Hearing Aids for Auditory Processing Disorder

Overseen By Melissa A Papesh, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Conductive hearing loss, Otologic problems, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

Duration: 6 months

142 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment for Auditory Processing Disorder?

Research shows that hearing aids have been increasingly beneficial for people with hearing impairments, and auditory training programs can improve listening skills in children with auditory processing disorder. Additionally, counseling and communication strategies in aural rehabilitation programs can help adults better use hearing aids and reduce their perception of hearing difficulties. ^{1 2 3 4 5}

Is it safe to use hearing aids for auditory processing disorder?

The research does not provide specific safety data for hearing aids used in auditory processing disorder, but hearing aids are generally considered safe for use in humans for various hearing conditions. ^{1 6 7 8 9}

How does the treatment of hearing aids and communication counseling differ from other treatments for auditory processing disorder?

This treatment is unique because it combines hearing aids, which amplify sound to help with hearing, with communication counseling, which provides strategies to improve understanding and communication skills. Unlike other treatments that may focus solely on diagnosis or auditory training, this approach addresses both the physical and cognitive aspects of auditory processing disorder. ^{4 10 11 12 13}

What is the purpose of this trial?

Every year, approximately 100,000 Veterans seek help at VA Audiology clinics for hearing and communication difficulties only to learn that they have normal hearing sensitivity. Unfortunately, there are very few established options to improve hearing and listening for these patients. To address this need, audiologists are increasingly prescribing hearing aids set to provide a small amount of amplification. Patients may benefit from the amplification or from modern hearing aid features such as noise reduction technology and the ability to stream sounds from a desired sound source directly to their ears thus reducing the background noise. This project will help to determine if prescribing hearing aids to patients without hearing loss is, in fact, beneficial and if so, why. It will also help to determine if some patients benefit more from hearing aids than others so that in the future, rehabilitation strategies can be better targeted toward individuals.

Research Team

Melissa A Papesh, PhD

Principal Investigator

VA Portland Health Care System, Portland, OR

Eligibility Criteria

This trial is for Veterans with normal hearing sensitivity who still experience communication difficulties. They must be eligible for VA Healthcare, able to visit the VA Portland Medical Center often, and have a moderate to significant perceived hearing handicap but no major ear problems or severe hearing loss.

Inclusion Criteria

I can travel to VA Portland Medical Center for multiple visits.

You can hear sounds at certain frequencies without any problems.

Veteran eligible for VA Healthcare

Exclusion Criteria

I have hearing loss or ear problems.

English is not my first language.

I cannot do the tasks required in the study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Baseline Assessment

Participants undergo assessments of peripheral and central auditory system function, cognitive and psychological status, and medical chart review

1-2 weeks

1 visit (in-person)

Treatment

Participants are randomized into one of three intervention arms: SOC, SOC + hearing aids, or SOC + hearing aids with remote microphone

6 months

Multiple visits (in-person and virtual)

Follow-up

Participants are monitored for changes in hearing handicap and other outcomes at 2 and 6 months post-intervention

4 weeks

2 visits (in-person)

Treatment Details

Interventions

• Communication Counseling
• Hearing Aids
• Remote Microphones

Trial Overview The study tests if using hearing aids can help veterans without hearing loss by providing slight amplification or features like noise reduction and sound streaming. It also includes communication counseling and remote microphones to see which methods are most beneficial.

Participant Groups

Group I: Hearing Aids with Remote Microphones Experimental Treatment 3 Interventions

Individuals randomized to this group will receive communication counseling as well as hearing aids set to provide a low level of amplification and remote microphones that can be used in some situations to improve the signal-to-noise ratio.

Group II: Hearing Aids Experimental Treatment 2 Interventions

Individuals randomized to this group will receive communication counseling as well as hearing aids set to provide a low level of amplification.

Group III: Communication Counseling Active Control 1 Intervention

Individuals randomized to this group will receive information on how to improve their ability to hear and communicate including tips on environmental modification and communication repair strategies.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

Recent advancements in the design and functionality of wearable hearing aids have significantly increased their effectiveness, allowing more people with hearing impairments to benefit from them.

