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AUDIOLOGY TODAYAUDIOLOGY TODAY

AMERICAN ACADEMY OF AUDIOLOGY • 11730 PLAZA AMERICA DRIVE • SUITE 300 • RESTON, VA 20190Caring for America’s Hearing

THE BULLETIN OF THE AMERICAN ACADEMY OF AUDIOLOGY

VOLUME 17 NUMBER 6 NOVEMBER/DECEMBER 2005

Scrabble® & ©2005 Hasbro, Inc. Used with permission.

The American Academy of Audiology offers its members many benefits. Some members reportthat they are not aware of some of the advantages that come with being an Academy member.Not only are our members part of the world’s largest professional organization of, by and for

audiologists, but they also benefit from discounts in a number of programs. Here they are!

For more information about these benefits, contactthe Member Benefits Coordinator, at 703-790-8466 x1044 or [email protected].

PUBLICATIONS:• Audiology Today• Journal of the American Academy of Audiology

The largest audiology convention in the world,displaying the latest technological advances inaudiology at reduced member registration rates.• 2006 - Minneapolis, MN• 2007 - Denver, CO

CONTINUING EDUCATION:The Academy,s CE Registry provides a transcript ofyour CEUs at a discounted member rate.www.audiology.org/professionals/ce

PROFESSIONAL SUPPORT MATERIALS:The Academy offers discounted prices to memberson a wide variety of:• Educational Publications • Audiograms• Marketing Tools • Ear Anatomy Posters• The Front Line • Interactive CD,s

Office Training Kit • Tapes and more

FIND AN AUDIOLOGIST/LINKUP:LINKUP advertises your website for an annualsubscription fee. E-mail [email protected] order. This web feature helps consumers find youand enables you to network with other audiologists.

RESEARCH DOME:The Dome online research subscription is the premierinformation service developed for clinicians, educators,researchers and students in the field of Audiology andCommunication Sciences and Disorders. Save 47% off theregular price ($119.95) of an annual Dome subscription.

The special member price is $63.95. Academy candidatemembers save too! Candidate members subscribe for $35(regular student price is $49.95), a 30% savings. Go to www.audiology.org for a free trial or to subscribe.

HEARCAREERS:Whether you are seeking a job or advertising a position,the American Academy of Audiology’s HearCareers sitehas everything you need to achieve your hearing careergoals. This online employment service allows job seek-ers to post their resume and view job postings for free.HearCareers offers discounted rates to our members whopost positions. Go to www.audiology.org/hearcareers tomake your next career connection with HearCareers.

HEALTH INSURANCE:Association Health Programs at (888)450-3040 orwww.associationpros.com provides health, long-term care,life, disability, dental and vision plans (and more!) tomeet members needs. Call today.

WORLDWIDE CALLING CARD:This dual-purpose card can be used as a GlobalPhonedomestic or international calling card. It is also yourpermanent membership card for easy reference to yourmembership number. U.S. rates are from 3.9 cents perminute with no surcharges. To activate your calling card, call 1-800-866-895-5714 or go towww.audiology.org/calling card.

PROFESSIONAL LIABILITY INSURANCE:The Academy has endorsed the professional liabilityinsurance program offered through Healthcare ProvidersService Organization (HPSO). We selected this programbecause of the plan’s many benefits, affordable rates, and their commitment to customer service. For moreinformation, call 1-800-982-9491 or visit their website at www.hpso.com.

AMERICAN ACADEMY OF AUDIOLOGY MEMBERSHIP BENEFITS

ARE YOU TAKING ADVANTAGE OF YOUR MEMBERSHIP BENEFITS?

FRAMING SUCCESS:Members receive discount prices on quality frames to display your membership certificate. Call 1-800-677-3726 today and proudly display your membership certificate or credentials.

ACADEMY CREDIT CARD:With the Academy Credit Card, MBNA ''gives a littlesomething back'' to the Academy every time you make a purchase, and you can earn points towardtravel and brand-name merchandise. Apply online atwww.audiology.org/professional/members/benefits orcall 866-227-1553. Please mention priority code QL6K.

CAR RENTAL DISCOUNTS:Members can get up to 15% off with Hertz and Alamo. Additionally, coupons are available for one car-class upgradeand $10 off a weekly rental with Hertz, and one free day or$10 off with Alamo. For Hertz use Discount Code (CDP#1299750) and/or call the Academy for member discountcoupons. For Alamo be sure to request Rate Code BY andID# 706768 and/or call the Academy for discount coupons.

COMPENSATION & BENEFITS SURVEY:The American Academy of Audiology conducted its fourthannual Compensation and Benefits Survey in the Fall of2004. A full report of the survey with detailedinformation is available for Academy members online at www.audiology.org/hearcareers.

GEICO AUTO INSURANCE:Academy members may qualify for an additionaldiscount off GEICO’s already low rates. Call GEICOtoday for a free rate quote at 1-800-368-2734. Tell them you are a member.

AUDIOLOGY TODAY 3VOLUME 17, NUMBER 6

AUDIOLOGY TODAY

Statement of Policy: The American Academy of Audiology publishes Audiology Today as a means of communicating information among its members about all aspects ofaudiology and related topics. Information and statements published in Audiology Today are not official policy of the American Academy of Audiology unless so indicated.

Audiology Today accepts contributed manuscripts dealing with the wide variety of topics of interest to audiologists, including clinical activities and hearing research, currentevents, news items, professional issues, individual-institution-organization announcements, entries for the calendar of events and materials from other areas within the scope ofpractice of audiology.

All copy received by Audiology Today must be accompanied by a 100M Zip disk or CD clearly identified by author name, topic title, operating system, and word processingprogram (in WordPerfect or Microsoft Word, saved as Text). Submitted material will not necessarily be returned. Specific questions regarding Audiology Today should beaddressed to Editor, Audiology Today, 11730 Plaza America Drive, Suite 300, Reston, VA 20190 or by e-mail to [email protected].

EDITORIAL BOARDEditor

Jerry L. NorthernEditorial Office c/o American Academy of Audiology

11730 Plaza America Drive, Suite 300, Reston, VA 20190800-AAA-2336, ext 1058

[email protected]

A.U. BankaitisOaktree Products, Inc.Chesterfield, MO

Lucille B. BeckVA Medical CenterWashington, DC

Deborah HayesThe Children’s HospitalDenver, CO

Jane MadellBeth Israel Medical CenterNew York, NY

Marsha McCandlessUniversity of UtahSalt Lake City, UT

Patricia McCarthyRush-Presb-St. Luke’s Med CtrChicago, IL

H. Gustav MuellerVanderbilt UniversityNashville, TN

Georgine RayAffiliated Audiology ConsultantsScottsdale, AZ

Jane B. SeatonSeaton ConsultantsAthens, GA

Steven J. StallerAdvanced Bionics CorporationSylmar, CA

Sydney Hawthorne DavisJoyanna WilsonAcademy National OfficeReston, VA

Gyl KasewurmProfessional Hearing ServicesSt. Joseph, MI

EDITORIAL ADVISORY BOARD

Term Ending 2006Theodore J. GlattkeDept of Speech & Hearing SciencesUniversity of Arizona1131 E Second StreetTucson, AZ [email protected]

Lisa L. HunterUniversity of Utah390 South 1530 East, Rm 1201 BEHSSalt Lake City, UT [email protected]

Sharon G. KujawaMassachusetts Eye & Ear InfirmaryDepartment of Audiology243 Charles StreetBoston, MA [email protected]

Term Ending 2007Karen A. JacobsAVA Hearing Center, Inc.Grands Rapids, MI [email protected]

Craig W. NewmanCleveland Clinic Desk A71 9500 Euclid AvenueCleveland, OH [email protected]

Helena Stern SolodarAudiological Consultants of Atlanta2140 Peachtree Road, #350Atlanta, GA [email protected]

BOARD MEMBERS-AT-LARGE

BOARD OF DIRECTORSPresident

Gail WhitelawOhio State University • 141 Pressey Hall

1070 Carmack RoadColumbus, OH [email protected]

AUDIOLOGY TODAYN O V E M B E R / D E C E M B E R V O L U M E 1 7 , N U M B E R 6

EDITORIAL STAFF

Term Ending 2008Debra J. AbelAlliance Audiology, LTD1207 West State StreetAlliance, OH [email protected]

Carmen C. BrewerHearing Section, Neurotology Branch,Nat’l. Institute on Deafness & OtherCommunication DisordersBethesda, MD [email protected]

Therese C. WaldenArmy Audiology & Speech CenterWalter Reed Army Medical CenterWashington, DC [email protected]

AUDIOLOGY TODAY welcomes feature articles, essays of professional opinion, special reports and letters to the editor. Submissions may besubject to editorial review and alteration for clarity and brevity. Closing date for all copy is the 1st day of the month preceding issue date.

ACADEMY MEMBERSHIP

DIRECTORY

ONLINE AT

www.audiology.org

The American Academy of Audiologypromotes quality hearing and balance care by advancing the profession of audiologythrough leadership, advocacy, education, public awareness and support of research.

President-ElectPaul Pessis

North Shore Audiovestibular Lab1160 Park Avenue West, 4N

Highland Park, IL [email protected]

Past PresidentRichard E. Gans

American Institute of Balance11290 Park Boulevard Seminole, FL 33772

[email protected]

NOVEMBER/DECEMBER 20054 AUDIOLOGY TODAY

Audiology Today (ISSN 1535-2609) is published bi-monthly byTamarind Design, 2828 N. Speer Boulevard, Suite 220, Denver, CO80211, e-mail: [email protected] or FAX: 303-480-1309.

The annual subscription price is $85.00 for libraries and institutions and$45.00 for individual non-members. Add $20 for each subscription outsidethe United States. Single copies are available from the Academy NationalOffice at $15 per copy for US non-members, $20 for single copy ordersfrom outside the US, and $20 for libraries and institutions. For subscriptioninquiries, telephone 703-790-8466 or 800- AAA-2336. Claims forundelivered copies must be made within four (4) months of publication.

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Publication of an advertisement in Audiology Today does not constitutea guarantee or endorsement of the quality or value of the product or servicedescribed therein or of any of the representations or claims made by theadvertiser with respect to such product or service. ©2005 by the AmericanAcademy of Audiology. All rights reserved.

INSIDE THIS ISSUE • VOLUME 17, NUMBER 6, 2005

AUDIOLOGYTODAY

POSTMASTER: Please send postal address and e-mail changes to: Audiology Today, c/o Ed Sullivan,Membership Director, American Academy of Audiology,11730 Plaza America Drive, Suite 300, Reston, VA20190 or by e-mail to [email protected].

