By Ross J. Roeser
As I have discussed here in two previous Hearing Views, proper accreditation of university programs that educate future audiologists is very important. One way I recently put it is that audiology accreditation isn’t a life or death situation for the future of audiology. IT IS MUCH MORE IMPORTANT THAN THAT!
Last week, I gave the first five reasons why separate, independent audiology accreditation is essential for university programs. This week, in concluding my three-part series on accreditation, I’ll offer five more reasons, rounding out my Top Ten list (in David Letterman style). This post focuses on reasons why Accreditation Commission for Audiology Education ( ACAE) accreditation is critical for the audiology profession.
6. ACCREDITATION SHOULD BE A NEUTRAL PROCESS AND MUST STAND ALONE
The current standards of the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) constitute a de facto conflict of interest with the American Speech-Language-Hearing Association (ASHA). The CAA standards largely compel university programs to prepare students for the certification from the Council for Clinical Certification in Audiology and Speech-Language Pathology, ASHA. In order to achieve this, students must be supervised for a period of time by audiology preceptors who maintain ASHA certification. This has several potential negative consequences (as also implied in Ramachandran’s article, “Clinical Education in Audiology, The Case of the Emperor’s New Clothes,” published in the September/October 2011 issue of JAAA).
- First, ASHA certification is utilized as a credential for clinical educators for no justifiable reason, potentially eliminating qualified preceptors from providing clinical education. This, coupled with the conflict of interest inherent in the relationship between CAA and ASHA, may negatively affect the public’s view of the audiology profession because of the absence of any legitimate independent oversight of its educational programs.
- Second, the pressure for clinical educators to maintain ASHA certification likely inflates the membership of ASHA with audiologists who maintain certification solely to be eligible to provide clinical education to students. Audiology is, by far, the minority profession of ASHA, and when the interests of speech-language pathology and audiology conflict, the organization must be responsive to its majority constituency. This can be harmful to audiology.
NOTE: Accreditation and Certification are two different entities and have little relationship with one another. They should not be confused with one another. Accreditation is a quasi-legal entity that is required by a profession to independently evaluate an academic program at the professional entry level. Certification is a post-graduate option that an individual decides whether or not to apply for. It can be a generic certification or involve a particular specialty.
7. ACAE EXISTS FOR THE RIGHT REASONS
The inherent concern about excellence and improvement in audiology education is one of the main reasons that ACAE exists. The individuals involved with the Commission care deeply about the future of the profession and know that the proper and rigorous preparation of students will perpetuate generations of highly skilled audiologists. In a profession that is heavily based on the sciences, there is a mandate to achieve perfection; striving for excellence must be an ongoing endeavor.
A profession must insist upon having an accreditation agency that focuses on rigorous standards, competency, quality, and higher education. This is especially true in doctoral education. Accreditation cannot be lax or a rubber stamp approval system. It must hold its programs accountable, so that the profession is assured of an ongoing supply of audiologists with the best possible education.
8. THE ACAE ACCREDITATION PROCESS IS AN INTEGRATED WEB-BASED SYSTEM
ACAE made an important and contemporary transition to a web-based system (the first of its kind in accreditation). By creating this online process, ACAE goes beyond accreditation to drive quality and work for improvement. This collaborative and easy method is efficient, cost-effective, and provides value-added benefits. Thanks to modern technology, what once seemed like an onerous task is now more like a productive and intellectual electronic game, with engaging interactions between faculty and site evaluators.
9. WHAT IF ACAE DIDN’T EXIST?
If ACAE weren’t in place to oversee audiology accreditation with a mandate to higher levels of performance in academic programs, we would be delegating the future of audiology to a system, CAA, that is dominated by another profession. Would audiology thrive under such delegated authority? Would standards be raised? In future years, would the profession of audiology be valued and respected by other professions for its quality of education and comprehensive clinical care? ACAE is needed to cultivate growth and foster creativity in audiology.
10. THE FUTURE HOLDS EXCELLENT POTENTIAL
Demographic factors make it inevitable that the demand for audiologic care will increase in the years ahead. The Bureau of Labor Statistics estimates that audiology will grow by 37% from 2010 to 2020. Also, one need only look at population numbers across the spectrum to see how many infants will need diagnostic evaluation and how many children, adolescents, adults, baby boomers, and older seniors will need rehabilitative treatment for their hearing impairments (see some statistics below).
The growing demand for better hearing health, requiring an increasing number of qualified AuDs in the US, is apparent. To meet that demand, audiology must have academic programs that are on a par with other doctoring professions (noted last week in Reason #3), e.g., medicine, osteopathy, pharmacy, psychology, optometry–all of which have autonomous and independent accreditation agencies.
Key statistics from NIDCD
The following statistics compiled by the National Institute on Deafness and Other Communication Disorders (NIDCD) illustrate the enormous demand for audiologic services that we’ll see in the decades ahead:
- Of adults 65 years and older in the United States, more than 12% of men and nearly 14% of women are affected by tinnitus.
- Approximately 17% (36 million) of American adults report some degree of hearing loss.
- There is a strong relationship between age and reported hearing loss: 18% of Americans aged 45-64 years, 30% of those 65-74, and 47% 75 or older have a hearing loss.
- Two or three out of every 1000 children in the United States are born deaf or hard-of-hearing. Nine out of 10 children who are born deaf are born to parents who can hear.
- NIDCD estimates that approximately 15% (26 million) of Americans between the ages of 20 and 69 have high-frequency hearing loss due to exposure to loud sounds or noise at work or in leisure activities.
- Only one of every five people who could benefit from a hearing aid actually wears one.
- Three out of four children experience ear infection (otitis media) by the time they are 3 years old.
Those of us who have been in audiology for years, particularly those involved in academia, have seen the impact of educational programs on the clinical, research, and external perception of our profession.
Dr. Jim Jerger, founder of the American Academy of Audiology and the person who unquestionably has had more influence on the profession in the U.S. than anyone else, said in a recent interview in Audiology Today that “…having our own accreditation process…is absolutely essential…”
He further stated that “…we [audiology] must break the bond that ties us to ASHA accreditation. Until we have control of the process of accrediting training programs in audiology, our development as an independent healthcare profession will be unduly influenced by a different model for the delivery of clinical services, by persons trained at a different level, in what is in many ways a different field of endeavor.”
Who other than Dr. Jerger has the insights and leadership ability to guide us in the direction we as audiologists need to go?
Ross Roeser, PhD, is Professor and Head of the Doctor of Audiology Program at the University of Texas at Dallas/Callier Center for Communication Disorders, and Executive Director Emeritus of the Callier Center. He is also Editor-in-Chief of the International Journal of Audiology, and was the founding Editor of Ear & Hearing.