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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

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Sound Activity Monitor Improves Hearing Aid Fitting

 

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

 

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Award for hearing aid concept

 

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

 

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The Audiogram: Explanation and Significance

 

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

 

 

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New Department of Defense Hearing Conservation Toolbox Released

 

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

 

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Au.D.s Now at 23 Percent

 

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.

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What’s still growing on your patients’ hearing aids?

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

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What Do Children Hear? How Auditory Maturation Affects Speech Perception  

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

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Sounds from the Bionic Ear Within!

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

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Audiology and Quality of Life: Is there a Connection?

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

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Audiologists in Demand - in India!

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

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Let's Replace Hearing Aid Evaluation with Functional Communication Assessment

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

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Hearing Aid Customers Satisfied with Dispensers

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

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Self-Report Assessment of Hearing Aid Outcome

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

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Eyes a Window to Hearing Loss?

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

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Amplification Considerations for Children With Minimal or Mild Bilateral Hearing Loss and Unilateral Hearing Loss

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

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Ida Institute Sets Sights on Easing Patient Journey to Better Healing

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