NATIONAL OFFICEAmerican Academy of Audiology

11730 Plaza America Drive, Suite 300Reston, VA 20190

PHONE: 800-AAA-2336 • 703-790-8466FAX: 703-790-8631

Laura Fleming Doyle, CAE • Executive Directorext. 1030 • [email protected]

Cheryl Kreider Carey, CAE • Deputy Executive DirectorConvention, Exposition & Education

ext. 1050 • [email protected] A. M. Sullivan • Assistant Executive Director

ext. 1034 • [email protected] Bishop, CPA • Director of Finance

ext. 1046 • [email protected] Chappell • Director of Health Care Policy

ext. 1032 • [email protected] Cross • Continuing Education Coordinator

ext. 1043 • [email protected] Devlin Culver • AAA Foundation Manager

ext. 1049 • [email protected] Hawthorne Davis • Director of Communications

ext. 1033 • [email protected] Gayle • Health Care Policy Coordinator

ext. 1048 • [email protected] Hargrove • Communications Coordinator

ext. 1039 • [email protected] Kana • Information Systems Manager

ext. 1053 • [email protected] Kelley • Continuing Education/Convention Coordinator

ext. 1037 • [email protected] Blair Lake, Esq. • Director of Certification

ext. 1060 • [email protected] Lawrence • Clerk

ext. 1056 • [email protected] Nelson • Receptionist

ext. 1000 • [email protected] Oldenburg • Exposition Coordinator

ext. 1042 • [email protected] Olek • Director of Education and Standards

ext. 1036 • [email protected] Owens • Staff Accountant

ext. 1045 • [email protected] Quinn • Membership Assistantext. 1051 • [email protected]

Vanessa Scherstrom • Member Benefits Coordinatorext. 1044 • [email protected]

Sarah Sebastian • Membership Managerext. 1047 • [email protected]

Sabina A. Timlin • Director of Expositionext. 1041 • [email protected]

Marilyn Weissman • Executive Assistantext. 1040 • [email protected] Wilson • Publications Manager

ext. 1031 • [email protected] Yonkers • Assistant Convention Director

ext. 1038 • [email protected]

VIEWPOINT 10Signs of a Maturing Profession — James Steiger

A MOMENT OF SCIENCE 11Central Auditory Processing in Mice — Lisa Cunningham & Lendra Friesen

INFECTION CONTROL 12Hearing Aids: Lick’em and Stick’em — A.U. Bankaitis

CONVENTION UPDATEA Standing Ovation for AudiologyNow!SM: Learning Labs 14Schedule of Events 17Minneapolis: Sights and Sounds 18

CLINICAL UPDATE 21Insert Earphones for Occupational Hearing Conservation Testing — Allan Gross

VIEWPOINT 25Continuing Education: What Were They Thinking? — Michael Metz

AMERICAN BOARD OF AUDIOLOGY 27Many Thanks and More — John Greer Clark

AMERICAN ACADEMY OF AUDIOLOGY FOUNDATION 28At AudiologyNOW! 2006 AAAF Focus

THE MARKETING SCENE 31Building Blocks to Successful Marketing — Gyl Kasewurm

THE BUSINESS OF AUDIOLOGY 33Brand Your Practice — Robert Traynor

CLINICAL UPDATE 37Noise and Military Service: Implications for Hearing Loss and Tinnitus

AUTHOR INDEX 52Index for Volume 17, 2005

Membership Benefits 2President’s Message 5Executive Update 8

Washington Watch 40News & Announcements 41Classified Ads 51

APPRECIATION IS EXTENDED TOSTARKEY LABORATORIES FOR THEIRSPONSORSHIP OF COMPLIMENTARY

SUBSCRIPTIONS TO AUDIOLOGY TODAYFOR FULL-TIME

AUDIOLOGY GRADUATE STUDENTS.

AUDIOLOGY TODAYAUDIOLOGY TODAY

AMERICAN ACADEMY OF AUDIOLOGY • 11730 PLAZA AMERICA DRIVE • SUITE 300 • RESTON, VA 20190Caring for America’s Hearing

THE BULLETIN OF THE AMERICAN ACADEMY OF AUDIOLOGY

VOLUME 17 NUMBER 6 NOVEMBER/DECEMBER 2005

Scrabble® & ©2005 Hasbro, Inc. Used with permission.

Alfred M. Butts invented Scrabble® in 1948 andnow it is estimated that one out of every threehomes in America has a Scrabble® game on hand,so that there is no doubt that Scrabble® hasbecome a household name. The AmericanAcademy of Audiology is working diligently tomake “Audiology” a household word through thepromotion of our slogan, “How’s Your Hearing – Ask An Audiologist.” As you can see from thismonth’s cover design, those words could scorehigh enough to make us all winners!

ON THE COVER

VOLUME 17, NUMBER 6 AUDIOLOGY TODAY 5

P R E S I D E N T ’ SP R E S I D E N T ’ S M E S S A G EM E S S A G E

This President’ message is written as I amreturning from the American Academy ofOtolaryngology-Head and Neck Surgery

(AAO-HNS) annual convention in Los Angelesand as I prepare to leave for the AAA Board ofDirectors meeting in Minneapolis, host city forAudiologyNOW! 2006. The timing of thesetrips in relationship to each other sets the stagefor the topic of this message—partnership andcollaboration.

We will be completing the update to theAcademy’s strategic plan as part of our OctoberBoard meeting. The Board has been looking atthe goals of the Academy; however, two areparticularly relevant for this message:promoting a member-driven environment and partnering withother organizations to “advance hearing and balance” care. Afrequent message received from members is related topromotion of the profession of audiology. Another messagefrom members is the appeal to act in a collaborative mannerwith other organizations, the types of comments that our Boardrefers to as requests to “play well with others.” In some cases,these two messages may be at odds in the need for theAcademy to be the voice of audiology while understandingagendas of other professional organizations that also addresshearing and balance care.

I have written and spoken on the Academy’s “coming ofage” as an 18-year-old organization. The analogy of evolvinginto adulthood can also be viewed as a maturing of thecommunication that occurs between the Academy and otherorganizations. As adolescents grow to adulthood, they arebetter able to effectively address differences of ideas, opinionsand viewpoints, and in these interactions, compromise andcollaboration become viable options. So, too, should be thecase with evolving organizations.

Change is both inevitable and desirable in organizations. Intheir 2001 book Ten Tasks of Change: Demystifying ChangingOrganizations, authors Jeff Evans and Chuck Schaefer state that“changing is the continuous process of an organizationattempting to align itself with shifts in its environment.” BonnieLitch, in a 2005 article in Healthcare Executive, points out thatchange “is what organizations do, not what you do to them.” Inthis context, the Academy has matured and evolved in how weinteract with other professions and organizations.

The Academy is the professional home of audiology and inthat role has had opportunities and challenges to developrelationships with other organizations. Our previous experienceshave helped to shape our current interactions, and the Academyhas learned from previous successes and obstacles that have

been encountered. The intent is to enhance theAcademy’s ability to develop partnerships thatbenefit the profession and advance hearing andbalance care. Poet Maya Angelou sums up thislearning experience in her quote “You did what youknew how to do and when you knew better, youdid better.” As the Academy matures, we arecommitted to “doing better” in a number of thesetypes of relationships and I wanted to take thisopportunity to share some of these interactionswith you.

One of the partnerships that has been cultivatedand venerated by the Academy over the years isthat with the Academy of Dispensing Audiology(ADA). The Academy and ADA have been united

in numerous activities to advocate for audiology and shape thefuture of the profession. Recently, leadership of the Academyand ADA had breakfast with Senator Tim Johnson and his staff,sponsor of Senate Bill 277 for direct access to audiologyservices for Medicare beneficiaries. We look forward tocontinuing to nurture the relationship with ADA, as well asnurturing relationships with other audiology organizations.

This year, the Academy has joined with the AmericanSpeech-Language-Hearing Association in a number ofimportant initiatives that will help to shape the future ofaudiology. These initiatives have included addressing theprospect of decreased reimbursement for audiological servicesproposed under the Medicare fee schedule, participating in ajoint meeting to discuss the future of program accreditation, andparticipating in the planning process for the second audiologysummit meeting to be held in February, 2006 on the topic ofclinical education.

The Academy continues to enjoy a mutually beneficialpartnership with Self Help for Hard of Hearing (SHHH). For anumber of years, the Academy worked to develop our own“consumer council” to understand the patient perspective andaddress joint advocacy efforts. In recent years, the Academy hasenjoyed a strong relationship with SHHH, which has fulfilledthe desired goals of the Academy’s own consumer council andhas offered us much more. We have partnered in advocacyefforts for hearing and balance care and have enjoyedopportunities to share information and ideas that have advancedthe goals of both organizations. In June, Past-President RichardGans; the Academy’s Director of Health Care Policy JodiChappell; and I attended the SHHH Convention in Washington,DC as presenters and participants. A number of Academymembers volunteered at the Academy booth and providedinformation about audiological services and consultation. Morerecently, the Academy has partnered with SHHH, the Texas

Playing Well With OthersGail M. Whitelaw, PhD, President, American Academy of Audiology

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Academy of Audiology, and a number of industry partners inhurricane relief efforts.

Most recently, the Academy has been working to foster astronger relationship with the American Academy ofOtolaryngology-Head and Neck Surgery (AAO-HNS). ManyAcademy members have commented on their positivecollaborations with their otolaryngology colleagues, and thisfeedback is the backdrop for forging new ways for the Academyto work in partnership with AAO-HNS. Initial meetings betweenthe Academy’s Executive Director, Laura Fleming Doyle, andAAO’s Executive Director, David Nielsen, provided a frameworkfor addressing issues that help both professions advance hearingand balance care and establish common ground. Academy andAAO leadership enjoyed a meeting in August to discuss mutualinterests and explore opportunities for collaboration. RichardGans, President-Elect Paul Pessis, and I also had the opportunityto attend the AAO-HNS convention in Los Angeles and were ableto talk with individual AAO-HNS members regarding audiologyand to interact with Academy members that were in attendance.We are looking forward to ongoing meetings with the AAO-HNSleadership during the coming months and to host AAO leaders atAudiologyNOW! 2006.

The Academy’s commitment to promoting the mission andgoals of the independent profession of audiology will be firstand foremost. However, as the Academy has grown andmatured, the value of collaborative relationships and developingalliances with other organizations has become more evident. Insome cases, this will reflect a partnership with an organizationon a specific issue or activity. In other cases, the Academy willwork to seek common ground by understanding positions thatmay be in conflict with that of the Academy. The conclusion inthese situations may be to “agree to disagree,” as compromisingthe profession and professionals in order to placate partnerorganizations is not an option. As with all relationships,disagreement can be a springboard to new ways of addressingproblems and issues. Conflict does not have to mean the end ofa relationship and we will strive to keep lines of communicationopen despite potential disagreements. In the end, these types ofinteractions are of mutual benefit in advancing hearing andbalance care and in promoting the profession of audiology.

REFERENCESEvans, J. & Schaefer, C. (2001) Ten Tasks of Change: Demystifying Changing

Organizations. New York: Pfiffer.Litch, B. (2005). Facing Change in an Organization: How to chart your way

through the chaos. Healthcare Executive, September/October, p. 20-24.

