Audiology FAQ - Part I

by Cheryl DeConde Johnson, Ed.D.

As parents of children with a hearing loss or professionals who serve them, haven’t we all wished for the opportunity to sit down with an expert who would answer our questions and calm our concerns without sending us a monstrous bill afterward? Attendees of the Hands & Voices National Conference in July were granted this wish during a class with audiologists Dr. Cheryl DeConde Johnson and Dr. Sandra Gabbard.

This article is part one of a two-article series, and it contains answers given by Dr. Johnson, who currently works with the Exceptional Student Services Unit of the Colorado Department of Education. Cheryl serves as the President of Hands & Voices National, and in addition to 22 years’ practice as an educational audiologist, she is also able to help and relate to others by drawing upon her own experience of raising a daughter with a hearing loss.

Q. What are some good web references to learn about hearing aids, cochlear implants, and hearing assistance technology?

A. Here are several of my favorite web sites:

1. www.utdallas.edu/~thib/

This is the web site of Dr. Linda Thibodeau at the University of Texas, Dallas. Under the heading of Aural Habilitation you will find:

  • A demonstration of benefits gained from the use of an FM system. Listen to sound clips of recordings from FM and environmental microphones in quiet and noise and the differences in various settings, such as with the environmental microphone on (necessary to hear other students in the class), and the environmental microphone off (leaving only the teacher transmitter on).
  • Downloadable Power Point tutorials on troubleshooting hearing aids, troubleshooting using FM systems with cochlear implants, coping skills for teenagers with hearing loss, and more.
  • A CD-ROM (accessible on the web site) called EARRING—Educational Audiology Resource for Reducing Interference in Noisy Groups. This section contains incredible information, such as simulations of hearing loss, cochlear implants, auditory neuropathy, and FM systems; different assessments to determine listening ability and skills; and a Power Point presentation about the educational needs of students with a hearing loss.
  • Information for parents and teachers regarding children with hearing loss

2. www.babyhearing.org

At first glance, the home page of this web site, hosted by Boys Town National Research Hospital, may seem to be relevant only to parents of children who have just received their newborn screening, but it actually contains valuable information applicable to all ages and situations. Don’t be deceived by the simple headings used on the web site—take some time to delve deeper into the incredible resources this site has to offer, including information on preparing your deaf or hard of hearing child for school, positive parenting techniques, suggestions on how to read with and encourage the literacy of children with a hearing loss, and various parent perspectives and articles.

3. www.listen-up.org

This web site includes easy-to-understand information that extends well beyond amplification. With a bookstore (linked with Amazon.com) offering hundreds of titles related to hearing loss, access to an Internet bulletin board where you can communicate with other parents of children with hearing loss, fun links for kids, and a huge “Information and Resources” page, you could spend hours exploring and learning on this site.

4. The hearing aid and cochlear implant manufacturers

The hearing aid and cochlear implant manufacturers all have excellent resources and educational materials on their web sites. Try the following:

Q. How do you locate the “right” professional?

A. Just as when you are choosing a physician, you need to find an audiologist with whom you can feel confident in the information given and comfortable with the manner in which you and your son or daughter are treated. In rural areas, you may only have access to one audiologist who serves all populations, from infants to geriatrics, and who also contracts with the schools. In this case, your options are limited by how far you are willing to drive.

First, start with the basics: double-check to make sure the audiologist has the appropriate credentials. Look at their business card, web site or promotional materials to answer the following questions:

  • Do they hold a current license to practice audiology in your state?
  • Do they hold national certification—either by the American Board of Audiology or the American Speech-Language-Hearing Association?

Next, determine what their level of experience and expertise is with children.

  • Do they promote themselves as pediatric or educational audiologists?
  • Are they affiliated with a center that specializes in children?
  • Are they employed by a school district or educational agency?

At this point, call to schedule an interview. Prepare your interview questions in advance. Some sample questions to consider include:

  • How many children do you treat per month? Per year?
  • (If they are not at a center) What do you do when a patient may need more in-depth diagnostic procedures? Do you work with another audiology center?
  • What is your experience with cochlear implants?
  • How many hearing aids do you fit on children per month? Per year?
  • What hearing aid brands do you recommend for children?
  • Describe your process for selecting and fitting hearing aids?
  • Describe your philosophy on fitting FM or hearing assistance devices?
  • Describe your relationship with the local school district (or your child’s school)?
  • How do you communicate information to the school? Do you send information directly to the school’s educational audiologist (or deaf education teacher if they do not have an educational audiologist)?
  • What is your philosophy about the various communication approaches used by children who are deaf or hard of hearing?

