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Saturday, July 4, 2020

With some large events being canceled this year and many Americans still sheltering at home, the American Speech-Language-Hearing Association (ASHA) is encouraging the public to take steps to protect their hearing if they are planning their own fireworks celebrations this Independence Day.

Sales of consumer fireworks are up over previous years, according to several large fireworks companies. Fireworks and firecrackers can be as loud as 150 decibels—significantly louder than what is considered a safe listening level (75–80 decibels). That's louder than a jackhammer or jet plane takeoff.

"This year, people who choose to celebrate at home with fireworks and noisemakers may be exposed to sound levels well beyond what they would experience at a larger event, which already can be very loud. This could increase their risk of hearing damage if they don't take steps to protect themselves," said ASHA 2020 President Theresa H. Rodgers, MA, CCC-SLP in a press release.

Noise-induced hearing loss (NIHL) is completely preventable. However, once it occurs, it is irreversible. The louder the noise, the less time it takes to damage one's hearing. Although NIHL can result from consistent exposure to loud noise, such as listening to earbuds or headphones regularly at high volumes, it also can occur from just one exposure to a very loud "impulse" sound like an explosion.

By taking basic precautionary measures, which apply to large public gatherings as well as small ones, people can protect themselves:

1. Use hearing protection. Basic earplugs, which can be picked up at most drug stores, offer good hearing protection for most teens and adults. Children are generally better off wearing well-fitting earmuffs instead of earplugs.

2. Keep a safe distance. Stand at least 500 feet away from noise sources, such as speakers or a fireworks launch site. The closer you are, the more likely you are to hurt your ears.

3. Know your limits. If you are experiencing ringing in your ears or any other ear discomfort, leave the noisy situation. Listen to your body!

4. Help children appreciate their hearing. Talk with your children beforehand about the risk involved and the importance of protecting their ears. Model those good behaviors.

ASHA also encourages some neighborly consideration. "People may be sensitive to fireworks and other loud noises for a variety of reasons. Giving those who live near you some advanced warning of your plans could be very helpful," Rodgers noted in a press release

Editor’s note: The original material was provided by ASHA. The accuracy of information in this press release are the responsibility of the source, and opinions expressed are not necessarily the views of The Hearing Journal.

Friday, June 26, 2020

Among adults who own hearing aids, 20 percent don't actually use these devices, a new study found.

Researchers from the University of Manchester, along with audiologists from the Betsi Cadwaladr University Health Board in North Wales, analyzed data from the annual National Survey for Wales, which contains the largest sample on hearing aid use in the United Kingdom, and published their findings in the International Journal of Audiology.

This investigation found that approximately 20 percent of adults currently do not use their hearing aids at all, 30 percent use them some of the time, and the remaining 50  percent use the devices most of the time. Of note, they also found that the number of people who never use their hearing aids has been gradually reducing over the past 15 years that the survey has been conducted, and the number of people who regularly use their hearing aids has been increasing over this period.

"Hearing loss is the most common sensory problem in the world, experienced by one in six people in the UK," said study co-author Kevin Munro, PhD, MsC, in a press release. Munro is from The University of Manchester and serves as the Hearing Health Theme Lead at the NIHR Manchester Biomedical Research Centre (BRC). "It has a well-known association with cognitive decline and dementia, and as hearing aids are the primary treatment, it can have a huge benefit to wearers."

According to Munro, the reasons for not using hearing aids include patients' lack of perceived benefit from the devices when managing hearing difficulties.

"Although under-use or non-use of treatments by some patients is by no means unique to hearing aids, achieving uniformly high use of hearing aids by those who need them would provide a major benefit to society," said study lead author Harvey Dillon, PhD, also from The University of Manchester.  

"We already know that the largest predictor of hearing aid benefit is the quality of interaction with the health professional, rather than the degree of hearing loss, " he added. "But it's imperative that more research is done to understand why non-use can set in so quickly for some, and devise efficient procedures to prevent this from happening."

