By Gloria Nathanson
A deaf audiologist may appear to be an oxymoron. People often ask, “Don’t you have to hear to do the job?” when I inform them that I am pursuing my AuD, a four-year clinical doctorate degree for audiology at Gallaudet University. I am also enrolled in the audiology PhD program and am almost done with the required course work. However, I am not the first deaf person in this program. Gallaudet has already graduated several other deaf people with audiology degrees. Currently, there are three other deaf students in the program and another deaf person is interested in enrolling this fall. In fact, one of the first documented hard of hearing audiologists, Dr. Mark Ross, has been practicing for over 40 years.
It is becoming less unusual to encounter deaf or hard of hearing audiologists. They are not limited in their scope of practice, deaf and hard of hearing audiologists have worked in various positions such as clinicians, clinic supervisors, private practitioners, professors, and researchers. Some choose to work for various hearing aids/cochlear implant companies. Last year the American Speech-Language Hearing Association (ASHA) profiled some audiologists with hearing loss.
Many instruments are now available to visually show the outcomes of diagnostic tests for hearing, balance or the performance of listening devices. A recording can be used to administer the speech portion of the audiologic assessment, and if age appropriate, the client can write down what was heard or point to a picture board. Some prefer to evaluate their responses via assistive listening devices. However, there continue to be areas that pose a greater challenge for deaf and hard of hearing audiologists, such as listening checks of hearing aids. Many have found ways to compensate for this shortcoming. Some admit they use a hearing person to do the listening check, and others use ingenious home-made amplifiers.
People also wonder how deaf or hard of hearing audiologists communicate with their clients. Some rely on speaking, speechreading, and assistive listening devices. I elected to use an ASL interpreter. I was initially concerned about potential resistance from my clients or supervisors to my interpreter during internships but I am pleased to report that my fear proved to be unfounded, so far. In fact, there has always been a positive reception by my supervisors and clients upon learning about my deafness.
Association of Medical Professionals with Hearing Losses (AMPHL) is a resource for people with a hearing loss who may be interested in thinking of becoming an audiologist (or for any other medical-related professions). There is plenty of advice as well as a listing of various universities that have graduated or currently have deaf and/or hard of hearing audiologists. Another organization, the Association of Audiologists with Hearing Loss has been a great organization for people like me to share tips on how they manage certain tasks. They currently have 57 registered members, including members from other countries. The organization estimates that there are over 70 audiologists and audiologists-to-be who are deaf or hard of hearing across the nation.
The last question people tend to ask, “Why audiology?” My response is that it makes the most sense to me. Audiologists work with deaf people, often providing the first contact for parents of deaf children and providing the earliest and most information. Why can’t deaf people work with deaf people? We are most likely able to empathize with others that are dealing with their own newfound deafness or parents of children who were just diagnosed with a hearing loss. What better person to see than an audiologist who truly understands?
Gloria Nathanson is a candidate for the AuD/PhD in Audiology degree at Gallaudet University. She graduated from the Model Secondary School for the Deaf in ‘95 and got her B.S. degree from the University of Minnesota. She was born deaf and ASL is her first language.
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Interesting. I commend you for entering a field where there are not many deaf/hoh and succeeding in it.
I would like to know if your personal biases, if any, would affect your work? I mean, for example, what if a deaf individual approaches you to discuss about cochlear implants? What would you do? Actually, this isn’t directed at you personally, but to all deaf/hoh audiologists whose primary language is ASL.
This is a good question and I’m interested in hearing the answer.
Would also be interested in hearing your viewpoint regarding medical insurance coverage of CIs vs none for the hearing aid.
To be fair, we should also ask if a bigger motivator, financial incentives or kickbacks, “affect” the work of audiologists:
http://www.cochlear.org/sys-tm.....ysicians2/
(I cannot vouch for the accuracy or credibility of this link, but I’ve heard about this before and this is the closest match I found on the Internet)
Yes, I recently came from a board meeting where someone brought a report on their research into hearing aid companies. The person found out that audiologists are in on the scam with hearing aid companies by overcharging their clients! Digital hearing aids are sold to consumers at 5-8k for a pair. Alas, the MOST that they really cost is $300-something dollars!!!! This is absolutely an outrage and it puts so many people, deaf, late-deafened and hard of hearing people at risk financially and emotionally (denied access). The solution to this problem is to get the legislature to pass a law where audiologists are required to disclose every single cost that the consumer is being charged for (similar to car dealerships, in VT anyway).
