Hearing Practitioner December 2024

OPEN FOR BUSINESS

Tips for starting an independent practice

DIRECT AUDIOLOGY REFERRAL TO ENT PROPOSED

Peak bodies discuss the recommendation which is before the health minister

CONSIDERING UPSKILLING IN AUDIOMETRY?

Checking in with the Australasian College of Audiometry after its first year

CONFERENCE COVERAGE AND INDUSTRY INSIGHTS

HPA covers the hot topics discussed at recent audiology and audiometry nurse events

DIRECT AUDIOLOGIST-TO-ENT SURGEON REFERRAL MOOTED IN FINAL SCOPE OF PRACTICE REPORT

Some peak hearing industry bodies have welcomed the landmark scope of practice review recommendation that audiologists and speech pathologists in Australia should be able to refer patients directly to ear, nose and throat (ENT) specialists, by-passing GPs.

Other bodies are more cautious such as the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) which believes the move could pose risks to patient care, leave patients without timely medical care initiated by GPs while awaiting specialist consultations, and further strain regional ENT capacity.

There were also suggestions an ENT referral may not always be warranted, could lead to longer ENT waiting lists and would not address workforce shortages. Therefore, a framework ensuring safe, effective

care and clearer guidance on referral criteria may be needed to avoid an overloaded system.

Changes to referral pathways were among 18 recommendations made to the Federal Government in the Unleashing the Potential of our Health Workforce – Scope of Practice Review final report released on 5 November 2024 by health minister Mr Mark Butler who is considering the proposal.

The review suggests “audiologist and speech pathologist referral to an ENT surgeon where an underlying medical condition is suspected as contributing to the speech, hearing or auditory system issues the patient is experiencing, and medical treatment, including surgery, may be required”.

It said direct referrals must be within the health professional’s scope, and they must digitally notify other treating practitioners, including the patient’s

It’s hoped direct referral pathways to ENTs will simplify and expedite patient care. Image: Halfpoint/stock.adobe.com.

GP. It added there was potential for confusion about roles of audiologists and audiometrists, and “without registration and title protection, there is no mechanism to address this”.

Audiology Australia CEO Ms Leanne Emerson said: “As peak accrediting and advocacy body for audiology, Audiology Australia played an integral role in consultation informing the review. We welcome release of the report and we will share

ATO REVEALS AVERAGE HEARING PRACTITIONER INCOMES IN AUSTRALIA

The average taxable income for an audiologist in Australia is $96,933, (median $90,285), according to the latest income data released by the Australian Taxation Office (ATO).

Male audiologists earn on average nearly $24,000 more than their female counterparts. ATO data from the 2021-2022 financial year, the latest available, revealed male audiologists had an average taxable income of $115,015 (median $103,556) while for their female colleagues it was $91,072 (median $86,393).

The figures were based on tax returns from 3,211 audiologists in Australia including 2,425 females and 786 males.

The data also revealed that ENT

surgeons were the fourth most highly paid profession in the nation behind ophthalmologists ($644,898), plastic and reconstructive surgeons, and neurosurgeons.

The average taxable income for otorhinolaryngologists (ear, nose and throat surgeons) was $576,925 (median $464,990) overall for males and females combined. This was based on data from 131 specialists.

Males earnt $640,270 (median $543,284), which was about $332,000 more than their female colleagues on $308,344 (median $227,624).

The data was based on information from 106 male orothinolaryngologists and 25 females.

The information is limited in nature; for example, it only includes data visible to the tax department and captures annual incomes of all part-time, casual and fulltime workers.

For professions where a greater proportion work part-time, this could skew salaries down so when comparing across professions or between men and women, it may not necessarily be a like-for-like comparison.

Health practice managers earned on average $83,205 (median $70,264), based on data from more than 9,000 people. Females earned on average $79,934 (median $68,753), while again, about 1,000 male health practice managers earned more

information with our members before releasing further comment”.

Hearing Business Alliance CEO Ms Jane MacDonald said many members reported that accessing ENT support for their clients could be challenging, especially in rural areas.

"In cases where urgent care is required, such as with sudden sensorineural hearing loss, the ability to make a direct referral, and not require the patient to first see their GP, can facilitate prompt access to the medical treatment they require.

“Many patients experience long waiting times to see GPs in rural areas, further contributing to delays in medical treatment," she said.

This could be alleviated if the recommendation was approved, she added.

Ms Julie Watts, executive officer of

continued page 8

NOISE-INDUCED HEARING LOSS

New research from Hearing Australia shows 11% of Australians have experienced hearing damage from workplace noise. More awareness and prevention is needed.

Life sounds better with an edge

IN THIS ISSUE

18

CAPPING OFF A SUCCESSFUL YEAR FOR THE SECTOR EDITORIAL

Welcome to Hearing Practitioner Australia’s issue of 2024. What a busy year it has been in the hearing sector with many developments and events to keep practitioners engaged alongside their busy practice schedules.

Wow factor

Starkey’s Genesis AI hearing aids feature the industry’s first on-chip deep neural network accelerator.

22

Making a difference

Two Sydney audiometrists have set up a charity offering free refurbished hearing aids and care to locals in Fijian villages.

24

Country care

Two of Victoria’s largest regional independent audiology networks have joined forces to deliver more for their communities.

26

Evolution in deaf education

Today’s technology means we’re closing the gap between hearing peers and students with hearing loss.

Our feature, 'What 2024 had in store', showcases the diverse achievements and activities of practitioners in Australia. The big issues, which are ongoing but should see some resolution in 2025, included the health ministers putting Ahpra registration on the table for audiologists, and the Hearing Services Program review. The scope of practice review recommending direct referral for audiologists to ENT surgeons was another big development for the audiology world.

This year we also covered ACAud and HAASA merging, and exciting news of the world’s – and Australia’s – first cases of gene therapy for children with congenital deafness, along with Audiology Australia winning the bid to host the World Congress of Audiology in Sydney in 2030. Turn to page 33 to find out more and marvel at how much the industry has accomplished in 2024.

As HPA editor, I enjoy covering the range of topics this industry offers, and this edition was no exception. We look at two very different practice fit-outs –including one by independent audiologist Dr Signe Steers who also provides business tips for starting your own practice. The other is NextSense’s new $75 million centre of innovation which is a masterpiece of inclusive design and architecture.

Other inspirational people featured in this issue include Sydney audiometrists Steve and Robyn Reinhardt whose Helping Ears charity provides free ear care and refurbished hearing aids to help Fijian locals.

There’s in-depth coverage of Audiology Australia’s Online Conference, Independent Audiologists Australia’s Audiology for Life! seminar, and the Audiometry Nurses Association of Australia’s 40th annual conference.

Other features delve into workplace noise-related hearing loss, deaf education and a one-year update for the Australasian College of Audiometry.

Lastly, we look at Country Hearing Care’s successful merger of two of Victoria’s largest independent regional audiology networks and what this means for rural patients.

And to our readers, thank you for your support in 2024, and for allowing HPA into this passionate and thriving industry. We look forward to serving you further in 2025.

HELEN CARTER Editor

Just as HPA went to print, VICTORIAN HEARING'S principal audiologist and manager Ms Nicole Bowden was named a finalist in the 2024 Victorian Disability Sector Awards. She was nominated in the adult advocacy category. The awards recognise the tireless work of people living with disability, volunteers or professionals and their role as advocates. Victorian Hearing was previously named a finalist in the professional medical services category of the Australian Small Business Champion Awards 2024. And Bowden

OFF THE BEATEN TRACK

UPFRONT STAT

Weird

Geckos use a mechanism usually associated with balance to sense vibrations, leading to new insights about how animals hear and feel their surroundings. In a Current Biology study, US biologists revealed geckos use the saccule to detect low-frequency vibrations and this “sixth sense” plays a complementary role to their normal hearing. Findings shed light on how the auditory system may have evolved from fish to land animals, including humans.

Wonderful

A deaf Cinderella is making the children’s classic more accessible to youngsters who are deaf or hard of hearing. In the production by Deaf Austin Theatre, actors use American sign language and there is supertitle text above the stage. Many actors in the cast are deaf or hard of hearing, including the lead, Cinderella. "This is a different approach; there are scenes where there is only signing, and scenes where there is spoken English only and scenes that use both," she said.

Wacky

was recognised in the women’s small business champion award category. Victorian Hearing has 10 clinics in Melbourne, Mornington and Geelong.

I N OTHER NEWS , The Shepherd Centre has signed a partnership to export more than 50 years of expertise to Japan’s Shizuoka Prefecture Hospital to improve outcomes for Japanese children with hearing loss and cochlear implants. The centre will deliver a pilot early intervention program starting in April 2025, the first publicly funded early intervention service for deaf children in Japan. It will train Japanese clinicians to support deaf children with cochlear implants to boost their listening and

spoken abilities to that of their hearing peers. FINALLY, Deaf Connect has launched its Ageing Well program for Deaf, deafblind and hard-of-hearing seniors in Victora due to the growing needs of Deaf seniors. The organisation said its comprehensive Auslan-delivered Home Care Package under the My Aged Care program was now available for Deaf seniors in Victoria. Deaf Connect’s Ageing Well Service is also offered in New South Wales, Queensland, South Australia, the ACT and Western Australia. The launch on 10 October 2024 was during seniors’ month at Melbourne Polytechnic’s Collingwood campus.

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WHAT'S ON

THIS MONTH

The University of Cincinnati in the US is the only place in the world where an audiologist can receive a graduate certification as an animal audiologist. There, dogs are fitted for canine hearing aids and military dogs receive hearing protection devices. Its animal hearing and bioacoustics lab conducts screening, full audiological assessment and imaging for dogs and animals in zoos, including elephants.

SIGNATURE SERIES LAUNCH

FROM DECEMBER

Watch the launch webinar for Starkey’s Signature series with presenters Dr Judy Grobstein and Mr Steven Le. Two ACAud inc. HAASA CEP points; one CPD point AudA endorsed category 1.2. Acaud/com.au/events-conferences/

Complete calendar page 51.

NEXT MONTH

AUDIOLOGY AUSTRALIA ONLINE CONFERENCE

JANUARY

From now until 19 January 2025 you can register and gain CPD from recordings of the Audiology Australia Online Conference which happened online in October 2024. Audiology.eventsair.com/audaonline24/faqs

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Otitis externa from AirPods

Otitis externa is becoming more common with teens using AirPods because

reduce ventilation of the ear canal. Page 40.

CALLS FOR MORE DETAIL ON REFERRAL FRAMEWORK

continued from page 3

Independent Audiologists Australia (IAA), said it had urged the ENT pathway in its submission and enthusiastically welcomed the recommendation.

“IAA views these recommendations as beneficial for independent audiologists and their patients, allowing for delivery of high-level care aligned with their advanced training,” she told HPA

“The introduction of direct referral pathways to specialists like ENT surgeons will simplify and expedite patient care and has the potential to significantly improve patient experiences and outcomes.

“Audiologists are well-placed to recognise when ENT referral is appropriate for their patients, and patients are more likely to receive timely specialist care with barriers of time and cost (removed) for returning to their GP for a referral.”

Watts believed all audiologists could provide a more comprehensive level of care through direct referral and changes would benefit all audiologists.

“While otitis media primarily affects children, and paediatric audiologists will welcome the ability to refer directly to ENTs, audiologists working with adults in a rehabilitation setting will regularly make incidental findings requiring timely ENT referral, such as asymmetrical hearing loss, unilateral tinnitus, sudden sensorineural hearing loss or cochlear implant candidacy,” she said.

“Vestibular audiologists will also be able to provide more streamlined care for their patients via direct ENT referral.”

Watts urged development of a national skills and capability framework to

demonstrate competency before taking on new responsibilities, with a university-level education and rigorous qualifications as prerequisites for scope expansion.

ASOHNS said it would welcome a collaborative approach between government, audiology representatives and itself to develop a framework that ensured safe, effective, and patient-centred care.

“We believe this is the best way to address the challenges and opportunities presented by the proposal,” a spokesperson told HPA “Whilst we highly value the collaborative relationships we have with audiologists and respect their significant contributions to patient care, we have serious reservations about the proposal for audiologists to be able to directly refer to an ENT surgeon.

“This matter warrants more careful consideration by the government, and meaningful discussions with ENT surgeons to determine how such a system could operate effectively in specific circumstances. For example, while there are scenarios such as cochlear implantation where direct referrals might work well, there are many others where this could pose greater risks to patient care."

ASOHNS acknowledged removing the need for a GP referral in some instances could reduce patient costs and wait times but said there were circumstances where GP involvement was critical.

"In many cases, GPs initiate medical treatment while patients await specialist consultations, particularly given the lengthy wait times in regional areas," it said. “The proposed changes could inadvertently bypass this essential step, potentially leaving

“MANY PATIENTS EXPERIENCE LONG WAITING TIMES TO SEE GPS IN RURAL AREAS, FURTHER CONTRIBUTING TO DELAYS IN MEDICAL TREATMENT.”

JANE MACDONALD, HEARING BUSINESS ALLIANCE

patients without timely medical care.”

It was concerned about the potential impact on members in regional and remote areas, where ENT wait times are significant, as increasing demand under the proposal could further strain their capacity to provide care.

The Royal Australian College of GPs urged the government to exercise caution in assessing recommendations, some of which “may sound good on the surface” but will result in a costlier health system. It was concerned direct referral would “set us up for a two-tiered health system”, resulting in higher costs for patients and the system, more delays, and higher out-of-pocket costs.

The Australasian College of Audiometry (AuCA) cautiously welcomed the proposal, with its audiologists who are trainers stating it would be a major step forward for audiologists with huge benefits. But they said ENT referral may not be warranted if a GP could have dealt with it first and it may lead to longer ENT waitlists for appointments. They said there was a need for clearer guidance on referral criteria to not overload the system.

AuCA education supervisor Ms Jessica Wagenfeld said referral pathways from audiometrists to ENTs, perhaps involving review and approval by an audiologist, could be considered.

Deafness Forum Australia acknowledged there were efficiencies in direct referral but said GPs were crucial in managing referrals to prevent unnecessary specialist visits, and while changes might streamline processes, they would not address workforce shortages in specialised areas. Even with direct referrals, patients especially children may still face waits of up to a year for an ENT specialist.

ENT SURGEONS AUSTRALIA'S FOURTH HIGHEST EARNERS

continued from page 3

averaging $107,691 (median $90,800.)

There was no specific data for audiometrists as they are included in the broader medical technicians category.

Medical technicians (other category) made $69,694 (median $59,927) overall for males and females combined. Males earned on average $18,000 more ($78,687, median $68,923) than females on $60,706 ($53,921).

Australasian College of Audiometry director Mr Chedy Kalach said the industry was working to have audiometrists classified under their own Australian and New Zealand Standard Classification of Occupations

(ANZSCO) code rather than under the medical technician code.

There was no category for audiometry nurses but child and family health nurses overall earned $75,507 (median $72,687), with females earning $74,888 (median $72,137).

Community health nurses earned overall $73,827 ($71,306) with males earning more ($85,876 or median $85,587) and females earning less, ($72,402 or median $69,823).

The data revealed the average taxable income of all Australians increased from $68,289 to $72,327 in 2021-2022, and the median rose from $50,980 to $53,041.

TOP 10 EARNING PROFESSIONS: (Men and women grouped together)

• Ophthalmologist – $644,898

• Plastic and reconstructive surgeon – $608,669

• Neurosurgeon – $593,221

• Otolaryngologist/ENT – $576,925

• Urologist – $543,818

• Cardiologist – $513,526

• Orthopaedic specialist – $504,563

• Vascular surgeon – $490,193

• Cardiothoracic surgeon – $473,371

• Judge – $459,843

Source: Australian Taxation Office.

IN BRIEF

LIFETIME AWARD

Hearing Australia has honoured Ms Ann Porter AM, the founder and CEO of Aussie Deaf Kids, with the 2024 Hearing Australia Lifetime Achievement Award. The award recognises a person in the hearing sector who has made a significant and sustained contribution to improving the hearing health of Australians. Porter has worked with Hearing Australia over many years, helping to improve service delivery. “As the founder and CEO of Aussie Deaf Kids, Ann has made an incredible contribution to families with children who are deaf or hard of hearing,” Hearing Australia said. Aussie Deaf Kids aims to empower parents raising a child with hearing loss through online support, information and advocacy. Porter established the organisation in 2001. She is also a founding member and co-chair of The Global Coalition of Parents of Children who are Deaf or Hard of Hearing.

GESTATIONAL DIABETES

A review of seven studies suggests hearing loss (HL) is more prevalent in newborns whose mothers have gestational diabetes mellitus (GDM) than babies whose mothers do not have GDM. Researchers said their findings from auditory brainstem response and otoacoustic emissions suggested auditory functioning in newborns may be impaired due to GDM. Globally, about one in seven pregnant women have gestational diabetes, they said in the Annals of Otology, Rhinology and Laryngology. One study found almost 71% of babies from diabetic pregnancies demonstrated evidence of HL compared to 45% from non-diabetic pregnancies. It concluded children of diabetic pregnancies faced increased risks of developing HL, particularly bilateral and sensorineural.

IMPLANTED CI

America’s Food and Drug Administration has approved a clinical trial of Envoy Medical’s Acclaim fully implanted cochlear implant, the first cochlear implant with no external device. The company said the technology was a first-of-its-kind hearing device as it included a sensor designed to leverage the natural anatomy of the ear instead of a microphone to capture sound. The device is designed for severe to profound sensorineural hearing loss not adequately addressed by hearing aids.“The Esteem FI-AMEI hearing implant is invisible and requires no externally worn components and nothing is placed in the ear canal for it to function. The implant offers true 24/7 hearing,” Envoy Medical said. It announced on 1 November 2024 that its Investigational Device Exemption application for the study had been approved and it was selecting some of the top cochlear implant institutions in America as investigational sites for the study, with a feasibility study taking place at Mayo Clinic.

DRUG CAN PREVENT RESIDUAL HEARING LOSS IN CI PATIENTS

Melbourne ENT surgeon Professor Stephen O’Leary has revealed encouraging results from a trial of cochlear implant patients who received drug treatment to preserve residual hearing.

He reported “clinically significant effects” in the preservation of residual hearing after cochlear implantation in adult patients who received an oral drug, SENS-401, twice daily for a week before surgery and 42 days after.

After seven weeks of treatment with SENS-401 (and six weeks after cochlear implantation), the study revealed the reduction in residual hearing loss was “systematically better at all frequencies” in the treated group than the placebo group.

This protective effect was also observed eight weeks after stopping treatment (14 weeks post-cochlear implantation).

Results showed 40% of SENS-401 treated patients showed complete hearing preservation compared to 0% in the control group.

Prof O’Leary, head of Otorhinolaryngology at The University of Melbourne and The Royal Victorian Eye and Ear Hospital, revealed details of the Phase 2a clinical trial at the 36th World Congress of Audiology (WCA) in Paris in September 2024.

“The final results of the SENS-401 3 Phase 2a study are very encouraging as they support the conclusion that the administration of SENS-401 preserves residual hearing in patients undergoing cochlear implantation,” he said.

“This represents a crucial step for cochlear implantation candidates as residual hearing is very important to maintain and improve the quality of hearing of such patients.

“Residual hearing loss usually occurs mainly in the first six months after surgery; thus, early action is crucial.

“These positive data encourage us to pursue the clinical development of

SENS-401, in order to offer innovative therapeutic treatments to patients scheduled for cochlear implantation as the level of residual hearing preservation showed in the study means patients have a better chance of understanding speech against background noise and perceiving more natural sound quality with speech and sounds.”

Biotechnology company Sensorion said the data validated the favourable safety profile of its therapy in treated patients, in line with previous studies of 125 patients exposed to SENS-401.

“These positive results strongly support the continuation of the clinical development of SENS-401 for hearing preservation in treated patients,” it said.

Sensorion CEO, Ms Nawal Ouzren, was pleased with the progress.

“We have reported the final results, including the positive secondary efficacy endpoints, of our Phase 2a clinical trial for the preservation of residual hearing, developed in collaboration with Cochlear Limited,” she said.

Prof O’Leary and ENT surgeon Professor Christophe Vincent from Salengro Hospital, France, reported final data analysis at a WCA symposium sponsored by Sensorion.

They said analysis showed “clinically significant effects” on the preservation of residual hearing in patients treated with the small molecule treatment compared to the control group.

The trial in association with cochlear implantation is a multicentre, randomised, controlled open-label trial aimed at evaluating the presence of SENS-401 in the cochlea (perilymph) after seven days of twice-daily oral administration in adults before cochlear implantation due to moderately severe to profound hearing impairment.

Of 16 patients, seven were treated with SENS-401 and nine were in the control group. The open-label trial was designed to assess the presence of SENS-401 in the perilymph after treatment in adults undergoing cochlear implantation.

