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Full Interview: AudA Audiologist Kathleen Stoop on World Hearing Day

Mar 1, 2024

This World Hearing Day (WHD) 2024, we sat down with Kathleen Stoop, an Audiology Australia Accredited Audiologist with experience in a variety of clinical audiology roles including paediatric audiologist, clinical educator, diagnostic audiologist and hearing aid dispenser. As an overseas-qualified audiologist,  she’s had the opportunity to work in three countries and to experience audiology service provision across major cities, regional areas and remote locations.

Now Kathleen is the Coordinator Quality, Training and Community (Early Childhood Approach) at Wanslea Limited, a non-profit headquartered in Western Australia that provides services that supports children and young people across Australia to grow and develop safely.

Kathleen Stoop

Here is our full interview:

What does this year’s WHD ‘Changing Mindsets: Let’s make ear and hearing care a reality for all’ mean to you?

I see the theme as a challenge to make ear and hearing health everybody’s business. This involves not only redefining professional roles but also reimagining service delivery models to meet the diverse needs of communities.

This includes advocating for:

  1. A Community-Centred Approach: Emphasising the importance of community involvement in promoting ear and hearing health, as well as ensuring that services are tailored to meet the specific needs of different cultural groups.
  2. Accessibility and Affordability: Acknowledging the need for ear and hearing care services to be accessible, affordable, timely, and culturally appropriate for everyone, regardless of their socioeconomic status or geographical location.
  3. Technology Integration: Recognising the role of technology in advancing ear health care, including the use of innovative tools for checking ear health and screening hearing levels. This suggests a move away from solely relying on traditional face-to-face appointments with audiologists.
  4. Service Delivery Models: Advocating for the reimagining of service delivery models to better accommodate the goal of providing hearing care for all. This could involve exploring alternative methods such as teleaudiology, community-based clinics, or mobile health units to reach underserved populations. This would likely mean that the role of the audiologist may be to manage and oversee screening programs provided by trained nonclinical staff or remote assessments facilitated by trained local staff.
  5. Challenging Perceptions: Encouraging a shift in perceptions around what constitutes best practices in ear and hearing health care, particularly in light of advancing technologies and the need for more inclusive and scalable approaches.

What do you see as some of the barriers to access to hearing care?

My experience in providing ear health and audiology services in regional and remote communities in Western Australia provided insight into some of the challenges faced in these areas.

  1. Coordination of Services: The reliance on fly-in-fly-out specialists can lead to challenges in coordinating services effectively. This may result in fragmented care and difficulties in ensuring consistent access to specialised care for individuals in these communities. The fly-in-fly-out model isn’t sustainable in the long-term and technology exists to deliver services remotely via telehealth to overcome the geographical barriers and support continuity of care.
  2. Understanding Community Priorities: Recognising the importance of understanding the unique priorities and needs of each community is crucial for delivering effective ear health and audiology services. Cultural sensitivity and community engagement are essential for tailoring services to meet local needs and preferences.
  3. Transport: Limited access to transportation can pose a significant barrier for individuals seeking medical treatment, including ear health and audiology services. Lack of reliable transportation options can hinder access to care, particularly for those living in remote areas.
  4. Access to Medical Treatment: Limited availability of medical facilities and specialists in regional and remote areas can make it challenging for individuals to access timely and appropriate medical treatment for ear-related issues and hearing loss.
  5. Education and Awareness: There may be a lack of awareness and education within these communities regarding the importance of protecting hearing and recognising the symptoms of hearing loss. Providing education and raising awareness about ear health can empower individuals to take proactive steps to protect their hearing and seek timely medical attention when needed.

What are the real costs and consequences of not meeting these needs?

The consequences of neglecting ear and hearing care needs are significant, impacting both individuals and society as a whole.

  1. Financial Costs: Neglecting ear and hearing care needs can result in increased healthcare expenditures due to the treatment of preventable conditions, such as chronic ear infections or advanced hearing loss. Additionally, there may be indirect costs associated with reduced productivity and increased reliance on social services.
  2. Human Costs: The human toll of untreated ear and hearing issues is profound. For children, long-standing ear health problems and hearing loss can interfere with their educational attainment and social development. Misinterpreted as behavioural issues, these children may face disengagement from the education system, hindering their future opportunities and potentially leading to involvement with the justice system.
  3. Educational and Employment Opportunities: Poor literacy levels resulting from untreated hearing issues can limit individuals’ chances of obtaining gainful employment, perpetuating cycles of poverty and inequality. This lack of economic opportunities may further exacerbate social disparities and increase the likelihood of contact with the justice system.
  4. Psychological and Social Impacts: Untreated hearing loss in adults can lead to social isolation, depression, and diminished quality of life. Hearing loss affects communication, making it difficult for individuals to engage in social interactions and maintain relationships. This isolation can have profound psychological effects, contributing to mental health challenges and reducing overall well-being.
  5. Safety Risks: Our sense of hearing plays a crucial role in localising sounds and detecting potential dangers in our environment. Untreated hearing loss can compromise individuals’ ability to perceive auditory cues, increasing their vulnerability to accidents and endangering their safety.

