Scope of Practice in Clinical Audiology: What Audiologists Are Trained to Diagnose and Evaluate
Audiologists complete years of specialized training to help you understand your hearing, get the right diagnosis, and find solutions that actually work for your life.
The 3 key takeaways
- An audiologist’s scope of practice covers more than hearing aids — They are trained to diagnose hearing and balance conditions, manage tinnitus, and provide long-term hearing care.
- Their training includes extensive real-world patient care — Audiologists complete supervised clinical experience, including a full-time externship before practicing independently.
- Understanding their scope helps you get the right care — Knowing what audiologists do—and when they refer to other specialists—helps ensure you’re seeing the right provider for your needs.
When most people think of an audiologist, they picture a hearing test or hearing aids. That’s part of the job, but it’s only a small piece. Audiologists provide a wide range of services that go far beyond hearing aids and are considerably more varied than a single type of appointment might suggest.
Understanding what audiologists are trained to do — and equally, what they can’t do — can help you get the right care and know when you may need a referral.
This article walks through the full scope of clinical audiology practice according to our board of audiologists.
What “scope of practice” means, according to an audiologist
According to audiologist Dr. Jessica Hinson, Au.D., “scope of practice” defines what a healthcare provider is trained and allowed to do. It helps protect your safety by ensuring you receive care from qualified professionals. Scope of practice for a doctorate level audiologist includes tinnitus treatment, balance evaluations, cranial nerve assessment, cognitive screenings, newborn to geriatric hearing assessments, and so much more!
For audiologists, scope is shaped by:
- National professional organizations (ASHA, ADA, AAA)
- State professional organizations
- Education and training
- State licensing laws
All audiologists follow the same core standards, but roles may vary from one workplace to another.
Hearing tests and diagnostic evaluations
A core part of audiology is identifying hearing and balance conditions through comprehensive testing.
- Pure-tone audiometry. Measures what sounds you can hear at different volumes and pitches. The results, which are mapped on an audiogram, are the core of any hearing evaluation.
- Speech audiometry. Tests how well you understand speech at various loudness levels, which provides information about auditory processing.
- Tympanometry. Checks middle ear function, including eardrum mobility, and is commonly used to identify conductive hearing loss.
- OAE testing. Measures inner ear function via the outer hair cell movement in the cochlea and is often used for newborns.
- ABR testing. Electrophysiological assessment of the auditory nerve and brainstem pathway used to evaluate how sound travels from the ear to the brain.
Balance (Vestibular) Tests
- VNG testing. Tracks eye movements to assess inner ear balance function.
- VEMP testing. Measures balance-related reflexes in the head and neck..
- Rotary chair testing. Evaluates how your balance system responds to motion.
- Posturography. Assesses how you maintain balance across different sensory conditions.
Specialized Tests
- Tinnitus evaluation. Measures and characterizes ringing in the ears.
- Central auditory processing testing. Evaluates how the brain recognizes and interprets sound.
- Electrocochleography (ECoG). Helps assess inner ear conditions such as Ménière’s disease
Treatment and management of hearing and balance conditions
Diagnosis is only the beginning. A large portion of audiology’s scope consists of the treatment, management, and rehabilitation services that follow from assessment findings.
Hearing aids and follow-up care
Audiologists are trained to help you choose the right hearing aid. They’re able to perform electroacoustic analysis to verify that a device performs according to its specifications, use real-ear measurement (the insertion of a thin probe microphone into the ear canal) to verify that a programmed device is delivering the prescribed amplification at the eardrum, and provide follow-up care to optimize outcomes over time.
Cochlear implants and implantable devices
Audiologists evaluate candidates, program devices, and provide follow-up care for cochlear implants and bone-anchored systems.
Tinnitus management
Audiologists are trained to provide evidence-based symptom management for tinnitus. This can include tinnitus habituation techniques or recommending a hearing aid for tinnitus relief.
Balance treatment and vestibular care
Audiologists with specialized vestibular training provide assessment and management for balance disorders, often working in collaboration with physical therapists and otolaryngologists. Management may include performing repositioning maneuvers for BPPV.
Auditory rehabilitation and communication support
Audiologists teach communication strategies and provide tools to improve daily listening. This can improve listening skills in difficult environments and adjust to hearing loss in ways that go beyond what technology alone can address. Group rehabilitation programs, communication partner training (helping family members communicate more effectively with hearing-impaired loved ones), and assistive technology counseling all fall within this domain.
