human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This paper addresses the development and effectiveness of a home education program . The program , design ed for hearing-impaired elders and their significant others ( SO ) , deals with communication strategies and speech reading . Participants were r and omly assigned to a training group ( hearing aid fitting + home education program ) or a control group ( hearing aid fitting ) . The training group included 24 hearing-impaired subjects and 24 SO 's . Controls were 24 affected individuals and 22 SO 's . Question naires addressing emotional response , communication strategies and the IOI-HA , IOI-AI and IOI-SO were used . A repeated measures analysis of variance was applied to test group differences between pre , post , and 6-months follow-up measures . Increased awareness of benefits of speech reading and improved interaction with the SO were observed in the training group only ( p < 0.05 ) . No group difference on ‘ emotional response ’ was found . IOI-AI and IOI-SO demonstrated favorable attitudes towards the program . Follow-up measures showed improved quality of life and satisfaction in the training group , while a decrease was observed among the controls ( p < 0.05 ) . Some effects differed between first-time and experienced hearing aid users . Addition of services to amplification and involvement of the SO are relevant in aural rehabilitation BACKGROUND Audiologic rehabilitation aims to improve communication for people with hearing impairment . Education is widely regarded as an integral part of rehabilitation , but the effect of the delivery method of an educational program on the experience of hearing problems has rarely been investigated in controlled trials . PURPOSE The purpose of this study was to examine the short-term effects of complementing an educational program for hearing aid users with telephone consultations , delivered through weekly discussion s with the subjects about information obtained from a book on hearing and hearing aids . RESEARCH DESIGN This study used a r and omized , controlled design . STUDY SAMPLE In total , 69 hearing aid users were r and omly assigned to an intervention group ( n = 33 ) or a control group ( n = 36 ) . INTERVENTION The intervention group had access to a book and received weekly topic-based reading instructions related to the different chapters of the book . Five telephone calls were made to the members of the intervention group . During the calls , an audiologist discussed new information with the participant as needed . The control participants also read the book , but they did not discuss the contents of the book with a professional . DATA COLLECTION AND ANALYSIS The Hearing H and icap Inventory for the Elderly ( HHIE ) , the Hospital Anxiety and Depression Scale ( HADS ) , and the International Outcome Inventory for Hearing Aids ( IOI-HA ) were used to measure the outcomes of this study . RESULTS Participants in the intervention group had a reduction in self-reported hearing h and icap , while there were no significant changes in the control group . In the intervention group , 45 % of the participants showed an improvement of ≥36 % on the HHIE , while only 17 % of the control group showed an improvement of ≥36 % . There were also improvements on the HADS total and the depression subscale for the intervention group . No changes occurred on the IOI-HA . CONCLUSIONS Reading about hearing and hearing aids can reduce the hearing h and icap and reported anxiety in hearing aid users . In this study , discussing the content of the book that was provided with a professional during weekly telephone consultations and having weekly home assignments further improved emotional well-being , as demonstrated by the HHIE ( emotional scale ) and HADS ( depression scale ) , but these activities had no effect on hearing aid outcomes as measured by the IOI-HA Auditory training has long been advocated to enhance communication but has never been time or cost-effective . This article describes the concepts underlying the development of a home-based , interactive adaptive computer program design ed to engage the adult hearing-impaired listener in the hearing-aid-fitting process , provide listening strategies , build confidence , and address cognitive changes characteristic of the aging process . An investigation using a between-group , within-subject design with pre- and post-test objective and subjective measures was conducted at five clinical sites . Sixty-five subjects were r and omly placed into two groups , one receiving LACE ( Listening and Communication Enhancement ) immediately following baseline testing and one serving as a control for one month and then receiving training as a crossover group . Results showed statistically significant improvements for the trained subjects on all but one of the outcome measures . Barriers facing the widespread implementation of home-based aural rehabilitation are discussed Objective : To examine short- and long-term subjective benefits of providing a counseling-oriented audiological rehabilitation ( AR ) program as an adjunct to hearing aid intervention for individuals with adult-onset hearing loss . Design : One hundred six veterans ( 68 men and 38 women ) , fit binaurally with digitally programmable analog hearing aids , participated . The Communication Profile for the Hearing Impaired ( CPHI ; Demorest & Erdman , 1987 ) was administered to all