When hearing tests reveal the presence of an issue, it can be difficult to know precisely who to turn to in order to get the best help. Hearing aid specialists or audiologists? Hearing specialists or ENT doctors? Navigating the world of hearing health professionals can be daunting; fortunately, there are ways to navigate these waters successfully, in order to make sure that you are receiving the care best suited to your needs. Below, we will dive deeper into the different types of hearing health professionals, including their specialties and who they are most likely to help.
What Is An Audiologist? Audiology Explained
Audiologists are considered the primary healthcare professionals equipped to properly evaluate, diagnose, treat, and manage hearing loss and balance disorders. Audiologists are equipped to manage the cases of people of all ages, and all hearing abilities. The American Academy of Audiology encourages those looking into hearing health management and treatment to turn to audiologists to help treat and manage hearing and balance conditions, including the following:
- Sensorineural Hearing Loss
- Hidden Hearing Loss
- Non-Syndromic Genetic Hearing Loss
- Syndromic Genetic Hearing Loss
- Congenital Cytomegalovirus (CMV) Infection
- Noise-Induced Hearing Loss
- Auditory Processing Disorders
- Ototoxicity
- Symptoms such as Tinnitus (ringing in the ear), Vertigo, and Dizziness (inner ear balance disorders)
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Although it is helpful to understand what exactly audiologists are able to address, it can still be useful to more thoroughly understand what an audiologist is and what they do. An audiologist is a trained hearing health professional who understands and programs hearing aids, cochlear implants, assistive listening devices, bone-anchored hearing aids, and more. An audiologist is the only qualified hearing health professional who is able to diagnose patients with auditory processing disorder, also called “hidden hearing loss”. Ultimately, audiologists are often considered hearing aid specialists, but they can do much more than program a hearing aid, including running diagnostic testing and developing treatment and management plans. An audiologist can perform comprehensive hearing evaluations, in order to deliver the best and most accurate diagnosis in people displaying symptoms of hearing loss and other hearing conditions.
Hearing Instrument Specialist/Hearing Aid Dispenser
Unlike an audiologist, a hearing aid dispenser (HAD) is a professional who is specifically qualified to assess hearing and provide aftercare for hearing aids. A dispenser’s range of expertise is going to be narrower than an audiologist’s, and they may not be able to assist patients with as wide a range of technologies. Hearing aid dispensers are able to deliver the best in hearing aid technology, but may not be equipped to deliver diagnostic testing that evaluates for the presence of issues other than hearing loss, and may not be able to discuss and deliver different interventions for hearing.
The International Hearing Society identifies a hearing instrument specialist (HIS) as a state-licensed health professional who is trained to evaluate the most common types of hearing loss found in adults, and subsequently fit those individuals for hearing aids. Hearing instrument specialists are licensed to perform tasks directly tied to hearing aid fittings. These tasks may or may not include programming hearing aids, and making earmold impressions to make sure that a hearing aid is fitted properly and capable of delivering the best intervention to address hearing issues.
People who are qualified for dispensing hearing aids are not qualified to address conditions that use hearing aids as part of a more specialized intervention program. This is true of balance disorders and tinnitus, which is one of the main differences between an audiologist and a hearing aid dispenser: an audiologist can address tinnitus, while a dispenser cannot.
Although HADs and HISes are similar in their training and purpose, they are somewhat different. A hearing aid dispenser is trained to deliver audiometric testing and fit for hearing aids, a hearing instrument specialist is trained to help patients find the best hearing aid or hearing instrument for their needs.
Similarities: Audiologist Vs HIS
Both audiologists and hearing instrument specialists (or hearing aid dispensers) are trained to perform hearing tests to ascertain the health of an individual’s auditory function. Both are also licensed to dispense hearing aids, as well as programming, repairing, cleaning, and maintaining hearing aids. Both are able to follow best practices when working with hearing aids, including real ear measurements, and both are prepared to work with adults. Both are involved in hearing assessment instrumentation and delivery, though the extent to which they are involved in hearing issues differs.
The Key Difference: Audiologist vs HIS
Although there are considerable similarities between audiologists, hearing instrument specialists, and hearing aid dispensers, there are some important differences that can help inform whether or not you seek out the help of an audiologist. The most important differences between audiologists and hearing instrument specialists can be summed up in six ways, which we have gone into greater detail about below.
Education/Training
Audiologists are required to earn a doctoral degree. The training and education process of an audiologist is quite comprehensive when compared to the education of an HIS or HAD, and covers the services provided by these individuals (fittings and instrument delivery) as well as all aspects of health care for the hearing system. In contrast, becoming a Hearing Instrument Specialist requires a 2-year Associate’s Degree, representing a different, more focused educational route within the field of hearing care. Both career paths play vital and distinct roles in supporting individuals with hearing needs.