P.S. Hi, Gloria! Long time, no see! Congrats on your endeavors! =D
I can respond to what appears to be the appalling cost of hearing aids. The way the billing system currently works is that the insurance companies pay us minimally for the use of equipment only. The true costs are not really reflected, such as cost for the time for the service, which is not included in the payment. For instance, if we performed a hearing test, we might get paid only $20 (depending on the insurance) for an hour of test procedure. This is not even enough to cover the facilities rent, utilities, staff payroll, and for the future hours of services for fitting/repairing the hearing aids,and so on. The facility has to break even somehow and unfortunately the only way that is possible is to compute these costs into the cost for hearing aids. Audiologists do recognize the flaw in this system and are trying to change it but this is a difficult process.
I also wanted to clarify whether the dispensers are a certified audiologist or simply hearing aid dealers? Both of them can dispense but their credentials are entirely different. Hearing aid dealers are more business-based. It is important to consider whether commission is involved and that may contribute to a difference in how they price their products.
I have actually been approached by deaf people, as well as parents of deaf children, to discuss cochlear implants. I have had different outcomes for each one. I am just one person among many that they have talked to. It needs to be clear that cochlear implants are not for everyone. I have seen people benefit a lot from them and I have seen people that get no benefit from it, so I remind people that there are no guarantees with this and their expectations should be realistic. I find that many people are well informed and are indeed realistic about it. I do have my personal biases (especially about whether sign language should be used with children who have implants) but I am a professional and I handle these situations like one. I don’t have a problem with the technology, per se, but I sometimes have a problem with certain individuals that work with them.
Gloria,
I have no question about your abilities as a future audiologist.
Is your skin thick enough to handle the flak and scourge from the ASL/Deaf culture extremists?
Richard
I have a question for you, Richard. Do you ever step off your self-righteous soapbox where you smugly condemn anyone who you deem to be undesirable?
just wondering.
I love it, wildstarryskies. I’ve wondered the same thing many times. Now my question for you, Richard - do you EVER comment or have ANY opinions on ANYTHING that does not involve the “scourge” or the “old guard?”
Oh gosh that’s wonderful! I’d love to have a deaf audiologist who actually understood where I was coming from, instead of a little paternalistic b**** who cautions me that it’s dangerous to go outside without my hearing aids…
Gloria,
I surely trust you as a deaf audiologist after knowing you as a person. Wish you all the best within your audiology career.
I was bewildered after meeting another deaf audiological major at the DC social scene. This person said “Please do not hate me because I majored in audiology”. I assured the same individual that I was not prejudiced toward hir (him/her).
Your presence to deaf youngsters will be very reassuring within your audiology profession.
Robert L. Mason (RLM)
RLM,
Perhaps this is one reason why it is important to have the audiology department on Gallaudet campus? Otherwise people like Gloria (and hearing audiologists) would not have the opportunity to learn about audiology in an environment that demonstrates deaf people are capable of being contributing members of society, regardless of their communication preference. I’ve seen at least two other deaf v/blogs calling for everything related to audiology to be thrown off of Gallaudet campus. I’m not sure if this is the right approach, especially when audiologists are often the first people parents go to see after they discover their child’s deafness.
Gloria, I think it is incredibly benevolent of you to take on a such challenging (or so it seems) profession. I have always had great audiologists, but there were always moments when I felt completely left out as they discussed *my* options with my mother.
Judging from the comments left here, I think the most intriguing aspect (for us, at least) is the perceived biases involved — not just coming from you, but also from your clients, insurers, supervisors, and so forth. As open-minded as a hearing client may be about accepting your use of ASL, would s/he still have an inherent, albeit subconscious, distrust of you — because you’re not hearing, and hearing is the first thing associated with audiology? Somewhat like a patient of a minority not always wanting to trust a “white” doctor’s advice, no matter how well-intentioned it is.
Still.. in the end, what really matters is that little deaf child encountering a deaf, competent professional.
