Why do you screen cognition for a hearing test?

At Alabama Hearing Associates, we don’t just treat your ears; we treat the whole person.

While your ears collect sound, your brain is what interprets it into meaningful speech.

In other words, you hear with your ears but you listen with your brain. 

There is increasing evidence that links age-related hearing loss with an accelerated progression of cognitive decline and a decrease in brain volume.

Long-term hearing deprivation can affect cognitive performance by decreasing the quality of communication with others.

That’s why we use Cognivue® as an integral part of our “Connect 365” Functional Hearing Assessment.

How do I complete the Cognivue® Thrive?

Cognivue is a 10-minute screener that is completed using a laptop.

One of our staff will set you up in a dimly lit room with no distraction to ensure the best score possible.

You’ll first start with this quick introductory video: 


The exercise becomes more difficult the better you do.

At the end, your results are compiled and compared to other people your gender and your age.

The audiologist will go over the results at the end of the appointment. 

One thing I love about Cognivue® is that hearing ability isn’t a factor in the process. Even the short introductory video includes captions for those with more severe hearing loss.

This feature is very uncommon as most cognitive screeners only use auditory instructions and questions. 

Cognivue® evaluation

What does the Cognivue® evaluate?

Cognivue® evaluates three cognitive domains (memory, visuospatial, and executive function) and two parameters (processing speed and reaction time) that heavily influence hearing in everyday listening environments. 

For more specifics on the Cognivue® domains and parameters, read below:

Memory: As hearing loss becomes more severe, your risk of not storing information properly increases, making it more difficult to retrieve information. On the other side of this, someone’s ability to remember decreases if trying to remember a degraded signal (such as what happens when someone hears through a hearing loss).

Visuospatial: Visuospatial capabilities are important for localization, whether it’s a dog barking or if you’re moving around a room. A decrease in visuospatial functioning in addition to untreated hearing loss increases your risk of falling—BUT the research shows us that correcting your hearing loss reduces your risk of falling.

Executive Function: Executive Function impacts your ability to hear in noisy environments. People with impairment in executive function tend to have more difficulty in situations with multiple speakers than in environments with non-speech noise (such as wind or road noise).

Processing Speed: Processing Speed impacts your ability to efficiently use your executive functioning. For people with an impairment with processing speed it may take a bit longer to process conversational speech in noise and someone may be more likely to stop paying attention if the listening environment is very difficult.

Reaction Time: Reaction Time impacts your ability to follow rapid conversation and follow multiple talkers, as well as your ability to respond quickly to questions and comments.

If you would like to schedule an appointment for a Cognivue® screening, please call us at 256-319-4327 or submit a contact request and one of our helpful team members will call you back shortly.

Do you know somebody that needs to see this? Why not share it?

Dr. Jan Liles

Dr. Liles earned her bachelor’s degree from the University of Montevallo and her master’s degree from the University of Alabama. From 1991 to 2001, she worked with two ENT medical practices and initiated one of the first newborn hearing screening programs in the state. In 2002, she was awarded a doctorate in audiology from the University of Florida. Dr. Liles and her longtime best friend, Dr. Sheehy, founded Alabama Hearing Associates in January 2002.
    Basic Hearing Test

    A basic hearing test begins with an air conduction test. You will be seated in a soundproof booth and single-use, foam earphones will be inserted into your ear canals. The Audiologist will ask you to push a button or raise your hand when you barely hear a series of beeps (tones) presented at various frequencies (pitches) to obtain your air conduction thresholds.

    To determine whether your hearing loss is a conductive (mechanical) loss, sensorineural (permanent) loss or combination of the two, we perform a bone conduction test.  

    For this test, a head band is place on the bone behind one of the ears to obtain your bone conduction thresholds. This process provides a different form of sound transmission using vibration, which bypasses the eardrum and the middle ear bones and directly stimulates the auditory nerve. When you hear the beeps/tones, you will push a button or raise your hand.

    If bone conduction thresholds are better than air conduction thresholds (through the foam inserts), you have a conductive hearing loss. This suggests a problem with the mechanical structures (moving parts) of the ears.

    Conductive hearing loss is often a medically treatable condition for which we will provide you with a referral to an Ear, Nose and Throat (ENT) physician. However, if bone and air conduction thresholds match, it indicates a sensorineural hearing loss (permanent), and the treatment will likely involve hearing aids.



