A Hearing

Report
from China
The living standard and accessibility to hearing services for people living in cities have improved greatly. Yet
time is frozen for people living in poor areas, and it is
almost impossible for them to access hearing services.
BY KING CHU NG, BECK Y Y ING M A,
MICH A EL W EN-PENG CUI, SHU-FENG WA NG,
A ND FA NG X U

42

AUDIOLOGY TODAY May/Jun 2014

China,

a country with more than

5,000 years of civilization,

is the largest country in the world by

population. It is one of the four ancient
countries of the world and has treaded
through many social and economic
challenges. Today, China has the
second largest economy in the world
and is well-known for its cultural heritage, delicious food, beautiful scenery,
technology advancement, and rapid
economic growth.

Audiological Education
and Practices
Audiology is a relatively new and
rapidly developing field in China
with most infrastructures for hearing care developed in the past 30
years. The first audiological service
center was established in 1983 by
the Department of OtolaryngologyHead and Neck Surgery of Beijing
Tongren Hospital, which is affiliated
with Capital University of Medical
Sciences in Beijing. Two years later,
two more hearing and rehabilitation
centers were established in two hospitals at Tianjin City and Xuzhou.
The first formal audiology was
initiated in 1996 through the Joint
Sino-Australia Audiology Program,
which was jointly developed by
Australia Hearing, Capital University
in Medical Sciences in China, and
Macquarie University in Australia.
Most of the initial 14 participants
are ear, nose, and throat (ENT)
physicians. Eight of them were sent
to Australia for clinical practicum
training and received a joint masters
degree from the two universities (Liu

et al, 2009). The program continues

to train hearing care professionals,
and it has produced approximately
1,000 graduates to date (Liang and
Mason, 2013).
Currently, there are three universities offering bachelors degrees
in audiology in China. The Capital
University of Medical Sciences in
Beijing established a biomedical
engineering degree with audiology emphasis in 1999. It produces
approximately six to eight graduates each year (Feng and Su, 2009).
Zhejiang Chinese Medical University
in Hangzhou established the first
audiology bachelors degree program in 2002. The program enrolls
approximately 30 new students each
year (Feng and Su, 2009). East China
Normal University in Shanghai established the second bachelors degree
program in audiology in 2004. It is
currently the only higher education
institution that also offers masters
and doctor of philosophy degrees
in audiology (Feng and Su, 2009).
Although several other medical universities also offer masters degrees,
those mainly train ENT doctors with
an audiology emphasis.
Several higher education institutes also offer diploma programs
with an audiology emphasis. For
example, Beijing Union University
offers a three-year diploma program,
and Nanjing Technical College of
Speech Education offers several audiology courses in the Department of
Rehabilitation Sciences.

May/Jun 2014 AUDIOLOGY TODAY

43

A Hear ing Repor t from China

China is experiencing a great shortage of professionals

who can provide quality hearing care. There are only 10,000
hearing care professionals with various levels of training
serving a population of 1.37 billion in China (i.e., one per
137,000 people). The professional-to-population ratio is
extremely low compared to that in the United States (i.e.,
one personnel per 9,000 people), approximately 13,000 fulltime audiologists, 9,000 hearing aid dispensers, and 10,000
ENTs for a population of 314,000,000 (Freeman, 2009; ASHA,
2012; Neuwahl et al, 2012).
Despite the shortage, there is a general lack of financial support from the central government because the
Department of Education does not recognize audiology
or hearing sciences as majors in universities (Feng and
Su, 2009). Thus, no designated student quota or government funding is allocated to audiology programs. The
universities would need to squeeze the quota from other
programs in order to establish an audiology program.
Many audiology programs, therefore, rely on foreign
donations, advocacy groups, and/or foundations for disabled persons for financial support. Some programs have
closed because of lack of fundingthe most well-known
one was a joint masters program for ENT doctors by
Sichuan University West China Hospital and Dalhousie
University in Canada.

Another factor contributing to the shortage is that

many graduates from audiology programs are ENTs, for
whom audiology is only a small part of their medical
practices. The attrition rate from the profession is also
high as some people with university degrees or diplomas
do not remain in the field after graduation. This shortage is often partially met by short-term training courses
provided by universities (e.g., Sichuan University West
China Hospital), professional organizations (e.g., Beijing
Hearing Society), nonprofit organizations (e.g., Ying Wah
Fishermen Association), or hearing aid/cochlear implant
manufacturers through short-term courses, which ranged
from two to five days to a few months.