Normative Data for the Attitudes towardLoss of Hearing QuestionnaireGabrielle H. Saunders, Kathleen M.Cienkowski, and Anna Forsline

Real-World Performance of a Reverse-Horn VentFrancis Kuk, Denise Keenan, Chi-chuenLau, Nick Dinulescu, Richard Cortez, andPatricia Keogh

Effect of Signal-to-Noise Ratio onDirectional Microphone Benefit andPreferenceBrian E. Walden, Rauna K. Surr, Kenneth W.Grant, W. Van Summers, Mary T. Cord, andOle Dyrlund

Effect of Stimulant Medication on theAcceptance of Background Noise inIndividuals with AttentionDeficit/Hyperactivity DisorderMelinda C. Freyaldenhoven, James W.Thelin, Patrick N. Plyler, Anna K. Nabelek,and Samuel B. Burchfield

The Chinese Hearing Questionnaire forSchool Children. Xingkuan Bu, Xiaolu Li, and Carlie Driscoll

The Auditory P300 at or Near ThresholdFrank E. Musiek, Robert Froke, and JeffreyWeihing

Event-Related Brain Potentials Elicited bySemantic and Syntactic Anomalies duringAuditory Sentence ProcessingAnja Faustmann, Bruce E. Murdoch, SimonP. Finnigan, and David A. Copland

Speech Recognition in Multitalker BabbleUsing Digits, Words, and SentencesRachel A. McArdle, Richard H. Wilson,Christopher A. Burks, and Deborah G.Weakley

Effect of Earcanal Occlusion on Pure-ToneThreshold SensitivityRoss J. Roeser, Lydia Lai, and Jackie L. Clark

Vent Configurations on Subjective andObjective Occlusion EffectFrancis Kuk, Denise Keenan, and Chi-chuen Lau

Journal of the American Academy of Audiology

JAMES JERGER

GABRIELLE H. SAUNDERS, KATHLEEN M. CIENKOWSKI, AND ANNA FORSLINE

FRANCIS KUK, DENISE KEENAN, CHI-CHUEN LAU, NICK DINULESCU,RICHARD CORTEZ, AND PATRICIA KEOGH

BRIAN E. WALDEN, RAUNA K. SURR, KENNETH W. GRANT, W. VAN SUMMERS,MARY T. CORD, AND OLE DYRLUND

MELINDA C. FREYALDENHOVEN, JAMES W. THELIN, PATRICK N. PLYLER,ANNA K. NABELEK, AND SAMUEL B. BURCHFIELD

XINGKUAN BU, XIAOLU LI, AND CARLIE DRISCOLL

FRANK E. MUSIEK, ROBERT FROKE, AND JEFFREY WEIHING

ANJA FAUSTMANN, BRUCE E. MURDOCH, SIMON P. FINNIGAN, AND DAVID A. COPLAND

RACHEL A. MCARDLE, RICHARD H. WILSON, CHRISTOPHER A. BURKS, AND

DEBORAH G. WEAKLEY

ROSS J. ROESER, LYDIA LAI, AND JACKIE L. CLARK

FRANCIS KUK, DENISE KEENAN, AND CHI-CHUEN LAU

What’s New in JAAA October 2005 (Vol. 16, No. 9)

PRESIDENT’S MESSAGE


Executive UPdateLaura Fleming Doyle, CAE

AUDIOLOGY & KATRINA

Iwasn’t sure there was much I could dofor the victims of Katrina other than offermy prayers and make a donation to theRed Cross. I felt helpless and removed,as I am sure many of you did. I could

see the pain and devastation but feltfrustrated that there was nothing I could per-sonally do to help.

That was soon to change. Within a weekafter Katrina hit, I received two emailsalmost simultaneously: one from Terry Portisof SHHH and the other from Academy Past-President Dave Fabry of Phonak. They bothhad the same idea. Let’s coordinate an effortthrough the audiologists of the Academy tohelp those evacuees who are in need ofhearing aid repair or replacement. Phonakhad located a mobile hearing van and wasdonating 500 hearing aids; SHHH had Dry-Aid kits and hearing aid batteries with newdonations coming in daily. I contacted someof our exhibitors to see if they could donateadditional materials and received a positiveresponse from Mid-States Laboratories andWestone for impression materials and earmolds. Next, we needed audiologists to com-plete the equation. The Academy contactedPhil Allred, President of the Texas Academyof Audiology. The TAA agreed to coordinate arelief effort starting in Houston at theAstrodome. Local SHHH members assistedby not only cutting through some of thebureaucratic red tape, but by going throughthe crowd at Houston’s Astrodome and iden-tifying those in need of hearing aid repairand replacement. Within 4 days of receivingthose emails from Terry and Dave (only 12days after Katrina hit New Orleans), audiolo-gists from the Texas Academy of Audiologywere at the Astrodome helping evacuees inneed of hearing aid repair.

In addition to providing assistance to thoseevacuated to Houston’s Astrodome, we haveasked our members from around the country

to help those who have relocated into theircity as a result of Katrina. SHHH is workingto get the word out to consumers that evac-uees can contact the Academy to be pairedwith an audiologist in their new city. Yourresponse has been heartwarming. Once aconnection has been made between therelocated consumer and the Academy mem-ber, the Academy is working with them tosecure the donated materials from Phonak,Westone or Mid-States Laboratories.

The day after I received those emails fromTerry and Dave, the Academy received a gen-erous offer from Barbara Cone-Wesson toaccept PhD students displaced by Katrina atthe University of Arizona. We decided to con-tact other universities to see if they could alsoaccommodate displaced students. Within amatter of hours, we had 12 similar offers. Wethen sent a notice out to over 700 studentmembers asking them to help us get the wordout to fellow students who were displaced .

In addition to these efforts, StarkeyLaboratories has also gone into theAstrodome and set up operations to test andfit hearing aids for those displaced byKatrina. My sister, who is an otolaryngologistin Houston, placed one of our members towork in her practice after Katrina forced ouraudiologist member out of New Orleans.And I am sure there are many other acts ofkindness and generosity by the audiologycommunity of which I am not aware.

One of the reasons I have always enjoyed myrole as Executive Director of the AmericanAcademy of Audiology is because the mem-bers are so caring. This catastrophe has onlyconfirmed what I already knew about yourkindness, generosity and compassion. Thankyou all for your kindness to those displaced byKatrina and for your generosity in supportingthe Academy’s efforts to help in whateversmall way we possibly can. (At this writing,12 evacuees in need of assistance with theirhearing aids have been connected with audiol-ogists who have volunteered their time.)

AudBlog“I’m hopeful that one yearaudiology will be showcasedat the fair and a seven foottall butter ear will appear inthat refrigerated showcase.”Welcome to the Blogosphere. Be sure to read AudBlog— President Gail Whitelaw’s weekly musings on the state

of audiology and the Academy.

www.audiology.org/blog


Ihave been an audiologist or an audiologistin training for a quarter of a century. Istudied audiology as an undergraduatestudent, graduate student, PhD student,

and PhD candidate. I taught audiology as ateaching fellow, assistant professor andassociate professor. I practiced audiology as aclinical fellow and university supervisor, and Iam currently a full-time clinician. I love myprofession. I can’t imagine doing anythingelse for a living.

Over the years I have been intrigued by thewords and habits of audiologists, and I havenoticed subtle changes in the seemingly smalland insignificant things we say and do in ourroutine professional lives. However, I believethese words and habits are neither small norinsignificant. I believe they reflect our collec-tive self-perception. In this paper I sharesome of my observations, beginning with thewords and habits I have thought stifling, butending with evidence of our maturation.

The topic of this paper first occurred to me,believe it or not, during my undergraduatestudies in the early 1980s. I read a textbookpassage that troubled me. I cannot recall thetext or author(s), but the passage, as best Ican now recall it, read in part: “As audiolo-gists, we should not go flapping about inwhite coats.” I wondered; why couldn’t wewear white coats? And if we did, why wouldwe be “flapping about” in our white coatswhile physicians, dentists and optometristswere doctoring in their white coats? I do notknow the beliefs or intent of that now forgot-ten author(s), and I can’t even be sure of howaccurate my memory of that passage is. I onlyknow that those words had an impact on atleast one impressionable young student.

Later in that decade, I became acquainted witha professor who wore a white coat in the clin-ic, to the snickers of the students. I detecteda similar resistance to medical garb in lateryears when wearing scrubs or having my ownstudents wear scrubs. I also recall, in the1990s, when a retired audiologist saw mewearing latex gloves and scoffed, “soaudiologists wear gloves now.” But why

wouldn’t I wear gloves when removingcerumen? Why must I touch cerumen-coatedhearing aids with my bare hands? Why didmedical garb look foreign on an audiologist?

Perhaps some of us worried about appearingpretentious. We were, after all, not doctors.Consider the tools we rejected, includingstools and headlamps to use when examiningears, removing cerumen, or taking earimpressions. These are medical paraphernaliathat, when we used them, seemed out ofplace. But those of us who have tried themknow their utility. On a stool, one can positiononeself to view ear canals’ typical upwardcourse. And with a headlamp, one’s hands arefree to work. Yet many audiologists stoodhunched over in an uncomfortable arc whilethey worked in patients’ ears in the dark.

We seemed not to want a lot of tools around,as if our jobs must be too simple for all that.Some of us had one syringe and one type ofimpression material to use on ears of all sizes,shapes and textures. And when we finishedwith the syringe, it could often be found onthe counter with the hardened impressionmaterial in it when the next client arrived. Incontrast, physicians and dentists have trays ofvarious and cleaned tools at the ready. Andwhen finished, the tools are placed in a con-tainer to be cleaned. I believe our habits were,in part, attributable to our training in universi-ty rather than medical clinics, and to our lackof audiologic equivalents of nurses and dentalassistants to do the preparation and clean up.Nevertheless, I noticed the habits.

Similarly, we often preferred not to add to ourtest repertoire; rather, we replaced old withnew. With the advent of real-ear measures,sound-field testing immediately becamearchaic and was largely abandoned. A similarfate was reserved for Bekesy audiometry, syn-thetic sentence index, pitch pattern sequence,and many other tests some of my fellow oldtimers may recall and occasionally use. Iwonder if the tendency to throw out, and evenridicule, those old tests reflected doubt in thevalue of what we had been doing. Or perhapswe longed for the perfect test to make clinical

skill and interpretation unnecessary.

But sometimes, our words can be the mostself-limiting. We tested hearing, seemingly atechnician’s job, while physicians conductedphysical exams, dentists conducted oralexams, and optometrists conducted eyeexams. We had clinical impressions and werehabilitated, while doctors diagnosed andtreated. We ordered hearing aids from amanufacturer or company, while dentists andoptometrists ordered their prosthetics from alab. We worked and held a job, whilephysicians, dentists and optometrists were inpractice in a profession. Our words were notthose of doctors.

But I have observed changes in our words andhabits. We have declared that we are a doc-toring profession. We have an Audiology Oath(Steiger, Saccone, and Freeman, 20021), andthat oath has been recited at graduationceremonies and at white-coat ceremonies forour doctoral students. Many of us wear whitecoats or scrubs, we see patients, and we usewhatever tools will help us help our patients.Our clinical practices are varied and complex.We are even starting to diagnose and treathearing loss, tinnitus and balance disorders.We are imposing fewer self-limitations throughour words and habits. We are maturing.

Do you agree that words and habits matter asI have suggested? If you do, then take care.There may be an impressionable student read-ing thoughtfully what you write, watchingcarefully what you do, or listening intently towhat you say. Consider letting them hear thewords I wrote in the first paragraph of thispaper: I love my profession.

REFERENCE1Steiger, J.R., Saccone, P.A., & Freeman, B.A.,

(2002). An Oath for Audiology. Audiology

Today. 14 (5)

The opinions expressed in this Viewpoint arethose of the author and in no way should beconstrued as representative of the Editor,officers or staff of the American Academy ofAudiology.

VIEWPOINT

Signs of a Maturing ProfessionJAMES STEIGER, PHD, WEST PALM BEACH VA MEDICAL CENTER, FL


Auditory Processing Disorder (APD, sometimes called CentralAuditory Processing Disorder, or CAPD) is generally defined asdifficulty with listening that cannot be explained by peripheral audito-

ry testing. (C)APD has recently been examined by both ASHA and theBritish Society of Audiology. ASHA defines (C)APD as “difficulties in theprocessing of auditory information in the central nervous system (CNS) asdemonstrated by poor performance in one or more of the following skills:sound localization and lateralization; auditory discrimination; auditory pat-tern recognition; temporal aspects of audition, including temporal integra-tion, temporal discrimination (e.g., temporal gap detection), temporalordering, and temporal masking; auditory performance in competingacoustic signals (including dichotic listening); and auditory performancewith degraded acoustic signals.” (ASHA, 2005)

APD is clearly a disorder that is difficult to diagnose and treat. Manyscientists, educators and audiologists are studying methods of improvingthe communication of children and adults with APD. It appears that APDcan be either acquired (as may be the case in some children with historiesof chronic otitis media) or inherited, as some language disorders appear tobe. Interestingly, the auditory processing problems of language impairedchildren may not be inherited (Bishop, 2002), pointing to the complexity ofthis interaction. How can we determine the causes of inherited APD?