In March 2024, Sensorion confirmed the presence of SENS-401 in the perilymph at levels compatible with potential therapeutic efficacy in all patients seven days after the start of treatment. These results demonstrated SENS-401 administered orally crossed the labyrinth barrier and confirmed the primary endpoint was met.

Melbourne ENT surgeon Prof Stephen O’Leary. Image: The Royal Victorian Eye and Ear Hospital.

SYDNEY TO HOST WORLD CONGRESS OF AUDIOLOGY

Audiology Australia (AudA) has pulled off a major coup with a successful bid to host the world’s biggest audiology and hearing health event, the 39th World Congress of Audiology (WCA), in Sydney in 2030.

The International Society of Audiology (ISA) named Sydney as the host city on 24 October 2024. The ISA will support the congress.

AudA confirmed the event will take place from 5 to 8 May 2030 at the International Convention Centre Sydney.

CEO Ms Leanne Emerson thanked Business Events Sydney for its support during the bid process.

Emerson travelled to the 36th World Congress of Audiology in Paris in September 2024, attended by more than 2,000 delegates, to make the bid alongside AudA president, Dr Barbra Timmer.

Emerson said Audiology Australia and the Australian audiology community were thrilled the ISA had chosen iconic Sydney to host the congress.

than Sydney,” she said. “Not only is it a leading hub in Australia’s world-class audiology research, innovation and clinical audiology program but its iconic landmarks, outstanding local cuisine and rich cultural heritage provide a quintessentially Aussie experience.”

“We’re ready to welcome the world to Australia in 2030 and it doesn’t get better

Thanking the ISA executive committee for its support, Dr Timmer said AudA was delighted to open an important opportunity to showcase regional audiology innovation, research, practice and industry including local technical tours of state-of the art facilities, while

fostering global ties.

“The ISA’s decision to award Sydney 2030 opens up the world stage to our region to deliver a world-class scientific program that showcases our research, innovation and clinical leadership while driving connection across the world to benefit global hearing health,” Dr Timmer said.

It will be the third time Australia has hosted the world’s biggest hearing health event since it launched in 1953, with Melbourne hosting in 2002 and Brisbane in 2014.

AudA has set up a web page for the congress which invites audiologists from around the world to “join us ‘down under’ for a world-class scientific program”.

“We can’t wait to showcase Australian innovation to the Asia-Pacific region and audiologists worldwide,” the web page states.

“Australia is a world-class provider of audiology services, research, innovation and clinical practice. More than 3,600 audiologists offer their services in Australia at the leading edge of best audiological practice.”

REVIEW OF AUDIOMETRY QUALIFICATIONS UNDERWAY

A review of audiometry qualifications in Australia has begun, the first in nearly 10 years to “address several critical issues facing the industry”.

The Audiometry Qualification Review project will critically evaluate and update the HLT47415 Certificate IV in Audiometry and HLT57415 Diploma of Audiometry qualifications to ensure they reflect technological advancements and align with current industry needs and regulatory requirements.

HumanAbility, the organisation conducting the review, said that since the last update in 2015, rapid technological advancements, evolving professional standards and increasing demand for specialised hearing care services, especially for professionals fitting hearing aids or working as hearing service providers, had emerged as key drivers for change.

Australasian College of Audiometry (AuCA) director Mr Chedy Kalach welcomed the review.

“Industry organisations have been lobbying for a review for at least two

years,” he said. “AuCA added its voice to the movement and, during discussions with HumanAbility regarding the review of another course, further championed the hearing industry, giving a final push to include the Diploma and Certificate IV in Audiometry among the first qualifications to be reviewed.

“The review is now in progress, and we’re proud to have played a key role in achieving this outcome, particularly within the first 12 months of our launch. The current training package is 10 years old.”

HumanAbility is a not-for-profit, industry-led organisation, entrusted by the Federal Government to drive the advancement of education and workforce development in industries including health.

“The existing structure of the qualifications is outdated, with numerous superseded elective units, reflecting industry concerns about skill inconsistencies and shortages,” it said.

“Project outcomes will result in qualifications better aligned to current industry needs and regulatory requirements, leading to clear and

The review is seeking input from the public and practitioners. Image: Dusko/stock. adobe.com and HumanAbility.

sustainable career pathways to support existing and future growth in the industry.”

A committee developed draft qualifications, skill sets and units of competency for national stakeholder consultations.

Stakeholders involved in discussions have included ACAud inc HAASA, AuCA, TAFE NSW, public and private audiology providers, Indigenous health organisations and research bodies.

People can take part in online consultation workshops on 17 December 2024 and 15 and 16 January 2025 by registering at humanability.com.au.

Audiology Australia CEO Leanne Emerson (left) and president Dr Barbra Timmer. Image: Audiology Australia.

POSITION STATEMENT ON AI SCRIBES RELEASED

AUDIOLOGIST IS FRED HOLLOWS HUMANITARIAN OF

THE YEAR

Queensland audiologist Ms Vi Bui is the 2024 Fred Hollows Humanitarian of the Year for her charity work providing free hearing care to vulnerable adults and children locally and internationally.

The award recognises "someone who cares for others in a decent, practical and no-nonsense way – just like Fred did".

Audiology Australia (AudA) has released a position statement providing guidance to audiologists on use of artificial intelligence (AI) scribes in audiology practice.

Artificial Intelligence Scribes in Audiology Practice is downloadable from the AudA website and was launched to support decision-making during integration of the technology into practice.

AudA cautioned that while AI scribes could significantly reduce manual work required for documentation, they could not fully replace the audiologist’s role in ensuring accuracy of records.

Mistakes made by AI scribes could compromise quality and safety of client care if not carefully corrected so practitioners should review all AI-generated outputs to ensure accuracy of content and recommendations, the statement advised.

“It remains the responsibility of the audiologist to carefully review and verify the information generated by the AI scribe to ensure that the client’s health record is accurate and complete,” the statement said.

“Good quality systems will require the clinician to review, edit and approve AI developed content before saving it to the digital health records.”

Speaking at The Fred and Humanity Awards ceremony on 11 November 2024 at The University of Sydney, Bui said she was honoured to receive the award.

“Many people are disadvantaged, disconnected, disappointed and using our skills to help them is what humanity is all about,” she said. “I’m grateful for the generosity I’ve received, which empowers me to give back. Together, we can make a lasting difference.”

New Zealand born Australian ophthalmologist the late Associate Professor Fred Hollows started the Fred Hollows Foundation to keep his dream alive of restoring sight to those less fortunate. Millions have avoided blindness through the foundation’s actions.

The foundation’s founding director, Ms

Gabi Hollows said the foundation may be an eye health organisation, but "we know just how vital hearing is and the connection and joy it brings to people’s lives".

Bui has worked in healthcare in Queensland and the Northern Rivers of NSW for 25 years, including 12 as an oncology/haematology nurse at Royal Brisbane and Women’s Hospital, and 16 years as an audiologist with Amplifon. For six of those years she worked as both a nurse and an audiologist.

Her volunteering journey began in Samoa in 2018 and by 2023 she had founded her own practice, Brighter Ears in Brisbane, providing free services to refugees, migrants, and people experiencing homelessness.

In 2025, Bui plans to collaborate with AusViet Charity Foundation Limited to provide audiology support in Vietnam. Her colleagues describe her as a ‘lifeline’ for providing essential hearing services and education.

Friend and colleague Mr Tausif Junaid, from Manning Audiology, nominated her for the award.

INTERNATIONAL AWARD FOR NEWCASTLE ENT SURGEON

The statement covers key features, functions and use, potential benefits, challenges and risks, professional practice and ethical AI. A checklist advises what to consider before use.

“AI scribes hold the promise of improving clinical workflows in audiology but careful consideration is essential,” the guide said.

“Use in clinical documentation has the potential to significantly enhance the efficiency and accuracy of healthcare including audiological practice.”

It said use of AI in this context must adhere to legislative and professional practice requirements to ensure patient/client safety and appropriate use.

Indigenous Newcastle ENT surgeon

Professor Kelvin Kong AM has received the prestigious John Conley, MD Lecture on Medical Ethics award before thousands of the world’s leading otolaryngology experts.

The American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF) president Dr Douglas Backous presented the award to Prof Kong at the AAO-HNSF 2024 annual meeting and Oto Expo in Miami from 28 September to 2 October 2024.

The award is named after Dr Conley, an esteemed leader in the specialty, and is based on his passion for head and neck surgery and belief in the professionalism of the practice of medicine.

A recording-breaking 7,000+ attendees including more than 1,900 international delegates from over 90 countries heard Prof Kong deliver the lecture at the opening ceremony.

Prof Kong said he was thrilled to receive the award. “This is a real recognition of

the fight against ear disease that we are experiencing in Australia,” he said.

“I’m honoured to receive such an opportunity but simultaneously saddened to receive it on the back of my community suffering from the effects of otitis media.

“Our privilege and responsibility as caregivers should not be underestimated.”

Prof Kong spoke about Aboriginal and Torres Strait Islander ear health in Australia from an Indigenous perspective and the disparity in health outcomes between Indigenous and non-Indigenous children with ear disease.

“Equitable access to quality healthcare is one of the most pressing global challenges,” he said.

Prof Kong, an otolaryngologist and head and neck surgeon in Newcastle on Awabakal and Worimi Country is a professor at the University of Newcastle’s School of Medicine and Public Health, an honorary professor at Macquarie University and an associate professor at UNSW.

Gabi Hollows (left) presents the award to Vi Bui. Image: The Fred Hollows Foundation.

AAO-HNSF president Dr Douglas Backous, (left) presenting the award to Prof Kelvin Kong. Image: AAO-HNSF.

AI scribes enable the audiologist to be hands-free from typing to concentrate on patient interaction. Image: ninelutsk/stock.adobe.com.

WORLD-FIRST PROSTHETIC EARDRUM FROM SILKWORMS

Ear Science Institute Australia is developing a world-first prosthetic eardrum based on biomaterial using silk spun from silkworms to repair chronic ruptured eardrums.

ClearDrum is an implantable device developed by Ear Science and invented by world-renowned ear, hearing and skull base surgeon scientist based in Perth, Professor Marcus Atlas AM.

The transparent membrane is blended from silk using silk fibroin from Bombyx Mori, an FDA-approved natural protein derived from silk spun by silkworms. It has been tested on tympanic membrane related human cell lines and found to support the growth of tympanic membrane cells, promoting tissue regeneration.

Ear Science said that each year there were millions of tympanic membrane perforations worldwide due to trauma, barotrauma, drugs, infection or genetic causes.

A WA Government grant will aid preparations for manufacturing and clinical trials of the implant. Ear Science said it was potentially a major

advancement in the treatment of chronic ear conditions, with the potential to significantly improve patient outcomes.

It said most small, acute perforations would heal independently but larger, more complex or chronic perforations required tympanoplasty to repair the tympanic membrane using autologous graft material such as temporalis fascia, cartilage or perichondrium.

The prototype ClearDrum prosthetic eardrum made from material from silkworms. Image: ClearDrum.

Chronic middle ear disease leading to eardrum perforation was also one of the major causes of hearing loss in Indigenous populations in WA and across the world.

“Our innovation will change the way the tympanic membrane is repaired and enhance the treatment and quality of life of patients worldwide,” Prof Atlas said.

Ear Science researchers spent 10 years researching and developing the implant, based on the silk fibroin natural biopolymer which is safe to use in humans. They developed expertise to change the mechanical properties and biodegradability profile

of silk biomaterials.

Ear Science partnered with Deakin University to develop the prototype to provide an off-the-shelf implant that addresses difficulties with current treatments in a single, straightforward surgical procedure.

Prof Atlas and the institute’s research and development manager, biomedical scientist Dr Filippo Valente, have been the main minds behind the invention.

Dr Valente, who has led its research and development since 2020, leads a research program in silk biomaterials and collaborates with clinical and business units to develop medical applications and solutions for patients. The research led to a spinoff into the ClearDrum startup company in 2022-2023 of which Dr Valente is Chief Technology Officer.

WA Medical Research Minister Mr Stephen Dawson announced on 24 October 2024 that the project was one of eight WA Innovation Fellowships winning a share of $1 million from the government’s Future Health Research and Innovation Fund.

LOCAL LINK TO CHANNING TATUM HEARING LOSS MOVIE

Hollywood actor Channing Tatum will star in and produce a movie based on a true story about a young man who had an auditory brainstem implant following deafness triggered by tumours.

American-born Queensland audiologist Dr Angela Alexander has co-produced a documentary short film detailing her auditory processing treatment of the man the movie is based on, American Mr Matt Hay.

Dr Alexander, a specialist in auditory processing disorder (APD), co-wrote the documentary, Between Two Ears, which screened online on 22 November 2024. The documentary demonstrates her work with Hay using the power of systematic training and music memory to retrain his brain.

Hay shared his story on a podcast which reportedly inspired Tatum and Paramount Pictures to option the motion picture rights to his life story, and St Martin’s Press, an imprint of MacMillan Books optioned his memoir, published in 2024.

“Channing Tatum was so inspired by

Matt’s story that he purchased the rights to make a feature film about his life,” Dr Alexander said.

A merican magazine The Hollywood Reporter, said the movie itself, Soundtrack of Silence, was based on the story of Hay, a US college student who wanted to capture the sounds that were slipping away as he was losing his hearing including the songs and soundtrack of his youth.

“That has the young man listening to music with a new appreciation as he develops a silent soundtrack in his head and deeper love for his girlfriend,” the magazine states.

Hay has neurofibromatosis type 2 (NF2), an autosomal dominant disorder characterised by development of multiple tumours involving the central nervous system. Bilateral vestibular schwannomas are its hallmark feature.

Dr Alexander, who founded the Auditory Processing Institute, said Between Two Ears, “challenges everything we know about hearing”. “This 18-minute documentary

demonstrates the link between hearing loss and auditory processing by highlighting Matt’s auditory brainstem implant journey,” she said.

“It explores the intricacies of auditory processing and the brain’s remarkable ability to relearn sound, illustrated through the fascinating case of Matt Hay. It delves into the innovative techniques used in auditory rehabilitation and showcases the resilience of the human spirit in overcoming hearing loss.”

For future screenings visit bte. getresponsesite.com

Channing Tatum (from left), Queensland audiologist Dr Angela Alexander and Matt Hay. Images: Oscar Gonzalez Fuentes/ Shutterstock, Angela Alexander and Matt Hay.

JUSTIN LANGER OPENS UP ON TINNITUS BATTLE

Lions Hearing Clinic brand advocate, former Australian Test cricketer, Mr Justin Langer, has opened up about his battle with tinnitus and vertigo, explaining a recent flare-up left him hardly able to stand.

One of Australia’s greatest cricketers and most successful coaches, the former opening batsman credits the clinic with discovering and treating his hearing issues including tinnitus, vertigo and vestibular migraines.

“It’s been a hectic year for me (in 2024) spending time in India and England,” Langer said. “I recently completed a company director course and when I got my exam results, I felt such relief that it was all done but the next morning I had a complete physical meltdown.

“I could hardly stand up and my tinnitus and vertigo were through the roof. I was in a bad way, and it was my body telling me if you don’t slow down, I will slow you down.”

Langer said he sought help and it all came down to stress.

“Whenever I am run down, stressed or have any sort of illness it goes to the weak spot in my body, which is my left ear,” he added. “With some good advice and treatment, I was good to go, and my message is that everything is treatable if you get help. I happen to be in the public eye but no matter who you are, struggling with things like vertigo and tinnitus can be debilitating.”

Langer said he hoped his advocacy encouraged everyone to get their hearing checked and strive for early intervention when it came to hearing related issues like his own.

He is backing the Lions Hearing Clinic expansion into NSW with four new clinics in Sydney. Ear Science Institute Australia operates 16 Lions Hearing Clinics in WA and has expanded to four clinics in Chatswood, Neutral Bay, Bondi and Sydney CBD.

It is the only clinic network in Australia owned and operated by an ear and hearing medical research institute, with all proceeds from the clinic’s solutions going to Ear Science to fund world-renowned research into ear and hearing disorders.

TINNITUS AUSTRALIA CHANGES NAME TO TINNITUS AWARENESS

Soundfair care

coordinator Melissa Gotliebsen (left) and audiologist Anushka Vallabh wearing the 'T is for Tinnitus" campaign t-shirts. Image: Soundfair.

Soundfair’s Tinnitus Australia initiative has changed its name to Tinnitus Awareness but retains the same aim: to give voice to people living with tinnitus through awareness, information and advocacy.

Tinnitus Awareness, Soundfair’s national campaign, is also planning Australia’s first national consumer survey from funds raised during Tinnitus week, which it hopes will shape future advocacy, research and systemic change.

“It’s a new name but the same aim, to unite voices, raise awareness, and improve the lives of those impacted by tinnitus,” said Soundfair CEO, audiologist Dr Caitlin Barr.

For global Tinnitus Awareness Week from 3-9 February 2025, Tinnitus Awareness will run a national digital campaign, entitled, ‘T is for Tinnitus: Unseen, Unheard, Ignored’.

“It will focus on highlighting the serious mental health impacts of tinnitus, but the lack of a dialogue about lived experiences at a population level in Australia,” Dr Barr said. She said the campaign aimed to make the condition visible and talked about and appealed to those in the hearing sector to become involved and promote the week.

“The campaign seeks to generate funds to enable Soundfair to launch Australia’s first national consumer survey entitled ‘Living with tinnitus,’ aimed at understanding the hidden struggles faced by individuals living

with this condition,” Dr Barr said.

“The survey will gather data and share results of mental health impacts, financial and wellbeing costs, support and service gaps. Results will be shared widely to inform future advocacy, research, treatment and policy positions.”

The campaign encourages people to share their own tinnitus story on social media using #TisforTinnitus and #TinnitusAwareness and show their support for people with tinnitus by posting on social media with the T hand signal.

It also encourages people to organise and run their own T-themed event such as a morning tea, tennis match or treasure hunt and share it using the hashtags (the first 100 registered will receive a free host kit containing T-themed items), plus donate to Soundfair to support Tinnitus Awareness work and fund the survey.

Soundfair said hearing practitioners can promote their work and tinnitus to their community by following Tinnitus Awareness socials, encourage their clients to share their story on the Soundfair website, sponsor the campaign, volunteer to promote the campaign to their networks or organise an event in their organisation or community.

NOTE: For information and a free campaign kit, visit: soundfair.org.au/tinnitus-awareness/

QLD NEWBORN HEARING SCREENINGS HIT 1.1 MILLION

Children’s Health Queensland’s Healthy Hearing Program is celebrating 20 years of service, having performed more than 1.1 million free newborn hearing screenings on Queensland babies.

The statewide Healthy Hearing Program was introduced in October 2004 and since then, practitioners working for the program have diagnosed more than 3,200 newborn babies with hearing loss and supported their pathway from diagnosis to early intervention.

More than 1,000 of these children have been fitted with hearing aids or cochlear implants.

Before newborn screening was introduced, children in Queensland waited until they were an average 2.5 years old before hearing loss was detected.

Children’s Health Queensland Healthy Hearing Director, speech pathologist Ms Lauren McHugh, said early detection of a hearing issue and appropriate support could help children to learn, play and communicate with their families.

“Before universal newborn hearing screening began in Queensland the average age of detection of permanent hearing loss in children was approximately 30 months,” she said.

“Twenty years later, we have 68 facilities and a workforce of more than 900 screeners who offer newborn hearing screening to about 59,000 eligible babies each year.”

About one in 1,000 babies are born in Australia each year with moderate or more severe hearing loss in one or both ears.

Justin Langer (right) with ESIA CEO Sandra Bellekom and the board of trustees' John Schaffer. Image: ESIA.

Tan-An Trac (right), graduate audiologist with Healthy Hearing/Queensland Children’s Hospital. Image: Children’s Health Queensland.

Fitted out for success

A practice fit-out might only be the first step when opening a new clinic, but nailing it from get-go can set the clinic on a successful trajectory. Audiologist Dr Signe Steers provides some sage advice from her experience while NextSense offers a glimpse into its newly constructed $75 million centre.

When audiologist Dr Signe Steers opened her independent practice in Forestville, in Sydney’s northern beaches, she ordered scrubs proudly displaying its name, The Audiology Place, on her pocket.

“When I go down the street, I’m a walking billboard for my business in my community,” she explains. “Subliminally, the more people who see it, the better, and also I don’t have to decide what to wear every day!”

After nearly 20 years working for others, the mum of two decided the time was ripe to venture out on her own in October 2024. This followed a Bachelor of Speech and Hearing Science and a Masters in Clinical Audiology from Macquarie University, and working for several independents, networks and an ENT doing vestibular diagnostics.

“Once I turned 40, my kids were at school and I decided to do a Doctorate in Audiology online at A.T Still University, Arizona. It reinvigorated in me all the things audiologists can do,” she says. “I wanted to build a practice where I could do all audiology, not just hearing aids. I took a leap of faith and the doctorate solidified that this is my career and I love it.”

It was initially daunting but spending six months on a business plan consolidated the proposal. “I spent a lot of time developing a business plan, how would it work, would it work and could it work,” she adds.

