Publications

This study examined home-delivered auditory training for adult hearing aid users, focusing on live-voice training with communication partners and comparing its impact in quiet versus with a competing talker. The results showed cognitive and speech-in-noise improvements, with both groups reporting increased awareness of listening strategies and better concentration. This suggests that active listening—especially when supported by family—could help reduce the social isolation often linked to hearing challenges. With respect to Lace AI Pro, these findings highlight the potential for cognitive and auditory training to enhance speech understanding and cognitive engagement, even without formal, clinician-led sessions. Lace AI Pro offers a practical, high-quality solution for hearing care providers who lack time to conduct aural rehabilitation themselves, enabling care that addresses both auditory and cognitive needs.

This study examined the effectiveness of LACE auditory training in enhancing speech understanding for both new and experienced hearing aid (HA) users. Participants, ranging from 50 to 81 years old with mild to severe sensorineural hearing loss, were divided into training and control groups. After 4 weeks, new HA users who completed the LACE training showed significant improvement in speech-in-noise recognition on the QuickSIN test, with SNR reductions averaging 2.9 dB, indicating a meaningful enhancement in understanding speech in noisy environments. Experienced HA users also benefited from training. Improvement was most notable among those with greater difficulty at baseline, supporting the idea that individuals with higher initial deficits gain the most from training. The study highlights LACE's adaptability for home use and suggests that training could help reduce HA returns by accelerating acclimatization and improving perceived benefit.

This study highlights the benefits of tailoring auditory training to individual needs, an approach central to LACE’s philosophy. Researchers worked with 69 hearing-aid users, who trained for six weeks with either a single voice or a mix of voices. The goal was to see if focusing on specific voices in training could help participants better recognize those voices in real-life situations. The results were clear: those who practiced with a single voice improved more when listening to that particular voice, while those who trained with multiple voices got better at understanding a range of different voices. This “personalized training” approach shows that by aligning training with each person’s unique listening goals—whether it’s to improve communication with a loved one or navigate conversations in the community—hearing-aid users can get the most out of their devices. It reinforces LACE’s commitment to designing training that meets patients where they are, supporting their specific communication needs for real-world success.

This study of 96 hearing aid users with and without Lace found that Lace reduced returns from 15% to 3%, translating to an estimated $150,000 in retained annual revenue. The authors concluded that Lace likely improves return rates by driving higher levels of patient satisfaction.

In this study, 65 adults, primarily experienced hearing aid users, participated in a four-week auditory training program called Listening and Communication Enhancement (LACE) to improve listening and communication skills. The training focused on degraded speech comprehension, cognitive skills, and communication strategies, using adaptive tasks tailored to each participant’s performance. Outcome measures included the Quick Speech-in-Noise Test (QuickSIN), Hearing in Noise Test (HINT), Hearing Handicap Inventory for the Elderly (HHIE), and Communication Scale for Older Adults (CSOA). Post-training results showed significant improvements in QuickSIN scores (2.2 dB at 45 dB and 1.5 dB at 70 dB, p < 0.05) and in subjective measures like HHIE and CSOA. Participants with poorer baseline scores, greater perceived hearing handicap, or more severe hearing loss tended to benefit most. Notably, improvements were not limited to those with significant deficits. For instance, a 75-year-old participant with mild hearing loss and strong baseline skills reported substantial gains in confidence, concentration, and willingness to engage in challenging listening situations, despite her modest gains on specific tasks. This suggests that LACE training may provide valuable benefits even for those with mild impairments or limited baseline needs, as even small gains can lead to meaningful improvements in communication quality and confidence.

