By: Dr. Matthew Seldine
Audiology as a healthcare discipline has been around for over 50 years. It is relatively young compared to other healthcare disciplines like medicine, dentistry, and even optometry. As such, Audiology is an ever-evolving field that encompasses a range of interests, capabilities, and professional endeavors. This post is to help clarify what an Audiologist is, as defined by the American Academy of Audiology, the defined Scope of Practice, and some Best Practice guidelines. This is not an exhaustive listing.
We at Hearing Partners of South Florida believe in educating our patients regarding how we can best help in their hearing healthcare and that includes informing our community on these key pieces of our field that help define who we are.
Definition of an Audiologist
“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 prevention of hearing loss and the audiologic identification, assessment, diagnosis, and treatment of persons with impairment of auditory and vestibular function, and to the prevention of impairments associated with them. Audiologists serve in a number of roles including clinician, therapist, teacher, consultant, researcher and administrator. The supervising audiologist maintains legal and ethical responsibility for all assigned audiology activities provided by audiology assistants and audiology students.” (American Academy of Audiology, updated 2004).
Audiologists are specially trained clinicians whose central focus is concerned with all auditory impairments and, most importantly, their relationship to disorders of communication. The key word here is communication. Communication is an integral part of the human experience. It is how we acquire, share, and disseminate information for our well-being and advancement. Additionally, some Audiologists have specialized training in vestibular (balance) disorders and tinnitus identification and management.
Scope of Practice
There is a lot that can be shared here, but we will keep it to the key points. Audiologists are involved in a lot. It starts with identification of communication disorders. Most often, this means hearing loss. Did you know there are 3 types of hearing loss? Properly identifying this diagnosis significantly impacts the course of treatment and management any patient requires. To do so, audiologists engage in assessment to help define the diagnosis. This involves administration and interpretation of a battery of evaluation measures using standardized testing procedures, calibrated instruments, and holistic review of case history and all acquired evaluation results (i.e. connecting all the dots!). Then comes treatment. Here, Audiologists are responsible for providing recommendations of appropriate amplification devices and adherence to clinical best practices for the determination of that appropriateness for patients’ benefit. Counseling and training on the use of these systems is necessary. Every patient will require a different approach. What Hearing Partners believes is important, though, is the development of a long-term care approach to help continually strengthen understanding and support healthy listening habits over time.
Best Practices
Regardless of the approach taken for any individual patient, it is crucial to adhere to certain clinical standards. Such standards foster the trust the community has in any healthcare provider. Audiologists are of no exception. The management of a patient requires careful consideration of their unique medical history, presentation of symptoms, and specific communication needs, goals, and desires. With this backdrop, an auditory evaluation is completed that should address the entire auditory system. This includes completion of speech-in-noise measures, a key component of the evaluation process commonly omitted by many providers. The outcomes of the case history and evaluation results provide further evidence for the need of medical referral, or, if appropriate, a specific recommendation of an amplification system (i.e. hearing devices) to treat any manageable hearing loss. Again, every patient is different, and Audiologists are trained in the proper selection of these systems for their patients. There are many, many options out there and sorting through such an array of devices is overwhelming. Trust in your Audiologist to provide professional guidance. Consider them a fiduciary for your ears. Your Audiologist may also elect to discuss with you, one way or another, your self-perception of the impact of the diagnosis. These discussions help frame realistic expectations of the treatment plan and subjective benefit. Taking care to properly fit a hearing aid serves to address objective benefit. Measures taken to ensure this is achieved include, at a minimum, Real Ear Measurements and functional gain assessments. What is important to understand here is that the hearing device itself is useless unless it is professionally programmed to address the unique needs and anatomy of the patient. This helps establish functional improvements in the stated patient goals and these improvements can be tracked over time.
The bottom line here is producing effective outcomes and Audiologists are trained to help patients achieve their desired outcomes. Much thought goes into treating any patient who needs help hearing. Even more thought goes into listening to every individual patient and helping them listening and improve their ability to communicate effectively.