The Need for Audiology Outreach in Northern Communities – Part I

The Need for Audiology Outreach in Northern Communities

by Jack Scott, Ph.D.

Dr. Jack Scott, guest author of this week’s post on Hearing International, is an Assistant Professor/Clinical Supervisor at Western University,London, Ontario, Canada.  Jack is discussing a program where services are brought to a remote part of Canada………

From the sky, the reserve of Attawapiskat looks like a postage stamp crisscrossed with plywood houses and dirt roads, surrounded by only tundra and patches of thick woods.  It is a small community east of James Bay in Ontario, Canada; roughly the size of one square mile, and populated by just over 1600 members of the Attawapiskat First Nation – Omushkego Cree.

There are few ways to get to Attawapiskat.  Access to the reserve is by way of propeller plane or, for the not-so-faint-of- heart, driving over a frozen river during winter.  It would be wrong to ask why choose such a remote and isolated area to live.  Actually, the current location of Attawapiskat was originally a hunting and fishing ground only used during the spring and summer months.  During the winter, they would travel along the Attawapiskat River, following the food. It wasn’t until an agreement between the Canadian Government and the leaders of the community generations ago that what is now known as Attawapiskat was established.  Since then, the residents have been working to maintain their life and culture in the Far North.

The remoteness of the community, compared to other reserves, helps the residents maintain some of their cultural traditions.  Unfortunately, the isolation also limits the type of services available to them.  With regard to medical access, the community has a health clinic and a 16-bed hospital.  The hospital is run primarily by nurses with doctors and specialty physicians flying in on rotation.  For those needing specialized care, the hospital flies them to more southern communities such as Moosonee or Kingston, Ontario.  In the past, audiological services were provided to the coastal communities of James Bay.  But, as funding was cut, trips by the audiologist were limited, until, finally, patients had to be flown to the audiologist on the hospital charter flight.  Of course, seats on the flights go to cases with the highest priority, and  audiological patients would typically be the first bumped from the flights.  Hearing loss was not considered a medical emergency.

Attawapiskat is not only lacking in on-the-ground audiological services but also speech pathology services.  Realizing the need for speech and language intervention in the North, five years ago, Sue Schurr and Taslim Moosa, two clinical speech-language pathology (SLP) supervisors from Western University, arranged and organized community outreach placements in the North for graduate students.

During the week-long placement, the supervisors and students travelled to hospitals and schools in several Northern communities to provide services.  In their assessments of school-age children in Attawapiskat, the supervisors ran across the dilemma of not knowing if a child’s speech and language deficit/delay was due to hearing loss or some other underlying factor.  Clearly, this knowledge would affect the type of intervention.  However, as government funding was cut, pre-school hearing screenings were no longer viable.  This is especially troubling not only for the children with permanent hearing loss, but also for those with progressive hearing loss or conductive hearing loss due to otitis media (a chronic condition in First Nation communities).

Following their trip to the North, the SLP supervisors approached the audiology faculty about their concerns and recommended the North as an audiological placement.  Realizing the need for services, the potential learning opportunity, and the community outreach, the Department of Communication Sciences and Disorders within Western University created an outreach program for Audiology.

The first trip for the audiology component of the outreach occurred in April 2010.  Because it was the initial trip, one audiology supervisor and one graduate student participated.  Assistance with arranging room and board and setting up contacts within the community were provided by the SLP supervisors.  However, given the equipment-dependent nature of audiology, the logistics for acquiring the necessary equipment and facilitating shipping had to be determined and coordinated.  In addition, any other services provided (i.e., hearing aid checks, ear wax removal) would increase the need for additional items and shipping concerns.  In Part II, we will present more detail regarding placement, services provided, specific procedures and equipment requirements.

This week’s article for Hearing International is written by Guest Author Dr. Jack Scott, who is an Assistant Professor/Clinical Supervisor in Audiology at  Western University in London, Ontario.  Jack received his B.S. and M.A. from The University of Texas at Austin and his Ph.D. from The University of Texas at Dallas.  His areas of interest include hearing aid acclimatization, vestibular assessment, and adult and geriatric hearing assessment and hearing loss remediation.  He is a member of ASHA, AAA, and a past president of the Scott Haug Audiology Foundation.

 Photos were added by Robert Traynor, Editor,  Hearing International, Hearing Health and Technology Matters.  Watch for Part II of Jack’s article next week at Hearing International!