The Audiologists Role in Kids Learning to Listen

For children with hearing loss to succeed they need a village. The village is a big one. Obviously parents and extended family play a big role. They need therapists, teachers, physicians etc. But today I want to focus on the role of the audiologist.

Why is the audiologist important?

The answer is obvious. Audiologists are the people who are responsible for making sure that children hear well enough. But fitting technology is not all they need to do. Their task list is long.

• They need to understand that hearing loss in children is a neurological emergency because of the effect of hearing loss on developing the auditory brain and the result that will have on speech and language development. (If audiologists understand that hearing loss is a neurological emergency they will do what needs to be done.)
• They need to correctly identify the type and degree of hearing loss.
• They need to fit technology and be ABSOLULTELY CERTAIN THAT CHILDREN ARE HEARING WELL ENOUGH
• Help families understand that hearing loss is a neurological emergency. The conversation about developing the auditory brain has to happen very early. It strongly impacts families decisions. The ears are the doorway to the brain
• Understanding what is necessary to obtain a listening and talking outcome
  • Maximizing audition
  • Wearing technology at least 10 hours/day
  • Exposing children to a rich linguistic outcome
• Talking to families about what their goals are for their children
  • Where do they want their child to be in 5, 10, 15, 20 years.
  • How do they want to communicate with their child.
    • Realistic information about what it takes to get there.
    • What kind of language exposure does a child need.
    • 95% of children with hearing loss are born to parents with typical hearing. How long will it take them to learn a new language if they choose to use sign.
  • Be sure that families know how to monitor technology
    • Listening check every day with Ling sounds, words and sentences/questions
    • Understanding that children who wear technology more than 10 hours/day do better than children who wear technology less than 10 hours/day.
  • Be sure that families understand their role in developing language – this cannot be left to others. It doesn’t happen enough. Audiologists need to help families understand
    • Help families understand how to provide a great listening environment at home
    • Understand the difference between hearing, listening, and understanding
    • Understand the relationship between spoken language and literacy
    • Understanding that children must be exposed to lots and lots of language – parents need to talk talk, talk, talk, talk.
      • The 30 million word project clearly demonstrates what is needed.
    • Children who are read to have better language and academic skills than children who are not read to.
    • Provide information in small bits and at the level families can accept and understand.
    • Help families connect with other families.
    • Provide sympathy
  • Monitoring hearing in schools
    • Once children are in school, the clinical audiologist may need to be the monitor. Unfortunately, most schools no longer have an educational audiologist. If there is no educational audiologist the clinical audiologist will need to
      • Help school staff understand what a child with hearing loss needs
        • Hearing loss is a neurological emergency
        • Classroom acoustics need to be monitored
        • Classroom strategies for success
        • Appropriate seating etc.
        • Auditory access in all situations
        • Use of remote microphone
      • Participate in the IEP/504 process
      • Classroom observation if possible
    • Have frequent audiology visits. The audiologist is the monitor.
      • If we do not monitor hearing frequently we will miss things
      • Included in audiology visits should be conversation about what is happening in therapy, school if appropriate, academic and language skills, friends, bullying and how parents are managing.
      • If we don’t ask we won’t know. If we don’t know what’s happening we cannot know what we can do to help.

It’s a big job

Audiologists need to provide more than fitting technology. If we cannot follow up on all things required to help children succeed we are not doing our jobs. And the job we do will not be that exciting.