Now Open: Our New Milton Location!Serving New York & Vermont for Over 40 Years

Serving New York & Vermont for Over 40 Years

Adirondack Audiology

Hearing Care Questions, Answered

The questions our patients across northern New York and Vermont ask most often — about hearing loss, testing, hearing aids and tinnitus. If yours is not here, call your nearest clinic or send us a message and we will answer it.

Understanding hearing loss

How do I know if I have hearing loss?

Hearing loss usually comes on gradually, which is why the people around you often notice it before you do. On average it takes seven years from first noticing a problem to doing something about it. Signs worth paying attention to:

  • People seem to mumble, and you ask them to repeat themselves
  • You need the TV or radio louder than everyone else
  • You struggle in restaurants and avoid the noisy ones
  • You miss the doorbell, the phone, or birdsong
  • You find yourself watching faces to follow what is said
  • You laugh along at jokes you did not quite catch
  • You hear ringing in your ears, especially when it is quiet

If several of those sound familiar, our free hearing assessment takes a couple of minutes online and we will call you back to arrange a proper evaluation.

What causes hearing loss?

Aging and noise exposure are the two most common causes, but hearing loss can also follow from certain medications, ear or head injury, infections, genetic factors and a range of medical conditions. It is estimated that around 48 million adults in the United States report some degree of hearing loss.

Most of it builds slowly over a lifetime, which is part of why it is so easy to miss. There is more on the different types of hearing loss and on how hearing works.

What are the different degrees of hearing loss?

Results are plotted on a chart called an audiogram: pitch runs left to right, loudness top to bottom. Hearing level is measured in decibels (dB HL) and grouped into categories:

  • Normal hearing: 0–25 dB HL
  • Mild hearing loss: 26–40 dB HL
  • Moderate hearing loss: 41–70 dB HL
  • Severe hearing loss: 71–90 dB HL
  • Profound hearing loss: greater than 91 dB HL

The degree matters, but so does the shape of the loss across pitches and how well you understand speech — two people with the same average can have very different experiences.

What are the signs of hearing loss in children?

Hearing loss in children can be present at birth or acquired later through ear infections, head injury, certain medications or genetic factors. Things to watch for:

  • A failed newborn hearing screening
  • Delays in babbling, speech or language
  • Frequent ear infections
  • Not startling at loud sounds, or not turning towards sound after six months
  • Difficulty following spoken directions, or frequent daydreaming
  • Turning the TV up loud
  • Concerns raised by a teacher, or a failed school screening

Our pediatric audiologists test children of all ages. Anything you are unsure about is worth checking promptly, because speech and language development depends on it.

Getting your hearing tested

What is an audiologist?

Audiologists are healthcare professionals who evaluate, diagnose and treat hearing loss and related conditions such as tinnitus and balance disorders. They also help prevent hearing loss — custom hearing protection is part of the job. Audiologists work with all ages, from newborns upwards, and some specialize further.

Audiologists now hold a doctoral degree and must be licensed by the state in which they practice. Some also hold the Certificate of Clinical Competence in Audiology (CCC-A) from ASHA, or Fellowship of the American Academy of Audiology. You can meet our team and see their credentials.

What is the difference between an audiologist and a hearing instrument specialist?

An audiologist is trained to diagnose, treat and monitor disorders of the hearing and balance systems. That means roughly eight years of study — an undergraduate degree plus a doctorate in audiology — followed by a supervised externship, a national examination, state licensure and ongoing continuing education. For diagnosis of hearing, auditory or balance problems, an audiologist is the most qualified professional to see.

A hearing instrument specialist (HIS) is licensed to perform audiometric testing and to fit and service hearing aids. Licensure generally requires a certification program, supervised field hours and an examination. An HIS can fit and repair hearing aids but does not diagnose hearing loss.

We have both on the team, and who you see depends on what you need.

What does a hearing evaluation involve?

A full diagnostic evaluation is more than the quick screening you may have had at a health fair. It starts with your history and a look inside the ear canal and eardrum, then tests how you hear tones across the pitch range and how accurately you understand speech — including with background noise, which is usually the part people find hardest. Tests of middle-ear function may be added depending on what we find.

Results are plotted on an audiogram. That audiogram, together with your speech scores, is what any hearing aid is programmed from — and it is also what tells us if you should see a physician instead.

What do audiologists treat?

Between us, the team covers:

Hearing aids

What style of hearing aid do I need?

That depends on the degree and shape of your hearing loss, the size of your ear canals, how much dexterity you have, and what you want the hearing aid to do.

  • Receiver-in-canal (RIC) is the most commonly fitted style today — small, rechargeable, discreet, and suitable for most degrees of loss.
  • Behind-the-ear (BTE) handles more severe losses, has the longest battery life and is the easiest to handle.
  • Custom in-the-ear, in-the-canal, completely-in-canal and invisible-in-canal models sit in the ear itself and are far less visible — but the smaller the shell, the less room there is for battery, microphones and features.

