Estelle Novella: Speech Therapy and Audiology

Issue 2 : Published 17 February 2010

SPEECH THERAPY AND AUDIOLOGY

I hope that you learnt something about Speech Therapy in last month’s article. This month we are focusing on Audiology.

As the word Audio-logy suggests, it has to do with audio (sound) and more specifically with hearing and the hearing system.

What is an Audiologist?
An Audiologist is a professional person, with at least a 4 year University degree. An Audiologist could also be dual qualified as a Speech therapist.

An Audiologist is trained in preventing, diagnosing and managing hearing, balance and related disorders. They manage those with hearing loss and proactively help to prevent related damage.

An Audiologist aims to determine whether someone is able to hear sounds within the normal range. If the person cannot hear these sounds, an Audiologist then determines which portions (frequencies) of their hearing are affected and to what degree. They also determine the type of hearing loss, and depending on the result, would present the client with the options available to them. They may e.g. refer to a medical practitioner, or a speech therapist, or they may recommend hearing devices, like hearing aids, or assistive listening devices. An Audiologist can then fit these devices and will help with the process of getting used to the new sounds and experiences.

Causes of hearing loss:
Some of the causes of hearing loss are: congenital abnormalities, hereditary hearing loss, viral disease, noise damage, age, some children’s illnesses, head injury, ear infections and excessive ear wax. A hearing loss could be present from birth, or could be acquired at a later age. It could also be temporary, e.g. in the case of an ear infection. (Remember that untreated ear infections or chronic ear infections could also cause permanent hearing loss).

A hearing loss has an impact on many aspects of a child’s development, including speech and language development, listening skills, concentration, academic achievement and social functioning. A hearing test can be done as early as a couple of days after birth, and the sooner a hearing disorder is detected, the better the chances are that your child can achieve their full potential.

When is an assessment needed?
A mother tends to have a fantastic sixth sense and very often has a niggling feeling that something might be amiss. Trust your instincts! Having said that, we often don’t want to believe that there may be a problem, and so I include some basic warning signs to look out for:

For older children:

• Your child has a problem paying attention at school. 
• Your child has a problem understanding if you speak from behind. 
• You think your child can hear but only when he or she wants to. 
• You think your child speaks too loudly. 
• Your child complains that the volume of the television is turned too low. 
• Your child has/had frequent ear infections. 

If any of the above sounds familiar, a hearing test should be booked with an Audiologist.

What does a hearing test entail?

The type of tests done varies depending on the age of the person being tested, as well as the specific problem they present with. The following are some of the tests we use:
Pure tone audiometry:  This is a test where a person needs to listen to beep tones of varying volume and pitch. They then need to respond to this tone to indicate that they heard it. When children do this test we would often get them to clap hands when they hear the sound, or to put a block in a box etc. These results would tell us if a person is able to hear the different pitches at the expected volume.
Speech audiometry:   When doing this test, we read out words, and the person being tested needs to repeat these words. We can then determine whether they are able to hear fine differences in words correctly. For younger children we could also ask them to point to pictures or to body parts in order to get similar results.
Tympanometry: This is a pressure test done to determine whether the eardrum and the little bones in the middle ear are moving as they should. If a problem is found on this test, it could e.g. indicate fluid behind the eardrum, or a middle ear infection. This test is often requested by doctors to decide whether antibiotics are needed. It is also a monitoring test that can be done once a child has been on antibiotics, to determine whether the fluid has cleared.
Otoacoustic Emisions (OAE’s): This is a very specialised test used to measure the response of the inner ear. This could often indicate the presence/absence of a hearing loss. This is the test used to test new-born babies just a few days after birth and can thus be used for any age. It is an automatic test and does not require a response. It helps a lot if the room is quiet while doing this test, so we often do it while a child is sleeping.

The tests mentioned above are some of the basic tests we can use to determine whether a person can hear and should there be a problem, where the problem may originate. There are many other more sophisticated tests that can be done as and when needed, and should you have any questions regarding this, you are more than welcome to contact me.

Estelle Novella
Speech Therapist and Audiologist
info@hear-sa.co.za
www.hear-sa.co.za