Severe and profound hearing loss: Updated guidance for clinical practice

Updated with the latest evidence, these international guidelines bring together 17 authors from eight countries to support high-quality hearing care.

In December 2020, a landmark document was published in Seminars in Hearing. Laura Turton, a prominent Scottish-based audiologist, with more than 25 years of experience working with adults with severe-to-profound hearing loss, joined 11 other experts from four countries to review the available evidence and professional opinion. The result was a set of practice guidelines designed to support clinical decision-making and the care and empowerment of adults with severe and profound hearing loss.¹

The original guidelines quickly became an essential resource for clinicians around the world. Six years later, they remain the journal’s third most-read article, reflecting their relevance to clinical practice.

The importance of this work was previously highlighted in Laura Turton’s blog article, Guidance we have all been crying out for!, which explored the need for comprehensive, evidence-based recommendations for this unique client population.

Adults with severe and profound hearing loss often face challenges that extend beyond reduced hearing sensitivity. Effective care requires consideration of communication needs, technology, counselling and the wider psychosocial impact of hearing loss.

Recognizing that both the evidence base and clinical practice would continue to evolve, the original authors recommended that the guidelines be reviewed and updated after five years. The 2026 edition fulfils that commitment.

What’s new in the 2026 edition?

Work on the revision began in late 2024, with the goal of producing a comprehensive update that reflects current evidence and clinical practice. Once again led by Laura Turton, the new guidelines bring together 17 authors from eight countries. Many contributed to the original publication, while additional experts joined the project as the scope of the guidelines expanded.²

Every section of the original publication has been reviewed and updated. The 2026 edition also introduces recommendations in several emerging and increasingly important areas of practice, including:

Sign language users and Deaf awareness
Electrophysiology
Music with hearing aids
Auracast and public broadcast systems
Remote fittings
Implantable hearing technologies in addition to cochlear implants
Genetic hearing loss and emerging gene therapies

Although the publication spans more than 100 pages, it has been structured to help clinicians find and apply information in practice. Each section presents clear recommendations, together with practical resources to help readers understand the supporting evidence and translate it into everyday care.

The appendices provide further resources that add to the practical value of the guidelines:

Appendix 1 – Evidence tables: These tables summarize the evidence supporting each recommendation, including strength-of-evidence and quality ratings. The 2026 edition also retains ratings from the 2020 guidelines, allowing readers to examine how the evidence supporting individual recommendations has evolved over time.

Appendix 2 – References: The references are divided into new evidence from 2020 to 2026 and previous evidence included in the 2020 guidelines. The evidence base for severe and profound hearing loss has not changed completely over the past five years. Including earlier literature allows readers to review important foundational evidence that continues to inform and guide clinical practice.

Appendix 3 – Toolkit tables: These tables provide links and suggestions for practical tools relevant to each topic. The authors may also direct readers to specialist resources and websites that provide additional information in specific areas of practice.

Appendix 4 – Clinical checklists: These resources allow professionals and services to benchmark current practice against the recommendations and identify areas where changes may be beneficial. Depending on the topic, the checklists may also serve as useful tools in day-to-day clinical practice.

These resources are intended to make the guidelines useful, not only as a reference document, but also as a practical day-to-day clinical resource.

A rewarding international collaboration

On a personal note, contributing to the development of these updated guidelines has been incredibly rewarding, both professionally and personally. I have learned a great deal and gained new insights into clinical practice.

Working alongside internationally recognized experts who all face common challenges has reinforced for me the importance of collaboration in advancing hearing health care.

On behalf of all the authors, we hope these updated guidelines become a practical resource that supports hearing care professionals in delivering high-quality, evidence-based care for adults with severe and profound hearing loss.

The guidelines are open access in Seminars in Hearing.

In the coming months, we will be featuring a series of blog articles from individual co-authors, sharing their perspectives on key aspects of the guidelines.

References

Turton, L., Souza, P., Thibodeau, L., Hickson, L., Gifford, R., Bird, J., … & Timmer, B. (2020, August). Guidelines for best practice in the audiological management of adults with severe and profound hearing loss. In Seminars in Hearing (Vol. 41, No. 03, pp. 141-246). Thieme Medical Publishers, Inc..
Turton, L., Timmer, B.H.B., Hockley, N.S., Aiken, S.J., Bance, M., Bird, J,… & Thibodeau, L. M. (2026). Updated Guidelines for best practice in the audiological management of adults with severe and profound hearing loss. In Seminars in Hearing. Thieme Medical Publishers, Inc.