participants before hearing aid fitting . Half the patients were r and omly assigned to receive hearing aids alone ( i.e. , control ) ; the other patients were assigned to participate in a 4-wk group AR program in conjunction with receiving hearing aids ( i.e. , HA+AR ) . At the end of the AR program , the CPHI was again administered to all participants to assess short-term benefit and at 6 mo and 1 yr after hearing aid fitting to assess long-term benefit . Results : A separate repeated- measures version of the general linear model was used to examine short- and long-term benefits for the CPHI factor scores ( communication importance , communication performance , adjustment , interaction , and reaction ) and for individual importance ratings and scale scores . Hearing aid use improved both short- and long-term self-perception of communication performance , with no additional benefits from participation in the AR program . Consistent with the goals of a counseling-oriented AR program , differential short-term treatment effects were found for communication strategy usage , which led to differential short-term benefits for the interaction and reaction factors . Although failing to reach strict criteria for statistical significance , there was an observable difference in short-term outcomes between the two groups for the adjustment factor , with greater improvements occurring for the HA+AR group . Over the course of the year , benefits measured for the HA+AR group remained stable , whereas scores for the control group continued to increase , result ing in no differences in factor scores between groups at 1 yr after intervention . Conclusions : The finding of a short-term differential treatment benefit for AR in terms of interaction and reaction , and possibly for adjustment , was important , as better outcomes in these areas may be important in the decision to keep hearing aids . If this is the case , then the data support the inclusion of a counseling-oriented AR program . Differential treatment effects in interaction and reaction appeared to result from communication strategy use , indicating that the AR program is meeting many of its goals in this area . The lack of long-term differential effects appeared as the result of continued changes in adjustment , interaction , and reaction with continued  hearing aid experience PURPOSE To attempt to determine whether group audiologic rehabilitation ( AR ) content affected psychosocial outcomes . METHOD A r and omized controlled trial with at least 17 participants per group was completed . The 3 treatment groups included a communication strategies training group , a communication strategies training plus psychosocial exercise group , and an informational lecture plus psychosocial exercise group . Evaluations were conducted preclass , postclass , and 6-months postclass ; they included hearing loss-related and generic quality of life scales , and a class evaluation form . RESULTS All treatment groups demonstrated short- and long-term improvement on the hearing loss-related quality of life scale . Minimal differences were measured across treatment groups . A significant difference was observed between the lecture plus psychosocial exercise group and the communication strategies training group for 1 hearing loss-related quality of life subscale . Better outcomes were measured for the 2 groups with psychosocial exercises versus the communication strategies training group on 1 generic quality of life subscale . The results for the class evaluation did not discriminate among the treatment groups . CONCLUSIONS Class content had only a minimal influence on treatment outcomes . Recommended AR class content includes a mix of interventions including information , training , and psychosocial exercises Results of this study demonstrate the advantages of both pre- and postfitting hearing aid orientation ( HAO ) sessions . This study demonstrated that HAO counseling is helpful in expediting hearing aid benefit and satisfaction through the education of our clients and that this benefit and satisfaction is age dependent as measured by the Glasgow Hearing Aid Benefit Profile ( GHABP ) ( Gatehouse , 1997 ) . Patients with greater initial disability  , as identified by item 1 of the GHABP , receive significant benefit from prefitting and /or postfitting counseling as compared to patients receiving no counseling . Implication s of these findings are discussed BACKGROUND Since the psychosocial effects of hearing loss are different in the spouse ( SP ) than in the person with hearing loss ( PHL ) , it seems reasonable that rehabilitation programs design ed for PHLs may need to be adapted to benefit SPs . PURPOSE To evaluate the effectiveness of training in communication strategies and psychosocial exercises for SPs of PHLs by determining whether SPs who completed the group class had improved mood , reduced stress , improved marital communication , and greater awareness of their partners ' hearing loss-related quality of life ( HL-QOL ) in comparison with SPs who did not participate in a group class . Additionally , to determine whether PHLs of SPs who participated in a  group audiological rehabilitation ( AR ) class had significantly improved mood , reduced stress , improved marital communication , and better HL-QOL scores in comparison with PHLs whose SPs did not participate in a group class . RESEARCH DESIGN A r and omized controlled study . STUDY SAMPLE A total of 72 individuals participated in the study , 36 PHLs and 36 SPs . The PHLs were hearing aid users or cochlear implant users ; the SPs had normal or near normal hearing . INTERVENTION PHLs in the control group participated in a traditional group AR program while their SPs received no treatment .  