Audiologists: Go Beyond the Audiogram It benefits patients to guide discussion to acknowledgment and acceptance of a hearing loss. In Private Practice
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In Private Practice  |   December 01, 2016
Audiologists: Go Beyond the Audiogram
Author Notes
  • Stuart Trembath, MA, CCC-A, is an audiologist in Mason City, Iowa, and owner of the private practice Hearing Associates. He has also worked in hospital and educational settings. He is an affiliate of ASHA Special Interest Groups 6, Hearing and Hearing Disorders: Research and Diagnostics; 7, Aural Rehabilitation and Its Instrumentation; 8, Audiology and Public Health; 9, Hearing and Hearing Disorders in Childhood; and 18, Telepractice. trembath@cltel.net
    Stuart Trembath, MA, CCC-A, is an audiologist in Mason City, Iowa, and owner of the private practice Hearing Associates. He has also worked in hospital and educational settings. He is an affiliate of ASHA Special Interest Groups 6, Hearing and Hearing Disorders: Research and Diagnostics; 7, Aural Rehabilitation and Its Instrumentation; 8, Audiology and Public Health; 9, Hearing and Hearing Disorders in Childhood; and 18, Telepractice. trembath@cltel.net×
Article Information
Hearing Disorders / In Private Practice
In Private Practice   |   December 01, 2016
Audiologists: Go Beyond the Audiogram
The ASHA Leader, December 2016, Vol. 21, 36-37. doi:10.1044/leader.IPP.21122016.36
The ASHA Leader, December 2016, Vol. 21, 36-37. doi:10.1044/leader.IPP.21122016.36
You’ve completed the hearing evaluation—now what?
Counseling patients about their hearing loss can be a daunting task, even for the more experienced audiologist. Most clinicians are good at explaining X’s and O’s, frequency, and intensity, but if you overuse audiology jargon and simply suggest the use of an appropriate device, how meaningful is the information?
Regardless of patient age and hearing loss severity, most post-evaluation counseling sessions should include a discussion of the hearing evaluation and an assessment of communication needs. Meeting the patient’s needs—a patient-centric approach—is vital to successful hearing health care. Have we done what is best for the patient by simply explaining the audiogram and telling them whether or not they need hearing aids, without moving forward to a treatment plan?

Our job as audiologists is to help each patient with hearing difficulty acknowledge the loss, accept the loss and create realistic expectations about treatment and outcomes.

Post-audiogram
Every evaluation has multiple components: fact finding (history), data acquisition (the hearing evaluation), information sharing (counseling) and treatment plan creation. Our job as audiologists is to help each patient with hearing difficulty acknowledge the loss, accept the loss and create realistic expectations about treatment and outcomes.
For some audiologists, an explanation of the hearing loss with the audiogram and the statement “you need hearing aids” constitutes counseling—but simply telling someone they have a hearing loss usually does little toward acceptance or acknowledgement. Without finding out more about communication needs, it is difficult to determine what the patient wants or needs. In my experience, patients may not acknowledge that their hearing ability creates difficulty for them. And everyone is different; just because the audiogram indicates a loss of hearing doesn’t mean the effect of that loss won’t vary widely for each patient.
Consequently, the information audiologists collect prior to the evaluation—on daily activities, social life, work environment—plays a vital role in a patient’s journey to acceptance of the hearing loss and a desire to hear better. Helping the patient understand the impact of hearing loss by suggesting ways it will affect their daily life assists in building acceptance. It’s also important to help the patient consider how the hearing loss affects their family.
It can also be helpful to give patients an idea of what better hearing might be like. I often place amplification devices in patients’ ears to give them a bolstered listening experience before discussing their evaluation results, which helps with the delivery of this important information.

I often place amplification devices in patients’ ears to give them a bolstered listening experience before discussing their evaluation results, which helps with the delivery of this important information.

Silence is golden
Throughout the session, waiting to talk is crucial for the audiologist. Listening and silence are the most important skills—and hardest to learn—in counseling. All too often, clinicians feel a need to talk, rather than allowing the silence necessary for the patient to process what has been discussed.
Another difficult skill is asking how the patient feels and then waiting for an answer. Loss of any kind is emotional. Listening to and acknowledging the patient’s feelings, and letting them know they’re not alone in feeling that way, is another critical step for the patient in accepting their hearing problems.
Once the hearing loss is acknowledged, the next step, obviously, is developing the treatment plan. Meeting the needs of the patient may require amplification devices, improved communication strategies, and involvement of friends and family. In our practice, we recommend habilitation/rehabilitation classes for patients (both new and veteran users of hearing aids) and their families. Participants report greater understanding of hearing’s impact on their lives and better ability to complete daily activities.
Successful counseling is so much more than an explanation of the hearing loss—it’s a process that should be patient-centric, meeting the unique needs of the person and their family. No two patients are alike.
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December 2016
Volume 21, Issue 12