Let me first preface that I am recent Au.D. graduate so I am in no ways a specialized pediatric audiologist. During my externship it became abundantly clear to me that pediatric audiology is a specialization and a realm of audiology in and of itself. Because of the critical learning and language window that is the childhood years along with the great variability of rate of development there is a different mentality and approach when it comes to diagnostics and treatment/intervention. I had the opportunity to work with an audiologist who's main job was to head up and run the newborn hearing screening program of the hospital, and had 20 some years of experience in pediatric diagnostic testing, follow-up and parent counseling. I learned a great deal from her and there is much I do not know still. The following may be a bit jumbled but hopefully will provide enough information to get you started. If you want clarifications feel free to ask =) ill be sure to check up on this regularly during the next week.
1. What is your role in working with children with hearing loss, or more specifically, what are your duties that involve children with hearing loss?
As a pediatric audiologist the number one goal is to identify hearing loss and the extent of the hearing loss. This can be broken up into 2 relatively broad categories – congenital (born with) or non-congenital (developed later in life, has other outside influencing factors).
Congenital - Identifying hearing loss begins with newborn hearing screening. It should be noted that a screening is not diagnostic in nature meaning there will be kids that fail the screen when they actually have good hearing and there are kids that will pass the hearing screening but may have or will develop some degree of hearing loss later. If a child is found to have some degree of congenital hearing loss it is important to arm the parent with information about what the hearing loss means, in terms of language and communication needs, and with information about what help and services are available to the child and the family.
Non-congenital – this can be due to something as run of the mill as ear infections, the development of a cholesteatoma, foreign body lodged in the ear canal or due to illness or drugs (certain antibiotics or chemotherapy drugs). In these cases obtaining diagnostic information is important but may difficult and can require multiple visits to obtain a complete audiogram (hearing test). It is with this information that the audiologist can make referrals and inform the parent about what is going on what the next steps in treatment should be. It is important to have regular follow-ups, normally within 3 to 6 month periods.
2. When you work with children who have hearing loss, what are the two or three consequences or effects of the hearing loss that you think have the biggest impact on the child's life?
With childhood hearing loss, it is important to deal with the question about will the child learn language and how to communicate. It is important to take into consideration the whole family dynamic and as a unit. If a child was born with hearing loss into a deaf family, the child could flourish just fine as he/she would develop a social and cultural identity with the Deaf, even if there was some degree of hearing. What is more difficult is a child born with severe hearing loss to hearing parents. The parents would make the decision about whether or not to raise the child with hearing help, be it hearing aids or cochlear implants, or to learn and become part of the Deaf community. Neither is wrong but it is when a child and a family gets caught up and does not decide that particularly difficult problems arise aside from normal family quarrels and what not.
3. Do you think that children with hearing loss are being adequately served in the area where you work?
Sadly I do not know this information for where I live in LA but what I can speak on is the service that I saw when I was externing at the Yale-New Haven Hospital. One thing I should mention before starting in though is that New Haven is a rather poor community outside of Yale so the children we saw were more often than not on some kind of Federal or State health insurance. In addition, Yale seemed to be the only hospital that actually had dedicated time and service set aside for diagnostic ABR (auditory brainstem response) testing which is necessary with infants who fail their newborn hearing screenings. There is currently no other means of obtaining diagnostic hearing information so you can imagine how important and valuable this test is. Connecticut has 3 locations that offer follow-up services to families who qualify in the case of a child being born with hearing loss, which is fair but I understand that their normal wait time to see someone could run as long as a month or so.
4. What kinds of things would you like to see happen differently for children with hearing loss where you work?
I would like to think that we were providing the best care possible at Yale but I would have liked to see children and their families have closer and quicker access to testing facilities and treatment/intervention.
5. If you are familiar with the speech and language services that children with hearing loss receive in your school or community, do you think that these services are meeting the needs of the students? Why do you think this?
I did not have information regarding the school system.
6. If you are aware of the hearing related services that children with hearing loss are receiving in the schools or community where you are, do you think that these services are meeting the needs of the students? Why do you think this?
I did not have this kind of information.
7. Do you have anything that you would like to see done differently by people who work with kids with hearing loss? (e.g. programs, funding, devices, etc..)
The interaction that I had with Connecticut's Birth to Three program were all pretty good. From what I understand and what I observed and experienced at Yale, the program ran decently enough. There was always an issue with funding and I wish that could be improved, but that did not stop us from providing the services.
You will note that I did not really talk about cochlear implants. Cochlear implants are an important part of pediatric audiology but a specialty in and of itself. There are pediatric audiologists and there are cochlear implant audiologists and there are pediatric cochlear implant audiologists. I could give some information if you like but it is really quite specific and the information I could give probably only scratches the surface.
