ACAud inc. HAASA’s recording-breaking 2026 National Congress on the Gold Coast in April delivered on its theme – Hearing humanity: Where AI meets the art of care.
Innovation in the hearing sector was the drawcard at the Australian College of Audiology incorporating HAASA’s 2026 National Congress, but delegates were reminded throughout that it is patient-centred care that is integral to successful practice.
The college has grown to more than 1,100 members, and a record-breaking 962 delegates attended the 2026 Congress ‘Innovation with Heart’ at the Gold Coast Convention and Exhibition Centre.
Delegates were treated to quality presentations, workshops, a trade exhibition, gala dinner and a welcome function.
Executive officer/congress convenor Marguerite Rushworth said organisers were delighted with the turnout, calibre of presentations, and success of the event.
Chair, Kylie Dicieri, said it brought together an exceptional community of professionals, clinicians, researchers, educators, industry partners and leaders united by a common purpose to improve hearing health outcomes and advance the profession of audiology across Australia and beyond.
“Over the course of the program, we explored new research, challenged existing thinking and engaged in meaningful discussions about the future of our profession,” she said. “We heard from inspiring speakers, exchanged ideas with colleagues and strengthened connections that will continue well beyond this event.
“Importantly, we’ve taken time to reflect on the evolving needs of our clients and communities, and the roles we play in meeting those needs with excellence, compassion and integrity.”
Melbourne audiometrist Daniel Pistritto delivered a moving and insightful opening address from lived experience, explaining what it felt like to live with hearing loss every day.
Diagnosed at 13 with otosclerosis, he grew up believing hearing loss was something to be hidden and was too embarrassed to wear hearing aids at school. “The reality of hearing loss is that it’s a hidden disability,” he said.
He used a hearing aid in his right ear since early adulthood but said a cochlear implant in his left ear “changed everything in a way he had hoped and dreamed” despite listening fatigue remaining.
“It felt like I had been living in a black and white world and I could now see the world in sharp, clear colour,” he said. “Hearing the sound of a vision impaired crossing signal through my implanted ear after switch on was one of the most emotional experiences of my life.
“But the biggest change was when I stopped trying to hide my hearing loss and instead of nodding and smiling and hiding my needs, I told people, ‘I have hearing loss’, and to face me when they spoke. People responded positively.
“As practitioners, we don’t just provide devices, we help people understand, accept and advocate for themselves which improves their lives.
“But the audiogram is only part of the story so practitioners should ask better questions than ‘how is your hearing?’ such as, ‘when is it hardest to hear, what do you avoid, and how do you feel at the end of the day?”
CBT for tinnitus and hyperacusis
Keynote speaker, internationally renowned tinnitus, hyperacusis and misophonia expert, Dr Hashir Aazh from the UK, detailed evidence from studies showing that cognitive behavioural therapy (CBT) could help people with tinnitus, hyperacusis, and misophonia due to the role of emotions in these conditions.
“CBT models show how perception of sound triggers thoughts, emotions and behaviours, forming a cycle of distress,” he said. Brain scans showed certain areas were overactive if exposed to sounds that bothered tinnitus and hyperacusis patients, he said, with people’s reactions and thought processes leading to cognitive distortion.
“CBT can help modify those thoughts and explore modified behaviour,” he said. “CBT teaches tinnitus patients to break the cycle it presents.”
Dr Aazh said trials in England’s National Health Service showed audiologist-delivered CBT for patients with severe tinnitus was effective and acceptable, including internet-based CBT (iCBT) guided by audiologists.
Additionally, 10 of 11 clinical guidelines recommended CBT for tinnitus management, and four systematic reviews of randomised controlled trials found it had a significant medium to large effect in reducing the impact of tinnitus on people’s lives.
“There’s an opportunity for audiologists and audiometrists to help people with CBT as guided programs have lower dropout rates than self-guided ones,” he said.
Although hyperacusis and misophonia were studied less, CBT had also been found to be helpful in some trials of these conditions, Dr Aazh said.
Cognitive decline and audition
Dr Douglas Beck was also among the contingent of international speakers. He’s a celebrated American audiologist, one of the world’s most prolific authors in audiology over the past four decades and a noteworthy clinician, educator, researcher, leader and mentor.
Dr Beck said hearing was perceiving sound while listening was comprehending sound. Listening was a “whole brain” event involving vocabulary, comprehension, short term memory, psychology, emotions and more.
“The number one complaint from people with hearing loss is that they can’t understand speech in noise, they can hear, but they cannot understand, which is primarily a listening problem,” he said.
Dr Beck urged practitioners to do speech-in-noise testing instead of just hearing screening because “it’s the most important thing you can do to assess their functional hearing.”
“Do it unaided, then aided,” he said. “If you haven’t improved the SNR (signal to noise ratio) you may not have really helped solve their primary complaint – you’ve just made things louder.”
He said it was not accurate to say hearing loss caused cognitive decline. Rather, the evidence indicated that for people with additional risk factors for cognitive decline, untreated hearing loss could exacerbate cognitive decline.
“Hearing loss, and particularly speech-in-noise difficulty, could be the first warning of a potential cognitive issue,” Dr Beck added.
He said it was incorrect to claim hearing aids markedly reduced the risk of dementia across the whole population.
“The protective benefits of hearing aids have been shown to correlate with less cognitive decline in the “at-risk” population, not the general population with age-related hearing loss,” he said.
The at-risk population included older people, those with more significant hearing loss, or co-morbidities (untreated hypertension, diabetes, cardiovascular disorders, polypharmacy.)
But he believed the correlation between untreated hearing loss in ‘at risk’ people was real, and untreated hearing loss tended to exacerbate cognitive decline in people who are at-risk.
