How Auditory Training Can Improve Communication

For many people, hearing aids are life-changing. Conversations become easier to follow, environmental sounds return, and communication with family and friends becomes more enjoyable. Modern hearing technology is remarkably effective at helping people reconnect with the sounds of everyday life.

Many people tell me they notice things they haven’t heard in years: the birds singing outside, the indicator sound in the car, the hum of household appliances, or the footsteps of loved ones walking through the house. These are wonderful signs that hearing aids are doing exactly what they’re designed to do. They are helping people reconnect with the world around them.

But sometimes people notice something else. Even though they can hear more sounds, understanding conversations can still feel difficult.

Perhaps you’ve found yourself saying:

“I can hear people talking, but I can’t always make out the words.”

Or maybe:

“I do fine one-on-one, but restaurants are still really difficult.”

Or even:

“By the end of the day, I’m exhausted from trying to listen.”

If any of these sound familiar, you’re certainly not alone. The good news is that it doesn’t mean your hearing technology isn’t working. In many cases, it means your brain may benefit from some additional listening practice.

Hearing Happens in the Brain, Too

Most people think hearing takes place in the ears. In reality, hearing is a team effort between the ears and the brain.

Your ears collect sounds from the world around you, but your brain is responsible for figuring out what those sounds mean. It has to recognize speech sounds, separate a voice from background noise, remember what was said, and make sense of it all within a fraction of a second.

When hearing loss has been present for a period of time, the brain may not have been receiving a complete picture of speech. Once hearing aids provide improved access to those sounds, the auditory system begins adapting to this richer source of information.

For many people, that adjustment happens naturally. For others, additional auditory training can help strengthen listening skills and maximize the benefit they receive from their hearing technology.

Learning to Listen: Dr. Norman Erber’s Auditory Hierarchy

One of the pioneers in auditory rehabilitation, Dr. Norman Erber, described listening as a series of skills that build upon one another. His Auditory Hierarchy remains one of the most influential frameworks in auditory training today.

The first step is detection, or simply becoming aware that a sound is present. Hearing aids and cochlear implants are exceptionally effective at improving access to sound at this level.

The next step is discrimination, the ability to notice differences between sounds. For example, recognizing that “bat” and “pat” sound different even though they are very similar.

From there comes identification, where the listener is able to recognize and label what was heard.

Finally, there is comprehension, the ability to understand the meaning of spoken language and respond appropriately.

Most people think of hearing as a single skill, but Dr. Erber’s work reminds us that successful communication depends on all of these stages working together.

This helps explain why someone may hear that a person is speaking yet still struggle to understand the message, particularly in difficult listening environments. Hearing aids provide access to sound, but the brain still has to process and interpret that information.

Listening Is a Skill That Can Be Strengthened

Just as physical exercise can improve strength and endurance, listening skills can be improved through targeted practice.

Auditory training is designed to strengthen the brain’s ability to process sound efficiently and effectively. The goal is not to replace hearing aids or cochlear implants but to help individuals make the most of the auditory information their devices are providing.

Research has shown that the auditory system remains capable of learning and adapting throughout life. This ability, known as neuroplasticity, allows the brain to strengthen listening pathways through structured practice and repetition.

Why Some Listening Situations Are More Difficult Than Others

Many hearing aid users tell me that quiet conversations are manageable, but noisy places are another story. A busy restaurant. A family gathering. A meeting at work. A crowded coffee shop.

These environments require the brain to do a tremendous amount of work. It must focus on the speech you want to hear while filtering out all the sounds you don’t.

For some people, this process feels effortless. For others, it takes significant concentration and energy, leading to listening fatigue and frustration.

This is where auditory training can make a real difference.

Understanding the Buffalo Model

While Dr. Erber’s hierarchy explains how listening develops, the Buffalo Model of Auditory Processing, developed by Dr. Jack Katz, helps identify specific listening skills that may benefit from additional support.

The Buffalo Model focuses on four primary areas of auditory processing: Decoding, Tolerance-Fading Memory, Integration, and Organization.

Decoding involves accurately processing speech sounds. Individuals with weaknesses in this area may find that words sound unclear or that similar-sounding words are easily confused.

Tolerance-Fading Memory relates to listening in background noise and remembering auditory information. People with challenges in this area often report that noisy environments are exhausting and that they struggle to retain spoken information.

Integration involves combining auditory information with other language and cognitive skills. It helps us connect what we hear with meaning and context.

Organization supports our ability to sequence, structure, and manage auditory information. This skill plays an important role in following conversations, recalling information, and expressing thoughts clearly.