    Comprehensive 5-Year treatment plan with premium technology

    If you want premium “out of this world” technology and the highest level of service and expert support, our All-Inclusive treatment plan is the right investment for you.

    The All-Inclusive treatment plan offers long-term value for your on-the-go lifestyle, providing everything you need to connect with family and friends for years to come.


    • Stellar hearing devices from top manufacturer (rechargeable option available)

    • Wireless accessory included at no charge

    • Comprehensive Annual Visit including hearing assessment, hearing device adjustment, and 19-Point preventative maintenance valutaion

    • Bi-annual hearing aid software update and reprogramming

    • Same day diagnosis and in-office repair during weekdays for devices dropped off before 3:00 p.m.

    • 5-Year full-service repair warranty

    • Unlimited remote hearing aid adjustments

    • 100% moisture removal by Redux and cleaning

    • Hearing aid supplies (stock receivers, batteries, domes and filters)

    • $1000 contribution towards purchase of upgraded technology within 48 months

    • 3-Year replacement warranty for loss or damage (no deductible)

    • Dedicated team of hearing care experts at your service

    • Unlimited teleaudiology appointments

    • Access to our “speed of light” repair specialists

    Schedule Appointment

    Choose Your Level of Technology

    A Comprehensive12-Step Functional Hearing Assessment

    If you struggle to understand conversations in social situations, restaurants, or other noisy environments, you do not need to schedule a basic hearing test. You certainly don’t need to schedule a “free” hearing screening or online hearing test.

    You need to schedule a “Connect 365” Functional Hearing Assessment at Alabama Hearing Associates!

    Hearing Technology with a Methodical Plan

    Our community understands better than most what can be achieved when you combine technology with human intelligence and persistence. It is much the same with hearing technology.

    The latest hearing aid technology is incredibly powerful, offering stellar sound quality and performance. Wireless connections allow phone calls, music and television to stream directly to your hearing aids for exceptional clarity.

    But hearing aids do not fit and program themselves! For best outcomes, you also need the human touch and expertise provided by our Doctors of Audiology.

    How do I know my new hearing aids are working properly?

    Without verifying that the hearing aid is working correctly from the start, all of the other steps in the hearing aid fitting process are useless. The most sensitive quality control measure is something called Electroacoustic Analysis. We complete EAA on every new set of hearing aids, before delivery of repaired devices, and on an annual basis.

    What Is Real-Ear Measurement?

    Real-ear measurement (REM) is how an audiologist knows that hearing aids are working the way they should in each patient’s ears.

    Ears are as unique as a fingerprint. Because of this, every ear will collect sounds differently.

    Even if I had two patients with the exact same hearing loss and hearing aids, there’s almost no chance the hearing aids would be programmed the same way.

    Orientation, Counseling, and Follow-up

    Dr. Cliff (the creator of the Best Practice Pro Network) said it best:

    “Having a detailed orientation can dramatically improve how much success you have with hearing treatment.  Counseling & Follow-up care can also ensure that you have success for years to come.  Regular visits to a hearing care provider who spends the time to discuss treatment related information and who will maintain your devices is extremely important.”

    During the orientation, your provider will give you the tools you need to be a successful hearing aid user. Everyone has different learning styles and we want to make sure whatever works best for you is what’s used. After the 75 day adjustment period, routine checkups are necessary to maintain the hearing aids and to ensure optimal hearing healthcare. 

    Real World Adjustments

    Your hearing loss didn't occur overnight, so it will take some time to adjust to the hearing aids. Your patience and persistence will be well worth it.

    Wireless Connections

    Most hearing aids automatically come with wireless streaming from smartphones and it has been a lifesaver for those that are working remotely and spending hours on teleconferences. As for other wireless accessories, the two most popular solutions are a small microphone used in less-than-ideal listening environments and a TV streamer that streams the TV’s sound directly into your ears—which can be a lifesaver when watching British TV shows or during football season. If your audiologist believes they would be beneficial for you, they will discuss your options and demonstrate the device in the office.

    Assessing Outcomes

    To ensure the most success with your hearing devices, we measure the benefits of amplification at the end of your adjustment period—some of the surveys and tests included in the “Connect 365” Functional Hearing Assessment will be repeated to evaluate progress, quality of life, and patient satisfaction with the hearing aids.