Audiology Education in China

There is no defined scope of practice because audiology is
not recognized as a medical profession in China. The range
of services that a hearing professional provides greatly
depends on the training of the individual. ENTs working in the hospitals often provide electrophysiologic and
vestibular function tests. Hearing aid dispensers working
in private practices may only perform air and bone conduction pure tone tests, comfort and discomfort level testing.
Cerumen management is a task for ENT physicians.

is

i e s93. 8% (1. 2
8b
illi
o

Wi

th

ou

it
bil

n)

FIGURE 1. Number of people with and without disabilities in China.

Limb1.8% (24.7 million)

Hearing1.5% (20.5 million)
Multiple1.0% (13.8 million)
Vision0.9% (12.6 million)
Mental0.5% (6.3 million)
Intellectual0.4% (5.7 million)
Speech and Language0.1% (1.3 million)

44

AUDIOLOGY TODAY May/Jun 2014

A Hear ing Repor t from China

In 2010, China established a three-tier certification

system for hearing aid dispensers. Their rankings are classified as the fourth, third, and second grade in the five-tier
Chinese National Vocational Qualifications system, which
defines the knowledge, skills, and competency of different
professions. Applicants seeking the hearing aid dispenser
certifications need to take written and practicum exams
as well as satisfy a set of requirements (APPENDIX A).
As this qualification system is relatively new, the
participation is voluntary. In Beijing, for example, only
<200 practitioners obtained the certification at various levels. Also, there is no license required to practice
audiology in China. Most people are providing hearing aid
services with limited audiology training and without the
certification.

Audiological Services in China

Hearing disability is one of the six disabilities recognized
by the government, which commissioned the China
Disabled Persons Federation to supervise affairs relating
to individuals with disabilities (www.cdpf.org.cn/english/
aboutus/aboutus.htm), especially those with low income.
The goals of the federation are to represent the interests
of people with disabilities in China, help protect their
legitimate rights, provide comprehensive and effective
services, and promote social integration through training
and public awareness. Along with 10 other government
agencies, the federation also established March 3 as the
National Ear Care Day.
FIGURE 1 shows the government statistics on disabilities published in 2012. Each type of disability is divided
into four degrees of severity levels, and TABLE 1 shows
the classification of hearing disabilities. These levels are
applicable to children older than three years and adults
who have sought treatment of hearing loss for more
than one year.
Twenty and a half million people were reported to
have hearing disabilities (i.e., 1.5 percent of the total
population. This number likely underestimates the
number of people with hearing loss in China because the

percentage is significantly lower than those reported in

other countries, and because it does not include people
with multiple disabilities, hearing loss of less than 40 dB,
unilateral hearing loss, or those who are not registered
with the government.

Adult Audiological Services

Hearing health-care services are generally insufficient
for the 13.6 million older adults with hearing disabilities
because of the lack of infrastructure and awareness of
presbycusis. Studies on the prevalence of presbycusis
reported 3590 percent of older adults had some degree of
hearing loss. The large range was probably due to the lack
of age breakdowns and differences in audiometric criteria
and testing protocols (Jiang and Zou, 2006). With Chinas
aging population, the number of older adults with hearing
loss is estimated to increase from 2.8 to >4 billion from
2025 to 2040.
Data reported in professional journals indicate the
hearing aid adoption rate is between 1.1 and 8.0 percent
(Jiang and Zou, 2006; Miao, 2012). Many people do not
wear hearing aids because of
1. The lack of awareness for hearing loss and its negative
consequences,
2. Financial concerns,
3. The belief that remediation is not needed, as hearing
loss is a natural process of aging,
4. Cosmetic concerns, and
5. The lack of accessibility to hearing health care (Wong
and McPherson, 2008).
Hearing aids are generally more accessible in large cities. The range and quality of services, however, can vary
greatly. Large national-level government hospitals are generally better equipped and have better qualified hearing

TABLE 1. Classification for the Degree of Hearing Disability

(Better Ear)

Speech Discrimination
Score in Quiet (%)

Permanent Hearing Loss at 500, 1000,

2000, and 4000 Hz (dB HL)

Level 1

<15

91

Level 2

1530

8190

Level 3

3160

6180

Level 4

6170

4160
May/Jun 2014 AUDIOLOGY TODAY

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A Hear ing Repor t from China

care professionals. Small hearing aid dispensing offices

can often be found in the shopping strips along the streets
of large cities. Sound rooms and equipment beyond audiometers are rare finds. It is, however, common for larger
offices or some chain stores to have their own earmold
labs because there is no earmold company in China.
The Disabled Persons Federation directly manages
the welfare of adults with hearing loss. If local chapters
receive allocations from the central federation or donations from nonprofit organizations, they would provide
adults with low income (i.e., <2300 RMB/year/person) with
one free hearing aid. The level of technology varies, and
follow-up services are provided sometimes. As it is difficult to know who needs hearing aids in a district or region,
the federation usually announces the opportunity in the
news or on its Web sites and encourages people to sign up
in their local chapters. Recently, the federation has finished a tendering process and announced the availability
of midlevel digital hearing for adults with low income.