“Once I bought a business name, it kicked off. It’s my own practice so I can do what I want, and my motto is I cover everything from twinkle to wrinkle – from babies to older people, auditory processing disorders and tinnitus.”

One doctoral subject included a framework for setting up a business and a fellow student who had done so gave Dr Steers’ advice. “She told me what she’d been through and I also got advice from Independent Audiologists Australia members who were available any time for questions, guidance and support, saying I could do it.

“They advised breaking it down to work out how many patients I would need to see a day to add up to a certain number per year to devise an income estimate.”

Dr Steers and her husband Rob broke down appointment costs on a spreadsheet to determine how many patients and hearing aid fits would be needed daily and the consultation mix to make it work.

They subtracted rent and utilities from the patient count, always overestimating. Her accountant advised ‘not everything that goes through the eftpos machine is yours’ and to estimate business tax, transferring an amount every Friday into a separate untouchable account for BAS.

Ideal street facade

Rob did demographic searches to determine a good location with an elderly population that would not encroach on other independent audiologists and would stay within his wife’s contractual obligations of her previous job.

“I wanted it in a street where there's foot traffic, easy parking, bus stops, a spot for a taxi to stop for the elderly but also where people can go to a café or shops,” she adds.

She initially investigated renting a room in a clinic with other allied health

practitioners but quotes were almost comparable to commercial rent of a shop which made her decision easier.

She chose a three-year rental agreement because there were more discounts than for one year rental but it wasn’t as long as five, which seemed overwhelming. She made the most of down time, waiting for renovations to start, by applying for the Hearing Services Program (HSP), and setting up accounts with manufacturers.

“Once you have the venue, you can start the application for being a HSP provider as it takes a while. I started the process early and they were really helpful. When you submit the last document, they can fast track for approval within three days,” she adds.

Dr Steers wrote a master budget of all costs and added more, coming under budget of her estimated startup cost. To find a builder she googled medical fit outs and got lots of quotes.

“It was painful because the brief wasn’t listened to, and extra things were added that I didn’t need. They were quoting $150,000,” she recalls.

The problem was solved by a friend who recommended the builder who had worked on her dental fit out. The builder jumped at the chance of an audiology fit out because it was different.

Image: Signe Steers.

Dr Signe Steers at her new practice, The Audiology Place.

Dr Steers in the paediatric room.

Image: Signe Steers.

Dr Signe Steers and husband Rob. The clinic’s colour palette is her favourite colour.

Image: Signe Steers.

A lot of planning was done remotely. “Everyone I dealt with in this company from architects to builders, site managers and contractors were great, friendly, kind and observant.”

Using the Steers’ initial sketches, the architect designed the fit-out and they picked colours and materials based on a beach theme. Money was saved by ordering flatpack furniture which friends and family spent weekends putting together.

Dr Steers bought a $30 reception desk from E-Bay which she cut down and painted. She has a wax removal room which she hopes to upgrade to a sound booth when she hires a second audiologist, and a paediatric room.

“I wanted to plan for the future and that’s where the architects came in because I didn't know how to make this work but they helped it become real,” she adds.

The smallest consultation room is double walled with two layers of noise insulation through every wall and ceiling. The brief was power points on every wall in every room so, thinking to the future, things could change and equipment would still be able to be accessed.

As the premises was previously a hairdressers, money could be saved by preserving the kitchen.

She chose her favourite colour, greenish cyan for trims.

“I felt it was important to go with something I like which was also calming because this is my branding and I’ll be spending a lot of time here. It looks coastal and Rob said it should feel like you’re going for a spa or massage rather than something clinical. It’s clean, calm, and uncluttered and the white is non-medical.

“I want people to walk in and not see pictures of hearing aids – I don't want to focus on the deficit. I'll be doing that work but I want a different visual,” she says. “I also wanted the word audiology in the name because it's important and it's good to have audio as it's not just about hearing but auditory processing, tinnitus and so on.”

Dr Steers hand drew the logo – a house containing an ear and a heart so it’s homely – and Rob, who is working in the clinic front-of-house, digitalised it and created a website.

Information sheets for doctors

One manufacturer lent equipment to trial and Dr Steers visited GPs and ENTs alerting them to her new service.

“I let the doctors know I’m offering same day sudden hearing loss services because I believe in early intervention and as I live close by I can pop down and do a sudden hearing loss assessment if needed,” she says.

“Rob and I delivered 98 welcome packs to GPs, ENTs, paediatricians, physiotherapists, psychologists and speech pathologists. We had washing baskets full of them – with referral pads and info sheets about every service I'm offering – each service had its own information sheet.

“The feedback was how valuable it was to have information about what I do, because as one GP said, usually people just drop off their business cards but this shows everything I do. We’re also sending them letters reminding them we’re open.”

Dr Steers says launching a business could be thought of as an overwhelming amount of setup, new things to learn and costs but “once you’re in, you are just doing the same job you’ve always done.”

“It is more work though because you've got all the other stuff as well as audiology," she adds. "I don't have rose coloured glasses on about how hard it's going to be; I know there’ll be ups and downs, busy times and times where I’m scrambling.

“But that’s part of my business plan, making sure I'm realistic. When you first feel that self-belief, when I saw my first patient and they happily swiped their card because of me - what a feeling!”

Future plans include letterbox drops and community talks at service clubs. They’ve also documented everything and turned it into a policies and procedures manual to assist future hires.

NEXTSENSE’S INCLUSIVE DESIGN

About 20 kilometres away at Macquarie Park, Sydney a vastly different fitout occurred. When NextSense embarked on its highly ambitious project for a newly constructed $75 million innovation centre, it made sure to consult with experts, staff and clients.

“More than 20 consultants were involved in the design phase of the project leading up to the tender for construction,” head of Cochlear Implant Services, audiologist Ms Eleanor McKendrick, recalls.

“This included people living with, and experts in, vision and hearing loss, creating a benchmark for what’s considered ‘beyond accessible’ (inclusive) architecture and design.”

NextSense has provided diagnostic audiology services since 1991 and runs Australia’s largest cochlear implant program plus early intervention services. It leases the premises for most of its 20 centres, including the site of the centre for innovation.

Its North Rocks campus had been the focal point for national operations since 1963 but was no longer fit for purpose so NextSense sold it and moved to the new centre in August 2024.

The facility provides allied health, disability and cochlear implant services for children and adults, a school, preschool, and a major research and professional education program.

“It’s custom-designed for people who are deaf and hard of hearing, blind or have low vision,” McKendrick says. “The layout creates opportunities for interaction between our school teaching staff, clinicians and administration staff, and those from other organisations like Cochlear and the Australian Hearing Hub.

“We’ve also retrofitted existing commercial premises for some of our other centres, including more recently at Alstonville in northern NSW,

The NextSense reception area near the audiology clinic is non-clinical, with earthy accents, soft furnishings and bright brand elements and includes a multisensory wall.

Image: NextSense

The NextSense audiology rooms.

Liverpool in southwestern Sydney, and Werrington in western Sydney.”

Many of the children it supports who are deaf or hard of hearing have additional disabilities so it was important to provide an inclusive, welcoming space for all.

Non-clinical and earthy

Client areas were designed to be non-clinical, with earthy accents, soft furnishings and bright brand elements providing an inclusive and welcoming space for clients and their families. A multisensory wall in the client waiting area provides tactile and sensory activities for children and there’s a dedicated sensory room onsite.

The audiology wing, which mainly serves paediatric clients, is away from high-noise areas but close enough to the waiting area to feel welcoming and connected to other spaces.

Wall and ceiling panelling and carpets are acoustically rated.

Prefabricated audiometric testing booths were custom-designed and meet Australian Standards requirements in acoustics for audiometric test methods, with acoustic dampening materials and electromagnetic shielding to create a noise-excluding test area.

consideration of lighting.”

To create level flooring leading into the booths, the concrete slab was set down into the ground and the booths dropped in.

“Above all, our audiologists wanted audiometric booths to be flexible to accommodate children of all abilities,” McKendrick says. “This included having dimmable lights, castor wheels on all furniture so it could be easily moved, and a setup enabling all types of hearing testing to be carried out.

“This is particularly important for children with sensory and developmental disabilities who may use mobility aids or require careful

“Client areas were designed to be non-clinical, with earthy accents, soft furnishings and bright brand elements providing an inclusive and welcoming space for clients and their families.”

There was consideration around power point placement and ensuring there were outlets on all walls. Two booths enable Visually Reinforced Orientation Audiometry (VROA) testing, which provides visual rewards to a young child responding to sound. Adjoining control rooms have one-way glass.

Every element of the design was carefully considered, with state-of-the-art equipment and spaces tailored for people with hearing and vision loss. Accessibility features include the highest possible acoustic standards, a hearing augmentation system to deliver high-quality sound directly to hearing aids and high-contrast walls and furnishings to allow better depth perception.

Wide corridors make it easier for conversations in Auslan and accommodate wheelchairs, large prams and assistance animals.

The design aligns with best practice environmentally sustainable design principles for energy, water, materials, ecology, emissions, transport, indoor environmental quality and innovation.

Eleanor McKendrick NextSense

The building features 368 solar panels, two electric vehicle charging stations, water tanks, shading, ventilation and building materials that minimise energy consumption. The centre has a client parking area with accessible parking and is within walking reach of bus routes. “Extensive consultation with staff, including our audiologists, informed the final design, and for our audiologists, the accessibility and technology of the new facility goes above and beyond,” McKendrick adds.

ABOVE: NextSense audiologist Paula doing cochlear imaging mapping with a client in the new rooms.

Genesis AI’s 'wow' factor

Starkey’s Genesis AI hearing aids have made a big splash on the Australian market. Audiologists have been especially impressed with the device’s Neuro Processor which incorporates the industry’s first on-chip deep neural network (DNN) accelerator.

If there’s one piece of feedback Starkey’s regional director of education and audiology for APAC, Dr Judy Grobstein consistently hears from patients and practitioners about Genesis AI hearing aids, it’s the ‘wow’ effect of its sound quality.

Since its launch in Australia and the Asia Pacific in 2024, the company’s latest hearing aid has been doing “incredibly well”, she adds, helping hearing healthcare providers differentiate through innovations like its deep neural network (DNN) technology.

“We're hearing a ton of positive feedback from both clinicians and wearers. Patients are giving great testimonials and they're loving the sound quality," she says.

“The best description I've heard from many people is that Genesis AI sounds and feels kind of transparent, easy on the ears because they feel comfortable, but they also sound very comfortable and natural.”

Dr Grobstein says Starkey’s purpose is to build products that connect people through better hearing. “I’ve listened to many hearing aids over the years and firmly believe that Genesis AI features the best sound quality yet," she says. With Genesis AI, Starkey reinvented the hearing aid from scratch, she adds.

“The hearing technology has been completely redesigned from the

inside out, with Genesis AI featuring an all-new processor, all-new sound, all-new design, all-new fitting software and an all-new patient experience with the My Starkey app,” Dr Grobstein says.

“We really believe Starkey’s new Neuro Processor is by far the industry’s most advanced and strongest as well as being significantly smaller than our previous processor.

"It operates up to four times faster than its predecessors with six times more transistors, all while being more power efficient and delivering significantly higher processing capabilities."

The processor does this through its incorporation of artificial intelligence (AI) via machine learning deep neural network (DNN) technology. DNN is a machine learning (ML) algorithm that uses multiple layers of neural networks to solve complex problems.

Clearer speech by classifying sounds faster

The DNN accelerator is physically located in the chip of the hearing aid and makes speech clearer by classifying sounds faster and more accurately, a strength that is leveraged in an industry exclusive Edge Mode+ feature.

Dr Grobstein explains: "It allows speech and other sounds in the environment to sound incredibly natural, and what takes it to the next level is our core feature, Edge Mode+.

“One of our most popular features, Edge Mode+ uses AI to take a snapshot of the environment the patient is in, then instantly optimises sound quality to that place and time for either clearer speech or improved listening comfort.”

She says innovations like Edge Mode+ are unique to Starkey.

“The great sound quality is what sets us apart. When we do direct comparisons and have people listen, they tell us that the sound quality is absolutely incredible. We are hearing through direct testimonials from both clinicians and patients that the sound quality is significantly better than anything they have worn before,” she adds.

Lowering the noise floor also enhances sound quality, she notes, saying they are among the quietest hearing aids, especially if people have normal hearing in their low frequencies.

Better comfort and clarity on demand

“Wearers can easily engage the Edge Mode+ feature via a button in the My Starkey app, with the remote control or through a double tap of the hearing aids in the premium level,” Dr Grobstein explains.

Once activated, Edge Mode+ instantly conducts an acoustic analysis of the listener's environment and makes automatic adjustments to enhance speech or reduce noise.

Unlike other hearing aid technology that assumes the wearer’s listening intent, Edge Mode+ places the wearer in control of their listening situation and lets them decide on their listening intent.

Edge Mode+ will then automatically adjust the hearing aid settings in the background to accommodate what the wearer wants to hear.

“In addition, in the Genesis AI premium 24 technology tier Edge Mode+, the hearing aid settings will automatically adapt to the wearer’s environment while maintaining their listening intent," Dr Grobstein says.

"For instance, imagine a situation where the hearing aid wearer has coffee with a friend on a busy street. They select Edge Mode+ with clearer speech.

"As the environment around the wearer changes (e.g. becomes busier and noisier), Edge Mode+ will continually make adjustments in the background to help prioritise speech clarity for the wearer."

Dr Grobstein was so impressed she even fitted her mother in America with a pair of Genesis AI devices.

“She was wearing older Starkey technology, and I fitted her with

The Starkey Neuro Processor with on-board DNN accelerator engine.

Genesis AI a few months back.

"She loves it and could tell the difference right away and I could tell the difference when I FaceTime with her that she's hearing me incredibly well,” she says.

“Genesis AI has ticked all the boxes a patient is looking for when it comes to sound quality but also comfort, battery life, durability, connectivity and discrete options."

Dr Grobstein says Starkey is leading the industry on quality and durability. "We do extensive testing, going beyond what industry standards require when it comes to protecting devices from moisture and debris," she adds.

"In fact, all of our wireless rechargeable hearing aids are waterproof so if the patient accidentally jumps in the pool or shower, they won’t have any issues.”

Fifty-one hours’ battery life

With new power-saving algorithms that build on the more efficient Starkey Neuro Processor, Genesis AI uses up to 25% less battery power while delivering significantly higher computational processing.

“We have the industry’s longest lasting rechargeable battery in a

“Starkey's Neuro Processor uses a dedicated hardware-accelerated DNN for more advanced processing strategies.”

Dr Judy Grobstein

Starkey

Components of Starkey’s Genesis AI hearing aids.

Launching the Genesis AI at Sydney Opera House in February 2024 are Dr Achin Bhowmik and

Dr Judy Grobstein .

Images: Starkey

RIC with our RIC RT which offers up to 51 hours of battery life on a single charge and an impressive 41 hours for our micro RIC,” she says.

“We even have improvements with our custom rechargeables with 42 hours on a single charge.

“Three years down the road when the lithium-ion battery starts to deteriorate, we're still going to be providing battery life throughout the waking day to far exceed other available technology.”

Apart from the sound quality, Starkey says the hearing aid also leads the way in innovation through connectivity and its patient-friendly mobile app My Starkey.

Starkey was the first manufacturer to use sensors on hearing aids and is still the only one that uses sensors to detect falls and alert patient contacts, she adds.

“Most patients who wear hearing aids are seniors and research show’s there is a direct link between degree of hearing loss and risk of having a fall," Dr Grobstein explains.

"The My Starkey app allows Genesis AI wearers to enter details for up to three contacts and should the user have an unfortunate fall, it will alert the contacts via a text message."

Once the contact receives the alert, they click the link and can see the location where the fall happened.

“My mother has this feature activated and it gives her as well as my brother and I peace of mind knowing should she have a fall, we will be alerted,” she adds.

Starkey spent five years developing Genesis AI. That’s not only years of development but putting hundreds of hours of hearing-impaired people through its rigorous clinical trials wearing, evaluating and providing personal input on the devices to help Starkey deliver “the most studied and validated product”, Dr Grobstein says.

“When we brought it to market, we knew it was going to do everything we intended it,” she says.

Dr Grobstein has worked for Starkey for nearly 15 years, half in the US and half in Australia. She started as a regional trainer in the US and before that worked for several ENT surgeons.

From a practitioner fitting Starkey to an educator

“This included being head of audiology for one of Washington DC’s largest ENT offices for about eight years,” she recalls.

“For many of those years we were primarily fitting Starkey hearing aids on our patients, so I’ve had the nice opportunity of experiencing

First and smallest rechargable custom CIC

Long known as the industry leader in building custom technology, Starkey was excited to launch the Starkey Signature Series in Australia on 15 October 2024. The Signature Series is its smallest line of custom products yet.

Dr Grobstein says: “We are poised to lap the competition again with the new Signature Series that features three new non-wireless custom hearing aids.

“This includes the industry’s first and smallest rechargeable custom CIC (completely in canal), the Starkey Signature CIC R NW as well as a CIC NW and very discrete IIC (invisible in canal) NW.

“When you see a really great small custom product, you know it has Starkey’s signature on it. Nothing is smaller, and with the Neuro Sound technology, nothing sounds better.”

both sides – a practitioner fitting the product then a trainer and educator – during nearly 20 years of working with Starkey products.”

She was also fortunate to have the opportunity to test the products before launch by wearing them, testing programming software and the app, and looking for any issues so they could be fixed before client use.

“I don't have hearing loss, but I run a lot and travel, so I was testing the streaming and sound quality,” she adds. “I knew right away the sound was incredible.”

The technology evolved for many reasons including patient demand, she explains.

“We also have an incredible research team,” Dr Grobstein says. “Our chief technology officer and executive vice president of engineering Dr Achin Bhowmik came from an AI background and adds a lot of innovation expertise.

“Our chief hearing health officer, Dr Dave Fabry, also brings a wealth of expertise as a PhD audiologist.

"He and Dr Bhowmik work together closely, along with our huge research and development team, not only in the US but satellite offices worldwide, to bring this great technology to wearers.”

A client wearing the discrete and stylish Genesis AI.

Signature Series: The world's smallest custom rechargeable CIC hearing aid.

Record year for Specsavers Audiology ANZ

Specsavers Audiology recorded its fastest growth globally in 2023-2024 in Australia and New Zealand, the organisation’s latest annual review reveals.

by offering the best possible value in the provision of audiology outcomes,” the report stated.

Connectivity a feature of broadened product portfolio

Mr Paul Bott, Specsavers ANZ managing director, said that through its joint venture partnership model, Specsavers was working hand-in-hand in tough economies with optometry, retail and audiology partners to ensure they were well set up to care for their local communities.

Mr Tom Craw, managing director Specsavers Audiology ANZ, added: “We are incredibly proud of the difference Specsavers Audiology has made to the lives of Australians and Kiwis.

TSpecsavers Audiology dispensed almost three quarters of a million hearing aids globally in 2023-2024.

he network said it celebrated a record year for its audiology business in Australia and New Zealand (ANZ) in the past financial year, with a 30% increase in customers through its doors compared with 2022-2023.

It said Specsavers now offered hearing services in most of its optometry stores in Australia and New Zealand after achieving a record year in hearing-aid sales for the region.

“Our fastest area of growth last year was in Australia and New Zealand, where customers can now benefit from best-value hearing care in almost 80% of our stores in the region,” the Specsavers 2023-2024 annual review stated.

“We celebrated a record year, with a 30% volume increase on 2022-2023.”

In terms of overall performance, the review showed the Australian business, including optometry and audiology, contributed €874.5 million (AU$1.42 billion) to the company’s global group revenue of €4.01b (AU$6.5 billion) to the end of February 2024.

Australia achieved 17.7% growth, on top of the 10.3% reported in 2022-2023.

Of the 11 countries Specsavers operates in, the UK topped the field for revenue at €2.17 billion (AU$3.54 billion) with Australia being its second biggest market.

As of 6 November 2024, 311 of 393 Specsavers optometry stores in Australia and 48 of 61 stores in New Zealand provide audiology services, a spokesperson confirmed. There were also store enhancement upgrades and capacity reinvestments in 58% of stores across Australia and New Zealand.

The report said Specsavers Audiology “enjoyed another successful year ... dispensing almost three quarters of a million hearing aids globally in 2023-2024”. Its audiology businesses sold 717,899 hearing aids worldwide from July 2023 to the end of February 2024.

“We continued to grow our capacity and change the industry for the better

“Our mission has always been to make eye and hearing care accessible as well

“Thanks to all of our people, in stores and in the support office, who are dedicated to ensuring everyone who chooses Specsavers receives exceptional service and care, coupled with great value where and when they need it.”

Keeping at the forefront of innovations was key to offering advanced products as they come to the market, Specsavers said.

“Last year, we broadened our portfolio with the addition of next-generation Bluetooth LE Audio,” the report said.

