Auditory Rehabilitation: Auditory rehabilitation is a holistic approach to helping you get the best possible benefit from your hearing aids and improving communication in everyday life.
Leaflet Details
| Title | Auditory Rehabilitation |
| Department | Audiology |
| Author(s) | A. Lindsay |
| Review Date | May 2026 |
| Next Review | May 2029 |
| Download | A4 Handout PDF and A5 Booklet PDF |
| Accessibility Options | Click on the Recite Me button to show our accessibility resources |
Patient Information
What is Auditory Rehabilitation?
Auditory rehabilitation is a holistic approach to helping you get the best possible benefit from your hearing aids and improving communication in everyday life.
Hearing aids are an important part of this, but they work best when combined with:
- Good listening and communication strategies
- Environmental adjustments
- Assistive devices
- Listening practice and training
What can hearing aids do?
Hearing aids are:
- Programmed to a prescription based on your hearing test
- Designed to optimise the audibility of speech
- Able to amplify sounds to improve access to conversations and everyday listening
They can help you:
- Hear speech more clearly (especially in quiet environments)
- Be more aware of environmental sounds
- Stay connected with others
Hearing aids generally work best when you are within about 2 metres of the person speaking. Beyond this distance, their benefit becomes more limited.
How do hearing aids work in different environments?
Hearing aids are designed to automatically adapt to your surroundings. The general (automatic) programme adjusts depending on whether you are in quiet environments, background noise or very noisy environments.
They can change the direction the sound is amplified from (focusing more on sounds in front of you) and adjust the amplification (loudness) for different pitches.
This happens automatically to help you hear as clearly as possible in different situations.
You may also have the option of additional programmes, such as a programme specifically for speech in background noise (this can offer an improvement but does not remove all background noise). A loop programme can be added for use with loop devices. Other programmes depending on your needs may also be added.
What are the limitations of hearing aids?
It is important to understand that:
- Hearing aids do not restore normal hearing
- They do not make all sounds audible
- The poorer your hearing level, the less sound can be made audible
- People with hearing aids often still experience difficulty in background noise
- Hearing aids cannot fully restore clarity of sound
- No one hears perfectly all of the time, including people with normal hearing
This is because:
- Hearing loss often involves damage to the hair cells in the inner ear
- These cells not only amplify sound but also fine-tune it for clarity
- Once damaged, this function cannot be replaced by hearing aids
Because of this, hearing aids are only one part of your rehabilitation.
Getting the Best from Your Hearing Aids
- Wear your hearing aids consistently to allow your brain to adapt
- Be patient - it can take time to adjust to new sounds
- Use them in a variety of environments to build listening skills
- Attend follow-up appointments for fine-tuning if needed
Communication tactics
Practical Suggestions to Help You Hear
- Try to be within 1 to 2 metres of the person speaking
- Tell people when you cannot hear them
- Ask for speech to be slower or clearer, or ask specifically for what you missed e.g. “What time did you say we are going out?”
- Ask people to rephrase rather than repeat
- Re-educate friends and family and try not to take frustration personally
- Reduce background noise (e.g. turn off the TV during conversations)
- Use headphones for TV or music if helpful
- Be aware that noisy situations (e.g. cooking, housework) make listening harder
Listening Environment
Small changes can significantly improve how well your hearing aids work:
- Sit with your back to a wall in restaurants or open spaces
- Choose places with soft furnishings to reduce echo
- Sit near the main speaker in meetings or lectures
- Avoid background noise (e.g. traffic, open windows, office equipment)
- Ask to move desks if you work in a noisy environment
Tips for Family and Friends
They play an important role in helping you hear better. They can:
- Get your attention before speaking
- Face you clearly so you can see their face
- Reduce background noise
- Speak clearly (not shouting) and at a steady pace
- Make the topic clear
- Use full sentences
- Rephrase if needed, or write things down
- Allow yourself time to rest, as listening can be tiring
- Be patient, positive and relaxed
Lip Reading
Even with hearing aids, visual cues are very important:
- Watch lip movements and facial expressions
- Ensure good lighting
- Position yourself where you can clearly see the speaker
Combining hearing aids with lip reading significantly improves understanding.
Lipreading classes are run by Surrey Adult Learning.
https://www.surreycc.gov.uk/schools-and-learning/adult-learning
Telephone: 0300 200 1044.
Other contact methods are on their webpage.
Assistive Devices and Technology
There are many other devices and solutions which you may find helpful. They can be alerting devices such as alarms and doorbells or communication devices.
- Smoke alarms with vibrating alerts or flashing lights
- Doorbells
- Loop systems
- Amplified telephones
- Devices that connect to your hearing aids including TV streamers and remote microphones
- Headphones for TV or phone use
- Subtitles for television
Further information can be found at:
https://rnid.org.uk/information-and-support/technology-and-products
Devices can be purchased through them. Sight for Surrey (see resources section below) can provide some equipment.
For devices that connect to your hearing aids information about purchasing these is included in the Fitting Booklet.
Apps
- Voice amplifier apps
- Speech-to-text apps (live subtitles)
Resources:
https://www.hearinglink.org/technology/useful-apps-for-hearing-loss
Auditory Training and Listening Practice
It is important to know that we hear with our brain, not just our ears.
Your ears detect sound, but it is your brain that:
- Interprets speech
- Fills in gaps
- Makes sense of what you hear
The brain is very good at learning and adapting, and with practice it can improve how it processes sound, especially when using hearing aids.
As we age changes in the brain can affect how well we:
- Separate speech from background noise
- Focus on one voice in busy environments
This is why many people, even with hearing aids, still find background noise difficult.
The good news is that the brain remains adaptable, and training can help improve these skills.
Activities that can help train your brain:
- Learning a new language
- Learning a musical instrument
Training Programmes
Various Auditory training programmes are available online or on your app store. These include:
- Listening and Communication Enhancement (LACE)
https://www.neurotone.com/lace-ai-pro
- The Listening Programme
https://www.learning-solutions.co.uk/the-listening-program
- Apps such as EarGym
These aim to improve:
- Listening in noise
- Attention and memory
- Speech understanding
Wellbeing and Hearing
Listening effort is closely linked to your overall wellbeing.
- Listening can be tiring, particularly when using hearing aids or in difficult environments
- Factors such as tiredness, stress, and physical or mental health can affect your brain’s ability to process speech
- When the brain is fatigued, it becomes harder to:
- Focus on speech
- Filter out background noise
- Keep up with conversations
This can make hearing feel more difficult, even if your hearing aids are working well.
Ways to support yourself:
- Take regular listening breaks
- Pace yourself in challenging environments
- Use relaxation or mindfulness techniques
- Plan demanding listening activities for times when you feel more alert
The NHS website is a good place to find further wellbeing support.
Key Message
Hearing aids are a powerful tool, but they work best as part of a wider rehabilitation approach.
By combining:
- Your hearing aids
- Good communication strategies
- Environmental adjustments
- Listening practice
You can significantly improve your ability to hear, understand, and participate in everyday life.
Additional Resources
RNID (formerly Action on Hearing Loss)
The UK charity supporting deaf people and those with hearing loss and tinnitus. Has a lot of information including leaflets that can be downloaded.
They also have a shop to purchase a range of equipment.
Tel 0808 808 0123
Access to Work
Providing help and support at work
https://www.gov.uk/access-to-work
Sight for Surrey
Provide support with information about hearing loss, communication skills training & equipment and technology support
https://sightforsurrey.org.uk/
Tel: 01372 377701
Surrey Fire and Rescue
For information about accessing smoke alarms
Contact details
If you have any questions please contact us by email, phone or letter:
Telephone:
- 01784 884351 (Appointment Centre for new appointment enquiries)
- 01784 884156 (Audiology Department for follow up appointments and general enquiries)
E-mail:
Audiology Department
Ashford Hospital
London Road
Ashford
Middlesex,
TW15 3AA
https://www.ashfordstpeters.nhs.uk/audiology
Includes further information, links to forms and the video appointment system.