Hearing conservation and prevention
Audiologists design and implement hearing conservation programs for workplaces with hazardous noise levels, performing periodic hearing tests and providing education on noise-induced hearing loss prevention.
Pediatric and newborn hearing care
Audiologists conduct newborn hearing screenings, perform diagnostic evaluations for infants and children who fail those screenings, provide early intervention services for children identified with hearing loss, and work within school systems to support students with hearing-related needs.
What falls outside an audiologist’s scope of practice
Understanding what audiologists do not do is as important as understanding what they do. It can help patients best identify if they need to see an audiologist or ENT.
Audiology is a non-medical, non-surgical discipline.
Audiologists do not:
- Prescribe medications. When medication is indicated patients are referred to a physician or ENT.
- Perform surgery. Surgical management of hearing conditions is handled by ENTs.
- Treat ear infections or other medical conditions directly. When an audiologist suspects a medically active condition, they refer to an ENT or other physician.
- Diagnose neurological conditions. While audiological testing can identify auditory dysfunction, the diagnosis and management of neurological conditions involves collaboration with neurology and otolaryngology.
How an audiologist’s role can vary by setting
An audiologist’s day-to-day work depends on where they practice and the needs of the populations they serve.
An audiologist in a busy private-practice dispensing clinic will spend the majority of their time on hearing evaluation, hearing aid fitting, and follow-up care.
An audiologist in a major academic medical center may spend much of their time on cochlear implant programming, complex vestibular assessment, or intraoperative monitoring.
A school-based audiologist focuses primarily on pediatric screening, diagnostic follow-up, and supporting students with hearing loss in educational settings.
While responsibilities vary, all audiologists are trained to provide comprehensive hearing and balance care.
How over-the-counter hearing aids fit into audiology care
Over-the-counter (OTC) hearing aids became available in 2022 which means consumers with perceived mild-to-moderate hearing loss can now purchase self-fitting hearing aids directly, without a prescription. However, OTC devices do not replace the role of an audiologist.
Why audiologists still matter:
- They provide accurate diagnosis, not just device selection
- They identify underlying medical conditions that may require referral
- They ensure your hearing solution is properly fit and personalized
Without a clinical evaluation, it’s possible to choose a device that doesn’t match your hearing needs—or miss a condition that requires medical care. Audiologists are trained to provide a level of comprehensive care that a retail purchase alone cannot replicate.
Why understanding an audiologist’s scope of practice matters
Audiology covers far more than hearing aids. From diagnosis to treatment to long-term care, audiologists help you understand your hearing and manage changes over time.
Knowing what audiologists do, and what falls within their scope of practice, can help you feel more confident about when to seek care and what to expect at your appointment.
Frequently asked questions
Can an audiologist diagnose hearing loss?
Yes. Diagnosing hearing loss is a core part of what audiologists do. Audiologists determine the type and severity of hearing loss through comprehensive testing. However, they do not prescribe medication or perform surgery. If a medical issue is involved, they will refer you to an ENT doctor.
Can audiologists treat vertigo and dizziness?
Audiologists with vestibular training can assess and manage many forms of inner-ear-related dizziness and balance dysfunction. For a common condition called BPPV, audiologists can perform simple in-office treatments like the Epley maneuver. More complex conditions may require referral to an ENT or neurologist. Not all audiologists offer balance services, so it’s best to ask when scheduling.
Do audiologists work with children?
Yes. Pediatric audiology is a major and critically important component of the profession’s scope. Audiologists conduct newborn hearing screenings, diagnose hearing loss in infants and children, fit pediatric hearing aids and cochlear implants, and provide services within school systems. Audiologists who specialize in pediatric practice often pursue additional training and board certification in that area.
What is the difference between an audiologist's scope and a hearing instrument specialist's scope?
A hearing instrument specialist (HIS) is licensed specifically to select, fit, and dispense hearing aids. Audiologists are trained across the full range of hearing and balance needs, which includes but extends far beyond hearing aid services. When hearing concerns go beyond straightforward device fitting, an audiologist is the appropriate provider.
Can an audiologist clear earwax?
Yes. Earwax (cerumen) management is explicitly included in the scope of practice in many states, and most audiologists are trained to safely remove it using methods like irrigation, manual removal, and suction. However, rules vary by state, and some insurance plans may only cover removal when performed by an ENT—so it’s best to check with your provider and insurance company.