LACE (Listening and Communication Enhancement) is computer-based auditory training designed to improve your brain’s ability to extract speech from background noise and use degraded acoustic information more effectively. It’s a structured program of daily 30-minute exercises over at least four weeks, and it works best as a complement to properly fitted hearing aids or as a rehabilitation tool for auditory processing difficulties, not as a substitute for amplification when you actually need it. After fitting thousands of hearing aids, I can tell you the single most common complaint I hear isn’t about the devices themselves. It’s “I can hear, but I can’t understand, especially in noise.” That’s because hearing loss isn’t just an ear problem. It’s a brain problem too. When your auditory system has been deprived of clear sound input for years, your brain loses practice at the complex task of sorting speech from competing sounds. You can restore audibility with hearing aids (and we do, meticulously, using real-ear measurement to verify the amplification is correct), but that doesn’t instantly restore the neural processing that’s been degraded. That’s where auditory training comes in. 
What LACE Actually Does
LACE trains specific listening skills through adaptive exercises that get harder as you improve. The program targets several key areas: speech in competing noise, speech in competing speech, rapid speech processing, auditory memory, and the ability to use contextual cues to fill in missing information. Here’s what that looks like in practice. One exercise presents sentences with words missing while background noise competes for your attention. You have to identify the missing word, drawing on context and whatever acoustic information you can extract. Another presents rapid speech that’s time-compressed, forcing your brain to speed up its processing. A third trains auditory working memory by having you recall and manipulate information you’ve just heard. The exercises adapt in real time. If you’re getting 80 per cent correct, the difficulty increases: more noise, faster speech, more complex memory tasks. If you drop below 50 per cent, it eases off. This keeps you working at the edge of your ability, which is where neuroplastic change happens. You’re not passively listening to audiobooks or podcasts. You’re doing effortful, focused practice of specific skills that tend to be compromised in people with hearing loss or auditory processing difficulties. The original LACE program has been around since the mid-2000s, developed by audiologists at the University of California, San Francisco. The latest version, LACE AI Pro, uses artificial intelligence to personalise the training more precisely and includes updated speech materials and noise types that better reflect real-world listening environments.The Evidence Base
I’m not one for promoting anything without decent evidence, and LACE has been studied in multiple peer-reviewed trials. A 2006 study in the Journal of the American Academy of Audiology found that adults with hearing loss who completed LACE training showed significant improvements in speech-in-noise recognition, with an average gain of about 5 dB signal-to-noise ratio. In practical terms, that is the difference between following a conversation in a café or sitting there nodding while catching every third word. Those gains persisted at three-month follow-up. Subsequent studies have shown improvements not just in lab-measured speech perception, but in self-reported communication function in daily life. A 2010 study found that LACE users reported better listening ability in difficult situations, less frustration with communication, and reduced cognitive effort during conversations compared to a control group who received hearing aids alone. Does it work for everyone? No. Nothing does. But the effect sizes are meaningful for a substantial proportion of users, and the intervention is low-risk. You’re not swallowing anything, being exposed to radiation, or risking surgical complications. You’re spending half an hour a day doing exercises on a computer.Who Benefits Most
In my clinical experience, LACE is most helpful for three groups. New hearing aid users. When someone has had hearing loss for years and finally gets properly fitted with amplification, their brain is suddenly flooded with sound it hasn’t processed clearly in ages. It takes time to adapt. Real-ear measurement ensures the hearing aids are delivering the right amplification (we verify that every time; it’s not optional), but verification doesn’t train your brain. LACE accelerates that adaptation process. I often recommend it in the first few months after a fitting, particularly for people who are motivated but struggling in complex listening environments despite having good audibility. People with auditory processing difficulties. This includes diagnosed Auditory Processing Disorder in children and adults, but also the broader group of people who have normal hearing sensitivity on a pure tone audiogram but struggle disproportionately with speech in noise. Their ears work fine; the bottleneck is central processing. LACE addresses that directly. It’s not a cure (APD is complex and often requires a multifaceted approach), but it’s a useful tool in the rehabilitation toolkit. Anyone with significant speech-in-noise difficulties. Even people who’ve worn hearing aids for years can benefit if they’re still struggling in background noise. Sometimes that struggle is due to inadequate amplification: hearing aids that haven’t been programmed or verified properly, or technology that’s too old to provide sufficient noise reduction. We address that first. But sometimes the aids are doing their job and the problem is upstream, in the brain’s ability to use the acoustic information it’s receiving. That’s when auditory training makes sense. LACE is less likely to help if your hearing aids aren’t fitted properly to begin with. No amount of brain training will compensate for insufficient gain, incorrect frequency response, or physically uncomfortable devices you won’t wear. We verify every fitting with real-ear measurement and conduct speech-in-noise testing to establish a baseline. If someone is struggling, we troubleshoot the amplification first. Auditory training is a complement, not a workaround for bad fitting.LACE AI Pro: What’s Different
The AI Pro version adapts more intelligently across multiple dimensions of difficulty, not just within individual exercises. It tracks your performance across all exercise types and adjusts the overall training program to focus on your weakest areas while maintaining practice in stronger ones. The speech materials have been updated to include more diverse accents and realistic acoustic environments (cafés, cars, open-plan offices) rather than just generic background babble. It’s also more user-friendly. The interface is cleaner, it works on tablets and modern computers without the installation headaches the original version sometimes caused, and the progress tracking is more detailed and easier to interpret.How We Use It at The Audiology Place
We provide access to LACE AI Pro and monitor your progress as part of a broader rehabilitation plan. Here’s the typical process: after your hearing aid fitting or APD assessment, if we determine auditory training would be beneficial, we set you up with login credentials and walk you through the first session to ensure you understand how it works. You complete the exercises at home, 30 minutes per day, at least five days per week. The program recommends four weeks minimum; many people benefit from longer. We check in at two weeks to review your progress data, troubleshoot any technical issues, and ensure you’re training at an appropriate difficulty level. At four weeks, we reassess with speech-in-noise testing (usually the Bamford-Kowal-Bench sentences in noise, the same test we use diagnostically) to measure objective change. We also discuss your subjective experience: are you noticing improvement in real-world situations? The cost is built into our rehabilitation packages for new hearing aid users, and available as a standalone service for existing patients or those managing APD or other auditory processing difficulties. It’s not claimable through Medicare, as there’s no item number for computerised auditory training, but some private health funds provide partial rebates under “audiology services” depending on your level of cover.What It Won’t Do
LACE won’t restore normal hearing if you have sensorineural hearing loss. It won’t replace hearing aids if you need them, and if your pure tone average is worse than 40 dB HL, you need them. It won’t fix listening problems caused by poorly fitted hearing aids, untreated middle ear pathology, or cognitive decline that’s primarily related to dementia rather than auditory deprivation. It’s a training tool, not a treatment for hearing loss itself. That distinction matters. I’ve seen people delay getting hearing aids because they read online that “brain training can restore your hearing.” It can’t. What it can do is help your brain make better use of the sound information it receives, whether that’s through hearing aids or through a compromised but still-functioning auditory system. If you’re struggling with speech understanding despite normal or near-normal hearing, or if you’ve been fitted with hearing aids but still find noisy environments exhausting and frustrating, auditory training is worth considering. It requires commitment (those 30-minute sessions need to happen consistently), but for motivated patients working with properly verified amplification, it can make a measurable difference in real-world communication.
