I would more than happy to be apart of the organizing a group. I think it is such a great thing not only for students but for other audiologist to contact audiologist that can share some insite on hearing aids by way of personal experience.

 

Great ideas and hope to help out in any way in the future.

 

Todd Landsberg

Audiologist Salem, Oregon

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From: HOHAudiologists@yahoogroups.com [mailto:HOHAudiologists@yahoogroups.com] On Behalf Of Jessica Levine
Sent: Thursday, April 23, 2009 9:49 AM
To: HOHAudiologists@yahoogroups.com
Subject: [HOHAudiologists] AAA Deaf/HOH Discussion Group Update!!!

Hi Guys,

I apologize for this delay!!!  It's been an extremely hectic past few weeks with school and personal life stuff that came up. 

The meeting went extremely well and many people seemed to benefit a lot from the discussions.  We had a variety of individuals that had different types of hearing loss, some with cochlear implants, a few professors with students that have a hearing loss in their program, and friends that came to support us! 

Due to the incredibly large file size of the power point, we decided to just type everything up.  Below is an outline of what were discussed at our deaf/hoh audiologists luncheon! We apologize for the incredibly long email! If you have any questions or concerns, please feel free to ask Abe, Stephanie, and I.  :) 

I wanted to add that, at the end of this meeting.  We all agreed to form a committee to petition to AAA to create the Deaf/HOH Audiologist Group as a formal subcommittee part of AAA, have a board, and perhaps even create an additional website/link onto the AAA website that includes information about Deaf/HOH audiologists, our techqnieus in the clinic, a list of schools that have worked with deaf and hard of hearing students.  Several people in the audience complained how there were not a lot of resources available and not many people are even aware about AMPHL.  We agreed that creating a sub-group with AAA can give us more recognition and acceptance from audiologists in the field.  For those who could not attend, what do you think?  A few of us have volunteered to write up a petition and be more proactive in this.  I think having an official group along with a board (a president, VP, secretary, web site coordinator, a convention planner for deaf/hoh group, etc. ) to plan the presentations each year will make things go smoothly.  I'm not even sure if I can run this group again next year at AAA in San Diego.... If you're interested volunteering to make our group official, please let me know and I will send out an email in 2 weeks about creating a petition and a "board". 


Deaf & HOH Group Discussion- AAA 2009
Presented by Abe Vore (Abram.Vore@...) & Jessica Levine (Jessica.l.levine@...)

“Regardless of what field, or industry.... who is anyone to state what one individual can or can not do? Or what they are or are not capable of achieving, or accomplishing if they set their minds to it? A person's potential is their own, and what they are and are not capable of achieving is their own choice. Anything is possible. Our hearing loss is our strength... it is the spark inside us all that ignited into a flame to assist others with their hearing loss. Let us be proud, and continue to pave the way for success for our patients, and for future audiologists with hearing loss.”   -  Quoted by Jayna Altman (www.jaynaaltman.com)

Acknowledgements
The following slides contain much of the informative wealth that has been discussed in the Deaf/HOH website forum and from other websites.

Topics
- Listening Checks
- Testing at the Audiometer
- Stephanie Schutzenhofer’s Capstone Research Project
- Current discussion topic for this year
- Wrap-up stuff

 Listening Checks (Pictures shown on ppt)
- Works whether you use a hearing aid or a CI
- To increase audibility from a HA by decreasing feedback from the HA and/or ambient noise
- Plug the vents
- Do check in a sound booth
- Use 2-3 inch tubing length with rubber tips at each end

 Listening Checks for CI Users
- Advanced Bionics Harmony Users
T-Mic and use of a regular stethoset. –Tina Childress

- Can’t use earbud earphones to perform listening checks on a CI? -Sam Atcherson
Maybe headset/superaural headphones will work? Or a bigger rubber tip on the stethoset?
If so, maybe contact CI manufacturers to request for this.
- Cochlear’s Freedom Users: While using an FM/Mic Adapter Stethoset, have one program set with an FM/Mic mixing ratio at 10:1 to help decrease ambient noise

 Listening Checks for CIC/ITE Users
- Earbuds for listening checks -Greta Stamper
      Use custom fit earmold w/ adaptors to fit the earbuds, which fits above the CIC hearing aid.
      Sound bore of the earmold should be in line with the mic of the CIC.
Downside is the possibility of feedback.
- Can replace earbuds with large superaural headphones to help deal w/ feedback issues. -Dr. Suzanne Yoder

 Cross Checking with our listening checks!
- Electroacoustic analysis (picture shown on ppt)

Testing at the Audiometer
- Use a FM system:  It is recommended to use HA or CI boot receivers and using a mixing ratio of mic + FM setting (in case a supervisor or colleague needs to communicate)
               - Recommendation for CI Mixing Ratio is 70 : 30
-The transmitter
     -Can be worn by the patient
     -Can be hardwired into the audiometer headset -Dr. Yoder

- Can have the mic hanging from the ceiling over the patient to provide a more direct signal.  Not a good solution for those are on the move.

- Dealing with HA feedback issues while using a normal headset connected to an audiometer
        - Turn down the volume of audiometer
        - Use the automatic or manual phone program.
        - Attach magnet to headset if not switching over in the automatic phone program

Pediatric Testing at the Audiometer
- FM near child
- Two-Tester-give the FM to the other tester
- Other strategies to help improve communication with children inside/outside of the booth?

