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Building the patient profile
Published in Stephanie Martin, Working with Voice Disorders, 2020
Hearing may be a relevant contributing factor to dysphonia, where the patient has reduced self-monitoring of pitch, volume and quality of voice and may use excess effort with increased volume to ensure being heard. Conversely, some hearing-impaired patients produce quiet, inadequate voice with little output of airflow in voice production, thus producing an aerodynamic disturbance and dysphonia. In other instances, profoundly deaf adults have been known to use raised pitch, resulting in fatigue, weakness and loss of tone in the vocal fold musculature. Similarly, the increased anxiety and tension, which may be caused by failure of others to understand the communication of the hearing-impaired adult, can result in a MTD. It is imperative, therefore, if there is any question of hearing disturbance, that a full assessment is made by the audiologist. Consideration should also be given to the potential presence of presbycusis (gradual hearing loss) in an older patient as a common feature of ageing. About 30–35% of adults age 65 and older have a hearing loss and it is estimated that 40–50% of people aged 75 and older have a hearing loss.
Late Effects of Treatment for Childhood Brain and Spinal Tumors
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Ralph Salloum, Katherine Baum, Melissa Gerstle, Helen Spoudeas, Susan R. Rose
A complete audiologic evaluation to include at least pure-tone air conduction (and bone conduction if air conduction is abnormal), speech audiometry, tympanometry, and otoacoustic emissions is recommended for screening in patients at risk (exposed to cisplatin at any age or exposed to carboplatin at <1 year of age). Auditory brainstem response evaluations can be performed if results are inconclusive or the patient is not cooperative enough. A suggested algorithm for surveillance has been established by the COG and can be found on www.survivorshipguidelines.org/. If hearing loss is detected, retesting is to be recommended by an audiologist and appropriate referrals should be placed. Management of hearing deficits should also include environmental accommodations, both at home and at the child’s school. In schools, preferential seating, FM systems, and guidance from a professional who specializes in educating children who are deaf and hard of hearing are indicated. Of note, pneumococcal vaccination is indicated for patients with cochlear implants.
The Role of the Audiologist in Life Care Planning
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
William D. Mustain, Carolyn Wiles Higdon
Audiology, an autonomous profession that encompasses both health care and educational professional areas of practice, is the study of hearing, balance, and related disorders. The audiologist is the independent hearing health care professional who provides comprehensive diagnostic and habilitative/rehabilitative services for all areas of auditory, balance, and related disorders. These services are provided to individuals across the entire age span from birth through adulthood, which is in concert with the goals of a life care plan; to individuals from diverse language, ethnic, cultural, and socioeconomic backgrounds; and to individuals who have multiple disabilities. Within life care planning, the audiologist should be involved in pediatric and adult rehabilitation efforts when clients experience decreased hearing sensitivity, auditory processing problems, auditory neuropathy (auditory dys-synchrony), or balance problems. Clients may experience auditory or balance deficits due to genetic or natural aging factors, ear disease, physical trauma, brain injury, environmental noise exposure, or reactions to medications that are toxic to the auditory or balance system.
International survey of audiologists during the COVID-19 pandemic: effects on mental well-being of audiologists
Published in International Journal of Audiology, 2022
Rebecca J. Bennett, Vinay Manchaiah, Robert H. Eikelboom, Johanna C. Badcock, De Wet Swanapoel
Audiologists provide hearing healthcare services to persons with ear and hearing disorders. Although audiologists are not considered frontline workers, in many countries during lockdowns they were classified as essential healthcare workers and permitted to continue service provision during periods of lockdown. Audiology services require the clinician to put themselves in close proximity to the patient’s ear, putting them within an infectious zone should the patient be contagious. Furthermore, the use of face masks for protection is particularly challenging for audiologists as masks undermine speech communication for patients with hearing loss (Chodosh, Weinstein, and Blustein 2020). Although face masks with clear windows could allow access to vitally important facial expressions and lip movements, there are few manufacturers, and supplies are low. In the absence of a safe alternative, many audiologists anecdotally report feeling obliged to disregard face masks and instead provide clear communication to their hearing-impaired patients. Despite guidance and support from representative bodies (Audiology 2020), it has been suggested that audiologists lack clarity and support around safe service delivery in the midst of the pandemic, and demonstrate poor practices towards infection control measures, especially in terms of handwashing (Gunjawate et al. 2021).
International survey of audiologists during the COVID-19 pandemic: effects on the workplace
Published in International Journal of Audiology, 2022
Vinaya Manchaiah, Robert H. Eikelboom, Rebecca J. Bennett, De Wet Swanepoel
Audiologists in the current study were working in a range of clinical practice areas (Figure 1). Over 70% of the participants were involved in providing adult hearing aid services, although the sample included audiologists who provided paediatric hearing aids (35.6%), adult implants (21.7%), paediatric implants (14.2%), worked in the hearing instrument industry (18.4%), and/or worked in the academic or research roles (34.4%). Moreover, audiologists in the study sample provided a range of services with over 60% of them providing hearing screening, hearing assessment, discussion of hearing loss and intervention options, hearing aid fitting, fine-tuning and review appointments (Figure 2). Less than half (47.8%) provided communication training and only one third (31.5%) provided psychosocial support. Here, psychosocial support refers to social and emotional support as a part of audiological rehabilitation program to address psychosocial consequences to individuals with hearing loss and their significant others. Other services (25.5%) provided included tinnitus assessment and management, vestibular assessment and management, and some non-clinical duties such as training and advice on policy making. These results show that the study sample included audiologists from a wide range of work setting and service provision.
Parental satisfaction with an advanced audiology-led triage service in paediatric ENT outpatient clinics
Published in International Journal of Audiology, 2022
Michelle A. Pokorny, Peter R. Thorne, Arier C. Lee, Bernard C. S. Whitfield, Wayne J. Wilson
The service assessed for patient satisfaction in this study was a paediatric advanced audiology-led ENT outpatient service that has been described elsewhere (Pokorny et al. 2020). Briefly, this service functions as an independent first point of contact clinic for children referred to ENT outpatient services with middle ear or hearing concerns. It is co-located and runs concurrently with existing ENT outpatient clinics. To be accepted, children need to be two to 17 years of age and referred for middle ear, hearing, or speech concerns and/or routine grommet insertion (with or without adenoidectomy). Younger children or children with complex ear or hearing concerns are not accepted into the service. The lower age limit was set in recognition that the complexity of middle ear disease is greater, and treatment guidelines are different, for otitis media in children under two years of age. The service also functions using a single audiologist for each appointment, and children under two years of age generally require two clinicians to obtain reliable hearing thresholds (using Visual Reinforcement Audiometry). Referrals deemed ineligible included complex middle ear disease (for example chronic suppurative otitis media, suspected cholesteatoma); otitis externa; diagnosed sensorineural hearing loss; and wax impaction as these cases are more likely to require medical or surgical interventions.