FAQs

Audiologists are trained for a minimum of 6 years and graduate with a Masters or Doctoral level degree at an accredited university. Audiologists specialize in accurately assessing hearing and provide complete hearing health care to all ages. Only audiologists and physicians can prescribe hearing aids in Ontario. Audiologists are licensed by a regulatory college, the College of Audiologists and Speech-Language pathologists of Ontario (CASLPO), just like dentists and optometrists. This college requires audiologists to upgrade their training every year and abide by professional standards.

Ear Infections (Otitis Media): Most ear infections are caused by either bacteria or viruses that invade the middle ear. The infection may cause fluid to build up in the middle ear space which may persist even when the infection has ended. Fluid can also build up in the middle ear if the tube that connects the middle ear space and the back of the throat (the eustachian tube) is blocked.

Prevention: Common colds can lead to ear infections. The best way to prevent an ear infection is to avoid risks associated with contracting the common cold.

• Limit your child’s exposure to large crowds and others who have colds

• Encourage your child to wash their hands frequently

• Reduce or eliminate your child’s exposure to second hand smoke

• Be aware that children with cleft palate, respiratory illnesses, and chronic allergies that cause congestion are at a higher risk for developing ear infections

Treatments

• Bacterial infections can be treated with antibiotics prescribed by a physician

• It is important that your child receives the entire antibiotic dosage prescribed, even if your child feels better prior to the completion of the medication

• Viral infections cannot be treated with antibiotics

• The physician may also prescribe medication to relieve pain or discomfort your child may experience

Ear Infections and Hearing Loss

• Hearing is temporarily affected in most children with ear infections and usually improves in the weeks following the infection

• The fluid in the middle ear space may persist for several months and can cause temporary hearing difficulties

• Children who experience chronic middle ear infections and / or persistent fluid in the middle ear may require medical intervention such as long-term antibiotic treatment or ventilation tubes (to drain the fluid from the middle ear).

• Untreated chronic ear infections could lead to temporary or permanent hearing loss in some cases and may interfere with your child’s language development

This information should not be used as a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

Noise Induced Hearing Loss (NIHL): Noise exposure is a common but preventable cause of permanent hearing loss caused by repeated exposure to loud sounds. The level of the noise you are exposed to (the intensity) and the length of exposure (the duration) both significantly affect the amount of damage experienced. This means the louder the sound and the longer one is exposed to the sound, the more damage will likely be done to the hearing system. Everyone from infants to older adults are susceptible to noise induced hearing loss.

Common Sources of Dangerous Noise

• Power tools

• Motorcycles, ATVs, etc.

• Loud music

• Rifle or gunfire

• Loud machinery in the workplace

Characteristics of Noise Induced Hearing Loss

• Hearing loss caused by noise exposure varies from person to person and depends on the person’s susceptibility.

In the early stages of noise exposure:

• A reduction in hearing sensitivity or ability may be experienced. This is referred to as a temporary threshold shift.

• Tinnitus (a ringing, roaring or buzzing in the ear) may also be experienced for a brief period.

• These symptoms subside after the ear has had time to rest and the system returns to normal functioning.

With increased noise exposure:

• A permanent reduction in hearing most likely will occur. This is referred to as a permanent threshold shift.

• The tinnitus experienced most likely becomes permanent.

For exposure sounds that are of short duration but at a very high intensity or level (called impulse sounds), severe and permanent hearing loss often occurs if the ears are not protected. This is due to the physical damage caused by the impulse noise to the organ of hearing (the cochlea).

Effects of Noise Induced Hearing Loss on Communication

• Noise exposure typically damages the area in the cochlea that responds to the high frequencies (or pitches) that are used in speech.

• High frequency sounds are related to consonants such as (f, s, th, p, t, k, ch, sh). It would be difficult to follow conversations if you don’t have access to these sounds. Your brain would have to “fill in the blanks” for what your ears are missing.

Noise is too loud

• If it exceeds the allowable noise exposure standards set out by the government for workplace settings ( this varies from province to province)

• As a general rule, noise may damage your hearing if you are at arm’s length and have to shout to make yourself heard.

• If your ears hurt or you experience tinnitus during or after the noise exposure

Prevention

Wear hearing protection (earplugs or ear muffs) that can be purchased from our clinics.

Yes. The Ontario government provides funding through the Assistive Devices Program. Assistive Devices Program (ADP) The objective of the Assistive Devices Program (ADP) is to provide consumer centered support and funding to Ontario residents who have long-term physical disabilities and to provide access to personalized assistive devices appropriate for the individual’s basic needs. ADP funding can be used towards the purchase of:

• Behind-the-ear hearing aids, in-the-ear hearing aids, canal and completely-in-the-canal hearing aids, eyeglass hearing aids and body hearing aids.

