Audiology
We all know what an audiologist is, right? She's the
person who tests our hearing and prescribes hearing aids to help us hear
better.
That may be the common perception, but
there's a bit more to it than that. The American
Academy of Audiology Position Paper on the Scope of Practice
includes several paragraphs that define the audiologist's role. It
states, in part:
"An audiologist is a person who, by
virtue of academic degree, clinical training, and license to practice
and/or professional credential, is uniquely qualified to provide a
comprehensive array of professional services related to the assessment
and habilitation/rehabilitation of persons with auditory and vestibular
impairments, and to the prevention of these impairments. Audiologists
serve in a number of roles including clinician, therapist, teacher,
consultant, researcher and administrator. In addition, the supervising
audiologist maintains legal and ethical responsibility for all assigned
audiology activities provided by audiology assistants and audiology
students."
The minimum required academic credential
for an audiologist is currently a Master's Degree, but there is a
movement afoot to increase the requirement to a Doctorate. The Audiology
Foundation of America is one of the organizations leading this
drive.
Whether a Master's Degree or a Doctorate is the
appropriate degree, the bottom line is that audiologists need to know a
lot about each aspect of hearing and balance. An audiologist applies
only a small portion of that knowledge to treat a typical patient, but
it should be reassuring to know that additional knowledge is there if
needed.
Audiologists are often the cornerstone of hearing
loss treatment; they are typically the first hearing professional a
consumer sees, and they are intimately involved in resolving a client's
hearing loss issues.
Is your
favorite audiologist part of a nationwide plot to seize control of all
hearing aid dispensing and prohibit sales by hearing aid dispensers? You
might be surprised!
If you're interested in what's going
on in the audiology industry from a business point of view, you'll find
some interesting articles here!
Interested in having your hearing tested?
March 2002 - Most people think that an
audiologist's job is to test hearing and prescribe hearing aids. And in
some cases that may be all that's needed. But Dr. Neil Bauman believes
that an audiologist's job is to assist people in coping with their
hearing loss. Hearing aids are certainly a part of that, but there's a
lot more. In my humble opinion, every hearing loss professional should
be required to memorize "What I Wish Audiologists
Understood before beginning their
practice. This is another article you might consider sharing with your
audiologist and other hearing loss professionals.
September
2003 - Have you ever wished there was a quick and reliable online
hearing test? Not as comprehensive as what an audiologist provides, but
a rough indication of whether you should have your hearing evaluated?
Well, here's an article about and a link to just such a
test.
September 2003 - Ever wish you could have a
conversation with your audiologist or hearing aid provider about the
services you WISH they provided? Chances are you wish they treated the
entire person rather than just the hearing loss; you'd probably like
them to inform you about all the various resources that can assist you,
not just hearing aids.
You may never be able to have that
conversation with your hearing aid provider. But here's a
short article you might want to pass along to her.
January
2004 - For all you techies out there, here's
a great site with lots of acoustics and physics. Non-techies may
benefit from the verbiage if they are able to ignore the equations.
January
2004 - Here's
a link to another online hearing evaluation. It allows you to
measure the equal loudness contours of your ears - assuming you have
enough hearing to hear the tones!
March 2005 -
You may be surprised to learn that a
leading audiologist claims that many of his colleagues do NOT do a
proper job of fitting hearing aids!
June 2005 - Here's a
great article on matching hearing aid technologies to individuals.
It's our report on Scot Frink's Hearing Aid Technology workshop at the
Western Symposium on Deafness.
December 2005 - Karl
Strom's recent "Hearing Review" article entitled "Twenty
Trends Influencing the Hearing Health Care Field" is "must
reading" for all professionals in the field, and for consumers who
want to be well informed. He provides a great overview of where the
industry has been in the last several years, and some glimpses into
where it might be going. Full
Story
February 2006 - Deafness Research UK has recently
awarded a prize to a Cambridge University student for her work to
develop an objective method to measure frequency regions with little or
no hearing response. Here's the press release.
March 2006 - Sound
Activity Monitor Improves Hearing Aid Fitting
May 2006
-
Award for hearing aid concept
June 2006 - The Audiogram: Explanation and Significance
August 2006 - New Department of Defense Hearing
Conservation Toolbox Released
September 2006 -
Au.D.s Now at 23 Percent
September 2006 - Presbycusis and Speech
Discrimination
October 2006 - What’s still growing on your patients’ hearing aids?
