Hearing (Audiology) Services

Hearing Tests for Adults

What is a hearing test?

A hearing test is a procedure that provides insight about an individual’s ability to hear. An audiologist is licensed to administer a comprehensive hearing test, interpret results, and counsel patients based on their individualized needs. The procedure includes a thorough case history, where questions and concerns of the patient are addressed. The outer ear and ear canal are examined. Then, the patient sits in a sound proof room while the audiologist plays tones (or beeps) through a headset. Upon hearing the beeps, patients are instructed to either raise their hand or push a button in response. The goal of a hearing test is to measure the softest beep that a person can reliably hear. Additionally, patients might be instructed to repeat words and/or sentences to the audiologist.

After the testing is complete, the audiologist is able to interpret results to determine if the hearing loss permanent or treatable, and how much hearing loss is present. From there, hearing test results are shared with the patient, management options are discussed, and referrals to other professionals can be discussed, if needed.

When to schedule a hearing test?

A hearing test for adults can be recommended for many reasons, including: difficulty understanding conversation in quiet and noisy environments, ear pain, ringing in the ears, and/or balance difficulties. Hearing tests are typically recommended annually or whenever concerns arise.

FAQs / Summary

• Who can get a hearing test?
  Anyone! If you have concerns about your hearing, an audiologist would be more than happy to meet with you to discuss your concerns and determine possible management. Additionally, if you have risk factors for hearing loss (i.e., history of ear infections, loud noise exposure, family history, etc.), it is highly recommended that your hearing is evaluated routinely.
• Who can diagnose hearing loss?
  Audiologists are trained and licensed professionals who assess the hearing and balance systems. Part of an audiologists’ role is to evaluate hearing ability, diagnose hearing loss, and counsel patients on management options and strategies. Other professionals can screen for hearing loss, but only an audiologist can comprehensively evaluate hearing and diagnose hearing loss.
• What are management options for hearing loss?
  Depending on the type (permanent or treatable) and amount (mild, moderate, severe, profound) of hearing loss, different management options can be recommended.
• What should I do before a hearing test?
  Expect a hearing test to be about 1 – 1.5 hour(s) in duration. Have a clear idea of your hearing concerns or difficulties ready to discuss with the audiologist. This ensures that your concerns are addressed during the appointment. Make sure you eat and take any required medications as you normally would.

Ear Impressions for Swim Plugs or Noise Reduction Ear plugs

What are custom ear plugs used for?

Custom ear plugs for swimming are devices that are used to prevent water from entering the ear canal.

Custom ear plugs for noise reduction are worn to help prevent hearing damage through exposure to occupational or recreational loud noises. Noise reduction ear plugs are often used by musicians and hunters.

How can I get custom ear plugs?

To create custom ear plugs, ear impressions are taken of one or both ears and are sent to an earmold company. The earmold company uses the impressions to make the actual swim plugs or ear plugs.

What to expect:

An appointment for custom ear plugs can be broken into several parts: evaluating the need for custom ear plugs and making recommendations, making the impressions, and fitting the devices once they arrive to the clinic. During the evaluation, the reason for getting the ear plugs is discussed (are they for swimming, noise reduction, etc.) and recommendations can be made by the audiologist. Then, impressions are taken by filling the ear with a putty-like material. This dries in the ear for about 5 minutes and is then removed. After this, the impressions are sent to the company to be made. Once the plugs arrive at the clinic, the patient returns to be fit with them.

FAQs / Summary

• Who can use custom ear plugs?
  Anyone who is exposed to loud noises can benefit from the use of custom ear plugs as forms of hearing protection. For example, many hunters, musicians, or those who work in industrial settings can use custom ear plugs to protect their hearing. Additionally, those who wish to keep water or liquid out of the ear canal can use custom ear plugs while bathing and swimming.

Hearing Conservation

What is Hearing Conservation?

Hearing conservation, or the prevention of hearing loss, consists of the routine monitoring and protection of hearing. This is commonly completed for individuals who work in industrial or loud environments, or for those who have hobbies that involve loud sounds. For example, hunters and musicians

What services are included?

The patient and audiologist discuss any relevant noise exposure or other information that would impact hearing. Many times, hearing is tested on a routine schedule to monitor for any changes. Ways to protect hearing are discussed, and might include the use of hearing protection in noisy situations.