Launched in 2004, the National Survey for Wales contains questions on self-perceived hearing difficulty, adoption and use of hearing aids, and the occurrence of difficulty with hearing while wearing hearing aids. The survey includes annual hearing aid data from 10,000 to 16,000 people, collection in person by independent researchers.

While the study involved data on patients from Wales, Munro said that the data set was comprehensive and reliable that "there's no reason to believe the situation is much different in the rest of the UK."

In comparison, hearing aid use estimates obtained from different countries have been of varying quality. with data on hearing aid non-use fluctuating between one and 57 percent among those fitted with hearing aids.

Overall, Munro stressed that the study results highlight an urgent need to tackle non-use and under-use.

Editor's note: The original material was provided by the University of Manchester. The accuracy of information in this press release are the responsibility of the source, and opinions expressed are not necessarily the views of The Hearing Journal.

Wednesday, June 24, 2020

By Alexis Guerra

Three national audiology assiociations sent a joint letter to the Centers for Medicare and Medicaid (CMS) requesting the removal of the Medicare physician order requirement. The Academy of Doctors of Audiology (ADA), the American Academy of Audiology (AAA), and the American Speech-Language-Hearing Association (ASHA) sent the letter on June 2.

"Our organizations request that CMS remove the requirement under Medicare that beneficiaries obtain a physician order prior to an appointment with an audiologist because it exceeds state scope of practice laws, impedes beneficiary access to care, and adds unnecessary costs to the healthcare system," the letter states.

Because of the requirement, Medicare beneficiaries must go to their physician first before getting access to an audiologist's services. Most states and private insurances, however, do not have this requirement — allowing patients with private or no medical insurance to have direct access to an audiologist.

The letter states that the Department of Defense, the Veterans Health Administration (VHA), and a majority of the plans offered through the Federal Employees Health Benefits Program also allow direct access.

"Medicare's requirement that a patient has a physician order for the diagnostic testing services of the audiologist is sort of contrary or contradicts what most states, if not all states, currently expect," said ASHA's Director of Health Care Policy, Medicare, Sarah Warren.

According to Warren, the requirement delays access to Medicare beneficiaries because of the need to coordinate an appointment with both the physician and audiologist. If the requirement were to be eliminated, "the harmful downstream effects of untreated hearing loss such as fall and expedited cognitive decline" could decrease, according to the letter.

In addition to the impediment to care, the physician order requirement adds unnecessary costs to the health care system. The letter includes quotes from then VHA Acting Deputy Under Secretary for Health, Michael Kussman, MD, about the VHA's direct access policy from a 2004 letter. The quotes say that the direct access policy avoids unnecessary clinic visits, and the VA has not experienced patient complaints or problems as a result of the policy.

The letter also points out that there is no statutory language in place that prohibits Medicare from allowing beneficiaries direct access to audiology services — giving CMS the authority to eliminate the physician order requirement. It also states that allowing direct access would not have an impact on the role of physicians and other primary care providers.

To bypass the physician order requirement, the letter suggests that audiologists could also be added to the list of certain non-physician providers currently able to administer diagnostic tests without a physician order. Warren says that legislation (H.R. 4056 and S. 2446) presented previously to the U.S. House and Senate by audiology organizations would not only remove the physician order requirement but also allow for covered treatment outside of diagnostic testing, and reclassify audiologists under Medicare as practitioners.

"The legislation would enable audiologists to perform the treatment that's within their scope of practice under state law that they're trained and educated to provide by the virtue of completing their doctoral program," Warren told The Hearing Journal.

Reclassifying audiologists as practitioners would also allow for audiologists to provide Medicare-covered telehealth services. Currently, there is a statutory exclusion for those classified as a supplier under Medicare to do so.

"This legislation is so crucial because all three organizations worked together to develop this legislation and are working hard together to get it passed," said Warren. "I think that speaks volumes about how critical this legislation is."

Audiologists looking to support these efforts can use ASHA's take action center, where information on key legislation and elected officials can be found, or visit the AAA and ADA websites.

Thoughts on something you read here? Write to us at hj@wolterskluwer.com.

Monday, June 15, 2020

The American Speech-Language-Hearing Association (ASHA) is deeply concerned about the risk of hearing damage from the use of Long Range Acoustic Devices (LRADs).

