Audiobooks for Hearing Loss App as Auditory Training
Condition: Hearing Loss; Hearing Impaired Children; Hearing Impairment
MeSH terms: Hearing Loss; Deafness
Study type: Interventional

Summary: 
      The goal of the proposed project is to create an Audiobooks for Hearing Loss (HL) App - an
      audiobook App that has a wide array of user-selectable features designed to provide auditory
      training. The effects of the Audiobooks for Hearing Loss App as Auditory Training for those
      With CI and HA Users was measured with a 6-week trial of using the app and measuring changes
      in listener abilities and adherence to the program.
    

Detailed description: 
      Twenty percent or more Americans have a Hearing Loss (HL), a commonly used term that includes
      congenital deafness as well as aging-related hearing challenges, so severe that it may make
      communication difficult. Worldwide, this translates into 65 million people with English as a
      first language.

      Hearing aids (HAs) and cochlear implants (CI's) are not enough to remedy this. The types of
      enhancement these devices can perform is inherently limited due to the requirement that they
      need to perform their task in real time, since otherwise they would not be lip-synchronized,
      which is essential in face-to-face communication. For example, they cannot change the
      temporal structure of incoming speech, even if that may help intelligibility. But there is a
      deeper shortcoming. When individuals wait too long with obtaining these devices, synaptic and
      pathway re-organization takes place in the auditory cortex that needs to be addressed, and
      mere device usage may not be up to this task. Cochlear implants provide a special challenge:
      Individuals may initially have great difficulty deciphering the unfamiliar sensory input
      generated by these devices.

      There is a growing consensus that HL cannot be addressed with HAs or CIs alone: auditory
      training is also needed. While face-to-face auditory training is available, this intervention
      is generally not covered by insurance plans. Auditory training Apps have become available to
      fill this need in a cost-effective manner. Unfortunately, evidence for the efficacy of these
      products is weak; a recent large-scale randomized controlled trial found no effect on a wide
      range of outcome measures. A likely suspect for these results is that most aural rehab Apps
      are repetitive, even with gamification and rewards. A popular method used by individuals with
      HL to improve their listening skills is listening to audiobooks. Audiobooks have the strong
      advantage over many aural rehab Apps of being intrinsically motivating. However, existing
      audiobooks do not adequately accommodate individuals with more severe levels of HL unless
      they are fundamentally re-thought.

      The goal of the proposed project is to create an Audiobooks for Hearing Loss (HL) App - an
      audiobook App that has a wide array of user-selectable features designed to provide auditory
      training: Help individuals with recent Cochlear Implants/Hearing Aids through the difficult
      initial adjustment process, and help with transitioning at one's own pace toward the goal of
      understanding "habitual speech" (speech spoken without special effort to be intelligible).
      Even if not used for auditory training, this app would provide access to audiobooks where
      standard audiobooks fail. Thus, the App serves both auditory training and accessibility.
      Proposed features include enhanced ("clear") speech modes, visual support by simultaneous
      display of text and a talking face, and other features that can be enabled or disabled to
      serve the user's unique needs.
    

Intervention name(s): Audiobooks for hearing loss App
Intervention type(s): Other
Intervention description(s): Same as Arm 1
Intervention model: Single Group Assignment
Intervention model description: 40 subjects will participate in total, including children and adults with HL aided with either Hearing Aids or Cochlear Implants
Masking: None (Open Label)
Primary purpose: Health Services Research