Becoming A Hearing Conservationist Audiologist: Heather Malyuk, AuD

“Becoming a __________ Audiologist” is a continuation of the “So You Want to Be a __________ Audiologist” interview series on the SAA website and is dedicated to informing students of the vastness of audiology and how they can become the audiologist they never knew they wanted to be.

Dr. Heather Malyuk is the owner and clinician for Soundcheck Audiology, a practice focused on hearing wellness with an emphasis on the music industry. Aside from audiology, Dr. Malyuk maintains a busy schedule as a professional musician herself.

Q: How would you describe your place of work?

A: I am the owner and sole clinician for Soundcheck Audiology, a private audiology practice. Though Soundcheck Audiology is headquartered in northeast Ohio, my services are in high demand throughout the United States and abroad, so I am often working elsewhere.

Q: What got you initially interested in becoming an Audiologist?

A: When I first found out about audiology, I had just completed my undergraduate degree in music history and was beginning graduate studies in ethnomusicology at Kent State University. Just as the academic year was about to begin, I felt unsettled. I sensed an urgency to do something hands on for “my people,” a community that consisted of musicians and others within the music industry. I felt compelled to serve them directly and individually and knew there must be more in store for me. I began searching online and came across an ad for the Northeast Ohio AuD Consortium (NOAC) and my interest was sparked! What better way to care for musicians? The whole POINT of music is HEARING it! After doing some basic research on ear anatomy and physiology, it shocked me that, as a musician, I had never been taught about this amazingly intricate and priceless piece of my body; a critical, physical component of music and musicianship! That was when I knew that a specialized approach to audiology was my calling. I immediately dropped out of the ethnomusicology program, applied and was accepted to NOAC, and the rest is history!

Q: What are some things that you like about being an Audiologist that specializes in Hearing Conservation?

A: I LOVE keeping hearing stable for people who are exposed to hazardous sound levels on a daily basis! It can be suspenseful, is often exciting, and never fails to satisfy me as both an audiologist and musician! One of the most gratifying scenarios I get to experience is working with young musicians. It is so thrilling to begin with a baseline hearing test that’s within normal limits, followed by educating them about their ears, fitting them for hearing protection or in ear monitors, and then getting to follow up with them annually. Confirming and celebrating that they are properly protecting their hearing by seeing test results that are consistent from year to year is almost magical!

Q: What are some misconceptions you have heard about Hearing Conservation, especially when it comes to musicians/music appreciators?

A: In audiology world, hearing conservation rarely gets a seat at the table. We have the National Hearing Conservation Association, an organization to which most hearing conservationists belong but, on a national scale, the audiology community in general doesn’t seem to care as much about the nitty gritty of hearing conservation. In general, and anecdotally, I find that audiologists see hearing conservation as “easy” simply because they are often under-educated in this area of practice. In fact, that is especially true of music audiology, a branch of hearing conservation. Hearing conservationists have highly specialized education, training, and knowledge, and we adhere to specific best practices and ethics. Currently, there are about five of us who practice full time as highly specialized and experienced music audiologists. A few audiologists dabble in it as a side project and I have found that many audiologists around the country are happy to oblige any musician who comes into their office seeking “molds”, but it’s so much more than that!

In regards to musicians, music industry professionals, and music appreciators, there are many misconceptions about who audiologists are and what we do. Many view an audiologist as a means to an end—someone who will take their ear impressions so they can buy custom fit gear. No education, no care, no relationship; just a quick service to get to the next step. Honestly, that’s our own fault. There has been a lack of education in non-industrial hearing conservation training; we are not meant to serve only those with hearing loss or hearing disorders. The fact of the matter is that we are the gatekeepers of hearing care for EVERYONE, which requires a diversity of training and additional skill sets. Hearing conservation care involves far more than ear impressions and selling a device.

Students, if you are reading this and would like to learn more about hearing conservation best practices or would like to speak with those of us who are hearing conservationists with private practices, I highly encourage you to join the National Hearing Conservation Association. The organization is not only an amazing resource, but a ton of fun!

Q: Why should people buy custom made ear plugs from an Audiologist as opposed to ear plugs that one can get at the grocery store?

A: This is a great question and I could probably come up with 50 different answers. However, I’m going to focus on one that I don’t think audiology students hear enough: as an audiologist, you offer SO MUCH MORE than earplugs. If someone is buying hearing protection, they are concerned about their hearing and want to protect it or prevent any existing hearing loss or disorders from worsening. As the friendly, local audiologist, you need to let your community know that earplugs are only a small part of hearing wellness. You can provide education, consultation, and more! Not to mention that an annual hearing evaluation is essential for anyone looking to protect their hearing! Patients may or may not need custom earplugs or might not be able to afford them. Your value is not in a sale of earplugs, it is well-rounded, EXPERT care.