Education/Exam Requirements
Both professions require an examination to be completed in order to receive certification. Audiologists are required to undergo a Praxis exam for comprehensive hearing healthcare, whereas a Hearing Instrument Specialist (HIS) is required to clear an exam specifically focused on the fitting of hearing aids. This means that one is trained in diagnostics and treatment, while the other is trained in fitting and sales.
Clinical Practice Requirements
An audiologist is required to spend far more time in supervised clinical practice under seasoned audiologists in order to receive their certification. Most audiology programs require over 2,000 hours of clinical practice prior to sitting for exams and receiving official certification. An HIS, however, is given a permanent license, and does not require supervision.
Research
Audiologists are required to complete capstone projects during their doctorate program. A capstone project helps audiologists train, in order to better understand what qualifies a research project as a thorough and accurate one, and what should be incorporated into practice and what should be discarded. These projects can also help determine best practices, technology that changes rapidly, and what should and should not be brought into a clinical practice. An HIS, conversely, is not required to perform any research as part of their certification process.
Certification Requirements
An audiologist has the option of joining different national associations (ASHA, ABA, and ADA are common options, though there are other state boards designed to work toward higher ethics and improved patient care). These certifications are not requirements, but they can help better inform an audiologist’s clinical practice. An HIS has the opportunity to take exams and attend programs to become board certified (called a BC-HIS). Most Audiologists are also required to complete CEUs (continuing education units) each year in order to maintain an active license or membership with these national associations.
Scope Of Practice
An HIS is qualified to deliver hearing aid support, but is not able to dive deep into a hearing issue; an audiologist is qualified to complete a deep dive, in order to get to the root of a hearing concern, and develop a treatment plan to either resolve or treat it. An audiologist can provide an evaluation and diagnosis, whether that diagnosis reveals a medical issue or other root cause. An HIS cannot develop a treatment plan, and is instead limited to using hearing devices in the most basic amplification option possible. One provides comprehensive hearing health care including tinnitus treatment, while the other provides a single, specific service.
Education And Training Required For Hearing Care Practitioners
Audiologists
As briefly discussed above, the education and training requirements for hearing professionals differs substantially. An audiologist is required to have a clinical doctorate in audiology (AuD), or Doctorate of Philosophy (PhD) in audiology. In some cases, a Master’s degree is authorized if the individual in question is “grandfathered in,” or became an audiologist prior to education requirement changes. Knowing this, audiologists are required to have a minimum of 6 years of training, and as many as 10 years of training.
Audiologists must also pass the PRAXIS exam, and complete continuing education credits in order to stay abreast on the latest in hearing and balance health care. The precise continuing education required depends on the state in which an individual is licensed. Most audiologists obtain a Certification of Clinical Competence (CCC-A) through ASHA, or the American Speech Language Hearing Association, to demonstrate that they met high standards in both academic and professional settings. Certification from the American Board of Audiology and pediatric specialty certification are also options for audiologists. Certificates in tinnitus management are also available to audiologists through the American Board of Audiology.
Hearing Instrument Specialists
The requirements for HISes are not quite as cut and dried as those for audiologists, as they vary widely between states. Most require at least a high school diploma and on-the-job training with another HIS for a minimum of 1-2 years. Some receive formal education or training in a 2-year program, but this may not be required by state certification boards. Obtaining a license occurs when someone passes both a written and practical exam, and some states will require these professionals to continue their education in order to maintain their licenses and keep them valid.
Pediatric Hearing Care
Only licensed audiologists are qualified to work with children below the age of 18, even to fit hearing aids. Audiologists can provide support for children who have deafness, hearing loss, and difficulties with speech or communication. A pediatric audiologist is specifically trained on how to diagnose and treat hearing loss in children. An HIS does not receive special pediatric training for hearing evaluations or even hearing aids themselves. Because childhood care differs from adult care significantly, it is important to have adequate training prior to working with children.
How Do I Know If I Should See An Audiologist Or Hearing Aid Specialist?
Determining whether you should turn to an audiologist or hearing aid dispenser first requires an evaluation of your root causes. If you believe your hearing loss is the result of a medical issue rather than standard hearing degeneration, an audiologist is likely to better meet your needs. If you are simply looking for information and advice regarding hearing aids, a hearing aid dispenser is likely the better option. People who are seeking help for the first time should see an audiologist first, in order to rule out any underlying issues that could be causing hearing loss. Only an audiologist can deliver a comprehensive hearing and balance examination, which will evaluate balance, tinnitus, pediatric issues, and other concerns. Ultimately, the scope of expertise for an audiologist is much greater. It is important to educate yourself on the difference between an audiologist and hearing aid specialist to make an informed decision about what is and is not best for you.
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