Depending on the unique needs of the clients and insurance provider, it may be appropriate for clients to receive services through Zoom. We work with clients to offer engaging and beneficial evaluation and treatment options through a HIPAA compliant platform. This option works well for many patients who wish to not attend face to face sessions for a variety of reasons.
Before beginning audiometric testing, the audiology clinician will look into your ear canals with an otoscope (an instrument used to direct light into your ear canal). The clinician will be looking at the condition of the ear canal and eardrum. The clinician will also note the amount of earwax and/or anything unusual in the ear canal.
Pure Tone Audiometry
Pure tone audiometry is administered while you are seated in a sound isolated booth. During this test, the clinician uses an audiometer to generate auditory signals of different pitches (frequencies) or "pure tones". The test signal can be presented through earphones; through a small vibrator, which delivers the tones through the vibration of the skull; or through loud speakers. You will be asked to respond each time you hear the tone by pushing a button or raising your hand. The responses are called thresholds and represent the levels at which tones are barely audible. These thresholds are recorded on an audiogram, which indicates the softest level you hear each pitch for each ear. Results of pure tone audiometry indicate the presence or absence of hearing loss, the type of hearing loss, and the degree of hearing loss.
Speech audiometry includes speech recognition thresholds, word recognition testing, and sensitized speech testing (filtered, compressed, speech in noise, etc.). Speech recognition thresholds are determined for each ear and represent the lowest hearing level at which speech can barely be understood. Word recognition testing measures how well the individual understands speech stimuli. Speech audiometry is used for the evaluation of a) hearing sensitivity, b) speech perception ability and c) site of lesion testing.
Another important part of audiological assessment is tympanometry, which measures the mobility of the eardrum. The clinician will place a soft rubber tip in your ear canal, which must fit snugly in order to begin the test. You will hear a buzzing sound and feel some pressure changes in your ear. By recording the response of the eardrum to the changes in air pressure, the audiologist can determine if the eardrum is moving normally. Abnormal eardrum movement may affect hearing ability.
Acoustic Reflex Testing
Acoustic reflex testing is completed for each ear following tympanometry. The acoustic reflex is an involuntary contraction of the muscle attached to one of the small bones behind the eardrum.
During this test you will hear a series of loud sounds of varying pitches in each ear. The equipment measures the presence or absence of the reflex. Acoustic reflex test results provide valuable information regarding the type and severity of your hearing loss and the possible cause of your hearing loss. It is also an important test in detecting problems in the auditory pathway.
Otoacoustic Emissions Testing
Otoacoustic emissions (OAEs) are sounds produced by the cochlea (inner ear) either spontaneously or in response to sound. During this test, a soft tip is placed in your ear canal and you will hear a series of sounds. Results of this testing can indicate presence or absence of hearing loss and the type of hearing loss. In addition, presence of OAEs tends to rule out any abnormality in the conductive pathway (i.e. middle ear). OAEs is a non-invasive objective test, which contributes to the detailed assessment of the auditory system.
Auditory Evoked Potentials
Hearing involves not only the ear, but also the brain. When a sound is heard, we expect some change in the electrical activity of the brain. These minute voltage variations in response to sounds are called AUDITORY EVOKED POTENTIALS. Auditory evoked potentials which occur in the first ten milliseconds after the presentation of a sound originate in the part of the brain called the brainstem and are called the AUDITORY BRAINSTEM RESPONSE (ABR).
The ABR is recorded from scalp electrodes placed on the head, forehead, and earlobes or mastoids. Each ear is tested separately with an earphone. The patient does not respond to the sounds and can even sleep during the test. Sounds called "clicks" are presented at various loudness levels and at different rates. The responses from the inner ear and brainstem, which are detected by the electrodes, are amplified, averaged, and stored in the computer.
The ABR is a non-invasive, objective test, which can be used as an estimate of hearing loss or for assessment of neurological function. ABR can also assess the functional integrity of the central auditory pathway, and can detect abnormalities, such as acoustic tumors.
Auditory Processing Disorders Evaluation
Auditory processing can be defined as "what we do with what we hear" (Katz). It involves various steps or processes that occur, as the auditory signal travels from the inner ear through the central nervous system to the brain. Assessment of auditory processing disorders includes a battery of behavioral and electrophysiological tests in order to evaluate a wide variety of skills. AP testing may be appropriate when the individual is experiencing academic or communication difficulties involving attention, understanding speech, comprehension, memory, or listening in noise.
According to the National Institute on Deafness and Other Communication Disorders (NICD), approximately 17% (36 million) of adults have some degree of hearing loss. The incidence of hearing loss increases as a person ages (47% of adults 75 years and older). The NICD estimates that approximately 26 million Americans between the ages of 20 and 69 have some degree of high frequency hearing loss due to noise exposure from work or leisure activities. Two to three of every 1000 children born in the United States are deaf or hearing impaired.
There are many causes of hearing loss, including:
- accumulation of ear wax
- trauma (i.e. punctured ear drum, fractured temporal bone)
- ear infections
- childhood diseases (i.e. mumps or measles)
- hereditary disorders
- German measles during pregnancy
- Meniere’s disease
- Certain medications (ototoxic)
- head injuries
- birth defects
- the aging process (presbycusis)
- sudden or extended exposure to harmful noise
- Acoustic neuroma
Hearing Aid Selection
Hearing aids are sound-amplifying devices designed to help people who have impaired hearing. An audiological evaluation must be completed prior to the purchase of a hearing aid. The results of this testing will indicate the type and degree of hearing loss, the need for medical treatment and/or referral to a licensed physician, the candidacy for use of amplification, and the benefit of auditory rehabilitation.
Once hearing aid candidacy is verified, the audiologist will counsel you regarding amplification options. The Auburn University Speech and Hearing Clinic dispenses state of the art hearing aid technology from a variety of manufacturers. There are different types and styles of hearing aids with numerous special features. The audiologist will help you to select the appropriate hearing aid fitting, based on the audiometric test findings, your communication needs, and your lifestyle.
Hearing Aid Dispensing
When the hearing aids are dispensed, you are oriented to the use, care, and maintenance of the instruments. You will practice using the hearing aids. The audiologist will verify that sounds are audible and comfortable, speech is understandable, and noise is not too loud.
Hearing aids are fit with a thirty-day adjustment period. You will return to the Clinic for a hearing aid check about two weeks after receiving your hearing aids. During this visit, the clinician will ensure you are using the hearing aids properly, the instruments are physically comfortable, and your ability to hear has improved. Any necessary adjustments can be made at this time. Two weeks later, you will return for another hearing aid check to make certain you are satisfied and are benefiting from the hearing aids.
Hearing aids are dispensed with a two year service contract. Follow-up services, hearing aid checks, and annual hearing tests are provided during this period at no additional charge. In addition, the manufacturer provides a repair warranty and accidental damage/loss/theft coverage.
The Speech and Hearing Clinic offers hearing aid walk-in clinics on Tuesday and Thursday afternoons for hearing aid maintenance, hearing aid adjustments, and minor hearing aid repairs. No appointment is necessary. Contact the Speech and Hearing Clinic at (334) 844-9600 for hearing aid walk-in clinic times.
Digital Hearing Instruments
Digital hearing aids are like miniature digital computers. The hearing aid microphone picks up the sound, and converts the incoming sounds to numbers, which are analyzed according to rules called algorithms. The digitized numbers are manipulated based on the algorithm, reconverted to an analog form (sound), and delivered to the ear. The result is a clear signal with minimal distortion.
Digital hearing aids detect and process sound faster than the blink of an eye. Some digital hearing aids can sample sound one million times per second and analyze these sounds 32,000 times per second. The audiologist adjusts the digital hearing aid with a computer using the manufacturer’s software. The hearing aid automatically adjusts to the listening environment according to the parameters programmed into the chip, which controls the hearing aid. Sound is reproduced at a comfortable level for the listener, not too loud or too quiet.
Assistive Listening Devices
The Americans with Disabilities Act (1990) requires communication accessibility for those individuals with hearing loss. Use of assistive listening devices (ALDs) by persons with hearing impairment helps to accomplish this goal. There are three types of ALDs: 1) those that assist in face-to-face communication and with listening to the television; 2) those that assist in telephone communication, and 3) those that assist in awareness of environmental sounds. ALDs can be very simple and inexpensive or very elaborate and more costly. For example, a portable phone amplifier, powered by batteries, can be carried in the pocket or purse by a person with hearing impairment. When that person wants to use the telephone, they simply slip the device over the phone receiver to listen to amplified speech over the telephone. ALDs can be more elaborate such as listening systems for churches, meeting rooms and classrooms. ALDs should be fit to the individual and delivered by an audiologist who has the professional expertise to make sure the device is compatible for a person’s hearing aid.
Auditory rehabilitation involves assisting children and adults with hearing impairments to overcome their disability to help them meet the daily communication needs. Hearing loss that is present at birth is called congenital hearing loss. With newborn hearing screening programs, many children with congenital hearing loss are identified at birth so that aural rehabilitation efforts with these children and their families can begin as early as possible. Audiologists and speech-language pathologists work closely with the child and family to maximize the residual hearing through placement of hearing aids, auditory training and speech-language therapy. Adults who acquire a hearing loss also benefit from aural rehabilitation involving placement of hearing aids, speech reading techniques, assertive listening strategies, and use of assistive listening devices.
Noise-induced hearing loss is one of our nation’s worst health epidemics. Audiologists often work with industry and the military to ensure that our nation’s workers and servicemen and women are not exposed to excessive noise levels. Workplace noise levels exposing persons to more than 90 decibels of sound over an eight-hour period can result in noise-induced hearing loss. Audiologists assist in noise measurement, control, and abatement. Audiologists manage industrial hearing technicians in monitoring worker’s hearing through yearly testing and education regarding the importance of hearing conservation. Workers exposed to high noise levels must wear hearing protection devices to protect their hearing.
Musicians practice and perform with different musical instruments in a variety of settings. They can be exposed to high levels of sound for long periods of time. Musician earplugs can attenuate sound with minimal effect on tone quality. Audiologists also encourage individuals to practice hearing conservation at home by avoiding hazardous noise and using hearing protection.
- Language/Speech Delay
- Developmental Delay
- Cleft Palate
- Voice Disorders
- Literacy (Pre-reading skills and reading comprehension)
- Aphasia (Stroke)
- Traumatic Brain Injury (TBI)
- Voice Disorders, including the use of Video Stroboscopy
- Dysphagia (Swallowing)
- Accent Reduction
Treatment of Stroke, Traumatic Brain Injury (TBI)
- Verbal expression
- Auditory comprehension
- Reading comprehension
- Written language
- Cognitive/linguistic skills
- Swallowing difficulties
- Memory deficits
Treatment of Voice Disorders
- Paradoxical Vocal Fold/Cord Dysfunction/Vocal Cord Dysfunction (VCD)
- Hypernasality caused by Cleft Palate or Neurologic disease or injury
- Voice changes due to nodules/polyps/cysts
- Voice loss following surgery (Laryngectomy)
- Professional voice users
- Parkinson's Disease – Lee Silverman Voice Treatment (LSVT)
The AU Speech and Hearing Clinic offers the 4 week Lee Silverman Voice Treatment approach known as LSVT® LOUD. Currently, there are only 7 speech pathologists certified to provide this therapy in Alabama, with two of those on the AU faculty.
Research shows 89% of persons with Parkinson's disease will experience speech or voice disorders. Frequently, they are not aware of these speech or voice changes, even though those around them notice a decline in intelligibility. The LSVT® LOUD is a scientifically documented efficacious program for treating the voice and speech disorders and increasing intelligibility in patients with Parkinson's disease. You can learn more by contacting the clinic, or calling the LSVT Global organization at 1-888-438-5788 or through www.LSVTGlobal.com.
- English as a second language (ESL)
- Enhancement of Standard American English
- Learning new patterns of speaking that facilitate fluency
- Altering speech rate, loudness, effort and/or respiration patterns
- Changing attitudes and perceptions concerning stuttering
- Using devices such as auditory maskers or delayed auditory feedback
- Exercises to facilitate oral-motor movements related to swallowing
- Patient/Caregiver education of strategies to promote safe swallowing
- Acquisition and production of developmentally appropriate sounds
- Early language stimulation for late talking or non-verbal children
- Treatment of children with language deficits related to developmental delay
- Specific language treatment for any language modality (auditory and reading comprehension, verbal expression, grammar, vocabulary, pragmatics)
Language Therapy for Adolescents
- Academic organization
- Oral language production
- Written language composition
- Reading comprehension
- Lidcombe Program for treatment of preschool stuttering
- Traditional stuttering therapies for older children
- Parent/family education
- Cleft Palate
- Hoarse or harsh voice quality
- Exercises to facilitate oral-motor movements related to feeding
- Specialized techniques to enhance feeding skills
- Use of specialized utensils based on client need
- Increase tolerance of various food textures