The Little Hearing Aid that Can’t

Hearing aids have come a long way.  We now have sleek and tiny digital signal processors with automatic directionality, noise suppression, feedback control, frequency shaping and a plethora of features designed to enhance the user experience.

In ‘one on one’ conversation, hearing aids do a fine job.  The noisy restaurant, family gathering or fellowship hall after church…..this is where the trouble starts.  The hearing aid alone can’t fully solve the user’s problem.  The ultimate goal, of course,  is to hear and understand.  While the ear is a player in this complicated and sophisticated sensory process, the brain plays an even bigger role.  Hearing aids can deliver crystal-clear signals but if the brain doesn’t respond to what the ear (hearing aid) sends, that hearing aid experience is going to be viewed as a failure.

We provide counseling regarding realistic expectations and communication hygiene.  We tell patients to clean up the auditory environment, e.g. “Honey, please don’t talk to me with my head in the refrigerator.”  Additional technologies including hearing loops for the home and  community help many to get more utility out of their hearing aids.  We can add relay devices to send signals from telephones directly to the hearing aid , FM systems and remote microphones. But even with the best hearing aids, the best assistive technologies and the best communication hygiene counseling, often there is not enough improvement to convince many to use hearing aids.  Or, if they do decide to use them, they are less than thrilled with the experience.  I would also venture to guess that many of our older patients would prefer not to have to use so many extra gadgets.  It stands to reason that if the hearing aid experience was better, our infamously low market penetration rate might improve.

Hearing aids restore audibility.  But, audibility does not necessarily equal comprehension, which is what the user is looking for.  To understand what the hearing aid has sent, the brain must accurately identify and assign meaning.  Just as exercise and physical therapy are useful for our bodies, brain-training exercises are proving to be very useful for our minds.  The recent surge in the number and popularity of these programs suggests that people are willing to participate.



Brain training has also been shown to be very effective in helping people with hearing loss.  People with hearing loss can be trained to better “use” the signals that they are receiving from their hearing aids.  Click here to watch a very entertaining video about auditory brain training.

As seen in the video, the most widely known  program designed to improve listening and understand is LACE® – Listening and Communication Enhancement by Neurotone, Inc.  LACE has been around for years and until recently, it was distributed as a CD or DVD.  It consisted of 20 sessions designed to improve performance in background noise as well as with competing and rapid talkers.  LACE has solid research claiming to be able to provide a 40% improvement in hearing in noise.  Even with all of that support from independent researchers, compliance has historically been pretty low – and that includes compliance from both patients and hearing care providers.  There are probably multiple reasons for this apathy, but the folks at LACE have redesigned their program in an effort to make us all more compliant.

LACE Online is now available.  They have reduced it to 11, 20-minute sessions with more entertaining content. The program is accessed through the LACE website so there are no CDs or DVDs to keep track of.   It is compatible with PC, MAC, iPad or Android devices. Patients simply log in with a registration code, set up a username and password and complete their listening lessons.

LACE Online Day 1

One hearing care practice management software system,, has integrated with LACE Online.  Providing the  patient instructions as well as tracking patient progress and compliance are built into the integration.  Visibility over who has started a LACE program in progress (Figure 1)

LACE Online Progress
Figure 1


and compliance alerts (Figure 2)

Figure 2

are hallmarks of the integration.  LACE Online is an exciting addition to our toolbox of products, programs and counseling that we can offer those who come for professional hearing care.  Now, as Drs. Hosford Dunn and Kolind pointed out, we need to keep trying to figure out how to make hearing aids cool.


Disclosure:  Dr. Diles is a consultant to the Product Management Team at  and  a long time customer of the company.



  1. You’re welcome Kerry……we are going to give LACE a full throttle effort in our offices this time! I hate being accused of non compliance :)

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