What do you think are the biggest misconceptions and stigmas affecting Australia’s mindset about hearing as health priority for action?

Misconceptions and stigma surrounding hearing loss can vary significantly between children and adults 

  1. Invisibility of Hearing Loss: Despite efforts to raise awareness, hearing loss remains largely invisible to many individuals and families. This invisibility can lead to underestimation of its prevalence and impact, resulting in delayed recognition and intervention.
  2. Misconceptions about Newborn Hearing Screening: There is a common misconception that passing a newborn hearing screening means a child’s ear and hearing health is fully assured until they reach school age. However, conditions like glue ear, which can cause fluctuating hearing loss, may not be detected by newborn screenings. This can lead to missed opportunities for early intervention and support.
  3. Asymptomatic Nature of Glue Ear: Glue ear, often associated with fluctuating hearing loss, may not present obvious symptoms. As a result, parents and caregivers may overlook the potential impact of ear and hearing health on their child’s development, particularly in areas such as speech and language development and balance.
  4. Delayed Manifestation of Hearing Loss: While some forms of genetic hearing loss may be present at birth, others may not manifest until later in childhood. This delayed onset further complicates the identification and management of hearing loss, as it may not be immediately apparent in early screenings or assessments.
  5. Education and Social Integration: Children with hearing loss may face challenges in education and social integration due to communication barriers and the need for accommodations. Stigma can arise from a lack of understanding among peers and educators, leading to feelings of isolation and exclusion.
  6. Age-Related Assumptions: In adults, hearing loss is often associated with aging, leading to misconceptions that it’s a natural part of getting older. This belief may discourage individuals from seeking treatment or support, as they may perceive hearing aids as a sign of frailty or decline.
  7. Stigma of Wearing Hearing Aids: There’s a stigma associated with wearing hearing aids among adults, with some viewing it as a sign of weakness or inferiority. This stigma can prevent individuals from seeking help for their hearing loss and may contribute to social withdrawal and isolation.
  8. Employment and Professional Impact: Adults with hearing loss may face discrimination in the workplace due to misconceptions about their abilities. Fear of negative repercussions, such as being passed over for promotions or job opportunities, can deter individuals from disclosing their hearing loss or seeking accommodations.

Hearing health intersects with many other areas of health but is still not well understood by other health providers and professional. What do you think is impacting this understanding and how can we begin to change the health conversation around hearing and hearing loss?

In my experience, there are significant gaps in the training and understanding of ear health and audiology among medical professionals, particularly general practitioners (GPs).

  1. Limited Coverage in Training: It’s my understanding that the anatomy and physiology of the ear are often covered briefly during medical training, with insufficient emphasis on their importance within the context of overall well-being. This lack of comprehensive education can result in gaps in understanding among healthcare professionals.
  2. Misconceptions about Otoscopy: Some GPs may rely solely on otoscopy (inspection of the eardrum) as a means of assessing ear health and hearing ability, without fully understanding its limitations. This narrow focus may lead to missed diagnoses of middle ear diseases and cochlear hearing loss.
  3. Emphasis on Hearing Aid Sales: There’s a perception among some medical professionals that hearing assessments are primarily conducted to facilitate hearing aid sales, rather than recognising the broader diagnostic value of audiology in differential diagnosis, especially for conditions like vertigo or tinnitus.
  4. Need for Proactive GP Education: There’s a clear need for more proactive education and training for GPs in the field of audiology, ideally beginning at university level. This education should encompass not only the basics of ear anatomy and physiology but also the broader implications of ear health for overall well-being and the diagnostic role of audiology in identifying various ear-related conditions.

What information or engagement is needed to change public perception and understanding of hearing health and hearing loss?

A public awareness campaign aimed at promoting hearing health, preventing hearing loss, and encouraging early intervention could indeed have a significant impact on improving ear and hearing care practices. Drawing inspiration from successful campaigns like the SunSmart Skincare Routine (“Slip, Slop, Slap, Seek, Slide”), a similar campaign for hearing health could employ catchy slogans or mnemonics to convey key messages.

