Auditory Training for Better Hearing in Noise

Auditory training is a set of guided listening exercises that teaches your brain to make better use of the sound your ears deliver. At Toronto Hearing Services, we offer it at our North York, Markham and Etobicoke clinics. It’s for adults who struggle with speech in noise, want to sharpen listening and thinking skills, or are settling into new hearing aids.

Why Can’t I Hear in Restaurants? The Science Explained

Restaurants are about the hardest listening environment there is. Your brain has to pull one voice out of clatter, music and a dozen other conversations, in a room full of echo.

Understanding the noise problem

Why is it so hard to hear in noise? When noise competes with speech, soft consonants are buried first. Your brain then spends extra effort guessing, which is why a dinner out can leave you drained. Noise makes conversations harder for everyone, and it hits harder when hearing, attention or processing is already strained.

Speech in noise trouble isn’t limited to one group. It can show up with:

1. Age-related hearing loss;

2. Auditory processing disorder;

3. Neurocognitive changes;

4. Traumatic brain injury; and most importantly,

5. A normal-looking hearing test.

Normal hearing on a standard hearing test never means you don’t have hearing issues. In a review of 5,808 patients at the Stanford Ear Institute (Fitzgerald et al., 2023), many showed significant difficulty on a speech-in-noise test despite excellent word-recognition scores in quiet. To actually understand your hearing needs, you need to learn about how your ears are doing with the extended high frequencies, and how your brain is doing with processing speech in noise.

Why Do I Need To Test My Speech Perception in Noise

A standard hearing test checks the softest sounds you can detect. It doesn’t show how you cope in a noisy room. Speech-in-noise testing fills that gap. 

In a survey of 275 U.S. audiologists, the most common reason for running these tests was validating a patient’s report of difficulty in noise. Lack of time was the main barrier. A baseline also lets us show you how much you’ve improved after training. Toronto Hearing Services takes speech in noise concerns seriously using LISN-S speech in noise test and QuickSIN test. Book your speech in noise test here today.

What Is Auditory Training and Why Is It Important?

Think of it as physiotherapy for listening. Your ears and hearing aids supply the sound. Training works on the brain’s side of the job: sorting speech from noise, holding on to what was just said, and filling in gaps.

Auditory training matters for three reasons:

• It targets the situations that frustrate people most, like crowded rooms and fast talkers.

• It adds to hearing aids and doesn’t replace them.

• It gives you something active to do, which many people find encouraging.

Auditory training for hearing loss

Hearing aids can’t solve everything. A study of 40 experienced users noted that hearing aids cannot completely alleviate all the problems adults with hearing impairment face (Van Wilderode et al., 2023). The trained group improved on trained tasks, consonant identification and speech in noise. The authors also felt their program wasn’t challenging enough, which shows that program design matters.

Hearing professionals have long realized the need for auditory training. Neurotone, the maker of a leading auditory training program offered at Toronto Hearing Services, LACE, already noted this gap in 2010: “fewer than 10% of audiologists offered auditory training”.

How Does Auditory Training Work? Joining Up Thinking and Listening

Auditory training works because hearing is an ear and brain job. Your ears collect sound, and your brain uses attention, memory and language knowledge to make meaning from it. A review in Frontiers in Psychology looked at three training studies and suggested that developing complex cognitive skills may matter more than refining sensory processing (). Good programs don’t only drill sounds. They ask you to listen, remember and respond under pressure.

What Happens In The Brain With Auditory Training

One LACE study followed 28 adults and found that training strengthened the brainstem’s response to pitch cues in noise. It also found behavioural gains on speech-in-noise tests, with benefits still present at six months, while an untrained control group showed no change (Song et al., 2012). Further studies also support the idea that the brain adapts with training to provide real-life benefits for everyday communication. (e.g. Anderson et al., 2013).

LACE AI Pro is the auditory training program offered at Toronto Hearing Services. It trains degraded speech comprehension, cognitive skills and communication strategies. Tasks adapt to your performance as you go. Its current version, Lace AI Pro, runs as a mobile app.

