Does LACE Work? Scientists Say Yes.

Public domain image

Public domain image

Here at Neurotone we talk a lot about Listening and Communication Enhancement (LACE), the aural rehabilitation program that retrains your brain to listen. Created by audiologists to help new hearing aid users make sense of all the sounds they’re hearing for the first time in years, LACE also works for veteran hearing aid users as well as for those who are just tired of missing out on conversations.

Whichever category describes you, LACE training helps you develop strategies and skills for listening so that you can get the most out of the sounds you do hear.

How It Works

LACE training consists of 20 sessions, each lasting 30 minutes and including multiple exercises covering five areas (listed below). The program is interactive, so it responds to your performance. When you do well, it ratchets up the challenge so you can hone your listening skills even further. When you’re struggling, it eases up so you can experience victories and make solid and sustainable progress. There are five types of exercises:

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A User Shares Tips

We recently received a letter from LACE user Jim Kurfess. Jim, 84, used hearing aids successfully for more than two decades before encountering severe deterioration in hearing and listening comprehension.

Since then, Jim has made two helpful discoveries:  a way of using LACE to demonstrate his difficulties to a dubious spouse, and a simple but effective communication tool that aids him in every social situation. Read on.


“Dear Neurotone,

“I believe that hearing loss is the most complex, most misunderstood and most devastating, if lost or significantly weakened, of all our senses. My own very difficult and ongoing transition from moderate to severe hearing loss is the reason for this opinion. The vast array of products, services, support groups et al that exist to help hearing impaired people strengthens it mightily.

“After using hearing aids successfully for 22 years, my hearing deteriorated over a two-year period during which my wife, PeeDee, and I learned the disaster caused by severe hearing loss! The final piece of the puzzle of my hearing loss fell into place on a cruise in January 2015. I sat at a table for six in the boat’s huge dining room and literally couldn’t understand a word my tablemates said. I could hear them well: I couldn’t understand them!

“We were thus catapulted into a terribly difficult world which has taken years to understand, to the extent possible, and try to learn how to deal with. For most of that very difficult two-year period, my wife absolutely couldn’t believe I was “hard of hearing.” After all, we had talked to and understood each other well for 54 of our 56-year marriage. That was the worst we faced.

“I have the LACE listening course to thank for finally convincing her that I am truly hard of hearing. I scored 131 on the comprehension test at the beginning of the course! After trying 6 sessions, I had a “eureka” moment and asked PeeDee to watch a segment of a lesson with me and tell me how many words, phrases or sentences she could understand and repeat out loud; she understood and could repeat every word of every sound bite. I could do none! She truly understood from that moment on. Thank you! Perhaps this is a potential new service to add to your array.

“Hearing loss is very, very complicated, grossly misunderstood and is unique individual to individual. What works for me is not necessarily applicable to others, but I suggest the card/note as an arrow in the quiver for people with hearing loss to be used if and when necessary. They can keep a few cards in their wallet, pocket, pocketbook, etc. for use with doctors, lawyers, financial advisers and even more important, with family involved in important decision-making discussions. For me it is comfortable to have around—my neck!”

—Jim Kurfess

What’s on that card?


I Have Hearing Loss

Please talk to me face to face

So I can read your lips.


The idea for the card came to Jim just before his wife’s scheduled hip surgery in 2016. He needed to be able to hear and be understood by doctors and nurses. And now he takes it many places:

“With the card in full view hanging from a lanyard around my neck, I can confidently go anywhere I want to go! I am comfortable going to stores, shops, doctors’ offices, a crowded VA medical clinic, etc. I am comfortable because people who want to or have to talk to me or vice versa will be aware of my severe hearing loss and how to overcome it! It works very, very well.”

For more ideas on quickly improving your listening comprehension, read 10 Tips on Communication for the Hard of Hearing from LACE Auditory Training.

Do you have tips on coping with your hearing loss? If so, please share them in the comments section!



10 Tips on Communication for the Hard of Hearing

When you’re hard of hearing, day-to-day communication can be difficult, and group activities can be downright exhausting. Here are some tips from the audiology specialists at LACE on making conversation easier.


1. Position yourself about 3 to 5 feet from the person you are talking with. The loudness of sound fades rapidly as it travels, so the farther away you are from a speaker, the harder it is to hear what is said.


2. Avoid carrying on conversations from another room. It is tempting, but unproductive!


3. Look at the person who is speaking. Position yourself to get a full view of the face, not just the profile.


4. Concentrate on the main idea the speaker is expressing rather than straining to understand every word that is said. Oftentimes speech is redundant and predictable.


5. Don’t bluff and nod as if you understand when you don’t. It is better to ask questions than to continue down the wrong path.


6. Maximize the use of lighting. Have the light behind you so the speaker’s face is well illuminated.


7. Minimize interfering background noise by turning off the television, radio, running water or fan when conversing, or find a quiet corner for your conversation.


