by Dr. Levi A. Reiter
Audiologists are healthcare professionals who evaluate, diagnose, treat, and manage hearing loss and hearing conditions like tinnitus and balance disorders. An audiologist holds a minimum of a Master's degree in Audiology. Professionals seeking education in Audiology who do not currently hold a Master’s degree must now pursue a Doctoral degree in Audiology (Au.D). Audiologists must be licensed in the state where they practice, and are regulated by the Division of Consumer Affairs.
An audiologist may be awarded the Certificate of Clinical Competence in Audiology by the American Speech-Language-Hearing Association (ASHA), otherwise known as the CCC-A. With additional training and expertise, the audiologist may receive the honor of Fellow, which is bestowed by the American Academy of Audiology (AAA).
Common services and treatments provided by an audiologist include:
If you think you or a loved one may have hearing loss, you are not alone. Oftentimes people notice signs of hearing loss but do not take the steps to get it treated right away. Typically, it takes people an average of seven years to seek treatment. You may have hearing loss if:
Hearing loss can be due to several factors such as the aging process, exposure to loud noise, medications, infections, head or ear trauma, congenital (birth) or genetic factors, diseases, as well as a number of other causes. Recent data shows that about 20 percent of adults in the United States (48 million) report some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime.
If you have any symptoms of hearing loss, you should see an audiologist to have a formal hearing evaluation. This hearing test, or audiologic evaluation, is diagnostic in nature and allows the audiologist to determine the type, nature and degree of your hearing loss. Your sensitivity, acuity and accuracy to speech understanding will be assessed as well. Your audiologist may also test for speech understanding at different volume levels and in different conditions, such as noise, to provide an indication as to how successful of a candidate you will be for hearing aids.
The hearing evaluation will also include a thorough case history and a visual inspection of the ear canal and eardrum. Additional tests of middle ear function may also be performed. The results of the evaluation can be useful to a physician, if the audiologist believes your hearing loss may benefit from medical intervention.
Results of the hearing evaluation are plotted on a graph called an audiogram. The audiogram provides a visual view of your hearing test results across various pitches or frequencies, especially the ones necessary for understanding speech.
The audiogram and results from your speech understanding tests are used to create a prescription by which hearing aids are programmed, if necessary.
After you undergo a hearing evaluation, the results are plotted on a chart called an audiogram. Loudness is plotted from to bottom. The of the graph is very quiet and the bottom of the graph is very loud. Frequency, or pitch, from low to high, is plotted from left to right. Hearing level (HL) is measured in decibels (dB) and is described in general categories, not by percentages. The general hearing loss categories used by most hearing professionals are as follows:
There are four types of hearing loss:
Hearing loss in children can occur at any time in life from other acquired factors such as ear infections, head trauma, certain medications, and genetic factors. You may suspect your child has a hearing loss if you observe any of the following:
There are many types of hearing aids today, and the style or device is dependent upon the user's individual needs. There are in-the-ear styles as well as behind-the-ear styles. Also, hearing aid technology has advanced, with many new and improved options from which to choose.
Hearing aids are available in many different sizes and styles, thanks to advancements in digital technology and miniaturization of the internal components. Many of today's hearing aids are considered sleek, compact, and innovative - offering solutions to a wide range of hearing aid users. When selecting a style of hearing aid, the following should be considered:
People with all types and degrees of hearing loss can benefit from an assistive listening device (ALD). Since the microphone of a typical hearing aid is worn on or behind your ear, its ability to enhance the talker-to-background-noise ratio is limited. However, ALDs are designed to increase the loudness of a desired voice, such as a radio, television, or a public speaker, without increasing the background noise. This is because the microphone of the assistive listening device is placed close to the talker or device of interest, while the microphone of the hearing aid is always close to the listener.
ALDs include alarm clocks, TV listening systems, telephone amplifying devices, and auditorium-type assistive listening systems. Many newer devices are small, wireless, and compatible with a person’s digital hearing aids. Alarms and other home ALDs may be small devices that are placed discreetly on tables, next to the TV, or on the wall.
Tinnitus is a common disorder affecting over 50 million people in the United States. It is often referred to as 'ringing in the ears,' although some people hear hissing, roaring, whistling, chirping, or clicking. Tinnitus, often called head noise, is not a disease, but a symptom of another underlying condition of the ear, auditory nerve, or elsewhere. Tinnitus can be intermittent or constant, with single or multiple tones. Its perceived volume can range from very soft to extremely loud.
The exact cause of tinnitus is not known in every case. However, there are several likely factors which may cause tinnitus or make existing head noise worse. These include:
Generally, most patients will not need any medical treatment for tinnitus. There are several treatments and measures to help with the management of tinnitus including:
If these measures do not work, there are several medications that have been utilized to suppress tinnitus. Some patients benefit with these drugs and others do not. Each patient has an individual response to medication, and what works for one patient may not work for another.
There are vast differences in the professional roles in diagnosing and treatment of hearing loss. It is still common today for someone to get screened, tested, or fitted with a hearing aid by someone and still not know what qualifications that person had. How do you know who you can trust? An important distinction to understand when treating your hearing loss is the difference between an Audiologist and a hearing aid dispenser. An Audiologist is a Doctor of Audiology who is extensively trained in the science of hearing; while a hearing aid dispenser applies for a license after meeting some basic requirements (see below).
Audiologist: An Audiologist is trained to diagnose, treat and monitor disorders of the hearing and balance system. They are trained in anatomy and physiology, amplification devices, cochlear implants, electrophysiology, acoustics, psychophysics and auditory rehabilitation. Doctors of Audiology complete, at a minimum, an undergraduate and doctoral level degree in audiology, as well as a supervised externship prior to state licensure and national certification. This usually requires 8 years of post-secondary education (4 years of college and 4 years of graduate school). The graduate school years focus on the medical, diagnostic and rehabilitative aspects of hearing loss, hearing aids and the vestibular system. Upon completion of training, Audiologists must also pass a national standardized examination in order to be eligible for state licensure. Continuing education requirements must be met in order for an Audiologist to maintain state licensure.
Hearing Aid Dispenser: A hearing aid dispenser is licensed to perform audiometric testing for the sole purpose of selling and fitting hearing aids. In order to obtain a license, hearing aid dispensers are required to pass an exam. Prior to taking the exam, certain requirements must be met, which vary from state to state. In many states, hearing aid dispensers are only required to have a high school diploma. In other states, hearing aid dispensers must complete two years of college or post-secondary education in any field prior to applying for licensure. Some states require completion of distance learning coursework prior to taking the exam.
In summary, the requirement for state licensure to dispense hearing aids is based on the minimum education necessary to protect the health, safety and welfare of the patient. The differences in education required for Audiologists versus hearing aid dispensers reflect the significantly larger range of professional practices that Audiologists are permitted to engage in.
Audiologists are highly trained degree professionals. Audiologists receive extensive training in assessment of hearing, diagnosis, fitting and adjustment of hearing aids that helps to ensure: