When Should You Have a Baseline Hearing Evaluation?
Like many other health screenings, it is good practice to have a baseline hearing evaluation by age 60, if not before, when noticing difficulty understanding conversation in noise, presence of tinnitus (ear noise), history of familial hearing loss, and/or history of noise exposure.
What is a Diagnostic Hearing Evaluation?
A hearing exam determines your hearing ability, but just as important is knowledge of your medical and hearing history as well as the social impact of your hearing loss.
To determine the unique aspects of your hearing loss, a physical (ear) examination, pure tone hearing test, and testing of your speech recognition in both quiet and noise will be conducted.
The final step of the appointment includes: consultation after the hearing assessment to discuss the results, reason for medical referral if indicated, recommendation for amplification or other assistive listening devices if appropriate, and discussion of strategies to improve communication. Bringing a spouse or other family member is beneficial when discussing communication repair strategies.
What's Your Hearing Number?
Hearing loss is most often reported as degree of hearing loss using the terms: mild, moderate, severe, or profound. While most understand the difference between having a mild loss versus severe, this does not reflect ability to hear conversation.
The Gold Standard for quantifying Hearing is a value reflecting ability to understand speech based on the degree and slope of hearing loss referred to as Speech Intelligibility Index (SII). The SII relates to the intelligibility of speech heard 1 meter from the ear. The SII can be measured with and without amplification to verify benefit. A SII of 92-100 is desirable.
What's the Difference Between an Audiologist and a Hearing Specialist?
Many different levels of care exist for those who need hearing help. A hearing professional’s education, experience, and scope of practice vary widely.
Audiologists were originally required to hold a Master’s degree in Audiology. In the 1990s, this transitioned to a Clinical Doctorate (AuD) or Research Doctorate (PhD). Audiologists have an additional 4 yrs of post graduate education.
An Audiologist is trained to identify ear, hearing, and balance disorders as they occur in isolation or are related to other health conditions. They recognize communication disabilities as a result of hearing loss, and recommend treatment options including medical referrals when indicated and the dispensing of hearing devices.
They serve patients of all ages; newborn to senior adult. Their scope of practice also includes cerumen (ear wax) management.
Audiologists are certified by the American Speech and Hearing Association upon completion of an educational program and National exam.
Hearing Instrument Specialists are now required in some states to obtain an Associate Degree in Hearing Science. Others have held a temporary license (requiring only a high school diploma) and are mentored prior to a state exam. Most states limit their scope of practice to the dispensing of hearing devices to adults.
The State of Missouri requires registration and licensure for both professions. Medicare, Medicaid, and Insurances only recognize an Audiologist as a professional equipped to provide a Diagnostic Hearing Evaluation.
How We Hear
What is the Impact of Hearing Loss on an Individual?
Individuals with even a mild hearing loss are three times more at risk of experiencing unexpected, injury-causing falls.
We hear with our brains, so untreated hearing loss can lead to cognitive difficulties and increase the risk of developing dementia and Alzheimer’s.
Left untreated, hearing loss impacts quality of life.
Loss of interest in daily life, depression, anxiety, and isolation can happen with increased hearing loss. Hearing loss in adults is typically gradual; therefore, these changes can be mistaken for dementia in the senior population.
Is it Hearing Loss...or Something Else?
Hearing loss is the 3rd most prevalent medical condition following heart disease #1 and arthritis #2.
One in two adults has a chronic medical condition and one in four adults has multiple chronic conditions.
Senior adults with hearing loss left untreated are more likely to report depression, anxiety, and paranoia. Senior adults experience more difficulty with rapid speech due to the aging brain. Senior adults typically do not process the complexity of speech as fast and accurately as they once did. What might seem like the beginning signs of dementia, could be signs of hearing loss or slower auditory processing. Both are gradual in onset.
The simultaneous presence of two or more diseases or medical conditions such as heart disease, small vessel vascular disease or diabetes, to name a few, can cause changes in blood supply, thus oxygen saturation. The inner ear requires a delicate balance of oxygen. It is open to irreversible damage when other chronic medical conditions are not well managed.
The associated conditions of tinnitus (ear noise) to one ear or both can occur as an isolated symptom or in conjunction with hearing loss.
Likewise, dizziness or vertigo can occur as a result of an acute or chronic inner ear disorder. This condition can also be the result of an underlying neurologic or vascular disorder. A comprehensive evaluation of an individual's hearing often assists your primary physician in determining a diagnosis or make appropriate referrals to a Specialist.