Adult aural rehabilitation practices among audiologists in India – a cross-sectional survey

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Abstract Background Adult hearing loss is a major global health concern. Adult aural rehabilitation (AR) is a comprehensive intervention that extends beyond hearing aid fitting to address communication, psychosocial well-being, and participation. Despite its recognized importance, information regarding adult AR practices among audiologists in India is limited. Objectives To investigate the current practices, service delivery models, assessment approaches, barriers, and perceptions related to adult AR among audiologists in India. Methods A nationwide cross-sectional survey was conducted among 206 practicing audiologists using a questionnaire adapted from Makhoba and Joseph (2016) and modified for the Indian context. Descriptive statistics summarized respondents’ characteristics and adult AR practices. Chi-square, Kruskal–Wallis, and post hoc analyses were used to examine associations between clinician characteristics and rehabilitation practices. Results A majority of respondents (89.3%) reported providing adult AR services. Hearing aid fitting and related support (89.8%) and informational counselling (85.9%) were the most frequently provided interventions, whereas communication partner training (49.0%), speech reading (52.4%), cochlear implant mapping and related support (53.9%), psychosocial counselling (59.2%), and assistive device services (38.8%) were less commonly offered. Individual rehabilitation was the predominant mode of service delivery, while group rehabilitation and tele-audiology were less frequently used. Assessment relied primarily on clinical judgment and informal methods, with limited use of standardized outcome measures and theoretical frameworks. Time constraints, lack of standardized guidelines, insufficient training, and resource limitations were the principal barriers reported, with no significant differences across work settings or years of professional experience. Respondents considered adult AR to be highly essential, and most identified audiologists as the most appropriate professionals to provide these services. Conclusion Adult AR is widely practiced by audiologists in India; however, its implementation remains centred largely on hearing aid fitting and related services. Strengthening evidence-based assessment, standardized rehabilitation frameworks, professional training, and comprehensive patient-centred rehabilitation approaches may improve the quality and consistency of adult AR services.