DENVER-- Hearing loss prevention was the prevailing theme of the 19th Annual Convention of the American Academy of Audiology (AAA). AudiologyNow! 2007 drew more than 7,400 attendees, "the largest gathering worldwide of audiologists," according to president-elect Alison Grimes, AuD. Program chair Sharon Sandridge, PhD, said the convention set an attendance record for member registration.

Denver native Marion Downs, MA, Hon. DSc, who praised her hometown as the "center of the audiology universe," gave the official welcome; and convention-goers responded with a standing ovation. "At this age I get a standing ovation for just standing!" she joked. "It's a privilege to be with you today, but at 93 it's a privilege to be anywhere."

She reported with disappointment that Colorado had the dubious distinction of being the last state in the country to enact a licensure bill. The legislation went into effect last month.

To acknowledge the conference theme the academy invited Boston area musician Ben Jackson to perform a song he wrote about preventing noise-induced hearing loss. The rap song was called Turn It to the Left.

The past year was a busy one for the academy, observed president Paul Pessis, AuD. The year was marked by "an impressive list of accomplishments." He outlined the progress of the major initiatives of the organization, as well as his plans to move forward in each area.

One area that continues to be a priority is the accreditation of university AuD programs, he said. "Audiologists must take ownership for accreditation of audiology programs."

Central Michigan University (CMU), in Mount Pleasant, and Washington University, in St. Louis, MO, were the first to undergo the accreditation process developed by the Accreditation Commission for Audiology Education (ACAE) in compliance with the requirements of the U.S. Department of Education, he announced. The ACAE Board of Directors voted unanimously to bestow accreditation on CMU. Applications from other university programs will be accepted beginning in July.

Dr. Pessis praised the decision by the Centers for Medicare and Medicaid Services (CMS) to eliminate the non-physician work pool service provision.

"This is an unprecedented change in the CMS mindset," he said. "It will have global reimbursement implications."

Ethics continues to be a divisive issue for the academy, he reported. "It is a polarizing topic within our ranks."

He praised the work of Jane Kukula, AuD, chair of the AAA Ethical Practices Board. "Congress and the public have the expectation that a profession should take ownership of its ethical practices," Dr. Pessis said. Discussion on the issue will continue, and he urged members to be patient.

Dr. Grimes outlined her presidential priorities for the coming year. She hopes to strengthen the presence of AAA on Capitol Hill, differentiate the academy from other audiology organizations, and raise its public profile. The pursuit of direct access remains "critically important," she said.

Members need to continue contributing to the AAA Political Action Committee (PAC), she said, calling the fund a "necessary vehicle" for getting face time with legislators. Members also should continue writing to their state representatives to support legislative initiatives that benefit the profession.

"Your efforts on the local level pay off tremendously on the national level," Dr. Grimes said.

AAA plans to open an office in Washington, DC, she said, and the academy is devoting considerable energy toward its search for a new CEO. To address the "graying" of its leadership, the academy is working to mentor new leaders.

Because the profession is experiencing a shortage of audiologists, AAA plans to develop an audiology assistant program and encourage younger students to enter the field, Dr. Grimes reported.

During the general assembly, keynote speaker Alison Levine discussed the importance of survival skills and how they can be adapted successfully to the workplace. Levine was the leader of the first American women's expedition to Mount Everest.

The convention featured nearly 200 courses, sessions and learning modules on professional, technological and research issues.

Walter Nance, MD, PhD, of Virginia Commonwealth University, in Richmond, presented the 2007 Marion Downs Lecture in Pediatric Audiology. The geneticist spoke on "How Can Newborn Hearing Screening Be Improved?" He is working to map and identify the genes for non-syndromic deafness.

"Hearing loss is extremely variable in onset, progression, severity and laterality," Dr. Nance said. While the frequency of deafness at birth varies, the current estimate of severe to profound hearing loss is one in 1,000 children.

"One thing newborn hearing screening has taught us is that for every child with a profound loss, there are one or two children with unilateral losses," he said. These cases of "lesser" deafness are important and should be an imperative research initiative in audiology.

More than half of all hearing loss at birth is caused by genetic factors, he reported. To ultimately improve the outcomes of NHS Dr. Nance called for increased attention to etiologic factors in the diagnosis of hearing loss and the standardizing of diagnosis screening protocols. "Diagnosis is incomplete until you know what the cause of deafness is," he said.

Ali Danesh, PhD, an associate professor at Florida Atlantic University, in Boca Raton, presented a session on "Sudden Hearing Loss: Audiological Diagnosis and Management." Sudden sensorineural hearing loss (SSNHL) can last up to three days and often is accompanied by tinnitus, nausea, vertigo and aural fullness. One ear is affected in most cases.