PHLs in the experimental group also participated in a traditional group AR program while their SPs participated in a treatment program design ed for SPs of PHLs . Classes consisted of 90 min sessions meeting once a week for four weeks . DATA COLLECTION AND ANALYSIS All participants completed question naires measuring HL-QOL ( the SPs filled out third-party reports of HL-QOL ) , stress , mood ( positive affect and negative affect ) , and communication in the marriage . Scales were completed three times : prior to the AR program , within two weeks after completing the AR program , and 6 mo later . SP awareness of their PHL 's HL-QOL was measured by comparing preclass and 6 mo scores with reported critical difference values . Preclass , postclass and 6 mo data were examined with repeated measures ANOVAs . RESULTS All SPs reported significant improvements in third-party HL-QOL between the preclass and postclass visit . At the 6 mo visit , these reports remained consistent in the control SPs but declined in the experimental SPs . Awareness of HL-QOL in PHLs was improved in SPs who participated in AR classes and remained consistent in SPs who did not . All SPs demonstrated a trend ( moderate effect sizes ) for decreased stress and decreased negative affect after they and /or their partners completed the AR program . All PHLs demonstrated significant improvements in HL-QOL , significant reductions in stress , significant decreases in negative affect , and significant improvements in marital communication . There were no differences in outcome across the experimental and control PHLs . CONCLUSIONS When PHLs participate in an AR program , they receive significant improvements in QOL ( quality of life ) . Congruence ( as defined by similar scores ) between SP and PHL assessment s of HL-QOL improved in the experimental group , suggesting that the principal impact of the AR program on SPs was improved underst and ing of PHL experiences with hearing loss PURPOSE This study attempted to determine whether auditory-only and auditory-visual speech perception could be trained in a group format . METHOD A r and omized controlled trial with at least 16 participants per group was completed . A  training-only group completed at least 5 hr of group speech perception training ; a training plus psychosocial group  completed at least 5 hr of group speech perception training and psychosocial exercises ; and a control group did not receive training . Evaluations were conducted before and after training and included analytic and synthetic measures of speech perception , hearing loss-related and generic quality of life scales , and a class evaluation form . RESULTS No significant group changes were measured on any of the analytic auditory-only or auditory-visual measures of speech perception , yet the majority of training participants ( regardless of training group ) reported improvement in auditory and auditory-visual speech perception . The training participants demonstrated a significant reduction on the emotional subscale of the hearing loss-related quality of life scale , while the control participants did not demonstrate a change on this subscale . CONCLUSIONS Benefits of group audiologic rehabilitation classes may not result from an actual improvement in auditory or visual speech perception abilities , but participants still perceive training in these areas as useful We assessed the effects of perceptual training of syllable identification in noise on nonsense syllable test ( NST ) performance of new ( Experiment 1 ) and experienced ( Experiment 2 ) hearing aid ( HA ) users with sensorineural hearing loss . In Experiment 1 , new HA users were r and omly assigned to either immediate training ( IT ) or delayed training ( DT ) groups . IT subjects underwent 8 weeks of at-home syllable identification training and in-laboratory testing , whereas DT subjects underwent identical in-laboratory testing without training . Training produced large improvements in syllable identification in IT subjects , whereas spontaneous improvement was minimal in DT subjects . DT subjects then underwent training and showed performance improvements comparable with those of the IT group . Training-related improvement in NST scores significantly exceeded improvements due to amplification . In Experiment 2 , experienced HA users received identical training and testing procedures as users in Experiment 1 . The experienced users also showed significant training benefit . Training-related improvements generalized to untrained voices and were maintained on retention tests . Perceptual training appears to be a promising tool for improving speech perception in new and experienced HA users Two methods of fine tuning the initial setting s of hearing aids were compared : An audiologist-driven approach––using real ear measurements and a patient-driven fine-tuning approach––using feedback from real-life 
    Output:
    
agent
Satisfaction and speech perception were frequent secondary outcomes .
There was diversity in measures used to report patient outcomes .
Outcome categories other than patient health status and behavior were rarely reported .