October 2006 - Bluetooth
101: The Audiologist's Guide
October 2006 - What
to Expect from a Complete Hearing Test
March 2007 - Bill Would Give Seniors Direct Access to
Audiologists
April 2007 - Arizona Requires
Dispensers to Inform Consumers About Telecoils
April 2007 - What Do Children Hear? How Auditory
Maturation Affects Speech Perception
June 2007 - Sounds from the Bionic Ear Within!
June 2007 - Audiology
and Quality of Life: Is there a Connection?
June 2007 - For
Those With Hearing Loss, the Noise Can Be Awful
June 2007 - Audiologists
in Demand - in India!
September 2007 - Researcher
Developing New Method for Hearing Loss Assessment
September 2007 - Evaluating the
Performance of a Hearing Aid in the Real-Ear
September 2007 -
Hearing Assistance Technology:
Integrating HATs into Clinical Practice
September 2007 -
Let's Replace Hearing Aid Evaluation with Functional
Communication Assessment
September 2007 - Indiana
Jones &The Lost of Art of Tuning Fork Testing
September 2007 -
Hearing Aid Customers Satisfied with Dispensers
October 2007 -
Self-Report Assessment of Hearing Aid Outcome
November 2007 - The Future
of Hearing Health Care
February 2008 - Straight Talk
from an Audiologist
February 2008 - Eyes a Window to Hearing Loss?
February 2008 - Amplification Considerations for Children
With Minimal or Mild Bilateral Hearing Loss and Unilateral Hearing Loss
March 2008 - Ida Institute Sets Sights on Easing Patient
Journey to Better Healing
June 2008 - Audiology Telepractice Overcomes
Inaccessibility
August 2008 - AuDNet Releases Report for Consumers
August 2008 - Do Audiological Reading Materials
Improve Consumer Outcomes?
February 2009 - Audiology Makes "30 Best Careers For
2009" List
July 2009 - Audiologists Respond to "Consumer Reports"
Criticisms
October 2009 - Programming hearing
aids using speech rather than beeps!
October 2009 - Audiologists Should Educate Patients'
Caregivers
December 2009 -
Audiologists break away,
move hearing-aid sales online
February 2010 -
Tele-audiology becoming a worldwide reality
February 2010 -
A few secrets about bone-conduction testing~~~~~~~~~~~~~~~~~~~
March
2006
The
key is knowing whether the person spends a lot of time in noisy
environments. Or quiet ones, in groups or one-on-one. But that
information had to come from a patient's recollection and that's not
always accurate. Enter this little device. The sound activity monitor,
or SAM for short. A patient wears it for a few days or a week while it
records all the sounds around the patient. Then the audiologist uploads
the information into a computer, generating a picture of the patient's
sound world. Full
Story
~~~~~~~~~~~~~~~~~~~
May 2006
A team of
unsung heroes from Lynn's Queen Elizabeth Hospital are celebrating after
scooping a major regional award for speeding up the fitting of hearing
aids - with an innovative use of dental equipment. Patients no longer have
to wait weeks for tailor-made hearing aids to be produced, as clever
thinking between the audiology and dental departments means they can now
have them fitted the same day, saving both time and money. In an idea
developed by service managers Mark Brindle, from audiology, and Keith
Powell, from the dental laboratory, hearing aids can now be made on site
using dental acrylic moulding equipment used to make orthodontic models.
Full Story
~~~~~~~~~~~~~~~~~~~
June 2006
Recently,
I've been trying to organize some of the columns and articles I've written
over the past ten years. As I was looking through them, it became apparent
that I've neglected to discuss what is perhaps most important hearing
dimension of all, the simple audiogram. In reality, however, the "simple"
audiogram, and particularly its implications, is not quite so simple. Even
though just about everybody who receives a hearing aid has his or her
hearing tested with a pure-tone audiometer, not everybody receives a
comprehensive explanation of exactly what the results mean and what the
implications are for them. And even for those that do, at a time when
prospective hearing aid purchasers are being inundated with new
information, anxious about the test results, and worried about the cost
involved, much of this explanation will be forgotten or misconstrued the
time several weeks have passed.
Full Story
~~~~~~~~~~~~~~~~~~~
August
2006
Available
via the US Navy website this online resource consists of 5 modules:
Module 1 -
Introduction & History of Hearing Conservation in the Military
Module 2 -
DoD Occupational Hearing Conservation Certification (CAOHC Approved)
Module 3 -
Directing a Hearing Conservation Program
Module 4 -
Educational Resources on Hearing Preservation
Module 5 -
Hot Topics in Hearing Conservation References and Contributors
The
Toolbox can be accessed directly
here
~~~~~~~~~~~~~~~~~
September
2006
New data
collected by the AFA shows that 23 percent of the audiology profession now
holds the Au.D. degree. Two states, Florida at 37 percent and North Dakota
at 34 percent, rank highest among the states.
