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Speech and Hearing Services for Children and Adults:

What is an Audiologist?

Au-di-ol-o-gists: Audiologists are the primary health-care professionals who evaluate, diagnose, treat, and manage hearing loss and balance disorders in both adults and children. They recommend amplification to those with hearing loss, evaluate infants for hearing loss, assess and treat APD (Auditory Processing Disorder), and assess and treat tinnitus (ringing in the ear). Most Audiologists earn a doctoral degree in audiology (AuD), some still may hold master’s degree; however all must be licensed and registered in the state they practice. As a licensed healthcare provider Audiologists are clinically and academically trained to determine if a patient needs a medical referral and the results of the audiometric evaluation indicate the possibility of a medical problem. Audiologists are not technicians nor are they hearing instrument specialists, they are highly educated healthcare professionals, with the knowledge for proper assessment and/or treatment of hearing loss. A hearing instrument specialist’s minimum requirement for state licensure is a high school degree or GED.

What is a Speech Pathologist?

A Speech Language Pathologist will assess, diagnose and treat speech, language, cognitive, voice, swallowing, fluency, and other related disorders. Speech Therapy focuses on receptive language (the ability to understand words spoken to you) and expressive language (the ability to use words). It also deals with the mechanics of producing words, such as articulation, pitch, fluency, and volume. Adults may need speech therapy after a stroke or traumatic accident which can change their ability to use language. With children, it generally involves pursuing milestones that have been delayed. The speech-language pathologist or speech therapist, will work to find fun activities to strengthen your child in areas of weakness. The Speech Language Pathologist is an educated healthcare professional and will determine the best course of treatment for your child. Speech-language pathologists often work as part of a team, which may include teachers, physicians, audiologists, psychologists, social workers, rehabilitation counselors and others.

What is an Otolaryngologist?

Otolaryngologist (also called ear-nose-and-throat, or ENT, doctors) are physicians who have advanced training in disorders of the ear, nose, throat, head and neck. They are physicians who typically treat disorders of the ear (or hearing mechanisms) requiring medical solutions.

Hearing Loss in Children

Hearing and speech are essential tools of learning, playing and developing social skills. Children learn to communicate by imitation; therefore if they have an undetected/untreated hearing loss they can miss the vast majority of the speech and language around them. This results in delayed speech/language development, social problems and academic difficulties. The most effective treatment is achieved through early intervention. Early diagnosis, early fitting of hearing aids, and an early start on special education programs can help maximize a child’s hearing.

A Discussion of Ear Infections (Otitis Media)

A chronic ear infection is inflammation or infection of the middle ear that persists and causes long-term or permanent damage to the ear. Fluid in the middle ear may become very thick. Sometimes, the eardrum (tympanic membrane) may stick to the bones in the middle ear. Acute infections results in fluid; however, get resolved much faster. Ear infections are more common in children because their Eustachian tubes are shorter, narrower, and more horizontal than in adults. Chronic ear infections are less common than acute ear infections; however both types of OM can affect both adults and children.

What is an Auditory Processing Disorder (APD)?

In its very broadest sense, APD refers to how the central nervous system (CNS) uses auditory information. To avoid confusing APD with other disorders that can affect a person's ability to attend, understand, and remember, it is important to emphasize that APD is an auditory deficit that is not the result of other higher-order cognitive, language, or related disorders. Auditory Processing (also called Central Auditory Processing Disorder-CAPD/APD) is a term used to describe what happens when your brain recognizes and interprets the sounds around you. Humans hear when energy that we recognize as sound travels through the ear and is changed into electrical information that can be interpreted by the brain. The “disorder” refers to an adverse effect on the processing or interpretation of the information.

Children with APD often do not recognize subtle differences between sounds in words, even though the sounds themselves are loud and clear and may get the words and or meaning mixed-up or confused. Noisy situations such as the classroom, restaurants, and parties are the most commonly problematic environments for these children.

Assistive Listening Devices (ALD’s)

An Assistive Listening Device (ALD) is used to provide hearing ability for people in a variety of situations. You may have certain communication needs that cannot be solved by the use of hearing aids alone. These situations may involve the use of the telephone, radio, television, and the inability to hear the door chime, telephone bell, and alarm clock. There are many assistive listening devices available today, from sophisticated systems used in theaters and auditoriums to small personal systems.

What is Tinnitus?

Tinnitus (pronounced TIN-u-tis) is not a disease. Tinnitus is reported by 10-15% of the population on a daily basis.Tinnitus is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and the parts of the brain which processes sound. Tinnitus is commonly described as a ringing in the ears. It also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Tinnitus can be intermittent or constant with single or multiple tones. Tinnitus can be temporary (acute) or permanent (chronic).

