SayWhatClub December 2006 Newsletter

^{PEARL: Michael, I would think you've worked with every age group, and have seen every type of hearing loss come through your office. What would you say was your biggest challenge?

MICHAEL: Hands down, the most difficult thing that I ever have to handle is the initial diagnosis of a child with hearing loss. Many parents and extended family members that I have worked with have initially viewed that day as a major traumatic event in their lives. My hope and goal is to try to help the parent/family to see the positives, to consider the potential, and to not dwell on things that cannot be changed. I am well aware that many parents tune me out immediately upon hearing the news, and that it is important to give the family some time to think about everything presented to them. I have been fortunate in my career to have been surrounded by professionals who are peer counselors, and consider the support of other parents to be something that cannot be duplicated. For all of the knowledge an audiologist, or any other professional, can provide (and that can certainly be substantial), it simply cannot match the shared experiences that a support group can provide.

PEARL: So, if you and your students encounter a family with a child who is discovered to have a hearing loss and/or deafness diagnosis, do you refer them to a support group? an agency?}

^{MICHAEL: Each child is different, of course. Depending upon the age, we will either fit the child or refer outside. One of our clinical audiology faculty members, Dr. Anita Stein-Meyers, has over 20 years' experience with pediatric amplification, and is affiliated with a large, local facility that offers an array of support services. We often make referral there or to other regional centers that can provide a team approach. There are a number of qualified pediatric audiologists in our area. It is most important that audiological management is made by someone with pediatric experience.

PEARL: I see that you are on the faculty of the Masters and Doctorate Programs of Audiology. With all your years of experience in the audio booth, hearing aid fittings, counseling the families, etc., what is the most important message you find is necessary to convey to your audiology students?

MICHAEL: Gosh, I have to narrow it down to one? I think, amongst so many others, it is important to have students realize that the patients that they will eventually be working with are real live, breathing people with all sorts of varying history, background, experiences, etc. What I try to convey to students, consistent with the philosophy of our program at Brooklyn College, is that whether one is engaged in assessment or treatment, it is important to assess or treat the person, not the impairment.

PEARL: It's very clear that the numbers of baby boomers who are hearing impaired or becoming hearing impaired in the U.S is increasing rapidly. We also know that 1 out of 3 hearing aids ends up in the drawer, never to be worn again. Obviously, hearing aids are not the solution for everyone. In your opinion and from your experience and interaction with other audiologists, what do you think the problem is?

MICHAEL: There are many reasons for this phenomenon. People reject hearing aids, in some cases, because the devices are flawed. Sometimes they are returned due to some difficulty on the patient's part. Sometimes there is limited motivation to wear the device, or the device is sought or the "wrong reasons". The research is clear that audiologic rehabilitation and follow-up results in lower return rates and greater acceptance of amplification. The obvious implication is that today's technology, while something that can provide significant benefit to many people, is still imperfect. Hearing aids alone are rarely the answer. Rather, a rehabilitative plan that includes, but is not limited to, hearing aids appears to provide the best prognoses for patients, based upon the technology to date. The person who expects the hearing aid to be a magical device that will cure all hearing difficulties will be sadly mistaken and greatly disappointed.

PEARL: With hearing aid technology constantly changing, how do your students keep up with the changes? the programming of the aids?

MICHAEL: Well, that is actually part of the reason why our national accrediting bodies have felt the need to increase the entry-standard for education of Audiology students. All audiologists entering the profession will now come from doctoral programs (typically 4-years) with a minimum of 75 credits. The older educational model typically produced a student with one hearing course, while our CUNY Clinical Doctoral Program has three such courses, and additional fieldwork specific to amplification. The doctoral programs have also significantly increased coursework and training in other newer technologies available to the field, such as cochlear implants, as well as diagnostic and rehabilitative tools for balance, tinnitus and other disorders related to the ear. You are correct that certain aspects of hearing aids have changed rapidly (perhaps a topic for another day), but the bottom line is that the basic components of hearing aids (microphone, amplifier and receiver) are the same as those of historic devices.

PEARL: What is the best advice you would give our membership concerning the purchasing of hearing aids? and what should they be cautious of?

MICHAEL: You would like me to answer this in ONE newsletter? I'm sure that you don't have the space...I could go on and on. For today, let me simply say that each member can be his/her own, best advocate. Read about today's technology, arrive at the appointment with questions, consider all options, and be open to try things that might not have been previously considered. Realize that most state licensure laws afford the patient a trial period of several weeks to put the devices to the "ultimate test", that is to allow the patient and family to determine benefit where and when it matters most. One thing to be cautious of is to make an assumption that a one-day or one-week trial will be enough to determine benefit. Adopting hearing aid use is a process, one that may take many weeks, several visits and modifications. The process is facilitated by open lines of communication with the practitioner.}