An audiologist is a licensed healthcare professional who specializes in the auditory and vestibular systems, which govern hearing and balance. This specialization involves identifying, diagnosing, treating, and monitoring disorders that affect these sensory systems across the entire lifespan. Audiologists are considered the primary experts in the non-medical, non-surgical management of hearing and balance conditions. Most audiologists hold a Doctor of Audiology (Au.D.) degree, representing the highest level of professional education in this field. They help individuals manage conditions like hearing loss, tinnitus, and vertigo, working to improve overall communication and quality of life.
Assessment and Diagnostic Services
The audiologist conducts a comprehensive audiological evaluation to identify the nature and extent of any hearing or balance problem. This process begins with pure-tone audiometry, a behavioral test that measures a person’s hearing sensitivity for specific frequencies across the speech spectrum. Results are plotted on an audiogram, which illustrates the degree and type of hearing loss in each ear.
The diagnostic battery also includes speech testing, which assesses a person’s ability to hear and understand spoken words in various listening conditions. To evaluate the middle ear system, tympanometry is performed by introducing air pressure changes into the ear canal. This measures the eardrum’s movement and checks for fluid or negative pressure, as a healthy middle ear is necessary for sound transmission.
For objective assessment of inner ear function, the audiologist utilizes otoacoustic emissions (OAEs), which are faint sounds generated by the healthy outer hair cells within the cochlea. The presence of OAEs suggests the cochlea is working properly, while their absence often indicates damage or significant hearing loss. Auditory brainstem response (ABR) testing is another objective measure, using electrodes placed on the head to record the electrical activity of the auditory nerve and brainstem in response to sound.
When a patient reports dizziness or imbalance, the audiologist performs specialized testing, such as videonystagmography (VNG). This test uses infrared goggles to track and record involuntary eye movements (nystagmus) while the patient is moved or the ear canal is stimulated. The VNG helps determine if the balance problem originates in the inner ear’s vestibular system or in the central nervous system. These tools allow the audiologist to distinguish between sensorineural, conductive, and mixed hearing losses, and to localize the source of balance dysfunction.
Hearing and Balance Rehabilitation
Once a diagnosis is established, the audiologist focuses on the management and rehabilitation of the patient’s condition using non-surgical interventions. For hearing loss, this involves the selection, fitting, and programming of advanced hearing aid technology, which are specialized medical devices that amplify sound based on the individual’s hearing loss profile. The audiologist ensures the device output is precisely tuned to the patient’s specific needs using verification methods like real-ear measurements.
Beyond hearing aids, audiologists recommend and fit other assistive listening devices (ALDs), such as personal frequency modulation (FM) systems or alerting devices, to improve hearing in challenging listening environments. For individuals with severe to profound hearing loss, the audiologist plays a role in the cochlear implant process. They determine candidacy, program the sound processor through mapping, and provide long-term follow-up care to optimize speech understanding.
A significant component of rehabilitation is aural rehabilitation, which includes communication strategies and listening training designed to help the patient maximize the use of their residual hearing. The audiologist also provides counseling for patients coping with hearing loss, tinnitus (ringing in the ears), and hyperacusis (sound sensitivity). Tinnitus management may involve sound therapy or habituation techniques to reduce the perceived severity of the noise.
For balance disorders, the audiologist may implement or coordinate Vestibular Rehabilitation Therapy (VRT). This exercise-based program improves balance and reduces dizziness by promoting central nervous system compensation for inner ear deficits. Techniques include specific head and eye movements to stabilize gaze, balance retraining exercises, and maneuvers to treat conditions like benign paroxysmal positional vertigo (BPPV).
Specialized Areas of Practice
Audiologists work in a variety of settings outside of general practice, applying their expertise to unique populations and environments.
Pediatric Audiology
Pediatric audiology focuses on the needs of infants, children, and adolescents, often involving early identification of hearing loss through newborn screening programs. These specialists use age-appropriate testing techniques and are involved in early intervention programs to support language and developmental milestones.
Educational Audiology
Educational audiologists work directly within school systems to manage the hearing health of students, ensuring proper access to classroom instruction. Their responsibilities include managing hearing assistance technology, consulting on classroom acoustics, and training school staff on the needs of students with hearing loss. They coordinate services outlined in a student’s educational plan.
Industrial/Occupational Audiology
This area is concerned with preventing noise-induced hearing loss in the workplace. These professionals design and manage hearing conservation programs, which include monitoring noise exposure levels, conducting annual hearing screenings for employees, and fitting specialized hearing protection. Their work focuses on regulatory compliance and protecting workers’ long-term hearing health.
Military and Veterans Audiology
This specialization addresses the high prevalence of hearing loss and tinnitus among service members and veterans due to noise exposure. Audiologists in this setting provide comprehensive diagnostics, fit advanced hearing technology, and offer rehabilitation services tailored to the unique challenges faced by this population.