Child Audiological Services

China has 19 million live births every year and the prevalence of congenital hearing loss is approximately 0.10.3
percent, and approximately 0.1 percent has severe to profound hearing loss. Currently, there are >800,000 children
with hearing loss who are under seven years, and approximately 40,000 are born with hearing loss every year.
Chinas first Universal Newborn Hearing Screening
program was implemented in 1999. Since then, the
program has been expanded to 30 of the 32 provinces,
autonomous regions, and direct municipalities. In
large cities, approximately 95 percent of the babies are
screened between 48 and 72 hours after birth using
otoacoustic emissions. If they fail, re-screening is carried out using otoacoustic emissions at approximately 42
days. Those who fail the re-screening are usually tested
using automatic auditory brainstem responses (ABR) at
three months old. Some hospitals also conduct genetic

NIU team members (Left: Dr. King Chung, Felix Zheng, Thomas Bishop, Emily Hehn, Maggie Clements, Danielle Morrow, and Alexandria Rosenbalm). A
student at the school for special education got his ears checked. Emily, Ms. Ma, and Sandy are testing the principal of the school for special education.

46

AUDIOLOGY TODAY May/Jun 2014

A Hear ing Repor t from China

screening at the same time to examine the genes that are

known to cause hearing loss or deafness.
In rural and remote areas, however, high-risk children
are referred to screening centers within one month of
birth, and the parents of others are only distributed pamphlets to inform them of the risk and consequences of
hearing loss (Liang and Mason, 2013). High-risk children
who failed the initial screening are recommended for
rescreening and follow-up services. Due to the lack of
awareness of the negative effects of hearing loss on
childrens speech, language, hearing, and cognitive
development, the attrition rate for follow-up services is
generally high in both cities and rural areas.
The China Rehabilitation and Research Center for Deaf
Children is responsible for providing comprehensive services and managing the welfare of children with hearing
loss, although they also started to distribute hearing aids
for adults in recent years. Its mission is to provide comprehensive clinical services, to conduct basic and applied
research, to advocate for social and educational integration, and to serve as an education and technical training
center for children with hearing loss and deafness. It also
collaborates with universities to establish speech and
hearing sciences programs, and publish text books and
professional reference books to increase the standards of
audiological services and to disseminate audiology and
rehabilitation information.
Rehabilitation centers are established throughout
China. Large centers are well equipped, and they adopt a
multidisciplinary approach and provide otolaryngology
and audiology services, dental care, radiology, psychological evaluations, genetics testing and counseling, aural
rehabilitation, and speech language therapy services.
Smaller local centers are responsible for rendering
habilitation and rehabilitation services to children with
hearing aids and cochlear implants. Children are fitted
with binaural hearing aids, and the level of technology depends on the financial resources of the family.
Children from low- income families receive binaural
digital hearing aids with midlevel technologies for free
every five to eight years. The recommended aural rehabilitation options are either full-time school with 0.5 hour
of individual instruction or three times per week for one
hour each time. Parent instructions are also required for
children enrolled in the latter option.

Distinguish Your
Audiology Career

Apply for an ABA Specialty

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The ABA is offering two certification
exams on October 5, 2014,
in Philadelphia, PA.
Pediatric Audiology Specialty
Certification Exam
Cochlear Implant Specialty
Certification Exam

Demonstrate to colleagues, other

health-care providers, patients, and
employers that you have a high level
of knowledge by passing a rigorous
exam in a specialty area of audiology.

Demonstrate your adherence to high

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education.