This review has highlighted considerable diversity in patient-reported outcome measurements in r and omized control trials in the context of adult auditory rehabilitation .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This paper addresses the development and effectiveness of a home education program . The program , design ed for hearing-impaired elders and their significant others ( SO ) , deals with communication strategies and speech reading . Participants were r and omly assigned to a training group ( hearing aid fitting + home education program ) or a control group ( hearing aid fitting ) . The training group included 24 hearing-impaired subjects and 24 SO 's . Controls were 24 affected individuals and 22 SO 's . Question naires addressing emotional response , communication strategies and the IOI-HA , IOI-AI and IOI-SO were used . A repeated measures analysis of variance was applied to test group differences between pre , post , and 6-months follow-up measures . Increased awareness of benefits of speech reading and improved interaction with the SO were observed in the training group only ( p < 0.05 ) . No group difference on ‘ emotional response ’ was found . IOI-AI and IOI-SO demonstrated favorable attitudes towards the program . Follow-up measures showed improved quality of life and satisfaction in the training group , while a decrease was observed among the controls ( p < 0.05 ) . Some effects differed between first-time and experienced hearing aid users . Addition of services to amplification and involvement of the SO are relevant in aural rehabilitation BACKGROUND Audiologic rehabilitation aims to improve communication for people with hearing impairment . Education is widely regarded as an integral part of rehabilitation , but the effect of the delivery method of an educational program on the experience of hearing problems has rarely been investigated in controlled trials . PURPOSE The purpose of this study was to examine the short-term effects of complementing an educational program for hearing aid users with telephone consultations , delivered through weekly discussion s with the subjects about information obtained from a book on hearing and hearing aids . RESEARCH DESIGN This study used a r and omized , controlled design . STUDY SAMPLE In total , 69 hearing aid users were r and omly assigned to an intervention group ( n = 33 ) or a control group ( n = 36 ) . INTERVENTION The intervention group had access to a book and received weekly topic-based reading instructions related to the different chapters of the book . Five telephone calls were made to the members of the intervention group . During the calls , an audiologist discussed new information with the participant as needed . The control participants also read the book , but they did not discuss the contents of the book with a professional . DATA COLLECTION AND ANALYSIS The Hearing H and icap Inventory for the Elderly ( HHIE ) , the Hospital Anxiety and Depression Scale ( HADS ) , and the International Outcome Inventory for Hearing Aids ( IOI-HA ) were used to measure the outcomes of this study . RESULTS Participants in the intervention group had a reduction in self-reported hearing h and icap , while there were no significant changes in the control group . In the intervention group , 45 % of the participants showed an improvement of ≥36 % on the HHIE , while only 17 % of the control group showed an improvement of ≥36 % . There were also improvements on the HADS total and the depression subscale for the intervention group . No changes occurred on the IOI-HA . CONCLUSIONS Reading about hearing and hearing aids can reduce the hearing h and icap and reported anxiety in hearing aid users . In this study , discussing the content of the book that was provided with a professional during weekly telephone consultations and having weekly home assignments further improved emotional well-being , as demonstrated by the HHIE ( emotional scale ) and HADS ( depression scale ) , but these activities had no effect on hearing aid outcomes as measured by the IOI-HA Auditory training has long been advocated to enhance communication but has never been time or cost-effective . This article describes the concepts underlying the development of a home-based , interactive adaptive computer program design ed to engage the adult hearing-impaired listener in the hearing-aid-fitting process , provide listening strategies , build confidence , and address cognitive changes characteristic of the aging process . An investigation using a between-group , within-subject design with pre- and post-test objective and subjective measures was conducted at five clinical sites . Sixty-five subjects were r and omly placed into two groups , one receiving LACE ( Listening and Communication Enhancement ) immediately following baseline testing and one serving as a control for one month and then receiving training as a crossover group . Results showed statistically significant improvements for the trained subjects on all but one of the outcome measures . Barriers facing the widespread implementation of home-based aural rehabilitation are discussed Objective : To examine short- and long-term subjective benefits of providing a counseling-oriented audiological rehabilitation ( AR ) program as an adjunct to hearing aid intervention for individuals with adult-onset hearing loss . Design : One hundred six veterans ( 68 men and 38 women ) , fit