Rehab Dialogue 2014 Issue 1

REHAB

Dialogue 20 14 I SS U E 1

OVERCOMING HEARING LOSS: A LOOK TO TH E FUTURE

By Bill Hodgetts, PhD, Sue Peters, MClSc and Karen Pollock, PhD

1 in 10

Canadians suffer from some degree of hearing loss.

There is currently

no audiology training program in Alberta, Saskatchewan or Manitoba.

The University of Alberta is positioned to take on a

Master's degree program

to train future audiologists.

There are

only 143 audiologists registered to practice in Alberta,

35 in Saskatchewan and 59 in Manitoba.

More than

We need to

train more audiologists in the prairie provinces, to meet the needs of those affected by hearing loss.

50% of Canadians over 65 will experience some degree of hearing loss, and more and more people are showing signs of hearing loss in their 30s and 40s.

Hearing aid images courtesy of Oticon and Phonak

Meet Kathleen and her daughter Paige. When Paige was two years old, she was diagnosed with hearing loss.

“It’s late onset genetic hearing loss,” explains Kathleen Jones.

“We were monitoring her hearing to be on the safe side and noticed in the new year that she wasn’t quite responding as much as she had before the Christmas holidays.”

Paige is now seven years old and has a four-year-old younger sister who doesn’t have hearing loss. Both Kathleen and Paige are thankful for the audiologists and specialists they see at the Glenrose Rehabilitation Hospital in Edmonton, Alberta.

Kathleen, like her daughter, has bilateral moderate to severe sensorineural hearing loss. Because her brother also has the same hearing loss, she made sure she watched Paige closely and brought her in to check up on her hearing.

“We regularly see an ENT (otolaryngologist), speech-language pathologist and audiologist,” Kathleen says. “Paige wears an FM system at school, where the teacher speaks into a mic and she can hear everything – even in the background noise. She sees an audiologist every six months and regularly gets the settings on her ear devices checked as well.”

“Paige is the perfect example of early intervention,” Kathleen says. “She currently wears two hearing aids, uses an FM receiver system and is like any other kid out there, enjoying life.”

Today Kathleen is the proud owner of Professional Audiology Clinic. Being hearing impaired herself brings another level of understanding and compassion to the needs of others who are overcoming their hearing loss.

F A C U LT Y O F R E H A B I L I T AT I O N M E D I C I N E

1

The audiologist, in many ways, goes through life with the person with hearing loss.

AGE DISTRIBUTION 1900-2050

MALE

FEMALE 85+ 80-84 75-79 70-74

As a hearing aid practitioner and a mother with hearing loss, Kathleen cannot overstate the role of the audiologist in the lives of those suffering from hearing loss.

65-69 60-64 55-59

“The audiologist, in many ways, goes through life with the person with hearing loss. We had the SLP, ENT and others, but the audiologist is our constant. If all goes well, the audiologist sees Paige through until she is an adult. My own audiologist still works at Glenrose, if it weren’t for her, I wouldn’t be here.”

50-54

Kathleen and Paige are 2 of 370,000 affected by hearing loss in Alberta. That number is expected to increase over the next 50 years, as our elderly population continues to grow.

25-29

45-49 40-44 35-39 30-34 20-24 15-19 10-14

Approximately 1 in 10 Canadians suffers from some degree of hearing loss. The prevalence of hearing loss increases with age, to the point where nearly 30 per cent of individuals over the age of 65 suffer from some degree of hearing difficulty.

In children, even minor hearing losses can negatively impact spoken language acquisition: the use of grammar and syntax, development of vocabulary and language concepts, auditory memory and perception skills and social maturation.

Left untreated, hearing loss at any age can seriously erode relationships, and lead to overall poor health, decreased physical activity and depression. Most importantly, the ability to communicate, especially in the presence of background noise, allows people to connect with others to maintain or establish new relationships. When communication is compromised, it can have a distressing impact on quality of life.

Unfortunately, we are not training enough audiologists to meet the increasing demands of hearing health care. Consider Alberta alone. With a population of 3.7 million people, there are approximately 370,000 individuals with hearing loss.

The Alberta College of Speech Language Pathologists and Audiologists (ACSLPA) has 143 registered audiologists in the province. If divided equally, that works out to nearly 2,587 people with hearing loss per one audiologist.

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5-9 0-4 1900 2050

The human lifespan has more than doubled since 1840, increasing at a rate of five hours every day. Charts of the distribution of human age used to be bottom heavy.

Now they show a broadening of the pyramid. This trend is projected to continue over the next 50 years, when there may be nearly as many elderly as there are younger individuals in the age distribution.

The rehabilitation professions will continue to see increasing numbers of elderly individuals with physical and cognitive difficulties that require multidisciplinary treatments. Given these trends, one of the rehabilitation professions whose importance will continue to grow is audiology.

WHAT IS AN AUDIOLOGIST? Audiologists are the primary health-care professionals who evaluate, diagnose, treat, and manage hearing loss and balance disorders in adults and children.

Audiologists are uniquely qualified to diagnose and treat hearing loss from birth through the lifespan.

Audiologists • assess and diagnose hearing and balance disorders • provide intervention for hearing and balance disorders including promotion, prevention, counselling, treatment, consultation, management, rehabilitation and education • prescribe and fit hearing aids • collaborate in cochlear implant and bone anchored implant programs • perform ear- or hearing-related surgical monitoring • design and implement hearing conservation programs and newborn hearing screening programs • consult and refer to other professionals • are involved in research

Why do we need to train audiologists in Alberta, Saskatchewan and Manitoba?

