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Because a lot can happen around, and in your ears, we believe that every hearing office should have Videotoscopy. We do! Because we believe that as partners for better hearing, you too deserve to see what’s going on inside your ears. The first Audiology Clinics in Durham to provide such high-tech EarScans, our Video Otoscope lets us view and record a live colour image of your eardrum and canal.

Did you know that one of the more common types of hearing difficulty is caused by cerumen (ear wax) accumulation? As partners for better hearing, you too deserve to see what’s going on inside your ears. With our Video Otoscope, you can see for yourself if earwax is a problem. The Video Otoscope is a miniaturized camera that displays a clear picture of your ear canal on a full-colour monitor. You will see right away if earwax is a problem.

Did you know that one of the most common causes of hearing aid break-downs is due to earwax? Video Otoscopy provides a strong magnification system to examine your hearing aids. We can see if there are any foreign objects, such as earwax, in the receiver or on top of the microphones, of your hearing aids. We can detect fine cracks, fissures in your hearing aids. And, we will be able to show you too. If your hearing aids are not working like they used to, then let us have a look at them using our Video Otoscope.

Signs to look for:

Reduced amplification, (hearing aid isn't as loud as it used to be)
Distortion (hearing aid not as clear as it used to be)
High battery drainage (replacing hearing aid batteries more frequently)
Any other concerns you may have about your hearing aids

Did you know that the Video Otoscope can also help us determine any fitting problems with your current hearing aids?

Our Video Otoscopy systems lets us view and record a live colour image of your eardrum and canal. These high-tech EarScans allow us to grind and modify the casings of hearing aids at the very precise pressure points causing the discomfort. And, EarScan high-resolution printouts, if required, can also be sent to the hearing aid manufacture for a ‘clear picture’ of the exact location of the problem area.


Retrocochlear Cause of Hearing Loss

Hearing loss can affect any part of the auditory system from the outer ear ending with specialized parts of the brain. Although rare, a hearing loss may be caused by a mass near the hearing nerve or by a loss of the special layer of insulation that normally covers the nerve.

This non-invasive test involves attachment of electrodes to your forehead and behind the ears and the use of headphones. This test will be conducted in a quiet, semi-dark room by a certified audiologist. During the test, you will hear moderately loud clicking sounds delivered to your ears.



Otoacoustic emissions are sounds generated within the inner ear. A test sound is generated in your inner ear which our Audiologist can measure how the outer hair cells of your inner ear are working. In other words, the primary purpose of otoacoustic emission (OAE) tests is to determine cochlear status, specifically hair cell function.


The cochlea is the sensory organ for hearing contained in the inner ear. It is housed within the temporal bone which is the hardest bone in the human body. Within the cochlea is a structure called the Organ of Corti. This structure contains the inner and outer hair cells. The outer hair cells act like a pre-amplifier. They enhance our ability to hear soft sound and inhibit loud sounds. When the inner ear is damaged, you lose both the ability to hear soft sound as well as the ability to tolerate loud sound. You also lose the fine tuning structure, so sounds may be distorted and not clear.


The audiologist will position an earplug in your outer ear. Moderate level tones are presented in pairs over a range from low to high frequency. The sounds enter your outer, middle, and inner ear. Recording microphones pick up the small sounds coming back from the inner ear, and the computer averages and processes the responses. The results are displayed on the computer screen for you and the audiologist to see.


My child is bright but is having difficulties at school - poor academic performance, poor social skills, short attention span. Is it due to deficits in listening and auditory processing? Auditory Processing Disorders (APD) are the ear's version of dyslexia and drastically reduce the ability to understand spoken information. If undetected, these auditory processing difficulties can have devastating scholastic and social consequences. Children with Auditory Processing Disorders have symptoms similar to those associated with learning disabilities and disorders of receptive and expressive language.


  • Frequently says "Huh?" or "What?" or constantly wants information repeated.
  • Responds inappropriately and/or slowly to spoken output.
  • Has difficulty following oral instructions particularly when two or more instructions are given at a time.
  • Appears not to pay attention.
  • Is easily distracted.
  • Has poor language skills (listening and speaking).
  • Does not hear well in the presence of background noise.
  • Has difficulty with phonics and picking out individual words.
  • Has poor memory skills.
  • Learns poorly from spoken instructions.
  • Has reading, spelling and other academic problems.
  • Displays behaviour problems.
  • Described as the class clown, lazy or a daydreamer.