The exact cause (or causes) of tinnitus is not known in every case although there are many neurophysiological theories. There are several likely factors which may cause tinnitus or make existing tinnitus worse: Noise induced hearing loss, ear and sinus infections, age-related hearing loss, wax build-up in the ear canal, ear diseases and disorders, jaw misalignment, head and neck trauma, diseases of the heart or blood vessels, Meniere’s Disease, certain types of tumors, certain medications, hormonal changes in women, thyroid abnormalities and many others. Tinnitus is sometimes the sign of hearing loss in older people. It also can be a side effect of medications. More than 200 drugs are known to cause tinnitus when you start or stop taking them.

There are many options for people who experience tinnitus. Studies have shown that 50-60% of people who have hearing loss and wear hearing aids find a reduction in the perception of the loudness of their tinnitus. Hearing aids with or without tinnitus masker programs are available. Along with counseling these tools can help people with tinnitus function better in their everyday life. Your audiologist is an excellent resource for issues and answers related to tinnitus.

Cochlear Implants

Generally speaking, cochlear implants are for patients with severe-to-profound, sensori-neural hearing loss. There are approximately 500,000 patients in the USA with severe-to-profound hearing loss. Cochlear implants are only recommended after patients have tried the most powerful and most appropriately fit hearing aids, and have not shown sufficient benefit from hearing aids. Cochlear implants are devices that are “permanently” surgically implanted into the inner ear. Cochlear implants are utilized in the patient who cannot benefit from hearing aids.

Middle Ear Implants

Middle ear implants are surgically implanted devices. The FDA has approved specific middle ear implants. The middle ear implant is a useful hearing instrument and is quite different from traditional hearing aids. Middle ear implants work by vibrating the middle ear bones, rather than by producing audible sound. If you are considering a middle ear implant, speak with your audiologist. Your audiologist can direct you to an otolaryngologist who can assist with implanting these devices. Not all patients are surgical candidates, and each candidate does not receive the same benefit.

What is Meniere's disease

Meniere’s disease is a disorder of the inner ear that causes severe vertigo (dizziness in the form of a spinning sensation), tinnitus, fluctuating low frequency hearing loss, and a feeling of fullness or congestion in the ear. Meniere’s disease usually affects only one ear. Meniere’s disease can develop at any age, but is more likely to happen between 40 and 60 years of age. Meniere’s disease does not have a cure yet, but your doctor might recommend some treatments that will help you cope with the condition.

Diagnosis is completed by an Audiologist and or ENT. It is based upon your medical history and the presence of:

  • Two or more episodes of vertigo lasting at least 20 minutes each
  • Tinnitus
  • Fluctuating low frequency hearing loss
  • A feeling of fullness/pressure in the ear

A Discussion of Dizziness

Dizziness is a symptom not a disease. It may be defined as a sensation of unsteadiness, imbalance, or disorientation in relation to an individual’s surroundings. The symptoms of dizziness may vary widely from person to person and may have several different causes; including ones of unknown etiology. It can range from a mild unsteadiness to a severe spinning sensation known as vertigo. Dizziness may or may not be accompanied by a hearing impairment.

Peripheral vs. Central Dizziness

Peripheral dizziness is one most common types of dizziness. Inflammation or infection of the inner ear or balance nerve is also a major cause. Peripheral dizziness is considered to be any dizziness that affects the vestibular system including the semicircular canals, vestibule (utricle and saccule) or the vestibular nerve. Common causes of peripheral dizziness are: Meniere’s, Labyrinthitis, BPPV (Begnin Proximal Positional Vertigo), Vestibular Neuritis and motion sickness.

Central dizziness is the second type of dizziness which is caused by injury to the balance center of the CNS. This would include parts of the vestibular nerve through the brainstem and cerebellum. Common causes of central dizziness are: infarcts, hemorrhages, tumors, vestibular schwannomas, epilepsy, cervical disorders/diseases, ataxia and migraines.

Any disturbance affecting the function of the inner ear or the CNS may result in dizziness hearing loss or tinnitus. Balance problems can accompany either type of dizziness. These symptoms may occur singly or in combination, depending upon which functions if the inner ear are disturbed. If you feel as if you may have a chronic dizziness condition, please see your local Audiologist or ENT for an evaluation.

Aural Rehabilitation

Aural rehabilitation is the process in which hearing-impaired individuals are taught to improve their ability to communicate. Methods taught include, but are not limited to, speech-reading, auditory training (LACE program for hearing aid users), use of hearing aids, and use of assistive listening devices such as telephone amplifiers and even cochlear implant programs such as Sounds and Beyond.

Audiologists and speech-language pathologists are professionals who work together to provide the patient with the best course of aural rehabilitation based on individual needs as each healthcare professional has their own role to play.

Patient Resources:

Tinnitus – www.ata.org– American Tinnitus Association Useful sites include www.asha.org and www.audiology.org