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Aural Rehabilitation
Aural rehabilitation is a tailored, evidence-based program that retrains the brain to make sense of speech and everyday sounds after hearing loss.
At Audiology Island, Dr. Stella Fulman and Dr. Zhanneta Shapiro build individualized rehab plans—auditory training, communication coaching, counseling, assistive tech—so patients move from simply hearing louder to actually understanding again.
Fitted with hearing aids, a cochlear implant, or still untreated? Aural rehab closes the gap between volume and clarity.
What Is Aural Rehabilitation?
Your hearing aids are in. The world got louder. But did it get clearer? For most people—honestly, no. Not right away. That gap between louder and clearer is exactly what aural rehabilitation exists to close. Sometimes called audiologic rehab or auditory re-training, it’s the clinical process of teaching your brain to do something useful with the sound signal your device now delivers. ASHA describes it as a broad set of services designed to shrink the communication barriers that hearing loss creates and squeeze more function out of whatever hearing remains (ASHA, 2023).
Here’s why retraining isn’t optional fluff. Hearing loss creeps. Sensorineural decline typically stretches across years while the auditory cortex quietly loses contact with certain frequency bands. The neural wiring that once cracked high-frequency consonants like /s/, /f/, /th/? It atrophies—neuroscientists call it cortical reorganization (Sharma & Glick, 2016). So when a hearing aid floods those pathways with sound again, the brain panics a little. Everything rings tinny, harsh, foreign. Aural rehab speeds up the comeback so you’re not white-knuckling through months of “this sounds awful.”
Dr. Stella Fulman and Dr. Zhanneta Shapiro at Audiology Island don’t bolt rehabilitation onto care as an afterthought. They weave it into every treatment plan from the first diagnostic hearing evaluation—backed by evidence that patients pairing amplification with structured auditory training score markedly better on speech-in-noise tests than those going device-only (Sweetow & Sabes, 2006).
How Does Aural Rehabilitation Work?
No cookie-cutter protocol here. Every ear is different, every brain adapts on its own schedule, and that variability is precisely what gives aural rehab its teeth. Most programs, though, rest on four pillars.
Auditory training hits the perceptual machinery head-on—physical therapy for your hearing nerve. Clinicians start broad: can you tell a doorbell from a barking dog? Then they ratchet toward finer tasks, like picking apart minimal word pairs buried under background chatter. Henshaw and Ferguson (2013) showed that even brief computer-driven training produces real bumps in working memory and speech perception. Effect sizes bounce around depending on age and severity, but the trend holds.
Speechreading and visual cues. Lip movements, facial expressions, body language—your eyes can backstop your ears in a loud room better than any algorithm. This piece of rehab teaches you how, deliberately.
Communication strategy coaching pulls family into the picture. Face the person you’re talking to. Kill the TV before you start a conversation. Rephrase instead of just repeating louder. These tricks sound embarrassingly simple written down, yet they reshape daily exchanges faster than any device firmware ever could.
Counseling for the emotional side. Hearing loss isolates people. It breeds anxiety about group settings, sometimes outright grief over lost ease of conversation. Untreated loss tracks closely with depression and social withdrawal (NCOA, 2000). Rehab gives patients a structured place to unpack that baggage—and people who feel heard emotionally tend to actually wear their hearing aids more consistently.
What Can You Expect?
Improvements roll in stages, not all at once. Weeks one through four? Mostly environmental. Sounds you forgot existed—refrigerator hum, birds outside your window, your own turn signal clicking—suddenly reappear. Some of them feel almost aggressive at first. That’s normal. The brain is recalibrating, and recalibration stings before it soothes.
Around weeks four to eight, speech in quiet rooms sharpens. Patients tell us they follow one-on-one conversations without straining so hard, catch TV dialogue without jacking the volume to 40. Practice matters here—big time. Those who run their home exercises 20–30 minutes a day land at a higher performance ceiling than sporadic trainers (Olson, Preminger & Shinn, 2013).
The real test? Noisy places. Packed restaurants, open offices, Thanksgiving dinner where four people talk at once. Even folks with textbook hearing struggle in those spots. Depending on how severe your loss is and how willing your neurons are to rewire, solid gains in noise can take three to six months. Dr. Fulman likes to put it this way: “The hearing aid does its job in the first second. Your brain does its job over the next several months.”
Common Auditory Training Exercises
No two rehab plans at Audiology Island look identical, but certain exercise families show up across nearly all of them—each one sharpening a different listening muscle.
Speech-in-noise drills. You hear recorded sentences while a wall of background babble plays at controlled volume ratios. Start easy, at a generous +10 dB signal-to-noise ratio, then the clinician gradually tightens the screws toward 0 dB—or below. Adaptive platforms like LACE shift difficulty in real time based on how you perform (Sweetow & Sabes, 2006).
Phoneme discrimination. “Bat” or “pat”? “Thin” or “fin”? These minimal-pair drills force the brain to parse razor-thin acoustic gaps that hearing loss smudges. High-frequency sensorineural damage erodes frequency resolution first, and these tasks rebuild it deliberately.
