History of Audiology

 Audiology is the branch of science that studies hearing, balance, and related disorders. The word audiology may be defined as - the study of hearing and hearing disorders. The professional who deal in the field of audiology are called audiologists. Audiologists are the individuals whose primary interest is in the identification and measurement of hearing loss and rehabilitation of those with hearing disorders.

Hearing is the sensation in which the particular sensory organ (ear) perceives the acoustical signals from the environment and enables us to understand the particular sound that is perceived.

Ø  History of Audiology

Even thousands of years ago, people began investigating hearing, hearing loss and its causes. Here's a timeline of important events in audiological history:

·         1550 BC - There are writings from a famous medical scroll - Ebers - that, among various other medical topics, discuss "treatments" for hearing loss. Historians believe that this document is based on even older writings, but they can only speculate.

·         4th century BC - Sometime between the 5th and 4th centuries BC, Hippocrates - that most famous Greek doctor and philosopher, whose legacy and impact on medicine is still apparent in the Hippocratic Oath - made his mark on the study of hearing loss. He was the first in written history to use clinical research to attempt to find a cause for hearing loss, which he thought was related to the direction of winds, weather changes and also tinnitus. He also believed that hearing loss could be related to skull trauma.

·         50 - 25 BC - Aulus Cornelius Celsus was the first to differentiate between various hearing disorders, and some of Celsus's treatments are still in use today in their most minimal form, including those dealing with foreign bodies in the ear, ulcers and ear wax blocking the ear canal.

·         1st century AD - Roman physician Arhigenes used loud sound to stimulate the auditory system, believing (incorrectly) that this could stimulate hearing in those with hearing loss.

·         4th century AD - Physician Alexander of Tralles used herbs to treat hearing loss, as well as the auditory stimulation method by blowing a trumpet directly into the ear canal.

·         Middle Ages - Other interesting rehabilitation methods were used by well-meaning ear doctors to stimulate hearing in patients with hearing loss, including speaking softly and using a small silver or gold tube to suction the eardrum.

No major progress was made in the understanding of hearing and how the ear works until the Renaissance, and big steps were not taken in audiology until the turn of the 19th and 20th centuries. Here are some of the biggest moments in modern audiology:

·         The profession of audiology had its origins in the 1920’s when audiometers were first designed for measuring hearing.

·         Interest in this profession surged in the 1940’s when soldiers returned from World War II with noise induced hearing loss due to near-by gunfire or to prolonged and unprotected exposure to machinery noise. Others had psychogenic (non-organic) hearing loss as a result of severe emotional and mental stress. The Veterans Administration took a lead role in providing hearing testing and rehabilitation through hearing aids, auditory training, and speechreading (lipreading) programs.

·         Since the 1940’s and 1950’s, the study of hearing, hearing loss, and audiologic rehabilitation has escalated and expanded.

·         The pioneers who developed audiology are Raymond Carhart and Norton Canfield,coined the name “audiology” in 1946.

·         By the end of II world war the development of  audiology field expanded as various rehabilitation centers focusing primarily on to rehabilitating the hearing impaired.

·         During the 1950s-60s, audiology programs emerged in community speech and hearing centers geared primarily to aural rehabilitation. In medical settings audiologists began conducting hearing assessments in the ENT clinic. The 1970s and 80s saw the emergence of subspecialty areas: pediatric audiology, educational audiology, industrial audiology, cochlear implants, and assessment of balance function.

Ø  In India

The Government of India established the All India Institute of Speech and Hearing, which has become the country's leading Institute in the field of communication disorders in 1966. The second Audiology & Speech Language Therapy program was started in the same year, at T.N.Medical College and BYL Nair Ch.Hospital in Mumbai. There are currently 20 Universities in India which provide Speech Pathology and Audiology programs. These programs are accredited by Rehabilitation council of India.

To practice audiology, professionals need to have either Bachelors/Masters degree in Audiology and be registered with Indian Speech and Hearing Association (ISHA) or the Rehabilitation Council of India (RCI). There are nearly 1000 or more private clinics in India providing speech and hearing services.

Ø  Where do audiologists work? (work settings)

Audiologists work in private practice offices, hospitals and medical centers, clinics, public and private schools, universities, rehabilitation or speech and hearing centers, health maintenance organizations and nursing homes. Audiologists work closely with government agencies, practicing physicians and hearing aid manufacturers. Audiologists conduct clinical activities with patients, are involved in hearing research, dispense hearing aids and assistive listening devices and teach at universities and medical schools.

