UCSF audiologists develop interactive system to improve listening

By Carol Hyman

Robert Sweetow, PhD -----

Many people lose their hearing as they get older and turn to a hearing aid for help.  Too often, however, the device doesn’t meet expectations and use is discontinued, along with complaints that it was not helping enough.

The culprit in this lack of success is not hearing, but listening, says Robert Sweetow, PhD, director of audiology at UCSF Medical Center. 

Recognizing the problem, he and his colleagues have developed a tool to help hard-of-hearing people, whether or not they use hearing aids, learn skills that help them become better listeners, and consequently, improve how much speech they understand.

“Hearing aids impact hearing,” Sweetow explains, “but they don’t impact listening and communication. As we grow older, not only does our hearing deteriorate, but we experience changes in the brain that may result in difficulty processing rapidly presented speech.”

“We have to remember that when most patients receive a therapeutic device—for example, an artificial limb—they are given physical therapy to help them learn how to best utilize the prosthesis and to strengthen adjacent muscles and develop compensatory behavioral skills,” Sweetow continues.
“We need to do the same thing with hearing aids. Hearing aids are getting better and better, but if patients don’t learn how to use their brains to listen and help ‘fill in the gaps’ that the hearing aids can’t provide, their benefit may be minimized,” he emphasizes.

Audiologists have long recognized this problem, but most training to help patients use hearing aids has not been time- or cost-effective, according to Sweetow.

Realizing that people don’t have a lot of time to devote to improving their listening skills, Sweetow and co-developer Jennifer Henderson-Sabes, staff research associate at UCSF, designed an interactive computer program called LACE, or “Listening and Communication Enhancement.”

For four weeks, a user spends one half-hour, five days a week working with the computer program to help enhance listening skills. The user gets immediate feedback regarding correct comprehension and can monitor his or her improvement from the beginning of therapy. In addition, the patient’s audiologist can observe progress via computer modem at a remote location. 

“Put simply,” Sweetow says, “the program force-feeds the brain with exercises to extract speech from background noise and improve listening strategies.”
Sweetow and Henderson-Sabes tested the training program at eight sites with about 80 individuals. Results showed improved ability to comprehend speech in a noisy environment along with increased confidence in difficult listening situations. 

“My goal is that in three years, everyone who walks into an audiologist’s office also walks out with a therapy plan,” Sweetow said.

Currently, the LACE program can only be used by people who have computers, but in the fall a portable device will be available that will allow anyone to train.

LACE is a product of NeuroTone, Inc., based in Redwood City, Calif. Sweetow is an unpaid consultant with the company.


NOTE: To see a demonstration of LACE or arrange interviews with Dr. Sweetow or patients who have used the program, contact Carol Hyman at (415) 476-2557 or (415) 502-9553. For more information about NeuroTone, log onto: LACE