Check out the map to see how your state is doing.
~~~~~~~~~~~~~~~~~
October 2006
Many of the people who seek
hearing healthcare services have compromised immune systems that make them
unusually susceptible to common microorganisms that, under certain
conditions, can cause localized infection or systemic disease. Dispensing
environments draw patients from all age and socioeconomic groups and who
come in with a wide range of underlying diseases and history of
pharmacologic interventions. These are all factors with potential
implications for a person’s immune system. In a clinical environment where
patients may be especially vulnerable to opportunistic infections,
infection control procedures play a critical role in reducing
crosscontamination and the risk of disease.
Full Story
~~~~~~~~~~~~~~~~~
April 2007
Auditory development is a prolonged process,
despite the precocious development of the inner ear. Audiologists know
that infants don't respond to sound at the low intensities to which
adults will respond. What hearing scientists have learned in 25 years of
studying the development of hearing in infants and children is that
youngsters' immature thresholds in the sound booth reflect immature
hearing, not just immature responses. These immaturities limit infants'
ability not only to detect a tone, but also to hear and to learn from
sound in real environments. Moreover, the process of auditory
development continues well into the school years, as children become
more selective and more flexible in the way that they process sound. Full
Story
~~~~~~~~~~~~~~~~~
June 2007
There's lots of excitement about digital hearing
aids, cochlear implants and other amazing advances in technology that
are bringing great benefits to people who are deaf or hard of hearing
(D/HH). But they are all just copies of nature's original creation - our
biological hearing aid, called the cochlear amplifier, that is a key
part of every healthy inner ear. Without it, about half of our hearing
would disappear. Full
Story
~~~~~~~~~~~~~~~~~
June
2007
Audiology
treatment, provided through hearing aids, assistive listening devices,
and/or cochlear implants, is highly successful in addressing the
negative consequences of hearing disorders. This is accomplished by
first reducing impairments to body function through improved audibility,
which then allows for improved speech intelligibility (reduction in
activity limitations), which can result in increased involvement in
family and social situations (reduction in participation restrictions)
and ultimate improvement is self-perceived HRQoL (health-related quality
of life.) Activity
limitations, participation restrictions, and HRQoL can be mediated
through audiologic rehabilitation programs such as those described by
Wayner and Abrahamson (1996) and Chisolm, Abrams, and McArdle (2004).
Full
Story
~~~~~~~~~~~~~~~~~
June 2007
Radhika Poovayya, Director and Principal of Samvaad
Institute of Speech and Hearing, says that the field of audiology and
speech-language pathology is fairly young in the country, which is one
of the reasons for lack of awareness about the field among students in
particular and the public in general. “The field has untapped
opportunities and the job prospects are enormous. There is a great
demand for trained professionals. Audiologists and speech-language
pathologists can pursue their career in hospitals, integrated schools,
hearing aid companies, speech and hearing institutes, rehabilitation
centres, etc.,” she says. With very few certified and recognised
institutes offering courses in audiology and speech-language pathology,
there is a great demand for trained professionals in the field.
Full
Story
~~~~~~~~~~~~~~~~~
September 2007
Periodically, governments, businesses, and
professions must reassess their mission and goals in order to sustain
their competence and maintain their relevance. The objective of this paper
is to propose a variation in our profession's direction and to provide a
general road map toward rendering this change viable. Specifically, I am
advocating that the generic "hearing aid evaluation" be replaced by a
"Functional Communication Assessment" designed to yield results that will
lead to an "Individualized Communication Enhancement Plan" (ICEP) for
every patient. This Functional Communication Assessment would be a battery
of objective and subjective measures intended to assess residual auditory
function beyond what can be determined by pure-tone and monosyllabic
word-recognition-in-quiet testing. From these data, an ICEP would be
constructed that would contain any or all of the following: education and
counseling, communication strategies, individualized auditory training,
hearing aids, assistive listening devices, and group education and
therapy. The goal of this proposal is to shift our focus from one that is
product-oriented (i.e., centered around hearing aids) to one that is
process-oriented (centered around enhancing communication).
Full Story
~~~~~~~~~~~~~~~~~
September 2007
A national consumer survey by Siemens Hearing
Instruments (SHI) reveals that hearing loss patients are more satisfied
with the treatment they receive from hearing care professionals, and most
of them rely on professional guidance when selecting hearing instruments.