Scientists are working to develop mouse models of APD (Moore, 2005).How can something as complex as auditory processing be examined in amouse? Several tests of auditory processing are under consideration foruse in mice. For example, a classic test of hearing in mice is the acousticstartle reflex. The startle response in animals and humans is a reflexivetwitch of facial and body muscles in response to a sudden, intense stimu-lus. This stimulus might be tactile, visual or acoustic (Koch, 1999). Thisresponse in mice is easily quantified by placing the mouse on a platformthat will move and measuring the latency and amplitude of the motion inresponse to the stimulus. While the startle response is not a test of centralauditory processing, it can become one when it is used to measure pre-pulse inhibition (PPI). PPI is the decrease in the magnitude of the startleresponse when the stimulus is preceded by another, less intense, sound. Ifthe mouse hears (and processes) the pre-pulse sound, then the measuredstartle response after the second (louder) stimulus will be decreased rela-tive to the classic startle response. PPI has the advantage over other teststhat it can be conducted rapidly, without training, enabling screening oflarge numbers of mice.

A variant of the PPI paradigm that has already been used to measureauditory processing is gap detection. Gap detection is a classic test of cen-tral auditory processing (CAP) in humans. The test involves detection of agap (silence) in a sustained noise. Children with APD frequently exhibit dif-ficulty in the temporal processing required to detect small gaps in noise(reviewed by Phillips, 1999). In mice, a gap in noise can be used as a “pre-pulse.” That is, if a gap in continuous noise precedes a startle stimulus,

the startle response will be decreased in a similar fashion as above for thepre-pulse sound (Ison et al., 1998). Since gap detection is a measure thatis affected by central auditory processing, it can be used as a measure ofCAP in mice. The ability to examine central auditory processing in ananimal model will allow scientists to better understand the central process-ing of auditory signals, and it will allow for studies of genes that alter cen-tral auditory processing in mice and humans.

ASHA Position Statement: American Speech-Language-Hearing Association (2005).(Central) Auditory Processing Disorders – The Role of the Audiologist [PositionStatement]. Available at: http://www.ASHA.org

Bishop, D.V. 2002. The role of genes in the etiology of specific language impairment.J Commun Disord 35:311-28.

Ison, J.R., P. Agrawal, J. Pak, and W.J. Vaughn. 1998. Changes in temporal acuitywith age and with hearing impairment in the mouse: a study of the acousticstartle reflex and its inhibition by brief decrements in noise level. J Acoust SocAm. 104:1696-704.

Koch, M. 1999. The neurobiology of startle. Prog Neurobiol. 59:107-28.Moore, D.R. 2005. Auditory Processing Disorders. In The Mouse as an Instrument

for Hearing Research II, The Jackson Laboratory, Bar Harbor, ME.Phillips, D.P. 1999. Auditory gap detection, perceptual channels, and temporal

resolution in speech perception. J Am Acad Audiol. 10:343-54.

A M O M E N T O F S C I E N C E

CENTRAL AUDITORY PROCESSING IN MICE

R E F E R E N C E S

Lisa Cunningham, Medical University of South Carolina, Charleston, SC

Lendra Friesen, University of Washington, Seattle, WA


INFECTION CONTROL

I am always stunned that, regardless ofwhat part of the world I am in, I am likely tosee a hearing aid wearer stick his/her hearingaid in their mouth - apparently to lubricatethe hearing aid shell - and then insert thehearing aid in their ear. Ugh! The intent ofthis informational piece is to provide audiol-ogists with an arsenal of information thatcan be relayed to all hearing aid wearingpatients about why sticking hearing aids inthe mouth is not a good idea.

Since 2002, several studies have docu-mented the presence of bacterial and fungalgrowth on hearing aid and earmold sur-faces.1,2 While some of the recoveredmicroorganisms were consistent with whatwould be expected to be found in the exter-nal auditory canal (i.e. Staphylococcus, diph-theroids, occasional fungal spores),3 themajority of the recovered microorganismswere not. Furthermore, several of themicroorganisms were considered extremelyvirulent (i.e. Staphylococcus aureus,Pseudomonas aeruginosa) while others wereconsidered exceptionally unhygienic; severalhearing aids were contaminated with light toheavy amounts of bacteria (Enterococci)specifically found in feces and fecal matter.1

In other words, there are things growing onhearing aid surfaces that do not belong in themouth, let alone the ear.

The mouth, as is the case of the ear, is anorifice of the body. Natural body orificesprovide an easy portal for microorganisms toenter the body. When a hearing aid is insert-ed in the mouth (or in the ear), microorgan-isms residing on those surfaces gain accessto a dark, warm, moist environment that ismore conducive to microbial proliferation. Inthe event the patient exhibits any degree ofimmunocompromise either due to underly-ing disease (i.e. diabetes), age (pediatric or

geriatric patient), or medical history(chemotherapy, pharmacological interven-tion), given the right conditions, even seem-ingly innocuous microorganisms can becomevery aggressive, causing localized or sys-temic infection and disease.

ROLE OF THE AUDIOLOGISTAs audiologists, it is our legal, ethical

and clinical responsibility to consciouslyestablish a health care environment designedto eliminate or reduce the potential for cross-contaminationthrough the imple-mentation of feder-ally mandatedinfection controlprotocols. TheOccupationalSafety and HealthAdministration(OSHA) requireswork places todevelop written,profession-specificinfection controlplans and protocolsaddressing employ-ee categorization,HBV vaccinationprocedures, infec-tion control trainingplan and records,engineering andwork practice con-trols, emergencyprocedures, andpost-exposure eval-uation with follow-up plans. Resourcesaddressing audiolo-gy-specific infec-

tion control requirements and protocols areavailable and address these issues in moredetail.4,5 As hearing health care providers,audiologists should also transfer infectioncontrol knowledge to their patients by doingthe following:

LEAD BY EXAMPLE: IMPLEMENTFEDERALLY-MANDATED INFECTIONCONTROL PLANS AND PROTOCOLS

Audiologists must implement federally-

A.U. Bankaitis, PhD, Oaktree Products, Inc.Chesterfield, MO

HEARING AIDS: LICK ’EM and STICK ’EM?

StickingHearing Aids in the Mouth is Not a Good Idea!


mandated infection control plans and prac-tice associated protocols. There are manyreasons why audiologists should implementan infection control plan which specificallyaddresses the audiology clinical environ-ment. The most definitive justification stemsfrom the fact that infection control representsa federally mandated requirement overseenand enforced by OSHA. Failure of compli-ance results in citations and significant fines.Beyond the legal obligations, the nature ofaudiology is inherently associated with ahigh degree of disease exposure. The servic-es provided by an audiologist and the corre-sponding infection control principles that heor she chooses to either apply or ignore caninfluence not only their own health, but theoverall health and well-being of theirpatients and co-workers. By putting infectioncontrol in the forefront, audiologists will bedemonstrating best practices to their patients.

TEACH YOUR PATIENTS WELLEducate patients on hearing aid hygiene

by taking thenecessary 2 to 3minutes to tellyour patientsabout the impor-tance of cleaningand disinfectingtheir aids andshowin them theproper tech-niques for doingso. Free educa-tional tools areavailable to audi-ologists to facili-tate this process,including an 8.5”x 11” laminatedcounseling cardand prescriptionpads. Both itemshave beendesigned specifi-cally for educa-tional purposesand do not pro-mote specificproducts. Thelaminated coun-seling card is atwo-sided educa-

tional tool. The front of the laminated cardillustrates the three main steps involved inproper hearing aid hygiene. The back of thecard provides a detailed explanation on theimportance of hearing aid hygiene and maybe used either as a script for the audiologistto use to relay important infection controlpoints or it may be given to the patient toread. Available prescription pads are halfsheets of standard paper that reiterate thethree major hearing aid hygiene steps. Eachprescription pad contains 50 half sheets.When counseling patients on proper hearingaid hygiene with the laminated counselingcard, tear off one of the half sheets forpatients to take home with them as a refer-ence and a reminder to clean and disinfecttheir hearing aids every evening.

BECOME A GREATER RESOURCETO YOUR PATIENTS

Provide patients with access to appropri-ate products. For those patients who are inthe habit of lubricating their hearing aids by

placing the devices in their mouth, teachthem why this technique is inappropriate andprovide them with alternative methods oflubrication by making appropriate productsavailable for resale at your office. In addi-tion, provide patients with access to appro-priate hearing aid disinfectants for use athome. For example, alcohol should not beroutinely used to clean and disinfect hearingaids. Alcohol, although technically a disin-fectant, chemically denatures, or breaksdown, acrylic, plastic, rubber and silicone.Since hearing aid shells and earmolds arecomprised of these materials, the use of alco-hol will degrade surfaces, creating a greaterneed for instrument repair and maintenance.Furthermore, alcohol does not possess abroad spectrum of bacterial or fungal kill.Given the extent of reported microbialgrowth on hearing aid surfaces, patientsshould be made aware of the availability ofdisinfectants specifically designed for hear-ing aid surfaces. These disinfectants shouldbe made readily available for resale withinaudiology clinical practices. This small con-venience serves as a tremendous opportunityto let your patients know that you, as theiraudiologist, are a resource for all their hear-ing health care needs.

FINAL THOUGHTSAs audiologists, it is our responsibility to

take the time to educate our patients on theimportance of hearing aid hygiene, makingsure that each patient clearly understandsthat hearing aids should not be inserted intheir mouth!

REFERENCES:1. Bankaitis, A.U. (2002). What’s growing on your

patients’ hearing aids? The Hearing Journal,55(6), pp. 48-56.

2. Sturgelewski, S. (2002). Microorganisms andHearing Aids: Considerations for InfectionControl. Unpublished AuD Capstone Project,Rush University.

3. Jahn, A.F. & Hawke, M. (1992). Infections of theexternal ear. In: C. Cummings, J.F. Fredrickson, L.Harker, C. Krause, & C. Schuller, (Eds.).Otolaryngology - Head and Neck Surgery, (2nd ed.)(pp. 2787-2794). St. Louis: Mosby - Year Book.

4. Bankaitis, A.U. & Kemp, R.J. (2004). InfectionControl in the Audiology Clinic. Boulder, CO:Auban.

5. Bankaitis, A.U. & Kemp, R.J. (2003). InfectionControl in the Hearing Aid Clinic. Boulder, CO:Auban.


You can feel the excitement as thecurtain rises, your senses heightenas the stage and the cast

members come into view. Your heartbeats in anticipation of the engagingevent that you are about to experience.Capture that feeling and more whenyou attend AudiologyNOW! 2006.Thereyou will be more than an enrapturedaudience member, rather you will

experience AudiologyNOW! as a castmember with the play written aroundyour experiences! Use our new,advanced Itinerary Builder to help youlearn your lines and create yourexperiences at AudiologyNOW!

ACT IWednesday, April 5, explores theLearning Labs, which feature hands-on

experiences. Samantha Lewis and herLearning Lab subcommittee haveassembled diverse course options fromVEMP to Marketing. Choose from threefull-day or four half-day Learning Labs.Later in that act you can participate inthe hot topics in Audiology with the 2-hour Focus Groups.