Yes, yes, yes, yes! Something I never experienced! This is something we need to fight for…
Gloria,
I was just thinking back to when you told me you were going to major in this field. I was so amazed. I had honestly never thought a deaf person would WANT to be an audiologist in the first place~ :)
But you just smiled and took it in stride. I walked away, convinced that damnit, deaf people can be audiologists if they want to be! Why the hell not?!
Good for you!
P.S.
Seriously, I’d like to hear about your experiences in this field. How do your clients receive you? Another audiologists? How do you deal with the “listening with your ears” requirements of the job (that is, if there really is any requirements that can’t be done by computer/digitally?)
I’ve always wondered if audiologists, as a field, are somewhat more audistic in their attitudes. I don’t mean to assume, but it seems that a field that is dedicated (for the most part) to making deaf people a little less deaf would naturally attract those who are of the “hearing is better” mindset? I haven’t met an audiologist who has been audistic towards me in any way, but who knows what they think and feel in their private time?
One more thing - I once had an interesting experience teaching a Deaf History class to deaf students. My boss (hearing, but pro-deaf, pro-ASL) and I had an disagreement over one thing. I wanted to teach my students about audiograms. She disagreed, due to the “box ear” thing, which is a perfectly valid arguement. On the other hand, deaf people SHOULD be able to read their own audiogram and understand the physical paramters of their deafness, so to speak. What shocked me is that most of my students did not know how deaf they were, they couldn’t read their audiograms, and their self assessment on the physical configuration of their deafness did not match the audiogram! For instance, a woman insisted to me that she was hard of hearing. She was actually profoundly deaf!
Oh, and LAST thing - Shane made a good point.. what is the financial incentives that might or might not prompt audiologists to make the decisions they do?
Gloria, I hope you’ll be checking back! We’ll all love to hear back.
I agree with you about teaching people how to read audiograms. I have taught over 6 courses to college students (both undergraduate and graduates) and I have found very few of them actually knew how to read their own audiograms. Many of my students told me they felt empowered to finally know exactly what the document, that defined many experiences they had, really meant.
As for audistic attitudes of audiologists, I think it is really no different than any other profession that you may choose. There will be people who harbor a belief system that favors hearing above all and there are people that do not.
Interesting blog! I never imagined a deaf person who used ASL would want to be an audiologist… Not because of the deaf community’s reaction, but because of how the profession in general views the deaf.
I think it’s cool that you’re becoming an audiologist. If more were like you, then maybe the profession wouldn’t have such a pathological view of us.
Gloria, I’ve always thought you rocked! Nice post!
When I was a much younger girl, I myself considered becoming an audiologist. Granted, this was at a time when my career goals changed on a weekly basis, so it couldn’t be taken too seriously. But at the time, I was having fairly regular visits with a very friendly audiologist who testing me to be fitted with new hearing aids. I saw him as “the nice man who was going to help me hear better.”
What was interesting was that when I told my mother, and then she told the audiologist, he broke into big smiles and said “I don’t see why she couldn’t… she would probably be better at it than the rest of us.”
Over the years, as I began my journey into Deafhood, my views of audiologists changed somewhat - mainly because as Deaf Pundit says, so many of them viewed me and my deafness as a pathological case. But I have been fortunate to have worked with a couple of great audiologists who didn’t have that attitude… a few who even knew sign language themselves and took a very positive approach to my Deaf identity.
I didn’t purse a degree in audiology, but I still have the greatest respect for the profession, and particularly to those members who respected me as an individual, even as they continued to struggle to fit me with a nice tight earmold (for whatever reason, I am hard to get a good fit with my earmolds!)
As I read this post, I remember back to that audiologist of my youth, and I agree with what he had to say…
Gloria, I commend you for choosing to go into this profession, and I do believe that you will probably be better at it than the rest of ‘em.
Kudos, and all the best!
“Some admit they use a hearing person to do the listening check, and others use ingenious home-made amplifiers.”
Fascinating. Say are there any visual ways to check hearing aids? For example can you plug one into a computer and check, you know, like a wave or something? Or are the best ways to check one still based on auditory methods?
There is a way to evaluate the performance of hearing aids through a machine, and I see waves, etc.. That is how I typically do it. However, if the complaint is the hearing aid is not changing programs appropriately, there is no way for me to see that on the monitor. That is an example of when I may recruit someone to listen in on that.