Understanding these listening skills can be empowering. It helps explain why two people with similar hearing tests may have very different listening experiences and why some individuals continue to struggle even when their hearing aids are working well.

Training the Listening Skills That Matter Most

The encouraging news is that listening skills can often be strengthened through targeted auditory training.

One of the strengths of Buffalo Model Auditory Training (BMAT) is that it doesn’t focus on just one aspect of listening. Instead, it is designed to strengthen all of the key auditory processing skills that contribute to successful communication.

Every BMAT session includes a variety of activities that work on different listening abilities. This comprehensive approach helps strengthen the brain’s ability to recognize speech sounds, understand speech in background noise, remember spoken information, and process language more efficiently.

Sessions often begins with phonemic training, which helps the brain become more accurate at recognizing subtle differences between speech sounds. This is an important foundation for communication because if the brain struggles to tell speech sounds apart, understanding words and conversations becomes much more difficult.

Another important component is phonemic synthesis training, which helps the brain combine individual speech sounds into meaningful words. This supports more efficient speech recognition and can make conversations feel clearer and easier to follow.

Because difficulty hearing in noise is one of the most common concerns among hearing aid users, every session also includes words-in-noise training. These exercises help the brain practice focusing on speech while managing competing sounds, building confidence in real-world situations such as restaurants, family gatherings, and social events.

Auditory memory training is also included in every session. Strengthening auditory memory can make it easier to follow conversations, remember important information, and keep up with the natural flow of communication.

What makes BMAT unique is that while every patient works on all areas of auditory processing, the program is never one-size-fits-all. Throughout the training process, the audiologist monitors progress and adjusts the activities based on each individual’s needs. Areas that are more challenging receive additional attention, while strengths continue to be reinforced.

In other words, BMAT provides a comprehensive approach to improving auditory processing while remaining personalized to the individual. By strengthening the entire auditory system and focusing on the areas that need the most support, patients can develop stronger listening skills and get even more benefit from their hearing aids or cochlear implants.

Small Improvements Can Have a Big Impact

Many people assume that communication difficulties are simply something they have to live with. However, even modest improvements in listening skills can make a meaningful difference.

Following conversations becomes easier. Listening requires less effort. Social situations become more enjoyable. Confidence grows.

Most importantly, people often find themselves participating more fully in the moments that matter. Whether that’s chatting with friends, enjoying family gatherings, attending community events, participating in meetings, or simply having an easier conversation across the dinner table.

The Good News: The Brain Can Continue to Learn

One of the most encouraging findings from hearing and brain research is that the auditory system remains capable of change throughout life.

This ability, known as neuroplasticity, allows the brain to adapt to new auditory information and strengthen listening skills through practice and experience. Research has shown that auditory training can improve speech understanding, listening confidence, and communication performance in adults with hearing loss, including those who use hearing aids and cochlear implants.

Just as physical therapy helps strengthen muscles after an injury, auditory training helps strengthen the neural pathways involved in listening and communication.

While results vary from person to person, many individuals report improvements in speech clarity, listening in noise, reduced listening effort, and overall communication confidence.

The combination of appropriate hearing technology and targeted auditory training offers a powerful approach to helping people hear better, listen better, and communicate more effectively.

Getting the Most from Your Hearing Aids

Hearing aids are one of the most important tools available for improving communication. They provide the access to sound that makes everything else possible. Auditory training builds on that foundation.

By strengthening skills such as speech discrimination, listening in noise, auditory memory, phonemic synthesis, and other auditory processing abilities, auditory training can help people make the most of the sounds their hearing aids are providing.

If you’ve ever felt that you can hear but still struggle to understand, it may be worth exploring whether auditory training could help.

Because hearing more is important but understanding more is life-changing.

About the Author:

Dr. Kaitlyn Lepore is a Doctor of Audiology and is the founder of Auditory Pathway, a specialized telehealth audiology clinic dedicated to the assessment and management of auditory processing difficulties, tinnitus, and sound sensitivity. Through evidence-based evaluation and personalized auditory training programs, Dr. Lepore helps teens and adults strengthen the listening skills needed for successful communication and greater confidence in everyday life.

To learn more about Auditory Pathway and its services, visit https://audpathway.com

References

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Katz J. The Buffalo Model Questionnaire Manual. Buffalo Model Foundation; 2007.

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Ferguson MA, Henshaw H, Clark DPA, Moore DR. Benefits of phoneme discrimination training in a randomized controlled trial of 50- to 74-year-olds with mild hearing loss. Ear and Hearing. 2014;35(4):e110-e121.

Henshaw H, Ferguson MA. Efficacy of individual computer-based auditory training for people with hearing loss: A systematic review. PLoS ONE. 2013;8(5):e62836.

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