Aural Rehab: Are We Getting the Job Done?

tin can 2Aural rehabilitation was once the root of our profession. ASHA defines it as “an ecological interactive process that facilitates one’s ability to minimize or prevent the limitations and restrictions that auditory dysfunctions can impose on well-being and communication, including interpersonal, psycho-social, educational and vocational functioning.” Audiologists know the importance of providing our patients with education, counseling, and training to overcome the challenges presented by hearing loss. However, the most recent MarkeTrak survey results indicate that very few of us are actually providing these services to our patients. This is an unsettling finding to say the least.

I truly believe that most audiologists attempt to provide their patients with adequate education and counseling. However, these MarkeTrak survey results prove that our attempts are not being received by our patients. I believe there are two factors at play: technological overwhelm, and unrealistic expectations. Patients are often so overwhelmed by the vast array of technology at their fingertips that their sole focus is on the technical workings of the hearing aids and wireless accessories. In addition, the vast improvements in technology lead our patients to believe that the hearing aids alone should address all their communication problems. What we are missing is a standardized, effective, and efficient aural rehab protocol that helps our patients to retain what they have learned, and use the strategies we teach them.

As a practicing audiologist, I face these challenges on a daily basis. As technology progresses, I find myself spending more clinic time educating my patients on the technical aspects of their new hearing aids. In a busy ENT clinic, time is of the essence, and this leaves very little time for counseling about realistic expectations, communication strategies, and auditory training. I tried various educational handouts as well as group AR classes, but struggled with patient compliance. I also found it difficult to engage family members in the rehabilitation process. When I read the MarkeTrak survey results, I realized I wasn’t the only audiologist facing these challenges. So in 2013 I set out to develop a fun and effective approach to aural rehab that would be easy for patients to comply with, and efficient for professionals to implement. I call it Cut to the Chase Counseling. There are three simple steps to this aural rehab approach:

1. Education: Patients need to be educated in a fun, easy, and efficient way. While there are many great educational materials on the market, I chose to create my own patient guidebook that organizes communication strategies into five simple keys (see below) that are easy for patients to remember. It is also important that our education addresses realistic hearing aid expectations as well as the importance of family member involvement. Our aural rehab approach defines the following components as the “5 Keys to Communication Success.” I will discuss these further in future blog posts.

2. Action: Patients need to immediately act on what they’ve learned to begin creating new communication habits early in their rehab process. We start this action with personalized Successful Communication Plans that guide the patient and their communication partners as they apply the five keys to their most challenging communication situations.

3. Follow-up: Patients simply cannot absorb and retain all of the education and counseling during their hearing aid trial period. They are often so overwhelmed by their hearing aids, that they may actually remember precious little from what we have been teaching them. For this reason, they must receive some kind of regular follow-up education. Studies show that consistent long-term follow-up drastically increases patient compliance and satisfaction. We provide this follow-up in the form of weekly emails that patients receive for an entire year following their hearing aid fitting. These emails reinforce effective communication strategies and encourage the patients to return to their hearing care professional with any questions or concerns.

We know that our job as rehabilitative audiologists goes far beyond fitting hearing aids. I hope this simple three-step approach will provide an efficient way for professionals to ensure that education and counseling are an integral part of every hearing aid fitting. In the following five blogs, I will dig deeper into the five keys to communication success and give you strategies for integrating them into your practice.

Dr. Dusty Ann Jessen, AuD, is a practicing audiologist in a busy ENT clinic in Littleton, Colo. She is the founder of Cut to the Chase Communication, LLC, a company dedicated to providing “fun, easy, and effective” counseling tools for busy hearing care professionals. She is also the author of Frustrated by Hearing Loss? 5 Keys to Communication Success. Dr. Jessen can be contacted at 


  1. Jane Harrison says

    Could you tell us where to get aural rehab procedures for elderly people in nursing homes.
    I always thought of aural rehab as something for deaf educators but now I cannot tell
    you how many patients I see that they want me to do aural rehab on them and I am a
    speech pathologist… A good program or something.

    • says

      Thank you Peggy, for your reply to Jane – all great resources you mentioned! Jane, another great resource for you: They have fantastic material!

      The first and second steps of our Cut to the Chase Counseling program could be very helpful for you – these are the Patient Guidebook (which is meant for the family members to read as well), and the Successful Communication Plan (which is just a simple framework to help the patient remember and apply what they learned in the guidebook). You can see more details about these at I’m assuming Step 3 of our program wouldn’t be as applicable for a nursing home population as it requires the patient to actively check email. Feel free to send me an email if you have any questions about our program or would like a hard copy of the book to really get a feel for it.

  2. Paula Stone, M.S.,C.C.C.-SLP says

    What is the role of the speech language pathologist in a SNF? Is aural rehab a medicare A or B billable service for the speech pathologist working in a SNF?

  3. Peggy Ellertsen, M.Ed., C.C.C.-S.L.P. says

    Jane Harrison: Active Communication Education (ACE): Hickson, Worrall and Scarinci; G.R.O.U.P., available on the Ida Institute website; Learning to Hear Again, Wayner and Abrahamson.
    Also, for continuing education, join the Academy of Rehabilitative Audiology and ASHA Special Interest Group 7 for Aural Rehabilitation and It’s Implementation.

  4. Munish Pundir says

    i am looking forward to five keys to communication success and strategies for integrating them in clinical practise…. Regards