Using Lace to debunk three common misconceptions in aural rehabilitation
All clinicians want the best for their patients, but oftentimes they accept suboptimal outcomes because they make three assumptions. All three of these myths are busted when Lace becomes a routine part of the services you offer all patients.
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Let’s cut to the chase: all clinicians want the best for their patients, but oftentimes they accept suboptimal outcomes because they make three assumptions. All three of these myths are busted when Lace becomes a routine part of the services you offer all patients.
1. Older patients can’t improve their listening ability.
Although it’s true that older adults tend to have more difficulty hearing in background noise, most adults can become more effective listeners with a single therapeutic dose of Lace training. Research confirms that the central auditory nervous system retains plasticity into older adulthood (Anderson & Kraus, 2013; Fisher et al, 2025), as auditory-cognitive training improves the neural encoding of speech signals in noise.
Lace auditory training leverages this to improve listening skills in those who actively engage in the training exercises. Studies using Lace have demonstrated statistically significant improvements in speech understanding in noise, auditory working memory, and processing speed among older adults – all essential components of listening ability.
2. Hearing aids should do all the work.
This myth stems from a failure to recognize that hearing and listening are two distinctly different tasks. Clinicians who prescribe hearing aids without integrating auditory training into their standard protocol are essentially validating this myth. While hearing aids restore audibility of sounds, they often fall short of expectations when addressing the challenges associated with understanding speech in adverse listening situations.
Hearing aids primarily enhance audibility but do not compensate for age-related central processing changes or normal cognitive decline. Recent research shows that when hearing loss is corrected with amplification, cognitive abilities related to listening can be improved through auditory training (Mattys et al 2016).
Holistic care requires targeting both the ears and the brain; pairing auditory training with hearing aids from the very beginning of the patient journey leads to greater self-confidence and better long-term functional outcomes.
3. Auditory training is not supported by clinical evidence.
The efficacy of auditory training is backed by a scientific consensus demonstrating real neuroplastic and functional brain changes (Henshaw, et al 2025). Systematic reviews and meta-analyses have shown that these programs improve auditory skills and cognitive abilities across various populations, including hearing aid and cochlear implant users (Lawrence, et al 2018; Fallahnezhad, et al 2023p Lerigo-Smith, 2026). Therefore, no one should be surprised that all the major professional organizations (ASHA, AAA, IHS, ADA) state in their practice guidelines that aural rehabilitation is part of their standard of care.
Here’s a bonus that solidifies the argument: electrophysiological tests provide objective evidence that auditory training enhances the robustness of subcortical speech representation, making it more resistant to the degradative effects of background noise (Anderson & Kraus, 2013).
The evidence is clear
These three common myths simply do not hold up against scientific scrutiny. By moving beyond the limitations of hearing aids alone and embracing the brain's natural plasticity, clinicians can significantly enhance patient outcomes.
Auditory training is already a standard of care; now is the time to make sure every patient in your practice has the tools to become a more effective, confident listener.
References
Anderson, S., & Kraus, N. (2013). Auditory training: Evidence for neural plasticity in older adults. Perspectives on Hearing and Hearing Disorders: Research and Diagnostics, 17(1), 37-57.
Fallahnezhad, T., Pourbakht, A., & Toufan, R. (2023). The Effect of Computer-Based Auditory Training on Speech-in-Noise Perception in Adults: A Systematic Review and Meta-Analysis. Indian journal of otolaryngology and head and neck surgery: official publication of the Association of Otolaryngologists of India, 75(4), 4198–4211. https://doi.org/10.1007/s12070-023-03920-0
Fisher, C., Karunathilake, I. M. D., Johns, M. A., Vance, A., Kuchinsky, S. E., Anderson, S., & Simon, J. Z. (2025). Neural and Behavioral Changes in Older Adults from Auditory-Cognitive Training. bioRxiv: the preprint server for biology, 2025.04.01.646593. https://doi.org/10.1101/2025.04.01.646593
Henshaw, H., et al (2025) Translating auditory training evidence into practice: are we nearly there yet? Seminars in Hearing. 46(02): 071-074
Lawrence B., et al (2018) Auditory and cognitive training for cognition in adults with hearing loss: a systematic review and meta-analysis. Trends in Hearing 22: 2331216518792096
Lerigo-Smith N, et al (2026) Auditory training for adults with hearing loss: a systematic review and meta-analysis. PLoS One. (in-press).
Mattys, S. L., O'Leary, R. M., McGarrigle, R. A., & Wingfield, A. (2026). Reconceptualizing cognitive listening. Trends in Cognitive Sciences, 30(5), 409–421. https://doi.org/10.1016/j.tics.2025.09.014