Audiologic Tinnitus Management: What To Do & How To Do ItThis course will provide step-by-step guidelines for the manage-ment of tinnitus by audiologists. A “progressive intervention”approach is described, which addresses five hierarchical levels ofclinical need: (1) rapid interview-screening to assess the need forintervention; (2) group educational counseling; (3) tinnitus intakeassessment; (4) ongoing treatment (1-2 years); and (5) extendedtreatment (2+ years). Techniques for selecting ear-level and sound-enhancing devices will be described, as well as a specificcounseling protocol.

James A. Henry, PhD, Tara L. Zaugg, MA, Martin A. Schechter, PhD

Clinical Application of Auditory Evoked Responsein ChildrenThere is unprecedented demand for diagnosis of hearing loss ininfants and young children. This practical presentation reviewscurrent strategies for confirmation and description of auditorydysfunction in children using electrophysiological measures. Thefocus will be primarily on ABR/ASSR techniques but will also provideattendees with guidance on the complete infant test battery. Mainpoints will be supplemented with case reports, and equipment will beavailable from a variety of manufacturers for hands-on learning.

James W. Hall, PhD, Roger A. Ruth, PhD, Barbara K. Cone-Wesson, PhD, and Todd B. Sauter, MA

Cracking the Reimbursement & PracticeManagement CodeReimbursement and practice management issues affect everyone,regardless of practice setting. In this session, we will examineaudiologic reimbursement issues including Stark, Safe Harbor &Anti-Kickback regulations, the rationale behind obtaining a ProviderIdentification Number (PIN), the National Provider Identifier (NPI),the cessation of “incident-to” billing, the use of proper proceduraland diagnostic coding, modifiers, Advance Beneficiary Notices anddocumentation. This in-depth review will enable participants tomake valuable choices for their practices.

Kadyn O. Williams, AuD, Paul M. Pessis, AuD, Alan Freint, MD

FULL DAY Learning Labs

Cerumen ManagementAudiologists provide a variety of services necessitating patients’ ears to berelatively free of cerumen as significant amounts interfere with diagnosticand rehabilitative procedures. As such, cerumen removal has become animportant practice management issue. This workshop will address coreissues related to cerumen management including a review of ear canalanatomy and physiology, the pathophysiology of cerumen, instrumentation,equipment considerations, infection control considerations, and cerumenremoval techniques. Video demonstrations will be presented and discussed.

A.U. Bankaitis, PhD

Marketing for Audiologists in all Practice SettingsThis session will present ideas of how to make your patients “patient’s forlife.” Interactive exercises will teach participants how to create a personalmarketing strategy and customer service policy. Participants will learn howto utilize Negen’s proven marketing concepts to draft their own marketingplan. Learn how to motivate patients to come to YOU and discuss ways toposition yourself and your organization as the BEST providers of qualityhearing health care.

Bob Negen

Utilization of Middle & Late Auditory Evoked PotentialsThere is a growing interest in middle and late auditory evoked potentials.These evoked responses appear to be underutilized by the audiologycommunity. This presentation is one that will focus on the basis of middle andlate potentials and their clinical application. Discussed and demonstrated willbe generators, recording parameters and interpretation of the middle (MLR)and late N1, P2 potentials with ongoing emphasis on clinical utility.

Frank E. Musiek, PhD, Gary P. Jacobson, PhD

Vestibular Evoked Myogenic Potentials (VEMP)The vestibular evoked myogenic potential (VEMP) is a simple, non-invasive testthat may supplement the current vestibular test battery by providing diagnosticinformation about saccular and/or inferior vestibular nerve function. Topics willinclude the acoustic sensitivity of the vestibular apparatus, VEMP recordingmethods, effects of stimulus parameters and clinical applications for the VEMP.Case studies will be presented to demonstrate clinical utility and hands-onexperience will be provided using several different recording techniques.

Faith Wurm Akin, PhD, Owen D. Murnane, PhD

HALF DAY Learning Labs

A Standing Ovation for

Minneapolis is known for many things: moretheater seats per capita than any city outside ofNew York, fine dining, jazz clubs, friendlypeople and beautifulscenery but the mainreason for choosingMinneapolis for the site ofAudiologyNOW! 2006 is thenumber of Hearing Aidmanufacturers located inthe area. As part of yourAudiologyNOW!registration you have the opportunity to tourtwo randomly selected hearing aidmanufacturing facilities the afternoon ofWednesday, April 5th. The tours also includevirtual tours of hearing air manufacturingfacilities from around the country and acomplimentary box lunch.

Finish the act by attending Celebrate Audiologywhere you will enjoy an enchanting evening ofstrolling performers, sophisticated acrobaticsand pure entertainment in the classical sense.Munch on your favorite concession stand treatswhile mingling with friends, both old and know.The stage is set for an evening of fun. We hopeyou enjoy the show!

ACT IIOn Thursday, April 6th, the curtain rises on the90-minute NOW!Sessions that feature thestate-of-the-art in audiology presented by topaudiologists, hearing scientists and physicians.This year, Bob Margolis and the FeaturedSessions subcommittee have lined up animpressive cast of invited guest speakers toeducate attendees on the many complex issuesand changes facing the profession.

Attendees will then gather at the GeneralAssembly to hear Academy leaders and keynotespeakers, led by President Gail Whitelaw withher state-of-the-profession address, kick-off theofficial welcome to AudiologyNOW!.

The next scene leads us to an “opening night,”so to speak, for Audiology Solutions (Formerlyknown as the Expo). The new name betterdescribes the service this part of AudiologyNOW!provides. Here you will find over 200 exhibitorswith solutions to the professional challenges


AudiologyNOW!SM is an experience in knowledge,science, and technology for audiologists. It’s an opportunity for Academymembers to encounter the state of the art in Audiology as well as thelatest in the science and technology of hearing and balance. TheAudiologyNOW! focus is on the learner and engaging attendees in thelearning experience. The 2006 Program Committee has been hard atwork reinventing the educational experience and building a memorableprogram of events.

WOW!Session with legends of Auditory Science. The Academy hasinvited four of the most prominent auditory scientists to discuss theirwork and the impact of hearing research on our profession.

Symposia on Gene Therapy, Stem Cell Research and the PhysiologicalEvaluation of Infant Hearing.

Learning Cores featuring six educational tracks for targeted learning

2.4 CEUs offered this year with CEUs now offered for ResearchPosters.

New, more powerful Itinerary Builder to help you plan your scheduleand make the most of your time at AudiologyNOW!

Manufacturer Tours - Minneapolis is not only a vibrant city but alsothe home of many hearing aid manufacturers. Reserve time on theafternoon of April 5th for an opportunity to tour a manufacturing facility.Tour hosts: GN ReSound, Starkey Laboratories and Unitron Hearing.Participants will be randomly assigned to a tour which will include visitsto 2 of the 3 companies.

Revised program books: PreviewNOW! and ProgramNOW!PreviewNOW! offers you an overview of the events, registration andhousing information. ProgramNOW! will be a complete compendium ofall session abstracts with presenter information, room numbers and allthe information you will need to have a successful time atAudiologyNOW!

You should receive your PreviewNOW! in December. If not please sendin your name and address to [email protected].

Audiology Solutions Over 200 manufacturer and professionalexhibitors’ representatives will be on hand to help you find solutions foryour patients and your professional growth.

Office Personnel Register your office personnel to attendAudiologyNOW! at a reduced fee. Choose from a series of courses in theProfessional Issues and Practice Management Core such as theNOW!Session “Medicare 101+: A Blend of the Old and New Information.”Included in the Office Personnel package price is a ticket to attend theLearning Lab “Cracking the Reimbursement and Practice ManagementCode,” access to all educational sessions, Audiology Solutions and boxlunches. CEUs are not available to Office Personnel registrants.

Register on-line at audiologyNOW.org.

Save money byregistering before

January 21st, 2006!

April 5-8, 2006

SESSIONS:Aging Listener: Challenges & Sensory-Cognitive

Interactions Audiologic Management of Unilateral Hearing Loss in

Children Early Hearing Detection/Intervention: National Perspective Ethical Issues Facing Audiology: Law & Professionalism Ethical Practices Board: What Were They Thinking? Etiology & Audiologic Evaluation of Deaf Blind Patients Evidence-Based Hearing Instrument Design Evoked Potentials & Cochlear Implants Fistulae, Perilymphatic or Otherwise, Do They Exist? Grand Rounds in Balance Function Testing Grand Rounds in Central Auditory Processing Disorders Grand Rounds in Cochlear Implantation Grand Rounds in Educational Audiology Grand Rounds in Hearing Aids Hearing Aids: 2005 in Review Improving Assessment & Management of Vestibular

Patients Integrating Hearing Aid & Cochlear Implant Technology Medicare 101+: A Blend of the Old & New Information Noise-Induced & Age-Related Hearing Loss Interactions Over-the-Counter Hearing Aids – A Debate Real-World Hearing Aid Fitting: Managing Expectations The Adult Patient: Assessment, Management

& Follow-up The How’s & Why’s of Automated Audiometry The Many Faces of Humanitarian Audiology Update in Otoprotective Agents

SYMPOSIA:Symposium on Gene Therapy Symposium on Stem Cell Research Symposium on Physiological Evaluation

of Infant Hearing


facing audiology professionals and their patients.

CEUs are available that afternoon at Exhibitor Courses andIntroductory Learning Modules (formerly InstructionalCourses). These courses are selected from our call forinnovative proposals to provide engaging and interactivelearning sessions.

ACT IIIThe lights will come up on Friday featuring the WOW!Session,Legends of Auditory Science with William Brownell, PeterDallos, Robert Galambos and Jozef Zwislocki discussing their groundbreaking work and the impact of hearing science on audiology.

There’s a two-hour intermission at noon to ready yourself forthe upcoming scenes. Take a break and stretch your legswhile visiting Audiology Solutions where you can enjoy yourcomplimentary boxed lunch.

When the clock strikes 2:00pm it’s your cue to return for theafternoon sessions. Introductory (1-hour) and Advanced (2-hour) Learning Modules will bring you up to date on the latestconcepts in one of 6 learning cores: Diagnostics, Disorders,Hearing and Balance Sciences, Hearing Conservation,Professional Issues and Practice Management, and Treatment.Later, join the festivities at the Foundation Research Awardsand Poster Presentations to discuss research with the Posterpresenters and also recognize the 2006 Research awardees.

ACT IVBefore AudiologyNOW! ends its run, take advantage of theSaturday finale starting with one of the morning’s openingsessions such as the three-hour Symposium onElectrophysiologic Evaluation of Infants or perhaps the 90-minute Symposium on Gene Therapy. The NOW!Session Real-World Hearing Aid Fitting: Managing PatientsExpectations, which will include an audience responsesystem, is just one of nine different NOW!Sessions that youcan choose from that morning.

After your lunch break, you will have one last opportunity toenjoy Audiology Solutions before it is time to strike the set.Select from one of the Advanced Learning Modules thatafternoon to round out your educational experience atAudiologyNOW!. Next, it’s on to everyone’s favorite way tobring down the house — Trivia Bowl; may the best team win!

Cast members will come away from AudiologyNOW! with ravereviews. We’ll have your souvenir “wardrobe” t-shirt for thefirst annual AudiologyNOW! waiting for you at registration.

