Clinical Effectiveness of an At-Home Auditory Training Program: A Randomized Controlled Trial

Objectives: To investigate the effectiveness of an at-home frequent-word auditory training procedure for use with older adults with impaired hearing wearing their own hearing aids. Design: Prospective, double-blind placebo-controlled randomized trial with three parallel branches: an intervention group who received the at-home auditory training; an active control group who listened to audiobooks using a similar platform at home (placebo intervention); and a passive control group who wore hearing aids and returned for outcomes, but received no intervention. Outcome measures were obtained after a 5-week period. A mixed research design was used with a between-subjects factor of group and a repeated-measures factor of time (pre- and post-treatment) to evaluate the effects of the at-home auditory training program. The intervention was completed in participants' own homes. Baseline and outcomes measures were assessed at a university research laboratory. The participants were adults, aged 54 to 80 years, with the mild-to-moderate hearing loss. Of the 51 identified eligible participants, 45 enrolled as a volunteer sample and 43 of these completed the study. Frequent-word auditory training regimen completed intervention at home over a period of 5 weeks. The active control group listened to audiobooks (placebo intervention) and the passive control group completed no intervention. The primary outcome measure is a Connected Speech test benefit. The secondary outcome measure is a 66-item self-report profile of hearing aid performance. Results: Participants who received the at-home training intervention demonstrated significant improvements on aided recognition for trained materials, but no generalization of these benefits to nontrained materials was seen. This was despite reasonably good compliance with the at-home training regimen and careful verification of hearing aid function throughout the trial. Based on follow-up post-trial evaluation, the benefits observed for trained materials in the intervention group were sustained for a period of at least 8.5 months. No improvement was seen for supplemental outcome measures of hearing aid satisfaction, hearing handicap, or tolerance of background noise while listening to speech. Conclusions: The at-home auditory training procedure utilizing frequently occurring words was effective for the trained materials used in the procedure. No generalization was seen to nontrained materials or to perceived benefit from hearing aids. ACKNOWLEDGMENT: The authors thank Christine Herring for coordinating the clinical trial and Charles Brandt for assisting with the tablet-based software development and cloud-based data transfer. This work was funded in part by the National Institute on Deafness and Communication Disorders R01 DC010135 awarded to L.E.H. and all authors received salary support from the university resulting from this grant. Portions of this article were presented at the International Hearing Aid Research Conference on August 11, 2016, Tahoe City, CA. L.E.H. designed the clinical trial with input from D.L.K, S.E.R, T.M.Q., and A.K.M., D.L.K., and S.E.R. implemented the home visits and performed baseline assessment. A.K.M., T.M.Q., and K.G.S. performed outcomes measures assessment. K.G.S. analyzed data and wrote the first draft of the article. L.E.H., D.L.K., and S.E.R. provided critical revision. The authors have no conflicts of interest to disclose. Trial registration: ClinicalTrials.gov Identifier: NCT01950013. Address for correspondence: Larry E. Humes, Department of Speech and Hearing Sciences, Indiana University, Bloomington, IN 47405, USA. E-mail: humes@indiana.edu Received March 9, 2018; accepted October 30, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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