Download The profession of Audiology

Audiology? The Profession
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What is Audiology?
•The study of hearing
•Emphasis upon the disordered aspect
•Audiologists are trained to
-evaluate hearing
-treat non-medical aspects of
hearing loss
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What do Audiologists do?
•Take a case history
-interpret symptoms for identifying pathology and for rehabilitation
•Evaluate hearing
-perform audiometry
•Determine if there is a hearing loss
card fld "Basic Evaluation"
Procedures audiologists perform…
The basic evaluation
•Case history
•Pure-tone air conduction
-sensitivity to pure tones
-sensitivity of the entire auditory system
•Pure-tone bone conduction
-measures sensitivity of a part of the auditory system, the sensorineural part
•Speech reception threshold (SRT)
-how has the hearing loss affected the ability to hear speech?
•Word recognition/identification testing
-how has the hearing loss affected the ability to understand speech?
•Immittance audiometry
√Tympanometry
-measures mobility of the middle ear system
√Acoustic (stapedial) reflex
-provides information about all the major divisions of the ear
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Audiology? The Profession
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-Acoustic reflex thresholds
-Acoustic reflex decay
•Explanation of results (counseling)
Procedures for children & difficult to test
•Behavioral observation audiometry (BOA)
-noisemakers
•Conditioned orientation response audiometry
(COR)
-utilizes a head turning response
•Play audiometry
-hear a tone, drop a block
•Objective, physiologic measures
-Auditory brainstem response (ABR) and otoacoustic emissions (OAEs)
-It is possible to determine if a one-day old baby can hear, or someone in a coma.
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Is there a hearing loss?
•If not, no further evaluation is needed
•Even this knowledge can be helpful to the patient who may worry about normal difficulty listening or
typical symptoms (e.g., tinnitus).
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Is there a hearing loss?
•If there is, then further evaluation is needed
•Perform special tests, determine if the lesion causing the hearing loss is medically treatable
card fld "Special Tests"
Special diagnostic procedures audiologists perform…
•Many of the techniques were designed to identify the presence of an acoustic nerve tumor
Traditional site of lesion battery
•Alternate binaural loudness balance test (ABLB)
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-determines presence of recruitment
•Short increment sensitivity index
-based upon the difference limen for intensity
•Threshold tone decay
-determines presence of adaptation
•Békésy audiometry
-another test of adaptation
•Rollover in the performance-intensity function (the speech intelligibility function)
-Does speech become unintelligible at higher intensities?
Newer procedures
•Immittance audiometry
-monitors status of the middle ear, cochlea, and auditory nerve
•Auditory evoked potentials (like the ABR, electrocochleography, P300s, mismatch negativity)
-A stimulus evokes electrical activity in the auditory pathway. Electrodes detect the activity and
computers process and display the results.
•Electroneurography (ENOG)
-monitors facial nerve activity
•Somatosensory evoked potentials (SSEP)
-monitors spinal column
•Electronystagmography
-evaluates the visual and vestibular components of the balance system
•Dynamic posturography
-evaluates the ability to maintain postural stability
•Otoacoustic emissions (OAEs)
-a technique to determine status of the outer hair cell population in cochlea
-to objectively screen for mild hearing loss
•Central auditory evaluation
-Special speech tests to uncover auditory processing deficits
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Is medical referral necessary?
•If so, make appropriate referral
•Do follow-up testing as needed
Audiology? The Profession
-e.g., monitor hearing, middle ear function of a child with tympanostomy tubes
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Is medical referral necessary?
•If not, then decide if aural rehabilitation is necessary
•Implement appropriate components of an AR program
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Aural rehabilitation…
•hearing aid selection, fitting, evaluation, followup
-cochlear implants, too
•assistive devices (FM systems, TV, telephone, signaling & alerting)
•Counseling
•Speechreading, auditory training
•Speech/language (re)habilitation
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What training does an audiologist have?
•Audiologists must have certificate of clinical competence (CCC)
–American Speech-Language-Hearing
Association (ASHA)
•Master's degree from accredited training program
-Council On Academic Accreditation
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audiologist training (continued)…
•375 clinical hours of supervised diagnostics/therapy
•pass a national exam (NESPA created by National Testing Service)
•completion of a clinical fellowship, usually lasts a year
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Audiology? The Profession
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The Au.D. — ?
•A professional doctorate in audiology
•A four-year post-baccalaureate degree
•similar in concept to training for optometry
•To be phased in from 2007 - 2012
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The Origins of Audiology…
•Raymond Carhart considered the "father" of Audiology
•Audiology is a marriage of speech pathology and otolaryngology — A need for someone familiar with
hearing to help with non-medical management.
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•Audiology began in the mid 1940s
•Captain Carhart at Deshon Army hospital was responsible for rehabilitating returning servicemen
-noise-induced hearing loss
•He implemented an aural rehabilitation program
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Where do we work?
•Employee in ENT physician's office
•Hospitals and clinics
√Military hospitals, VAMC
•Public schools (elementary & secondary)
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Where do we work? (continued)
•In Industry (industrial audiology, hearing aid manufacturers)
•University, teaching and clinic
•Private practice
√Own and operate small business
√Hearing aid dispensing
Audiology? The Profession
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