2The Role of Audiologic Evaluation in Progressive Audiologic Tinnitus Management

complete program of assessment and intervention but also can serve as a framework to involve other forms of therapy. Epidemiological studies indicate that about 10% to 15 % of all adults in different countries experience tinnitus (Hoffman & Reed, 2004). Of those, only about 20 % require some degree of clinical interven-tion for their tinnitus (Davis & Refaie, 2000; Jastreboff & Hazell, 1998). These percentages are in general agreement with the American Tinnitus Association’s (www.ata.org) estimates that 50 mil-lion Americans experience tinnitus, of which 12 mil-lion seek clinical care and 2 million are debilitated by their tinnitus. There are, thus, varying degrees of tinnitus effect across the population of all people who experience tinnitus, as illustrated by the “tinni-tus pyramid ” (see Figure 1; Dobie, 2004). This range of needs is what necessitates a progressive manage-ment approach. The overall goal of Progressive ATM is to minimize the effect of tinnitus on the patient’s life as efficiently as possible for both the patient and the audiologist. The method of Audiologic Tinnitus Management(ATM) is a specific and comprehensive proto-col for the management of tinnitus by audiol-ogists (J. A. Henry, Zaugg, & Schechter, 2005a, 2005b). Progressive ATM expands on the ATM methodology to create five hierarchical levels of tinnitus-management education and support so that patients are clinically managed only to the degree necessary to meet their needs (J. A. Henry, Zaugg, Progressive Audiologic Tinnitus Management (PATM) is based on the premise that tinnitus is managed most efficiently using a hierarchy of clinical services that address different levels of need. PATM includes five levels of management: (a) triage; (b) audiologic evalu-ation; (c) group education; (d) tinnitus evaluation; and (e) individualized management. This article provides an overview of PATM and focuses on the procedures that make up the Level 2 Audiologic Evaluation. The evaluation is conducted to assess the potential need for medical, audiologic (hearing loss, tinnitus, hyperacusis), and/or mental health services. The Tinnitus Handica