A hearing healthcare professional with training in the concept of the degree of hearing loss classifies audiograms by degree, type, and configuration. Measuring the degree of hearing loss has accurately predicted communication outcomes for adults and children alike. However, there are limitations to this practice. Degree of hearing loss is a predictive indicator, but it no longer correlates with outcomes as efficiently as it did in the past. According to a new journal article, the degree of hearing access may be a better measurement than the degree of hearing loss.
The International Classification of Functioning (ICF) is the World Health Organization’s framework for evaluating a disorder’s impact on a person’s life. It includes a body assessment, activity and participation, and environmental factors which help to understand the impact a physical impairment has on an individual’s abilities. The ICF model is concerned with functional health, and it emphasizes the interaction between health conditions and the surrounding contextual factors. The ICF measures the degree of an individual’s participation or the degree of hearing access. Four factors determine the degree of hearing access.
These are the characteristics of an individual’s hearing loss and auditory system. The toolbox includes measures such as speech discrimination, loudness perception, and localization. These types of tools help to form a complete picture of auditory integrity. It is essential that hearing healthcare professionals utilize as many of these tools as possible to build a clear understanding of hearing loss.
Amplification integrity is another variable to consider for access to communication. If a hearing aid, cochlear implant, bone-anchored hearing device, of hearing assistive technology is in use, it does not necessarily mean that the device is working correctly. An amplification device that is not in use due to a patient’s resistance, poor understanding of the device’s purpose, or other reasons can’t provide access to communication.
These are factors that a patient has control over. There are many factors including age, cognitive ability, complex needs, and self-advocacy. This self-assessment is essential to the development of metacognitive and problem-solving skills. Self-reporting can be used in counseling to help patients advance their ability to assess their performance in communication situations.
The environment includes the physical listening environment, speaker variables of the communication partner, and complexity of listening tasks. This factor can change quickly. Within the ICF framework, this factor goes beyond an individual’s physical space and includes a broader social context. A large amount of work has addressed challenging acoustic environments, but more work remains on universal design for hearing.
With so many variables, how is the degree of hearing access evaluated? There are measurements such as the speech intelligibility index (SSI) and other tests which can provide a comprehensive understanding of an individual’s degree of access. The authors believe that by using the concept of degree of hearing access, it may help hearing healthcare professionals help patients anticipate and manage communication. The addition of the degree of hearing access to the clinical evaluation can further help patients with hearing loss.