Enjoy AudiologyNOW!, enjoy Minneapolis, and enjoy thevariety of musical venues and Tony Award-winningproductions the city is known for. Now, “lets all go to the lobby…”

SESSION:Legends of Auditory Science

Marion Downs Lecture on Pediatric Audiology: Beyond Newborn Hearing Screening*

*A Standing Ovation for


SCHEDULE OF EVENTSWednesday, April 5

8:00am – 7:00pm – Registration 8:30am – 5:30pm – Learning Labs9:00am – 3:00pm – State Leaders Workshop

11:00am – 5:00pm – Reg Express at Minneapolis Hilton & Hyatt Regency12:30pm – 5:00pm – Manufacturer Tours

3:00pm – 5:00pm – Focus Groups5:15pm – 6:00pm – Student Volunteer Orientation5:30pm – 7:00pm – AAA Foundation “Happy Hour and a Half”7:00pm – 9:00pm – Celebrate Audiology

Thursday, April 67:00am – 5:00pm – Registration 8:00am – 9:30am – NOW! Sessions

10:00am –11:30am – General Assembly12:00pm – 6:00pm – Audiology Solutions 2006

3:00pm – 4:00pm – Exhibitor Courses4:30pm – 5:30pm – Learning Modules, Research Pods, Exhibitor Courses6:00pm – 7:30pm – Academy Awards Reception7:30pm – 8:30pm – International Reception

Friday, April 77:00am – 5:00pm – Registration 7:00am – 7:50am – Academy Business Meeting Breakfast8:00am –11:30am – WOW!Session, NOW!Sessions and Symposia9:30am – 5:00pm – Audiology Solutions 2006

12:00am – 1:30pm – Student Research Forum & Luncheon2:00pm – 4:00pm – Learning Modules4:30pm – 5:30pm – Learning Modules, Research Pods, Exhibitor Courses5:00pm – 6:30pm – Foundation Research Reception & Poster Presentations

Saturday, April 87:00am – 5:00pm – Registration Open8:00pm –11:30am – NOW!Sessions and Symposia9:30am – 2:00pm – Audiology Solutions 2006

12:00pm – 1:00pm – Discussion Groups2:00pm – 4:00pm – Learning Modules4:30pm – 6:30pm – Trivia Bowl6:30pm – 8:30pm – Open Houses

Save Time & Money: Why“Booking in the Block” Is SoImportant• The economic impact of

AudiologyNOW!, which is largelybased on room nights, allows us tonegotiate reduced rental rates for theConvention Center – which in turnsaves attendees money by keepingregistration rates lower.

• Every room night we lose to a hoteloutside our hotel block dilutes ourfuture buying power and the ability tonegotiate the best dates and rates.

• The fast and convenient shuttle serv-ices only the official conventionhotels; you could incur additionalexpenses, such as cab fare, and losevaluable time.

• We contract, inspect and have strongrelationships with our selected hotels.

• Your deposits are secure, your roomsare guaranteed, your safety and secu-rity kept in mind, and most impor-tantly we can assist you if somethinggoes wrong.

Book Inside the Block!If you have comments or would like

additional information please contactLisa Yonkers at 703-226-1038,[email protected]

For session abstracts,schedule of events,

registration and housinginformation and more

go to audiologyNOW.org

MEMBERS IN NOVEMBERAs a benefit of membership, Academy members are able to register in November to get their first choice of housing! Take advantage of the reasonable rates and rooms we have secured by registering early.General registration and housing open for all attendees on December 1, 2005.

April 5-8, 2006


Minneapolis is looking forward toseeing you at AudiologyNOW! 2006.In preparation for your trip to our Cityof Lakes, there are a few things youshould know. First, we do not alwaysspeak of Minneapolis/St. Paul by theirgiven names. Instead, we may say the“Twin Cities,”or “the Cities,” for short.

While it is wise to be prepared foreither a cold spell or a heat wave in theTwin Cities in early April, for the mostpart you won’t be lugging coats to ses-sions at AudiologyNOW! 2006. Theskyway system is practically a citywithin a city, completely climate con-trolled. If your hotel is too far away towalk to the Convention Center, shuttle

buses will be running as they have atpast conventions.We do speak English up here in theCities, but you might want to brush upon the local dialect. How to TalkMinnesotan by Howard Mohr is a goodreference. A few examples:

“Uff Da” Pronounced oof duh, thisterm defies precise definition as itdenotes anything from disappointment,sudden pain, surprised reactions tounexpected conditions. It is also a phi-losophy that one doesn’t have to swearor fly off the handle – just uttering theexpression helps you let off somesteam and then you can surmount theproblem at hand.

“Not too bad/Could be worse/Can’tcomplain” Not ones to toot their ownhorns, Minnesotans might use any ofthese phrases to answer the question“How are you?” even after they justwon the Pulitzer.

“You bet” Another multipurpose term,“You bet” works well in lieu of thankyou, but is also great to use as aresponse when you really don’t knowwhat else to say. It is meant to be pleas-ant and agreeable, without actuallycommitting yourself to a strong opin-ion. Further north you’re likely to hearthe “Yah, sure, you betcha” of Fargofame, but in the Cities, a simple “Youbet” will suffice.

Stroll alongNicollet Mall Thismall is a pedestrian-onlythoroughfare, with plentyof our favorite wateringholes, sidewalk dining, andcountless shops. You caneven take a photo withMary Tyler Moore – herstatue adorns the cornerjust across the street fromwhere the hat-tossing sceneat the end of the MaryTyler Moore Show creditswas filmed.

Visit Spoonbridge and CherryYou knew you’d seen photos of it before,now you know its name. A Minneapolisicon since its completion in 1988,Spoonbridge and Cherry is one of the fea-tures of the Minneapolis Sculpture

Garden at the Walker ArtCenter. The sculpture gar-den is one of the largest ofits kind and includes morethan 40 works of art.

Travel by skywayThe skyway system is oneof the features that makeMinneapolis unique. Theseven miles of enclosedwalkways link togetherover 60 blocks of down-town hotels, restaurants,theaters, and merchants,

connecting most of the downtown in cli-mate-controlled bliss.

Experience the rich riverhistory Along the Mississippi, youcan tour St. Anthony Falls Lock andDam and walk across the pedestrian

Stone Arch Bridge. The upper St.Anthony Falls Lock offers nearly a 50foot lift to vessels “locking through.”Originally built for rail use in 1883, the2,100 foot long Stone Arch Bridge is ariverfront icon.

…the Sights & Sounds

Minneapolis

If you find yourself with some free time or you plan to make time to sightsee, you won’t be disappointed. Here are some things youshould add to your To Do list:

JOcelyn Martin, AuD, Convention programCommittee, subhead for Community Support

A Standing Ovation for


Walk the lakes Lake Calhoun,Lake Harriet, and Lake of the Islestogether are known as the Chain ofLakes and offer a great way to get awayfrom it all while still in the city. Enjoymore than three miles of trails for walk-ing, jogging, biking and in-line skating –all with the Minneapolis skyline as yoururban backdrop.

Tour Mill Ruins Park Located onthe banks of the Mississippi River, thisarea of mills, canals and other historicresources made up the largest water-powered facility in the world and wasthe birthplace of General Mills andPillsbury. Today, you can visit the recentexcavation of this historical site to get aglimpse into an era when Minneapoliswas number one in flour milling.

Shop at Mall of America Or ifshopping isn’t your thing, eat, drink, seea movie, visit an aquarium or ride arollercoaster. You can do it all under oneroof at the largest mall in the country.

Our new light rail’s Hiawatha lineconnects the entertainment packedWarehouse District in downtownMinneapolis with the Mall of America.The Mall has more than 520 stores, anentire level of restaurants and bars, andan amusement park. The best part? Nosales tax on clothing in Minnesota.

Live it up in the WarehouseDistrict The Warehouse District is a 30block area that was added to the NationalRegister of Historic Places in 1989.Historically a center of retail and com-merce, it is now home to innovative arts,sidewalk cafes and a vibrant nightlife.

Learn some of the history ofgreater Minnesota If you’d liketo spend a few days touring, there aremany wonderful places to visit. You canspend a few hours at the MinnesotaHistoric Society, or you can venture outand experience it yourself. From SplitRock Lighthouse on the North Shore ofLake Superior to the headwaters of theMississippi at Lake Itasca to the HistoricBluff Country that is SoutheastMinnesota, the outlying areas of thestate have a great deal to offer. Most ofthese sites are within a two hour drivefrom the Twin Cities.

These features and more makeMinneapolis, Minnesota a great venue forthe first incarnation of AudiologyNOW!.Minnesotans are thrilled to welcome youto our neck of the woods. Looking for-ward to seeing you in April! Until then,here is some random local trivia thatshouldn’t steal any of Gus Mueller’sTrivia Bowl thunder:

• Known as the City of Lakes,Minneapolis is home to 22 lakes with-in city limits

• These products were all invented inMinnesota: Post-it notes, sandpaper,VCRs, synthetic rubber, Thinsulate,Masking Tape, Scotch Tape, Cream ofWheat, Wheaties, Cheerios, the pace-maker and Rollerblades

• Minneapolis was named Cleanest Cityin the Country by Travel+Leisure

• Minnesota led the nation in voter turnout in 2004

• Minnesota has more shoreline thanCalifornia, Florida and Hawaiicombined

April 5-8, 2006

MarchSUN MON TUE WED THU FRI SAT

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S ince their introduction in the late1980’s, the multiple advantages ofinsert earphones in clinical testinghave been well documented

(Clemis et al, 1986; Killion et al, 1985;Mueller, 1993). Both hearing health careproviders and audiometric equipmentmanufacturers have steadily increasedtheir use and acceptance of these devicesduring the intervening years. However,the application of insert earphones foraudiometric testing in occupationalhearing conservation programs (HCPs)has unfortunately been limited by theregulatory restrictions imposed by theOccupational Health and SafetyAdministration (OSHA), and by certainpractical considerations. This article willreview the basis and implications of theregulatory issues, and argue that some ofthe restrictions imposed by OSHA on theuse of insert earphones in HCPs are notappropriate. The practical issues will alsobe addressed, showing that the small costand time constraints of using insertearphones in HCP testing, as well as in theclinic, are outweighed by the advantagesprovided by this technology.

From the regulatory perspective, theproblems for those who wish to use insertearphones in HCP testing are primarilythe result of explicit reference to anoutdated consensus standard by thecurrent OSHA Occupational NoiseExposure; Hearing ConservationAmendment; Final Rule of March, 1983.To the exclusion of all else, theamendment mandates compliance withANSI S.3.6-1969, Specifications forAudiometers, with regard to audiometrictesting. While the ANSI Specification forAudiometers has evolved to include newinformation and technological advances(ANSI S3.6-1989, 1996, and currently2004), the 1983 OSHA amendment itselfremains inexorably linked to a consensusstandard that predates the introduction ofcommercially available insert earphones.Any audiometric technology, regardless of

its potential contribution, not consistentwith the requirements sections of the 1969ANSI Standard, is also subject tocomparable restriction.

Specifically, paragraph (h) (2) of 29CFR 1910.95, Occupational NoiseExposure; Hearing ConservationAmendment; Final Rule states,“Audiometric tests shall be conductedwith audiometers (includingmicroprocessor audiometers) that meetthe specifications of, and are maintainedand used in accordance with, AmericanNational Standard Specification forAudiometers, S3.6-1969” The GeneralRequirements section of that document,in paragraph 3.2, “Earphones” finalsentence, states: “Each earphone shall beequipped with an earphone cushion forcontact with the head of the subject.”Paragraph 3.3, “Headbands” states:“There shall be provided a springheadband which is adequate to hold theearphones against the ears to provide asatisfactory seal.”

