SLP. TOD. Ed.Aud, AVT – Who Does What?


Myriam and Andrew, 8-2006Children with hearing loss in mainstream schools receive services from a number of different professionals. In some schools, services are available from educational audiologists, teachers of the deaf, and speech-language pathologists, but not in all schools. Almost every school has a speech language pathologist available, at least part time – and they may or may not have experience working with children with hearing loss.


Some schools districts will have a teacher of the deaf and other districts will have the services provided by special educators. While educational audiologists used to be available in many districts, many use consultants who come into schools occasionally.


What do each of these professionals do?

Speech language pathologists are responsible for evaluation and management of speech, language, and literacy for children in their care. Educational audiologists evaluate and manage technology with the goal of ensuring that children with hearing loss can use listening to learn. Teachers of the deaf are responsible for ensuring academic development.


Teachers of the Deaf

Teachers of the deaf are responsible for assessing educational performance for children with hearing loss or other auditory disorders. They provide instruction to children with hearing loss, individually or in small groups. TOD’s are uniquely qualified to provide preview of academic material before it is taught in class so the child with hearing loss has the vocabulary and concepts to learn with the rest of the class. In addition TOD’s can review academic material after it is taught to be sure that the student. Depending on the others who work in the school, TOD’s may be responsible for monitoring hearing aids, cochlear implants and FM systems. TOD’s will also work on developing advocacy skills.


Educational audiologists

Educational audiologists will manage hearing screening programs. In some school districts they provide full audiological services including selecting, recommending and fitting technology. In other districts, they may review audiological evaluations from other facilities and monitor hearing aids, cochlear implants, and bone anchored devices but not select or fit. Educational audiologists are responsible for fitting, validating and monitoring FM and other remote listening systems and teaching school staff to use them appropriately. They will assess classroom acoustics and make recommendations for modifications.


Speech-language pathologists

Speech language pathologists are responsible for evaluation and management of speech, language and literacy. While many SLP’s have excellent skills working with children with hearing loss, other may not specifically have training in evaluation and management of children with hearing loss. In some training programs, SLP’s will have a course or part of a course in managing auditory disorders. They may or may not have had clinical practicum experience working with children with hearing loss. Others may have had significant coursework and clinical practice with children with hearing loss. While they are knowledgeable about speech and language, best results for children with hearing loss includes listening therapy. For more information see Sylvia Rotfleisch’s blog on what SLP’s need to know about working with a child with hearing loss, (SLP’s and HL).


Auditory verbal practitioners

Auditory verbal therapists and auditory verbal educators have specific training in evaluation and management of speech-language and listening for children with hearing loss. Very few school districts have auditory verbal practitioners on staff but some contract with them to either provide services or to have them train school staff.


Collaborative activities

While each professional have areas of specialization, there are many areas of overlap. All can perform classroom observation to assess communication skills, and classroom acoustics. All can assist classroom teachers in understanding how to maximize classroom performance include use of FM and other remote listening systems. All participate in IEP and 504 meetings. And all can educate school personnel about the effect of hearing loss on hearing in the classroom. All can assist in teaching advocacy skills, and in organizing support programs. All participate in multidisciplinary teams.



Children with hearing loss are best served when they have the advantage of services by educational audiologists, teachers of the deaf, speech-language pathologists and auditory verbal therapists. Each have skills that are specific and critical. When children do not have access to all services, they do not have the opportunity to be the best they can be.

About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 7 books, and written numerous books chapters and journal articles, and is a well known international lecturer.