Originally developed for the military, LRADs have been used for communication with large crowds and to disperse them. They can emit sound at extremely high decibel levels (up to 162 dB SPL) greatly exceeding that of a jet engine and significantly surpassing the average auditory threshold of pain (approximately 130 dB SPL). That level of sound is capable of causing not only permanent hearing loss, but also migraine, vestibular, and other auditory symptoms. Moreover, children, elderly individuals, and others with pre-existing sound injuries could be at increased risk of harm.

ASHA is encouraged by reports that support safer use of LRADs by police and law enforcement agencies. One city decided to stop using the devices altogether. Another undertook developing a policy for safer practices after it was sued successfully because an individual suffered permanent hearing loss from police LRAD use.

Proponents say these devices, which have speech communication capability, are needed for purposes such as making public addresses to large or noisy crowds. Yet, the decibel level of speech presented through LRADs is unsafe, capable of causing a temporary and permanent hearing loss for thos­­­e in front of, behind, or on the periphery of the device. And the troubling fact remains: LRADs have been and can be easily set at extremely high decibel levels that can cause serious lasting harm.

For their own hearing protection, ASHA encourages people headed to large public gatherings of any kind to take sound-reducing ear plugs or ear muffs with the highest decibel noise reduction rating they can find.*

Also, in the event of extremely high decibel LRAD use, people should:

·        look for places to shelter; sound waves deflect off dense and rigid surfaces

·        get behind brick or concrete walls, which are a good bet for shelter

·        without shelter, imagine the sound as a beam and walk perpendicularly to the direction of that beam—that is, if the LRAD is in front of you, go left or right, rather than just backing up.

To choose the right hearing protector, check out these tips from Christi Themann of the National Institute for Occupational Safety and Health (NIOSH). 

Editor’s note: Original content was provided by ASHA.

Monday, June 15, 2020

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On July 13-16th, 2020, the Interacoustics Academy will be hosting a live online learning event on trends in pediatric assessment and hearing aid fitting. The event will be hosted as an online classroom environment with video presentations, software demonstrations, and Q&A sessions. Here's the webinar schedule:

Monday July 13th, 2020 10:00-11:30AM (CST): Advances in ABR

Presented by, Amanda Goodhew, International Clinical Trainer and Johannes Callø, Product Manager ABR/OAE. Course facilitator, Sherrie Weller, MS, Manager Field Training. https://events.interacoustics.com/usadvancesinabr

Tuesday July 14th, 2020 10:00-11:30AM (CST): Advances in ASSR

Presented by, Leigh Martin, Interacoustics Academy Global Manager and Johannes Callø, Product Manager ABR/OAE. Course facilitator, Cammy Bahner, AuD, Director Clinical Research. https://events.interacoustics.com/usadvancesinassr

Wednesday July 15th, 2020 10:00-11:30AM (CST): Advances in Tympanometry

Presented by, Amanda Goodhew, International Clinical Trainer, and Lillian Nielsen, Senior Product Manager, Audiometry/Tympanometry. Course facilitator, Ashley Hughes, AuD, Clinical Audiologist. https://events.interacoustics.com/usadvancesintymp

Thursday July 16th, 2020 10:00-11:30AM (CST): Advances in Hearing Aid Fitting and Evaluation

Presented by, Leigh Martin, Interacoustics Academy Global Manager, and Dennis Mistry, Clinical Product Manager, Hearing Aid Fitting. Course facilitator, David Speidel, MS, Director Audiology. https://events.interacoustics.com/usadvancesinhearingaidfitting

Other webinars in June and July 2020

June 18th (Thursday) OAEs: The Theory of Best Practice, 9-10AM (CST)

June 25th (Thursday) The Clinical Application of VEMP Tuning Measurement, 9-10AM (CST)

July 30 (Thursday) The Advantages and Benefits of Performing Real-Ear Measurement 10-11AM (CST)

Learn more online: https://www.interacoustics.com/academy/live-events

Editor’s note: Original content was provided by Interacoustics.