SSNHL has more than 100 possible causes, including viral and bacterial infections, multiple sclerosis, cardiopulmonary bypass, acoustic neuromas and vascular occlusion. Root causes can be idiopathic or direct. Only 10 percent to 15 percent of patients ever find out the cause of their hearing loss. Some patients have a 40 percent to 70 percent chance of spontaneous recovery two weeks post onset.

Because of the long list of possible causes, SSNHL requires "a diagnosis of exclusion." said Dr. Danesh. Once a patient experiences sudden hearing loss, timing is everything. "This is an emergency," she said. "The sooner we get them in for treatment, the better."

The most common treatment is steroids. While corticosteroids are effective, the steroid prednisolone has been the most effective to date. It is "the only class of drug with demonstrated efficacy in clinical trials," reported William Andreassen, an AuD candidate at Nova Southeastern University in Fort Lauderdale-Davie, FL.

Because otolaryngologists will not always be involved in treatment, it is critical for audiologists to educate primary care physicians about the condition, he said. "Educate them on the importance of the time frame. Chances for recovery decrease by the day the longer you wait."

In the session "Pediatric Audiology in the Trenches," Jacqueline Scholl, AuD, FAAA, of the Tulsa Health Department, in Oklahoma, and Lisa Christensen, AuD, CCC-A, of the Arkansas Children's Hospital, in Little Rock, offered tips for working with children.

They discussed some of the tools and strategies they use to get information from a population that is difficult to test. Children 0-3 who are at risk for developmental delays sometimes are reluctant to get into the sound booth.

One strategy is for clinicians to dress up the sound booth as though it were a school bus or barn, for example, and offer to "Get on the bus" or "Go see the cows" with them. When it comes time to perform a tympanogram, audiologists can use TV sets and bubble blowers to get a child to sit still.

Clinicians can make testing fun by using toys that will fit into a bucket, stickers, or the popular game Connect Four® byHasboro. "Even 12- or 13-year-old children will do that," said Dr. Christensen.

The etiology of a child's hearing loss is important, Dr. Scholl noted. "If you don't have a geneticist, find the closest link to one."

Babies often will pull out their hearing aids if something is going on in the ear of if there is too much or too little happening.

Audiologists should invest in hearing aid maintenance kits and encourage parents to buy modest accessories such as headbands for their children who wear hearing aids.

"It's important for parents to feel like their child doesn't have a medical device strapped to their heads," said Dr. Scholl. "They deal with enough."

Three presenters addressed the evolution of hearing loss treatment and prevention and the changing role of the audiologist in a session titled "Prevention of Hearing Loss: Past, Present & Future." Richard Danielson, PhD, a retired Army colonel, presented the military perspective on the history of hearing loss prevention; Howard Hoffman, MS, reported on hearing loss trends across the United States; and Mark Stevenson, PhD, MPH, predicted the emerging prominence of NIHL.

Many aspects of military life present a hostile environment for hearing health, explained Dr. Danielson, manager of the Audiology and Hearing Conservation Clinic at the NASA Johnson Space Center in Houston, TX. In addition to weapon fire, the everyday noises that are part of their routine put soldiers at risk.

However, the Army has played a major role in the history of audiology, he noted. It developed the Elements of Hearing Conservation Program that is still used by audiologists today.

Current hearing health challenges that face military audiologists include tinnitus, the third most common disability in the Department of Veterans Affairs (VA). The VA is "significantly challenged" in this treatment area, said Dr. Danielson.

Hoffman, chief of Epidemiology and Data Systems at the National Institute on Deafness and Other Communication Disorders (NIDCD), reported on U.S. hearing loss trends according to the results of the National Health Exams.

NIHL will become more prominent among the populace, predicted Dr. Stevenson, of the Centers for Disease Control and Prevention (CDC). "One in five adult patients comes to your clinic because all or most of their hearing loss is due to NIHL," he said.

He expressed concern about NIHL in the workplace, particularly on construction sites where only 17 percent of workers wear hearing protection

"We do not know how many noise-exposed workers are in the United States. We have a very poor understanding of the relation of noise exposure to tinnitus," he said. That area should be a major research focus for audiologists.

NIHL education and training must reach and influence managers as well as employees, he stated. "We hope the research we will be doing in the next 10 years will touch every worker in America."

The 2008 AAA Convention will be held April 2-5 in Charlotte, NC.

Alyssa Banotai and Jason Mosheim are Associate Editors at ADVANCE.