By using a combination of traditional and digital media channels, community outreach programs, and partnerships with healthcare providers, schools, workplaces, and other relevant stakeholders, such a campaign could effectively reach and engage a wide audience. The goal would be to foster a culture of proactive ear and hearing care, reduce stigma surrounding hearing loss, and empower individuals to take control of their hearing health for a better quality of life.  Some excellent resources already exist (e.g. Dangerous Decibels and Deadly Ears) that could be used to run state-based and national campaigns with the support of government funding.

What are the biggest or most frequent misconceptions you have encountered?

  1. Hearing Loss as a Behavioural Issue: The misinterpretation of hearing loss as a behavioural problem in children is a significant barrier to early intervention. Symptoms of hearing loss, such as difficulty following instructions or being easily distracted, may be mistaken for behavioural issues rather than indicators of sensory impairment.
  2. Perception of Hearing Loss as an Age-Related Issue: Many adults perceive hearing loss as a condition that only affects individuals in old age and therefore may not consider seeking intervention until later in life. This misconception may lead individuals in their fifties or sixties to believe they are “too young” for hearing aids.

What actions does Australia need to take to improve equitable access to hearing ear and hearing healthcare for all?

Recognising the critical role of hearing in various aspects of life, such as speech-language development, literacy, academic achievement, employment opportunities, social connection, and emotional well-being, is essential. Implementing policies that support equitable access to hearing assessments for both children and adults is a crucial step toward addressing hearing health disparities. Here’s how providing a Medicare rebate for hearing assessments can contribute to improving access and promoting better hearing health outcomes in Australia:

  1. Early Detection and Intervention: Offering Medicare rebates for hearing assessments encourages individuals to undergo regular screenings, leading to early detection of hearing issues. Early intervention can help mitigate the impact of hearing loss on speech-language development in children and prevent potential academic and social challenges.
  2. Promoting Preventive Care: Accessible hearing assessments can promote preventive care behaviours among adults, encouraging them to monitor their hearing health proactively. Identifying hearing loss early allows for timely intervention and may prevent further deterioration of hearing abilities, thereby preserving speech comprehension and communication skills.
  3. Reducing Financial Barriers: Providing Medicare rebates for hearing assessments alleviates financial barriers that may deter individuals, particularly those from lower-income backgrounds, from seeking essential healthcare services. This can help ensure that everyone has access to the necessary diagnostic evaluations for optimal hearing health.
  4. Facilitating Treatment Planning: Medicare rebates for hearing assessments enable individuals diagnosed with hearing loss to access appropriate treatment and management options, including hearing aids, assistive devices, and rehabilitative services. This supports personalised treatment planning tailored to individual needs, promoting better outcomes and quality of life.
  5. Raising Awareness and Normalising Hearing Care: Incorporating hearing assessments into Medicare rebates helps raise awareness about the importance of regular screenings for maintaining overall health and well-being. Normalising hearing care as an integral part of preventive healthcare encourages individuals to prioritise their hearing health and seek timely evaluations when needed.

Looking into the future what changes do you hope to see?

There are so many changes that I would like to see and I believe that they are feasible and achievable with concerted efforts and support. I would love to see:

  1. A comprehensive public health campaign with a catchy slogan that can help raise awareness among children and adults about the importance of hearing health and encourage proactive measures to protect and monitor their ears and hearing.
  2. Medicare rebates for hearing assessments
  3. Integration of smart devices for monitoring ear and hearing health in various settings. Screening and surveillance could be conducted by non-clinical staff, but overseen and managed by audiologists.
  4. Increased access to telehealth services for hearing assessments to overcome geographical barriers and make evaluations more accessible to individuals in remote or underserved areas. Rebates for telehealth assessments would ensure affordability and promote widespread access to care.
  5. Personalised medicine may lead to tailored prevention and treatment plans for individuals with genetic predispositions to hearing loss or other ear-related conditions. Hopefully we’ll see a breakthrough in regenerative therapies in my lifetime.
  6. An expanded role for audiologists, including managing screening and surveillance programs, managing quality assurance for telehealth assessments and focusing on diagnostic audiology to support differential diagnosis and new personalised medical or technological options.

Any famous last words of wisdom?

Making ear and hearing care a reality for all requires collaboration among healthcare professionals, policymakers, advocacy groups, and the community. By working together, we can create a future where ear and hearing healthcare is accessible, personalised, and focused on promoting optimal health and well-being for all.  But it all begins with making ear and hearing health everybody’s business!

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