binaurally with digitally programmable analog hearing aids , participated . The Communication Profile for the Hearing Impaired ( CPHI ; Demorest & Erdman , 1987 ) was administered to all participants before hearing aid fitting . Half the patients were r and omly assigned to receive hearing aids alone ( i.e. , control ) ; the other patients were assigned to participate in a 4-wk group AR program in conjunction with receiving hearing aids ( i.e. , HA+AR ) . At the end of the AR program , the CPHI was again administered to all participants to assess short-term benefit and at 6 mo and 1 yr after hearing aid fitting to assess long-term benefit . Results : A separate repeated- measures version of the general linear model was used to examine short- and long-term benefits for the CPHI factor scores ( communication importance , communication performance , adjustment , interaction , and reaction ) and for individual importance ratings and scale scores . Hearing aid use improved both short- and long-term self-perception of communication performance , with no additional benefits from participation in the AR program . Consistent with the goals of a counseling-oriented AR program , differential short-term treatment effects were found for communication strategy usage , which led to differential short-term benefits for the interaction and reaction factors . Although failing to reach strict criteria for statistical significance , there was an observable difference in short-term outcomes between the two groups for the adjustment factor , with greater improvements occurring for the HA+AR group . Over the course of the year , benefits measured for the HA+AR group remained stable , whereas scores for the control group continued to increase , result ing in no differences in factor scores between groups at 1 yr after intervention . Conclusions : The finding of a short-term differential treatment benefit for AR in terms of interaction and reaction , and possibly for adjustment , was important , as better outcomes in these areas may be important in the decision to keep hearing aids . If this is the case , then the data support the inclusion of a counseling-oriented AR program . Differential treatment effects in interaction and reaction appeared to result from communication strategy use , indicating that the AR program is meeting many of its goals in this area . The lack of long-term differential effects appeared as the result of continued changes in adjustment , interaction , and reaction with continued  hearing aid experience PURPOSE To attempt to determine whether group audiologic rehabilitation ( AR ) content affected psychosocial outcomes . METHOD A r and omized controlled trial with at least 17 participants per group was completed . The 3 treatment groups included a communication strategies training group , a communication strategies training plus psychosocial exercise group , and an informational lecture plus psychosocial exercise group . Evaluations were conducted preclass , postclass , and 6-months postclass ; they included hearing loss-related and generic quality of life scales , and a class evaluation form . RESULTS All treatment groups demonstrated short- and long-term improvement on the hearing loss-related quality of life scale . Minimal differences were measured across treatment groups . A significant difference was observed between the lecture plus psychosocial exercise group and the communication strategies training group for 1 hearing loss-related quality of life subscale . Better outcomes were measured for the 2 groups with psychosocial exercises versus the communication strategies training group on 1 generic quality of life subscale . The results for the class evaluation did not discriminate among the treatment groups . CONCLUSIONS Class content had only a minimal influence on treatment outcomes . Recommended AR class content includes a mix of interventions including information , training , and psychosocial exercises Results of this study demonstrate the advantages of both pre- and postfitting hearing aid orientation ( HAO ) sessions . This study demonstrated that HAO counseling is helpful in expediting hearing aid benefit and satisfaction through the education of our clients and that this benefit and satisfaction is age dependent as measured by the Glasgow Hearing Aid Benefit Profile ( GHABP ) ( Gatehouse , 1997 ) . Patients with greater initial disability  , as identified by item 1 of the GHABP , receive significant benefit from prefitting and /or postfitting counseling as compared to patients receiving no counseling . Implication s of these findings are discussed BACKGROUND Since the psychosocial effects of hearing loss are different in the spouse ( SP ) than in the person with hearing loss ( PHL ) , it seems reasonable that rehabilitation programs design ed for PHLs may need to be adapted to benefit SPs . PURPOSE To evaluate the effectiveness of training in communication strategies and psychosocial exercises for SPs of PHLs by determining whether SPs who completed the group class had improved mood , reduced stress , improved marital communication , and greater awareness of their partners ' hearing loss-related quality of life ( HL-QOL ) in comparison with SPs who did not participate in a group class . Additionally , to determine whether PHLs of SPs who participated in a  group audiological rehabilitation ( AR ) class had significantly improved mood , reduced stress , improved marital communication , and better HL-QOL scores in comparison with PHLs whose SPs did not participate in a group class . RESEARCH DESIGN A r and omized controlled study . STUDY SAMPLE A total of 72 individuals participated in the study , 36 PHLs and 36 SPs . The PHLs were hearing aid users or cochlear implant users ; the SPs had normal or near normal hearing . INTERVENTION PHLs in the control group participated in a traditional group AR program while their SPs received no treatment .  