"The new standard for connectivity enables multiple simultaneous connections and hands-free calls with other compatible devices as well as higher sound quality with significantly lower battery consumption. In addition, we introduced Auracast broadcast audio, which transforms how people experience sound in both public and private locations.”

The launch of speech-in-noise (QuickSIN) testing across audiology markets helped customers make a more informed choice when buying hearing aids, the review stated. “The test measures the ability to distinguish speech amongst background noise – a challenge many of our customers face,” Specsavers said. “It also more accurately advises our clinicians on the type of hearing instruments required and whether an additional device, such as a remote microphone, would better meet a customer’s needs.”

During the past 12 months, the network served more than 23.5 million customers online, in-store or at home globally. In February 2024, there were 2,721 optical, audiology, domiciliary and ophthalmology Specsavers businesses operating worldwide.

Pipeline to partnership

The organisation has nearly 50,000 employees worldwide including almost 5,500 partners and 44,000 store and support office team members.

Australia and New Zealand’s partnership development program launched in 2022, and during 2023-2024, 98% of partners participated to improve capabilities. Specsavers Pathway, an in-house program for those aspiring to partnership, provides an internal pipeline to partnership, the review said.

“A success in all our markets, pathway candidates receive bespoke training and support in preparation for formal appointment,” Specsavers said. “Last year, the program resulted in hundreds of graduates globally – with 98 candidates in ANZ alone – who are now ready to move into business ownership.”

"We are incredibly proud of the difference Specsavers Audiology has made to the lives of Australians and Kiwis. Our mission has always been to make eye and hearing care accessible and affordable."

Tom Craw Specsavers Audiology

ANZ

Ears to You Steve and Robyn

Ten years ago, audiometrist Steve Reinhardt launched Ears to You, a mobile diagnostic hearing service based in Sydney, providing critical services to aged care residents, rural communities, and clients who are housebound. Together with his wife Robyn, they also founded Helping Ears, a charity that offers free refurbished hearing aids and audiological care to remote villages in Fiji.

As a drummer in a progressive death metal band, Mr Steve Reinhardt surprised many — including himself — when he switched from studying music to a career in audiometry. It turned out to be a life-changing decision, one he grew to love. Eventually, he even convinced his wife, Robyn, to retrain as an audiometrist.

Steve was studying music at Macquarie University when his mother, audiologist Mrs Lindsay Reinhardt, suggested audiometry as a career path. Taking her advice, he enrolled in TAFE to study audiometry, setting him on a path that would bridge his love of music and hearing care.

Wanting to extend his clinical work and philosophy to those unable to attend a traditional clinic, he pioneered mobile hearing care in Sydney. With his musical background, he has also been managing the hearing needs of Sydney Symphony Orchestra musicians since 2017. He has even led hearing protection workshops for drummers, maintaining a strong link to his musical roots.

Steve’s first professional role was in Warrnambool, regional Victoria. “It was a fantastic induction program, and I learnt a lot working for Australian Hearing,” he recalls. “It taught me so much about the Australian hearing health system.”

In 2008, he returned to Sydney to work at his mother’s practice, Northside Audiology, which now operates four clinics. Today, he is a co-director of the practice, together with several specialist doctors.

Steve spends four days a week at Northside Audiology, with one day dedicated to Ears to You. “I was Sydney’s first independent mobile diagnostic hearing service provider for aged care and schools, where I also conduct hearing screenings,” he says. “My goal was to provide access to regional and metropolitan areas across NSW.”

A significant part of his work is in aged care, which often involves travel to locations including Young, five hours from Sydney, and Mudgee, two and a half hours away.

Repurposing hearing aids for charity

During aged care visits, relatives and staff often asked what to do with the hearing aids of residents who no longer had a need for the devices. This sparked the idea for Helping Ears, which was cemented during a holiday for Robyn’s 40th birthday in Savusavu, Fiji.

“We were at a resort, and the entire village came to sing happy birthday to Robyn – it was surreal,” Steve recalls. “The resort manager and I started talking about ears, and he asked if we’d return to provide audiological services. There was a shortage of allied health services, and many locals were experiencing hearing problems.”

“We collect hearing aids from aged care facilities and urge clinics to donate any devices their patients no longer need, as long as they’re in good working order and under warranty. We prefer battery-operated devices because electricity is scarce.”

Steve Reinhardt Helping Ears

Steve and Robyn Reinhardt surrounded by happy Fijian schoolchildren.

The couple returned to Fiji with a plan. Their middle child, Gabe, even gathered donations of school supplies from his classmates — 43 kilograms worth — which were packed with handwritten notes for Fijian schoolchildren. “Our first day, we had five people on the list in the first hour, which quickly turned into 70 through word of mouth shortly after. We ended up seeing about 300 people,” Steve recalls. “At the time, we only had five donated hearing aids.”

On their next trip, they saw 600 people in one week. “We worked from 8am until 6pm each day. There’s little electricity, so they boiled water for us on campfires to perform ear irrigation,” Steve explains. “It’s a whole new level of audiology—the locals were fanning us with palm fronds because it was so hot — but it’s the most fulfilling work.”

Twenty of 220 kids’ ears were ‘normal’

The Reinhardts have since provided education to community leaders in ear health, training local medical staff, and providing school screenings, including screening 220 children at one school. “Only 20 of them had normal ears,” Steve recalls. “The rest had some form of perforation, eustachian tube dysfunction, or foreign bodies in their ears. The incidence of perforations is high, likely due to their free-diving activities to retrieve pearls and fish.”

The couple conducts otoscopy for all patients, tympanometry for children, and either wax removal or an audiogram if otoscopy is clear and patients are reporting issues with hearing. Cerumen removal is challenging due to environmental factors. “Clean Ears donate products that work effectively to soften wax, making removal easier,” Steve says.

Each patient’s age and the severity of their hearing loss determine the allocation of hearing aids. “Deciding who receives one (of a limited supply) can be tough, but we strive to act ethically,” he adds.

On recent trips, Helping Ears has seen about 900 patients, fitting donated hearing aids for 10 people, with more than 50 on a waiting list. Additionally, they’ve removed impacted wax for 103 patients, diagnosed perforations, extracted foreign objects from children’s ears, and referred numerous patients to doctors for antibiotics.

One memorable patient was Leno, 48, who had lived with untreated hearing loss for 42 years. “His father had a car accident when he was six, driving off a cliff with Leno strapped in the back seat,” Steve says. “He survived but lost hearing in one ear and had moderate loss in the other.

gratitude: “Thank you very much for helping. I can hear from a distance, I can hear the housekeeping ladies talking and the birds. I am so happy.”

A call for donated hearing aids and computers

The Reinhardt’s foundation, Helping Ears, is seeking strategic partners to support their work. “We collect hearing aids from aged care facilities and urge clinics to donate any devices their patients no longer need, as long as they’re in good working order and under warranty. We prefer battery-operated devices because electricity is scarce,” Steve says.

Similarly, the couple has donated refurbished computers to Fijian schools. “During one visit, we found a computer lab with monitors but no computers,” he adds. “Our practice was upgrading 15 computers, so we formatted, serviced, and donated them. We’ve now set up three schools and hope to expand if any clinics have refurbished computers in good working order.”

Living up to its motto, Helping Ears, Changing Lives, the charity aims for sustainability. “We don’t want to be a one-hit wonder. We’re committed to creating a lasting impact, which is why we keep returning to Savusavu,” Steve says.

Helping Ears is registered with the Australian Charities and Not-for-profits Commission (ACNC), and donations over $2 are tax-deductible.

“For 42 years, he couldn’t hear normal conversation. With hearing aids, he realised birds made sounds — he used to see them just as flashes of colour, not realising they could sing. Stories like Leno’s drive us to keep going, but our help is limited by the number of devices we have.”

A video on the Helping Ears website shows Leno expressing his

“Financial donations are hugely appreciated to assist in buying medical equipment for the local GP, acquisition of hearing aids and to support the program overall,” Steve says.

Clinics, practitioners, and industry members interested in donating hearing aids or computers, or helping on the ground in Fiji, can reach out via info@helpingears.org. For more information, visit https://www. helpingears.org/

Steve performing cerumen removal.

A grateful villager with Steve.

Robyn putting a child at ease.

Caring for hearing in the country

Two of Victoria’s largest regional independent audiology providers have joined forces. Those behind the merger explain how they will deliver even more for regional communities.

Hot on the heels of amalgamating its five permanent sites with Ballarat Hearing clinic’s two, the new and improved Country Hearing Care (CHC) is already finding new ways to support the hearing needs of more patients in country Victoria and beyond.

The major regional audiology service has also opened a new premises in Bendigo that serves as its headquarters, overseeing eight permanent clinics, 13 visiting clinics and its work in aged care facilities.

CHC is an Australian independent audiology success story which continues to gather momentum through its broad service and unique flavour of audiology.

Another win announced in November 2024 is a contract to provide audiology services to Bendigo Health, enabling CHC audiologists to perform public audiology services at the hospital.

CHC’s managing director Mr Malcolm Comfort says that apart from providing private audiology services in its clinics, the business is thrilled to provide public audiology in hospitals in Ballarat, Bendigo and Mildura. Ironically this is where its Mildura and Ballarat businesses began decades ago – in a small room at their local hospital.

At Bendigo Health, the team works in the audiology suite, providing paediatric and adult services and care. “This is a big part of what we do –deliver our proud brand of best-practice audiology,” Comfort says.

Comfort has worked for the organisation for almost 10 years and says both of the founding businesses have proud and diverse histories of serving their communities for decades.

“CHC was originally Sunraysia Hearing Clinic formed in Mildura 22 years ago by audiologist Jane MacDonald,” he explains. “It started with paediatric care then adult care in a room in Mildura Base Hospital.

“Her husband Don retrained as an audiometrist and joined the business which quickly outgrew the room to a private practice nearby.”

Further expansion followed to permanent locations in Swan Hill, Broken Hill, Echuca and Eaglehawk in Bendigo, all with satellite and aged care sites for visiting practitioners.

About 18 months ago talks began with audiologist and director of Ballarat Hearing Clinic, Mr Campbell Stevens, about a merger possibility. Stevens had joined the clinic in the early 2000s and bought it in 2007 from now retired audiologist Mr Richard Roper.

Roper established the business in the 1980s in the hospital. “He was one of the original independent audiologists,” Comfort says. “Jane and Don looked to

Richard as an unofficial mentor, so it’s come full circle. Richard encouraged the MacDonalds to build their business and provide care to regional communities.”

Cochlear implant program

Stevens says Ballarat has a rich history in hearing care, particularly newborn screenings. Ballarat Hearing clinic was instrumental in establishing the Victorian Infant Hearing Screening Program (VIHSP), and the Victorian Cochlear Implant Program (VCIP).

“Ballarat Hearing Clinic pushed for many years to get pre and post implant audiology care into regional areas to negate the need for people to travel to Melbourne,” he adds. “It was the test case for the VCIP and a fantastic catalyst for change.

“VCIP deals with everything for cochlear implants in regional locations bar surgery, with switch on, mapping and ongoing care all performed locally.”

While a handful of other clinics do this, Ballarat was the first and CHC now provides the program at several locations, including Bendigo and Mildura.

Cerumen removal and tinnitus management are also offered at CHC and a collaboration with vestibular physiotherapists will offer balance services.

Country Hearing Care travels to areas such as Mundi Mundi near Broken Hill.

Country Hearing Care directors, (from left)

Campbell Stevens, Malcolm Comfort and Don MacDonald infront of the new Bendigo headquarters.

The reception area in the new Bendigo premises.

tests including with mining companies.

“At Elmore recently, I did just over 150 hearing screens in three days,” she recalls. “I see a mix of young and older people at almost every community hearing screening event.

HSP contracts, multiple software and retraining about 50 staff.

“It’s not to be underestimated the work involved in a merger of that size but the goal was to increase our ability to provide these services that we’re very proud of to a wider market and build the foundations for further growth,” Comfort explains.

“Apart from geographical growth, our goal is to set the standard for innovative and trusted hearing care countrywide in regional communities throughout Australia. We also want to shine a light on the fact that independent hearing care is alive and well with new businesses popping up everywhere which is fantastic.”

Bendigo is now HQ

Strategically, CHC has made Bendigo its new headquarters with key management and administrative staff based there because of its central Victorian location. Comfort and MacDonald found the venue – a 100-year-old former bus station 500 metres from the hospital – when scrolling realestate. com.au

“We bought it in 2021 aiming to convert it into a multi-clinician clinic,” MacDonald recalls. “It was a 450-square metre heritage-listed red brick building with a mechanics pit inside. It took three years to bring it to fruition.”

The team used local builders, architects, planners, trades and an interior designer who attended the launch night with local GPs, health professionals and the mayor.

The clinic has six consulting rooms including a paediatric suite, five administration offices and a board room. “It’s come up beautifully. It took a year for the fit-out as there were delays with planning, council and the water authority due to needing new drainage,” MacDonald adds.

Bendigo has one full-time and one visiting ENT surgeon as a long-standing surgeon recently retired, leaving a service gap. “We’d like to see if there’s solutions we can offer and would love to have surgeons consult at our consulting rooms,” he says.

Comfort adds: “Our goal is to minimise or negate the need for our clients to travel to metropolitan areas for any element of hearing health care. We collaborate with ENTs so if we can provide a solution in-house we will, but we also have strong referral pathways.”

The build included double thickness insulated walls for soundproofing, acoustic buffers, acoustic tiles on walls to reduce reverberation, and an extra layer on the ceiling in the paediatric suite to soundproof it.

The design kept many original features including a double high ceiling, original beams and exposed rafters in reception. While consulting rooms have lower ceilings for acoustics, they kept the exposed original Bendigo Bricks

“Younger people are more 'health aware' and I tell them common earphones such as AirPods and Beats are not certified hearing protection. I do a lot of hearing safety education with younger people.”

Field days attract people who work on the land, a demographic at higher risk of hearing damage. “There’s still huge social stigma regarding hearing loss and in particular hearing aids in our aging population,” Sharpe says.

“I spend time trying to break down people’s fears and misconceptions about hearing aids. Our hearing health is just as important as other regular health checks.

“Field Days are a great way to talk with people and help them understand hearing aids are not just an 'old people’s' thing and treating hearing loss earlier has many benefits.”

Sharpe also educates people on ear hygiene using a video otoscope as they love to see inside their ears. She’s attended country shows, primary schools, heavy vehicle forums and health awareness days.

below windows, creating an industrial sheik style.

“The building was the same shape, footprint and area as the Mildura clinic,” Comfort adds.

Staff are mainly audiologists and administrative staff but there’s also audiometry nurse Mrs Karina Sharpe and, given her impact, CHC's recruiting to replicate the role in Ballarat.

“Karina’s our audiology support nurse and wears many hats which takes pressure off the audiology calendar including wax removal, hearing aid repairs and industrial screening tests,” Comfort explains.

“She attends field days, does industrial testing and has landed us contracts with mines. Karina is one in a million and advocates passionately for hearing protection. We didn't actually plan this as she started part-time but it just organically happened.”

The business also takes part in career information nights with other regional clinics to showcase benefits of regional Victoria.

“It’s an amazing opportunity to live and work regionally," Comfort says. "Clinics are multi-disciplinary, there’s professional and leadership opportunities, and CPD.

“In the past 12 months we’ve seen more interest in regional positions. Recruiting can be hard but retention’s good.”

When mayor Cr Andrea Metcalf attended the opening of CHC’s headquarters in October 2024, she said it was wonderful to see an old Bendigo building repurposed and keep its heritage yet have a new lease of life. It’s poignant that it’s served the community for so long as a bus station and is doing so again in a different way.

Evolution in deaf education

Education for people who are Deaf or Hard of Hearing has come a long way since deaf Scottish migrant Thomas Pattison opened Australia’s first school for deaf children in Sydney in 1860. Today, children with hearing loss have many options including integration into mainstream schooling, learning Auslan and attending stand-alone deaf facilities.

Technology, along with community attitudes, have changed the face of education for people who are Deaf or Hard of Hearing.

The advent of newborn hearing screening has also enabled earlier diagnosis and treatment with cochlear implants or hearing aids. This has transformed deaf education because these early interventions enable infants to hear sounds and learn speech from a young age, improving their chances of better integration into mainstream schooling.

Despite this, and many technological advancements in computers and classroom hearing augmentation systems, extra support for Deaf and Hard of Hearing children is advisable to enable the best chance for equal access with hearing peers.

Yarra Valley Grammar is one school in Melbourne’s eastern suburbs that is an excellent example of how to integrate these children into a mainstream education. In 2022 its Hearing Unit celebrated 50 years of providing additional support to Deaf and Hard of Hearing children.

Its academic success – and success at integration – is evidenced by students travelling from around Australia to attend. One family relocated from Cairns and another student from Tasmania lived in Ringwood during the school term.

Ms Rachel Wilson, a teacher of the deaf who manages the Hearing Unit, explains: “We’ve put provisions in place early, particularly around testing, so they can have success in VCE. In the six years I have been here, all the Hearing Unit students have gone on to their chosen degree. In recent years that has included dentistry, business, commerce, engineering and interior design.”

Wilson, also the school’s director of learning support and individual programs from preschool to year 12, ensures the same systems and structures are in place schoolwide.

In the late 1960s Melbourne woman Mrs Nancy John, who taught her deaf daughter to speak, began working with other families of hearing-impaired children. She formed the Advisory Council for Children with Impaired Hearing in 1968 which ran early intervention programs from her house. John taught

children to use what hearing they had through hearing aids and lip read and this evolved to become Taralye early intervention centre.

“In 1972 when Yarra Valley Grammar was an all-boys school, four local families wanted a mainstream education for their deaf sons,” Wilson says.

“Nancy John and her group, along with the original staff led by teacher Mr Bill Robinson, were exploring which school would be a good fit. They chose us as we were only five years old and they wanted to embed a facility that would grow with the school.”

Over the years, the unit’s reputation has grown along with its staff, facilities and technology.

“We’re very big on technology so in the Early Learning Centre (ELC) there might be a Roger touch screen being worn by the teacher and as students progress, there are pass around microphones in conjunction with what the teacher wears and a surround sound speaker,” she says.

Students wear radio frequency aids in the classroom and in environments with competing background noise while soundfield technology is used throughout the school to assist with classroom clarity. “We have soundfields in every room with teachers wearing them in every class which benefits all students, not just the hard of hearing,” Wilson adds.

“Today’s technology means we’re closing the gap between hearing peers and students with hearing loss. There’s more tech now, and AI has transformed captioning and transcription and can even summarise lessons for students.”

The intervention model is needs-based with staff constantly monitoring and reviewing where students are at, how they’re going and putting individual goals in place. Students attend regular classes and if they need extra intervention, they receive it.

“Otherwise, we follow that inclusive model where we build the capacity of the classroom teacher to understand their needs,” she adds.

Learning assistance in class includes being guided by the teacher as to what they need, supplementing the program and as they get older, teacher supports

Image: Yarra Valley Grammar.

A Yarra Valley Grammar teacher assisting Hard of Hearing students.

are more involved in note taking and support.

A charitable foundation, which provides financial assistance, said when deciding which facilities to support it found Yarra Valley Grammar’s was “one of the best internationally".

Auditory memory is tracked and if students need auditory training, they receive it. Sometimes it is linked to a cochlear implant and staff support them getting used to the processor.

Deaf awareness is a big thing in the school, with all students taking part in activities such as hearing awareness week and NextSense’s loud shirt day.

“We have a whole team around the child, an occupational therapist, psychologist, speech pathologist, teachers of the deaf and an audiologist to focus on giving them what they need early,” Wilson says.

“Our audiologist Rebekah Vaiopoulos is like one of the staff and she’s just up the road so if anything goes wrong with devices, we can run them up to her, get them fixed and bring them back.”

Meaningful impact

For 19 years, Vaiopoulos, a paediatric audiologist with Hearing Australia in Croydon, has been visiting the school monthly to help the students in the Hearing Unit.

“This was an initiative set up by Hearing Australia and the Victorian Education Department many years ago to support schools with a deaf facility/hearing unit,” she explains.

“I visit monthly and check in with as many students and teachers as possible.

“Tasks will vary from general equipment/ear health checks and troubleshooting to impressions, discussions of advocacy/device use, troubleshooting of various classroom equipment or situations such as Johnny had a problem in science last week. We may visit the space and troubleshoot accordingly.”

Vaiopoulos says she also has discussions about tinnitus, mental health and wellbeing and external supports available to support sense of self and improve deaf identity such as deaf sports.

“We also practise “appointment dialogue” and teachers encourage them to anticipate the types of questions I might ask and the types of answers they may give to describe their problem and ultimately become their own best independent advocate,” she adds.

She does device adjustments and hearing tests on request to supplement services provided by local hearing practitioners, not to replace them.

“Depending on the problem we may be able to provide immediate assistance and if we can, we will,” she says.