Applications due August 5, 2014.

www.AmericanBoardofAudiology.org

Cochlear Implant Services

Accessibility to cochlear implants has been a challenge.
The costs of cochlear implants and associated surgery
are almost prohibitively high for the majority of people
in China. The combined cost can range from 100,000

May/Jun 2014 AUDIOLOGY TODAY

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A Hear ing Repor t from China

RMB (~16,400 USD) for a low-cost cochlear implant made

in China (Nurotron) and 300,000 RMB (~46,000 USD) for
the newest model made from the big three international
cochlear implant companies.
There are only approximately 60 well-trained cochlear
implant surgeons in mainland China (Liang and Mason,
2013). The support from the government for cochlear
implants to adults is limited because most resources are
allocated to servicing children. Adults represent only
14 percent of the total units implanted in China in 2011
(Liang and Mason, 2013). Those with severe sensory hearing loss can seek cochlear implantation in their hospitals
of choice using private funds. Individuals with financial
resources often go to Hong Kong, Taiwan, or foreign countries for the cochlear implant surgery believing that better
and more reliable services are offered outside of China.
Most governmental resources are invested on
implanting children one to six years old (63 percent of
units implanted). Cochlear implant systems are usually paid for by charity organizations or government
agencies (Jiang, 2013). The newest government program
is Project Rainbow Dream, which is supported by a
government tender system and from a Taiwanese company. Approximately 33,500 cochlear implantations are

budgeted between 2011 and 2015. The program provides

one cochlear implant unit per child, and subsidizes the
majority of fees associated with the surgery and one year
of aural rehabilitation after the implantation at the 199
selected rehabilitation centers (criteria in APPENDIX B).
Children between 7 and 17 years of age can also
apply, but they need to be postlingually deafened or have
received rehabilitative services and enrolled in mainstream school. The number of cochlear implants granted
to the older age group would not exceed 15 percent of the
total cochlear implants available for the fiscal year.
Prior to being granted free cochlear implants, children
need to go through a comprehensive test protocol that
includes pure tone audiometry, aided sound field thresholds, speech recognition tests, otoacoustic emissions, ABR,
learning ability evaluations, psychological and behavioral assessments, auditory steady-state response tests,
tympanometry, CTs and MRIs, and genetic tests. Children
waiting for cochlear implantation can also apply for free
loaner hearing aids to reduce the cost associated with
amplification.
Due to Chinas massive population, much work is still
needed to increase the quality of hearing health care and

FIGURE 2. Hearing status of students in mainstream primary schools and adults in nursing homes in
Shandong, China.
100
Wax plus

90

Wax only

80

Clear canal

Percent (%)

70
60
50
40
30
20
10
0
Pass

48

Refer

CNT

Monitor

HL

Pass

Refer

CNT/DNT Monitor

Students in Mainstream Primary School

Adults in Nursing Homes

N = 184

N = 106

AUDIOLOGY TODAY May/Jun 2014

A Hear ing Repor t from China

to make hearing health services accessible. Immediate

actions are needed to
1. Recognize audiology as a medical profession;
2. Create more quality audiology programs to train
future audiologists;
3. Educate the public about the importance of hearing
and the negative consequence of hearing loss;
4. Establish hearing centers, especially in rural areas for
adult and geriatric populations;
5. Encourage research and dissemination of information to
both professional communities and the general public;
6. Institute systems to allow the sharing of information among the local hospitals that provide newborn
hearing screening, the rehabilitation centers, and
the Disabled Persons Federation so that followed-up
services can be coordinated among different agencies
throughout the life span; and
7. Increase funding to subsidize hearing aids and
cochlear implants and to provide follow-up re/habilitation services throughout the life span.
With approximately one-fifth of the worlds population, China should be the largest hearing aid market in
the world. Yet consumer data showed that only approximately three percent of the worlds hearing aids were
bought by China in 2004. As the population ages and
the size of middle class grows, the number of hearing
aids sold has been increasing steadily. China and India
are expected to be the most rapidly growing hearing aid
markets in the world.

Results of Hearing Tests in Shandong,

China
A faculty member (first author) from Northern Illinois
University took a group of students and an alumnus to
China. They provided hearing tests for elderly in four
nursing homes, students in four primary schools, and a
special education school in the Yimeng Shan region a
mountainous area marked by natural beauty but poor
living conditions. Some schools and nursing homes could
only be accessed via winding unpaved country roads.
The screening protocol included otoscopy, distortion
product otoacoustic emissions at 1.5, 2, 3, 4, 5, and 6 kHz,

and tympanometry (EroScan Pro). Those who failed the

screening were followed up by pure-tone audiometry.
Students in the mainstream primary schools had an
87.0 percent passing rate (FIGURE 2), which is among the
highest passing rates in the underserved populations
the NIU team tested in the past several years. Only 9.8
percent failed, and most of these students (7.6 percent)
needed wax removal. One student was newly identified with mild hearing loss and his teacher and parents
were informed. The generally high passing rate is likely
a reflection of the Chinese culture to take care of and
invest in their children even though parents have limited
financial resources.
We met one female student in a primary school who
had a known severe to profound hearing loss. She was
wearing two different brands of hearing aids with insufficient power that she received from two separate charity
events. Her teacher told us that she was from a farmers
family with several children (the younger children were
born illegally because of Chinas One Child policy). Her
parents had very limited resources, and they were basically waiting for her to grow up and get married. We
were touched by her story, and we found a local hearing

