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.

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!

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.   

March 2006 – Sound Activity Monitor Improves Hearing Aid Fitting

June 2006 – The Audiogram: Explanation and Significance

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HINT Hearing Test Now Available Online

September 2003

Editor: There have been several online hearing tests over the past few years, but none has been very accurate. The ones I’ve seen have all been pure tone tests that try to measure a person’s hearing at various frequencies. The problem is that computer sound systems vary so much in quality that the test is often a measure of the quality of the computer sound system rather than of a person’s hearing. My laptop speakers, for example, have very little output at either low or high frequencies, so anyone taking the test on my laptop would fail the low and high frequency portions of the test.

The HINT test doesn’t try to measure hearing at different frequencies. It presents several sentences with background noise – hence the name Hearing in Noise Test (HINT) – and asks the user if he understood each sentence. Because virtually all of the signal and noise are in middle frequencies – which all speakers reproduce pretty well – a person can take this test on virtually any system.

Here’s the notice (with the appropriate URL), as it appeared in bhNEWS.

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The Hearing in Noise Test-Functional Screener is now available.

A simplified version of the House Ear Institute’s hearing in noise test (HINT) for evaluating functional hearing ability in noisy conditions is now accessible online.

The HINT is being offered on the HealthyConnections.com and HEI.org Web sites as the HINT-FS (Hearing in Noise Test-Functional Screener).

The HINT-FS is the first online hearing test that detects a person’s difficulty understanding speech in background noise, while not being subject to the variances in computer speakers. The online test measures speech recognition within a variety of “noisy” situations using a fixed (or constant) signal-to-noise ratio.

It has been clinically validated, but is not intended to replace a full audiological evaluation by a health professional.

“The online version of the HINT test allows people to determine if they might have suffered hearing loss and need to seek help from a qualified professional,” according to Paul Dragul, MD, otolaryngologist and founder of HealthyConnections.com.

Dr. Dragul worries that most people at risk for hearing loss will not seek out an office-based hearing test, because they don’t recognize their own hearing loss.

BobNote: Here is the direct link to the condensed version of the well acclaimed HINT test from the House Ear Insitute:

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Treating the Person

September 2003

My wife and I are very active in our local ALDA (Association of Late Deafened Adults – http://www.alda.org) group. We got involved because we were looking for help with her hearing loss and related issues, and ALDA has made a huge difference in our lives. That’s the reason I get so depressed when new people show up at one of our meetings!

Don’t get me wrong – it’s wonderful that they found us, and I have no doubt that hooking up with an ALDA group will make a huge difference in how they deal with their hearing loss issues. That’s the wonderful part. The depressing part is that they’ve often had significant hearing loss and worn hearing aids for 20 years or more, and they just now learned about ALDA. Not only did they not know about the various support groups that could help them, they often didn’t know about free amplified telephones or TTYs, assistive listening devices, captioned movies, or even that their television set has captions! Many claim to have never met another person with hearing loss!

The only thing they know about is hearing aids. They’ve been wearing them for 20 years or more, and they’ve purchased several pairs in that time. Think about how much better their lives would be today if they had taken advantage of some available resources 20 years ago . . . . . or ten . . . . . or even five.

I know that many of you try to educate your patients about various resources, and sometimes they don’t want to hear about it. And I know that sometimes you’re just too busy to spend the time to educate them. But I also know the isolation that so often results when your patients are uninformed – whatever the reason.

If you could provide each of your patients with information that will help them lead more fulfilling and productive lives, and if you could do it at virtually no cost in money or time, wouldn’t you commit to doing that?

Well, the fact is that you can!

Hearing Loss Network provides a “Coping with Hearing Loss Information Sheet” that directs your patients to the resources they need. You’ll find it in our online library (http://www.hearinglossnetwork.org/serv/out/docs/docs.htm). Please download, copy and distribute it.

While you’re there, why not grab a copy of the “Communications Tips Sheet” as well? Note that this is a two-sided sheet with tips for a person with hearing loss on one side and tips for a hearing person on the other. Please copy and distribute that, as well.  

These flyers won’t take the place of the time you devote to patient education in your office; words on a page don’t invoke the trust your patients have in your experience and judgment. But just maybe, after they get home and kick back and think about their day, they’ll remember those papers you gave them, and they’ll make a call or visit a website. And then they’ll thank you for treating the person rather than the hearing loss.  

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.

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.

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