“I love liaising with the students and teachers and hope to have a meaningful impact on their hearing journey. It’s most rewarding to see them develop into teens and young adults and achieve their dreams.”

NextSense reaches nationwide

Deaf education began in Australia when seven children enrolled in deaf Scottish migrant Thomas Pattison’s first school for deaf children in Sydney in 1860. The school later expanded to become the Royal Institute for Deaf and

“I love liaising with the students and teachers and hope to have a meaningful impact on their hearing journey. It’s most rewarding to see them develop into teens and young adults and achieve their dreams.”

2021 was renamed NextSense.

NextSense School is a primary school situated at a new centre for innovation on the Macquarie University campus and is custom designed for people with vision and hearing loss. NextSense also houses preschools on site and in Melbourne. It provides early intervention and cochlear implant services for children and adults nationally.

The NextSense Institute also enables research on best practice education to be put into practise on site.

Additionally, the organisation provides support for students who are Deaf or Hard of Hearing and those with vision impairment in 78 mainstream, independent schools across NSW, the ACT and Victoria.

This includes regular classroom visits, assessment and guidance on learning aids and assistive technologies in-person or via telepractice. It also provides training and development for mainstream teachers equipping them with skills to make the classroom more inclusive and to use assistive technologies to support children’s learning. The organisation also trains people to become teachers of the deaf.

The school has purpose-built learning environments and low teacher-student ratios. It uses research to drive new teaching approaches and techniques in its dedicated spoken language, sign bilingual (Auslan and English), and blind and low vision programs for those who are blind, deafblind or have vision loss.

NextSense preschool includes hearing and sighted children learning alongside peers who are deaf, hard of hearing, blind or have low vision.

Rebekah Vaiopoulos Hearing Australia

Nominated for a 2024 Australian Childcare Alliance NSW Excellence in Early Childcare Awards, it is leading the way in integrated early learning for children aged three to five.

The facility is custom designed, with features including a bush tucker

Blind Children and in

ABOVE: Hearing Australia audiologist Rebekah Vaiopoulos with a Yarra Valley Grammar student.

Image: Yarra Valley Grammar.

Image: Yarra Valley Grammar.

Deaf and Hard of Hearing students at Yarra Valley Grammar are integrated in daily classes but receive extra assistance.

Image: Hearing Australia.

sensory garden with edible plants, an accessible playground, braille and tactile signage, and state-of-the-art acoustics and lighting to provide optimal learning environments.

Students who attend NextSense School partner with a school of the family’s choice when the student’s skills have progressed and their confidence grown to prepare them for high school. The partnership may involve one to three days a week, progressively increasing, and supports a strong transition to the school of choice.

Alternatively, a partnership program enables students from education systems across the Sydney metro area to attend NextSense one or two days a week to complement their learning in their main school.

In addition to the wraparound support provided to children and families who choose either the bilingual education stream or the spoken language stream, the organisation is also the largest provider of cochlear implants nationwide. It supports both children and adults, having performed more than 7,500 implants.

When NextSense chief executive Mr Chris Rehn started in 1996 only about 12 children a year received cochlear implants in NSW; that has now skyrocketed due to evidence showing benefits of the technology and early implantation, which has flowed onto better schooling integration and success.

“The cochlear implant is the intervention for most children in a significant hearing loss category and it has come down the spectrum, and we’re using it in many more children in moderate to severe categories rather than just severe or severe to profound categories,” Rehn says.

“The great success that we have seen with the implant has guaranteed that it’s been more widely used at different levels of hearing loss with good degrees of success.

“Earlier implantation can lead to language development similar to hearing

peers, with proper support and rehabilitation. Incubating best practice is something Australia can really take pride in and while we learn from the world, we also teach the world.”

NextSense, partnering with the Australian Hearing Hub and implant manufacturers including Cochlear, delivers that equal opportunity to 10,000 families a year nationwide, through education, early intervention and cochlear implants.

Rehn says, however, that there’s a national shortage of teachers of the deaf in Australia . Roles and work requirements differ around the country, which influences whether teachers choose to embark on tertiary studies in the field.

NextSense’s Master of Disability Studies offers postgraduate studies to develop knowledge and skills to adapt content, develop teaching methodology, and apply specialised instructional techniques to meet needs of children with sensory disabilities.

The course provides employment opportunities in inclusive education, the disability sector and opportunities to conduct research or complete further study.

The Shepherd Centre

The Shepherd Centre, based throughout NSW, the ACT, Tasmania and Queensland, is another example of a service that has helped thousands of children with hearing loss reach their full potential over the past 50 years.

It offers a world-leading early intervention program for babies, toddlers and preschoolers that gives deaf children the support and skills they need to succeed and thrive at mainstream school alongside hearing classmates.

Its evidence-based early intervention programs aim to help children start mainstream school with listening and speaking skills similar to those of hearing peers. It also has a mentoring program, called Hear for You, for school-aged children and teenagers.

In 2024 about 70 children graduated from the early intervention program and are embarking on their next step – mainstream school. “We’re privileged to support more than 900 deaf children and their families across 10 centres, and remotely online, in NSW, the ACT and Tasmania,” CEO Dr Aleisha Davies says. For parents who prefer their children to attend a school for the deaf, there are also options .

For example, three Victorian ‘Schools for the Deaf’ – Aurora School, Furlong Park School for Deaf Children, and Victorian College for the Deaf provide a bilingual (Auslan and English) holistic education.

They support children from infancy to age 18 and enable students to learn from teachers of the deaf with staff comprising deaf and hearing teachers. Computer technology and hearing interventions also make tertiary education far more accessible for today’s hard of hearing students.

Image: NextSense.

Image: NextSense.

Children at NextSense School using the latest technology.

Signing at NextSense School.

New research from Hearing Australia shows 11% of Australians have experienced hearing damage from workplace noise. More prevention and awareness are needed.

Workplace toll on hearing

It’s a noisy world but nobody should lose their hearing because of their work. Some workplaces are worse than others when it comes to excessive noise that can damage hearing but Australian researchers and practitioners are working to prevent industrial deafness as well as reduce impacts.

It’s not just noise that damages hearing at work though as studies show exposure to ototoxic chemicals also causes hearing loss, and exposure to both noise and chemicals increases susceptibility.

Hearing Australia says the main industries at risk of excessive noise exposure are manufacturing, construction, mining, farming and defence. But there are other industries, such as hospitality, entertainment and retail, which are also exposed to loud noise. Musicians, workers in the automotive industry and airport ground staff are also at risk.

Its recent nationwide online survey of 1,012 people found more than one in 10 workers (11%) have experienced hearing damage from workplace noise and almost 25% know someone who is affected by workplace noise-related hearing damage.

It found only one in four thinks about hearing protection and use it at work or when undertaking noisy activities during their leisure time. And surprisingly Australian women appear to think less about protecting their hearing than men.

Hearing Australia principal audiologist, Ms Karen Hirschausen, says these statistics are a real concern.

Image: Hearing Australia.

“Work health and safety laws that stipulate noise-exposed workers should have their hearing tested when they start the job, then at two-yearly intervals, should be reinforced.”

“Hearing is such an important sense but more than 1.1 million Australians are exposed to hazardous noise in their workplace, according to 2019 data,” she says. “Noise-induced hearing loss is one of the most common occupational diseases but it’s also one of the most preventable.”

30,000 workers comp claims

Between 2015 and 2022 Australian workers lodged close to 30,000 workers compensation claims for hearing loss. The majority of these were the result of long term exposure to hazardous noise.

High occupational noise levels are also associated with other health problems, according to research from the National Acoustic Laboratories (NAL). Its Making a noise about hearing report from 2020 found excessively noisy workplaces were associated with stress, headaches, tinnitus, fatigue and increased absenteeism.

They also have the potential to cause increased heart rate, higher blood pressure and a greater risk of cardiovascular disease, the report said.

The NAL report found that concerningly, mitigating noise exposure was not a high priority for employers, employees or regulators.

“Small to medium-sized businesses (SMEs) appear to be at greater risk of noise exposure,” Hirschausen adds. “Safe Work Australia research from 2010 found that within SMEs, there was insufficient knowledge of the effects and the impact of loud noise on people’s hearing and quality of life, and little consideration given to the benefits of noise control."

Mr Kim Terrell, Hearing Australia’s managing director, says the organisation is committed to helping prevent avoidable hearing loss in the workplace. “And we believe more needs to be done to protect workers in high-risk industries such as construction, manufacturing and agriculture,” he says. Hirschausen stresses: “Work health and safety laws that stipulate noise-exposed workers should have their hearing tested when they start the job, then at two-yearly intervals, should be reinforced.”

Karen Hirschausen Hearing Australia

The NAL report also revealed hearing loss among farmers and agricultural workers is widespread, with statistics indicating 65% of farmers aged 15 to 75+ experience some degree of hearing loss.

“Young farmers are around seven times more likely to have hearing loss

Ear protection is vital in industries such as mining.

Working the mines

Audiology support nurse, Mrs Karina Sharpe from Country Hearing Care (CHC) regional independent audiology network, does hearing tests at field days, community events, local manufacturing businesses and mines. She says CHC has a contract with a large mining company in Victoria/NSW to manage its entire industrial hearing program.

majority in males aged 55-59 years, Safe Work Australia says.

“There are likely many more workers who have noise-induced hearing loss, but they don’t realise it until it’s too late. On average, it takes up to 10 years for people to seek help,” Hirschausen adds. “Early detection can help prevent further damage. It’s crucial to identify occupational noise-induced hearing loss as soon as possible then take steps to reduce noise exposure to prevent it from worsening.”

One Australian study suggested occupational noise-induced hearing loss cost at least $26 billion over 10 years.

Safe Work Australia explains that under the model Work Health and Safety (WHS) laws, workers must not be exposed to noise above 85 decibels (as an average) over eight hours at work. Machines such as blenders, lawnmowers and leaf blowers are around 85 decibels.

The risk of noise-related injury increases depending on how loud the

“We visit each of its sites every two years and also conduct noise level surveys,” she says. "We visit a few different locations, from mines to processing sites.

“Onsite testing is quite enjoyable, not only do I get to pass on my knowledge about hearing health and safety, but I often learn about the industries.

“Mine sites are very heavily regulated and controlled so I only venture down into the mining sites for noise level surveys.”

Sharpe finds it rewarding to educate miners on hearing health.

“Many of the younger employees are health conscious and interested to hear what I have to say. The health literacy of most people in terms of ear hygiene is quite poor though so we spend time explaining how to take care of their ears.”

She says industrial hearing loss is still quite common in the older generation.“They are unfortunately a product of their time from when hearing protection and OHS (occupational health and safety) in general didn’t exist or wasn’t enforced.

“A recent round of hearing tests at a mining site revealed about two out of every 10 workers tested had a hearing loss that required audiological follow up.”

As most employees are males and males typically engage in noisier hobbies and activities outside work, Sharpe also encourages them to wear hearing protection when working on their cars, shooting or using noisy garden equipment.

She says the companies that CHC deals with are doing a lot to protect the hearing of their workers. “One company has invested in a fit testing program that allows employees to test whether they are wearing their hearing protection adequately,” she adds.

“New hearing test requirements for NSW workers which began in 2024 also mean that companies are now more aware of their obligations to protect their employees’ hearing.”

Sharpe says that sometimes active noise cancelling headphones are used as hearing protection by some employees. “These noise cancelling devices allow employees to listen to audio while blocking out background noise. The issue with these devices is that virtually none met the Australian Standard AS:1270 which means they cannot be relied on to provide adequate (if any) hearing protection.

“Well fitting, class appropriate hearing protection that has passed the AS:1270 is still the best option available, aside from ultimately eliminating loud noise exposure.”

Image: Country Hearing Care.

Image: AuCA.

Image: AuCA.

A worker from Kembla doing audiometric testing of a colleague in a soundproof booth during AuCA’s occupational audiometry course.

These four workers from Kembla were the first to do AuCA’s occupational audiometry course.

noise is and how long the worker is exposed to it. The louder noise is, the less time a person can be exposed before hearing damage occurs. For example, the risk at 91 decibels over two hours is the same as 85 decibels over eight hours.

Workers must not be exposed to a noise level over 140 decibels as any exposure above this level could instantly damage hearing. Sledgehammering or gunshots can be 140 decibels or higher.

Occupational audiometry

course

Safe Work Australia notes that employers must provide audiometric testing for workers if they need to frequently wear personal hearing protection to protect them from noise above the noise exposure standard.

The Australasian College of Audiometry launched an occupational audiometry short course for workplace hearing tests in 2024 which assists training for this requirement.

Several employees from MM Kembla (mines) recently did the course.

PREVENTION TOOLKIT –

tips hearing practitioners can give clients

Hearing Australia’s prevention toolkit to help combat occupational-noise-induced hearing loss gives tips to protect hearing on the job.

These include:

• B uy equipment which generates lower levels of noise emissions.

• Always wear appropriate hearing protection such as earmuffs or earplugs especially in noisy environments.

• Ensure noise reduction aids, such as mufflers, which are used on equipment or tools, are in working order and report any faults to the manager/employer.

• Limit time spent in noisy environments and take regular breaks in quiet spaces.

• Use barriers or screens to block the direct path of sound.

• Use remote controls to operate noisy equipment from a distance.

• Par ticipate in training programs about hearing protection and workplace safety.

• B e familiar with safety guidelines and procedures.

• R ep ort hearing-related issues or discomfort immediately to supervisors, safety officers or the HR team.

• Have hearing checked regularly and see an audiologist or doctor if you notice changes.

Mr Chedy Kalach, AuCA director, says that further to offering the Certificate IV and Diploma of Audiometry, AuCA expanded its offerings with the intensive course in occupational audiometry.

“The Occupational Audiometry two-day course, in combination with an online learning module, provides participants with the skills and knowledge required in accordance with the Australian and New Zealand Standards AS/NZS 1269.4:2014 Occupational noise management –Auditory assessment standards,” he says.

“This intensive course is designed to give participants not only competence but also the confidence to conduct otoscopy, perform workplace hearing tests and analyse and present test results accurately and confidently.”

Online study and in person workshops

Kalach says the blended delivery mode utilising both on-line learning and in-person workshops allows instructors to deliver learning modules, quizzes, practical instruction and assessments that are in depth and engaging while allowing students to work through course material at their own pace then consolidate with an intensive hands-on workshop.

“The course materials and learning journey have been carefully designed to provide participants with the best opportunity to gain a practical understanding supported by a comprehensive knowledge base to achieve competency in occupational audiometry,” he added.

“Our AuCA trainers, who are audiologists, facilitate the course and are available to students via the discussion page as well as over the phone for support when needed.”

Course highlights include:

n online pre-workshop learning module addressing the 16 areas of the AS/NZS 1269.4:2014 Occupational noise management – Auditory assessment standards.

wo-day face-to-face workshop to gain practical, hands-on experience under the guidance of qualified audiologists. Participants practise audiometric testing techniques, troubleshooting, and data interpretation.

certificate of competency is awarded to participants after passing a final graded assessment.

Manufacturing also puts ears at risk.

Workers in the construction industry also have excessively noisy workplaces.

What 2024 had in store

It’s been a busy year in the hearing health sector since Hearing Practitioner Australia launched in April 2024. Hot topics have included health ministers considering Ahpra registration for audiologists, a scope of practice review, and the first gene therapy treatments for deafness including in Australia. Here’s a snapshot of key happenings.

Business highlights

The year kicked off with Specsavers opening its 300th audiology store in Australia in Geelong, Victoria. Its 2023-2024 annual review later revealed Specsavers Audiology recorded its fastest growth globally in Australia and New Zealand with a 30% increase in customers through its doors compared with 2022-2023. Its Australian business, including optometry and audiology, contributed $1.42 billion to the company’s global group revenue of $6.5 billion to the end of February 2024.

In March Cochlear and Hearing Australia signed a new three-year agreement to collaborate in key areas including training, research, awareness, access to hearing care, and improving hearing health of First Nations people. In May Cochlear completed its acquisition of Oticon Medical’s cochlear implant business from Demant, and said it would support hearing health outcomes of 20,000 people with Oticon Medical cochlear implants.

MED-EL and Starkey announced a collaboration to enable an all-new Bluetooth listening experience for people with a MED-EL cochlear implant and Starkey products. They said the new technology would expand Bluetooth connectivity solutions for people using bimodal hearing technology. MED-EL later acquired Austrian company BHM-Tech which specialises in bone conduction hearing systems.

Deaf Connect launched its Ageing Well program for Deaf, deafblind and hard-of-hearing seniors in Victoria, making its Auslan-delivered Home Care Package under the My Aged Care program now available. In July the National Sign Language Program extended to include sign language interpreting and captioning services for health and medical appointments and Deaf Connect began delivering the services. The Department of Health and Aged Care provides the free service to support older deaf, deafblind and hard of hearing people who aren’t eligible for the NDIS.

Amplifon announced strong growth in the first nine months of 2024 with revenues up 8% or $AU2.89 billion, allowing it to strengthen its presence in core markets and exceed 10,000 stores globally. GN’s interim report for the third quarter said its hearing division continued to gain significant market share leading to 10% organic revenue growth and the divisional profit margin increased to nearly 35%.

A new partnership between the Ear Science Institute Australia and the National Acoustic Laboratories brought together hearing researchers from across Australia to improve treatments for people with hearing issues. The partnership, announced in May, represented a collaboration of nearly 100 years of combined expertise in research, innovation and hearing healthcare.

Workforce and policies

The year’s hottest topic was Ahpra registration being among four options health ministers shortlisted as they consulted on the future of audiology regulation in Australia. A decision is expected next year. Shortlisted options in the Queensland Health Consultation Paper Audiology RIS (regulatory impact statement) are current self-regulation, national registration of the entire audiology profession through the National Registration and Accreditation Scheme under the Australian Health Practitioner Regulation Agency (Ahpra), targeted regulation of practitioners offering paediatric diagnostic and cochlear implant care services, and jurisdictional registration requiring audiologists to register in their jurisdiction to practise.

In a major win for audiologists and speech pathologists, a landmark review released in November recommended they should be able to refer patients directly to ear, nose and throat (ENT) specialists, by-passing GPs. It suggested this pathway if there was an underlying medical condition suspected as contributing to speech, hearing or auditory system issues the patient was experiencing, and medical treatment, including surgery, may be required. The ‘scope of practice’ report was commissioned by the Australian Government who is considering recommendations.

The Australasian College of Audiometry (AuCA) became the hearing industry’s newest training organisation, launching diploma and certificate courses, a course for workplace hearing tests and expanding services from Australia to New Zealand. AuCA was also instrumental in establishing a review of audiometry qualifications which began in October.

Another big issue was the Hearing Services Program (HSP) review which is

ABOVE, L TO R: The University of Melbourne celebrated 50 years of outstanding audiology education; Audiology Australia’s Leanne Emerson and Dr Barbra Timmer successfully bid for the World Congress of Audiology in Sydney in 2030.

Image: The University of Melbourne.

Image: AudA.

every two years. People can register and gain CPD until 19 January.

The OMOZ (Otitis Media Australia) 2024 conference in Newcastle in August was a sold-out success attended by more than 300 people keen to hear the latest research and brainstorm ideas for improving ear and hearing health for children.

Fifty audiologists from around Australia and New Zealand attended Independent Audiologist Australia’s first in-person event post-COVID in Melbourne, the Audiology for Life! seminar.

ongoing. A summary of the consultation process showed most stakeholders supported proposed changes to HSP assessments including removing Audiological Case Management items. But major concerns remained, with most opposing proposed changes to fittings and follow-ups. Planned changes to remote controls were an area of concern with most opposed to these while half were unsure about only allowing two replacements per year over five years. Most supported plans to amalgamate client review and rehabilitation items and changes to assistive listening device supply, replacements and spare devices, plus eligibility criteria for fitting.

In October, a new independent organisation to promote ethical hearing service practice and handle complaints against audiologists and audiometrists launched. The Hearing Professional Conduct and Complaints Body replaced the previous AudA and ACAud Inc. HAASA Ethics Review Committees.

The Medical Board of Australia (MBA) released details of its plan to fast-track certain internationally qualified medical specialists into the health system without doing exams as part of reforms to alleviate workforce pressures. Maldistribution and shortages in the ENT workforce are ongoing with an MBA report revealing there were 566 otolaryngologists registered to practise, over half in two states.

Key events

More than 840 people travelled from around Australia and the world to attend the Australian College of Audiology’s national congress ACAud 2024 in Cairns in May.

The theme was ‘The heat is on – sustaining audiology in a changing climate’. Audiology Australia (AudA) had a record attendance at The Sound Exchange’24 in Melbourne in May which featured workshops and masterclasses. AudA’s online conference in October was popular and will run

Hearing Business Alliance ran seminars on strategies for business success over three days in February on the Gold Coast, attended by a record number of delegates, and over one day in Perth in July.