Gloria — though I don’t know you, I want to really commend you for doing what you want to do. A deaf friend of mine was an audiology major at UVA a few years back and she was the first deaf audiologist I had encountered and I remember thinking — what a fantastic idea!
I know a lot of people up there (points up at the previous comments) have asked you a few questions. I have one of my own: What do/would you tell parents who are just finding out their child is deaf? Are you interested in UNHS (newborn hearing screening), educational audiology, or something else? I’m really curious.
I really want to see more audiologists embrace the responsibility of educating parents about options. I don’t mean telling parents what they should do, but saying “these are the available options out there.” *listing options* and point them towards research, etc.
Whatever area of audiology you end up focusing on, I’m sure you’ll do a great job! It sounds like it’s been a positive experience for you thus far. :)
It’s nice to know that deaf people are going for audiology major. As a deaf person who rely on hearing aids for listening to music and television/movies and one on one conversation with a hearing person, some would call me HOH but I say I am deaf. You are either deaf or hearing. There are various degrees of deafness, some can hear but no speak well, some cant hear but speak well, some can hear and speak well, on and on.
For the past 5 years, I have had so much problems with hearing audiologist, because the new “rage” with audiologist is DIGITAL HEARING AIDS, I was like wow, it’s new technology? It will help me? Audiologist would say YES YES YES FABULOUS. I was intrigued. When I got it, Audiologist believed in it and got it for me without trial use (BIG MISTAKE). Sure digital hearing aids helped me hear myself speak better but when it came to movies and music, it was totally different, not better! The range of sound from talking to explosives were the same! The louder it became, the digital hearing aid would block some of it forcing some of the sounds out. It caused my ear to ring. I went home with ringing ears from the movie theatres (OC movie ofc) and It really bugged me. Then I was listening to my car radio with CD with heavy beats, my ears started ringing again!! NEVER I experieced that before until I got this digital hearing aid!
After several weeks, I tried everything, turning down the volume and so on. I went to my audiologist and said something is wrong, my ear is ringing ever since I got the digtal hearing aid. She looked at me like I know nothing about digital hearing aids and that I must simply turn down the volume!!! I was like OH OK but still puzzled. (ofc none of my audiologist knows ASL, very rare to see one!!) Since I was not able to afford to get a new hearing aid, I was stuck using what I had til I figure something out, after a year, I fought to get a new one that must be ANALOG hearing aid like I have had for many years. To find out digital hearing aid caused my hearing to go down due to ears ringing!! I lost 10 decibals on the hearing that I relied on, I was able to hear phone ringing, tea kettle whistling, and sirens, now I cannot but I can only hear the sirens but phone ringing and tea kettle good bye!
Audiologist said I WAS WRONG cuz the WHOLE WORLD LOVED IT. I told them well good for them, I am not the whole world, it bothers me! To find out it happened to 2 of my friends who are now not able to talk on the phone or hear radio like they used to. Same with me.
Maybe with a deaf audiologist, they will understand me better!! Just few days ago, I demanded ahearing test to prove that digital hearing aids caused my hearing to go down, I was right!! ofc no one believed me! If you see the hearing test before and after digital hearing aid, a dramatic difference.
I went to a different audiologist (3rd one, the other 2 gave me rude faces like I was stupid) and this one is no better but much nicer, said no it’s not from digital hearing aid, it’s you. I said NO, I’m 34 years old! for 32 years never a change on my audio test until digital came along, I’m telling you dont tell me I’m wrong, I know my own body! He was like OK fine, I said I do not want digital ever again! I went back on Analog hearing aid and my ringing went down dramatically! I even told the audiologist, you do not understand what it is like to wear a hearing aid, so how do you know it’s GREAT?
I am not saying hearing audiologist is BAD BAD but they do not understand deaf people’s feelings when it comes to various sounds or trying to understand speech.