As a parent, you may have observed behaviors in your child which suggest a possible hearing problem. You may have observed the child having difficulty following oral instructions. The child may demonstrate poor listening skills and appear distracted or inattentive especially when listening in background noise. The child is not hyperactive, restless or impulsive. There may be a history of academic difficulties.

What It's Like to Have Auditory Processing Disorder

To get an idea of what it is like to have Auditory Processing Disorder, imagine that you are in a noisy room, such as a classroom. The teacher is speaking, but you find it very hard to follow what she is saying because of the background noise. Because of this, you decide to focus on drawing on your paper.
When the teacher calls your name several times, you don't hear her. Finally, she comes and touches your shoulder and says your name. You look up, only to realize that everyone in the room has been trying to get your attention verbally.
This is just one example of what it may be like to have auditory processing disorder. It can be frustrating, and the person with the disorder has no control over their ability or inability to process auditory signals in certain situations.

Symptoms of Auditory Processing Disorder

Auditory processing disorder can look different in each individual. Symptoms of the disorder are almost always worsened by noisy or highly stimulating environments.
Here are some possible symptoms of APD:

  • Difficulty listening in background noise
  • Difficulty following complex oral instructions
  • Varied response to auditory stimuli
  • Easily distracted, impulsive, and frustrated when too much noise is present
  • Short auditory attention span; easily tired or bored during required listening activities
  • Appearance of day dreaming or not listening
  • Verbal requests are often met with “huh?”, even after several repetitions
  • Difficulty with reading and spelling


"Normal results" on a hearing test may not explain your observations or concerns. Children with an auditory processing disorder have normal hearing in the usual sense. They have good peripheral sensitivity for very faint sounds and can discriminate simple speech sounds in a quiet environment. However, when a listening environment is less favorable, i.e. when there is background noise or the speech signal is distorted in some way or the spoken message is long or complex, the child has difficulty hearing and understanding. Various coping strategies can be recommended. The child can succeed and frustration can be reduced for all concerned.

The Audiologist can diagnose and identify auditory processing disorders. Once identified, parents, teachers, and children themselves, can better understand the ineffective listening abilities. Management of the child's listening environment and direct interventions are possible. If assistive listening devices, such as an F.M. System, are needed, the Audiologist will prescribe them, and provide Parents with a full detailed report.


We receive referrals on a regular basis from school boards, private tutoring services, speech language pathologists, doctors and concerned parents for the assessment of school aged children who are suspected of having an auditory learning disorder.

Our procedure includes some of the following:

  • A preliminary hearing screening test to determine whether or not a child is "at risk" for an APD.
  • If the child fails the screening, then we will proceed with a full battery of tests for APD.
  • All children between the ages of 7 and 16 referred for APD will be given a preliminary screening test, the BKB-SIN (Bamford-Kowal-Bench-Speech in Noise). This test quickly assess the child's functional skills for listening in noise. The age specific norms for children will allow us to identify a child "at risk".

Parents of children who are deemed to be "at risk" will receive two questionnaires. One is to be completed by the classroom teacher and one is to be completed by the parent in addition to the case history.

Our APD battery includes the MAPA or Multiple Auditory Processing Assessment which is comprised of four tests: Competing Sentences, Dichotic Digits, Pitch Pattern Sequence Test and the SAAT or Selective Auditory Attention Test. In addition to the MAPA, the child will also receive the Masking Level Difference for Speech and the Spondee Binaural Fusion test.


Screening, completion of the questionnaires and carrying out the MAPA and MLD/SBF battery is expected to take approximately three to four weeks. A comprehensive report summarizing each test and the child's performance relative to his/her peer group complete with recommendations and suggestions for educational planning will be mailed to the parents.

At our Advanced Hearing - Pickering location, we provide APD assessments for ages 7 - 16. Our clinic is one of the few clinics in Ontario offering complete diagnostic tests of central audition.


  • $90.00 for the APD screening visit
  • $360.00 for the APD assessment visit and includes the cost of reviewing the questionnaires, scoring the APD test, and writing the report.