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What Are The Key Signs That A Client Needs To Be Referred To Audiology?

Carly Alicea, AuD, PhD, CCC-A

October 15, 2025

Question

What are the key signs that a client needs to be referred to audiology?

Answer

A speech-language pathologist (SLP) should consider an audiology referral based on several key signs, or "red flags," observed in a client. The primary goal is to rule out hearing loss before diagnosing a speech or language disorder. This applies to both children and adults.

Key indicators that an SLP should refer a client include:

  • Frequent requests for repetition

  • Inconsistent responses to sounds or speech

  • Difficulty with phonological awareness that may be influenced by hearing status

  • Delayed speech and language milestones in children

  • History of frequent ear infections, which may affect hearing

  • Difficulty hearing in noisy environments

The key point is to rule out hearing loss before diagnosing any speech or language disorder. This applies to both children and adults. Knowing a client’s hearing levels ensures that hearing loss is not an unrecognized factor influencing communication before you proceed with a diagnosis.

This Ask the Expert is an edited excerpt from the course Audiology Essentials for Non-Audiologists, presented in partnership with RIT/National Technical Institute for the Deaf, presented by Carly Alicea, AuD, PhD, CCC-A​​​​​​. 

Continued and its subsidiaries provide professional education authored by qualified Subject Matter Experts for continuing education purposes. These materials are intended for educational purposes and do not constitute medical advice or a substitute for individual clinical judgment. Continued is not a clinical healthcare provider; the licensed professional is solely responsible for ensuring that the application of any techniques or information presented is within their legal scope of practice and jurisdictional requirements.


carly alicea

Carly Alicea, AuD, PhD, CCC-A

Carly Alicea is a clinical audiologist in the Department of Communication Studies and Services at Rochester Institute of Technology/National Technical Institute for the Deaf (RIT/NTID). She provides a full range of diagnostic and rehabilitative services to RIT/NTID students, faculty, staff, and dependents.

Dr. Alicea also serves as a member of the department's committee on continuing education, planning, coordinating, and teaching continuing education workshops for other audiologists and speech-language pathologists at and outside the institute. Additionally, she has worked as an assistant professor teaching courses in speech-language pathology and audiology and at a non-profit speech and hearing clinic serving children and adults from a diverse array of backgrounds. 


Related Courses

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