According to the survey, two-thirds (66%) of consumers say that the
recommendations of their hearing care professional are important when
selecting a hearing instrument, and an overwhelming 85% of consumers
who've been seen by a dispensing professinals report satisfaction with
their treatment. More than half (53%) of the respondents reported they
received hearing care from an audiologist, 21% from an otolaryngologist,
and 16% from a "hearing aid practitioner." "The hearing care professional
is vital to the fitting and hearing instrument selection process," says
Thomas Powers, PhD, vice president of audiology and professional relations
at Siemens Hearing Instruments. "It is very gratifying to know that
customers are having good experiences in the offices and are heeding the
advice they receive from their professionals."
Full Story
~~~~~~~~~~~~~~~~~
October 2007
Patients have always provided clinicians with
real-world outcome assessments of their hearing aids. Watson and Tolan
(1949) and Davis and Silverman (1947) both address the importance of
gathering information from the "patient's perspective" during the initial
trial period with hearing aids in everyday listening environments. In a
study of 20 hearing aid users, aided speech discrimination scores did not
predict with any degree of reasonable accuracy how much benefit was
obtained in everyday listening situations (Tonning, 1978). One of the
conclusions of this study emphasized the need for self-report measures of
outcome: "... results indicate that we need to pay attention to the
patient's experience with hearing aids under everyday listening conditions
in each individual case when a hearing aid is selected" (p.13). Until
quite recently, however, most real-world assessments of outcome involved
informal discussions with the professional. Rather than formally measuring
real-world outcomes, professionals relied on laboratory measures of
fitting outcomes. These measures included speech recognition in quiet and
in noise, insertion gain, and aided loudness judgments. In the past 20
years, there has been a proliferation of self-report measures of hearing
aid outcome. Unfortunately, the majority of clinicians still do not
routinely administer self-reports of outcome. (Lindley, 2006). The goal of
this paper is to review the history and provide a short summary of these
measures so that the practicing clinician can have an easy reference to
integrate these useful tools into their daily practice.
Full Story
~~~~~~~~~~~~~~~~~
February 2008
The eyes may not just be a window to the soul, they may also provide a
clear view to the state of your other senses. A new study reports that the
eyes can provide clues that tell researchers how well a person can hear.
This finding may be especially helpful for diagnosing hearing problems in
babies, very young children and in people who can't actively take a
hearing test, such as those with a traumatic brain injury. "When most
animals detect a change in their environment, their pupils dilate. And,
the quieter the sound, the less the dilation," explained study author
Avinash Bala, a research associate at the University of Oregon in Eugene.
"One of the things you can use this for is to see when a sound becomes
detectable." About 28 million Americans have some degree of hearing loss,
according to the National Institute on Deafness and Other Communication
Disorders. Approximately two to three out of every 1,000 children are born
deaf or hard-of-hearing. Because hearing is so critical to speech and
language development, experts believe that the sooner a hearing problem is
diagnosed in babies and young children, the better.
Full Story
~~~~~~~~~~~~~~~~~
February 2008
Children with minimal or mild bilateral hearing
loss and unilateral hearing loss are at higher risk for academic,
speech-language, and social-emotional difficulties than their normal
hearing peers. The choice to fit infants with moderate or greater degrees
of bilateral hearing loss has been standard practice for most clinicians,
but for those with minimal or mild bilateral hearing loss or unilateral
hearing loss, the fitting of hearing technology must be based on limited
data. Evidence does not yet exist to support all the management decisions
that an audiologist must make upon identifying an infant with minimal or
mild bilateral hearing loss or unilateral hearing loss. It is not yet
known which children are at the greatest risk for educational problems nor
is it known if the provision of early amplification in this population
will help a child avoid later difficulties. Some of these considerations
and current hearing technology options for children with minimal or mild
bilateral hearing loss or unilateral hearing loss are reviewed in this
article.
Full Story
~~~~~~~~~~~~~~~~~
March 2008
Are we missing the forest for the trees? The
hearing care field is often wrapped up in the minutia of resolving
people's hearing problems by using various forms of hearing assessment,
patient education and consultation, selection and fitting, as well as
post-fitting adjustments, verification, counseling, aural rehabilitation,
and validation. Dispensing professionals often find themselves obsessing
over word recognition scores, MCL/UCLs, hearing in noise performance, and
prescriptive gain targets. And this is all good and necessary. However,
what does the scientific and clinical evidence really tell us about when
patients decide to seek hearing help, how they perceive hearing care
services, what actions are effective and satisfying for them, or how much
benefit is derived from these myriad facets of professional hearing care?