“In some articles, hearing aid amplification has been shown to correlate with slowed or reduced risk of cognitive decline over the long term, for those at-risk,” Dr Beck said.
University of Queensland researcher, audiologist Professor Piers Dawes, added: “Practitioners should avoid saying hearing loss is known to cause dementia, and that hearing aids are known to prevent dementia.
“Instead, say ‘hearing loss reduces your ability to communicate with ease, and means that your brain may need to work harder to understand what is being said’.
“There is no convincing evidence that hearing loss causes cognitive decline or dementia, or that hearing aids are effective in reducing cognitive decline or risk of dementia.”
Rather than reinforcing stigma by linking hearing loss with dementia risk, Prof Dawes said practitioners should deliver a positive message about what hearing aids can do for people with hearing loss, including making listening less effortful, improving social engagement and quality of life.
Gene therapies
Professor Marcus Atlas AM, Ear Science Institute Australia director, and ear, hearing and skull base surgeon scientist, discussed how hearing loss treatment was changing including the “incredibly exciting” gene therapy revolution.
“It won’t do you out of your day job, but it will change everything and it’s happening right now,” he said.
Prof Atlas said the Aussie Ear Bank was taking ear tissue linked to genetically caused hearing loss from patients and turning stem cells from the samples into cochlea cells as the first step in mending broken genes.
The researchers aim to develop a treatment for Usher syndrome and are creating patient-specific mini cochleae or ear organoids from patients’ skin cells.
He said 30% of people with hereditary hearing loss had adult-onset hearing impairment which also lent itself to genetic
treatment. In future, audiologists could have a role in referring these patients for gene therapy, he predicted.
“You can all be involved now with personalised medicine for hearing loss by referring patients to our national registry to collect clinical data,” he said.
“Genetic testing is important for patients with hearing loss as it’s a precursor to future treatment. This is new and evolving.
“From their tissue we can create organoids to treat patients, including kids with hearing loss from a faulty GJB2V371 gene but to do this we need clinicians to be involved.”
Speech-trained hearing aid
Professor Simon Carlile from Google Research Australia discussed the application of machine learning (ML) in hearing aids. He shared his team’s work on the development of a machine-learning-driven hearing aid and said the team would release the code and models as open source.
“How can we get better models of an individual’s hearing impairment?” he asked.
“The Australian Future Hearing Initiative, of which Google is a partner, is working on training a machine learning hearing aid using a computational model (CARFAC) with 84 channels instead of 22. The plan towards the end of 2027 is to deliver a clinically tested machine learning hearing aid.”
Rather than looking at prescription fitting audiograms based on perceptual loss, his team looked at it from a neuroscientific perspective, he said.
“Personalisation is more detailed, and customisation meets unique needs of each user,” Prof Carlile said. “We have used a physiologically inspired model as a proof of concept, the CARFAC model, which was trained only on speech.
“We hope ML might produce better speech intelligibility via a physiological approach to fitting gain and compression, and we’re giving all this to the world (for free).”
Vestibular audiologist Dr Jessica Vitkovic from Dizzology said it took on average nine health care professionals and nine months for dizzy patients to get their first diagnosis. Patient reports could be vague including giddiness and feelings of ‘cotton wool’ in the head.
“Our vestibular system is the only sense we feel when it’s not working,” she said. “Timing and triggers more reliably inform diagnosis than symptom description. Targeted examination including eye movements and full vestibular assessment is recommended.”
A vestibular cause is more likely with vertigo, aural symptoms, exacerbation with head movement, or poorer balance in the dark, Dr Vitkovic said.
She said acute vestibular syndrome cases should be sent to hospital urgently for stroke assessment. Others could be referred or treated. “If you don’t ‘do dizzy’, refer to an audiologist, specialist or vestibular physiotherapist who does,” she said.
Musician and audiologist Dr Ian O’Brien from Audeara said studies showed about one-third of musicians had hearing loss, with risks often coming from their own instrument in a band/orchestra or private practice.
He said asymmetric hearing loss was more common, and players of string instruments such as violins were particularly impacted due to the left ear being so close to the instrument.
Well made, well-chosen hearing protection was vital with custom moulding the most effective way to reduce occlusion, he said.
Tests and rehabilitation for musicians included routine high frequency audiometry, OAEs, and considering client’s presenting issues before testing reflexes and loudness discomfort levels.
“Practitioners should fully understand the instrument, genre and different goals (live music versus recording) before deciding on technology such as hearing aids or assistive listening devices,” he said.
Cochlear implant referral
Dr Cathy Sucher, Adjunct Research Fellow at UWA and Curtin Universities, detailed how practitioners could decide whether to refer a patient for cochlear implant consideration.
She said cochlear implants were underused in adults, and discussion and referral often happened too late.
Simple tools could help including the visual Hearing Stages tool to promote discussion about management options, the 60/70 rule – a simple referral guide suitable for the Australian context, and person-centred factors such as the Living with CI Guidelines.
“Your role is to recognise and refer,” she said.
She also presented on a pilot study using the Hearing Stages tool in 16 clinics over a year and found that when used, the tool increased referrals for CI assessment and awareness of options, and encouraged hearing management discussions.
Post appointment surveys with a sub-group of clients showed 25% changed their hearing management plan after the tool.
Congress MC Petris Lapis said innovation in hearing care, as elsewhere, could be as simple as small tweaks or asking, ‘how can I improve on that?’ It did not have to be a big change, she said.
“AI can’t make new connections, but people can,” she said. “At team meetings bring up an issue and get people to throw out as many ideas as possible and say nothing is silly. Open the door to a beginner’s mindset. Don’t just do things that way because we’ve always done it that way.”
