Here at Neurotone, we talk a lot about Listening and Communication Enhancement (LACE), the aural rehabilitation program that retrains your brain to listen. Created by audiologists to help new hearing aid users make sense of all the sounds they’re hearing for the first time in years, LACE also works for veteran hearing aid users as well as for those who are just tired of missing out on conversations.
Whichever category describes you, LACE training helps you develop strategies and skills for listening so that you can get the most out of the sounds you do hear.
How It Works
LACE training consists of 11 scored sessions, each lasting 20 minutes and including multiple exercises covering four areas (listed below). After you complete the initial 11 sessions, you are free to continue to use LACE for as long as you’d like! The program is interactive, so it responds to your performance. When you do well, it ratchets up the challenge so you can hone your listening skills even further. When you’re struggling, it eases up so you can experience victories and make solid and sustainable progress. There are four types of exercises:
Speech in Noise – In these exercises, you are tasked with listening to a person speak over background noise that gets progressively louder and more distracting.
Competing Speaker – Competing Speaker exercises feature two people speaking at once. You are instructed to listen to only one of them; after each sentence, the program checks for comprehension.
Rapid Speech – Just what it sounds like. A very fast talker speaks and you are asked how much of the sentence you understood.
Target Word – This challenging exercise really helps you practice focusing on a speaker, as it asks you to identify the words before or after target words have been uttered.
˜Clinically Significant Improvements’
How do we know LACE works? Scientists tested it. In 2006, audiologists Robert Sweetow and Jennifer Sabes, creators of LACE, entered the lab with 65 subjects. The subjects’ average age was 63, and most wore hearing aids.
Sweetow and Sabes tested the subjects on all five LACE categories four times: before LACE training (baseline), two weeks into training, at the end of the four-week training program, and then four weeks after completing the LACE program. Between the baseline testing and the final testing, 87% of subjects showed improvement in Speech in Noise, 88% showed improvement on Rapid Speech comprehension, 84% showed improvement on Competing Speaker, 80% improved on the Target Word test and 75% improved on the Missing Word category. So they retained those improvements a month after finishing the testing.
Even more impressive, when tested on a new category that the LACE training did not include-Quick Speech in Noise-85% of subjects showed an improvement, and 46% showed clinically significant improvement, suggesting that people can apply skills learned during LACE training to new situations (a term called generalization). In other words, the subjects hadn’t just gotten really good at answering LACE-type questions but could take what they’d learned and apply it.
Similarly, in two other types of test that are different from the LACE testing models-the Stroop Color-Word Test and the Listening Span Test-those who had received LACE training showed statistically significant improvements (76% and 79% respectively), whereas a control group that did not receive LACE training showed no improvement. Again, that suggests that those who had taken LACE training were applying what they’d learned to new situations. You can read the study results.
So do the improvements from LACE training last? Studies say they do.
In 2011 the journal Cerebral Cortex published an independent study showing that test subjects who had received LACE training exhibited significant improvements in speech-in-noise perception that were retained 6 months later. Wrote the authors: We provide the first demonstration that short- term training can improve the neural representation of cues important for speech-in-noise perception.
Since understanding conversation in the presence of background noise is a major challenge to people with degraded hearing (even if they wear hearing aids), we consider that real validation. You can read about it and find a link to the original study.