$10 million grant. The William Demant and Wife Ida
Emilie Foundation wants to know the answers to these types of questions.
With a $10 million grant, the Foundation has created the Ida Institute to
support hearing care professionals in helping hearing-impaired people
address the challenges associated with hearing loss.
Full Story
~~~~~~~~~~~~~~~~~
June 2008
When distance and inaccessibility pose barriers to
health care, the answer for some providers is telepractice-and
audiologists are no exception. Telepractice brings newborn hearing
screening to hospitals in Canada; it shortens the distance families of
young children must travel for cochlear implant mapping in Florida; and it
helps diagnose medical conditions in Alaska. According to ASHA's position
statement (ASHA, 2005), telepractice (also called telemedicine or
telehealth) is an appropriate model of audiology service delivery,
provided the quality of services is consistent with the quality of
face-to-face services. It offers "the potential to extend clinical
services to rural, remote, and underserved populations, and culturally and
linguistically diverse populations." Telepractice has its advantages-and
its disadvantages. Telepractice may save money and time for patients, but
delivering service remotely may be more costly than an in-person
appointment. Computer connections can result in audio delays or break down
completely. Counseling and communication with patients may be compromised.
Full Story
~~~~~~~~~~~~~~~~~
February 2009
Citing the current financial crisis and economic
recession as key factors in bringing about career changes across the
country, US News & World Report's "The 30 Best Careers for 2009" features
audiology as one of the most reliable and enjoyable fields for this year,
and those to come.
The
national news magazine rated hundreds of careers on five criteria:
1. Job
outlook
2. Average
job satisfaction
3.
Difficulty of the required training
4.
Prestige
5. Pay
Full Story
~~~~~~~~~~~~~~~~~
July 2009
The recent Consumer Reports (CR) article on
hearing aids (see HJ Report) was intended primarily for consumers, of
course. But it also reached a much smaller and even more interested
secondary audience: all of us involved in the hearing care field. It's
also safe to say that those two audiences drew different messages from the
story and will respond to it in different ways. [snip] True, the opening
paragraphs must have raised doubts in the minds of potential hearing aid
wearers. They report that two-thirds of the 48 hearing aids fitted on a
dozen hearing aid "shoppers" recruited by CR amplified too little or too
much.
Full Story
~~~~~~~~~~~~~~~~~
October 2009
Hearing and understanding are ultimate challenges
in everyday life, often made more difficult by the medical and physical
challenges of aging. Paraphrasing Bette Davis: "Getting old isn't for
wimps." As a result, it is important for audiologists to listen to
patients' communication needs while guiding them to upgrade their hearing
aids or to consider cochlear implants. That said, it is important to
remember that caring for older hearing-impaired patients isn't for wimps
either. As people age, they often progress to more controlled living
styles, such as assisted care and long-term care, and it is vital that the
caregivers in these facilities receive proper education on their patients'
hearing needs. By helping caregivers understand hearing technology and
devices, audiologists not only can ensure optimum care for their patients
but also strengthen relationships with local care facilities.
Full Story
~~~~~~~~~~~~~~~~~
February 2010
Just as telemedicine can connect individuals
living in remote areas of the planet with physicians and other healthcare
specialists in urban centers hundreds or thousands of miles away, tele-audiology
is quietly gaining momentum as an approach that can follow a similar
pattern. Hearing care providers are taking cues from established success
models in telemedicine to develop their own ways to provide professional
services that can be delivered effectively from afar. One of those in the
forefront of tele-audiology is James W. Hall III, PhD, clinical professor
in the Department of Communicative Disorders at the University of Florida.
Hall observes that when the developed nations have such a wealth of
trained hearing care providers and sophisticated technology for diagnosing
and treating hearing loss, it's ironic that an estimated 90% of people who
could benefit from these resources live out of reach of any audiologist,
ENT physician, or hearing instrument specialist.
Full Story
~~~~~~~~~~~~~~~~~
February 2010
Since the earliest testing using tuning forks,
assessment of bone-conducted hearing sensitivity has been an essential
component of audiometric differential diagnosis. It was Bekesy, in 1932,
who demonstrated that it was possible to cancel a bone-conducted tone by
introducing an air-conducted tone of the same frequency, but with
different phase. This supported the notion that the two signals had the
same mechanical displacement patterns at the basilar membrane-a topic of
some debate at the time. In the 1960s Tonndorf added to Bekesy's work by
providing a detailed description of three different modes of
bone-conduction transmission.
Full Story
