Audiology – state of the art

Abstract

From its origin in the 1940s audiology - the discipline concerned with hearing in all its aspects - has grown in many directions. Knowledge about the functioning of the auditory system has improved for both the normal and disordered state. Hearing loss can greatly diminish the quality of life of the individual affected and of those closely associated with him/her. It is more widespread than generally recognized, a fifth of the adult population having hearing below the level of social adequacy, with the cost to the community in monetary terms probably being between ±200 million and £300 million a year.

Detection of hearing loss in infancy, or even in the foetus, is vital to early and effective treatment; a number of new techniques are being investigated to improve the accuracy of hearing screening procedures. Transient hearing loss in early childhood is very common. In this age group the problem to which much attention is being directed is the identification of a minority in whom the usually transient condition becomes permanent and handicapping.

In adult subjects the diagnosis of hearing problems is now well developed and effective. For those unable to benefit from medical or surgical treatment the situation is less satisfactory. For the elderly hearing impaired and for some of the less elderly also, the principal form of remediation is through amplification - mainly, but not exclusively, hearing aids. Yet of those likely to benefit from this form of assistance only about one quarter are actually receiving help. The poor take up of hearing aids stems partly from the somewhat thoughtless and ill-informed public attitude to hearing impairment and partly from weaknesses in service provision.

The audiologist has a role to play in remedying this situation and also in the area of hearing loss prevention. Noise is the major cause of avoidable hearing loss, both in the industrial and entertainment areas. Education about, and prevention of hearing loss are likely to be significant growth areas for audiologists in the future.