Efficacy of Self-Directed Auditory Rehabilitation in Individuals With Hearing Loss: A Systematic Review and Meta-Analysis

Background and Objectives: Hearing loss negatively affects communication and quality of life. While clinician-led rehabilitation is beneficial, access barriers and poor long-term adherence limit its overall impact. This systematic review evaluated the efficacy of self-directed auditory rehabilitation across the lifespan.Materials and Methods: A systematic search was conducted using five electronic databases for peer-reviewed studies involving children, adults, and older adults with at least mild hearing loss, who participated in self-directed auditory rehabilitation and reported behavioral, objective, or patient-reported auditory outcomes.Results: Twenty-two studies with 1,851 screened records were included in the synthesis, which encompassed varied populations, devices, and rehabilitation formats. Random-effects meta-analyses showed significant speech recognition improvement in pediatric participants (Cohen’s d=1.32, standard error [SE]=0.12, 95% confidence interval [CI]: 1.08-1.56; p<0.05), with effects maintained at 1-3 months. A moderately significant benefit was observed in both adults and older adults (Cohen’s d=0.55, SE=0.05, 95% CI: 0.45-0.65). Although publication bias was present in some adult studies, the sensitivity analyses confirmed the robustness of the results.Conclusions: Self-directed auditory rehabilitation produces meaningful and sustained speech recognition benefits in individuals with hearing loss, endorsing its integration as an accessible adjunct to conventional audiologic care. Future studies should refine the program content and reduce intervention variability.