By Frank Butts, Ph.D.; Co-owner of Hearing Clinics of Virginia
I am a bit out of the ordinary in the world of Audiology and dispensing of hearing aids, having earned my Audiology Ph.D. with a specialization in temporal masking, a form of central auditory processing, focusing on the aging auditory system. We have three offices in the Richmond area with seven audiologists. Our group dispenses hearing aids to about 80 patients per month. We deal with lots of geriatric patients older than 70.
I was attracted to LACE for several reasons:
The critical issue for the next generation of hearing aid users will be adapting new hearing aid technologies to their specific environment. LACE demonstrates the critical dimensions of speech perception, and proves to users that improvement is possible.
In the future, there will be many places where patients can get high-tech hearing instruments, but few places that will support that technology with outcome-based procedures that ensure the patient will realize real improvement in communication. Those who commit to LACE will be committing to the essential role of therapist, who accepts the need for a long-term relationship with the patient and provides real value for their investment.
The process of LACE helps the patient move from the perspective of getting a “fix” for hearing loss with a device, to the perspective of successfully managing a chronic problem – a condition that can be controlled if patient and audiologist commit to a treatment plan. Moreover, LACE is a brief enough treatment course to give patients a sense of accomplishment in a short time while allowing them to continue to practice with the material when they need a booster shot.
Our industry must face the fact that audiologists are historically not therapists. Despite this, we now need to accept the therapy role. The problem is that changing the behavior of professional people is one of the hardest things in the world to do.
Here is perhaps the most interesting and valuable aspect of LACE that we have identified: virtually everyone over the age of 50 has some speech processing difficulties; we just don’t multitask that well after 50. Actually, when I did my research at the University of Virginia we found that most people over thirty have some word-processing degradation. There are temporal resolution changes that are unavoidable, especially by age 50. Hence, even with no hearing loss, LACE with its rapid speech and other exercises can benefit practically everyone. Consequently, from a business standpoint we see LACE as a way to introduce people to the idea of exercising their brains. Some significant percentage of these people will ultimately need some form of amplification to go with their LACE auditory training.
We know that incorporating LACE into our practice will take commitment, and that patients and audiologists alike will experience frustration with the learning of new ways to deal with this difficult problem. However, the opportunity exists to change the world’s perception of hearing aids from something that costs a lot and doesn’t work to instruments that, when properly fitted and used in concert with a rehabilitation treatment plan, will yield a real improvement in the quality of life.