Author Archives: Meryl Miller


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Has your audiologist recently positioned you in front of an unfamiliar computer and asked you to sit very still and quiet while they perform measurements on your hearing aids?   If they have not done this, they should!  These measurements are called real-ear measurements which are imperative for appropriate and successful hearing aid fittings on all hearing aid users.

We at Audiological Consultants of Atlanta take pride in our patient care and attention to detail. We believe that if we do not practice audiology by appropriate standards that we are not doing right by our patients or our profession.  Part of practicing audiology by appropriate standards is using evidence based practice.  This means that we practice audiology based on information and evidence from our audiology research community.  The audiology research community continuously publishes peer reviewed studies to help the audiology community better understand and treat hearing loss.  Real-ear measurements have been proven by the audiology research community as the gold standard for hearing aid fitting verification.

Real-ear measurements are important because they measure how a hearing aid’s intensity (volume) and frequency response (pitch) are affected by your ear. When hearing aid manufacturers create a hearing aid and decide how to program it they do so based on one sized and shaped ear.  Real-ear measurements allow us to apply the hearing aid fitting to your specific ear.  Using real-ear measurements, we are able to measure how your ear affects the intensity and frequency response of the hearing aid and adjust the hearing aid settings based on that response.  The results are hearing aid settings that are best suited for the size and shape of your ear and for your hearing loss.

When we do real-ear measurements, we start by putting a thin, soft tube into the ear canal and playing a sound to measure how the size and shape of the ear affects and changes the sound. Next, we put the hearing aid into the ear and play speech and other sounds to see what amplified sound looks like as it arrives at the ear drum.  Finally, we make appropriate adjustments based on the patient’s audiogram, the response we see on the computer screen and, the patient’s feedback as to how the hearing aid sounds.  We also use evidence based amplification targets to help guide our decisions as to how to set the volume of the hearing aids.

At ACA we do real-ear measurements to assist with all hearing aid fittings. However, we also use real-ear measurements when we need to make adjustments to hearing aids at hearing aid checks, to show us when a hearing aid is weak or not working correctly and needs repair, and to give patients’ a visual demonstration of what they are or are not receiving in terms of amplification from hearing aids.

Unfortunately, there are my audiologists who do not use real-ear measurements in their audiology practice. We believe this is a mistake.  Not only does it make their job more difficult, but not using real-ear measurements also results in less accurate and less effective hearing aid fittings.  At ACA we use real-ear measurements because we pledge to serve our patients with the best Audiological care.  According to evidence based practice, the best audiological care cannot be provided without the use of real-ear measurements.

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“Is it me? Or is it EXTREMELY NOISY IN HERE?”

Just this past summer I turned 30 years old, yet when I go to a restaurant I can’t see to read the menu or hear what my friends are saying to me during conversation. Read Full Article

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Baby, Can You Hear Me?

In a little over three months, my husband and I will meet our baby girl for the first time.  She is due to arrive in December. There are so many things to think about and wonder about our baby’s development. It is incredible that the intricacies of human development are occurring inside of me every day.

As an audiologist, I cannot help but think about my baby’s developing ears and hearing. She can now hear the sounds of my body, including my heartbeat, which lulls her to sleep and the sounds of my voice as I talk to patients throughout the day. When my little girl is born in December, she will already be familiar with the sounds of my voice.

A baby hears its mother’s voice better than all other sounds because her voice is transmitted through vibrations in her body. Studies have shown that infants prefer their mothers’ voices to other voices, and further prefer their mothers’ voice when filtered to sound as it did in the womb.

A study referred to as the “The-Cat-in-the-Hat Study” asked mothers to read the children’s book The Cat in the Hat aloud during pregnancy for 3½ hours. Two to three days after birth, the babies showed a preference for hearing The Cat in the Hat over other stories read aloud. These babies were not only able to hear in the womb, they were also able to remember and recognize a specific story.

The tiny structures of a baby’s outer, middle and inner ears develop during the first 20 weeks of pregnancy. Although a baby is able to hear after these tiny structures have developed, hearing becomes more sophisticated as the auditory parts of the brain develop in the last 20 weeks of pregnancy. This critical auditory brain development continues into the first 5 to 6 months of life. During this time, the auditory system uses outside stimulation such as music, speech and environmental sounds to finely tune how the baby hears and understands pitch and loudness.

Hearing and auditory function at birth are so important that almost all 50 states have programs in place to either administer newborn hearing screenings on all babies or at least to educate parents on the importance of having a newborn hearing screening.  In 2010, the state of Georgia screened the hearing of 96% of its newborns.

Why are newborn hearing screenings so important?  The most critical time for auditory development and for development in general, occurs in the first three years of life.  Before the use of newborn hearing screenings at birth, most children with hearing loss were often not identified until two years of age. By the time a child was identified as having a hearing loss, auditory development was already significantly delayed. Plain and simple, newborn hearing screenings enable early identification of hearing loss in babies which result in earlier intervention and treatment. This treatment takes the form of hearing aids and cochlear implants, as well as hearing and language training.

Though I have an extensive education and training on my baby’s auditory development, I am always questioning how my baby is reacting to sound and what she may be hearing. No doubt witnessing my daughter’s auditory development firsthand will continue to amaze and excite me as our journey together continues.

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Adjusting to Wearing Hearing Aids – It takes You … and Your Brain

If the truth be told, we hear with our brains, not with our ears. Now, certainly our ears do play an important role in what we hear and how we hear, but our ears are simply very sophisticated sound collection systems. Read Full Article

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LACE: Listening and Communication Enhancement

One of the most common complaints expressed by patients to their audiologists concerns the difficulty they have when attempting to listen in the presence of background noise. This difficulty includes, but is not limited to, situations where one tries to carry on a conversation in a restaurant, while a TV is on, while water is running, or when attending a cocktail or dinner party. The added noise present in all of these situations can have a significant negative impact on one’s ability to understand and follow a conversation. Read Full Article

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It Takes a Village:But the Rewards are Great!

Approximately thirty-six million, or 1 out of 10, Americans have some degree of hearing loss. So, take a moment to imagine how often you have been in a conversation with someone that is experiencing some communication difficulty! Read Full Article

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