AuCA attended the New Zealand Audiological Society conference in Christchurch in August, where it launched its expansion to NZ. The Audiometry Nurses Association of Australia celebrated its 40th annual conference in Queanbeyan, NSW in October.

Peak bodies/education

Two professional accrediting bodies for hearing practitioners, the Australian College of Audiology (ACAud) and the Hearing Aid Audiology Society of Australia (HAASA) merged in April to become ACAud inc HAASA. This created an organisation of 1,005 members and was a boost for the future of audiometry. Mr Miguel Diaz became CEO in June.

The Hearing Health Sector Alliance re-elected Ms Jane MacDonald as chair, and elected a new deputy, Audiology Australia’s new CEO Ms Leanne Emerson.

AudA introduced changes to CPD requirements for members to simplify the professional development process by only having two categories and included a CPD dashboard to help members keep tally. It released a position statement on using AI scribes in audiology practice.

In a major coup, AudA won a bid to host the 39th World Congress of Audiology (WCA) in Sydney in May 2030. The International Society of Audiology named Sydney host city in October after AudA’s CEO Ms Leanne Emerson and president Dr Barbra Timmer made the bid at the WCA in Paris in September.

The University of Melbourne celebrated the 50th anniversary of its audiology degree, with a celebration attended by more than 180 guests, many alumni. From 12 students in the inaugural 1974 cohort, it has grown to match demand with 82 first year students in 2024.

Research, technology and therapies

In a pioneering breakthrough, doctors revealed in May that gene therapy had restored hearing in seven children with genetic deafness from the UK, the US and China. HPA revealed exclusively in October that the first Australian child had also received gene therapy for deafness in Sydney this year. Surgeon, Professor Catherine Birman, revealed details at the World Congress of Audiology in Paris.

Starkey launched on the Australian market a new hearing technology system using artificial intelligence to improve the experience of those with hearing loss. It said Genesis AI hearing aids analysed and optimised sound over 80 million times an hour.

Ear Science Institute Australia announced Australia’s first biobank to store tissue for genetic deafness therapies. Other Ear Science breakthroughs included developing a world-first prosthetic eardrum based on biomaterial from silkworms to repair chronic ruptured eardrums and MedChem Australia supporting an Ear Science project researching novel small molecules to treat sensorineural hearing loss.

A Macquarie University team proposed neural circuitry as a new theory on how humans hear, NextSense’s $75 million centre for innovation opened in August, and in September Macquarie University’s HEAR Centre became a WHO collaborating centre.

Hunter Medical Research Institute researcher Dr Guy Cameron started

Images: Laurie Upfold, Fred Hollows Foundation, AAO-HNSF, Hearing Australia, The Bionics Institute.

TOP: ACAud and HAASA merged in April, boosting members to more than 1,000.

ABOVE: L to R, Dr Laurie Upfold, Anne Porter (top line), Prof Kelvin Kong, Vi Bui and Prof Graeme Clark (bottom line) were recipients of major honours/awards.

Image: ACAud inc HAASA.

developing a model of human middle ear epithelium as a platform for transforming children’s ear disease research.

The Lancet Commission on dementia said hearing-loss was the equal biggest modifiable risk factor for dementia at a population level and an AIHW report found hearing loss was Australia’s fifth most common long term health condition.

The year’s most popular story was Apple announcing its AirPods Pro2 had FDA approval to be used as hearing aids for mild to moderate hearing loss.

Neuromod said it planned to bring its tinnitus device Lenire to Australia, and The Bionics Institute in Melbourne developed a world first test to objectively measure tinnitus with a brain imaging technique using near-infrared light.

Spiral Therapeutics announced its world first clinical trial in Australia of a gel steroid injection into the round window membrane of the ear reported ‘significant reductions in vertigo frequency and severity’, in Ménière’s disease patients.

A Perth study found audiology-led follow-up clinics for post-grommet insertion were “a viable option” for most children who had the surgery, and UK research found people with sudden hearing loss who received steroids within seven days were five times more likely to fully recover their hearing than those not given steroids.

Awards and honours

A founding father of audiology, Dr Laurie Upfold, received an OAM in the King’s Birthday honours while Indigenous Newcastle ENT surgeon, Professor Kelvin Kong AM received the John Conley MD Lecture on Medical Ethics award at the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF) annual meeting.

Brisbane audiologist Ms Vi Bui was named the Fred Hollows Humanitarian of the Year, and The Bionics Institute awarded its Visionary Award to cochlear implant pioneer Laureate Professor Graeme Clark AC for his “immense contributions to society.”

Hearing Australia awarded the 2024 Hearing Australia Lifetime Achievement Award to Ms Ann Porter AM, the founder and CEO of Aussie Deaf Kids.

Ear Science CEO Associate Professor Sandra Bellekom was nominated for BHP’s 2024 Western Australian of the Year award while Perth audiologist Ms Tamara Veselinović, whose research revealed high rates of hearing loss in Aboriginal infants in metropolitan areas, was a finalist in the WA Premier’s Science Awards.

Specsavers received major awards; in November it was named one of the world’s best workplaces when it ranked 16th in Fortune magazine's World’s 25 Best Workplaces in 2024. In September Specsavers was sixth on the 2024 Top 10 Best Workplaces in Australia list, and it was ‘highly commended’ for hearing services in Australia and New Zealand by Reader’s Digest magazine in its 25th annual Trusted Brands awards survey. Specsavers Audiology Australia received the ‘highly commended’ award in the hearing services’ category for the third year running while Specsavers Audiology New Zealand was highly commended for the second time in 2024.

People

We profiled some inspirational people going to extraordinary lengths to help others. These included Auditory Processing Institute founder, Queensland audiologist Dr Angela Alexander, and Mrs Yazdaneh Galt who overcame adversity to own her own independent audiology practice in Melbourne.

Mildura audiologist Ms Jane MacDonald discussed advocating for the nation’s hearing health sector as chair of the HHSA and HBA CEO, and AudA CEO Ms Leanne Emerson discussed plans to grow Audiology Australia, unite the industry and raise the public profile of hearing health.

Dual Melbourne optometrist/audiologist Mr Lachlan Smith flies to remote areas and practises both professions to help Indigenous patients, Microtia Australia founder Ms Simone Cheadle assists parents and children nationwide, and reconstructive plastic surgeon Dr Joe Dusseldorp from Sydney performs 3D ear implants.

World leading Ménière’s disease researcher Professor Jose Antonio Lopez-Escamez moved from Spain to the University of Sydney to establish the Ménière-Neuroscience Laboratory at the Kolling Institute.

APRIL

ACAud and HAASA merge

JUNE

Health ministers put Ahpra registration on table for audiologists

JULY

HHSA elects deputy Leanne Emerson; re-elects chair Jane MacDonald

OCTOBER

AudA secures World Congress of Audiology for Sydney

MAY

Gene therapy restores hearing in seven children

JUNE

SEPTEMBER

FDA announces AirPods2 can be used as hearing aids.

NOVEMBER

Scope of practice review urges direct audiology referral to ENT

Miguel Diaz appointed ACAud inc HAASA CEO

Upskilling in audiometry

It’s been a year since the launch of the hearing industry’s newest training organisation, the Australasian College of Audiometry. HPA checks in with staff and students to see how it's shaping the future audiometry workforce.

Retraining in a new career at age 56 was an easy decision for Mrs Louise Garland. She gets to remain in her existing managerial job while studying audiometry to upskill so she can also help with hearing assessments.

“The Diploma of Audiometry is quite a lot of study but it’s interesting and as you get older, you only study what you really want to so it’s not a chore,” she says.

“I love it, it’s not too stressful and the workload is not overwhelming.”

Garland, pictured above back row second from left, was the first New Zealand student to enrol in the diploma now offered by the Australasian College of Audiometry (AuCA). The organisation launched in December 2023 and is providing new opportunities for aspiring audiometrists through either a Certificate IV in Audiometry or Diploma of Audiometry.

When Garland's husband landed a job in the South Island town of Wānaka 13 years ago, the couple moved from France.

“I was lucky enough to be introduced to Scott Wright who was setting up an audiology clinic and he employed me to assist,” she recalls.

Mr Wright, who was co-founder of Bay Audiology (New Zealand and Australia), sold that business and founded New Zealand Hearing which now has 14 clinics nationwide. With a background in HR, administration, accounting and finances, Garland is executive manager of New Zealand Hearing.

“My role for 10 years has been to visit staff and set up clinics,” she adds.

“I thought audiometry was something I could consider so I could be more hands-on and when someone’s on leave, I’d be able to help by providing audiometry services.”

Garland had looked at TAFE opportunities in Australia but was put off by overseas student fees.

“I was at the New Zealand Audiological Society (NZAS) conference in August 2024 and was talking to a delegate who said there was a new organisation doing audiometry training and it had a stall there,” she recalls. “I walked over and signed up on the spot. I was the first Kiwi to sign up. Two of our other employees who work in administration, from Taupo and New Plymouth, are also doing the diploma.”

Garland says the course is mostly online and involves set reading followed with assessments. “You get five attempts at each quiz but must get 100% to pass. It’s fantastic that most of the work’s online so I can still work while studying," she adds.

“The AuCA family is great, the tutors are helpful and it’s easy to get help. Because I’ve worked in the field a long time, I have a bit of background knowledge so it’s not all new.

“I spend one to two hours a day studying after work or in my lunch break.”

There are also five workshops – three online and two practical workshops in Brisbane, Melbourne, Perth, Sydney or Auckland – where students learn hands-on about equipment and taking ear impressions. Garland did the first two-day online workshop from noon to 8pm NZ time.

Her two practical workshops are in Melbourne and the first in November 2024 coincided with her visit to New Zealand Hearing's new Australian clinics, Boutique Hearing in Wantirna South and Endeavour Hills.

Each student must do practical work in an audiology practice, supervised by an audiologist or audiometrist who fills in a logbook. They oversee the students performing diagnostic tests, tympanometry, otoscopy and hearing aid fitting

“The diploma has been the most popular course and is a mix of people, often with experience of hearing loss themselves or through relatives, and others working in reception in audiology clinics who are upskilling.”

Chedy Kalach Australasian College of Audiometry

Diploma of Audiometry students at a recent AuCA Melbourne workshop including audiologist teachers Dr Anne-maree Daley (far left) and Ms Katie Lian (far right front row).

Image:

AuCA.

Image: AuCA.

as part of a rehabilitation program. Wright is Garland’s supervisor.

“I’m trying to finish the diploma in a year,” she says. “It’s one of those careers where there’ll always be vacancies because the population’s ageing and the prevalence of hearing loss increases with age.”

Lived experience proves helpful

Students enrolled with AuCA span different age groups, with many being in their 20s. Mr Pat Biro is one of those. The 23-year-old is from Wonthaggi in country Victoria.

While studying a Bachelor of Science at Federation University in 2023, he was working as a disability support worker.

“I find it rewarding as helping people is what I want to do,” he says. “I’ve had congenital deafness in one ear since childhood so have seen audiologists from a young age and always found them very helpful.”

Biro started the Diploma of Audiometry in March 2024 and is still working in disability support. “It’s well delivered, staff are helpful, knowledgeable, respond promptly and support you through the work,” he says.

“There’s an online forum where you can ask questions, and the study is a manageable number of hours which fits around work. Being self-paced means you have to be motivated though so I make sure I do at least one hour study a day and a few at weekends.”

His logbook so far for supervised work at a local audiology practice covers pure tone audiometry, speech testing and ear wax removal.

“I’m quiet, so I need to learn skills for doing a case history. I sat in on one testing and audiometry review where the patient was potentially motivated to get hearing aids and the audiologist was explaining things were safer with hearing aids,” Biro says. “I piped up that I had a hearing aid and I think that helped the client.”

Biro finds the study interesting.

“It’s one of those things you have to look into to see if you would enjoy it but audiometry is a job that has a lot of unique characters,” he adds.

He also likes that there are no set deadlines, except that reading and quizzes must be done before each workshop which covers those topics.

AuCA's origins

AuCA was established by Mr Chedy Kalach and Mr James Gibbins, founders of the country’s largest trainer of optical dispensers – the Australasian College of Optical Dispensing (ACOD) – to deliver quality training and continual professional development opportunities.

“We’ve had decades running training in the optical field and worked that out through trial and error so the audiometry college has the benefit of that experience,” says Kalach, AuCA’s director.

“This first year has been great, we’ve hit the market and built on it and feedback has been nothing but positive. The diploma has been the most popular course and is a mix of people, often with experience of hearing loss themselves or through relatives, and others working in reception in audiology clinics who are upskilling.

“We’ve had one group working in OHS at a mining company do our short occupational course for workplace hearing tests, and a cohort’s undertaking Certificate IV in Audiometry.”

General manager Ms Heather Joseph says highlights have included the launch, introducing AuCA through HPA, being welcomed by the industry, attending ACAud’s Cairns congress and the NZAS conference.

“Extending the college to New Zealand is already proving to be successful, and we've had several New Zealand students attend the November practical workshop in Melbourne,” Joseph says. “The first face-to-face workshop in New Zealand will be in Auckland in April.

“The 10 workshops run so far in Australia are another highlight, with students and trainers enjoying and benefitting from the opportunity to meet and engage in discussion around the content being delivered.”

Kalach also had a major role in securing Australia’s first review of audiometry

qualifications in a decade. This will address critical issues facing the industry including evaluating and updating diploma and certificate qualifications to ensure they reflect technological advancements and align with industry needs and regulatory requirements. AuCA had already modified its curriculum from the existing TAFE curriculum, he says.

“Our audiologists spent 18 months developing questions for the quiz bank which randomly spits out questions leading to assessments,” he adds.

A further achievement was the college being approved as a NSW Government ‘Smart and Skilled provider,’ saving students significant amounts on course fees. The move allows government subsidises for eligible NSW students meaning the college can offer discounted fees saving students thousands and, in some cases, up to $5,000.

Kalach says this will help address a nationwide skills shortage in the field. He continues to lobby other state governments for similar subsidies.

Other developments include supporting work led by ACAud inc HAASA to have audiometrists classified under their own Australian and New Zealand Standard Classification of Occupations code rather than the medical technician code. AuCA’s other staff are education supervisor Ms Jessica Wagenfeld, and audiologists, course co-ordinator Ms Katie Lian, audiometry educator Dr Anne-maree Daley and audiometry trainer Ms Lian Gijo.

ABOVE L to R: AuCA staff including Dr Anne-maree Daley, Ms Jessica Wagenfeld, Mr Chedy Kalach, Ms Heather Joseph and Ms Lian Gijo.

AuCA student Pat Biro studying at home.

Image: Pat Biro.

Image: AuCA.

Online audiology conference a hit

The Audiology Australia Online Conference enabled delegates to upskill and gain CPD points from their home or clinic, with recordings and CPD still available until 19 January 2025. The conference will continue to run every two years.

Audiology Australia’s Online conference on 24 and 25 October 2024 was a hit with delegates learning about many topics relevant to ear and hearing care.

“I am delighted with the response to this year’s contemporary audiology program headlined by international and national field leaders,” CEO Ms Leanne Emerson said. “This event is part of our continuing commitment to offer flexible, practical, contemporary CPD to members and Australian audiologists that works around life and its challenges in and beyond the clinic.”

National Acoustic Laboratories (NAL) researchers, Dr Bec Bennett, Dr Padraig Kitterick and Ms Taegan Young, discussed turning routine practice into evidence-based best practice. Young cited a study which surveyed more than 700 health professionals about views on evidence-based practice. It revealed that while 96% felt evidence-based best practice was a good idea, only 42% turned to the literature when making a difficult clinical decision.

Young said NAL was reviewing its Client Oriented Scale of Improvement (COSI) clinical tool used by clinicians to set goals with clients that are relevant to their hearing needs. The client and clinician choose SMART (specific, measurable, attainable, realistic and time bound) goals that are reviewed later, with both practitioner and patient agreeing on a score for their degree of change and final listening ability.

While the COSI is a popular clinical tool in Australia and worldwide, it has not been updated since its development in the late 1990s, she said. To review its use in audiology clinical practice, Young and her NAL colleagues took a multifaceted approach, conducting one on one interviews, observing appointments, reviewing literature and analysing COSI goal data from a major hearing service provider using AI.

“NAL reviewed data of more than one million COSI goals, representing

over 400,000 clients and more than 1,200 clinicians. Only 8% of goals were marked as achieved,” Young said. “Most clinicians did not routinely give clients a copy of goals to take home. These, and other insights from the COSI review, will support the development of an updated COSI tool, the COSI 2.0.

“COSI 2.0 will have more relevant and achievable goals based on a new goal setting framework, devised by NAL, built around the client’s active participation in goal setting.”

She advised audiologists could take a more client centred approach by avoiding using jargon in patient discussions and discussing the purpose of goal setting with patients.

Discussing barriers and facilitators to app use, Dr Bennett said that in 2015 there were about 200 health apps in the audiology space and this had doubled to 400 in 2020. They were grouped into education and information sharing, hearing assessment, rehabilitation, social enrichment, and other assistive tools to manage the environment.

“Using audiology apps can be cost effective and time saving. They can improve client outcomes, including quality of life and social connectedness,” she said. Barriers to use included lack of training and resources, cost, time for clinicians to learn about apps, and client frustration including with logins or not having compatible devices.

One NAL study of 769 adults aged 40 to 75 with hearing loss found half used health apps but barriers included cost, safety, privacy and sound quality. “If health professionals recommended an app, clients were more likely to adopt

Above: Speakers were, top from left, Dr Bec Bennett, Dr Nadine de Alwis, Yoav Fisher and Dr Jack Holman. Bottom, from left, Dr Padraig Kitterick, Kate Lewkowski, Dr Fiona McKenzie, Associate Professor Alexander Saxby, Dr Joaquin Tomas Valderamma Valenzela, and Ms Taegan Young.

it, so you guys hold the power,” Dr Bennett said.

“More than half of study participants wanted clinicians to tell them about apps that might benefit them, and then be left to download and use them themselves; whereas 20% wanted their hearing health professional to help set up the app and 22% wanted their health professional to collaborate in monitoring their progress with the app.”

The study also surveyed 149 audiologists and audiometrists across Australia, finding two-thirds recommended apps to most clients, with the other third refraining from recommending apps due to assumptions about clients’ abilities, age, lifestyle or behaviour.

“Clinicians should not act as a gateway to providing information, but rather be patient-centred; inform all clients of options available to them then let clients choose for themselves” she said. Some good apps included MindEar tinnitus CBT, Happy Hearing dealing with hearing loss, NALscribe live captioning, Braci sound alerts for doorbells and phones, Smiling Mind for mental health and Ambient Menu for quiet dining, she added.

Dr Kitterick discussed fitting hearing aids to benefit clients with significant hearing problems but ‘normal’ audiometry. “Pure tone thresholds alone should not be the only thing considered when determining the potential benefit from hearing devices,” he said.

“Research suggests that while there are an estimated 38 million people in the US with hearing loss, there are an estimated 25 million people who don't have audiometric hearing loss but report significant problems with their hearing.”

Data from audiology clinics in Australia suggested a significant number of people attending clinics for the first time had significant hearing needs but many had normal audiometry, he added.

“A large proportion of people who need help are told they have normal hearing,” Dr Kitterick said. “While that may be good news for some people, we should also challenge the notion that audiometric hearing loss when measured at the usual frequencies in the clinic is a necessary condition for someone to experience hearing problems.

“Research increasingly demonstrates that people with audiometrically normal hearing can benefit from hearing aids if they have hearing problems.”

Pure tone audiometry was also a poor predictor of benefits of hearing aids, he said, adding studies showed the biggest predictor of benefit was the level of hearing difficulties a client reported and how tired and fatigued they feel because of those difficulties.

Workplace noise and occupational tinnitus

Perth audiologist and epidemiologist Ms Kate Lewkowski discussed workplace noise exposure and occupational tinnitus including findings from the Australian Workplace Exposure Survey (AWES) – Hearing. Over seven years, the AWES-Hearing team has published seven papers on the results. The project involved Lewkowski spending a year compiling a database of everything that made a noise in Australian workplaces.

More than 5,000 people aged 18 to 64 were randomly surveyed to gain a true representation of the national population. Results showed that 19.5% of men and 2.8% of women were exposed over the 85dB noise level on any working day.

Hand-arm vibration and ototoxic chemical exposures can also contribute to hearing loss, she said.. The AWES-Hearing study found the most common workplace ototoxic chemical exposures in Australia were to toluene, p-xylene, ethylbenzene, n-hexane, styrene and carbon monoxide. These can be found in petrol, glues, jet fuel, fibreglass, and vehicle exhaust. Lewkowski said these exposures can be found in transport, driving, welding, mining, manufacturing and construction industries.

The survey found four out of five workers who were over the noise limit (LAeq,8h ≥85 dBA) were also exposed to at least one ototoxic chemical at work. The most common expsoure was carbon monoxide, commonly from vehicle exhaust.

“Studies have shown that exposure to ototoxic chemicals and noise can increase the risk of hearing loss,” Lewkowski said.

