ALL EARS

With rapid advance in technology, the scope for audiologists has gone up manifold,
writes Girja Shankar Kaura

ADITI is just 18 months old, but unlike other children her age, she is a special child. Born profoundly deaf in both ears, her shortcoming was detected by her parents when she was six months’ old. But they did not lose heart and met an audiologist, who concluded, after several tests, that the child’s hearing could be fully restored with a cochlear implant.

At 11months, Aditi underwent a small surgery in her ear for the cochlear implant. And now, several months down the line, she has started responding to various sounds and also begun speaking. Her parents would never have heard her babble had it not been for the cochlear implant, or more importantly, the efforts which are being put in by the audiologist for the "rehabilitation" of the child. By the time she is three, she is likely to develop language skills like any normal child.

Her case highlights the growing role of audiologists and speech therapists in correcting disorders of hearing and speech.

Congenital hearing loss is very common among Indian children. However, with improved technology, audiologists are helping children with congenital profound deafness, affecting both ears, to develop verbal language skills and get integrated into a normal school by the age of three or four, if they are exposed to "early intervention". Here, the operative phrase is "early intervention". Any disability—-whether auditory, visual or physical —– has a better chance of correction with early intervention. A host of very sophisticated audiological tools known as Oto Acoustic Emission (OAE), Brainstem Evoked Response Audiometry (BERA), and Auditory Steady State Response (ASSR) help accurately diagnose deafness even when the child is only a few days old.

Audiologists are medical professionals who diagnose hearing problems and are responsible for the fitting of hearing aids. They also work closely with children who need cochlear implants and provide post-surgical rehabilitative therapy.

Audiologists have to have either a Master’s or Doctoral degree from an accredited university. Their academic and clinical training provides the foundation for patient management from birth through adulthood.

According to Shivani Agarwal, an audiologist with the All-India Institute of Medical Sciences (AIIMS), their job is not simple. Audiologists not only determine appropriate patient treatment for hearing and balance problems by combining a complete history with a variety of specialised auditory and vestibular assessments but, based upon the diagnosis, they also present a variety of treatment options to patients with such problems. Audiologists dispense and fit hearing aids as part of a comprehensive rehabilitative programme.

Audiologists may be found working in medical centres and hospitals, schools, government health facilities and agencies, as well as colleges and universities, besides having a private practice. They also work as corporate audiologists with some of the companies manufacturing cochlear implants like the Cochlear Ltd, Australia, which has a worldwide presence and experts on its panel can be posted anywhere in the world.

Audiologists can find work with private practitioners, hospitals and medical centers, clinics, public and private schools, universities, rehabilitation or speech and hearing centers, health maintenance organisations and nursing homes. Audiologists work closely with government agencies, practising physicians and hearing aid manufacturers. Audiologists conduct clinical activities with patients, are involved in hearing research, dispense hearing aids and assistive listening devices and teach at universities and medical schools.

Audiologists are professionals who possess special training in the prevention, identification, assessment and non-medical treatment of hearing disorders.

Asha Agarwal, an audiologist and auditory-verbal therapist in Delhi, who is also attached to Sir Gangaram Hospital as a cochlear implant consultant, says that audiologists are required to complete a full-time internship and pass a demanding national competency examination.

By virtue of their graduate education, professional certification and licensure, they are the most qualified professionals to perform hearing tests, refer patients for medical treatment and providehearing rehabilitation services.

Test hearing: Audiologists use specialised equipment to obtain accurate results about hearing loss.

Audiologists are trained to inspect the eardrum with an otoscope, perform limited ear wax removal, conduct diagnostic audiologic tests, and check for medically-related hearing problems.

Hearing services for infants and children: Good hearing is essential to the social and intellectual development of infants and young children.

Audiologists test hearing and identify hearing loss in children of any age. This includes newborn and infant hearing screening and diagnostic hearing tests with young children. Audiologists provide hearing therapy and suggest hearing aids orcochlear implants on babies and young children with hearing loss.

Hearing services and counselling: According to Meenakshi Wadhera, who runs a speech and hearing centre in Delhi and is also attached with the Indraprastha Apollo Hospitals, Fortis Hospital and St. Stephens Hospital, audiologists are vitally concerned that every person, regardless of age, benefit from good hearing.

Audiologists provide individual counselling to help those with hearing loss function more effectively in social, educational and occupational environments.

It is a fact of life that we lose hearing power as we grow older, and that hearing problems are commonly associated with the elderly. Audiologists are committed to helping senior citizens to hear better, she points out.