Auditory training for hearing loss: How it works

Sound comes to you through your ears, but it's your brain that makes sense of it. This is why speech and other sounds become harder to comprehend for people with hearing loss, especially in louder places with competing sounds.  

Even with hearing aids, your brain may still struggle to interpret what you’re hearing, especially if you have age-related hearing loss. 

This is where auditory training comes in. 

What is auditory training?

Auditory training is a way to exercise your brain’s ability to recognize and interpret sounds, helping you make sense of what you hear. One of the main goals is reteaching your brain to focus on the important sounds you want to hear, while also relearning how to tune out distracting background noise. It is usally done at home using a smartphone app.

Is auditory training the same thing as auditory rehab?

Auditory training is similar to but not the same as auditory rehabilitation, which usually involves a series of in-office appointments and at-home "homework" overseen by a trained audiologist. Auditory rehab is most frequently used to help cochlear implant patients as well as those diagnosed with other auditory problems, such as auditory processing disorder.

Auditory training, on the other hand, usually means more of a self-directed, at-home program, such as through a smartphone app.

How much does it cost?

The cost of auditory training games or programs can vary a lot, from free options to Lace AI Pro, a comprehensive AI-powered training program that requires access through your hearing care provider. 

Auditory training apps

Several popular and affordable options for programs or apps you can download at your convenience include:

• AudioCardio: offers a free trial and then monthly, semi-annual or annual plans starting at $9.99/month. Also includes tinnitus training.
• Hearoes: free, with in-app subscription purchase options starting at $9.99/month
• Hear Coach: free

For a more comprehensive list check out: Top apps for listening comprehension and auditory training

How does it work?

Auditory training aims to improve communication

An auditory training program aims to improve key communication skills, such as:

• Working memory: To understand conversations, we rely on our working memory—the short-term memory that holds words and their meaning. Research suggests that as we get older, working memory can decline, making it harder to follow speech.
• Auditory processing speed: Auditory processing speed refers to your ability to keep up with what's being said. The average person speaks roughly 150 words per minute, but it can vary from 120 to 180 depending on the person. As we age our processing speed tends to slow down.
• Auditory attention: To hear and understand speech we often need to tune out background noise—for example, when we're talking with friends at a busy restaurant. This is known as auditory attention.

Using games to improve hearing ability

While there are multiple ways to engage in auditory training, one popular method is training that's similar to playing a video game. This makes it more likely you'll do the training, noted Nancy Tye-Murray, an audiologist and professor at Washington University in St. Louis who specializes in auditory training.

As you play, your brain releases dopamine “because it’s engaged in a pleasant activity and dopamine promotes perceptual learning,” she said. 

In a study led by Tye-Murray, most people said they had improved at least one aspect of hearing and many enjoyed the program. The research project included 93 hearing-impaired adults who completed 12 lessons designed to feel like games.

What are the benefits of auditory training?

Several studies have noted the benefits of auditory training for people with hearing loss as well as those with normal hearing. However, keep in mind many of these studies are small and the overall improvements are limited.

Improves speech understanding

In one 2017 study, older volunteers who wore hearing aids practiced for three and a half hours a week with a program designed to challenge their ability to understand speech against background noise. After eight weeks (35 hours of practice) they could correctly identify 25% more words in spoken sentences—even with noise in the background.

Another small 2023 study found that auditory training helped adults ages 60–75 who use hearing aids better understand speech. The biggest gains were seen in people who had more difficulty with speech understanding at the start, suggesting those with greater challenges may benefit the most.

Can help people with cochlear implants

Cochlear implants are worn by people who have severe or profound hearing loss. A  2024 systemic review looked at 23 studies on auditory training for adults with cochlear implants.

Overall, the research reviewed suggests that practicing listening skills can improve speech understanding, especially for recognizing sounds and hearing speech in noisy environments. However, the studies were small and varied in terms of the type and duration of the auditory training, as well as how success was measured. 

May help spousal communication

It’s possible that you’d benefit most if you had a tailor-made program using your partner's voice. When 10 couples tried this—using a six-week computerized auditory training program developed by Tye-Murray’s team—seven of the hearing-impaired volunteers said they had an easier time afterward hearing their spouse.

Improves 'auditory attention' skills

Even without hearing loss, people vary greatly in their ability to focus on one sound rather than another, known as auditory selective attention. Trained musicians are better at it, for example. Researchers have found that people can improve their auditory attention with only two hours of training.

What are the limitations?

While auditory training shows promise, its results are varied and not everyone finds it helpful.

For example, a small 2019 study from Indiana University found that older adults with hearing aids improved on listening tests after a five-week home program, and they kept those gains eight months later. However, when asked, most participants didn’t feel it helped them in daily life, and they didn’t keep training once the study ended.

A larger study of veterans using a popular program called Listening and Communication Enhancement (LACE) found a similar results. On average, people didn’t see big real-world improvements, although those who struggled the most at the start tended to benefit more.

Will auditory training help me?

If you’ve already worked with an audiologist and are getting used to your hearing aids, but still feel unsure about hearing in real-life situations, auditory training may be worth a try.

Think about your day-to-day life. Do you:

• Avoid busy restaurants?
• Ask people to repeat themselves often?
• Feel exhausted after conversations?

Those can be signs you're working hard to hear, even with hearing aids. Auditory training may help reduce these issues.

You may find it helpful even if you don't have hearing loss. Some people with normal hearing test results still struggle in noisy places due to changes in how the brain processes sound. Since auditory training is low-risk and non-invasive, it’s a reasonable tool to try.

Bottom line: If you’re committed to better hearing and you enjoy computer games, auditory training may be useful to you. 

Related: How audiobooks can sharpen your hearing