 Abe's idea of Testing at the Audiometer (Pictures shown on ppt) --if you want more information on this, please email Abe directly!
- Make a 2.5 mm male (RCA) and female Y-adaptor. (can’t do this at radioshack)
- Y-adaptor female end plugs  to the audio feeding into the audiometer.
- Connect one male end of the Y-adaptor to the audiometer.
- Connect the other male end of the Y-adaptor to the FM transmitter “mic” port. 
- Use receivers boots to obtain the signal.

Stephanie Schutzenhofer presented a summary about her Capstone project she is currently completing as part of her AuD degree at Washington University School of Medicine in St. Louis.  Titled: "Utilizing Hearing Assistive Technologies (HATs) to Assess Speech Recognition: Comparison of Word Recognition Scores Obtained by Hearing Aid Users"
This study is relevant to the issues of Deaf/HoH audiologists and AuD students performing word recognition testing in the clinic. 
    The purpose of this study was to determine the effectiveness of several HATs that audiologists and AuD students may clinically to assess word recognition scores.  The secondary purpose was to determine the convenience and feasibility of using the HATs in a clinical setting, which was determined using a questionnaire.  This topic is pertinent in our field because there is a consistent number (or possibly increasing number) of individuals with hearing loss entering the profession of Audiology.  Stephanie found that in 2008, approximately 5% of students enrolled in AuD programs had hearing loss.  There is also a concern that employers may hesitate to hire an audiologist with hearing loss due to uncertainties of his/her ability to perform tasks such as accurately assessing  speech recognition and performing listening checks. 
    For this study, she recruited individuals who have hearing loss and wear hearing aids bilaterally, and also individuals with normal hearing to participate in the same session.  Subjects with hearing loss played the role of the "audiologist" scoring word recognition while subjects with normal hearing played the role of the "patient."  One person from each group participated in a session together.  The subject with normal hearing sat in the sound-proof double-walled test booth.  His/her task was to listen to the CD recorded word list and repeat the words.  This subject was given a written list of the words that included a pre-determined number of errors to establish a target score.  Thus, he/she was to repeat the words on the list regardless of what he/she heard from the CD recording. 
    The subject with hearing loss sat in front of the audiometer outside the test booth listening to the CD recording of the word list and then to the subject with normal hearing repeat the words.  This subject's task was to determine if the subject with normal hearing repeated the words back correctly or not.  He/she was given a score sheet of words correctly represently the words presented by the CD recording.  A measured score was then determined for each listening condition and word list, which were both counterbalanced for each patient and randomized. 
    This study utilized a randomized block design with four listening conditions and four word lists (NU-6 words, Form A, lists 1-4).  The listening conditions included: 1) hearing aids only (reference condition), 2) Comfort Contego FM system with induction neckloop to hearing aids, 3) Phonak Zoomlink FM transmitter and Micro MLxS receiver/DAI to hearing aids, 4) NoiZfree induction earhooks adapted for use with GSI-61 audiometer.  Stephanie controlled for t-coil differences in the hearing aids, as well as volume adjustments needed on the audiometer and/or HAT for each subject with hearing loss.  Seventeen subjects with hearing loss and 17 subjects with normal hearing participated in this study.  Results are currently being analyzed to determine if subjects with hearing loss perform significantly better using a HAT device in addition to their hearing aids or not when scoring word recognition in a similar fashion as in a typical audiology clinic.  Although this study is not complete, it can be said that performance and judgments regarding these HATs vary greatly and one HAT does not fit for all individuals' needs.  More research is certainly needed in the realm of HATs as well as awareness of the technology that is available for patients and professionals. 

The Future: Freedom Stethoscope- Dr. Suzanne Yoder
http://www.freedomscope.com/
A wireless stethoscope- uses bluetooth technology
Maybe something similar to this can be developed for listening checks in the future…

Vestibular Testing:
Making sure patient is transmitting via FM before starting testing such as in rotary chair. -Julie  

Our Future as a Group
Where do you all see this group going? What issues are important?
Email List-Serv:    http://health.groups.yahoo.com/group/HOHAudiologists/
Peer/mentoring program?
What do you all think about establishing ourselves on Facebook as public or private group? 
Create an independent website for Deaf/HOH audiologists apart from AMPHL?
Is our group part of AAA or are we an outsider group?
Would people be interested in forming a ad hoc group for AAA to address communication needs and become the resource for other professionals?    -recommendation by Lisa Devlin        
Would anyone like to volunteer to be on a committee to write a mission statement and bylaws to become a formal group for AAA or as our own group?
Suggestions of how to improve communication within our group?
Random thoughts?  Throw it out there!


Future Topics to Discuss for Next year?
Interviewing for off-campus practicum, Externships, and/or Jobs
How and when to disclose your hearing loss?
In resume? Cover Letter? At the interview in person? 
How to deal with interview questions such as “How are you able to do speech testing?” “How do you communicate with your patients?” “How do you explain your hearing loss to a patient and/or colleagues?”
Dealing with adversity or discrimination by colleagues, professors, and/or  supervisors in clinic
Other ideas?

Accomodations at AAA
Issues or concerns?
2 different kinds of ALD systems 
FM vs. Infrared sound system
Who brings their own FM to AAA?
Are the Interpreters/CART reporters doing a good job?
At the April 2007 meeting there were 7,400 in attendance -Dr. Suzanne Yoder
If we requested 30 CART providers all day for 5 days
Membership cost would be about 10 dollars more a person to accommodate