Encephalitis herpes simplex: aural rehabilitation following bilateral deafness

Aural rehabilitation is a critical and often neglected aspect of a hearing-impaired patient's total rehabilitation. This case description illustrates the need for implementation of aural rehabilitation services. A 59-year-old woman exhibited bilateral profound sensorineural hearing loss following the onset of encephalitis herpes simplex. Auditory amplification attempts were unsuccessful. Aural rehabilitation was initiated immediately, and she was seen for lipreading and vibrotactile stimulation training. Goals progressed from identification of single words within a category to phonemic recognition. Vibrotactile stimulation was used to facilitate environmental awareness. Therapy goals reflected the patient's increased motivation to communicate within her environment. This patient's communicative status is viewed on a continuum: from success in individual treatment goals, extending to successful communication within the structure of the entire rehabilitation setting, and finally to functional communication within her home environment.