Educational Preparation of Pediatric Audiologists
Roush, Jackson, The Volta Review
Pediatric audiologists play a vital role in detection, diagnosis, and intervention for young children with hearing loss and their families. Preparing the next generation of pediatric audiologists necessitates a creative approach that balances the requirements of a broad curriculum with the special skills needed to serve a unique and varied population of children who are deaf or hard of hearing and their families. Fortunately, many university programs across the United States have developed specialty tracks, and a growing number are working in partnership with government and other agencies to improve and expand personnel preparation in pediatric audiology. They are joined in this effort by a cadre of talented students who are genuinely committed to working with this population. Still, many challenges remain, among them the sustained financial resources needed to support graduate training programs and students. There is also a need to substantially increase the diversity of our work force in pediatric audiology.
The roots of clinical audiology can be traced to the early years of the 20th century when "psychoacoustics" emerged as a branch of experimental psychology aimed at the study of auditory perception. However, it was not until the 1940s when thousands of young servicemen and women returned from World War ? with noise-induced hearing loss that audiology emerged as a professional discipline. The U.S. government moved quickly to establish hearing rehabilitation programs at the nation's military hospitals where hearing aid fitting and aural (re)habilitation procedures were standardized and implemented across the country. Audiology training programs followed, first at universities in the U.S. mid-west and eventually throughout the nation.
Specialization in pediatric audiology emerged in the 1970s with the refinement of behavioral procedures geared to the assessment of young children. This was also a period marked by improvements in amplification and expansion of intervention programs that emphasized development of spoken language. However, until the 1970s few audiologists considered pediatrics a specialty area. In the preface to the first edition of their classic text, Hearing in Children, Northern and Downs (1974) note:
Until recent years there has been an aura of magic around the audiologic evaluation of very young children. Few people were willing to work with this population because of the myth that the very young child could not be tested subjectively - nor indeed, it was felt, could anything beneficial be done for the infant who was found to have a hearing loss. (p. v)
The developments noted by these authors provided the foundation for a branch of audiology geared to the unique needs of children with hearing loss. Still, the progress that has occurred since the 1970s would have been difficult to imagine at that time. An increase in newborn hearing screening programs has lowered the age of identification so dramatically that "infant audiology" has emerged as a subspecialty. Improvements in technology have been accompanied by legal requirements for a "free and appropriate public education," and over the past decade all 50 U.S. states have implemented statewide programs for early hearing detection and intervention (EHDI). Despite these remarkable achievements, however, one thing has not changed. Most parents, faced with the diagnosis of permanent hearing loss, react with shock and apprehension. The audiologists who serve this population must be skilled at the technical aspects of the profession but also capable of providing counseling and family support. Preparing audiologists to serve young children and their families is challenging for students and for training programs, but it is this combination of technical and interpersonal demands that makes pediatric audiology stimulating and rewarding.
Currently, there is high demand for pediatric audiology services and an impressive pool of students interested in working with children and families. …