Audiologists: Making a difference in the COVID-19 crisis

Audiologists identify and assess hearing and balance function, and their associated disorders, and provide appropriate therapeutic rehabilitation and management. Applying their skills in hospitals, community clinics and independent practices, audiologists work with children and adults with these difficulties.

Gaby, Siobhan and Sam, who are lecturers in audiology, explain how audiologists in the NHS and at The University of Manchester are responding to COVID-19 and adapting audiology practice for the future.

Supporting infants with hearing loss and their families

One to two babies in every 1,000 are born with a permanent hearing loss. Due to the potential impact on their development, all babies in the UK are screened for hearing loss as soon as possible after birth, usually on the maternity ward in hospital or soon after discharge in a clinic. 

The vulnerability of newborn babies to disease means that currently they interact with as few healthcare professionals as possible, to reduce their risk of contracting COVID-19. This has had an impact on the ability to provide a screening service.

Our audiology team are working with professional societies to understand and mitigate these impacts on the newborn hearing screening service. Additionally they are planning to work with families of infants with hearing loss to understand the impacts on them and how to support them.

Siobhan explains:

"The time dependency of the newborn hearing screening diagnostic means that the suspension or reduction of some services could have significant impacts on some babies with permanent hearing losses.

“Furthermore, older children waiting for hearing assessment and management are affected as the capacity of audiology services is stretched after movement restrictions are lifted. 

“Our team at Manchester are investigating tools and questionnaires that can be utilised by departments to prioritise and mitigate the risks of delayed appointments for peadiatric audiological needs."

The impact of face masks on people with hearing difficulties

The use of face masks by the public is a topic of debate during the COVID-19 pandemic.

More and more people wearing face masks are visible on the streets of the UK. Kevin Munro, Professor of Audiology at Manchester, discusses the unintended consequences of this practice for people with hearing difficulties in an article for The Conversation.

“Wearing a face mask may impair the ability for some people to communicate with ease because it prevents lip reading and it can reduce the level of speech transmitted from the mouth”, says Kevin.

“An unintended consequence of wearing a face mask might be that social distancing is replaced with social isolation and poor mental wellbeing in older adults with hearing loss.”

Supporting vulnerable older patients 

Many of the older patients audiologists work with are likely to be in the vulnerable category and therefore self-isolating. It is important that these patients continue to receive support whilst being protected from Covid-19.

“Some aspects of current audiology practice are not compatible with social distancing”, says Gaby Saunders, a clinical lecturer on the course.

“For example looking into someone’s ear with an otoscope requires the audiologist to have their face in close proximity to their patient and doing a standard hearing test requires special equipment and a sound-proof booth.

“On the other hand, there are many aspects of audiology that can be done with as much success remotely as during a face-to-face appointment. Everyday new capabilities are coming available.

“For example”, explains Gaby, “most of the major hearing aid manufacturers now have hearing aids that can be programmed remotely via an app, video appointments allow audiologists to demonstrate how hearing aids work and to give hearing aid counselling in a one-on-one manner, and there are lots of apps that patients can use independently to practice listening skills.

“So, our challenge is to deliver the aspects of service that we can while using these new approaches to provide care in the months ahead. However, it seems likely that some of these ‘temporary’ practices will become permanent as audiologists and patients alike find them more convenient, satisfying and cost effective that standard in-clinic practice, while equally beneficial from an audiological point of view.”

The audiology team at Manchester have developed guidance for audiology remote practice in conjunction with the British Academy of Audiology. The team will be updating the information on an ongoing basis so its content remains up-to-date. In parallel, in the lab, researchers are developing online material for reliable hearing testing and tinnitus rehabilitation, and others are examining the effect of using face-coverings on hearing and communication.

There is concern that older people with hearing loss are at particular risk of loneliness and cognitive decline during lockdown that might be exacerbated by untreated hearing loss.

“We believe”, says Gaby, “that by providing audiological care remotely we can support hearing needs which in turn will improve the quality of life and decrease the risk of loneliness among older people with hearing loss."

Investigating the impact of COVID-19 on the music industry

Lecturer Sam Couth discusses how the lockdown has raised some interesting research questions in terms of how levels of noise exposure may have suddenly dropped for many music sector workers and whether this will allow a period of recovery for their ears, and what will happen to hearing health as restrictions are lifted in the coming months.

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