A Simple but Effective Method for Maximizing LACE Compliance

Hearing & Balance Lab, P.C. Everett, WashingtonA Simple but Effective Method for Maximizing LACE Compliance
By Nichole Kingham, AuD
Hearing & Balance Lab, P.C. Everett, Washington

Shortly after the AAA conference in Charlotte last April, having attended a presentation by Dr. Robert Sweetow we decided to integrate LACE auditory training into our hearing aid dispensing practice. Our only concern was patient compliance. It was clear that LACE works, in that it significantly improves a patient’s communication abilities. But how to maximize the likelihood that the patient would actually carry out their LACE training at home?


We devised the below “Commitment Form” to make it explicit to the patient what we expect them to do. We were somewhat surprised but nevertheless delighted to discover that this one-page form is amazingly powerful: by simply filling out the dates by which the patient is supposed to have completed various stages of LACE training, it tells the patient that we mean business and that they need to do their homework.

Here are the results as of 10 October of giving the patient this commitment form on the day of hearing aid fitting:

  • 70 copies of LACE dispensed
  • 60 patients (86%) have done all or part of the 20 LACE sessions at home: 35 patients (50%) have finished all 20 sessions, and 11 of the other 25 were still actively doing LACE as of early October.
  • Only 10 patients (14%) did not do any LACE sessions at all.

And this was with LACE Version 3, which means the patient had to do everything at home, including Session 1. We are confident that LACE 4, providing the ability to take the patient through Session 1 of LACE in the clinic before sending them home to continue their training, will only increase this already high compliance.

The other factor that increases compliance is that we have registered the patient on Neurotone Pro before sending them home with their LACE disc. Consequently, there’s a welcoming e-mail waiting for them when they get home, encouraging them to get started.

Here’s our commitment form: [Commitment Form – PDF format]

What else do we like about LACE, now that we have it fully integrated into our practice and have 86% patient compliance?

  • It takes the pressure off the hearing aid dispenser to completely solve the patient’s hearing loss on his or her own. With LACE, the patient willingly accepts responsibility for a significant share of the solution. We believe LACE represents 40% of the overall solution to a patient’s hearing loss. LACE transforms the patient from passive to active, and gives them control over this major portion of the solution.
  • LACE significantly increases the benefit/cost ratio for the patient. If aural rehab is indeed 40% of the solution, then given LACE’s cost of $50 to the practitioner, its impact on the benefit/cost ratio is enormous.
  • We especially like the DVD version included in LACE 4, even though so far only a few of our patients have used it. It runs slower than the computer version, but this more leisurely pace seems to suit a lot of our older patients.

Here’s hoping that some version of our commitment form can be adapted to other practices and help other hearing healthcare providers maximize their patient compliance with LACE.

Neurotone congratulates Nichole Kingham and the Hearing & Balance Lab for the development of this simple but extremely effective Commitment Form. With their permission, we have adapted their form and combined it with the protocol developed by Kathy Amos of Posey’s Hearing Aid Center to provide a simple, step-by-step procedure for implementing LACE 4 and maximizing patient compliance.

Here is the procedure: [Procedure Form – Word format]

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