About | 16.01.2022 | By Teresa Quail

QToDs and PTA

A member has asked a question which may resonate with other colleagues:

We are unsure in our team about if QToDs should be undertaking PTA now.

In our team we have 2 QToDs whose QToD course taught them PTA, at the time said to be sufficient to qualify them in undertaking PTA – do you know if theses QToD courses would still be considered sufficient as a ‘PTA qualification’?

Our other QToDs have qualified at later dates and their courses did not include sufficient PTA to enable them to undertake it. Do you know of any PTA courses that a QToD could undertake to become suitably qualified? Or do you know where I could enquire to find out?

The Consultant replies:

Non-qualified (but knowledgeable, skillful, and suitably experienced) allied health professional can undertake PTA, but this should only be considered as a screen and there should be referral to adequate hearing care pathways (Kokkonen & Varonen, 2021)

Smith & Evans (2000) provide caveats:

  • knowledge and understanding of the tester, (including otoscopy and identifying contraindications to PTA and significant pathology)
  • all equipment should be calibrated
  • PTA may only progress if the ambient noise* does not exceed 35dB(A).

*Insert earphones and noise-excluding earphones (e.g. Audiocups) will not require such stringent ambient noise levels, if they are fitted correctly (BSA 2018). However, full details of the frequency-specific attenuation characteristics of these devices needs to be considered.  Audiometry threshold measurements should be recorded in accordance with the maximum stated ambient noise levels advised in BS EN ISO 8253-1:2010.

Overall, I am not convinced that QToD status provides for PTA**  An additional Educational Audiology Qualification would cover audiometric assessment as long as the relevant skills were maintained, and professional registration is recommended.  It is essential that the latest BSA policies and guidelines should be followed.

**See Smith & Evans section 5.1 (2000) on requisite knowledge and skills.

BSA (2018) Pure tone air and bone conduction threshold audiometry with and without masking. (Current Recommended Procedure; accessed 17/01/2022).

BSI (2010) BS EN ISO 8253-1:2010 Acoustics — Audiometric test methods — Part 1: Pure-tone air and bone conduction audiometry.

Kokkonen, J. and Varonen, S. (2021) ‘Reliability of Primary Health Care Audiograms by Non-qualified Examiners-An Analysis of 1,224 Cases’, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 42(3), pp. e261–e266. doi: 10.1097/MAO.0000000000002982.

Smith P.A. & Evans P.I. 2000. Hearing assessment in general practice, schools and health clinics: guidelines for professionals who are not qualified audiologists. Education Committee of the British Society of Audiology. Br J Audiol, 34, 57-61.