This study tracked 625 patients who purchased new hearing aids to assess the impact of the LACE (Listening and Communication Enhancement) auditory training program on return rates. Participants were given uniform protocols across four clinics, including needs assessments, counseling, and follow-ups, with 173 opting into LACE training, available on personal or office computers. Results showed that only 3.5% of LACE participants returned their hearing aids compared to 13.1% of non-participants, with a Pearson chi-square test confirming this difference as significant. Logistic regression revealed that LACE participation and pure-tone average for the left ear (PTA-L) were the only significant predictors of returns, with greater hearing loss linked to fewer returns, while factors like age, clinic location, and device style showed no effect. The findings highlight LACE’s role as a cost-effective, impactful tool for reducing hearing aid returns and promoting device acceptance, suggesting that aural rehabilitation can be a critical factor in hearing aid satisfaction and adoption.

In this study, four elderly, bilingual English-Mandarin speakers underwent auditory training with the LACE program to assess its effectiveness in improving speech-in-noise perception in a bilingual population. The study, conducted over two months, involved 12 LACE sessions per participant, and QuickSIN (speech-in-noise) testing. The QuickSIN tests revealed a ~2dB reduction in SNR loss indicating improved speech comprehension in noisy settings after LACE training, suggesting the program’s utility for non-native speakers in difficult auditory environments.

This review by Olson et al. (2020) evaluates mobile apps that were available for auditory training (AT) as tools for adults with hearing loss to use independently. Recognizing that hearing aids alone often fail to meet users’ listening needs, particularly in noisy environments, the study explores how mobile AT apps might improve speech recognition, offering accessible training outside clinical environments. The study finds that while these other apps vary in usability and are not all fully evidence-supported, they provided valuable tools for self-managed auditory training and increased hearing awareness, with particular benefits for those reluctant to pursue hearing aids. When Olson et al. conducted this review, LACE was available only as a web-based program and so was not evaluated. Today, Lace AI Pro is available as a mobile app, built with an accessibility-first approach and backed by 20 years of science, delivering on Olson's criteria for mobile AT for adults with hearing loss seeking flexible, independent auditory training.

This study looked at the impact of a formal auditory training program on adults with high-frequency hearing loss, aiming to improve auditory processing, brain responses, and self-reported communication difficulties. Seven participants with moderate, symmetrical high-frequency hearing loss completed eight training sessions focused on exercises to enhance sound localization, timing, and understanding speech in noisy settings. Behavioral tests showed clear improvements in auditory skills, especially in speech-in-noise tasks and timing accuracy. Brain activity assessments indicated subtle changes in brainstem and cortical responses, suggesting a biological basis for these improvements. These results imply that LACE could similarly support people with high-frequency hearing loss, strengthening their auditory processing and communication skills in challenging environments by effectively training their brains.

This paper advocates for auditory training to enhance outcomes in hearing rehabilitation. The authors discuss how fewer than 10% of audiologists offer auditory training to hearing-impaired patients, despite evidence that it can improve outcomes and reduce hearing aid returns. The article explores strategies for making auditory training a more integral part of audiological care. This article was one of several that inspired the team behind Lace AI Pro to focus on patient compliance with more engaging content and improved gamification.

This paper advocates for aural rehabilitation and auditory training as crucial for addressing not only hearing thresholds, but also for enhancing quality of life by targeting communication skills, perceptual training, and emotional support. The authors maintain that to truly benefit patients, hearing care professionals must commit to presenting these therapies as integral to the hearing rehabilitation journey, not as "add-ons".

In a multi-site study, Sweetow and Henderson Sabes assessed the LACE (Listening and Communication Enhancement) program, which aims to enhance listening and communication skills for those with hearing loss. The study involved 65 subjects, ages 28-85, mostly experienced hearing aid users, who completed a four-week training with adaptive tasks in degraded speech comprehension, cognitive skills, and communication strategies, each tailored to individual performance. Results showed significant improvements across training tasks, including an average 2.8 dB gain in Speech in Babble (SB) and a 3.8 dB gain in Competing Speaker (CS), along with a faster response time on Missing Word (MW) exercises (p < 0.05 for all). Off-task measures like QuickSIN indicated a 2.2 dB improvement at 45 dB and a 1.5 dB improvement at 70 dB, with over 80% of participants showing progress. While the HINT (Hearing in Noise Test) showed a modest 0.9 dB improvement, subjective outcomes on the HHIE (Hearing Handicap Inventory for the Elderly) and CSOA (Communication Scale for Older Adults) showed significant gains.