Ø  What do audiologists do?

·         Hearing Testing

Audiologists use specialized equipment to obtain accurate results about hearing loss. These tests are typically conducted in sound-treated rooms with calibrated equipment. Hearing loss is caused by medical problems about 10% of the time. Audiologists are educated to recognize these medical problems and refer patients to ear, nose and throat physicians (known as otolaryngologists). Most persons with hearing impairment can benefit from the use of hearing aids, and audiologists are knowledgeable about the latest applications of hearing aid technology.

·         Hearing Services for Infants & Children

Good hearing is essential to the social and intellectual development of infants and young children. Audiologists test hearing and identify hearing loss in children of any age. This includes newborn and infant hearing screening and diagnostic hearing tests with young children. Audiologists provide hearing therapy and fit hearing aids on babies and young children with hearing loss.

·         Services for School Children

Audiologists provide a full range of hearing and rehabilitative hearing services in private and public schools for students in all grades. Such services are essential to the development of speech, language and learning skills in children with hearing problems.

·         Relationships with Other Disciplines

Audiologists often work with many other health care disciplines to provide services to individuals with hearing loss and those at risk for hearing loss. Audiologists frequently receive referrals from primary care physicians, otolaryngologists, school audiologists, etc. for concerns about a child’s hearing. One of the primary reasons for a child to be referred to an audiologist for a hearing evaluation is for concerns regarding a child’s speech and language development.

·         Team Assessment

Audiologists may work within multi-disciplinary teams to diagnose and provide recommendations for children. The professionals included in a multi-disciplinary team are based largely on the setting in which the audiologist works. On a multi-disciplinary team that assesses children at risk for development disorders, an audiologist's role is to determine if hearing loss is a factor in the child's development. Cochlear implant teams might consist of otolaryngologists, audiologists, psychologists, social workers, radiologists, and speech language pathologists. A school team might include the special education teacher, psychologist, speech pathologist, audiologist, general education teacher and the school nurse.

·         Hearing Services & Counseling

Audiologists are vitally concerned that every person, regardless of age, benefit from good hearing. Audiologists provide individual counseling to help those with hearing loss function more effectively in social, educational and occupational environments.

·         Hearing Aids & Assistive Listening Devices

Audiologists provide complete hearing aid services to clients with hearing problems. Audiologists are also experts with assistive listening equipment and personal alerting devices. Audiologists provide education and training so that persons with hearing impairment can benefit from amplification and communication devices.

·         Hearing Conservation Programs

Prolonged exposure to loud noise causes permanent hearing loss. Because audiologists are concerned with the prevention of hearing loss, they are often involved in implementing programs to protect the hearing of individuals who are exposed to noisy industrial and recreational situations.

·         Hearing Research

Audiologists engage in a wide variety of research activities to develop new hearing assessment techniques and new rehabilitative technologies, particularly in the area of hearing aids. Research reports of audiologists can be found in the professional literature of medical and scientific journals. Audiologists write textbooks on hearing evaluation, hearing aids and the management of people with hearing loss. Audiologists help develop professional standards and are represented on the boards of national and government agencies.

Ø  Multidisciplinary team work

Audiologists are part of a multidisciplinary team working alongside doctors, nurses, teachers of the deaf, speech and language therapists, physiotherapists, social workers, psychologists and others responsible for the care of the patient, as well as administrative and clerical staff.

Ø  Governing Bodies and Organizations

·         The Indian  Speech and Hearing Association (ASHA) is the professional  and scientific association of more than 2500 members  who are speech-language pathologists, audiologists, and speech, language, and hearing scientists in India and internationally.

Forming an association was first mooted on the 4th April 1966, at the First All India Workshop on Speech and Hearing Problems at Vellore. A firm decision of forming an association of Speech and Hearing was taken at Pune in 1967 at the Annual conference of the Association of otolaryngologists of India.  The ISHA came into existence on 15th December 1967.

·         The Rehabilitation Council of India(RCI) was set up as a registered society in 1986.On September,1992 the RCI Act was enacted by Parliament and it became a Statutory Body on 22 June 1993. The mandate given to RCI is to regulate and monitor services given to persons with disability, to standardize syllabi and to maintain a Central Rehabilitation Register of all qualified professionals and personnel working in the field of Rehabilitation and Special Education.

As per RCI, the ASLP professionals should apply for RCI accreditation after finishing the UG/PG degree and should possess RCI registration certificate.