![]() ![]() This is particularly problematic when the patient has a history of an etiology that may explain their communication deficits. However, patients express frustration when told by the audiologist that communication issues do not exist based on the fact that the audiogram is "normal," as if to negate their presenting concerns. The audiogram must certainly be a starting point. Despite this observation more than 50 years ago, audiologists often continue to hold the audiogram as the primary tool for addressing auditory behavior. Karlin (1942) noted that tests of conventional auditory acuity had little value in predicting auditory behavior in more complex social situations. The concept of looking beyond the audiogram is not new. The purpose of this paper is to address the need to look beyond the audiogram to further validate the concerns raised by the patient. The assumption is often made that because the results of the audiogram are consistent with normal peripheral hearing acuity, the person's reported concerns are not validated. However, some patients who present with concerns will demonstrate normal peripheral hearing acuity based on the results of standard audiometric testing. For many of these patients, the results of an audiologic evaluation are consistent with a peripheral hearing loss, and the findings of the evaluation help to direct audiologic treatment to address these communication difficulties or to direct recommendations. Patients report that these communication issues impact the quality of their lives- often the reason for seeking audiology services. ![]() ![]() These types of communication issues may include difficulty hearing in less than optimal listening situations, reliance on visual information to augment auditory information, a reduced appreciation of listening to music, and difficulty understanding speech when the speaker is unfamiliar. Audiologists are faced daily with patients who report communication issues that they may attribute to hearing loss. ![]()
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