Audiologists, You Know the Science of Hearing but Do You Know the Art of Listening? 

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As audiologists, we learn about anatomy, physiology, psychoacoustics, pathologies, technologies, and interventions. We are experts in assessing hearing sensitivity, diagnosing hearing loss, and providing audiological (re)habilitation with technologies and counseling.

Here’s a question, though: Are we experts in listening? To be an effective listener, you need to focus on the meaning of what you hear and take in to gain understanding. Have you ever taking a listening test? Have you ever given your patient a listening test?

There are many types of listening styles, and there’s also depth of listening. In reviewing the literature, I identified 27 different styles of listening and six depths of listening. I believe we use different listening styles and depths of listening based on what is happening in the moment. So, I am a client, I may, during a hearing test, be a discriminative, deep listener. Or if I am the patient learning about the new hearing aids you just fitted for me, I may be a content, full listener.

These are the four most common types of listeners.

People-oriented (empathic) listeners, who:

  • Build relationships and interpersonal connections
  • Search for common areas of interest
  • Tune into the speaker’s emotions, body language and prosody of speech
  • Ask, “Tell me all about it – what happened?”

Action-oriented (evaluative) listeners, who:

  • Prefer information that is well organized, brief and error-free.
  • Will digress when a speaker goes off on a tangent.
  • Evaluate information heard and do not take things at face value.
  • Ask, “What am I supposed to do with all this information?”

Content-oriented listeners, who:

  • Enjoy listening to complex, detailed information.
  • Ask questions to test speakers (are they credible?).
  • Focus on issues and if information is credible.
  • Ask, “Is that so?”

Time-oriented listeners, who:

  • Love “to do” lists.
  • Are overbooked, so they want messages delivered quickly and briefly.
  • Enjoy the role of keeping people on task during the meetings (the time keeper).
  • Ask, “And, what’s your point?”

If you are a people-oriented listener and your patient is a time-oriented listener, then your patient may feel that you are intrusive and not respecting their time. If you are a content-oriented listener, then be careful not to “throw the baby out with the bathwater”: When taking a patient’s history, you don’t want to ignore what could be key information because you believe there’s a lack of sufficient evidence.

And those audiologists who are action-oriented listeners may need to watch that they aren’t perceived as inpatient and not caring. Knowing your listening style can help you better understand how to adapt to various listening situations. Knowing your patient’s listening style will help you with how to deliver quality care!

There are multiple tests available to assess your dominant listening style.  Here are a few that I have used:

In establishing relationships with your patients, the importance is not so much in what you say as how you listen. Knowing hearing thresholds is only part of the evaluation. Listening to what your patient shares with you will drive your overall outcomes in patient care.

Tamala Selke Bradham, PhD, CCC-A, is associate director of quality, protocols, and risk management in the Department of Hearing and Speech Sciences at Vanderbilt University. She is an affiliate of ASHA Special Interest Group 9, Hearing and Hearing Disorders in Childhood.

How Bombs and Other Loud Booms Can Damage Hearing—and How People Can Get Help

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We live in a time of constant exposure to loud sounds. Some of them are completely unexpected and earsplitting, such as last month’s blasts at the Boston Marathon and explosions at the fertilizer plant in West, Texas, or the roadside bombs constantly encountered by military service members overseas.

The newspapers and television media share some of the awful lingering effects for survivors, particularly the physical and psychological trauma. Occasionally the media comment on the disorientation and temporary effects on hearing. But we seldom learn of the long-term effects that many of the survivors experience, especially in relation to hearing loss.

The hearing system is a wonderful and a very delicate tool that allows us to hear a wide range of sounds and words. We take our hearing ability for granted until something occurs to disrupt it. We attend a thunderous rock concert, watch booming 4th of July fireworks or listen to our electronic devices on top volume. Afterward we notice that we are not able to hear clearly for a while. But then our hearing gradually returns to what seems like normal, and we expose ourselves to that same noise again and again. Each time we do this, we increase the likelihood that our hearing will gradually be permanently affected—and we cannot get it back. This deterioration happens because the tiny sensory hair cells of the inner ear get destroyed. These cannot be restored!

Those who happened to near the Boston Marathon bombings were rendered disoriented and unable to hear by the sudden blasts. Some may have found their hearing improving and feeling OK by the next day. But others may now have a noise in their head that is either constant or intermittent—the result of the huge blast their ears were exposed to. These people may find it useful to speak with an audiologist about reducing the effects of this noise on their lives.

Others exposed to the blast may not be able to hear as well as they could before this traumatic event. Their speech may be unclear, or even greatly reduced, and they may hear themselves quite loudly but cannot hear others when they speak. They may wonder at the fact that others next to them have no such permanent effects. All of us are different. And for some reason, some of us can tolerate loud sounds a lot better than others and don’t seem to react as much as others. There is no way to predict at present who can tolerate loud sounds versus who cannot.

What can a person do when there has been a long-term effect on hearing? There are two groups of people who specialize in hearing disorders: Physicians who are ear, nose and throat specialists, and those who are doctors of audiology (audiologists). An audiologist has the training and knowledge to treat hearing disorders, and the physician is trained to treat medical issues related to hearing. Audiologists help those with noise in the ear or hearing loss reduce these effects. Physicians work to repair problems in the ear with medication and surgery.

But a physician’s work may not be enough to solve the problem, and that is when an audiologist may provide the most assistance. The important take-home message is that you do not have to live with deteriorating hearing. Reach out to audiologists and physicians, who can help you continue functioning well in society and access a high quality of life.

 

James Blair, PhD, CCC-A, is a professor of audiology at Utah State University and an affiliate of ASHA Special Interest Group 8, Public Health Issues Related to Hearing and Balance.