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May 30, 2006

Audiologist helps with hearing, confidence

From: The News Journal, DE - May 30, 2006

The News Journal

Stacy Szymkowski clasped her hand over Thomas "T.J." Wisely's fingers as he held the yellow plastic spool next to his face.

"Wait," she instructed him.

Behind him, fellow audiologist Lindsey Turover cupped her hands over her mouth.

"Mmmmmmm," Turover hummed.

Hearing the sound, T.J. dropped the spool into the bucket in front of him.

"Good job," Szymkowski bubbled to her 7-year-old patient.

Three years ago, T.J., who was born deaf, received a cochlear implant, a small electronic device that restores partial hearing. A few times a year, his mom, Dawn, brings him from their house in Drexel Hill, Pa., to the Alfred I. duPont Hospital for Children in Rockland to make sure his implant is programmed correctly. Each time he visits, he plays this game -- dropping colored spools into the bucket whenever he hears a sound.

It lets Szymkowski, one of seven audiologists on staff at the children's hospital, know that T.J., who also has autism, hears the noises and sounds he should.

Working with children who have cochlear implants is only one of Szymkowski's jobs as an audiologist. She tests infants and children suspected of having hearing loss. She fits those who have been diagnosed with hearing loss with amplification devices, such as hearing aids, to help them hear better. She also tests children with balance problems.

The variety in Szymkowski's job speaks to the diversity of the profession, which employs about 10,000 people, according to the Bureau of Labor Statistics. Audiologists are found in hospitals, private practice, schools and in the offices of ear, nose and throat physicians. They work with babies to senior citizens -- anyone suspected of having hearing loss.

Some of the youngest patients they see are newborns who have failed the state-mandated screening test and need to be retested. Unlike the hearing tests most adults are used to -- which involve raising a hand when you hear a sound in one of your ears -- the hearing tests on infants and children who can't speak don't require a response.

Instead, a sound-making probe is inserted in the ear and a small microphone detects the inner ear's response to the noise. Another kind of hearing test uses special electrodes to track nerve signals and identify where hearing loss has occurred. Both can be done while the baby sleeps.

Audiologists at A.I. duPont see patients throughout the hospital: They run hearing tests on patients with head injuries so doctors can learn what is going on in the brain; they check chemotherapy patients to make sure the medication isn't affecting their hearing, a possible side effect, and they test babies in neonatal intensive care who may have been too ill earlier to have their hearing screened.

Hearing loss happens for many reasons. Among them: genetics, medications or a virus, such as rubella, contracted by the mother while she was pregnant. Often, the cause is unknown, said Szymkowski, 33, of Philadelphia. Some children also suffer temporary hearing loss, often related to fluid in their ears. Called conductive hearing loss, it can usually be treated medically.

Sensorineural hearing loss, which occurs when there is damage to the inner ear or to the nerve pathways from the inner ear to the brain, is permanent and can't be corrected. Hearing aids can be used to amplify sound and make sounds audible. Surgery to insert a cochlear implant also may be an option.

Szymkowski said pediatricians are more proactive these days about referring children to an audiologist if they suspect a hearing problem. Three-year-olds who are not speaking or are having trouble articulating may have a problem with their hearing. Catching and correcting hearing problems early can make a big difference, she said.

"Kids with delays in speech and language can catch up faster," Turover, 28, of Claymont, said. "It gives them a lot of power."

As technology has changed, so has the profession. Audiologists must keep up on the ever-changing testing techniques and software improvements used to detect hearing loss. While they still have a technical part of their job in testing patients' hearing, audiologists also work with patients' families to support and educate them about their loved one's hearing loss. That includes teaching them about how hearing aids and cochlear implants work.

"Parents can be emotional, especially if it's the first time they have heard their child has a permanent medical condition," Turover said. "Families can feel overwhelmed."

It's rewarding for audiologists to see the changes in a child fitted with a hearing aid or cochlear implant, Szymkowski said. Thanks to a hearing aid, children can better connect with the world around them. Their speech improves, their delays in the classroom diminish. Even parents change as they realize their children can handle the responsibility of a hearing aid.

"Once they see the child benefit, they understand," she said. "They see them change over time."

Contact Kelly Bothum at 324-2962 or


Audiologists work with people who have hearing, balance and related ear problems. Their patients are all ages. Their job is to identify those with hearing loss and other auditory, balance and neural problems.

Using specialized equipment, computers and other testing devices, they measure the loudness at which a person begins to hear sounds, how the person distinguishes between sounds and the impact of hearing loss on daily life. Audiologists interpret these results and may coordinate them with medical, educational and psychological information to make a diagnosis and determine a course of treatment.

A 2004 survey by the American Speech-Language-Hearing Association found the median annual salary for full-time certified audiologists was $56,000.

For years, a master's degree in audiology was the standard credential. Now, a clinical doctoral degree is more common for people new to the field.

Source: Bureau of Labor Statistics

Copyright © 2006, The News Journal.