Teledelivery of Aural Rehabilitation to Improve Cochlear Implant Outcomes

Diane Majerus Brewer, Claire Marcus Bernstein, Dominique Calandrillo, Nancy Muscato, Kailey Introcaso, Cassandra Bosworth, Anne Olson, Rachel Vovos, Gina Stillitano, Sarah Sydlowski

Research output: Contribution to journalArticlepeer-review


Objective(s): This randomized controlled study evaluated the effectiveness of a Telehealth Aural Rehabilitation (TeleAR) training protocol to improve outcomes for adult cochlear implant (CI) users. Methods: This was a multisite clinical study with participants randomized to either an AR treatment or active control group. The AR protocol consisted of auditory training (words, sentences, and speech tracking), informational counseling, and communication strategies. The control group participants engaged in cognitive stimulation activities (crosswords, sudoku, etc.). Each group completed 6 weekly 90-min individual treatment sessions delivered remotely. Twenty postlingually deafened adult CI users participated. Assessments were completed pretreatment and 1 week and 2 months posttreatment. Results: Repeated-measures ANOVA and planned contrasts were used to compare group performance on AzBio Sentences, Hearing Handicap Inventory (HHI), Client Oriented Scale of Improvement (COSI), and Glasgow Benefit Inventory (GBI). The two groups were statistically equivalent on all outcome measures at pre-assessment. There was a statistically significant main effect of time for all measures. Improvement over time was observed for participants in both groups, with greater improvement seen for the AR than the CT group on all outcome measures. The AR group showed medium to large effect sizes on all measures over time, suggesting clinically significant outcomes. Conclusion: This randomized controlled study provides evidence of improved speech recognition and psychosocial outcomes following 6 weeks of TeleAR intervention. For adult post-lingually deafened CI users, including those >3 months post-activation, AR treatment can leverage neuroplasticity to maximize outcomes. Level of Evidence: 2 Laryngoscope, 134:1861–1867, 2024.

Original languageEnglish
Pages (from-to)1861-1867
Number of pages7
Issue number4
StatePublished - Apr 2024

Bibliographical note

Publisher Copyright:
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.


  • aural rehabilitation
  • cochlear implants
  • psychosocial outcomes
  • speech recognition
  • telehealth

ASJC Scopus subject areas

  • Otorhinolaryngology


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