By David H. Kirkwood
LEXINGTON, KY–The Academy of Doctors of Audiology (ADA) has demanded that the American Speech-Language-Hearing Association (ASHA) cease and desist making what it alleges are false statements to audiologists about the consequence of not holding ASHA’s certification in audiology, the CCC-A.
In a letter, sent on June 27 to ASHA officials, ADA’s attorney, Robert M. Gippin, asked that the association “take immediate steps to remedy the false statements and the consequences of making them.”
Disputes between ASHA and the two main professional organizations restricted to audiologists—ADA and the American Academy of Audiology (AAA)–have been going on for decades. Often, the issue in question has been the role of the CCC-A. While ASHA seeks to maintain its certification as the primary professional credential in audiology, ADA and AAA depict it as unnecessary and increasingly obsolete.
What prompted ADA’s complaint were form letters sent to some of its members by ASHA. One of these, addressed to audiologists who had given notice of canceling their CCC-A status, asked them to sign and return to ASHA an acknowledgment that they, “cannot supervise students in clinical practicum or during the clinical fellowship.” This statement, said Gippin, is “inaccurate.”
ADA’s attorney continued, “Even stronger inaccurate statements were made in a form letter to persons who had failed to file for their CCC-A Certification Maintenance.” In that notice, ASHA warned, “You will be prohibited from providing or supervising the provision of clinical services.” The association sent a follow-up notice to formerly certified audiologists stating, “You are no longer able to provide clinical services and/or supervise clinical fellows.” (Copies of the Gippin letter and the letters from ASHA are available at ADA’s web site, www.audiologist.org by clicking on the announcement headlined “ADA Seeks Cease and Desist and Monetary Relief for Audiologists Harmed by AHSA’s Illegal Conduct.”)
ASHA CALLS ADA’S CHARGES INACCURATE
As of this posting, ASHA had not responded to ADA. However, when Hearinghealthmatters.org contacted ASHA about the accusations, a spokesperson for the association (who asked not to be named) e-mailed the following statement on July 6:
“ASHA recently received a letter from an attorney representing the Academy of Doctors of Audiology (ADA). The ADA letter claims, among other things, that ASHA made numerous false statements in its communications to certificate holders about the CCC-A. Given the claims, inaccuracies, and contradictory statements in the letter, it will take us some time, working with ASHA’s legal counsel, to develop a complete response. Once we have done so we will share it with anyone who has inquired about this topic, and post it on the appropriate websites.”
RIGHT TO PRACTICE AT STAKE
In a June 30 press release from ADA, Bruce Vircks, AuD, the president of the academy, expanded on Gippin’s letter. “ASHA’s statements are totally false,” he said.
He added, “An audiologist’s legal right to practice is defined by state licensure requirements and not the CCC-A. Audiologists who drop, or consider dropping, the voluntary certification through ASHA should not be tricked into paying fees by being told that they would no longer be able to provide clinical audiology services. Audiologists who do not hold the CCC-A also can absolutely supervise audiology students during clinical practicum in order for the students to be awarded the AuD degree.”
ADA ASKS FOR REFUNDS
In his letter, Gippin demanded that ASHA provide notice to all audiologists about the false statements it had made and offer them the opportunity for a refund. He argued, “In the view of ADA, a very large number of audiologists have paid to maintain the CCC-A because they were misled to believing the false statements. The intended effect of the false statements has been to induce the continued payment of the CCC-A fee.”
ADA’s attorney also stated, “ASHA must have been aware that the statements are false. The statement as to being unable to provide clinical services [without the CCC-A] is grossly false and always has been.”
The letter went on to say that ADA views the requirement of the CCC-A for practicum supervision as a violation of the federal antitrust laws.
AAA CONSIDERS ITS COURSE
In past disputes, American Academy of Audiology, which has many times the members and resources of ADA, has often joined forces with its sister academy against ASHA. As of July 6, AAA’s leadership had not decided whether or not to get involved this time. A statement on its web site (audiology.org) said:
“AAA leadership is working with our legal counsel to determine the Academy’s position and plans regarding the ADA initiative. We will keep our members informed as more information becomes available.”
It’s clear that there is some support for the academy to join in the battle. At least two former AAA presidents, Angela Loavenbruck, EdD, and Robert Glaser, PhD, have written to AAA officials urging them to join with ADA in a coalition.
Loavenbruck wrote, “I would hope that the academy is going to wholeheartedly support this effort by ADA. The ASHA CCC’s and their monopoly on accreditation are the two remaining anachronisms that continue to tie the audiology profession to ASHA. Let’s hope the ADA’s David is the first step in getting rid of the ASHA Goliath once and for all.”
Your timely article causes me to recall two recent incidents that are pertinent to your discussion. The first one occurred when I decided to not send in my CEUs to ASHA, despite the fact that my employer, Gallaudet University, pays my ASHA dues. Finally I wanted to take a stand that possessing the CCC-A is NOT needed for to practice (I currently hold licensure in both DC and Maryland). I too received the letter mentioned in your article.
The second incident occurred a couple of months ago when I received a panicked email from one of my recent graduates asking me to assist her in submitting her clock hours to the state licensure board where she now practices. Her employer had informed her that she was required to apply for the CCC-A in order to bill Medicare for audiological services. I advised my graduate to inform her employer that this is not the case and all that is needed for billing is a state license. Unfortunately, her employer continued to insist that the CCC-A was necessary so I took it up a notch and let the employer know that we would be discussing this with Dr. Debbie Abel, Director of Reimbursement and Practice Compliance at the American Academy of Audiology AAA). Voila! The next day the graduate informed me that the CCC-A was no longer being required.
These incidents gave me pause and I decided it was time to provide full disclosure of the licensure, certification, and accreditation landscape to my students and wrote what turned out to be a six-page paper that lays out the situations an provides an accurate road map to the ability to practice audiology. Students are our profession’s future and we owe it to them to provide them with the truth so that they can advocate for themselves and for our profession’s autonomy.
Like many “dual programs” that train both audiologists and speech-language pathologist, Gallaudet’s training program is accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CCA).* However, it is imperative to understand that just because a program is accredited by CCA does NOT mean that its audiology students are required to be supervised during their clinical rotations by preceptors holding the CCC-A. Obtainment of the CCC-A is optional, not mandatory. This is very important as many intern- and externship sites no longer require their employees (who may serve as training program preceptors) to hold the CCC-A. The only time clinical hours need to be obtained under ASHA certified audiologists are if and when a student has made it clear that he or she desires to obtain the CCC-A. Programs need to explain to students the difference among the concepts of accreditation, licensure and certification. I believe that once a student understands the differences, then he or she can make a decision on what to do. For example, many of my graduates are now obtaining ABA board certification rather than the CCC-A.
In a perfect world, all politicians would vote for the good of the country, despite their ideological leanings. And in this same world all audiology organizations would also work together to represent a united front to congress to promote autonomy for our profession, rather than fighting with each other and making our profession look like it eats its young. But the world is not perfect and change is not easy. And we owe it to our students to honestly lay out the facts so that they have the knowledge they need to fulfill their dreams and become the professionals who take our profession to the next level.
Cynthia Compton-Conley, PhD
Gallaudet University
Washington, DC.
*In the interest of full disclosure, I should point out that I serve as a board member of the Accreditation Commission on Audiology Education (ACAE) and believe that all AuD programs should apply for this more rigorous, audiology focused, outcome-based accreditation. For more information, go to: https://acaeaccred.org/