Lesson 1Audiogram configurations and diagnostic reasoning: high-frequency sloping sensorineural loss typical of noise-induced hearing loss vs flat or mixed lossesExamines common adult audiogram patterns, focusing on high-frequency sloping from noise exposure versus flat or mixed losses, and how they guide diagnosis, outlook, and management in local settings.
Reading and describing audiogram shapesNoise-induced high-frequency sloping lossAge-related versus noise-related patternsIdentifying mixed and conductive componentsImplications for counseling and treatmentLesson 2External and middle ear exam: otoscopy findings to rule out wax, tympanic membrane pathology; when to perform tympanometry in adultsCovers adult ear checks, spotting wax, eardrum issues, and when to do tympanometry, with focus on documentation and next steps in Kenyan clinics.
Systematic adult otoscopy techniqueCommon cerumen and canal findingsRecognizing tympanic membrane pathologyIndications for tympanometry in adultsImpact on audiologic test planningLesson 3Objective tests: OAEs for cochlear outer hair cell function, when to order ABR/EP for retrocochlear concernsReviews objective tests for adults, OAEs for cochlear health, and ABR for inner ear or non-organic loss suspicions.
OAE types and clinical applicationsInterpreting absent or reduced OAEsWhen to order diagnostic ABR testingABR patterns in retrocochlear diseaseObjective tests in difficult-to-test adultsLesson 4When to refer for medical imaging or ENT: asymmetric loss, severe unilateral tinnitus, or abnormal neurologic signsClarifies referrals for ENT or scans in adults with asymmetric loss, one-sided tinnitus, or neurological signs suggesting serious issues.
Audiometric criteria for ENT referralRed-flag tinnitus and unilateral symptomsNeurologic and vestibular warning signsWhen to request MRI or CT imagingCoordinating care and reporting findingsLesson 5Comprehensive adult audiologic history: noise exposure, ototoxic medications, gradual vs sudden onset, communication situations, tinnitus characteristics, medical comorbiditiesGuides thorough adult history-taking, covering noise, harmful drugs, onset, communication challenges, tinnitus details, and other health issues for accurate diagnosis.
Characterizing onset and progressionOccupational and recreational noise historyMedication, illness, and ototoxic riskCommunication and listening situation reviewTinnitus description and impact inquiryLesson 6Key evidence-based resources and clinical practice guidelines for adult audiologic managementOutlines key guidelines shaping adult audiology, teaching how to find, understand, and apply them to daily decisions for hearing loss and tinnitus patients.
Major audiology and ENT guideline sourcesKey adult hearing assessment recommendationsBest practices for adult hearing aid fittingGuideline use in tinnitus assessmentKeeping current with evolving evidenceLesson 7Workplace accommodations and communication strategies: meeting strategies, assistive listening devices (FM/remote mic), legal/occupational considerations for office workersCovers workplace needs for office workers with hearing loss, including meetings, remote mics, accommodations, and legal protections.
Assessing workplace listening demandsEnvironmental and meeting modificationsRemote microphone and FM system optionsTraining communication partners at workLegal and occupational rights overviewLesson 8Diagnostic audiometry: pure-tone air and bone conduction testing, masking principles, interpretation of air-bone gapsProvides structured adult audiometry approach, pure-tone air/bone, masking, and air-bone gap analysis to separate sensorineural from conductive loss.
Pure-tone air conduction proceduresBone conduction and vibrotactile responsesWhen and how to apply maskingInterpreting air-bone gaps accuratelyQuality control and retest criteriaLesson 9Follow-up plan: hearing aid trials, rehabilitation, auditory training, monitoring progression and counselling for preventive hearing conservationDesigns individual follow-up plans with hearing aid trials, training, counselling, monitoring, and prevention strategies for long-term engagement.
Structuring hearing aid trial periodsScheduling and content of follow-up visitsAuditory training and communication rehabMonitoring thresholds and functional outcomesPreventive hearing conservation counselingLesson 10Red flags for urgent medical referral in adults: sudden sensorineural hearing loss, asymmetric loss, focal neurological signs, fluctuating symptomsDetails urgent referral signs like sudden loss, asymmetry, neurological issues, fluctuating symptoms, with timelines and documentation.
Criteria for sudden sensorineural lossRecognizing clinically significant asymmetryFocal neurologic and vestibular signsFluctuating hearing and episodic symptomsUrgent referral pathways and counselingLesson 11Tinnitus assessment: tinnitus history, psychoacoustic measures, Tinnitus Handicap Inventory and counselling approachesComprehensive tinnitus assessment including history, measures, questionnaires like Tinnitus Handicap Inventory, guiding counselling and plans.
Key elements of tinnitus case historyPitch and loudness matching methodsMinimum masking level and residual inhibitionUsing Tinnitus Handicap Inventory scoresLinking assessment to care planningLesson 12Management options: hearing aid candidacy, selection criteria, verification (real-ear measures), and fitting protocolsDetails hearing aid suitability, selection, real-ear verification, fitting, and counselling for expectations and adoption.
Determining candidacy and motivationSelecting style and technology levelPrescriptive targets and fitting formulasReal-ear verification and fine-tuningOrientation and expectation counselingLesson 13Tinnitus management: sound therapy, counselling (CBT principles), referral options, and hearing aid-based tinnitus approachesReviews tinnitus strategies: sound therapy, CBT counselling, hearing aids, and referrals to specialists.
Education and reassurance techniquesSound therapy and sound enrichmentCBT principles in tinnitus counselingHearing aids with tinnitus featuresReferral to specialized tinnitus servicesLesson 14Differential diagnoses: noise-induced hearing loss profile, age-related changes, ototoxicity, Meniere’s disease indicators, conductive componentsDiscusses differentiating noise loss, ageing, drug effects, Meniere’s, conductive issues, guiding referrals.
Noise-induced versus presbycusis patternsOtotoxicity history and audiometric signsFeatures suggestive of Meniere’s diseaseIdentifying conductive and mixed lossesIntegrating data for differential reasoningLesson 15Speech audiometry: speech reception threshold (SRT), word recognition scores (WRS), supra-threshold testing and significance for real-world communicationExplains speech tests: SRT, WRS, supra-threshold, relating to daily communication and hearing aid expectations.
Speech reception threshold proceduresWord recognition test selectionInterpreting WRS and rollover patternsSupra-threshold and speech-in-noise testsLinking results to communication needs
