Introduction
Aural rehabilitation involves techniques and programs for restoring or optimizing the deficits produced due to limitations of hearing loss. It involves measures for restoring a lost skill(hearing) in adults and is called adult aural rehabilitation. The hearing skill may not even be present in kids due to some diseased conditions. In such cases, the term habilitation is used and involves teaching the hearing skill in the first place. The main aim of aural rehabilitation is to improve the quality of life of the affected, as hearing plays a vital role in the active societal participation of the individual. Aural rehabilitation is also called hearing, audiology, rehabilitative audiology, and auditory rehabilitation.
What Is Child Aural Rehabilitation?
In children, the term aural habilitation is used rather than rehabilitation as it may not always be restoring a lost skill but teaching a skill(hearing) that is not at all present. In such cases, the speech and language development of the child is also affected. Early diagnosis and use of amplification devices positively affect language acquisition. Specific audiologic rehabilitation in children depends on several factors the present age of the child, the age of onset of hearing loss, the extent and severity of the condition, the age at which the child started using a hearing aid, and the age at which the disease was diagnosed. The child may use different communication modes like cued speech, and sign language coded English, or total communication, which also determines the habilitation services the child receives.
The habilitation services for children include the following:
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Auditory Perception Training:
An ear specialist carries out training in auditory perception. The training helps in improving the child's awareness of sounds. It enables the child to differentiate sounds, identify sounds and attach meaning to sounds. It also helps the child determine words based on the remaining hearing. Hearing aids and assistive learning devices are also used for developing hearing skills. The child also learns to handle difficult listening situations.
- Using Visual Hints:
Apart from differentiating sounds, the child is trained to collect information from visual cues like the facial expression of the speaker, the body language, and the context in which the speech takes place.
- Speech Improvement:
Speech improvement involves creating speech sound, speaking rate, quality of voice, breath control, speech pattern, and loudness.
- Language Development:
Language Development involves word knowledge, concepts, grammar, narrative skills, writing skills, and use in different situations. It requires language understanding and language usage.
- Communication Management:
Managing communication firstly involves the children's benign awareness of their condition. Overall it involves methods to make communication easier for the child.
- Hearing Aids and Assistive Devices:
Hearing Aids and Assistive Devices are fitted to children early, and the caregiver makes care and adjustments. Children are encouraged to participate in hearing aid care and management so that they take responsibility as they grow up.
What Is Adult Aural Rehabilitation?
Adult aural rehabilitation involves a holistic approach that involves sensory management, training, instructions, and counseling. The goal of which is to reduce the deficits caused as a result of hearing loss. Hearing loss can significantly affect one's quality of life by causing functional impairment and influencing active participation. A positive relationship should be established between the healthcare provider(audiologist, the patient, and the patient's significant other(communication partner). The rehabilitation measures undertaken are specific, primarily considering the individual's biological and social needs.
What Are the Components of Adult Aural Rehabilitation?
Aural rehabilitation has four components which include the following:
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Sensory management to enhance auditory function
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Formal instructions in hearing aid and assistive devices to improve positive outcomes of sensory management.
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Perceptual training.
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Informational and professional counseling.
The components of aural rehabilitation are explained as follows:
A) Sensory Management: Hearing aids and cochlear implants enhance auditory function and the ability to perceive others' speech. However, it does not restore normal function.
B) Assistive Listening Devices (ALDs) are used alone or with bone-anchored or cochlear implants, making the sound more accessible to the patient.
C) Hearing Assistive Technologies Systems (HATS) include devices that improve audibility in specific listening situations. Examples of HATS include the following:
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A telephone amplifier amplifies the speech made through the phone.
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A text telephone helps send and receive typed messages.
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A voice carries over the telephone.
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An induction loop system converts sound waves into magnetic forces, which are converted back to sound using cochlear implants.
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A personal amplification system amplifies sound Example: a remote microphone, digital applications, etc.
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An alerting device that produces a signal alerting that a sound has occurred eg clock alarm watch alarm, baby monitor, etc.
D) Instructions: Formal instructions after sensory management enhance function and activity as it makes the patient knowledgeable and an appropriate hearing device user. The patient should know how to use the device appropriately and about the associated inconveniences.
E) Perceptual Training: Perceptual Training focuses on the enhancement of perceptual skills like the improvement of formal speech perceptual tests.
F) Counseling: Counseling is provided to the patients and their families during the diagnostic, treatment, and management period. Counseling offers the individual clear, understandable, and health-literate information. The topics covered in counseling include the following:
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The type of hearing loss and its impact on speech and quality of life.
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Practical coping skills to minimize the effects of hearing loss.
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Self-management measures.
Which Are the Areas Addressed in Aural Rehabilitation?
The areas addressed in aural rehabilitation include the following:
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Auditory Training: Patients who have cochlear implants or other hearing aids benefit from auditory training. Post-cochlear implant training helps in improving listening skills with the implants. Those without hearing aid but who want to improve their listening skills can also undergo auditory training.
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Lip Reading: Analytical training helps in recognizing sound based on mouth shape. Synthetic training helps in understanding speech through speech training. It enables the person to process more information visually.
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Communication Training: Communication training aims at making effective communication and repairing communication breaks.
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Language Training: Language training includes training on vocabulary, idioms, and figurative language. It also provides training on improving written language and sentence structure.
Conclusion
Hearing loss can produce many limitations and significantly affect one's quality of life. Hearing loss in children, if addressed early, use of amplification devices and habilitation services can help optimize the limitations produced due to hearing loss. In adults, aural rehabilitation involves sensory management, training, and counseling.