8. Have someone take notes for you in meetings so you can concentrate on the speaker and be certain that you aren’t missing anything.


9. At social gatherings, arrive early before the party becomes too large and noisy. Find the quieter places to converse.


10. When going to a movie or play, read reviews in advance to learn about the plot.


These tips and others are offered throughout LACE Auditory Training, which you can do online in the privacy of your own home in 11 sessions. Sign up for LACE and begin retraining your brain to make the most of the sounds you do hear!

Listen Up! There’s Hope for the Hard-of-Hearing.


Listening is a skill you can master, even if you don’t have this guy’s natural advantages.

The statistics on hearing loss in America are pretty grim. It’s the #3 health issue for older adults, after arthritis and heart disease. It can lead to depression and mental decline, and it has major implications for quality of life.

Fortunately, humans are rational creatures who do sensible things to improve their circumstances, right?

Not so fast. Only 20% of people with hearing loss who could benefit from a hearing aid actually wear one. And typically, those folks have waited 7 to 10 years after their initial diagnosis to get fitted with hearing aids.

What the heck is going on?

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Hearing Loss and Military Service: A Muffled Epidemic

U.S. soldiers on patrol in Afghanistan. Hearing loss and tinnitus are the top disabilities plaguing American veterans. U.S. Army photo.

U.S. soldiers on patrol in Afghanistan. U.S. Army photo.

Hearing loss among military vets doesn’t get much respect, as injuries go. No one hugs overseas-bound soldiers at the airport saying, “Just make it back home with all your hearing, you understand?”

Maybe they should. According to the Hearing Loss Association of America, hearing loss and tinnitus are the two most common service-related disabilities among American veterans, outstripping post-traumatic stress disorder, back problems, lost limbs and a host of other war-related horrors—and costing individuals an average of $12,000 a year in lost income, not to mention frustration, isolation and, if left untreated, cognitive decline.

When you narrow the field to veterans of Iraq and Afghanistan, it’s unclear how prevalent hearing loss and tinnitus are, but indications are troubling. The Defense Department notes that in the current wars, 75% of injuries are from blasts—and 50% of those blasts cause permanent hearing loss (not to be confused with total hearing loss). According to the L.A. Times, 43% of Iraq and Afghanistan veterans on disability have tinnitus.

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Listening to loud music from headphones can lead to permanent hearing loss

Hearing, Listening and Your Brain

hand-to-ear“There is a distinct difference between hearing and listening,” writes Woodbury, N.Y. audiologist Diana Callesano in the January/February issue of Hearing Loss Magazine. “Listening incorporates a variety of cognitive skills that hearing alone does not require.”

We couldn’t have said it better ourselves. Neurotone’s LACE (Listening and Communication Enhancement) training was designed to sharpen up cognitive skills like memory and attention so that people with hearing loss and those with hearing aids can get the most out of the sounds they do hear.

Now there’s another reason to take LACE aural rehabilitation training: preserving brain function. Research is now suggesting that hearing loss, if left unaddressed, can lead to loss of cognition. Callesano explains how hearing loss taxes the brain and drains cognitive resources:

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The 5 Best Things About LACE Training

Photo by kilgarron on Flickr.

Photo by kilgarron on Flickr.

by Traci Hukill

I took the LACE training course in December. What that means is that for 30 minutes a day for three weeks, I sat down in front of my computer in a quiet room and did listening comprehension exercises designed to improve my listening skills, complete with regular testing to monitor my progress.

Besides helping me hone my ability to focus on speech even in tough circumstances, the LACE training was fun—a bonus I hadn’t counted on. Here are the things I liked best about it:

‘Competing Voices’ Exercises   In a nutshell, LACE training consists of five types of listening exercises. Competing Voices features two speakers talking at the same time about two totally different topics. The trick is to follow one of the voices (which means blocking out the other voice) and be able to repeat the sentence. The program makes it more difficult by increasing the volume of the voice you don’t want to hear. Just like life!

Testimonial Videos   The first few LACE training sessions include short testimonial videos from people who’ve completed the training. One of these is San Francisco Chronicle senior pop music critic Joel Selvin, who says he took LACE training as part of his research for an article but discovered unexpected benefits shortly afterward when he found himself seated at a large round table in a, yes,  noisy restaurant.

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LACE Online

Announcing the Upgraded, Feature-Rich LACE Online

Neurotone Inc., the golden standard in aural rehabilitation, is proud to announce that an upgraded, feature-rich LACE Online (LOL) has been launched. The new LOL replaces the existing LACE Home Edition & Clinic Edition software product lines.

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Hearing Aids, Then And Now

Say what you will about the eccentric Swiss aristocrat Madame de Meuron: she knew how to rock an ear trumpet with style. Wikimedia commons image.

