Audiology in Schools Draft

Just as an audiologist has many roles and responsibilities outside of the school system, an audiologist has many roles and responsibilities inside the school as well.

According to IDEA Part B, an audiologist must care for individuals ages 3-21. Their responsibilities include identification of children with hearing loss, determination of the range, nature, and degree of hearing loss, referral for medical or other professional attention, provisions of Habilitative activities, which include language habilitation, auditory training, speech reading, hearing evaluation, and speech conversation, creation of administration of programs for prevention of hearing loss, counseling and guidance for parents, children, and teachers regarding hearing loss, and determination of child’s needs for group and individual amplification, selecting of an aid, and evaluation of the effectiveness of amplification.
IDEA Part C states that an audiologist must care for children ages birth to two. Roles in this category are very similar to part B and include identification of children with an auditory impairment, using at risk screening techniques, determination of range, nature, and degree of hearing loss and communicative functions, referral for medical and other services necessary for the habilitation and rehabilitation of children with auditory impairments, provision of auditory training, aural rehabilitation, speech reading, listening device orientation and training, provision of services of prevention and hearing loss, and determination of the child’s need for individual amplification.
One of the most important roles an audiologist plays is identification of children with hearing loss. It is very important to identify children early so that the child does not fall behind or miss some of the most important milestones or years of development. Also, Habilitative or rehabilitative services need to be put in place as soon as possible. An audiologist goes into the schools and does a screening. A screening is a simple evaluation that tests the hearing at just a few frequencies. It lets the audiologist know if a further evaluation is needed. A screening is done annually from kindergarten to third grade. Additionally, it is done in 7th grade and 11th grade. Other people who are screened include preschoolers who are considered to be at risk, children who failed a previous screening, children absent during a screening, and children placed in special education programs.
There are some other things that an audiologist specializes in that are outside of the guidelines provided by IDEA. Some of these things include hearing loss and auditory processing disorders, FM systems, cochlear implants, and classroom acoustics.
Auditory processing disorders alone can be a huge problem and cause many problems for an individual. Some characteristics of APD include a short attention span, poor listening skills, distractibility, decreased ability to attend due to other factors in the classroom, and slow or delayed responses to verbal stimuli. To obtain a diagnosis, a child must have difficulties in one of the following areas: auditory attention, auditory memory, auditory discrimination, auditory figure-ground problems, or auditory cohesion. These things have to do with focusing on auditory signals, remembering it, being able to tell the difference in different sounds, the ability to hear a message in the presence of competing auditory signals, and the ability to integrate information.
As you can see, APD in and of itself can present a huge problem. When paired with hearing loss, it becomes an even bigger problem. When paired with hearing loss, APD causes even bigger deficits in academic achievement, communication skills, and psychosocial development. Problems in the area of communication skills include problems with all 5 areas of language, language delay, and difficulty with speech perception. Problems with academic achievement include lower scores on tests, increased need for support in the classroom, repetition of grades, and difficulties in verbally based learning. Psychosocial problems include feelings of isolation, embarrassment, or helplessness, more dependency in the classroom, and refusal to participate in classroom activities or groups.
The audiologist must jump in early and help to find ways to repair the hearing loss. The audiologist will sit down with the child and explain some things about the ear and about hearing loss. Then, the audiologist will perform a complete test battery and get the child on their way to improvement of the hearing loss to repair any more information that is lost than just from APD alone.
The next role of an audiologist lies within FM Systems in the classroom. FM stands for frequency modulated systems. They may also be known as “auditory trainer”. Auditory trainer refers to any system that helps to amplify hearing that is not an individual hearing aid. This may include a hard-wired, FM, infrared, or any other amplification system. A microphone is worn a few inches from the teacher’s mouth. Typically, it may be clipped onto the top of the teacher’s shirt. It wirelessly amplifies the sound to a few feet away. The receiver will wear a small microphone in the ear that may be barely noticeable by peers. Not only does it amplify the speaker, but it accounts for a much higher signal to noise ratio. Outside noise is eliminated, which helps the listener focus more on what the teacher is saying. It is the audiologist’s job to do a daily check of the FM system to make sure there is nothing wrong with the device. The audiologist is responsible for selecting, fitting, and adjusting the FM system. Additionally, the audiologist must do is take a simple look at the machine to make sure there are no broken parts and then do a quick listening check to make sure both parts are working properly. FM systems are able to offer wonderful benefits to children in the classroom who are not eligible or cannot afford personal hearing aids.
On the rise in the classroom is technology called a cochlear implant. If a child has profound hearing loss or is considered deaf, the parents may choose to have their child implanted with a cochlear implant. A cochlear implant is a device that is woven into the cochlea. The child wears a magnetic piece on the outside of the ear that acts as a sound collector. A child who is deaf will suddenly be able to hear after the surgery with the magnet attached. It has opened a huge window of opportunity for deaf children without having to learn sign language. More and more children with cochlear implants are entering the classrooms and being mainstreamed. Audiologists must be knowledgeable about implant process, device options, and monitoring the child after the implant takes place. The audiologist also plays a huge role in the pre -implant and post implant level. Before the implantation, the audiologist plays a huge role in counseling the child and the parents. The audiologist must be up to date with the cochlear implant team at the nearest hospital so that they can fully inform the parents of the full details of the surgery.
At the post implant level, the audiologist plays a role in monitoring the device. If something were to go wrong with the device, the audiologist must need to be able to figure out problem with the mapping of the sound to the inner ear. The audiologist must also be up to date on the performance measures and monitor the child to make sure that he/she is receiving the full potential of the device in the classroom. Again, after the surgery, the audiologist must play a big role in counseling the family about this new equipment.

The last major role of an audiologist in a school is classroom acoustics. One of the simplest things to help a child out is to create the best listening environment possible. The audiologist will examine the room and then meet with the teacher and educate them on creating a better classroom. Some simple tasks include adding more things to the walls, putting tennis balls on the bottoms of the chairs, or adding anything else that will soak up noise in the classroom. Many times, classrooms are in rooms with tile floor and hard walls. With all of the hard surfaces, sound just bounces off them and causes reverberation, or echo. The original signal must then compete with the echo and children may lose pertinent information. Classroom acoustics may be very simple, but it also may be a key role for helping children in the classroom. The audiologist must advocate for these better listening conditions.
As you can see, an audiologist plays a huge role in the school. Not only do they simply identify children with hearing loss, but also must repair the hearing loss and be familiar with up to date technology. Their services range from the simple things such as classroom acoustics, to the much more invasive procedures of cochlear implants.

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