Who We Are
Audiologists provide a variety of services relating to the evaluation, rehabilitation and prevention of hearing loss. Our practice has three audiologists: Renee Morel Callinan, M.S., CCC-A, FAAA, Heather Pianfetti, Au.D., CCC-A and Anne Madigan, M.A., CCC-A. They have many years of experience in a variety of clinical settings.
Comprehensive audiological evaluations give valuable information to the physician or physician assistant so they can provide appropriate medical management for a variety of medical conditions. In addition, the evaluation can aid in counseling and management of communication handicaps caused by hearing loss. The audiologists can assist the patient with full hearing aid services as well as hearing protective devices and other assistive listening device technology.
Types of Evaluations Performed
Audiological evaluations will vary depending upon the person being tested. For young children, usually 5 months through age 2, we will often use visual reinforcement audiometry (VRA). VRA involves having the child turn their head or eyes toward a sound source. The child is then rewarded (reinforced) visually with moving stuffed animals. Often times the testing is performed using sound field and warbled tones. The audiologist will attempt to get the child to respond within normal limits or document suspected hearing loss.
For children ages 3-5 we will often use conditioned play audiometry (CPA). CPA involves a play activity that serves as a reward. Most often we use headphones to get ear specific information. When the child hears a tone they use building blocks to build a tower or throw the blocks into a bucket. We try to establish the softest volume at which the child can hear specific tones. We will also ask the child to repeat words after us to establish a speech awareness threshold and sometimes ask them to point to body parts.
Routine audiometric testing is used for children ages 5 through adulthood unless VRA or CPA testing is judged to be more appropriate. It involves having the person indicate when they have heard a tone either by raising their hand or pressing a button. Our goal is to establish how well the person can hear specific tones. We also ask the person to repeat words to establish a speech awareness threshold and to determine how well they understand what is spoken.
The audiologists also evaluate otoacoustic emissions (OAEs) using a handheld device. OAEs are an echo that comes from the inner ear in response to a specific sound. OAE testing is routinely performed in hospitals for universal newborn hearing screening. As long as the person is quiet and still the testing is quite easy to perform. The presence of OAEs is consistent with normal cochlear function and normal middle ear function. When the OAEs are present it is likely the child has hearing within the normal range or at worse no poorer than a mild hearing loss.
Recommendations
With all of the testing we evaluate the person’s hearing and establish if there is hearing loss. If hearing loss is present we will discuss the degree of the hearing loss and make appropriate recommendations including medical management, hearing aid services, assistive listening devices, hearing protective devices, or we may even take a “wait and see” approach which includes monitoring at least once a year.
To help maintain good middle ear health, we often recommend and fit earplugs for patients who have a perforation in their eardrum usually due to a pressure equalization tube or other middle ear trauma.
Recommendations may also be made for a variety of testing including, but not limited to: electronystagmography, central auditory processing testing, auditory evoked potential testing, magnetic resonance imaging (MRI) or other medical imaging.