Auditory memory and sequencing. The clinician rattles off numbers, words, or short sentences. You repeat them back, in order. Chains get longer as you improve. The target is working memory—the cognitive engine behind following a live conversation—which tends to rust when hearing loss sits untreated for years (Lin et al., 2013).
Environmental sound ID. A whistling kettle. A car horn. A phone vibrating on a counter. These matter most for people with severe loss or fresh cochlear implants—brains that have literally forgotten what everyday sounds are. Seems basic, until you realize someone hasn’t clearly heard a smoke detector in five years.
Why Choose Audiology Island for Aural Rehabilitation Services
Lots of clinics sell hearing aids. Fewer care what happens once you walk out the door—and that’s exactly where results live or die. Dr. Stella Fulman, Au.D., and Dr. Zhanneta Shapiro, Au.D., lead the practice, both board-certified through the American Board of Audiology with ongoing training in rehabilitative audiology.
The real differentiator is continuity. Rehabilitation benchmarks get tracked from the first diagnostic visit through fitting, real-ear verification, and every follow-up after. That thread keeps patients from drifting into the depressingly common cycle: spend thousands on a device, find it uncomfortable, shove it in a drawer. Research backs this up—structured rehab and follow-up cut return rates and boost daily wear time (Abrams et al., 2012).
Process of Aural Rehabilitation at Audiology Island
Everything starts with a thorough audiological workup: pure-tone audiometry, speech recognition testing, and if warranted, a central auditory processing screen or tinnitus evaluation. Those results get layered against your own account of where communication breaks down, measured with validated tools like the APHAB (Abbreviated Profile of Hearing Aid Benefit). That snapshot becomes the yardstick. Skip it, and any later claims of “progress” are just guesswork.
From there, a custom plan takes shape. It might include weekly or biweekly in-office sessions (45–60 minutes each), a digital home-training program with built-in progress tracking, speechreading drills, and counseling sessions that loop in family members. Cochlear implant patients see their rehab synced to their mapping schedule—device tuning and brain training moving in lockstep.
Re-testing happens at 30, 60, and 90 days using the same baseline measures. The comparison lets clinicians adjust difficulty—and hands the patient proof. Not vague “I think it’s better” proof. Hard numbers. Watching your word-recognition-in-noise score jump from 42% to 71% in three months? That’s what keeps someone motivated long after the novelty of new devices fades.
Our Doctors of Audiology
Dr. Stella Fulman
Dr. Fulman completed her Doctor of Audiology degree at Northwestern University, followed by specialized fellowship training in vestibular assessment and rehabilitation. Her 22 years of clinical practice spans pediatric through geriatric populations, with particular expertise in complex diagnostic cases and tinnitus management.
Dr. Zhanneta Shapiro
Dr. Shapiro earned her AuD from the University of Florida, subsequently completing advanced training in hearing aid technology and real-ear verification techniques. Over 20 years, she’s fitted thousands of patients with amplification, developing refined strategies for addressing difficult-to-fit configurations and the adjustment process.
Our Office Locations and Hours
Main Office
11 Ralph Place, Suite 304,
Staten Island, NY 10304
Phone: (888) 995-5655
Office Hours
Mon & Thur
8:30AM – 7:00PM
Tue, Wed & Fr
8:30AM – 5:00PM
Sat-Sun
Clossed
Additional Locations:
Request Your Appointment
Done settling for louder when you could have clearer? Reach out to Audiology Island and book an aural rehabilitation consultation with Dr. Stella Fulman or Dr. Zhanneta Shapiro. First-time hearing aid wearer, veteran user who wants sharper results, cochlear implant candidate—we shape the program around your ears, your life, your targets.
Patient Testimonials
Patient Information
How long does aural rehabilitation take?
Most patients notice clearer speech comprehension within 4–8 weeks. Gains in tough listening environments—restaurants, group conversations, open offices—usually develop over 3–6 months of steady training and device use. Your timeline hinges on degree of loss, how long it went unaddressed, and how consistently you practice at home.
Is aural rehabilitation only for hearing aid users?
Not even close. Cochlear implant recipients, people with auditory processing disorder, and individuals managing untreated loss all benefit. It’s also useful if you’re switching device types or upgrading technology.
Does insurance cover aural rehabilitation?
Depends on the plan. Many carriers cover audiological rehab when it’s prescribed as medically necessary. Our team at Audiology Island checks your benefits before the first session so you know what to expect.
Can I do auditory training exercises at home?
Absolutely—and we push for it. Dr. Fulman and Dr. Shapiro assign digital home-training programs that work hand-in-hand with clinic sessions. Twenty to thirty minutes a day between appointments makes a measurable difference.
What is the difference between aural rehabilitation and auditory training?
Auditory training is one slice. Aural rehabilitation is the whole pie—speechreading support, communication coaching, emotional counseling, and assistive technology management all bundled together.
Other Services
Diagnostic Hearing Evaluation
Earwax
Removal
Balance/Fall Risk Assessment
Tinnitus Evaluations and Treatment
Hearing Care
for Children
Cochlear
Implants
Custom Hearing
Protection
TeleCare Service
(TeleAudiology)
Auditory Processing Disorder
Hearing Aid
Repairs