Finally, if you felt comfortable with the answers given in the interview, ask for references. Check them by calling those families and asking about their experiences with that audiologist. Three or four phone calls should give you a good idea of what the audiologist’s reputation is in the community.

After this process, hopefully the experience you have with the audiologist you select will be a positive one! But, should you encounter serious problems with an audiologist, be sure to help other families by documenting your experiences and reporting that audiologist to the state board that licenses audiologists.

Personal Devices

Classroom Technology

  • Vibrating alarm clocks/watches
  • Signaling systems (doorbells, telephones, fire alarms, etc.)
  • Pagers or cell phones with text messaging, instant messaging, and Internet access
  • TTY (nearly extinct due to pagers and text messaging)
  • Amplified phones
  • Video phone
  • TV listening systems
  • CART (Computer Assisted Real Time) captioning
  • CAN (Computer-assisted Note taking)
  • Captioned Films
  • Captioned Media Program (www.DCMP.org)

 

Q. How do you determine whether a certain hearing assistance technology is appropriate for a child/youth?

A. Once an audiologist has determined your child is a candidate for hearing assistance technology, there are a number of factors that must be considered when identifying the kind of device that is best suited for his or her needs. These factors include:

1. Student Factors

  • Social-emotional (motivation, attention and fatigue, self image, self advocacy, social acceptance, classroom culture, family support)
  • Functional (age and development issues, academic performance, communication skills, home communication environment)
  • Support (awareness of communication needs, willingness of family members to use hearing assistance technology, ability to use and manage technology, financial resources, out-of-school regulations such as Americans with Disabilities Act [ADA] requirements)

2. Audiological Considerations

  • Hearing status (normal, hearing loss, auditory processing problems)
  • Type of hearing loss
  • Current hearing aid status

3. Environmental Considerations

  • School learning environment and access needs (style of instruction, classroom acoustics, various instructional locations)
  • Technology in use at school
  • Home and community needs

4. Technology Considerations

  • Wearability
  • Convenience
  • Reliability
  • Maintenance
  • Compatibility with other equipment

Once the device is selected, it must be fitted appropriately using professionally recognized fitting and verification procedures. Verification procedures determine that the device is working according to specifications.

The next steps are to develop a usage plan that details when and where the device will be utilized and to provide your child with an orientation to the proper use of the device. In addition, training should be provided to teachers and school staff, and, if the device is also going to be used at home, to parents.

Validation may be the most important step in determining whether a device is appropriate. Validation refers to whether the device is accomplishing that individual’s established listening goals. There are several options for validation. These can be categorized as observation protocols, self-assessment protocols, or assessment protocols. Some of the most common procedures used are the Listening Inventory for Education (L.I.F.E.) and the Functional Listening Evaluation (FLE). The FLE can be downloaded from the Hands & Voices web site.

Again, the intent of these validation instruments is to determine the benefit of the recommended amplification. If it is not providing the desired benefit, it may not be appropriate for your child, or the device may need some adjustments or programming changes. Your child’s audiologist and deaf education teacher should work together to ensure that your child’s hearing assistance technology is indeed appropriate.

Q. Are there funding sources to assist parents with purchase of hearing aids?

A. Yes, there are several. Opportunities for funding assistance vary by state. Your audiologist (both personal and school) should be aware of local and state funding options for hearing aids. There are many service groups that will fund hearing aids. Some will also fund FM systems for home and community use.

The Internet is an incredible tool when looking for information about funding for or insurance coverage of hearing aids, assistive technology and cochlear implants. Here are a few links to help you get started:

Q. What technologies should we know about for deaf or hard of hearing high school students?

A. Depending on your child’s communication needs, there are a variety of assistive technologies that he or she should be familiar with or use in school. Discuss the list below with your child and his or her teachers to determine which are appropriate.

There are also several catalogs that specialize in assistive devices for individuals who are deaf or hard of hearing. You can purchase their products online. Some of these are:

Many more resources can be linked through the www.listen-up.org web site.

Part two of this article will run in the next issue of The Communicator. In part two, Dr. Sandra Gabbard will answer questions related to auditory neuropathy, up-and-coming technological advances in hearing aids and cochlear implants, recent study results in bilateral cochlear implantation, and more.  ~

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