If made properly (from using appropriate ear impression technique to choosing attenuation level and manufacturer), custom earplugs are obviously a step up from universal fit because they will fit an individual patient in an exact way. Because of that exact fit, it’s more likely that attenuation level will be consistent each time the patient wears those earplugs. You, as their audiologist, should verify the fit of the earplugs and ensure the patient can insert them properly. But remember, custom earplugs are a superior option than universal fit because of everything YOU, the audiologist, brings to the table. Does that mean you can’t or shouldn’t fit your patient with universal fit? No! It’s great to have some options available to serve a variety of needs. You don’t want someone who desires to protect their hearing to leave your office without hearing protection! Instruction on proper insertion of universal fit hearing protection and counseling on their use can be an ear-saver for that patient.

Q: What are some of the challenges you face as an Audiologist that specializes in Hearing Conservation?

A: I believe that hearing conservation is underrepresented in our community, whether it be at conferences or within online messaging boards, in publications or among audiologist colleagues. It’s one of those things that, unless you join NHCA and start making other hearing conservation friends, it might seem like hearing conservationists simply do not exist. Beyond that, I will admit that I am often aggravated by the responses provided to hearing conservation questions that are posted to online audiology forums. Recommendations for certain manufacturers or anecdotal opinions on what should be done with patients litter the comments. That’s not hearing conservation. That would be like me posting “Guys, I have someone coming in next week who wants me to program their cochlear implant and I don’t really do that often, can you quick give me some pointers and tell me where I can buy what I need for the appointment?” We, as a field, would NEVER let that fly, yet we all consistently look the other way when non-experts field questions regarding earplugs and in-ear monitors.

The landscape does seem to be changing, however. The general public is becoming more and more aware of noise pollution and sound levels, and many of them are hungry for accurate education and care regarding protecting their hearing. I’m also starting to see more young audiologists wanting to specialize in true, ethical hearing conservation for musicians which is thrilling. It’s time for audiologists to stand up and take our rightful place as the experts in hearing loss prevention. It shouldn’t be the earplug companies keeping hearing safe, it should be us! Dentists don’t sell toothbrushes; they sell care and maintenance. We, too, should sell care and maintenance in the form of hearing loss prevention skills (but only if truly proficient in that area of practice!).

Q: In your opinion, what is the most fascinating/enjoyable part of your job?

A: I will admit that I have a unique job in that I work with patients from all walks of life within the entertainment industry. I certainly have many interesting stories from being backstage with orchestras or on tour buses with rock bands. However, the most enjoyable part of my job is when a patient says to me “I am so grateful for the education and care you’ve given me. It’s truly changed my career for the better.” Typically, and sadly, I will often see patients who have been to other audiologists, had “molds” done, never received proper counseling or care and, as a result, have gotten a music-induced hearing disorder and/or hearing loss from their use of in-ear monitors or being improperly fit with hearing protection. When I see those patients year after year and watch their hearing remain stable because we’ve gotten their sound levels under control, it’s really rewarding. It’s also bittersweet because, while I’m certainly thrilled that they are now healthy, the potentially career-ending issues they are experiencing could have all been avoided had the proper care been given in the first place.

It’s disheartening to me that, even today, audiologists still don’t adhere to best practices for general hearing conservation. Additionally, why aren’t audiologists calling out more earphone companies for unethical marketing in regards to hearing loss prevention? Trusting these companies over our own resources and expertise as audiologists is unacceptable.

Q: What advice can you give to students wanting to specialize in Hearing Conservation?

A: To any students who want to become hearing conservationists, I just want to say welcome to the coolest (read: nerdiest) areas of practice! Even if your school has only 1 class in “noise” and maybe 1 professor who has worked as a hearing conservation audiologist, let that be your starting point! That’s all I had when I was getting started! You have a very special position as a student in that you, 1) get discounted membership to organizations where you can connect with hearing conservationists, and 2) have access to SO MANY amazing publications and articles (something I really miss about being a student). I know you’re overwhelmed with clinic, classes, and assignments, but this is the time to start honing in on a specialty. As soon as I started my AuD, I was downloading and reading every article I could get about music-induced hearing loss. I based almost every assignment or project I had on musicians, including my grand rounds presentation (I presented a case study on an opera singer I knew). I would encourage you to seek a 4th year position (or 3rd year depending on your program) with a hearing conservationist. If you’re reading this and you are interested in industrial hearing conservation rather than music audiology, even better! There are many more opportunities in that area of practice! Whether you’re decided or unsure, I think a great thing to do would be to come to the NHCA conference in February 2020 and speak with hearing conservation audiologists there. Start networking and let them know you’re interested in learning from them!

For my 4th year, I split my time between Sensaphonics in Chicago, IL, and the Hines VA Hospital in Hines, IL. It was the best of both worlds because I got a really well-rounded education at Hines and a very highly specialized experience at Sensaphonics. I did so well at Sensaphonics that I was asked to stay on following graduation and be the clinical director prior to starting my own private practice.

Here’s the bottom line: You can read every article and know all the science, but clinically, nothing will serve you better than training with someone who works in the field.

Q: Lastly, are you planning on going to AAA 2020 + HearTECH Expo in New Orleans, LA?

A: I am and I can’t wait! Hope to meet you there!

This interview was completed by Conner Jansen, a first-year audiology student at the University of Texas – Dallas. Conner is a member of the SAA Communications Committee.