# Evaluating Device-based Rehabilitation for Veterans with Functional Hearing Difficulties: A Randomized Controlled Trial

> **NIH VA I01** · PORTLAND VA MEDICAL CENTER · 2024 · —

## Abstract

At least 10% of Veterans seeking help in VA audiology clinics have clinically normal audiograms, a
figure that broadly confirms a recent prevalence study indicating that 33.6% of current active-duty military
Service Members are at risk of hearing and communication deficits despite having normal-hearing thresholds.
While a considerable amount of research effort over the past 20 years has been devoted to understanding the
potential causes for hearing difficulties in patients with normal hearing sensitivity, comparatively little research
effort has been devoted to rehabilitation and improvement of function for these patients. This predicament has
left audiologists and other medical professionals with very few evidence-based options to provide care for the
large segment of help-seeking Veterans struggling with functional hearing difficulties. Currently, audiologic
standard of care (SOC) for these patients involves reassurance of normal hearing and providing general
communication tips, though evidence suggests that many patients are unsatisfied with this approach and
request further testing and rehabilitation options. To help address patient concerns, many VA audiologists are
now prescribing hearing aids though there is very little data on whether these devices improve functional
outcomes for patients with self-reported hearing difficulties and normal hearing sensitivity. Therefore, the
purpose of this study is to compare the efficacy of device-based rehabilitation options with current standard of
care for Veterans with self-reported hearing and communication problems, and to identify subgroups in the
sample that may benefit differently depending upon patient-specific characteristics and needs. The general
hypothesis is that most Veterans with hearing difficulties and normal audiograms will benefit from device-based
auditory rehabilitation as reflected by decreases in perceived hearing handicap. However, the amount of
benefit will vary according to patient-specific characteristics including auditory, psychological and cognitive
factors in combination with the type and severity of auditory dysfunction experienced by the patient.
 All study participants will be Veterans with normal to near-normal pure-tone sensitivity but with
moderate to severe perceived hearing handicap who are interested in seeking professional help. Participants
will be interviewed to gather data regarding their hearing difficulties, including the context and impacts of
difficulties as well as goals for auditory rehabilitation. Next, participants will undergo assessments of peripheral
and central auditory system function including electrophysiological and behavioral measures and cognitive and
psychological status assessed using established NIH Toolbox® measures. Participant medical charts will be
reviewed to gather data on comorbid conditions and previous exposures known to be risk factors for
developing auditory processing difficulties. These data will be compiled to provide an est...

## Key facts

- **NIH application ID:** 10865152
- **Project number:** 1I01RX004791-01A1
- **Recipient organization:** PORTLAND VA MEDICAL CENTER
- **Principal Investigator:** Melissa Papesh
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-04-01 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10865152

## Citation

> US National Institutes of Health, RePORTER application 10865152, Evaluating Device-based Rehabilitation for Veterans with Functional Hearing Difficulties: A Randomized Controlled Trial (1I01RX004791-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10865152. Licensed CC0.

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