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| What Is Needed by Audiologists To Provide Services For Children with APD? |
| By Anne T. Molloy, M.S.Ed. and Jay R. Lucker, Ed.D., CCC-A/SLP, FAAA |
| Posted by Janis |
0000-00-00 |
Index
» By Anne T. Molloy, ...
One of the greatest concerns facing parents of children who have auditory processing disorders (APD) is whether the evaluation of their children is provided by a "qualified" professional. In the area of APD assessment, it is the audiologist who provides the testing. However, if parents look for audiologists to do the testing, is there any way for them to know whether that audiologist is "qualified?"
At present, there are only two ways that parents and other consumers know whether a professional is qualified to be an audiologist. One way is to ask if the audiologist is certified. Most audiologists are certified by the American Speech-Language-Hearing Association or ASHA (www.asha.org). ASHA certified Audiologists carry the letters CCC-A or CCC/A after their names. A few audiologists may carry certification by a new, as yet not widely accepted, board created by the American Academy of Audiology (www.audiology.org). These professionals carry the designator "Board Certified Audiologist."
Certification by ASHA, for example, requires that the audiologist complete a specific course of graduate level study meeting requirements in various areas of audiology including:
o Hearing science
o Anatomy and physiology of the auditory system
o Diagnostic testing for hearing loss including advanced tests to rule out hearing loss and related auditory abnormalities
o Knowledge of amplification systems such as hearing aids and FM systems including evaluation and fitting
o Knowledge of disorders of the auditory system including how to identify these disorders, relate test results to these disorders, and make appropriate referrals, especially medical referrals
o Rehabilitiative techniques related to persons with hearing loss including basic counseling, speech reading, application of technology (like FM systems and other assistive devices)
o Basic knowledge of human communication including speech, hearing and language development
o Knowledge of areas such as ethical practices
Additionally, the audiologist so certified must have completed a specified number of clinical practicum or training hours under another certified audiologist. Usually, from 3 to 5 placements are completed in obtaining these hours. Last, the audiologist must pass a comprehensive certification examination.
Other than finding a certified audiologist, most states require audiologists to be licensed. Thus, an audiologist who identifies him or herself as a Licensed Audiologist in your state has completed the state licensing board’s requirements. In most states, the licensing requirement is the same or similar to ASHA certification requirements.
In reviewing these certification/licensing requirements, note that there is no specification that an audiologist have any training, clinical experience or pass examination questions specific to the area of auditory processing disorders. Yet, the only knowledge parents have that an audiologist is "qualified" is that he or she is licensed and may also be certified.
For many audiologists, their graduate program offered, at most, one course in APD, which may have been an elective. Few programs require even this one course in APD. For many of these programs, the course in APD is taught by an adjunct if there are no faculty members who are knowledgeable of the area and feel qualified to teach such a course. Reviewing the course outlines for APD courses in a number of programs, the focus is on administering and scoring APD tests with emphasis on the neuroanatomy and neurophysiology of the central auditory pathways. Little focus relates to intervention as this is often viewed as being outside the practice of the audiologist, and within the practice of speech-language pathologists (SLPs). Yet, review of the typical graduate coursework provided in SLP programs indicates either no course in APD or an elective that may actually be the APD course developed for audiology majors. Thus, for most audiologists practicing as licensed and certified professionals and for the overwhelming number of SLPs in practice, there are no standards of qualification specific to APD, neither for assessment nor for treatment.
When realizing these facts, the authors decided to review the published works that may be considered the basic texts concerning the field of APD, especially those written by and for audiologists. In reviewing these publications, what comes out is that they all cover the following areas. As such, one would expect that an audiologist who "specializes" in APD or one who offers him/herself as qualified to assess children with auditory processing problems should have expertise in the following areas:
• Anatomy and physiology of the entire central nervous system with focus on the areas that involve auditory and language functions
• Neurobiology
• Psychology focusing on perception, emotion, learning, memory, cognitive development, and child/adolescent development
• Education related to how children learn, learning styles, learning disabilities and education laws
• Speech and language development including speech and discrimination, categorical discrimination, and the impact of auditory factors on speech and language
• Hearing science including acoustics for speech and hearing, physics of sound, perception of sound, experimental phonetics, and psycholinguistics
• Diagnostic measures in hearing focusing on differential diagnostic tests, speech audiometry, and electrophysiological measures
• Assistive technology including assistive listening devices (ALD), hearing aids, FM systems, and alternative augmentative communication (AAC) devices
• Counseling and working with parents, children, adolescents, teachers, and other professionals
This seems like a large list that an audiologist would need to study in order to be considered truly qualified to call him/herself a specialist in APD. One could question the validity of such a list. However, the stimulation for writing this paper came after reading a chapter on APD written by Daniel P. Harris (1996) in which the author describes what he felt were the necessary training audiologists needed in order to provide services for children with APD. Harris identified the need for audiologists to have knowledge of the following:
o "The relationships between neural maturation, speech, language, cognition, and memory appears to be critical"
o Association between the aspects listed above and child development
o ". . .familiarity with the basic principals of test construction, score standardization, and interpretation of results…"(p.163)
Therefore, even as early as 1996, there was a chapter written in a textbook intended for use in educating audiologists presenting concerns about the necessary knowledge that audiologists need in order to provide services for children with APD. Interestingly, Harris’ concerns, as well as those of the present authors, goes beyond the mere study of the auditory system and how to assess its functional integrity. Additionally, Harris cites a study by Henri (1994) that indicated that audiology graduates are "marginally prepared to deal with CAPDs."(p.163)
At present, there is no specialty certification audiologists need in order to provide services for children seen for APD, whether these services include assessment, consultation, interpretation, or treatment. But parents can do some things to achieve some level of comfort that the audiologist who may see their child is minimally qualified. You can ask about the audiologist’s background, coursework, and clinical experiences with children who have APD. Ask what is the audiologist’s approach to APD? Ask for samples of the type of recommendations that the audiologist makes after completing APD testing. Perhaps, the audiologist would provide you with a sample report. If you feel comfortable that this audiologist has the appropriate qualifications, then that audiologist may be the professional whom you are seeking to assess your child’s auditory processing abilities.
References
Harris, D.P. (1996). Central auditory processing disorders in children: Are we listening? In Martin, F.N. & Clark, J.G. (Eds.) Hearing Care for Children, 161-179. Boston: Allyn & Bacon.
Henri, B.P. (1994). Graduate student preparation: Tomorrow’s challenge. Asha, 36, 43-46.
About the authors: Anne T. Molloy is a student in the doctoral program in audiology and a research assistant in the Technology Access Program at Gallaudet Universtiy, Washington, DC. She is also a member of the NCAPD. Jay R. Lucker (dr.j) is an audiologist in private practice specializing in APD with offices in Washington, DC, Alexandria, VA, and Mineola, NY. He is a very active member of the NCAPD.
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