• FM systems and some accessories.

Applicants Must:

• Have a long-term hearing loss who requires the use of a hearing aid for six months or more

• Be eligible for Ontario Health Insurance and have a valid Health Card

• ADP does not pay for equipment available under the Workplace Safety and Insurance Board or to Group ‘A’ veterans for their pensioned conditions.

ADP Covers:

• ADP will pay the registered vendor 75 per cent up to a maximum of $500 of the cost of the hearing aid, earmold, accessories listed with ADP, and the dispensing fee.

• If two hearing aids a prescribed, the vendor will bill ADP for 75 per cent up to a maximum of $1,000 of the cost of two hearing aids, two earmolds, accessories listed with ADP, and two dispensing fees.

• For FM systems, ADP will pay the registered vendor 75 per cent up to a maximum of $1,350 of the cost of the ADP listed device and dispensing fee.

Some Conditions:

• You must obtain your hearing instrument from an authorizer/ dispenser who is registered with ADP.

• If your hearing aid is no longer working, and cannot be repaired at a reasonable cost, ADP will help replace it once every three years.

• If your FM system is no longer working and cannot be repaired at a reasonable cost, ADP will help replace it once every three years.

• ADP does not pay for replacement during those years if the original equipment is lost, stolen or damaged due to misuse. You may want to insure your hearing aid.

• ADP offers a 30 day trial period. If you are not satisfied with your hearing instrument(s), return it to the vendor before the end of this trial period.The vendor may charge you a handling fee.

Items Not Covered by ADP:

• hearing aids/FM systems that are used for only one purpose such as school, work, sports, recreation or social activities

• batteries

• optional service plans

• repairs

• used hearing aids/FM systems

For More Information: Assistive Devices Program www.health.gov.on.ca/english/public/program/adp/adp_mn.html 1-800-268-6021 (Toll-free in Ontario only) 416-327-8804 (Toronto) TTY 1-800-387-5559

You may be eligible to receive funding from one of the organizations or companies listed below.

Department of Veteran’s Affairs (DVA) Canada

• Access to DVA benefits depends on your eligibility and your health needs. Benefits may include items such as standard hearing aids, telephone amplifiers and hearing accessories.

• www.vac-acc.gc.ca

Workplace Safety and Insurance Board (WSIB)

• The WSIB provides hearing devices to workers if entitlement has been established for traumatic hearing loss or occupational noise induced hearing loss. A hearing device evaluation, authorized by the WSIB, is required prior to authorizing the purchase of a hearing device.

• www.wsib.on.ca

Services Canada: Services for Aboriginal Peoples

• The Non-Insured Health Benefits Program (NIHB) is a national, needs-based health benefit program. The program covers some of the costs of medically required benefits, items and services for eligible First Nations and Inuit.

• http://www.servicecanada.gc.ca

Private Insurance Companies 

Some Audiological services and devices may be covered by private insurance held by the client.

• Greenshield Canada: www.greenshield.ca

• The Canadian Auto Workers Union: www.caw.ca

• Manulife Financial:www.manulife.ca

• Johnson Inc:  www.johnson.ca

Auditory Processing Disorder (APD) [also known as Central Auditory Processing Disorder or CAPD] is a disorder in the way auditory information is processed in the brain. It is not a sensory (inner ear) hearing impairment; individuals with APD usually have normal peripheral hearing ability. APD is an umbrella term that describes a variety of problems with the brain that can interfere with processing auditory information.

Is my child a candidate for a Central Auditory Processing (CAP/APD) assessment?

Your child may be a candidate for this test if some or all of the following apply:

• Difficulties understanding the teacher.

• Appears to not be listening.

• Difficulty sustaining attention.

• Difficulty following instructions.

• Poor reading or spelling skills.

• Poor memory (difficulty following multi-step directions).

• Difficulties understanding in noise.

• Poor organizational skills.

What is involved in a CAP/APD assessment?

Two appointments are involved:

• The initial appointment involves a complete hearing and audiological assessment. The results and concerns about the child’s listening abilities will be discussed. A questionnaire that can be completed by the child’s teacher will also be provided.

• The second appointment is approximately one hour in length. Several different tests are completed based on the concerns regarding your child’s auditory processing.

What types of tests are involved?

Several different types of tests are available. These will be selected based on your child’s needs. The tests will determine your child’s ability to:

• Process speech that is distorted or unclear, such as when the teacher is walking around the classroom or writing on the blackboard while talking.

• Process speech in the presence of competing noise such as classroom noise.

• Process competing speech signals both at a word and sentence level; this could also be considered selective attention.

• Process rapid speech.

• Process speech quickly and accurately.

• Organize and sequence auditory information with other information.

