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Auditory Training for Adult Cochlear Implant Users

A Survey and Cost Analysis Study

Reis, Mariana1,2; Boisvert, Isabelle1,2,3; Beedell, Emma1,2; Mumford, Virginia4

doi: 10.1097/AUD.0000000000000724
Research Articles

Objectives: The aims of this study were as follows: (a) to describe audiologists’ practices toward auditory training (AT) for adult cochlear implant (CI) users with a postlingual hearing loss; and (b) to assess the cost of different AT methods for clients and service providers in comparison with no AT delivery.

Design: A survey was distributed to approximately 230 Australian CI audiologists to investigate the range, magnitude, and rationale of AT practices adopted as part of rehabilitation services with adult CI users. The cost of these different AT practices was then estimated from the perspectives of both clients and service providers, and compared against no AT delivery.

Results: Seventy-eight audiologists responded to at least one section of the survey (16% to 33% response rate), of which 85.5% reported that they viewed AT as a necessary component of rehabilitation. Home-based and face-to-face were the methods most frequently adopted to deliver AT. Methods used during training, such as stimuli type, feedback, and encouragement for training adherence, varied across respondents. The cost analysis indicated that home-based training resulted in the lowest program costs, whereas face-to-face AT (when delivered independently from routine appointments) was the method with highest cost for clients and service providers.

Conclusions: The type of AT, recommended frequency of sessions, and overall duration of programs varied widely across respondents. Costs incurred by clients depended mainly on whether the AT was home-based or clinician-led (i.e., face-to-face, group-based), program fees, and travel arrangements made by clients, as well as clinicians’ wages and the method chosen to deliver AT.

1The HEARing Cooperative Research Centre, Victoria, Australia

2Department of Linguistics, Macquarie University, New South Wales, Australia

3Macquarie University H:EAR [Hearing: Education, Application, Research], New South Wales, Australia

4Australian Institute of Health Innovation, Macquarie University, New South Wales, Australia.

Received October 12, 2018; accepted February 13, 2019.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal’s Web site (

This study was supported by the HEARing Cooperative Research Centre, established under the Australian Government’s Cooperate Research Centres Program. The HEARing CRC Program supports industry-led collaborations between industry, researchers, and the community.

Supporting Information: Survey of Auditory Training Practices in Cochlear Implant Clinics in Australia.I. B. conceived the experiment. M. R., I. B., and E. B. designed and conducted the experiment and data analysis for the survey. M.R., I.B., and V. M. designed and conducted the cost analysis. M. R. prepared the article with contributions from I.B., E.B., and V. M.

Parts of this work were presented at the British Society of Audiology Annual Conference, Harrogate, June 2017.

The authors have no conflicts of interest to disclose.

Address for correspondence: Mariana Reis, The Australian Hearing Hub, Macquarie University, Room G.330, Ground Floor, 16 University Avenue, NSW 2109, Australia. E-mail:

Online date: April 16, 2019

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