;Hawkins, 2005;Hawthorne et al, 2004;Olson, 2015), and several sources provide insights on best practices for AR (e.g., Ferguson et al, 2019;Glade et al, 2020;Sweetow & Palmer, 2005). However, few peer-reviewed articles describe the process of creating and implementing an audiologist-led teleaudiology AR program for adult CI recipients.…”

“…While the four pillars of a comprehensive AR program are well described (i.e., Boothroyd, 2007;Ferguson et al, 2019;Sweetow & Palmer, 2005), it is up to AR providers to select appropriate tools and format for their program. Glade et al (2020) conducted a focus group of comprehensive AR providers for adult CI recipients at nine clinical sites across the United States. Findings revealed that while all sites employed the four pillars of an effective AR program (sensory management, instruction, counseling, and perceptual training), they employed a variety of service delivery models.…”

“…Additional education and counseling points were employed based on patients' specific needs. Glade et al (2020) provide a comprehensive list of educational and counseling topics in their review of clinical AR programs in the United States.…”

“…Auditory training sessions have traditionally been provided face-to-face and revolve around building a range of auditory skills using various stimuli-phonemes, syllables, words, phrases, sentences, and passages (Erber & Hirsh, 1978;Glade et al, 2020). Analytic (bottom-up) training refers to having listeners identify speech sounds, often void of contextual cues.…”

“…Noted barriers of current AR models include: physical access to clinical sites (particularly for patients in rural areas), inadequate communication between providers (audiologists, speech-language pathologists (SLPs), and otolaryngologists), and lack of trained professionals (Glade et al, 2020). Neither of these three barriers prevented clinicians from developing and implementing a comprehensive AR program at the USA Speech and Hearing Center.…”