In a study of 65 patients, those who received Lace training showed significant improvements in objective measures such as QuickSIN (speech-in-noise test) scores, with a 2.2 dB improvement at 45 dB and a 1.5 dB improvement at 70 dB, as well as subjective measures like the Hearing Handicap Inventory for the Elderly/Adults (HHIE/A), where scores improved by an average of 7.5 points, reflecting a reduction in perceived hearing handicap. The study also showed significant improvements in cognitive processing speed and auditory working memory after Lace.

This review of the literature on auditory training highlights computerized auditory training with LACE as a way to increase accessibility and patient compliance with at-home aural rehabilitation. Multiple studies reviewed show significant improvements in communication skills, especially from synthetic training approaches that emphasize top-down listening strategies. Benefits include enhanced speech recognition in noise and improved psychosocial function.

In a UCSF pilot study involving eight experienced hearing aid users, four received LACE training (30 minutes a day, five days a week for four weeks), while four served as a control group. Every patient who completed the training showed improvements across all outcome measures: on the Hearing in Noise Test (HINT), trained subjects saw a measurable increase in their ability to understand speech in noisy environments, and on the Quick Speech-in-Noise (QuickSIN) test, they achieved an average improvement of 2.2 dB in signal-to-noise ratio, indicating better speech recognition in challenging listening conditions. In contrast, none of the control subjects showed improvement across all measures, underscoring the potential of structured, home-based auditory training to significantly enhance communication skills in a short period.

This study examines the impact of auditory training on the neural and behavioral responses in older adults, focusing on electrophysiological measures. It highlights the challenges aging adults face with speech comprehension, particularly in noisy environments, and explores the brain's adaptability (neuroplasticity) through auditory training. The study emphasizes that hearing aids, while effective in amplifying sounds, don’t fully address central auditory processing deficits or cognitive decline associated with aging. Electrophysiological tests, such as auditory brainstem response (ABR), auditory middle latency response (AMLR), and mismatch negativity (MMN), demonstrated neural improvements post-training, showing that auditory training can enhance central auditory processing and reduce cognitive load. The study supports the potential of patient-led auditory training programs, such as LACE, in leveraging neuroplasticity to improve speech-in-noise comprehension and cognitive engagement.

This systematic review analyzed studies on home-based auditory and cognitive training for adults with hearing loss, examining the effects on cognitive function. The review included nine studies with 620 participants, evaluating both auditory and cognitive interventions. Auditory training (including programs like LACE) showed small but significant cognitive gains, especially in working memory. The review suggests that auditory training may benefit cognition in adults with hearing loss, an early but encouraging finding. Following this and other research, Lace AI Pro has developed new, more advanced ways to address cognition through auditory training, moving from the original "Word Memory" exercises to more comprehensive "Working Memory" training, a feature coming in late 2024.

In this study, forty participants (20 with normal hearing and 20 with hearing loss) completed auditory and memory tests, revealing that individuals with mild to moderate hearing loss had lower auditory working memory scores contributing to cognitive decline, regardless of hearing loss type, duration, and laterality. Reduced auditory working memory has been shown to limit hearing-impaired adults’ ability to follow complex or lengthy conversations, particularly in noisy environments or with multiple speakers. Incorporating LACE Working Memory exercises into patient care directly helps address this aspect of hearing loss.

