Objective Persons with hearing aids or cochlear implants often have difficulty understanding speech well despite amplification, especially in noisy environments. Auditory training can help their brain refine their listening skills. The current study aimed to determine the efficacy of the ALICE program, a self-guided home-based health care program including monitoring, training and counselling.

Method A multicentric study was carried out, including hearing aid centers and a cochlear implant center in Flanders (Belgium). Participants were assigned randomly to an intervention or control group. Participants in the intervention group received a tailored flow of exercises that could be streamed to the device or presented in sound field. All participants were tested before and after 8 weeks using sentences in noise and different self-reports.

Results Participants in the intervention group were compliant during the 8-week training period. Significant on-task improvements were observed, as well as improved speech in noise understanding for the intervention group only. The self-report data did not reveal changes following the intervention.

Conclusions Our clinical trial shows that the self-guided ALICE training program is effective at improving the auditory system’s ability to parse untrained speech in noise. This enhancement in speech in noise performance is specific to the training group, as the control group did not improve. The results of the clinical trials imply that ALICE can be used as a scalable, accessible, and safe hearing care intervention.

LDR is co-founder of CELES (founded after the clinical trial, to market ALICE). AvW, TF and JW have a relationship with CELES concerning consultancy and equity.

ClinicalTrials.gov (NCT05329922).

C3-grant project from the KU Leuven (C3/21/046) and FWO-TBM grant no T000823N (CLINIC, PI van Wieringen)

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Ethical approval was granted by the Federal Agency for Medicines and Health Products (Eudamed number: CIV-22-06-039801-SM03).

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