I have found that many people who have grown up using analogs dislike digital, this is a very typical response. I suspect the reason for that lies in the way sounds are processed and the algorithms used to modify sounds to fit in your hearing range. Most digital hearing aids is designed to compress the sounds so that it does not exceed the level identified as the “loud” or “uncomfortable listening level” in order to protect the hearing from noise-induced hearing loss. Analogs typically out in an amount of gain and that meant that sometimes the sounds would peak over uncomfortable levels, giving you sensation of loudness. Listeners who have become accustomed to having their analog exceed that level, producing extremely loud sounds, often felt that these digitial hearing aids were too weak therefore didn’t work well. You are certainly not crazy :).
Many audiologists are not used to working with people that are long-term wearers. They usually fit people who just lost their hearing later in life and are first time wearers, thus they don’t know the difference, so they absolutely “love” the digital ones. Many audiologists are reluctant to allow the digital hearing aids to provide more gain or become louder than your established uncomfortable level as they don’t want to be liable for damage caused by exposure.
I would recommend that you tell the audioloigist in the future (if you get a digitial one again) to set the program of your hearing aids to imitate an analog type of gain as that is what you are accustomed to. Also, your brain has already learned to interpret the processed sounds that way so to try to re-train your brain can be difficult and requires some time. I hope this helps you understand what has happened.
I tried the DigiFocus (as I’d been an Oticon user since a wee child), but the compression was too much, and the audiologist couldn’t “release” it enough for me. So, I turned to Widex.
I was lucky enough to have an audiologist who knew me well and was willing to decrease the amount of compression on my Widex until I was satisfied. She calls me a power-hungry deafie, and I totally agree! ;-)
I love the clarity of the programmable digital aids — I just wish more of them had more flexibility in terms of compression.
Yes, I can certainly understand that. It was difficult for me to adjust to an digital one, after I got an analog. I still do wish I could “turn up” the volume, but I do recognize that the quality of sound is more clear and that I can hear more at a lower volume, which I like.
It is a relief to see a story like this, because I have used an analog hearing aid for 35 years — since suffering a bout of meningitis at the age of 2. I tried the newfangled digital aid about three years ago and found it to be conceptually a good idea but unrewarding in practical terms.
My fundamental critique of the digital hearing aid is that it is probably not sophisticated and subtle enough to effectively discriminate against unwanted sounds while amplifying the good sounds. I do think that digital technology is great, but I also believe it is in its infancy and that significant improvements are possible.
When the audiologists received my feedback on the digital hearing aid, they were condescending and looked as if they didn’t have time to field my concerns. I got the sense that they were accustomed to dictating their standards to a pliable geriatric clientele who had little or no experience with hearing aids.
Just a couple of weeks ago, I met with another audiologist who again seemed impatient about my reservations with digital hearing aids.
I had previously found audiologists to be a good group of people to work with — they helped me hear better, which is a valuable service. Their uncritical faith in digital technology, however, has soured me on the audiology profession.
yes I agree. I get the same reaction as you recieved from audiologist because they feel we should be up to date with technology. Cochlear Implants or digital hearing aids is REQUIRED AND RECOMMENDED by hearing corporations and hearing audiologist who cannot tell the difference between analog and digital and now understanding how compressing the sounds causes my ear to ring. With analog hearing aid when things got loud and uncomfortable, I just simply turn the volume down but at the movies, I loved the loud and explosions and so on but with digital, there was no loud explosions coming thru my hearing aid!!! To find out it compressed it and caused my ear to ring for at least 1 hour. I had to turn off my hearing aid in order to stop the ringing with analog, never had to.
Yes I agree people who used digital for the first time and never had analog cannot tell the difference and the comparison, true with digital hearing aid, I could hear myself speak beautifully which helped me correct my own speech but at the same time, out in the reality, it sucked! I prefer to hear what is surrounded by me, not that being deaf is bad but i’m used to wearing hearing aids as is.
My audiologist said over 30 major companies stopped making analogs!! I was so upset cuz my favorite ananlog was made by Bosch, but no more! Now I have to settle with analogs that are made cheaply and not as good as they would make it if it was a hot market.
Audiologist and corporations have to LISTEN to what we say not what is best in technology based or cheaper to manufacture since IT IS FOR US TO USE not for them to use.
B.C., I feel that you and I could sit down over drinks and get along real well on this matter.
The audiologist who met me a couple of weeks ago alerted me to the fact that companies were ending their commitment to analog hearing aids. Her notice seemed intended to prod me to accept the inevitable about digital technology.