Because an insert earphone has neitheran “earphone cushion” nor a “springheadband,” it cannot meet the aboverequirements. The 1989 revision of ANSIS3.6 included Reference equivalentthreshold sound pressure levels(RETSPLs) for insert earphones, withoutany references to cushions or a headband,in its Appendix G. Each subsequent ANSIS3.6 revision included a section withinthe body of the standard devotedexclusively to the use and calibration ofinsert phones. All of that recognition andguidance has no effect, however, withregard to OSHA’s Final Rule because itis, from an audiometric standpoint, frozenin time in 1969. While OSHA hasrecently considered updating regulationsin general to resolve problems related tooutdated consensus standards, no actionhas been taken.

OSHA citations inform the employerand employees of the regulations andstandards alleged to have been violated

and the proposed length of time set fortheir abatement. Penalties may beimposed in accordance with theseriousness of the alleged violation,employer willfulness, and failure to abate.The least serious category is a “DeMinimis” Violation. Under an OSHApolicy for de minimis violations,employers are allowed to comply with themost current consensus standardapplicable to their operations, rather thanwith the standard in effect at the time ofinspection, when the employer’s actionprovides equal or greater employeeprotection. De minimis violations arecontraventions of standards which have nodirect or immediate relationship to safetyor health. Whenever de minimisconditions are found during an inspection,they are documented in the same way asany other violation, but are not includedon the citation. De minimis violations donot have to be abated.

On August 31, 1993, Mr. Roger A.Clark, then Director, Directorate ofCompliance Programs for OSHA,responded to a request from themanufacturer of insert earphones,regarding the limitations imposed on theuse of insert earphones for HCPaudiometric testing. The complete text ofthis letter of interpretation is available onthe OSHA web site:http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=21245. Abackground narrative and nine bulletedparagraphs outline specific conditionsthat must be implemented by employerswho intend to use insert earphones forHCP audiometric testing in order to meetthe criteria of a de minimis violation. Ifthe nine conditions are met, only a deminimis violation exists. Failure to meetthe requirements of each of theconditions, however, could result in theissuance of a citation.

Insert earphones can be substituted forsupra-aural earphones for HCP testing

CLINICAL UPDATE Allan H. Gross, MA,

E-A-R Auditory Systems, Indianapolis, IN

Insert Earphones for OccupationalHearing Conservation Testing


without concern about any tangiblepenalty if one follows each of the pointsaddressed in the 1993 compliance letter.The nine points, somewhat redundant inrelation to the Final Rule itself, are notparticularly burdensome, with oneexception that reads as follows:

“At the time of conversion from supra-aural to insert earphones, testing mustbe performed with both types ofearphones. The test subject must have aquiet period of at least 14 hours beforetesting. Hearing protectors may be usedas a substitute for this requirement. Thesupra-aural earphone audiogram shallbe compared to the baselineaudiogram, or the revised baselineaudiogram if appropriate, to check fora Standard Threshold Shift (STS). Inaccordance with 29 CFR 1910.95 (g)(7) (ii), if the audiogram shows an STS,re-testing with supra-aural earphonesmay be performed within 30 days andthe resulting audiogram adoptedinstead of the prior one. If retestingwith supra-aural earphones isperformed, then re-testing with insertearphones must be performed inconjunction.”

If, in compliance with the above,subsequent annual testing can beaccomplished by relying solely on insertearphones, with the original insert-earphone test designated as the “newreference audiogram for all future hearingtests performed with insert earphones.” If no baseline testing with a supra-auralearphone exists, i.e., a new program isinitiated, insert earphones could beemployed without concern for the abovesection, as long the other conditions aremet. The other conditions, for the mostpart, amount to precautions that anyprudent examiner normally would follow,e.g., technician training, (foam) eartip fit,equipment calibration, ambient noiselevels, and appropriate record keeping. Itis hoped that OSHA will eventuallyeliminate the double testing requirement,but for now it remains a formidable, butnot insurmountable, barrier to insert

earphone use in HCPs.It is odd that OSHA views threshold

differences that could result from differenttypes of earphones on a single audiometeras problematic, when little or no regard isattached to an arguably greater potentialfor variability with different audiometers,or between one valid audiometric methodand another. As long as calibration isperformed appropriately and checked asrequired, with all other conditions equal,hearing thresholds obtained in the HCPwill be valid and reliable regardless of the

transducer employed.In spite of the existing constraints, there

are several reasons why employers andHCP service providers might considerusing insert earphones. All of the clinicaltesting advantages of coupling theearphone directly to the earcanalgeneralize to the threshold testingperformed for baseline and monitoringhearing conservation audiometry. Sincemost routine HCP testing is performed bytechnically competent personnel, butgenerally not by audiologists, insertearphone use may actually provide certainfail-safe advantages where procedures thatmay be routine in clinical work are notinitially available in the HCP.

The advantages of insert earphone useinclude:• Reduction of Background Noise

The ambient noise attenuation of asupra-aural earphone with an MX-41/AR cushion is weak in the lowfrequencies, with values in the 4-6 dBrange below 1 kHz, where problemsrelated to high ambient noise levels

predominate (Arlinger, 1986; Berger &Killion, 1989; Michael & Bienvenue,1981; Poulsen, 1988; Lindgren, 1990).Circumaural enclosures in conjunctionwith supra-aural earphones have beenfound to be a questionable solution tothe background noise problem becauseof lack of standardization and the“mixed results” obtained (Frank, Greer& Magistro, 1997). With a deeplyinserted foam plug serving as theconnection between the insert earphoneand the earcanal, however, the ambient

attenuation will typically exceed 30 dBin the 125-8,000 Hz region. Thegreatest difference in ambientattenuation between inserts and supra-aural earphones is in the frequencyrange below 1 kHz, where the effect ismost needed. Although one must use theOSHA “Maximum Allowable Octave-Band Sound Pressure Levels ForAudiometric Test Rooms” (Table D-1)that are less restrictive than the ANSIStandards now specify for ears-coveredtesting, the added margin of safety insertearphones provide can be a valuableadvantage, particularly if the measuredambient levels are borderline relative tothe guidelines, or if the soundenvironment is not stable. Table 1illustrates the difference between theears-covered ambient attenuation forsupra-aural and insert earphones.

• Greater Interaural AttenuationIn subjects with large thresholddifferences between the right and leftears there is a chance when testing thepoorer ear that the pure-tone signal will

TABLE 1. MEAN EARPHONE ATTENUATION VALUES FOR SUPRA-AURAL

EARPHONES (SAE) AND INSERT EARPHONES (IE) FROM ANSI S3.1-1999 TABLE A.1

Frequency in Hertz 125 250 500 1000 2000 3000 4000 6000 8000

Earphone SAE 6.0 4.0 5.0 12.5 19.5 25.0 25.5 24.0 23.0Type IE 29.9 31.4 33.7 34.0 34.1 37.9 38.6 40.7 42.7

CLINICAL UPDATE


be perceived by the non-test (better) ear.In a clinical setting, that problem wouldbe resolved by employing contralateralmasking to prevent the non-test ear’sparticipation. While masking is not apart of routine industrial audiometry, theincidence of crossover will neverthelessbe effectively reduced with an insertearphone (see Figure 1), therebydecreasing the need for audiologicalfollow-up testing.

• Elimination of Collapsed-CanalArtifact and Greater SubjectComfortThe lateral pressure that supra-auralearphones exert on the test subject’sexternal ear can result in a collapsedcanal artifact. This closure of theexternal canal in some subjects maycause a false threshold shift that maynot always be identified as such initially.Audiological follow-up testing wouldemploy one of several methods(including the use of insert earphones)

to resolve the problem and establishtrue air conduction thresholds. Withan insert earphone’s foam tipproperly seated in the external canal,canal collapse artifact is eliminated.Most test subjects also report greatercomfort with a lightweight relativelysoft foam tip in their ear comparedto the heavier feel and clampingsensation of a supra-aural earphone.

• Greater Flexibility in FittingDifferent Head SizesSupra-aural earphones canaccommodate a range of head size,but only to a limit. Most providershave encountered subjects whosehead size is beyond the adjustablerange of the supra-aural headband.In the clinical setting, the course ofaction to insure that the supra-auralearphone is properly aligned withthe external canal may involvepositioning the headband on theback of the neck if the subject’shead is unusually large, or byplacing a soft object between theheadband and the top of the headto prevent the earphone from

slipping downward during testing in thecase of subjects with smaller headdimensions. The time involved, and theuncertain resolution obtained makethese adjustments undesirable in HCPtesting. With an insert earphone, the testsubject’s head size is not an issue. Onlythe earcanal size and selection of theappropriate foam or “infant” eartip,from the five size options now available,need to be considered.

• Infection Control and MaintenanceInsert earphones, used as directed,provide increased hygiene (Bankaitis,2003). When discarded after a singleuse as recommended by themanufacturer, E-A-RLINK™ foameartips prevent any cross contaminationbetween subjects. The tips contain nolatex and have undergone independenttesting to confirm that the risk ofcontact sensitization is extremely low.Cleaning the tips for re-use can,

however, create a sensitization risk fromresidual chemicals that fail to rinse fromthe surface of these non-porous tips.

Insert phones have no headband toadjust, or cushions to clean andperiodically replace. Most subjects aremore comfortable with a foam tip intheir earcanal than they are with asupra-aural setup. The foam tips are notunlike the hearing protective devicesthat many noise-exposed workers wearfor much longer periods of time than themonitoring audiogram requires.

• Concluding RemarksThe practical constraints of using insertearphones involve a marginallyincreased cost per test, i.e., two foameartips at about $0.35 each, and theneed to examine the subject’s ear canals,select the appropriate size tip, andproperly roll it down for insertion. Inthe clinical setting these time andmaterial costs have a negligible impact,and insert phone use is widespread. ForHCP programs, where testing is limitedto the pure tone audiogram at six orseven frequencies, and multiple subjecttesting is common, the ‘so much for solittle’ premise is less dramatic but stillvalid. Insert earphones can provide asignificant contribution to our efforts inthe prevention of occupational hearingloss. HCP managers who may beinterested in them as an alternative tothe supra-aural earphone can considerwhether the advantages gained withtheir use outweigh the barriers involvedfor their own programs.This article was adapted from an item

that appeared in the July, 2005 issue of theNational Hearing ConservationAssociation’s “Spectrum.”

REFERENCESAmerican National Standards Institute. ANSI

S3.1-1999: Maximum Permissible AmbientNoise Levels for Audiometric Test Rooms. NewYork: ANSI, 1999.

American National Standards Institute. ANSI S3.6-1969-2004: Specification for Audiometers,New York: ANSI, 1969-2004.

Arlinger, S.D. (1986). Sound attenuation of

FFiigguurree 11.. (FROM KILLION, ET. AL., 1985)

RESULTS OF AN EXPERIMENT THAT COMPARES

INTERAURAL ATTENUATION OBTAINED WITH

INSERT EARPHONES AND WITH SUPRA-AURAL

HEADPHONES.

Average and range of Interaural attenuationobtained on six subjects with two earphones:TDH-39 (l) and ER-3 with deeply insertedplugs (n).

CLINICAL UPDATE


TDH-39 earphones in a diffuse field of narrow-band noise. Journal of theAcoustical Society of America, 79, 189-191.

Bankaitis, A.U. (2003). Infection control in audiological practice. AudiologyToday 15 (5), 12-19.

Berger, E.H. & Killion, M.C. (1989). Comparison of the noise attenuation ofthree audiometric earphones, with additional data on masking nearthreshold. Journal of the Acoustical Society of America, 86, 1392-1403.