FAQs / Summary:

• Can loud noises cause hearing loss?
  Yes, being around loud sounds can cause damage to the hearing system. The best way to prevent noise-related hearing loss is to avoid loud-noise situations when possible and use hearing protection, otherwise.
• I’ve been exposed to loud noises, but have never had my hearing tested. What should I do?
  If you are concerned about potential damage or hearing loss due to noise exposure, it is recommended that you speak with an audiologist.

Cochlear Implants

What is a cochlear implant?

A cochlear implant is a specialized device that aids in carrying sound directly to the hearing nerve.  There are two parts: one is internally implanted behind your ear and the second part is a processor that you wear on/near your ear.  Anyone who is not benefitting from the use of hearing aids should consider a cochlear implant.  Our clinic provides audiology and speech-language pathology services related to the use of a cochlear implant.

How can it be evaluated?

Prior to receiving a cochlear implant, you are required to undergo an evaluation process which includes an audiologist, speech-language pathologist, and an ENT physician.  You will first meet with an ENT physician prior to completing the remainder of the evaluation process.  During the audiology portion of the evaluation process, the audiologist will test your hearing with and without hearing aids to determine if a cochlear implant may be a good option for you.

What happens if I get a cochlear implant?

Following surgery for the cochlear implant, you will be scheduled at our clinic for audiology visits which will include activation (i.e., turning on the device) as well as follow-up visits.  Follow-up visits can include programming of the device, troubleshooting of the device, orientation to the device and associated accessories, and testing your hearing abilities while wearing the device.

FAQs

• Is surgery required?
  Yes, a cochlear implant does require surgery.  This surgery is conducted by an ENT physician.
• Who is part of the care team?
  The following members are part of the care team for patients with cochlear implants: audiologist, speech-language pathologist, and the ENT physician.  The audiologist and speech-language pathologist are both located in our clinic while the ENT physician is located at a separate facility in close proximity to our clinic.
• Are there follow-up appointments after I receive my cochlear implant?
  Yes, there will usually be audiology appointments at 1 month, 3 months, 6 months and then every 12 months after activation of the device.
• What manufacturers does your clinic work with?
  Our clinic works with both Advanced Bionics and Cochlear Americas.
• What if I got my cochlear implant from another office?
  Even if you initially received your cochlear implant from another office/hospital, you are still able to schedule an appointment with our office for services as long as you use a manufacturer that we service.
• Does my health insurance cover costs associated with a cochlear implant?
  While it depends on your particular health insurance coverage, many health insurance companies provide at least partial coverage for services related to cochlear implants.

Auditory Processing Disorder

Auditory Processing Disorder, or APD, is when someone has trouble focusing on, making sense of, and remembering acoustic information.  Put simply, normal auditory processing is “what we do with what we hear”.

The symptoms of APD can be different for each person. The most common complaints include difficulty listening in noisy places, trouble following directions, and trouble telling the differences between words. Most parents report their children seem to “mishear” information or just do not pay attention. Some of these children seem like they might have a hearing loss, as they may ask for clarification or repetition.

APD can only be diagnosed by an audiologist who specializes in the testing of APD. It is important to emphasize that APD is an auditory problem that is not the result of any other cognitive, language, or related disorders (such as hearing loss, autism or ADHD). APD can be hard to diagnose as the symptoms are similar to other problems listed previously. Therefore, at ECU-SLHC it is recommended children have a psychoeducational evaluation completed prior to scheduling the first APD session. This ensures no other diagnosis exists and normal cognition and brain function. A speech and language evaluation may also be suggested by the audiologist to rule out other disorders. The speech-language pathologists and audiologists work closely as a team to assess each individual.

What to expect:

The APD testing at our clinic is done in multiple sessions. To diagnose APD, the audiologist will first establish a full case history and assess hearing of the outer, middle and inner ears to confirm normal hearing. The audiologist will also complete speech testing in quiet and noise. After this, the audiologist will take the results from the extensive testing and make the decision whether another APD session is necessary for your child. If so, the audiologist will administer testing that requires careful listening and attention to assess a wide range of listening abilities.

FAQ

• Who can be tested for APD?
  To be considered for an APD evaluation, your child must also be at least 7 years of age or older and speak English as their first language.
• Who can diagnose APD?
  Only an audiologist can diagnose APD. Other medical professionals can screen for APD, but only an audiologist can diagnose it.
• What should I do before my APD appointment?
  Make sure your child has had a good night of sleep, has eaten that day, and has taken any daily medications. If you have been sent any forms or questionnaires, be sure to fill them out. Please arrive 15 minutes early to allow for completion of any further paperwork.
• How is APD treated?
  There is no cure for APD, but we can use some tools to help your child learn how to manage their APD. An educational audiologist can help find out what is best for your child in school.