This study revealed significant training-related improvements in the brain’s processing of speech-in-noise, specifically demonstrating that auditory training can enhance the neural encoding of pitch-related cues in complex listening environments. In a cohort of 28 adults who completed the LACE auditory training program, researchers observed strengthened brainstem responses to pitch cues, with the enhancements most evident in challenging, noise-filled listening conditions. This neural improvement corresponded to significant behavioral gains in speech-in-noise perception, as measured by QuickSIN (P < 0.001) and HINT (P < 0.001), with benefits persisting at a six-month follow-up. Notably, participants who initially exhibited stronger brainstem encoding of pitch showed the most pronounced improvements, suggesting that the brain's baseline processing capabilities play a pivotal role in auditory learning success. In contrast, the untrained control group showed no changes in either neural or perceptual outcomes, underscoring the potential of targeted auditory training to drive durable, brain-level adaptations that improve real-world listening skills.

This 2021 study by Holmes and Johnsrude highlights the powerful impact of training with a familiar voice, a concept that Lace AI Pro now brings to patients with its AI-powered Voices feature. The study involved 27 participants who listened to sentences spoken by both familiar and unfamiliar voices while undergoing fMRI. Researchers observed that participants understood up to 20% more of the familiar voices amidst background noise. This effect was linked to increased neural robustness in auditory processing areas, particularly the superior and middle temporal gyri, where familiar voices led to better signal filtering. The findings suggest that repeated exposure to a known voice strengthens the brain's ability to focus on that voice, even when other sounds are present. This aligns with the goal of Lace AI Pro to provide a more engaging, effective training experience, as listening to familiar voices significantly improves auditory focus and recognition​.

Newman and Evers (2007) conducted a study to examine how talker familiarity influences a listener’s ability to separate and focus on a specific voice amidst competing speech, a concept relevant to the Lace AI Pro’s familiar voice training feature. Involving 67 undergraduate students, the study divided participants into three groups: those with explicit knowledge of the target speaker’s identity, those familiar with the voice but without explicit knowledge, and those completely unfamiliar with the speaker. Participants were asked to "shadow" (repeat back) a target speaker’s words while ignoring a background voice. Results indicated that participants with explicit knowledge of the target talker made significantly fewer errors, especially missed words, compared to those with only implicit familiarity or no familiarity at all. The findings suggest that explicit knowledge about a voice helps listeners maintain attention and better process speech in noisy conditions, while mere familiarity did not enhance selective listening. These results underscore the unique cognitive advantage of explicitly recognizing a familiar voice when focusing in challenging listening environments​.

Allen and Miller (2004) examined how listeners recognize subtle timing differences in speech sounds unique to each talker, which has implications for personalized training features like those in Lace AI Pro. In this study, 20 participants were trained to recognize specific differences in the way two talkers pronounced words starting with a “T” sound. One speaker consistently used a shorter delay before voicing the vowel (a shorter "voice-onset time" or VOT), while the other used a longer delay. Listeners were able to learn and remember these patterns, reliably identifying the correct timing even with new words spoken by each talker. This shows that people can adapt to unique features of individual voices, making them better at recognizing familiar speakers even in new contexts. For Lace AI Pro, training with familiar voices could help listeners “tune in” to the specific patterns of familiar talkers, potentially enhancing speech comprehension over time.

An early study by Nygaard and Pisoni (1998) cited by 791 other peer-reviewed papers explored how learning to recognize specific voices impacts speech understanding in noisy environments, a concept that aligns with the new Lace AI Pro feature of training with familiar voices. The study involved 66 undergraduate and graduate students without known hearing loss. The researchers examined whether familiarity with a speaker’s voice improved word recognition in noise. Participants trained over several days to identify a set of voices and were then tested with new words or sentences spoken by both familiar and unfamiliar voices. Those who trained with familiar voices achieved significantly better word recognition in noisy conditions compared to those who listened to unfamiliar voices. This indicates that prolonged exposure to a known voice strengthens the brain’s ability to filter speech from background noise, suggesting that training with familiar voices could be a powerful method for enhancing listening skills in everyday, noisy settings