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May/Jun 2014 AUDIOLOGY TODAY

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A Hear ing Repor t from China

aid dispenser who was willing to provide free hearing aid

fitting and follow up services for her. We then contacted
a hearing aid company in Singapore and China that
donated and fitted a pair of high-power high-performance
digital hearing aids and secured unlimited free follow-up
services for her.
Data from the special education school are not plotted because of the small number of students (N = 8).
Five passed, one could not be tested, and two had wax
accumulation and unknown hearing status in at least
one ear. Their teachers and parents were informed of the
conditions.
Adults in the nursing homes had an alarmingly high
referral rate even though the 40 dB HL fence level was
used (91.5 percent, FIGURE 2). Many residents had disabilities, such as blindness, hearing loss, or intellectual
disabilities. Close to 60 percent had sensorineural hearing loss (i.e., failed with clear ear canal). Another 29.6
percent had significant wax accumulation with hearing
thresholds exceeding 40 dB HL (i.e., Wax Plus). Most of
them likely had sensorineural hearing loss because they
had Type A tympanograms. Requests have been made to
their local chapter of the Disabled Persons Federation to
provide follow-up hearing services.
China is an awakening giant that enjoys 8.9 percent of
economic growth in the past 30 years. The living standard
and accessibility to hearing services for people living in
cities have improved greatly. Yet time is frozen for people
living in poor areas, and it is almost impossible for them
to access hearing services. A great deal of work and professional development are still needed so that individuals
with hearing loss and deafness can reach their full potential and be fully integrated into the society.
More information about the Heart of Hearing
Humanitarian Research and Service Program to China can
be found on www.blurb.com/my/book/detail/4579999.

King Chung, PhD, is an associate professor of audiology at

Northern Illinois University. Becky Ying Ma, BA, is the director
of education at the Beijing Society of Audiology. Michael WenPeng Cui, BS, is the general secretary of Linqu in Shandong
Province. Shu-Feng Wang, MS, MD, is the vice president of the
Beijing Society of Audiology and the director of technology and
education of the Audiology Development Foundation of China.
Fang Xu, BS, is a businesswoman in China.

Acknowledgment: Sincere thanks to students at Northern

Illinois University who worked very diligently during the
program and to the government officials, school principals, and

50

AUDIOLOGY TODAY May/Jun 2014

nursing home personnel in Linqu, Shandong, for making all

the testing and lunch arrangements. Many thanks to Etymotic
Research for lending two EroScan Pro units, to Oticon, USA, for
their generous monetary support, and to Siemens China and
Siemens Singapore for donating a pair of high-power digital
hearing aids.

References
All cited Web sites were accessed in February 2014.
American SpeechLanguageHearing Association (ASHA) (2012).
www.asha.org/uploadedfiles/personnel-to-population-ratiosstate-2012.pdf.
Feng DX, Su, J. (2009) www.doc88.com/p-499549860080.html.
Freeman B. (2009). www.acaeaccred.org/ComingCrisis21.6.pdf.
Liang Q, Mason B. (2013) Enter the dragonChinas journey to
the hearing world. Cochlear Implant Intl 14 (S1):S27-S31.
Liu B, Liu ZC, Xu SG, Newall P, Han DM. (2009). http://www.
entnews.net.cn/uploads/soft/magz3/2009/200901/ztlt/005.pdf.
Newhal S, Fraher E, Pillsbury H, Weissler MC, Ricketts T, Gaul K.
(2012) www.facs.org/fellows_info/bulletin/2012/hpri0312.pdf
Miao Y. (2012) Progress in the research of presbycusis. Chinese
Journal of Rehabilitation Theory and Practice 18(6):554-557.
Wong LLN, McPherson B. (2008) www.asha.org/publications/
leader/2008/081216/f081216c.htm.

