Myths and challenges in hearing rehabilitation
What does one do when he has a hearing loss that is irreversible? Well, he uses a hearing-aid! (Wish the solution was as simple as that). Hearing rehabilitation is a challenge especially when those at the receiving end are children or senior citizens. Hearing aid dispensing these days is done indiscriminately. The aim of this article is to educate a potential receiver about the difficulties he may be facing and the possible options available for the same.
Adult hearing rehabilitation:
Whenever hearing loss is suspected or if the person is genetically or environmentally pre-disposed to hearing loss, it is mandatory that he undergo a hearing test at least annually. A qualified audiologist will perform a Pure Tone Audiometry along with Speech Audiometry and determine the degree and type of hearing loss. Speech Audiometry becomes important when a person complains of ‘not being able to understand’ in spite of ’hearing’ it. If middle ear problems are suspected then the ENT recommends an Impedance Audiometry. Hearing disorders (loss) which can’t be medically reversed, need to be compensated with adequate amplification i.e. hearing aid(s).
The client today is spoilt for choice with a number of companies and a number of hearing aid models! The advent of technology (read programmable hearing aids) has only added to the audiologists’ challenge. Though a client may insist on a particular make or company (usually because he has heard more about it, it is the audiologist who should help him make the ‘correct’ decision based on:
• Audiological suitability
• The clients’ specific requirement (i.e., traffic, interviews, board room meets, home, etc)
• Cosmetic requirement
• Financial aspects.
Digitally programmable hearing aids are a blessing for those with slopping hearing losses or the post-lingual deaf. These hearing aids (barring a few) have their limitations in cases of severe to profound hearing losses. The client must know that, more the number of features, greater is the cost. These features should be discussed with the audiologist before zeroing on aid (s) for trial. Once the fitting is done, the client should be informed of the care and maintenance of the hearing aid. Fine tuning (in case of digitally programmable hearing aids) should be conducted at least within a month for adequate benefits.
The client should be clearly explained about realistic expectations from a hearing aid and the limitations of the same. An important point to draw home is a hearing aid is ultimately an amplification device which can never replace our ears. Remember this when you light that sutli bomb the next time…….. Ears are precious!!
Hearing loss in children:
Aural habilitation in children is of utmost importance due to the developmental issues involved. Even before adequate amplification, comes ‘the correct diagnosis’ of hearing loss. It is often observed that a child at-risk for hearing loss or suspected loss is advised to undergo OAE and BERA. No harm done! But BERA is not a test of hearing… if it indicates a loss, then it has to be clinically correlated. From the age of 4 months a Behavior Observation Audiometry (BOA) can be performed and after about 6-8 months a Visual Reinforcement Audiometry (VRA) may be done. If hearing loss is indicated, then the child undergoes observation therapy sessions and finally gets fitted with the hearing –aids. Option of cochlear implants too should be explained to the parents. Once the child is aided then begins the very important stage of auditory training and speech-language therapy. It is a myth that the child with hearing impairment will speak immediately after fitting with hearing aids, without adequate training.
Another issue is the concept of partial deafness in children. Usually the age of diagnosis is higher considering the loss. However it is important that the parents `accept’ the hearing impairment and do the needful.
Considering the critical period of language development, it becomes imperative that the child be diagnosed early and habilitated well. So parents…… if your child is at risk, gear up quickly, else you may miss the bus!!!
What does one do when he has a hearing loss that is irreversible? Well, he uses a hearing-aid! (Wish the solution was as simple as that). Hearing rehabilitation is a challenge especially when those at the receiving end are children or senior citizens. Hearing aid dispensing these days is done indiscriminately. The aim of this article is to educate a potential receiver about the difficulties he may be facing and the possible options available for the same.
Adult hearing rehabilitation:
Whenever hearing loss is suspected or if the person is genetically or environmentally pre-disposed to hearing loss, it is mandatory that he undergo a hearing test at least annually. A qualified audiologist will perform a Pure Tone Audiometry along with Speech Audiometry and determine the degree and type of hearing loss. Speech Audiometry becomes important when a person complains of ‘not being able to understand’ in spite of ’hearing’ it. If middle ear problems are suspected then the ENT recommends an Impedance Audiometry. Hearing disorders (loss) which can’t be medically reversed, need to be compensated with adequate amplification i.e. hearing aid(s).
The client today is spoilt for choice with a number of companies and a number of hearing aid models! The advent of technology (read programmable hearing aids) has only added to the audiologists’ challenge. Though a client may insist on a particular make or company (usually because he has heard more about it, it is the audiologist who should help him make the ‘correct’ decision based on:
• Audiological suitability
• The clients’ specific requirement (i.e., traffic, interviews, board room meets, home, etc)
• Cosmetic requirement
• Financial aspects.
Digitally programmable hearing aids are a blessing for those with slopping hearing losses or the post-lingual deaf. These hearing aids (barring a few) have their limitations in cases of severe to profound hearing losses. The client must know that, more the number of features, greater is the cost. These features should be discussed with the audiologist before zeroing on aid (s) for trial. Once the fitting is done, the client should be informed of the care and maintenance of the hearing aid. Fine tuning (in case of digitally programmable hearing aids) should be conducted at least within a month for adequate benefits.
The client should be clearly explained about realistic expectations from a hearing aid and the limitations of the same. An important point to draw home is a hearing aid is ultimately an amplification device which can never replace our ears. Remember this when you light that sutli bomb the next time…….. Ears are precious!!
Hearing loss in children:
Aural habilitation in children is of utmost importance due to the developmental issues involved. Even before adequate amplification, comes ‘the correct diagnosis’ of hearing loss. It is often observed that a child at-risk for hearing loss or suspected loss is advised to undergo OAE and BERA. No harm done! But BERA is not a test of hearing… if it indicates a loss, then it has to be clinically correlated. From the age of 4 months a Behavior Observation Audiometry (BOA) can be performed and after about 6-8 months a Visual Reinforcement Audiometry (VRA) may be done. If hearing loss is indicated, then the child undergoes observation therapy sessions and finally gets fitted with the hearing –aids. Option of cochlear implants too should be explained to the parents. Once the child is aided then begins the very important stage of auditory training and speech-language therapy. It is a myth that the child with hearing impairment will speak immediately after fitting with hearing aids, without adequate training.
Another issue is the concept of partial deafness in children. Usually the age of diagnosis is higher considering the loss. However it is important that the parents `accept’ the hearing impairment and do the needful.
Considering the critical period of language development, it becomes imperative that the child be diagnosed early and habilitated well. So parents…… if your child is at risk, gear up quickly, else you may miss the bus!!!
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