What is an Akustiker?

When I went to Switzerland to work R/D and training with a hearing aid manufacturer in 1998, I had never heard the term Akustiker.  I knew that in some countries,  training for Audiologists is quite different than it is in the United States.  In the US,  where audiologists are graduate school educated with practicum in diagnosing and treating the hearing impaired, we are accustomed to the curriculum and its changes since adopting the Doctor of Audiology model in the mid 1990s. There are some countries, such as Mexico, Egypt, parts of Europe where an audiologist is an individual that has gone to medical school and then done a residency (usually 3 years) in Audiology.  At the end of their programs, participants are then Audiological Physicians and in some countries, such as Britan, they are referred to as Audiovestibular Physicians.  They have the capability of treating their patients with medications and procedures for many disorders that can not and should not be treated by audiologists in the US and other countries, based upon the depth of their training.  The audiological physician focuses on the diagnosis, treatment, and rehabilitation of children and adults who suffer disorders of hearing and balance. Some Audiological Physicians generalize in all aspects of their specialty and serve patients of all ages, while others subspecialize in a particular age group or disorder. For instance, some audiological physicians focus more on hearing problems or tinnitus and others may choose to focus on balance disorders.  Audiological physicians ensure that reliable test techniques are used, and they also perform research relating to diagnosis and treatment for the hearing-impaired. Audiological physicians often need to work cooperatively with other medical professionals like audiological scientists, hearing therapists, speech therapists, and clinical psychologists. Many work closely with otolaryngological surgeons, on conditions that overlap the two professions.  On a personal note,  I will never forget my first trip to Egypt and, while meeting with the Director of Audiology at one of the Egyptian Universities and her comment was, “Well, I see that you are from America…..Audiology requires quite a different training in Egypt than it does in the United States…” …..a lesson that THIS Audiologist will NEVER forget…. In many European countries the people that fit hearing instruments are not the audiologists but Akustikers.    For us, the tendency is to assume that these professionals are the same as commercial hearing aid dispensers in the US, but there is quite a bit to Akustiker training, it often begins very young, and continues throughout a lifetime of continuing education.   Well then…what is an Akustiker, and how are they trained?

The term comes from the German term HÖRGERÄTE-AKUSTIK, which literally means hearing aid acoustics.  These individuals have a specialized training in hearing instruments and their fitting.  On the surface, the training appears to be similar to that of the commercial hearing aid dealer in the United States, but generally it is significantly more indepth than our requirements in America.  The real difference is in the depth of training between our traditional commericial hearing aid dispensers and HÖRGERÄTE-AKUSTIK. HÖRGERÄTE-AKUSTIK professionals are typically trained in a vocational school curriculum upon graduation from the European equivalent of High School.   Although there are a number of schools across Europe, one example of this training is the AKADEMIE FÜR HÖRGERÄTE-AKUSTIK (Academy of Hearing-Aid Acoustics) in Lubek, Germany, that opened in 1972. At the Academy of Hearing-Aid Acoustics and institutions like it across Europe, students study indepth academic topics and conduct practium and (YES, even conduct) research that must be completed before beginning an independent career dispensing hearing instruments.  Curriculum at the Academy of Hearing Aid Acoustics is a follows:

Profession related Theory Part II

• Profession related fundamentals
• Mathematics, information technology, IT accessories incl. Multi media, statistics, physics, electro technical/electronics, digital signal processing
• Acoustics
• Theory of sound creation and propagation, theory of oscillations and waves, room acoustics, otoplastic acoustics, acoustic measuring technology
• Medicine and audiology
• Basics of biology and genetics, anatomy of the ear and the organ of equilibrium, physiology, neurology and pathology of the hearing organ, subjective and objective methods to evaluate hearing-related data
• Psychology and sociology of hearing-impaired people
• Basics of psychology and sociology, gerontology and perception psychology
• Auditive phonetics
• Basics of linguistics, language, fundamental principles of speech therapy
• Psycho-acoustic
• Basics of psychoacoustics, psycho-acoustic measuring methods
• Fitting of hearing systems
• Quality guidelines and quality management in hearing-acoustics, assessment of hearing profile 1: communication techniques and how to talk to a customer, assessment of hearing profile 2: Otoscopy, assessment of hearing-profile 3: Sound- and speech audiometric, agreement of objectives, selection of a certain technology and rehabilitations methods, fitting concepts and procedures, structured fine-tuning, evaluation and verification, legislation on medical devices and health-insurance contract law
• Extended rehabilitation and aftercare
• Aftercare, accessories, communication training, implantable hearing systems, cochlear implants, tinnitus, taking care of hearing-impaired children
• Hearing-system technology
• Signal processing technology, hearing-system product training, standardization and hearing-system measuring techniques
• Otoplastic
• Basic chemical principles, material and auxiliary material, process engineering, fitting of otoplastics
• Noise and noise control
• Service Marketing
• Calculation
• Costing, applications in hearing-aid acoustics

Economics and Law part III

• Cost accounting
• Economics
• Law and Social Welfare

Profession related pedagogy part IV

• Fields of activity according to new curriculum (analog to regulation on instructor aptitude)

At the Academy of Hearing-Aid Acoustics and other training programs in Europe, the course typically extends over an 11-month period and includes the recommended preparation for the European Diploma/Certificate Hearing-Aid Acoustician. In addition to the regular teaching units, the student selects a specific subject from the field of hearing acoustics, does research and writes a final thesis. He then also has to present this thesis in a colloquium as well as explain it to a committee of experts. In most european countries, to be able to open your own shop, you must have a perscribed amount of experience working under a licensed Akustiker before you will receive a license that allows you to work independently.

Moral of the the story?

Looks a bit like a US – University, Audiology program minus the sophisticated study of electrophysiological audiologic evaluations and vestibular assessment and treatment.  Due to their training and experience, an Akustiker may be more sophisticated in hearing instruments than many audiologists and is certainly vastly different than most US commercial hearing aid dispensers.  Your audiology education and training is valuable, but there are countries where audiologists have more training and can practice with more independence that we practice here in the US, while others where practice is limited to amplification products.

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