There are hundreds of suspected ototoxic chemicals but only a few have been studied, she said. More research needed to be done to examine how exposure length and dose affects hearing loss and if co-exposures (e.g. to noise) increase the risk, she added.

She said hand-arm vibration exposure could occur from tools such as jackhammers. “In Australia, we estimated that 6.5% of all men have hand arm vibration exposure in the workplace,” she added.

The AWES-Hearing data showed power tools and equipment were the major source of noise exposure. Lewkowski said an initiative to reduce noise levels of specific tool groups could save tens of thousands of workers being exposed over the daily noise limit.

The survey was Australia’s first to document the nation’s tinnitus prevalence in the workforce. It found one in four workers or 2.4 million people experience tinnitus with 5.5% or half a million people suffering constant tinnitus.

“Mechanics and drivers were the main occupations to report tinnitus, followed by farming, trades and construction workers,” she said.

Men are more likely to have constant tinnitus. Even after adjusting for worker characteristics, including occupation. the odds of having constant tinnitus were still 57% higher for men than women, she added.

Older men were more likely to report constant tinnitus with one in six men aged 55 to 64 affected.

Workplace noise was linked to tinnitus, as were exposures of carbon monoxide, lead, and toluene, she said.

TOP & ABOVE: Dr Joaquin Tomas Valderamma discussing emerging techniques; Conference MC Jenny Smith from AudA (top left) with NAL speakers (top right) Taegan Young (bottom left), Dr Bec Bennett and Dr Padraig Kitterick.

Images: Prime Creative Media.

"NAL reviewed data of more than one million COSI goals; only 8% were marked as achieved. Most clinicians did not give clients a copy to take home. These insights will support development of COSI 2.0.”

Medical management of conductive HL

Melbourne ENT surgeon Dr Nadine de Alwis detailed medical management of conductive hearing loss in children. “Audiologists are often first responders so it’s important to recognise red flags,” she said. “If children are not putting two words together at age two, be concerned.

“Middle ear infections are very common and by school age, most kids will have had one episode of acute otitis media (AOM).

“If it’s acute AOM, you should see a red, bulging tympanic membrane (not just red). Most children resolve within 24 to 48 hours with just analgesia but if not resolved in three days (after starting antibiotics) and the child is unwell, they should be referred to emergency or urgent ENT.

“Post AOM, half will have a middle ear effusion at four weeks but 90% will resolve by 12 weeks.”

Dr de Alwis said children who are not high risk can have paracetamol +/- ibuprofen +/- lignocaine ear drops (if nil perforation) for the first 24 to 48 hours. “If fever continues, an antibiotic script from a GP is required. Bilateral AOM requires antibiotics,” she added.

While the AA-OHNS guidelines suggested 40mg per kg per day oral amoxycillin, often GPs were giving 15-20mg per kg, “half the strength of what we would recommend”. “If the child is not improving, this could also be a reason,” she added.

She advised recurrent AOM (three cases in six months or four in 12 months) should be referred to an ENT. “Check to ensure it is not referred pain from teeth grinding or tonsillitis,” she added.

Suggestions to reduce recurrent infections included reducing dairy intake and avoiding swimming. “Get rid of the dummy by three months, definitely six months, and encourage kids to blow their nose,” Dr de Alwis said. “There’s low level evidence that probiotics reduce recurrent AOM and the Otovent balloon device, three times daily may help recover eustachian tube function.” Due to long waiting lists for public speech therapy via NDIS consider

referring early, she advised.

“Grommets should be kept dry initially for six weeks, then long term avoid soapy water - the surfactant in soap means that soapy water will go through the grommet,” she said.

Otitis externa (OE) was becoming more common with teens using AirPods because they reduce ventilation of the ear canal, Dr dr Alwis added. “Suspect fungal OE if ears are itchy and ‘wax’ is building up quickly.”

When referring to a GP, she advised audiologists could write they highly recommend an ENT referral.

Emerging techniques

Dr Joaquín Valderrama Valenzuela, from Spain’s University of Granada Department of Signal Theory, reviewed the fundamental principles behind standard neurophysiological methods based on electroencephalogram (EEG) recordings, such as auditory brainstem responses (ABR) and frequency-following responses (FFR). These are commonly used in hearing clinics to evaluate broad-band and narrow-band hearing detection, respectively.

“While these standardised measures provide relevant audiological information about a patient’s ability to detect sounds, other emerging techniques enable evaluation of higher levels involved in communication, such as discrimination (which can be used to evaluate binaural hearing pe rformance), identification (useful to assess cognitive processes such as selective attention), and even, speech comprehension,” he said.

“While these new methods may take time to reach clinical practice, new solutions are required to characterise hearing difficulties that are often hidden under normal audiograms.”

Dr Jack Holman from the University of Nottingham said hearing loss could impact emotion, emotional response to sounds and affect the way people could identify emotion in others.

Research comparing the impact of hearing loss and hearing aids on experienced emotion in listening situations, social connectedness and pleasantness of interactions found "hearing aids restored the emotional experience of everyday life to near normal levels", he said.

“This was true for most people but for some there was little or no difference," he said.

Research into social factors showed that hearing loss was related to smaller social network sizes, increased social isolation and loneliness, he added.

A fatigue study found that two weeks after hearing aid fitting, fatigue changed significantly for the better as did social activity, although both plateaued. Dr Holman said asking patients about challenges they faced and resources they have could help assess social and emotional wellbeing along with questionnaires.

Mr Yoav Fisher from Heidi Health shared how AI scribes are helping audiologists transform their practices by streamlining documentation, enhancing client interactions and boosting day-to-day efficiency.

He said Heidi Health helped them save hours a day on patient note-taking, allowing more time for patient care and less for paperwork.

He also addressed concerns around privacy and data security, stating Heidi Health hosts all data locally in Australia, and data is encrypted and de-identified to uphold highest standards of patient confidentiality.

Missed the conference?

You can still gain eight hours of CPD when you register to watch the full conference on demand until 19 January 2025. Register at https://audiology.eventsair.com/audaonline24/register-now

Taegan Young National Acoustic Laboratories

Image: Prime Creative Media. Image: Audiology Australia.

ABOVE: ENT surgeon Dr Nadine de Alwis says a red, bulging tympanic membrane (right) is acute otitis media.

Hearing Practitioner Australia is the only dedicated business-to-business publication for the nation’s hearing industry. Established out of a desire for premium, local and independent content for audiologists, audiometrists, otolaryngologists/ENTs and other Australian hearing professionals, HPA brings industry-specific reporting and analysis, in addition to the latest in news, business, products, policy, and research, plus more.

Audiology: a lifelong passion

Independent Audiologists Australia hosted its first in-person event since the COVID pandemic in Melbourne in October 2024. Fifty audiologists from around Australia and New Zealand heard thought-provoking and practical presentations to help their business and clinical decision making.

Professional identity, patient-centred care and ethical practice were the main themes of Independent Audiologists Australia (IAA)’s Audiology for Life! seminar at Melbourne Business School on 11 October.

Delegates were asked, ‘What’s your why?’ and put forward varied reasons why they became an audiologist and why they continue this passion.

IAA president Dr Tegan Keogh and vice-president Dr Greg Butcher welcomed attendees who heard presentations featuring person-centred care and community-centred care as recurring themes.

MC Professor Melinda Edwards, a lawyer, ethicist and Ethics Advisory Services managing director, said businesses were previously dominated by and concerned with just making money.

“The whole mood has changed, businesses need to step up and do more than make money but contribute to a world we want,” she said.

She advised steering culture to an environment of psychological safety where everyone could contribute, feel safe to speak up and had each other’s backs. Weekly meetings could give staff time to talk, discuss “how we lived our values this week and what we did for the community”, which would help staff see they‘re part of those bigger decisions.

Boards and businesses were increasingly conscious of investing that prioritises environmental, social issues and corporate governance, and the public, especially the younger generation, were urging this adoption.

“Even small businesses who can connect with that purpose have opportunity to do more and have more people invest in their success,” Prof Edwards said. “Engaging intentionally is the key to ethical business operations; you align business decisions with ethics, rather than just reacting and putting

LEFT,

L to R: IAA executive officer Julie Watts and speakers audiologist Dr Dunay Schmulian and MC, lawyer Professor Melinda Edwards.

out fires. You can ask does this align with what we want to build?

“Align systems, processes and ensure KPIs align before putting them in; there should be human intelligence before artificial intelligence as we get ethics and values from humanness.”

Mr Damian Attia, business development manager from the seminar’s platinum sponsor Heidi Health AI medical scribe, said the business was created by a former Melbourne surgeon and many executives have clinical backgrounds. “This is what differentiates Heidi. It asks your speciality and tailors notes to your language so as a clinician you don’t need to redo notes,” he said.

He said practitioners still needed to check notes before uploading to the patient record and must capture patient consent.

Dr Dunay Schmulian, clinical audiologist at Cotton Tree Audiology, and clinical lead at Sunshine Coast University Hospital, provided the context and case for professional supervision as a critical element to manage contemporary, evidence-based, person-centred clinical care. She acknowledged that often, independent practitioners were tasked with more complex cases.

“Clinician wellbeing is what has been missing from professional supervisory practice," she said. “Practitioners need a supportive environment to manage burnout and stress.

“Supervisors should ensure practitioners provide person-centred, ethical care every time and be alert to symptoms of burnout and compassion fatigue.

“Allocate CPD points for professional, not only clinical supervisory roles: for all clinicians, not only new graduates.”

Dr Schmulian suggested frameworks on how to review, reflect and critique case work, while replenishing clinician morale and wellbeing, extending the premise to advocate to professional bodies that professional supervision should be reflected in CPD.

Audiologist Ms Geraldine Todd, sales director for Widex Australia and New Zealand, another Platinum event sponsor, said the audiology retail sector was navigating a dynamic and highly competitive environment, with consumers increasingly informed, educated, tech-savvy and proactive about their health. “Many have started their journey online before visiting your clinic,” she said. She said that in 2023 WS Audiology conducted a survey of 1,026 people aged 55 to 90 to better understand consumer awareness of hearing services. Results highlighted a strong correlation between brand awareness and the number of retail locations. “Encouragingly, awareness of independent clinics is significantly increasing; consumers are beginning to recognise the breadth of services your clinics offer, and that’s something you can be proud of.”

The audience listening intently in the lecture theatre.

Advice to boost uptake included digital and traditional marketing – a professional website with an efficient online booking system, complemented by a strong presence on social media and Google. “The moment a client enters your clinic they should be immersed in an exceptional in-clinic experience where, they feel they’re in a high-value, high-quality environment,” she said. “This includes providing professional, personalised care and offering opportunities to trial cutting-edge technologies.

“Word-of-mouth referrals is one of the most powerful forms of effective marketing and promotion for your clinic.” Todd suggested a referral or business card with a QR code linking to the clinic’s booking system.

“Encourage satisfied clients to share it with someone they know who might benefit from your services,” she said.

to live. Even within Australian cities there was nine-to-15-years difference, he said.

More complex disease profiles and technology advances meant much health care occurred out of hospital. “Health care is a team sport but we’re not funded or trained to work in teams,” he added.

Supported direct ENT referral

Keynote speaker, ABC medical journalist, broadcaster and author Dr Norman Swan said community-centred care was as important as patient-centred care. He also urged value-based care which promoted ethics and gave patients autonomy.

“Are you providing value to your patient for the money, time and effort involved?” he asked. “Thirty to 40 per cent of what we do (in health) is waste (X-rays, tests, operations.) Unless you are value-based, there will be waste in audiology practice too; where is it? And if you practise value-based care, is there evidence behind your practice which supports value-based care?”

Dr Swan said although Australia’s health system was better than America’s, it was a lie to say we have universal health care when there are long waiting lists and unequal access with some people dying sooner due to inability to pay.

The postcode lottery where location could decide life expectancy meant a 40-year difference in lifespan between residents of the worst and best places

Dr Swan said audiologists should be able to refer directly to ENT surgeons. “There is no reason why audiologists who are registered can’t be trusted to do that but the first step is registration,” he said. “Having referral rights and treatment rights would make a difference. What audiologists are doing is essential work but you want a stronger, more meaningful role in the community.”

Ms Jane Lee, Deafness Forum Australia’s national manager of health programs, detailed her discussion paper on previous Hearing Services Program reviews. “Over three decades there have been many HSP reviews, a lot focusing on administrative and operative functions, but what about the patient and enhancing patient outcomes?” she asked.

She suggested improvements could include clearer information and objectives, a better website, prioritising participants’ outcomes and more telehealth. More could be done in aged care, rural, low income and Indigenous communities to improve access. “The overall framework should focus on how to improve participants’ outcomes,” she said.

Dr Emma Laird, project lead at Soundfair, detailed development of a web app – Luminear – to support the wellbeing of people living with hearing loss. The Soundfair and University of Melbourne project has included human-centred design and preliminary data suggests it significantly reduces anxiety, depression and stress for participants. A randomised, controlled trial will investigate further, Dr Laird said.

Dr Gerard William, founder of Hear with Me Audiology Care, said person-centred care included empowering clients to choose their own rehabilitation pathway by supporting them with clear explanations, involving loved ones where possible, and prioritising a therapeutic relationship involving compassion.

“Your systems should go beyond this and set up to be person-centred from their first interactions - such as a website inquiry or phone call, through to the last interaction - including payment and conversations afterwards," he said. "Aim to finish on a high as research suggests people tend to remember their last feeling. About 20% of people with hearing aids don’t use them, so there’s always room for all of us to improve aspects of our care. How can we create 10/10 experiences for them?

"Can we give patients better and more accessible information, be more transparent with them in our decision making, or listen to them- as we would like them to if we were in their shoes?”

Audiologists networking (from left) Khatija Halabi, Caron Brouwers, Taylah Vines-Chapple, Geraldine Todd and Yazdaneh Galt.

The trade expo was a hive of activity.

40 years of audiometry nurse education

The Audiometry Nurses Association of Australia celebrated its 40th annual conference in October 2024. HPA covers the event’s key takeouts and gains an insight into the association itself and the profession it advocates for.

Audiometry nurses began as a profession in New South Wales stemming from a need for hearing services in community health. Annual conferences and workshops started in the early 1980s to provide ongoing education for the nurses, and in 1990 the Audiometry Nurses Association of Australia (ANAA) formed.

In 2024 about 50 delegates gathered at the Royal Hotel Queanbeyan, NSW, from 23 to 25 October for the ruby anniversary conference.

Audiometry nurses are registered or enrolled nurses who have done a post graduate qualification in audiometry, explains new ANAA president Ms Kate Norton.

Norton is an audiometry nurse of 24 years’ experience who works for Northern NSW Local Health District at Grafton Community Health and Goonellabah Child and Family Health Service.

“Audiometry nurses mainly assess children and can work anywhere in Australia but are concentrated in NSW in community health,” she says. “We have a shortage due to older workers retiring and younger people not joining the profession.

“There’s a lot of autonomy as most of us work as sole practitioners. We do everything from assessments to referrals including referring those with permanent hearing loss to Hearing Australia. It’s a rewarding career especially when you see the results of children with hearing loss who you’ve helped.”

Most of the association’s full members are from NSW but some are from the ACT and associate members include other hearing practitioners such as audiologists and audiometrists.

Conference highlights

During the recent 40th annual conference, outgoing president Ms Tracy Hawes welcomed members and Aunty Matilda welcomed them to country.

Audiometry nurses Ms Kirsty Biddle from Inverell and Ms Lucy Rindo from Tamworth spoke about a two-day workshop they organise for audiometry nurses from the upper Hunter New England Local Health District. They arrange educational sessions which coincide with a technician coming to Tamworth to calibrate all audiometry equipment for the area. This allows for minimal downtime in conducting audiometry clinics.

Delegates mapped where all audiometry nurses are based and perform clinics, serving as an opportunity for nurses to meet colleagues who work in their own or neighbouring local health districts.

Conference convenor, Ms Sharyn Wilkinson, a community health audiometry nurse for NSW Health at Queanbeyan and ACT Health in Canberra, gave an overview of tympanometry.

“We have new and older audiometry nurses who benefit from expanding their knowledge on the basic processes of audiometry,” Norton explains.

Otoacoustic emissions added

Otoacoustic emissions (OAEs) is a fairly new area that has been added to the audiometry nurse's battery of testing,

Audiologist Ms Jan Pollard, chief audiologist at Sonic, presented an overview of OAEs and explained the difference between transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs).

Delegates also participated in an otoacoustic emissions workshop, learning about different equipment used for OAE testing and otoscopy, practising on each other.

Sonic equipment, Auditdata, Welch Allyn (Baxter) and Natus exhibited at a trade expo and presented on their companies and products.

This included audiologist and clinical sales specialist from Sonic Equipment, Ms Michelle Wallace, discussing play audiometry and providing tips for assessment of children.

With a multidisciplinary approach common in audiometry nursing, speech pathologist Ms Vanessa Howden helped nurses determine when to refer children to a speech pathologist. Howden, from Queanbeyan Community Health, reiterated speech development at certain ages.

Audiologist Ms Brooke McIntosh discussed the HAPEE program (Hearing assessment program early ears) run by Hearing Australia to provide hearing assessments to Aboriginal and Torres Strait Islander children from birth until school commencement.

Ms Sharyn Wilkinson presented on assessing children with difficult behaviours, and the use of the PA5 free field audiometer for testing young children.

Otitis media was a popular topic and Wilkinson also presented on the UK National Institute for Health and Care Excellence (NICE) review of otitis media guidelines for children under age 12 on behalf of Ms Kate Newall, nurse audiologist.

Lessons learnt treating otitis media in the Top End was the presentation given by audiologist Ms Kris Tregenza from Apunipima Cape York Health Council, while audiometry nurse Ms Gisella Laughton from Springwood NSW gave an overview of OMOZ 2024 conference in Newcastle.

ABOVE, L to R: Delegates at the conference dinner, some dressed in themed ‘80s gear; ANAA’s executive committee, (from left) Helen Gee, Belinda Wilson, Gisella Laughton, Kate Norton, Kirsty Biddle, Sarah Austin and Lee Lewis; Audiometry nurses enjoying fellowship; Holding their clinical advisor in audiometry nursing accreditation certificates from ANAA are (from left) Lee Lewis, Jennifer Adams, Karen Harris and Helen Gee.

Case studies were detailed by Ms Lee Lewis and Ms Karen Harris, audiometry nurses accredited as clinical advisors enabling them to supervise audiometry nursing students during clinical placement.

Laughton relayed the disturbing statistic presented at OMOZ that otitis media lasts for about three years in an Aboriginal child versus three months in other children.

Canberra audiologist Ms Anne-Marie Crowe from Hear Life Canberra discussed the cochlear implant journey from newborn hearing screening to diagnosis of hearing loss and implantation. She also brought a cochlear implant to show delegates.

Hearing Australia audiologist Ms Kristen Sutcliffe discussed when the organisation was established, what programs it offers, who is eligible for its services and factors affecting outcomes of children living with hearing loss.

The Systematically Together Overcoming Racism Model (STORM) research project is developing a tool to determine if racism is present in the hearing health workplace and work to decrease it. Mr Luke Halvorsen, senior project officer in the Indigenous Health Unit at the University of Newcastle, presented on the project.

Newborn hearing screening in the ACT was the topic for audiologist Ms Fran Freeman from ACT Health Directorate. She showed the Maico Beraphone easy screen machine used in the ACT for AABR. If a baby has three refer screen results, they also have a cytomegalovirus (CMV) saliva test. CMV and newborn screening were topics also covered by Ms Jenny Bursell, the Newborn Hearing Screening Coordinator in Canberra.

"We have a shortage of audiometry nurses due to older workers retiring and younger people not joining the profession. It’s a rewarding career especially when you see the results of children with hearing loss who you’ve helped."

University of Newcastle immunology and microbiology researcher, Ms Olivia Carroll, is studying biofilms in the middle ear and said the research team was looking at adding DNA to middle ear fluid to break down biofilm in the hunt for a cure for middle ear disease.

Ms Linlin Ho, Australian College of Nursing course coordinator, discussed a recent revision of the audiometry nursing course, explaining changes.

Association history

In 1982, Sydney audiometry nurse Ms Maggie Thompson started two-day conferences and workshops to provide ongoing education to audiometry nurses after they completed their studies. The events were at Camperdown Children’s Hospital with the sponsorship of Paxton- Barrand Hearing Aids in Sydney and Nestle.

Since then, a conference has occurred each year except for two years during the Covid-19 pandemic. The audiometry nurses organised and ran the conferences which have mostly been in NSW but several have also occurred in the ACT and Coolangatta, Queensland.

In 1990 a committee was formed with Ms Kathy Stoddart as president, Ms Maggie Thompson (life member) as treasurer and Ms Kathy Challinor OAM (life member) as editor.