Some of these tests may help to identify difficulties with short term memory and auditory attention ability.

What type of information will I receive following the assessment?

• The audiologist will discuss the results with you.

• After all test results have been completely scored and interpreted, a detailed written report will be forwarded to you.

• The audiologist will provide recommendations that are appropriate and based on your child’s individual case.

Is there any treatment / intervention available if my child has a Central Auditory Processing Disorder?

Recommendations will be made based on test results. These may include:

• Modifications to the classroom environment (child placement in the room).

• Noise reduction measures to reduce competing noise sources.

• Modifications to the way the teacher delivers instruction.

• Personal or Sound Field FM systems. This equipment provides an improved signal to noise ratio in the classroom to ensure the teacher’s voice is delivered at an optimal level and above other noise in the classroom.

• Auditory training programs. These are specially designed programs for children with auditory processing problems.

• Further assessments by other professionals may be recommended.

Tinnitus is the perception of sound in one or both ears or in the head when no external sound is present.

Symptoms

• The tinnitus may be perceived as a ringing sound, but many people may experience other sounds such as high-pitched hissing, sizzling, buzzing, chirping, or clicking.

• The sound may be constant or occur intermittently. Several noises may be heard simultaneously.

• Feelings of pressure and fullness or pain in or around the ears may accompany the tinnitus.

Prevalence

• More than 360, 000 Canadians experience bothersome tinnitus

• It can affect people of all ages, including children

• Not everyone experiences tinnitus to the same degree

Causes of Tinnitus

The exact cause or causes of tinnitus are unknown. There are, however, several likely sources known to trigger or worsen tinnitus.

• Noise-induced hearing loss: Excessive noise exposure can damage and even destroy hair cells in the inner ear. Coincidentally, up to 90 percent of all tinnitus patients have some level of hearing loss.

• Wax build-up in the ear canal: Sometimes, people produce enough wax that their hearing can be compromised or their tinnitus can seem louder.

• Certain medications: Some medications are ototoxic-that is, the medications are toxic to the ear. Other medications will produce tinnitus as a side effect without damaging the inner ear.

• Ear or sinus infections: Many people, including children, experience tinnitus along with an ear or sinus infection.

• Jaw misalignment: Some people have misaligned jaw joints or jaw muscles which can lead to tinnitus among other problems. Many dentists specialize in this temporomandibular joint (TMJ) misalignment and can provide assistance with treatment.

• High or low blood pressure: This may cause “pulsatile tinnitus” where you may hear a rhythmic pulsing, often in time with your heartbeat.

• Certain disorders: Disorders such as hypo- or hyperthroidism, lyme disease, diabetes, fibromyalgia, and thoracic outlet syndrome can have tinnitus as a symptom.

Treatment

An appointment should be made with your audiologist to investigate the possible cause of the tinnitus. In most cases, there is no specific treatment unless the underlying cause is identified and corrected, for example removal of excess wax or treatment of an ear infection. If the exact cause is unknown, other treatment options may include:

• Hearing aids: Some patients with hearing loss see a decrease in tinnitus related symptoms when they wear their hearing aids.

• Tinnitus maskers: These devices produce sounds that “mask,” or cover up, the tinnitus.

• Relaxation therapy and counselling: This can involve learning techniques to effectively manage the symptoms of tinnitus.

Additional Information: Tinnitus Association of Canada: http://www.kadis.com/ta/tinnitus.htm American Tinnitus Association: http://www.ata.org/ ASHA: http://www.asha.org/public/hearing/disorders/Tinnitus.htm

The advantages of binaural amplification (two hearing aids) as opposed to monaural amplification (one hearing aid) if you have hearing loss in both ears are listed below:

• Speech Understanding: You will hear speech and conversation better with two hearing instruments compared to wearing one hearing instrument.

• Understanding in Noise: Two hearing aids will give you better speech understanding in difficult listening situations such as in noise.

• Better Sound localization: Your ability to know where sounds are coming from is better with two hearing instruments.

• Improved Sound Quality: The sound quality is more natural and balanced when two hearing instruments are worn.

• Tinnitus Masking: Wearing hearing instruments in both ears may improve tinnitus by masking the bothersome noise in both ears.

• Volume: The volume needs to be much louder when only amplifying one ear. A high volume reduces battery life and increases the chance of feedback (whistling or squealing noise made by the hearing aid).

• More Choices: The smaller styles of hearing aids are not able to supply as much power as the larger styles. If you choose to wear two hearing instruments you may be able to select a smaller hearing aid style.

• More Comfortable Hearing: Individuals with binaural amplification find listening less tiring and more enjoyable than those with only one hearing instrument. It is easier to participate in conversations because they don’t have to strain to hear with their “better ear”.