We currently do not have an audiology training program in the prairie provinces. There are only three Englishlanguage audiology training programs in Canada: University of British Columbia, Dalhousie University, and University of Western Ontario. In total, these programs graduate approximately 40 students per year.

There is a great deal of unmet need within the prairie provinces. As Freeman (2009) notes, if we do not address this impending shortfall of audiologists, any gaps in hearing health care will be filled by alternatives from outside the profession (e.g., hearing instrument specialists, nurse practitioners etc.). While assessment and treatment of hearing loss by anyone is likely to be better than never being seen, audiologists are the most important factor in successful outcomes. Two recent surveys (HIA, 2007; Consumer Reports 2009) underscore this point. They indicated that the hearing health-care market is fractured and confusing and that the most important factor in the successful treatment of hearing loss was the “qualifications and competence of the provider” – an audiologist (Consumer Reports, 2009).

F A C U LT Y O F R E H A B I L I T AT I O N M E D I C I N E

3

Looking to the Future

HEARING LOSS

BY THE NUMBERS

• 50% of Canadians will need a hearing aid in their lifetime, and of those who need a hearing aid, only about 24% actually have one.

• With Alberta and Manitoba introducing the Universal Newborn Hearing Screening program, we will need more audiologists to evaluate, in a timely manner, the infants that do not pass the screening and manage those infants that are diagnosed with hearing loss. The care of these infants is not a one-time treatment, but a managed program of care across their lifetime.

• The indirect costs of hearing loss per person over a lifetime is $263,000.

• Expected growth rate for the audiologist profession is 37%, which is considerably higher than the average of all professions (14%).

PER 1,000 PERSONS

250 126.0

100 50

18.2

44.5

0 3-17

18-44

45-64 AGE

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REHAB DIALOGUE 2014 ISSUE 1

• Complement and enhance the Rehabilitation Audiology Research Centre that is being established at the University of Alberta; • Go beyond diagnosis and amplification to emphasize the complex and long-term rehabilitation needs of individuals with hearing loss; • Provide a focus on hearing needs common to the prairie provinces, including rural/remote service delivery and culturally safe practice in Aboriginal communities;

• Provide opportunities for post-professional training through the introduction of advanced course work in the Faculty of Rehabilitation Medicine Continuing Professional Education Program; and • Collaborate with other University of Alberta departments including Medicine, Nursing, Business, Education, and Engineering.

200 150

• Build on the already very successful speech-language pathology program at the University of Alberta;

• Introduce a working audiology clinic that not only provides students with a sheltered, controlled first practical experience; but provides services in gap areas and to underserved, rural and remote communities;

290.6

300

• Graduate 12 to 16 Audiology students per year;

• Showcase use of innovative technology including Telehealth & Electronic Medical Records;

PREVALENCE OF HEARING LOSS

350

The Department of Communication Sciences and Disorders (formerly the Department of Speech Pathology and Audiology) at the University of Alberta is eager to meet the need to train audiologists. We are proposing to introduce a new two-year Master’s degree in Audiology.

The proposed program will:

65+

The University of Alberta is ready and positioned to take on this program to train future audiologists. The Department of Communication Sciences and Disorders in the Faculty of Rehabilitation Medicine is equipped with the expertise and innovative teaching to meet Canada’s needs.

Sarah Bain couldn’t thank her audiologist enough.

“When I got my hearing aid for the first time, I was like, ‘Holy crap!’” she chuckles.

Diagnosed with hearing loss at nine years old, Bain found school very challenging.

“A lot of people in school didn’t quite understand me because of my hearing loss. It was challenging for me until I traveled to Edmonton for a pre-assessment for the Baha implant.” The Baha is a surgically implantable system for treatment of hearing loss that works through direct bone conduction.

“Thanks to audiologists Wayne Maclean and Bill Hodgetts, I was able to get assessed and treated. I feel like my life has changed.”

Bain is now a courtesy clerk at a Safeway in Calgary. “My coworkers and customers are very understanding and they love me for who I am.”

About the authors BIL L HO D G E T TS , PhD, is an

K A R E N P O L LO CK , PhD,

SUE PE TE RS , MClSc, is a health

associate professor in the Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta. He is also the program director of Bone Conduction Amplication at the Institute for Reconstructive Sciences in Medicine (iRSM). Hodgetts is an audiologist whose research interests focus on bone anchored hearing aids and noise exposure from MP3 players. He teaches in the areas of hearing science/audiology and research methods and statistics.

is a professor and chair of the Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta. She joined the Department in January 2003. Pollock is an expert in children’s speech sound disorders and has taught in the areas of child phonology, phonetics and augmentative communication.

Her research interests include vowel errors in children with speech sound disorders and speech-language acquisition in children adopted internationally.

care consultant and audiologist working with the Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, to develop the business case and proposal for a new degree program in audiology: a Master of Science in Audiology. As an Organization Change Professional, Lean Leader and Healthcare Planner, she has worked with a range of clients across North America including Alberta Health, Alberta Health Services and the Alberta Medical Association.

REHAB

Dialogue Rehab Dialogue is a series of interactive articles published by the University of Alberta Faculty of Rehabilitation Medicine. We invite government, health-care professionals and the community to engage in a discussion on various health-care topics where rehabilitation could or should play a greater role, improving function, reducing pain, maximizing potential and quality of life – and sharing the vision for a healthy Alberta.

www.rehabmed.ualberta.ca