Wikimedia commons image

A look back at some of the hearing devices of the past and their modern-day counterparts. 


Old-timey Hearing Aid: The Ear Trumpet  The first widely manufactured hearing aids were ear trumpets—those instruments of aural assistance that were about as discreet as a giraffe at your dinner table. They ranged from about 6 inches to 12 inches long and came in a variety of materials: silver, brass, wood, ivory, tortoiseshell, faux tortoiseshell. They came camouflaged in fans, curved like pipes and straight like soprano saxophones, but the basic principle remained the same: collect sound via a large opening and funnel it into the ear via a small opening.

Some people managed to make their ear trumpets fashionable, like the eccentric Swiss aristocrat Madame de Meuron, pictured above. She reportedly once answered the question of why she carried an ear trumpet by saying, “So I can hear only what I want to hear.” Hmph!

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Denver Theater Gets Serious About Hearing Accessibility


Actress Kate Finch signs in ‘Tribes’ as Andrew Patsides (l) and Tad Cooley look on. Photo by Adams Visual Communications.

For fans of live theater, life is far richer for it, and having to do without it because of hearing loss is a sad thing.

Maybe those people should consider relocating to Colorado. The Denver Center for the Performing Arts (DCPA) is in the middle of a pathbreaking season of equal opportunity for the hard-of-hearing, both onstage and in the house. From now through Nov. 15, the center is showing Tribes, the story of Billy, a deaf man raised in a family of proud, intellectual contrarians who can hear perfectly well but don’t listen for beans. When Billy meets Sylvia, a woman who teaches him sign language, he starts questioning what it means to be understood.

The actor in the lead role is deaf in one ear and losing his hearing in the other; the actor playing the woman he meets was raised using sign language. In a reversal of the usual translation dynamic, the production translates Billy and Sylvia’s signed conversations for the hearing audience via supertitles. And of course the topic itself—hearing and deafness, both literal and metaphoric—is of particular interest to anyone who has lost hearing ability and struggled to communicate.

The DCPA production of 'Tribes' includes the use of supertitles on the set to translate signed conversations. Photo by Adams Visual Communicatinos.

The DCPA production of ‘Tribes’ includes the use of supertitles on the set to translate signed conversations. Photo by Adams Visual Communicatinos.

All that is pretty remarkable. But DCPA is also distinguishing itself in the services it offers patrons with degraded hearing. For the duration of the Tribes run, DCPA is trying out 10 closed-captioning devices for the deaf and hard-of-hearing. With a screen roughly the size of an iPhone, the device clips to the back of the seat in front of the patron and discreetly displays dialog and stage activity (e.g., “phone rings”) typed in by a live captioning operator.

In several hours of web research, I haven’t found any other theater offering such a service. Most of the nation’s performing arts theaters offer Assistive Listening Devices (basically amplifiers worn as headsets) of varying degrees of sophistication and stop there.

The Kennedy Center in Washington, D.C., the leader in making theater accessible, offers two American Sign Language (ASL)-interpreted performances and at least two open-captioned performances per production. (In open-captioned performances, dialog and stage activity are printed in real time on an LED screen to one side of the stage). Victory Gardens Theater in Chicago offers one ASL performance and three open-captioned performances per production.

Other theaters with substantial hearing-accessible offerings—Broward Center for the Performing Arts in Fort Lauderdale, the Oregon Shakespeare Festival in Ashland and the Ahmanson Theatre in Los Angeles, to name a few—fall somewhere in the middle. Most all of them, save Victory Gardens, are on one of the coasts.

So DCPA—forward-thinking, pro-active and located in the middle of the country—is a rare animal. Its baseline hearing-accessible offerings, laid out in this video (the hearing section begins at 2:09), are robust: state-of-the-art assistive listening devices, one ASL performance per production and an open-captioned performance for about half the productions.

We find the example set by Denver to be seriously encouraging. Neurotone’s L.A.C.E. program was created on the premise that people can improve their listening skills even after they’ve suffered hearing loss by learning how to focus on context, tone and other aspects of communication. And we firmly believe that you don’t need perfect hearing in order to be an excellent listener. But it’s also nice to know that there’s a little hearing help out there in the world when we need it.

Resources for Hearing-Accessible Theatres in the U.S.

Click here to learn more about the Denver Center for the Perfoming Arts production of Tribes. If you live in the area and wish to reserve a closed-captioned device, call (303) 893-4100 48 hours ahead of time to reserve it.

Click here for a list of theaters around the country that regularly offer open-captioned performances.

Click for a list of upcoming open-captioned performances in the New York City area

Click for a list of upcoming signed, open-captioned or audio-described (for visually impaired) performances at the Los Angeles Center Theatre Group

Click here for a brief explanation of different assistive listening devices

—Traci Hukill