General introduction 25 The framework of aural rehabilitation is therefore increasingly applied in audiology (Ferguson et al., 2019). The aim of aural rehabilitation is to reduce the difficulties of individuals with hearing loss in daily life functioning, including difficulties in work participation. This can be achieved by the provision of technical interventions, but aural rehabilitation also includes three other components – perceptual training, instruction, and counselling – that may contribute to the reduction of difficulties with performing everyday tasks of societal involvement (Boothroyd, 2007, 2017). The four components of aural rehabilitation can be provided separately or in combination. Perceptual training includes training of speech reading or auditory skills. The rationale is that speech perception performance can improve when hearing impaired individuals extract more information from the speech signal or the context. Instruction mainly focusses on how technical devices can be used properly and may include demonstrating or coaching. The focus of counselling is to help with developing effective coping behavior. Aural rehabilitation can be provided in different forms (Boothroyd, 2010). It may consist of individual training, which has the advantage that it can be tailored specifically to individual needs. However, the variation of inputs – different voices, experiences of others – is small during individual training. Alternatively, aural rehabilitation can consist of group training with a clinician, which has the advantage that the participants might benefit from the interactions with their peers. In the Netherlands, group training involving aural rehabilitation is often referred to as a communication course. These communication courses are offered by several universitymedical centers and audiological centers, and consist of approximately ten to twelve sessions that include speech reading training, instruction, and counselling. Occupational health interventions The protocol of the Dutch Board for Occupational Medicine (NVAB) ‘hearing loss and tinnitus’ provides a framework for occupational physicians on the interventions that can be provided to individuals with work functioning difficulties caused by hearing loss. Several interventions have been suggested regarding external factors. Firstly, occupational physicians can investigate what measures could optimize the acoustic environment of the workplace. For example, environmental noise can be reduced by removing technical devices that produce noise – such as the printer – from the
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