Efficacy of a structured auditory training module in older individuals with hearing loss: a randomized controlled trial

PURPOSE: To develop and evaluate a culturally adapted auditory training module for Kannada-speaking older adults with hearing loss. METHODS: The initial phase focused on developing a structured Kannada auditory training module, followed by efficacy evaluation. Content was informed by the Listening and Communication Enhancement framework and refined through focused group discussions. Efficacy was assessed using a randomized controlled trial with a 2 × 2 factorial design. Eighty Kannada-speaking adults aged 45–65 years with bilateral mild-to-moderate sensorineural hearing loss were recruited. Participants were randomized using computer-generated permuted block allocation, stratified by hearing aid experience (< 1 year vs. >1 year), with blinded outcome assessment. The intervention group (n = 40) received 20 one-hour computer-based auditory training sessions over four weeks, while the control group (n = 40) underwent conventional aural rehabilitation. The primary outcome was improvement in speech perception under degraded listening conditions. RESULTS: The intervention group showed significant improvements compared to controls. Quick Speech-in-Noise scores improved by 7–8 dB (F(1,76) = 142.10, p < 0.001), with 85% achieving clinically meaningful improvement (≥ 3 dB; NNT = 1.2). Compressed and filtered speech processing improved significantly (1.17–3.38-fold). Reaction time decreased for target word identification (4.95–5.45 s; F(1,76) = 93.46, p < 0.001) and missing word detection (F(1,76) = 77.88, p < 0.001). Self-reported hearing handicap reduced significantly (F(1,76) = 81.04, p < 0.001). No differences were observed between new and experienced hearing aid users. CONCLUSIONS: Structured auditory training significantly improves speech perception, cognitive processing speed, and self-reported outcomes in older adults with hearing loss, supporting its integration into aural rehabilitation for Kannada-speaking populations.