Auditory Training for Enhanced Speech Perception

Can Auditory Training Improve Working Memory and Attention?

Possibly, with an important caveat. Following speech in noise uses working memory and attention, so building these skills can make listening feel less effortful.

Does auditory training work? The evidence is encouraging:

While many of these are small, and the gains in decibels are modest. A few decibels of better signal-to-noise tolerance can still make a real difference in a restaurant. The 2026 trial’s participants also had a different language and an average age under 65, so don’t expect the same size of gain.

What Do I Get From Auditory Training?

Auditory training has been well-researched in terms of task-specific and talker-specific gains. Just like how practice helps most on what you practise, auditory training programs like LACE AI Pro works the same way too. In a study of adults with hearing loss who trained for 12 hours, gains were largest when the task and talker matched training, smaller when the talker changed, and smaller again when the task differed.

An earlier trial on Neurotone’s list found that people who trained with one voice improved most on that voice (Newman & Evers, 2007), while those who trained with many voices got better across a range of voices. This is why we tailor goals. Training with a spouse’s voice, for example, is not the same as training for a busy café.

Does Familiar Voices Help?

Training with a familiar voice is a landmark feature of LACE AI Pro offered at Toronto Hearing Services. A study with 27 participants found people understood up to 20% more of familiar voices in background noise (Holmes & Johnsrude, 2021). This is early-stage research with healthy listeners, but it hints at why practising with voices you know can help.

Can Auditory Training Improve Working Memory and Attention?

Auditory training trains up the brain. Following speech in noise uses working memory and attention, which is why building these skills can make listening feel less effortful. When these abilities are trained, improvements in relevant parts of cognition are not surprising.

A systematic review of nine studies and 620 participants reported small but significant cognitive gains from auditory training, especially in working memory (Lawrence, 2018). The Frontiers review found that auditory training generalized to self-reported hearing, competing speech and complex cognitive tasks (Ferguson & Henshaw, 2015). However, working memory training on its own showed no real-world listening benefit, so the exercises work best when built into listening tasks.

Auditory Training With Hearing Aids

New hearing aids can feel overwhelming. Footsteps, paper rustling and running water return, and your brain has to relearn them. Training gives you structured practice during that adjustment. In one study, new hearing aid users who did LACE training improved about 2.9 dB on QuickSIN (Olson et al., 2013). A large analysis of 625 patients found that auditory training program such as LACE plays a great role in helping people with hearing loss to adapt to their restored hearing, where 3.5% of LACE participants returned their hearing aids, compared with 13.1% of non-participants. People chose whether to train, so that’s an association and not proof of cause. It’s still a reasonable sign that support helps people stick with their devices.

What to Expect at Toronto Hearing Services

Dr. Lorraine Vosu, Doctor of Audiology, owns the practice, which has three clinics. Here’s how it works:

Assessment. A hearing test plus speech-in-noise testing to set your baseline.

Goal setting. We choose the situations that matter to you, like a favourite restaurant or team meetings.

Training. Lace AI Pro app will be prescribed for you to work on at home. Our clinician will guide you through the setup process to get you started. We recommend you to complete 15 minutes of training daily, for 30 days straight according to the researched training protocol.

Review. We track your progress monthly, for the first 3 months to ensure you are progressing.

Who it suits:

• People who struggle in noise even with hearing aids.

• New hearing aid users.

• Adults with a normal-looking audiogram who still struggle in groups.

List of Clinics Providing LACE AI Pro

The clinics offering LACE AI Pro can be reached at 855-203-4863. 

