The management of hearing disorders is a multidisciplinary endeavour. Indeed, your GP, ENT specialist, hearing aid specialist, speech and language therapist, sophrologist and psychologist are all different hearing care professionals who can get involved and support you throughout your hearing care journey. As part of the coordinated care pathway, your first point of contact is your GP. What are the roles of each of these professionals?
The general practitioner
If you experience hearing problems, the first thing to do is to speak to your GP. As part of the coordinated care pathway, your GP will draw on all the necessary expertise to help you.
When it comes to hearing and the management of hearing loss, they will consult various specialists, starting with an ear, nose and throat (ENT) specialist, who is an expert in the nose, ears and voice.
The ear, nose and throat (ENT) specialist
Hearing loss is a symptom that only an ENT specialist is qualified to diagnose. To do so, they carry out a comprehensive hearing test. There can be a variety of causes for hearing loss. Sometimes, the ENT specialist may need to refer the patient for further tests, such as an MRI or a CT scan.
Once a clear diagnosis has been made, the ENT specialist prescribes treatment, which can take several forms. In some cases, the patient may need surgery; in others, medication is sufficient. Often, hearing loss is the result of presbycusis, that is, the ageing and deterioration of hair cells. This is a natural phenomenon linked to the ageing of the auditory system. In such cases, the ENT specialist prescribes a hearing aid. They do not determine which hearing aid is best suited to the patient, but simply confirm that wearing one has become necessary. However, the ENT specialist is there to explain to the patient what hearing loss is, to reassure them and, if necessary, to help them come to terms with wearing a hearing aid. It is strongly recommended that you see your ENT specialist once a year to ensure that your hearing loss has not progressed. If necessary, the ENT specialist will adjust their prescription.
The hearing aid specialist
Under public health legislation, an audiologist is a healthcare professional recognised by a state-awarded qualification. They work on the prescription of an ENT doctor to support the patient during the fitting process. In consultation with the patient, they select the most suitable hearing aid. They fit the device, teach the patient how to use and maintain it, and then provide regular follow-up to adapt the device to the patient’s lifestyle and any changes in their hearing loss. It is also the hearing aid specialist who carries out a full service of the hearing aid. Ensuring the patient’s acceptance of the hearing aid and their comfort are this specialist’s main concerns. They are there to reassure the patient and enable them to maintain effective speech comprehension skills. It is well known that ageing is made easier when one retains good hearing ability.
The speech and language therapist
They are specialists in communication and the voice. They work at various levels to address difficulties in understanding spoken and written language. Hearing problems requiring the intervention of a speech and language therapist can occur at any age. This care is a key factor in establishing effective compensatory strategies aimed at maintaining communication skills. Treatment by a speech and language therapist can only be provided on a doctor’s prescription and begins with a speech and language assessment. Analysis of the audiogram and hearing aid gain determines the treatment to be implemented. Lip-reading is a technique that can be taught by the speech and language therapist. Where a hearing aid is used, speech and language therapy support aims to assist with adaptation. The speech and language therapist then provides advice to help with the use of the hearing aids and to overcome any reluctance. They then work on helping the patient make sense of the sounds reaching the ear fitted with the hearing aid, recognise elements of speech and articulate clearly. In all cases, this also involves supporting and informing the person with hearing loss as well as those around them.
The sophrologist, within the framework of tinnitus management protocols
This discipline is very often used to help patients cope better with whistling, buzzing or other sounds that they hear either temporarily or permanently. These are ENT symptoms known as tinnitus. Because of their intrusive nature, tinnitus causes psychological distress.
Through breathing exercises, dynamic relaxation and mental visualisation, the sophrologist helps the patient with tinnitus to divert their attention away from the tinnitus. This is a technique known as ‘habituation’. Within a multidisciplinary medical setting, the sophrologist — who has undergone specialist training — uses specific session protocols to help patients cope better with hearing disorders by addressing the sensory and emotional aspects. Sophrology practitioners are not recognised as healthcare professionals. Patients are responsible for the cost of sessions. Some private health insurance schemes are beginning to reimburse a set number of sessions per year.
The psychologist
A state-registered psychologist can provide support in managing the various emotional and psychological states associated with hearing loss and other conditions such as tinnitus and hyperacusis. This practitioner will help patients navigate the stages of acceptance and adaptation to hearing aids. They can provide real support in learning to cope with the distress caused by tinnitus. They may use various techniques to support their patients, such as CBT and NLP.
Other professionals involved
- The occupational health doctor can advise you and set you on the right course of treatment, or help you make adjustments to your workstation;
- A social worker will help you put together your application for funding from the MDPH;
- Support workers, LPC coders and, above all, sign language interpreters or intermediaries can play a role in everyday life. Indeed, the close link between deafness and cognitive development is increasingly being demonstrated.
- Neuroscientists and neuropsychologists are increasingly involved in patients’ hearing care pathways.