Current guidelines for recommending hearing aids are outdated; now, individuals with any level of permanent hearing loss should be considered for aural rehabilitation and the use of hearing aids, regardless of their previous prognosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The successful hearing aid user. Sanders, JW.[2000]

A 12-week computer-based auditory training program significantly improved speech-in-noise perception and functional listening skills in children with auditory processing disorder (APD), with effect sizes ranging from 0.76 to 1.7.

The improvements in speech-in-noise performance were maintained for at least 3 months after the training, indicating the long-term efficacy of the intervention in enhancing auditory processing skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Auditory Training Effects on the Listening Skills of Children With Auditory Processing Disorder. Loo, JH., Rosen, S., Bamiou, DE.[2015]

A structured intervention program for 20 children with central auditory processing disorders (C)APD significantly improved their speech recognition in noisy environments compared to a control group of 10 untreated children, indicating the efficacy of the training.

The training, which included various listening exercises in both quiet and noisy conditions, led to notable improvements in performance for both ears, with specific enhancements observed in the left ear for competing sentence tests.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of speech in noise and dichotic listening intervention programs on central auditory processing disorders. Putter-Katz, H., Adi-Bensaid, L., Feldman, I., et al.[2019]

Participation in counseling and communication strategy-oriented group aural rehabilitation programs significantly reduces self-perception of hearing handicap in adults with hearing impairment, based on a systematic review of 12 studies.

While these programs may enhance the use of communication strategies and hearing aids in the short term, it remains uncertain if these benefits last longer than the initial period after the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of counseling-based adult group aural rehabilitation programs: a systematic review of the evidence. Hawkins, DB.[2020]

A study involving 33 audiology professionals from 5 countries identified 64 key competencies necessary for effective audiologic counseling, emphasizing the importance of knowledge, skills, and attitudes in this field.

The findings highlight a gap in current practice guidelines for audiology education, suggesting that these competencies should be integrated into graduate training programs to enhance counseling practices for patients with ear-related disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Counseling Competencies in Audiology: A Modified Delphi Study. Meibos, A., Muñoz, K., Twohig, M.[2019]

Building a strong, patient-centered relationship during the initial evaluation is crucial for encouraging patients with hearing loss to use hearing aids effectively.

Training healthcare professionals in specific counseling skills, such as Motivational Interviewing and the Teach-Back Method, can significantly improve patient adherence to hearing aid recommendations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing Foundational Counseling Skills for Addressing Adherence Issues in Auditory Rehabilitation. Johnson, CE., Jilla, AM., Danhauer, JL.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

The successful hearing aid user. [2000]

2. United States pubmed.ncbi.nlm.nih.gov

Auditory Training Effects on the Listening Skills of Children With Auditory Processing Disorder. [2015]

3. Germany pubmed.ncbi.nlm.nih.gov

Effects of speech in noise and dichotic listening intervention programs on central auditory processing disorders. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Response to the Letter to the Editor From Iliadou, Sirimanna, and Bamiou Regarding DeBonis (2015). [2018]

5. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of counseling-based adult group aural rehabilitation programs: a systematic review of the evidence. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Discovering the Unmet Needs of People With Difficulties Understanding Speech in Noise and a Normal or Near-Normal Audiogram. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Counseling Competencies in Audiology: A Modified Delphi Study. [2019]

8. England pubmed.ncbi.nlm.nih.gov

A randomized, controlled trial of the efficacy of a communication course for first time hearing aid users. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Developing Foundational Counseling Skills for Addressing Adherence Issues in Auditory Rehabilitation. [2020]

10. Poland pubmed.ncbi.nlm.nih.gov

[Application of Brain-Boy Universal Professional in preliminary assessment of auditory processing disorder]. [2018]

11. Germany pubmed.ncbi.nlm.nih.gov

[Central auditory processing in adolescents with communication impairments]. [2021]

12. Switzerland pubmed.ncbi.nlm.nih.gov

A European Perspective on Auditory Processing Disorder-Current Knowledge and Future Research Focus. [2020]

13. United States pubmed.ncbi.nlm.nih.gov

The diagnosis and management of auditory processing disorder. [2022]