References:

Anderson, S., White-Schwoch, T., Choi, H. J., & Kraus, N. (2013). Training changes processing of speech cues in older adults with hearing loss. Frontiers in systems neuroscience, 7, 97. https://doi.org/10.3389/fnsys.2013.00097

Ferguson, M., & Henshaw, H. (2015). Auditory training can improve working memory, attention, and communication in adverse conditions for adults with hearing loss. Frontiers in Psychology, 6, 556-556. https://doi.org/10.3389/fpsyg.2015.00556

Fitzgerald, M. B., Gianakas, S. P., Qian, Z. J., Losorelli, S. D., & Swanson, A. (2023). Preliminary Guidelines for Replacing Word-Recognition in Quiet With Speech in Noise Assessment in the Routine Audiologic Test Battery. Ear and Hearing, 44, 1548-1561. https://doi.org/10.1097/aud.0000000000001409

Gundmi, A., Yerraguntla, K., Rajashekhar, B. et al. Efficacy of a structured auditory training module in older individuals with hearing loss: a randomized controlled trial. Eur Arch Otorhinolaryngol 283, 3585–3594 (2026). https://doi.org/10.1007/s00405-026-10058-6

Henderson Sabes, J., & Sweetow, R. W. (2007). Variables predicting outcomes on listening and communication enhancement (LACE) training. International journal of audiology, 46(7), 374–383. https://doi.org/10.1080/14992020701297565

Holmes, E., & Johnsrude, I. S. (2021). Speech-evoked brain activity is more robust to competing speech when it is spoken by someone familiar. NeuroImage, 237, 118107. https://doi.org/10.1016/j.neuroimage.2021.118107

Ji Young Jeong , AU – Ji Min Jeong and AU – Jae Hee Lee (2025). Efficacy of Auditory Spatial Training in Multi-Talker and Real-Life Noise Environments for Adult Hearing Aid Users. Audiology and Speech Research, 21(2), 116 – 124.

Lai, C. Y., Ng, P. S., Chan, A. H. D., & Wong, F. C. K. (2023). Effects of Auditory Training in Older Adults. Journal of speech, language, and hearing research : JSLHR, 66(10), 4137–4149. https://doi.org/10.1044/2023_JSLHR-22-00621

Lawrence, B. J., Jayakody, D. M. P., Henshaw, H., Ferguson, M. A., Eikelboom, R. H., Loftus, A. M., & Friedland, P. L. (2018). Auditory and Cognitive Training for Cognition in Adults With Hearing Loss: A Systematic Review and Meta-Analysis. Trends in hearing, 22, 2331216518792096. https://doi.org/10.1177/2331216518792096

Mertes, I. B., Braun, S. T., & Billings, C. J. (2026). A Survey of U.S. Audiologists’ Speech-in-Noise Testing Practice Patterns for Adults. American Journal of Audiology, 1-18. https://doi.org/10.1044/2026_aja-25-00332

Newman, R. S., & Evers, S. (2007). The effect of talker familiarity on stream segregation. Journal of Phonetics, 35(1), 85–103. https://doi.org/10.1016/j.wocn.2005.10.004

Ockelmann, J., Scherpiet, S., Stropahl, M. et al. Personalized and gamified auditory-cognitive training improves naturalistic speech-in-noise comprehension in older adults with hearing loss. npj Sci. Learn. 10, 80 (2025). https://doi.org/10.1038/s41539-025-00369-4

Olson, A. D., Preminger, J. E., & Shinn, J. B. (2013). The effect of LACE DVD training in new and experienced hearing aid users. Journal of the American Academy of Audiology, 24(3), 214–230. https://doi.org/10.3766/jaaa.24.3.7

Song, J. H., Skoe, E., Banai, K., & Kraus, N. (2012). Training to improve hearing speech in noise: biological mechanisms. Cerebral cortex (New York, N.Y. : 1991), 22(5), 1180–1190. https://doi.org/10.1093/cercor/bhr196

Van Wilderode, M., Vermaete, E., Francart, T., Wouters, J., & van Wieringen, A. (2023). Effectiveness of Auditory Training in Experienced Hearing-Aid Users, and an Exploration of Their Health-Related Quality of Life and Coping Strategies. Trends in hearing, 27, 23312165231198380. https://doi.org/10.1177/23312165231198380