A Hear ing Repor t from China

Appendix A

Hearing Aid Dispenser Requirements for Chinese National Vocational

Qualification
Grade 4 (Entry Level) Hearing Aid Dispensers:
(Satisfy one of these requirements)
A. Worked continuously in the field for >1 year
B. Holds an intermediate-level vocational school or equivalent diploma
C. Obtained proper training for at least 480 hours and received completion certificate

(Satisfy all of the following requirements)

Work Function

Competency

Case history

a. Taking case history

b. File management

Pure-tone audiometry

a. Otoscopy
b. Pure tone audiometry including air and bone conduction testing,
masking if needed, most comfortable level, and discomfort testing
c. Play audiometry

Hearing aid selection

a. Audiogram interpretation, refer if needed

b. Hearing aid selection
c. Hearing aid feature selection

Earmold making

a. Proper insertion and removal of earmold materials

Hearing aid fitting

a. Maximum power output adjustment

b. Gain adjustment

Verification

a. Aided threshold testing

b. Administer and interpret questionnaires

Rehabilitation counseling

a. Hearing aid orientation

b. Follow-up services

Grade 3 (Medium Level) Hearing Aid Dispensers:

(Satisfy one of these requirements)
Worked continuously in the field for >6 years
Holds a high-level vocational or technical school or equivalent diploma
Worked continuously in the field for >4 years after obtaining Grade 4 Hearing Aid Dispenser competency certificate
Worked continuously in the field for >3 years after obtaining Grade 4 Hearing Aid Dispenser competency certificate
AND obtained proper training for at least 240 hours and received completion certificate
E. Graduated from an audiology bachelors program or related-professional program or above
F. Graduated from other professional programs in a university and worked continuously in the field >1 year
G. Graduated from other professional programs in a university AND obtained proper training for at least 240 hours and
received completion certificate
A.
B.
C.
D.

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A Hear ing Repor t from China

(Satisfy all of the following requirements)

Work Function

Competency

Hearing evaluation

a. Speech audiometry
b. Tympanometry
c. Visual reinforcement audiometry

Earmold making

a. Making impressions of ears with pinna deformity

b. Making impressions of ears with ear canal deformity

Hearing aid fitting

a. Directional microphone adjustment

b. Hearing aid programming
c. Hearing aid feedback management

Verification

a. Real ear measurement

b. Speech evaluation

Habilitation/rehabilitation counseling

a. Hearing aid use counseling

b. Aural rehabilitation training

Grade 2 (Senior Level) Hearing Aid Dispensers:

(Satisfy one of these requirements)
A. Worked in the field continuously for >13 years
B. Worked continuously in the field for >5 years after obtaining Grade 3 Hearing Aid Dispenser competency certificate
C. Worked continuously in the field for >4 years after obtaining Grade 4 Hearing Aid Dispenser competency certificate
AND obtained proper training for at least 120 hours and received completion certificate
D. Graduated from an audiology bachelors program or related professional program or above AND worked continuously
for >5 years
E. Graduated with a bachelor of science degree from a related field AND worked continuously in the field >4 years after
obtaining Grade 3 Hearing Aid Dispenser competency certificate
F. Graduated with a bachelor of science degree from an audiology program or a related-professional program, worked
in the field continuously for >3 years after obtaining Grade 3 Hearing Aid Dispenser competency certificate, AND
obtained proper training for at least 120 hours and received completion certificate
G. Graduated from a masters degree program or above AND worked in the field continuously for >2 years

(Satisfy all of the following requirements)

52

Work Function

Competency

Hearing evaluation

a. Acoustic reflexes
b. Otoacoustic emissions

Hearing aid fine-tuning

a. Electroacoustic analysis
b. Noise reduction adjustment

Verification

a. Listening in background noise test

b. Speech discrimination testing

Training

a. Training Grade 3 Hearing Aid Dispenser

b. Training Grade 4 Hearing Aid Dispenser

AUDIOLOGY TODAY May/Jun 2014

A Hear ing Repor t from China

Appendix B

Priority Selection Criteria for Cochlear Implantation

Children who have:
1.
2.
3.
4.
5.
6.
7.
8.

Severe to profound sensory hearing loss in both ears

No severe cochlea deformity
Worn hearing aids for >3 months and receive minimal benefit
No seizure or other conditions that are contraindications for surgery
Normal mental, intellectual, and behavioral development
A family with appropriate expectations
A family with limited resources (does not need to meet the low-income requirement)
A family that is supportive of long-term rehabilitation training, willing to carry out daily maintenance for the
cochlear implant, can afford cochlear implant accessories, and can provide an environment for aural communication

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