PHLs in the experimental group also participated in a traditional group AR program while their SPs participated in a treatment program design ed for SPs of PHLs . Classes consisted of 90 min sessions meeting once a week for four weeks . DATA COLLECTION AND ANALYSIS All participants completed question naires measuring HL-QOL ( the SPs filled out third-party reports of HL-QOL ) , stress , mood ( positive affect and negative affect ) , and communication in the marriage . Scales were completed three times : prior to the AR program , within two weeks after completing the AR program , and 6 mo later . SP awareness of their PHL 's HL-QOL was measured by comparing preclass and 6 mo scores with reported critical difference values . Preclass , postclass and 6 mo data were examined with repeated measures ANOVAs . RESULTS All SPs reported significant improvements in third-party HL-QOL between the preclass and postclass visit . At the 6 mo visit , these reports remained consistent in the control SPs but declined in the experimental SPs . Awareness of HL-QOL in PHLs was improved in SPs who participated in AR classes and remained consistent in SPs who did not . All SPs demonstrated a trend ( moderate effect sizes ) for decreased stress and decreased negative affect after they and /or their partners completed the AR program . All PHLs demonstrated significant improvements in HL-QOL , significant reductions in stress , significant decreases in negative affect , and significant improvements in marital communication . There were no differences in outcome across the experimental and control PHLs . CONCLUSIONS When PHLs participate in an AR program , they receive significant improvements in QOL ( quality of life ) . Congruence ( as defined by similar scores ) between SP and PHL assessment s of HL-QOL improved in the experimental group , suggesting that the principal impact of the AR program on SPs was improved underst and ing of PHL experiences with hearing loss PURPOSE This study attempted to determine whether auditory-only and auditory-visual speech perception could be trained in a group format . METHOD A r and omized controlled trial with at least 16 participants per group was completed . A  training-only group completed at least 5 hr of group speech perception training ; a training plus psychosocial group  completed at least 5 hr of group speech perception training and psychosocial exercises ; and a control group did not receive training . Evaluations were conducted before and after training and included analytic and synthetic measures of speech perception , hearing loss-related and generic quality of life scales , and a class evaluation form . RESULTS No significant group changes were measured on any of the analytic auditory-only or auditory-visual measures of speech perception , yet the majority of training participants ( regardless of training group ) reported improvement in auditory and auditory-visual speech perception . The training participants demonstrated a significant reduction on the emotional subscale of the hearing loss-related quality of life scale , while the control participants did not demonstrate a change on this subscale . CONCLUSIONS Benefits of group audiologic rehabilitation classes may not result from an actual improvement in auditory or visual speech perception abilities , but participants still perceive training in these areas as useful We assessed the effects of perceptual training of syllable identification in noise on nonsense syllable test ( NST ) performance of new ( Experiment 1 ) and experienced ( Experiment 2 ) hearing aid ( HA ) users with sensorineural hearing loss . In Experiment 1 , new HA users were r and omly assigned to either immediate training ( IT ) or delayed training ( DT ) groups . IT subjects underwent 8 weeks of at-home syllable identification training and in-laboratory testing , whereas DT subjects underwent identical in-laboratory testing without training . Training produced large improvements in syllable identification in IT subjects , whereas spontaneous improvement was minimal in DT subjects . DT subjects then underwent training and showed performance improvements comparable with those of the IT group . Training-related improvement in NST scores significantly exceeded improvements due to amplification . In Experiment 2 , experienced HA users received identical training and testing procedures as users in Experiment 1 . The experienced users also showed significant training benefit . Training-related improvements generalized to untrained voices and were maintained on retention tests . Perceptual training appears to be a promising tool for improving speech perception in new and experienced HA users Two methods of fine tuning the initial setting s of hearing aids were compared : An audiologist-driven approach––using real ear measurements and a patient-driven fine-tuning approach––using feedback from real-life 
    Output:
    