Tinnitus Evaluation

What is tinnitus?

Tinnitus is when a person hears a sound that is not present in the listening environment.  The sound is usually found with damage or a problem in the ear.  It is sometimes found with damage or a problem in the head or neck. That is why it is important to start with an evaluation of the ear and hearing by an audiologist and/or ear-nose-throat doctor.

What is non-bothersome tinnitus?

A person can have tinnitus but may be able to tune it out or ignore it. Once their ears and hearing are evaluated, basic counseling on tinnitus can be offered.   There is no need for a tinnitus evaluation.

What is bothersome tinnitus?

If a person hears a constant or frequent tinnitus, it can negatively impact everyday life.  It can cause problems with annoyance, emotions, relaxation, concentration, listening and getting to sleep or staying asleep.  People with bothersome tinnitus often need help learning to tune it out.  They will benefit from having an ear and hearing evaluation and a tinnitus evaluation.

When is tinnitus evaluated?

Before tinnitus is evaluated, it is important to have an ear and hearing evaluation first to find out if there is hearing loss or other medical problems to address.

What happens during a tinnitus evaluation?

The tinnitus evaluation at our clinic includes the following:

• Review of findings from ear/hearing evaluation;
• Review of medications to determine those with tinnitus as a possible side effect;
• Review of tinnitus, ear, head and neck problems;
• Questionnaires to determine how tinnitus is affecting everyday life;
• Screenings to rule out common problems found with bothersome tinnitus:  anxiety and depression, post-traumatic stress disorder, daytime sleepiness;
• Matching of tinnitus pitch and loudness to computer-generated sounds;
• Discussion of evaluation findings and likely tinnitus cause(s);
• Discussion of management options;
• Determination of patient goals for management;

What are some tinnitus management options?

Tinnitus generally cannot be eliminated or cured.  The main strategy for managing tinnitus is learning to tune it out or habituation.  This can be fostered with use of the following:

• Counseling as to the process of tuning out sounds;
• Sound enrichment or adding low to moderate levels of sound through the use of phone apps, hearing aids or other sound generators to refocus attention to other sounds;
• Cognitive behavioral/counseling strategies or ways to refocus thinking and change negative thoughts through use of phone apps, websites, or counseling with a mental health counselor

FAQs/Summary

• Who should be seen for tinnitus evaluation?
  Persons with bothersome tinnitus will benefit from tinnitus evaluation.
• Is there a cure for tinnitus?
  There is no cure for tinnitus.
• How is bothersome tinnitus managed?
  Sound enrichment and/or cognitive behavioral/counseling strategies

Aural Rehabilitation

What is auditory rehabilitation?

When a person has hearing loss there are 4 main areas of rehabilitation that can improve communication.  These include: 1) effective communication strategies; 2) assistive listening devices; 3) perceptual training and 4) support.

What are effective communication strategies?

These are actions you and your communication partners can use to improve communication and they include the following:

• Listener:
  • learn about hearing loss
  • use active listening (attending,
  • comprehending, clarifying)
• Talker:
  • learn about hearing loss
  • use clear speech (slowed)
  • organize and clarify comments
• Both:
  • enhance acoustic & visual information:
  • Distance-move closer
  • Angle-talk face-to-face
  • Reverberation-move away from walls
  • Noise-move away from or reduce

What are assistive listening devices?

These are devices you might use to better hear speech and other sounds and they include the following:

• Hearing aids
• Other devices for tv, phone, computer, or at distances
• Alerting devices
• Cochlear implants

What is perceptual training?

These are formal programs you may use to improve listening or lipreading of speech.

• Auditory/Listening Training—if you have poor listening in noise abilities OR are fit with a cochlear implant
• Lipreading Training—if interested

What is support for hearing loss?

Support includes reassurance, encouragement & understanding that help you cope with hearing difficulties and those offering support can include the following:

• Family, friends, communication partners
• Audiology/Speech Therapy care team
• Group (face to face; online)
• Mental health professional

How does the clinic offer AR?

Most patients receive individual AR.  Some patients are invited to participate in an AR group with others who have hearing loss.

FAQs/Summary

• What are the 4 main areas of AR that can help persons with hearing loss communicate better?
  Communication strategies, assistive listening devices, perceptual training, support
• How can patients receive AR?
  In individual appointments or in groups