Gloria, could I ask you what you know about the design and improvement of digital hearing aids? As I said, they seem to be a good idea. In practice, however, their benefits can be marginal or non-existent.
I know nothing about the production side of hearing aids, and what type of user feedback goes into their development.
That is a scary thought, no more analog hearing aids?? if so, I guess I will have to succumb to hearing’s belief in digital hearing aids in the future when my current analog breaks and just accept that I cannot use music or go to the movie theatres anymore with it. It’s like they are winning with cochlear implants telling people it’s the new IT thing for cure for hearing loss. SURE digital hearing aids and cochlear HELPS but it is not that great - there are alot of pros and cons for both while analog, there are few cons than pros since I am a big user of analog but when I wrote down pros and cons for digital and analog…analog I had none exept for it not lasting a lifetime while digital it causes my hearing to ring and compress sounds when it’s not true to what it should be sounded! so I think Analog trumps digital. AUDIOLOGIST read those blogs huh?
It annoys me only because audiologist and corporations’ decision is what is BEST for them not for us.
I’m sure the coroporation are thinking -cheaper to make digital hearing aids and newest technology, easy to fool deaf people, they wont know the difference! If it cuases their ears to ring and lose majority of what they have left, what’s the difference? they are already deaf, who are the public going to believe us or them?! (just guessing their greedy comments if digital fails to achieve what analog does and just being sarcastic! LOL)
The question regarding insurance coverages for cochlear implants and hearing aids really is just related to the bottom line. The number of indviduals who qualify for cochlear implants are quite small compared to the number of people who would be candidates for hearing aids. There is something like 28 million people who have hearing loss, a small proportion of that could qualify for cochlear implants. When you do the math of how much it would ultimately cost the insurance company if they had to cover hearing aids, it is tremendous. So, naturally the insurance company would resist the attempts to make them cover hearing aids. Another possible factor is a judgement base of “quality of life.” There are research that shows that a significant portion of people, especially those who lose their hearing later in life, are not totally satisfied with hearing aids and they end up sitting in drawers. This may be another factor that insurance companies consider in deciding whether to cover hearing aids.
I will never get Cochlear Implants!! If digital hearing aids are new to me and it causes my brain or my ears to react differently, suppose Cochlear Implant did that to me and how do I remove it? another surgery? no thanks! Digital, luckily I can just turn it off or put it away! No surgery required.
I think I will wait for future technology where it only requires ear drops where it helps regrow and repair the ear nerves. LOL
Shane,
In response to your comment #83301, I never say or call for ousting the audiology department out of Gallaudet University campus.
I did make following comments about SLCC’s questionable intentions of having the HSLS on two floors. That is all.
We could not possibly avoid the reality about audiologists as first responders to parents of deaf youngsters. Parents would find out about the hearing status of their or hir newborn infant at the hosptial.
The licensed audiologists do employ with the hosptials for newborn infant hearing screenings.
Gloria Nathanson is one of kind as a deaf audiologist on the front line against such paternalism and cultural misindentity. Her presence would be very reassuring for deaf youngsters which she is on their sides.
RLM
No, you didn’t say that. We’ve seen blogs that have implied that though. For example:
http://www.savegallaudet.org/?p=87
I understand that there are issues and questions about the space currently being allotted to the hearing and speech sciences department in the SLCC. I want to stress that people should not try to place “value” based on size of the space occupied. It really all boils down to basic logistics. Different departments have their own equipment used for evaluation, research, and so on.. It just so happens that the equipment that takes up a lot of space are from the audiology program. They include these acoustic booths, machines, as well as devices on demonstration for people to try out before deciding which fits them best before purchasing them (the availability of our demo area is advanced compared to any other university programs). The outcome is certainly a much larger occupation than a taping studio that might be used by ASL/Deaf Studies or Linguistics may need, for instance, or papers that are administered by other departments. In a way it is unfair to attempt to compare physical size between departments and imply that there is some underlying value being expressed here.
Currently the hearing and speech department is housed in one of the last academic buildings to be renovated on campus, in fact the engineers several years ago declared it essentially unsavable. Anyone who has been in the building before would agree it is really in very poor shape. Instead of three floors in Mary Thornberry Building, they will have a floor and a half in SLCC.