This week at Hearing International we have a guest author, Jennifer Drohosky, sharing her perspective on the Cochlear Implant Specialty Certification offered by the American Board of Audiology. Jennifer is both Pediatric Specialty Certified and Cochlear Implant Specialty Certified and works in an interesting position at Children’s Hospital Colorado in Denver, CO. RMT
I grew up in a small Midwestern town, with dreams of becoming a ballerina or an ambassador for the United Nations. I’d never met someone with a hearing loss, and had never heard of an audiologist, so I certainly didn’t foresee being where I am today. Like many others, I stumbled upon audiology in my undergraduate program, and was drawn to the combination of science while caring for others that the profession offered. I have now been practicing audiology for over 20 years, and feel very fortunate for the opportunities that this career path has offered. My first job was at Walter Reed Army Medical Center, where I saw patients of all ages and provided 
diagnostic services, aural rehabilitation classes, vestibular evaluations, and fit hearing aids. This provided great exposure and foundation for all aspects of audiology. It also became clear that I had a strong interest in working with the pediatric population, and I have always felt fortunate for the opportunity to incorporate that into practice in that setting. In 2000, I was offered a position at Seattle Children’s, which not only presented the opportunity to specialize in pediatrics, but also to develop a new area of expertise in cochlear implants with an outstanding team of professionals. Learning about the technology was (and still is exciting), but building relationships with patients and families who are considering a cochlear implant was (and still is) exciting and rewarding. This opened the door to work in a cochlear implant program overseas, and then to the Children’s Hospital Colorado, where I have been the cochlear implant program coordinator for the past 10 years.
Cochlear Implants
A cochlear implant is a device which is used when hearing loss is so significant that hearing aids are of limited benefit. Cochlear implants are comprised of the internal device (the implant), which 
is placed by a surgeon. The outside pieces (the speech processor) must be programmed by an audiologist for each individual patient. Cochlear implant candidacy is based on a person’s history of hearing loss and amplification, as well as counseling regarding realistic expectations. For pediatric patients, a multi-disciplinary team is the standard of care to ensure that the child and family are
well prepared and for the best outcomes for the child as a whole. It’s important to understand that a cochlear implant is not an “instant fix” or a “cure” for hearing loss. It is a technology which provides better access to sound, but requires consistent use and rehabilitation in order for the brain to understand the sound.
Audiologists who work with cochlear implants have completed extra training and typically focus their practice in this area. Given the rapid changes in technology within the field of audiology, ongoing education, practice, and training are necessary in order to stay current and provide the best care for patients. Cochlear implant audiologists must provide excellent care for their patients through preparing them for a cochlear implant surgery, programming of their devices for a lifetime, and guiding them through rehabilitation and other resources for their hearing loss and cochlear implant technology. The audiologist often serves as an informal “case manager” for the patient. It can be incredibly rewarding to be a part of the entire process, from considering a cochlear implant to seeing the outcome over months or years.
Certification
The American Board of Audiology (ABA) introduced the Cochlear Implant Specialty Certification (CISC) in 2005. This was the first specialty certification offered by the ABA, with the goal of providing standardization of training and practice in this specialty area. It provides recognition of professionals who have demonstrated knowledge in this area through practical experience and passing a thorough examination.
I became aware of the specialty certifications offered by the ABA, and was excited by the prospect for a variety of reasons. After obtaining the Pediatric Audiology Specialty Certification (PASC) in 2012, I sat for the CISC exam in 2013. The exam was challenging, and I was happy to see that it covered many aspects related to cochlear implant services, such surgical considerations, programming techniques, and case management.
In addition to being a licensed audiologist with at least two years of post-degree professional experience, the CISC application requires 450 direct cochlear implant post-graduate contact hours within a two year period within the past 5 years. Additionally, 50 hours of case management related to cochlear implants i
s also required.
The exam was developed by a group of experts in the field in partnership with HUMRO, which is a leading psychometric organization to create and validate the test items. Preparation for the exam was guided by these content areas: candidacy considerations, counseling/expectations, surgical considerations, programming principles/speech coding, device operation, troubleshooting, rehabilitation, and outcomes. The certification is valid for 3 years. Within that time, 60 continuing education hours must be obtained. These 60 hours include 3 hours of professional ethics, 15 hours of Tier 1 coursework, and 30 hours related to cochlear implants. Though these requirements seem rigorous, they have been relatively easy to obtain and have certainly benefited my practice. Having these guidelines have broadened my exposure to educational opportunities that I may not have pursued otherwise, and this has enhanced my practice.
Benefits
Holding the ABA specialty certifications has been beneficial for consumers and other referring professionals to more easily identify those who have areas of expertise and specialized practice. As more audiologists expand their practice to include cochlear implant services, it can be a helpful marketing tool and also provides consumer confidence. The ongoing continuing education that is required to maintain the certification has been greatly beneficial to my practice, which trickles down to better care for my patients. The certifications offered by the ABA have been beneficial for our practice as a whole, with many of my colleagues holding the PASC and CH-AP certificates as well. The PASC was initially encouraged and supported by our department leadership. I was encouraged to pursue the CISC, and because of the benefits, I have chosen to keep this certification for several years.
Guest Author: Jennifer Kolb Drohosky, Au.D., Board Certified in Audiology, CISC, PASC, CH-AP
Dr. Jennifer Drohosky is the Cochlear Implant Program Coordinator and Pediatric Audiologist at the Children’s Hospital Colorado in Denver. She is one of just a few audiologists in the country who holds both the cochlear implant and pediatric specialty certification through the ABA, and recently also completed the CH-AP certificate as well. Dr. Drohosky is married to Chris, and they have two Bernese Mountain dogs. Dr. Drohosky enjoys Colorado camping, travels, reading, fly fishing, and skiing.