There is a picture of each style on our hearing aid styles page, and we will talk the trade-offs through with you at your hearing aid evaluation.

Which hearing aid brands do you fit?

All six of the major manufacturers: Oticon, Phonak, ReSound, Signia, Starkey and Widex.

Each has taken a different approach to separating speech from noise, and each does something slightly better than the others. Because we are independent, the recommendation comes from your hearing test and how you actually spend your time — not from whichever brand we happen to stock. Our hearing aids page explains what the current technology does in plain English.

Are hearing aids rechargeable, and will they connect to my phone?

Most current models are rechargeable — you drop them in a case overnight and they last the day, with no small batteries to change. If you would rather keep disposable batteries, those models still exist.

Nearly all of them connect over Bluetooth and stream phone calls, music and TV audio straight into your ears. Every manufacturer offers an app if you want manual control, but you do not have to use one; the hearing aids adjust themselves. We also fit phone and TV accessories and captioned telephones where they make a real difference.

What is the difference between over-the-counter and prescription hearing aids?

The FDA created an over-the-counter category in 2022. OTC hearing aids are intended for adults aged 18 and over with perceived mild to moderate hearing loss, and can be bought without an exam, a prescription or a professional fitting.

Prescription hearing aids are for any age and any degree of loss, including severe and profound, and are fitted by a licensed professional against your actual audiogram. Personal sound amplification products (PSAPs) are a third thing again — consumer electronics intended for people with normal hearing, not medical devices.

If an OTC device is genuinely the right answer for you, we will say so. What a test gives you either way is knowing what you are dealing with, and ruling out causes that need medical attention rather than amplification.

What are assistive listening devices (ALDs)?

People with any type or degree of hearing loss can benefit from an ALD. Because a hearing aid microphone sits on your ear, there is a limit to how much it can favor a distant voice over the noise around you. An ALD puts the microphone close to what you actually want to hear — the speaker, the television, the phone — instead.

They include TV listening systems, telephone amplifiers, alerting devices for the doorbell and alarm clock, and auditorium loop systems. Most modern ones are small, wireless and work directly with digital hearing aids.

How much do hearing aids cost, and can I finance them?

Cost depends on the technology level and on how much follow-up care is included, so we will give you a clear figure at your evaluation rather than a number that turns out not to cover the aftercare. There is no obligation to go ahead.

We offer financing through Cherry, which spreads the cost over monthly payments instead of asking for it up front. You can check your options on our financing page.

Tinnitus and balance

What is tinnitus?

Tinnitus is the perception of sound with no external source — usually described as ringing, but it can be hissing, roaring, whistling, buzzing or clicking. Over 50 million people in the United States experience it.

It is not a disease in itself. It is a symptom of something else going on in the ear, the auditory nerve or elsewhere. It may be constant or come and go, in one tone or several, and anywhere from barely there to genuinely intrusive.

What causes tinnitus?

The exact cause is not identifiable in every case, but the common contributors are:

  • Noise-induced hearing loss
  • Age-related hearing loss
  • Earwax build-up in the canal
  • Certain medications
  • Ear or sinus infections
  • Ear diseases and disorders
  • Jaw misalignment
  • Head and neck injury
  • Cardiovascular disease and thyroid disorders
  • Certain types of tumour

Because some of those need medical attention rather than sound therapy, new or one-sided tinnitus is always worth getting looked at.

How is tinnitus treated?

Treatment depends on what is driving it. The approaches that help most people are:

  • Hearing aids with tinnitus-masking features — often the single most effective step, because treating the hearing loss reduces the tinnitus
  • Tinnitus retraining therapy
  • Sound therapy
  • Reviewing medications that may be contributing
  • Behavioral therapy for the distress side of it
  • Protecting your hearing from further noise damage

More on our tinnitus treatment page, and on hearing and balance if dizziness is part of the picture.

Appointments

How do I book an appointment?

Two ways. Call the clinic nearest you — numbers are at the top of every page and on the locations page — or fill in our free hearing assessment online and we will call you back to arrange an evaluation wherever suits you.

We have five offices: Plattsburgh, Potsdam and Saranac Lake in New York, and Shelburne and Milton in Vermont. Milton is our newest.

How long is the wait, and can I walk in for a repair?

The average wait for an appointment is around three weeks across the five offices. Plattsburgh and Potsdam tend to run longer; Saranac Lake, Milton and Shelburne are usually shorter. We hold room for urgent problems and do our best to see those patients quickly.

Hearing aid repairs we take as walk-ins. A quick call first helps — we can tell you the best time that day so you are not sitting waiting.

Still not sure where to start?

Answer a few short questions about your hearing and we will call you back to arrange an evaluation at the office that suits you.

Take the free hearing assessmentFind your nearest clinic