Rehabilitation: identification of needs, priorities and expectations, and the evaluation of benefit

Audiology services evolved from technical disciplines with emphasis on assessment of hearing impairments rather than the experiences of disabilities and handicaps. This article argues for a comprehensive, though structured, framework for the assessment of listening needs (disabilities) which, via sets of personal and societal contexts, lead to handicaps. Rehabilitative and instrumental interventions should be selected on the basis of disabilities and handicaps as modulated by individuals' expectations and attitudes, and configured as part of an overall management plan aimed at alleviating the consequences of impaired hearing. An evaluation structure to assess success and identify residual deficits as a guide to further intervention should map onto the original structure of disabilities and handicaps; all of this should take account of the social and personal contexts within which hearing-impaired listeners are required to function.