At its first annual general meeting in 1991 the group voted to become an incorporated association, the Community Audiometrist Association, but in 1995 the name changed to the Community Nurse Audiometry Association. In 2011 it fell in line with other nursing organisations to become the Audiometry Nurses Association of Australia.

A new committee was elected at the annual general meeting at the 40th conference comprising president Ms Kate Norton, vice president Ms Belinda Wilson, secretary Ms Kirsty Biddle, treasurer Ms Sarah Austin, committee members Ms Helen Gee and Ms Gisella Laughton and editor, Ms Lee Lewis. Delegates dressed in ‘80s gear for the conference dinner which had a 1980s theme, keeping with the birth of the event.

of Australia

Kate Norton Audiometry Nurses Association

“Due to most audiometry nurses working as sole practitioners, a gathering like this creates support networks and long-lasting friendships amongst our peers,” Norton says.

Images: Audiometry Nurses Association of Australia.

ACOUSTIC NEUROMAS DO NOT ALWAYS NEED ACTIVE TREATMENT

A/PROF NIGEL BIGGS explains why many patients with small acoustic neuromas can be safely monitored.

RECENT STUDIES HAVE STARTED TO FOCUS ON QUALITY-OF-LIFE OUTCOMES PRIORITISING PRESERVATION OF NEUROLOGIC FUNCTION OVER CURE.

A/PROF NIGEL BIGGS

Vestibular schwannoma, which is also known as acoustic neuroma, is a benign tumour of the vestibu locochlear (eighth) cranial nerve. Though its occurrence is uncommon (about 8% of all intracranial tumours) it can represent a significant health risk and burden to the individual and to the healthcare system. Treatment dates to the first surgery undertaken in the 1890s. This has evolved over the second half of the 20th century with further refinements in surgery and development of stereotactic radiation to control tumour growth. Over the past 30 years there have been extensive publications on the advantages and disadvantages of treatment modalities for this tumour and argument over which gives the best outcomes in tumour eradication and facial nerve results.

The classic presentation of these tumours is an asymmetric sensorineural hearing loss. The size of tumour presentation however is very variable ranging from tiny tumours two to three millimetres in size to those significantly compressing the base of the brain, posing an imminent threat to life.

outcomes prioritising preservation of neurologic function over cure, changing the treatment dynamic of these lesions.

TUMOUR CONTROL AND FACIAL NERVE

PRESERVATION

When required, treatment of these tumours is complex and requires a multidisciplinary approach. As the tumour arises on the eighth nerve it is usually difficult to successfully treat these tumours without severe or total loss of hearing. The primary aims of treatment are control of the tumour and preservation of the facial nerve which is usually stretched over the surface of the tumour. It is recommended that due to the complex nature of treatment, these lesions be treated in institutions that have a large experience in their management.

Widespread access to sensitive imaging such as MRI scans has increased the detection of small tumours, often in older individuals. It is known through many natural history studies that many of the smaller tumours often grow very slowly and a significant percentage do not seem to grow at all. This has led to the questioning of the need for treatment in many cases. More recent studies have also started to focus on quality-of-life

As an institution with more than 40 years of experience in treating acoustic neuromas, St Vincent’s Hospital Sydney has many patients on an active surveillance (watch and wait) program. From a personal cohort of almost 800 patients, we have more than 300 patients being monitored. Monitoring involves regular MRI scans – initially at yearly intervals – as well as clinical review, which can be in person or as a tele-consult.

RETAINING USEFUL HEARING

Seventeen per cent of these patients have been continuously monitored for more than 10 years and a smaller number over 20 years. It is evident that a number of patients will never need treatment in their lifetime. One of the issues with monitoring though is the risk that hearing will deteriorate over time.

Analysis of our data in more than 250 patients found 63% had retained useful hearing on last review. This compares favourably to radiotherapy (>50%) and surgery (>90%). From a hearing perspective, patients often end up using CROS type hearing aids as loss of integrity of the cochleovestibular nerve prevents cochlear implantation in most cases. The quality-of-life studies have

demonstrated that any intervention –radiotherapy or surgery – does impact on a patient’s long-term quality of life. These impacts include hearing loss, imbalance, potential facial nerve weakness and pain. Radiotherapy (sometimes known as gamma knife) has slightly better outcomes in small to medium tumours but cannot be used for large tumours where surgery is the only option.

The final concern is what proportion of patients being monitored develop growth in their tumour requiring treatment. We have also analysed our data on patients being monitored and have demonstrated over a five-year period, that approximately one-quarter of patients will require treatment of some nature. The outcome of treatment in this group is no worse than those who require treatment initially.

With modern imaging and regular review it is clear many patients with small acoustic neuromas can be safely monitored with minimal impact on their quality of life.

ABOUT THE AUTHOR: A/Prof Nigel Biggs is chairman of the Department of Otolaryngology, Head and Neck and Skull Base Surgery at St Vincent’s Hospital, Sydney with a special interest in otology and skull base surgery. He has extensive experience in the management of acoustic neuroma having operated on more than 500 lateral skull base cases.

PATHWAYS FOR UPSKILLING AND CONTINUING EDUCATION

In the second of a two-part series, DR ANNE-MAREE DALEY discusses options for training and continuing education particularly upskilling reception staff to audiometrists.

WITHOUT SUPERVISORS, THE PROFESSION OF AUDIOMETRISTS AND AUDIOLOGISTS WOULD CEASE TO EXIST.

DR ANNE-MAREE DALEY

n completing the Diploma of Audiology, students graduate as audiometrists and can pursue full membership with their professional body, The Australian College of Audiology (ACAud inc HAASA). The college offers a variety of courses, workshops and conferences to support continuing education for audiometrists and students. These programs cover the latest advancements in audiometry, hearing aid technology, patient care and tele-audiology, among other topics.

Several other courses are available that can enhance specific skill sets in audiometry.

The Australasian College of Audiometry (AuCA) offers all three courses listed below in flexible modes for the student, allowing students to continue working as reception staff while simultaneously studying audiometry.

The Diploma in Audiometry is also offered by TAFE NSW.

1. HTL47415 - Certificate IV in Audiometry

2. HTL57415 – Diploma of Audiometry

This advanced program covers more in-depth audiometric techniques, hearing aid prescription, and evaluation. This qualification pertains to audiometrists who perform hearing assessments to detect hearing impairment and take appropriate action based on the test results. They may recommend further audiological or medical evaluations for clients and participate in care management and educational initiatives. At this level, audiometrists also provide and dispense hearing aids and/or other non-implantable devices to aid in hearing rehabilitation. Audiometrists may practise independently in medical, industrial, or retail settings.

3. Occupational Audiometry Course

supervision sessions and appreciate the opportunity to learn from the company’s most experienced clinicians. It is crucial for businesses to continue to support students with supervision when they are called upon.

Without supervisors, the profession of audiometrists and audiologists would cease to exist. Increasing the number of training programs and educational opportunities for aspiring audiometrists within businesses will help address the supply issue. This includes the option of providing students with the opportunity to undergo the audiometry program as an incentive to attract them to the field.

BELOW: An audiometrist testing hearing.

This certification represents the responsibilities of audiometrists who perform hearing assessments to detect hearing loss, refer clients for additional audiological or medical evaluation, and participate in care management and educational initiatives. Individuals at this level are not authorised to prescribe or dispense hearing aids and are not qualified to practise independently. This course is designed for those who want to learn how to conduct hearing tests and make necessary referrals.

The two-day Occupational Audiometry Course is in combination with an online learning module. It provides the student with the skills and knowledge required in accordance with the AS/NZS 1269.4:2014 Occupational noise management –Auditory assessment standards to conduct otoscopy, perform workplace hearing tests, and analyse and present test results accurately. This course best suits employees working in industries that require monitoring of employees’ hearing in an occupational noise setting.

On-the-job training and mentorship

Many audiology businesses provide in-house support and training including clinical training days and manufacturer learning support. They may also offer one-day workshops and conferences for continuing education, allowing students and experienced clinicians to update their knowledge bank and stay abreast of the ever-changing audiology industry.

THE IMPORTANCE OF SUPERVISION

Supervision is an essential component of the Diploma of Audiometry. Not only does supervision foster a strong working relationship among colleagues but it cultivates a supportive ethos within the company. Supervision for reception staff is convenient as they are already on site to observe or obtain hands-on experience.

Students benefit greatly from the invaluable guidance provided during

Providing hands-on training under the supervision of experienced audiometrists and audiologists is a practical approach that ensures audiometry students gain real-world experience and confidence in their new role. It is, at this time, that the business can ensure students are taught the ways of the business, ensuring they are aligned with the business’s specific needs, values and culture.

Upskilling reception staff and continuing education of audiometrists are essential for addressing skills shortages, enhancing career opportunities, maintaining high standards of patient care and operational efficiency, as well as supporting economic growth in Australia.

By investing in the development of their workforce and providing opportunities for professional growth and development, businesses and individuals can ensure they remain competitive, adaptable and at the forefront of the rapidly changing world of audiology.

Addressing this shortage is crucial for enhancing the quality of life for individuals with hearing loss, now and in the future, ensuring they receive timely and effective care and delivering the best possible outcomes for their clients.

ABOUT THE AUTHOR: Audiologist of 19 years Dr Anne-maree Daley is an educator with the Australasian College of Audiometry. She has published articles on hearing health in local newspapers and professional journals including co-authoring research in the Australian and New Zealand Journal of Audiology.

BUSINESS TIPS FOR STARTING YOUR OWN PRACTICE

LOREN MURRAY helps allied health practitioners streamline their administrative tasks so they can dedicate more time to patient care. Here she provides a step-by-step guide for hearing practitioners wanting to start their own practice.

WHILE SETTING UP INVOLVES CAREFUL PLANNING - FROM REGISTRATION AND COMPLIANCE TO MARKETING AND FINANCIAL MANAGEMENTTHESE STEPS LAY THE GROUNDWORK FOR A PRACTICE THAT THRIVES.

LOREN MURRAY

Starting your own private practice as a hearing practitioner is an exciting step that can lead to significant professional and personal growth. Whether you’re newly qualified or an experienced practitioner looking to branch out, understanding the essential administrative, financial, and marketing aspects is crucial for success. This guide covers everything you need to know to set up your practice, from business registration and NDIS compliance to marketing, insurance, and ongoing professional development.

1. Business registration and structure

The first step is registering your business with the Australian Securities and Investments Commission (ASIC). Choose a business structure that suits your needs, either a sole trader, partnership, or company. Each structure has its own implications for taxes, liability, and operational flexibility, so consider seeking advice from an accountant or legal professional to make the right decision.

2. NDIS registration

BELOW: Starting your own practice is an exciting milestone in your professional journey.

If you plan to work with clients under the National Disability Insurance Scheme (NDIS), obtaining NDIS registration is crucial. While not mandatory for all practitioners, it significantly enhances the services you can offer and your credibility. The registration process involves compliance with NDIS Practice Standards, requiring thorough documentation, including evidence of qualifications and policies to ensure quality service provision.

3. Insurance essentials

Protect your practice with public liability, professional indemnity, and business insurance to cover potential risks such as negligence claims or property damage. Consult an insurance broker who is experienced in health practices to find the right coverage.

4. Establishing a digital presence

A professional website is essential as your digital storefront, showcasing your services, contact details, and client testimonials. Invest in search engine optimisation (SEO) to ensure your practice ranks highly in online searches. A strong social media presence on platforms such as LinkedIn, Facebook, and Instagram can boost visibility and client engagement.

5. Setting up financial systems and billing

Set up a separate business bank account and use accounting software such as Xero or MYOB for tracking expenses and invoicing. Create a fee structure that covers your costs and aligns with industry standards. Implement a billing system using practice management software that handles scheduling, invoicing, and integrates with Medicare as well as health fund claims.

6. Compliance and documentation

Compliance with industry regulations is crucial to avoid legal and operational issues. Ensure your practice meets standards set by relevant bodies. Maintain meticulous client records, follow data protection laws, and stay updated on changes in compliance requirements.

7. Support from a virtual assistant

A virtual assistant (VA) can greatly enhance your practice’s efficiency by handling client intake, email management, and administrative tasks, allowing you to focus more on client care. A VA experienced in the allied health sector can streamline your workflows and help automate processes, such as appointment reminders and follow-ups, to improve productivity. Their support can help maintain a well-organised practice.

8. Marketing and networking

Attracting clients requires a comprehensive marketing strategy. Use digital marketing techniques such as content marketing, email newsletters, and social media campaigns. Build a referral network by collaborating with local clinics and allied health professionals. Engage with your community through workshops or local events to boost visibility. Networking at industry events and joining associations such as Allied Health Professions Australia can provide valuable connections and resources.

9. Ongoing professional development

Maintaining your skills through continuous professional development (CPD) is not just an industry requirement but also essential for personal growth. Attend conferences, workshops and webinars to stay up-to-date with advancements in your field. Incorporating evidence-based practices into your work will enhance client outcomes and reinforce your professional reputation.

Starting your own private practice is an exciting milestone in your professional journey, full of opportunities for personal and career growth. While setting up involves careful planningfrom registration and compliance to marketing and financial management – these steps lay the groundwork for a practice that thrives.

Embracing the support of VAs, leveraging technology, and building strong networks can help navigate the complexities and focus on providing top-quality care. This venture isn’t just about running a business; it’s about taking control of your career, making a meaningful impact in your community, and creating your success.

ABOUT THE AUTHOR: Loren Murray is director/ virtual assistant at Allied Admin Partners, providing online administration services for allied health professionals, along with a membership offering exclusive access to free resources and guides tailored for allied health professionals.

SOAPBOX

OPTIMISING HEALTH AND WELLBEING IN AGED CARE

the impact of dementia on quality of life, increasing behavioural and psychological symptoms (agitation, hallucinations, aggression and depression). This leads to increased use of pharmaceutical and physical restraint, communication barriers and social isolation, cognitive decline, higher care need and care costs. Hearing impairments also impact on carers, increasing social isolation, depression, relationship stress and care burden for both informal as well as paid carers.

Hearing interventions are effective in improving quality of life, functional ability, mental wellbeing and social participation, including for people living with dementia. Unfortunately, hearing impairments often go under-identified and under-treated, among people in residential aged care communities.

Reports identify critical shortcomings

According to the Royal Commission into Aged Care Quality and Safety Final Report: Care, Dignity and Respect, people in aged care settings do not receive regular hearing checks, and there is under-engagement between aged care and hearing services.

The parliamentary ‘ Still waiting to be heard’ report on the Inquiry into the Hearing Health and Wellbeing of Australians cited numerous

submissions from consumer and community organisations and identified high unmet hearing needs of older Australians in the aged care system. The report recommended service models be adjusted to better meet the needs of people in residential aged care. While up to 90% of people in residential aged care have a hearing impairment, less than 15% use hearing aids. Stigma, difficulties handling devices, as well as discomfort when wearing hearing aids contribute to poor uptake and adherence with devices.

Hearing aid uptake and use is even lower for people with dementia compared to those without dementia suggesting that additional barriers exist for people with dementia. Even when hearing aids are used, they are often poorly maintained, with up to 70% being faulty, having dead batteries, clogged vents, and volume, tubing or sound malfunctions. Background noise is particularly a concern for people with dementia, triggering confusion, behavioural changes (i.e. agitation and aggression) and non-adherence with hearing aids.

Barriers to effective hearing care

Our review of barriers and facilitators to hearing support for people with dementia in residential aged care found that people with dementia benefit from hearing interventions but need additional support to successfully use hearing aids and rely on staff to access hearing services.

The Royal Commission into Aged Care Quality and Safety report identified that the aged care workforce is under pressure and lacks key skills. We recently completed an international study involving more than 1,000 aged care staff and families in seven countries (UK, Australia, India, Bangladesh, Korea, Greece and Indonesia) to ascertain knowledge, attitudes and practice regarding hearing health for people with dementia in aged care settings.

Universally, we found that:

• knowledge regarding screening/ diagnosis/impact of hearing-cognitive co-morbidity was low;

• h earing impairment was mostly unaddressed, with no linked-up care pathways for hearing-cognitive health;

• a nd staff had a strong desire to implement better hearing care. Support for use of hearing aids is lacking due to lack of staff awareness, poor task delegation and lack of clear referral pathways. Staff report not prioritising hearing, insufficient training, high workload and nihilism all contributing to low levels of awareness and recognition of hearing as a priority.

The solution Supporting hearing care and quality of life of people with dementia in residential aged care settings is a critical national priority. Effective management and support of hearing loss in residential aged care relies on several factors including those concerning the residents themselves, the staff, the local environment, as well as the wider care ecosystem. Hearing care professionals must identify opportunities to work more closely with aged care providers to improve quality of life for people in residential aged care settings.

Note: references will appear in the online version.

Name: Professor Piers Dawes Affiliations: Director of the Centre for Hearing Research (CHEAR) and Professor of Audiology at the University of Queensland, and Professor of Audiology at the University of Manchester. Professor Dawes leads NHMRC-funded SENSEcog projects, working with people who have hearing and vision difficulties, aged care staff, families, and hearing and vision professionals to provide home-delivered sensory support to people living independently at home, as well as support for people in residential aged care.

Location: Brisbane, Queensland. Years in industry: 19.

“WHILE UP TO 90% OF PEOPLE IN RESIDENTIAL AGED CARE HAVE A HEARING IMPAIRMENT, LESS THAN 15% USE HEARING AIDS.”

Professor Piers Dawes.

Image: Piers Dawes.

ABOVE: The Royal Commission into Aged Care Quality and Safety found people in aged care do not receive regular hearing checks.

People on the move

graduated from Johns Hopkins University School of Medicine, is the second African American president in the academy’s 128-year history. He was elected by academy members and will serve a one-year term leading nearly 13,000 members who specialise in treatment of ears, nose, throat, and related structures of the head and neck.

Committee. The committee offers expert guidance on development and regulation of digital health technologies. Dr Bhowmik said he was honoured to support the FDA and contribute to the evolution of digital health. Starkey president and CEO Mr Brandon

of a Consumer and Community Involvement Panel

co-designing an Australian website and online national support service for hearing loss. The Sunshine Coast cochlear implant recipient and advocate is a motivational speaker on hearing loss and hearing technology and CICADA Queensland president. In this role he attends disability and other expos representing CICADA and lived experience of hearing loss. He recently hosted a Hearing Solutions Summit for patients and families and attended an advocates summit in Austria for MED-EL.

NEW AUDIOMETRIST FOR CONNECT HEARING

Medical Sciences in Iran in 2008, he gained significant 2023, Pourmotemed was executive manager and training manager of Interton Exclusive Distributor in Iran. In November 2023 he moved to Australia and began clinical practice with Connect Hearing in early 2024. He recently earned his QP and is embarking on the next phase of his career in Australia.

Bupa has appointed Mr Chris Carroll, Bupa managing director, health insurance, Australia, to CEO, Bupa UK Insurance. He will move to London in January 2025. Carroll joined Bupa in November 2020 as director, domestic retail portfolio, health insurance, before being appointed to his current role in March 2022. He has more than 25 years’ commercial experience including most recently as CEO of WS Audiology Asia Pacific. Ms Kate Williams, director, domestic retail portfolio, health insurance will be appointed to acting managing director, health insurance in Australia while a search is underway for a permanent replacement.

UK ROLE FOR BUPA'S CHRIS CARROLL

EVENTS CALENDAR

To list an event in our calendar please email helen.carter@primecreative.com.au

prevent deafness and hearing loss and promote ear and hearing care.

FEBRUARY 2025

HEARING BUSINESS ALLIANCE

Annual seminar Melbourne, Australia 28 February - 2 March hearbusiness.com.au

TINNITUS AWARENESS WEEK

Awareness campaign Australia and worldwide 3-9 February soundfair.org.au/tinnitus-awareness/

MARCH 2025

WORLD HEARING DAY

Awareness campaign Worldwide 3 March who.int/campaigns/world-hearing-day

ASOHNS 2025

Annual scientific meeting Sydney, Australia 28-30 March asohns.arinex.one/

APRIL 2025

AUDIOLOGY AUSTRALIA 2025 National Conference Adelaide, Australia 1-4 April audiology.asn.au

NEXTSENSE

Mainstream teachers’ workshop to improve outcomes of DHoH students Live stream 9 April nextsense.org.au

MAY 2025

INTERNATIONAL ADULT AURAL REHABILITATION CONFERENCE 12th meeting Massachusetts, US 5 May hearingrehab.org

JUNE 2025

HLAA 2025 CONVENTION Indianapolis, US 11-14 June I hearingloss.org/

NOVEMBER 2025

FRONTIERS 2025

The Art, Science and Future of Otolaryngology, Head and Neck Surgery Sponsored by the Passe & Williams Foundation Hobart, Australia 13-15 November thefrontiersconference.org/

World Hearing Day, organised by the World Health Organization, is on 3 March annually to raise awareness of how to

Image: Richard Juilliart/Shutterstock.com.

students.

The 2025 Audiology Australia conference will be at the Adelaide Convention Centre from 1-4 April 2025.

Image: NextSense.