Clemis, J.D., Ballad, W.J., & Killion, M.C. (1986) Clinical use of an insertearphone. Annals of Otology, Rhinology & Laryngology. 95, 520-524.

Frank, T., Greer, A.C., & Magistro, D.M. (1997) Hearing Thresholds,Threshold Repeatability, and Attenuation Values for Passive Noise-Reducing Earphone Enclosures. American Industrial Hygiene AssociationJournal, 58, 772-778.

Killion, M.C., Wilber, L.A., & Gudmundsen, G.I., (1985) Insert Earphonesfor more interaural attenuation. Hearing Instruments, 36, 34-36.

Lindgren, F. A. (1990). Comparison of the Variability in Thresholds Measuredwith Insert and Conventional Supra-Aural Earphones. ScandinavianAudiology, 19,19-23.

Michael, P.L.. & Bienvenue, G.R. (1981) Noise Attenuation characteristicsfor supra-aural audiometric headsets using the models MX-41/AR and51earphone cushions.Journal of the Acoustical Society of America, 70, 1235-1238.

Mueller, H.G. (1993) A practical guide to today’s bonanza of underused high-tech hearing products. The Hearing Journal, 46, No 3, 13-27.

US Occupational Safety and Health Administration. (1983) Occupationalnoise exposure: Hearing conservation amendment, 29 CFR 1010 (Vol. 48,No. 46). Washington, DC: Department of Labor.

Poulsen, T. (1988) Sound attenuation of TDH-39 earphones in a standard headsetand in A noise-excluding headset. Scandinavian Audiology, 17, 147-149.


CONTINUING EDUCATION: WHAT WERE THEY THINKING?Michael J. Metz, PHD, MEMBER, ETHICAL PRACTICE BOARD, AMERICAN ACADEMY OF AUDIOLOGY

How many audiologists could

pass a state licensing exam or

national certification test if it

were required every few years

to stay in practice? It may well

be that the length of time

between finishing grad school

and taking the licensing test

would be indirectly related to

the number of persons passing

the exam. All professional

fields move forward with

respect to philosophies,

protocols, methods, equipment

and instruments, as well as even

some of the fundamental

concepts underlying all of the

above. Somewhere in the not-

so-distant past, licensing

boards, certifying agencies, and

professional organizations

determined that, in order to

assure the integrity of the

profession, it would be in the

best interest of all, especially

the consumer, to require

continuing professional

education. The American Academy of

Audiology is no different. Principle 2 of

the Code of Ethics states that Academy

members will maintain high professional

standards. Rule 2g pertaining to this

precept requires members to participate

in continuing education.

Rule 2g: “Individuals shall maintain

professional competence including

participation in continuing education.”

In concept, continuing education (CE) is

terrific. Requiring people to keep abreast

of new developments in their area of

expertise is good for everyone. The

problems arise when specific details of the

requirements are left undefined. The

vagueness in more codified requirements

was intentional so as not to limit

professionals from evaluating their own

limitations and acting to minimize their

own shortcomings. In audiology, if one

judged him-or-herself to be in need of, say,

updating in the area of neonatal techniques,

one would pursue that CE avenue to

“balance” their professional growth.

The “balance” of professional

knowledge, breadth and depth, was the

center focus in establishing the CE

requirement. Even though there are

clinicians who specialize, the intent of

CE was to help assure that all members

of the profession maintained a

minimal degree of clinical

competence as the profession

moved forward.

A large portion of the American

Academy of Audiology

membership is involved in the

dispensing of hearing aids. As

instrument technology advanced,

the need for product-specific

training arose. Instrument

manufacturers, in an effort to

promote use of their products,

began offering CE credit for

training specific to their hearing

aid. A significant number of

Academy members obtain the

required CE every year with

nothing more than product

specific training. Many hearing

instrument manufacturers report

that, if CE is not offered as a part

of their programming training,

attendance at these sessions is

difficult to assure.

The necessity of being able to

manipulate hearing aid software is not

the point under discussion, but rather,

whether this training alone satisfies the

intentions of continuing education. And,

it is not the educational intentions of the

clinician that must be met, but rather the

intentions of the licensing, certifying,

and/or professional organizations which

have set the CE requirements in place,

including the American Academy of

Audiology and its Code of Ethics.

Rule 2g:

“Individuals

shall maintain

professional

competence

including

participation in

continuing

education.”

V I E W P O I N T

The opinions expressed in this Viewpoint are thoseof the author and in no way should be construed asrepresentative of the Editor, officers or staff of theAmerican Academy of Audiology.

Did you ever see that scene in the movie 10when Bo Derek and Dudley Moore are on thebeach running toward each other? He is leapingthrough the air in anticipation of finally connect-ing with his vision of the perfect match. This con-cept is the service that HearCareers hopes toprovide to employers and job seekers who posttheir job openings or resumes on our website. Itis our intention to help those looking to hire orbe hired find that perfect 10 person or position.

At the American Academy of Audiology, we arealways in search of ways to provide efficientservices that help our members streamline theeveryday tasks necessary to function successful-ly. One of our greatest Academy resources isour employment service called HearCareers,which provides a place for employers and jobseekers to interact.

Employers who post their available positions onour website can do so knowing that they aregetting the lowest rates available. For membersof the Academy, these rates are offered at aneven greater discount.

What we offer employers that many conventionaljob posting sites can’t (aside from the phenome-nal pricing) is a targeted audience. Have youever received an application and wondered if the candidate even read the job profile beforethey applied? That is not a problem when yousearch through the growing database of resumes the Academy has available. Thoseposting their resumes with HearCareers havegone to the largest organization of, by and foraudiologists for a reason; they want a job in thefield of audiology.

HearCareers also gives employers the ability tokeep tabs on how many applicants have viewedtheir job posting. Again, unlike many other jobposting options, you can be assured that thoseviewing your posting are looking for positionswithin the profession. Why else would they begoing to the American Academy of Audiology tosearch for a job rather than one of those massjob-posting sites? Employers have the option tocontacting job seekers directly through the site,or they can have job seekers contact them.

Job seekers also stand to benefit by usingHearCareers for their employment searchingneeds. We provide tools to help them not onlysearch for a job, but get a job. Look throughthe HearCareers page of the website in the sec-tion titled “Resume & Interviewing Tips &Techniques” for assistance in creating a resumethat gets noticed. Find out what questions youmay want to be prepared for when you go in foran interview. Job seekers also have the option ofusing the Notify Me! service provided throughHearCareers. When a person signs up for NotifyMe! they receive weekly emails alerting them thata job matching their search criteria has beenposted. Let Notify Me! bring the jobs to you.

It is our job at the American Academy ofAudiology to advance the profession. It is ourhope that by helping to make the connectionbetween audiologist and employer we are onestep closer to achieving that goal.

Get the connection going today at www..audiology.org/hearcareers

HearCareers: Finding That Perfect 10

You kiss your loved onesgood-bye, take a look at theworld outside, and inhale thelast breath of fresh air you

will be breathing for a long time tocome. You are either about to clean outyour basement storage or are on theverge of the arduous task of research,research, and more research. One wouldthink that with all of the availableresources out there, it would be an easytask to undertake, but sometimes all ofthat information can work against you.There is either too much informationthat isn’t relevant to your question,unreliable sources, or web links thatlead to other links, which lead to otherlinks…and the cycle goes on. So whatthe Academy proposes is that you go toone place for your information needs,the Dome.

The Dome is an information servicespecifically designed for audiologists,speech-language pathologists andstudents. No more weeding throughmaterial that has absolutely nothing todo with your field of study. Withconstantly updated listings of multiplesources, the Dome is designed withresearchers, clinicians, students andeducators in mind. Academy memberscan save 53% off the regular price($119.95) of an annual Domesubscription. The special member priceis $63.95. Academy student memberssave too! Student members subscribefor $35 (regular student price is $49.95),a 30% savings. For more information,check out the Academy’s benefits pageat www.audiology.org/professional/members/benefits/ or contact theNational office at (800) 222-2336, x1044.

(DOME) TThhee DDrreeaaddeedd TTaasskk


Members of the ABA

Board of Governors

John Greer Clark, Chair

James Beauchamp

Bruce Edwards

Patricia Kricos

Erin Miller

Don Vogel

David Zapala

American Academy of Audiology Board of Directors LiaisonTherese Walden

Past Chair & Ex Officio MemberMelanie Herzfeld

Public Members J. Thomas & Sondra King

For ABA information contact:Sara Blair Lake, Esq.

Director of Certification

American Board of Audiology™

11730 Plaza America Drive

Suite 300

Reston, VA 20190

1-800-881-5410

As we approach the closing of a year as busy as 2005, there are so many things I could write about to fillthis page; but I would be remiss if I didn’t begin by stating my appreciation to the many who work onbehalf of ABA. This would not only include our seemingly tireless Director, Sara Lake, but the entire ABABoard with whom I have had the pleasure to work and grow professionally for several years now.

Each year two members of the ABA Board rotate off and are replaced by two new members eager tocarry on the board’s important work. These new ABA Board members are elected by those who holdBoard Certification following a typical nomination process. I would encourage all ABA Board Certifiedaudiologists to consider what they can give back to their profession through work with the Board, eitherin service within one of a variety of committees or on the Board itself. Anyone interested in working withthe ABA Board need only contact Sara Lake at [email protected] for further information.

“So what has the ABA Board been up to?”

2005 was the roll-out year for our first, and highly successful, specialty certification. As of this date, wehave had four administrations of the examination for Specialty Certification in Cochlear Implants. Boththe quantity and quality of candidates exceeded the ABA’s high expectations. The entire ABA Board ofgovernors is thankful for the hard work and leadership put forth by Patricia Chute and Cheryl DeCondeJohnson along with their committee members in bringing this certification program to fruition.

2005 has been the planning year for a second, eagerly awaited, specialty certification program. A focusgroup which met at the American Academy of Audiology Convention this year and a survey of theaudiology community revealed a strong desire for a Specialty Certification in Pediatric Audiology. Animpressive 78% of responding audiologists believed pediatric audiology had progressed to the point thatit should be considered a specialty area. Jim Beauchamp and a tight working group of nationallyrecognized pediatric audiologists have been charged with making this specialty certification a reality.

2005 was also the year that brought increased recognition that, as audiology moves staunchly forwardtoward greater autonomy as a doctorate-level health-care profession, there is need for a new nationalexamination: An examination not only reflective of our new entry degree but also an examination whichwould better test future audiologists’ application of newly learned and developed clinical skills.

“If I don’t have time to serve on committees or on the Board, how might I help ABA change theprofession for the better as they continue their work?”

Well, as you might suspect, significant costs will be accrued when working with a testing consultant toguide ABA through the requisite job analysis, examination item writing and test construction, andsubsequent test delivery, scoring and reporting which will be integral to the development of a newnational audiology examination. The ABA is not new to this process and our experiences in thedevelopment and implementation of the Specialty Certification in Cochlear Implants will serve us well.

To make the new national examination a reality, the ABA is working with the American Academy ofAudiology Foundation (AAAF) in a fundraising campaign aimed at interested individuals andorganizations in support of this initiative. Our alliance with AAAF in our fundraising efforts makes yourdonations 100% tax deductible. Regardless of whether you are Board Certified, we need your help tobuild this portion of the road to autonomy and strength as a profession. To donate toward thedevelopment of a new national examination in audiology you may send your check to: The AmericanAcademy of Audiology Foundation (AAAF), 11730 Plaza America Drive, Suite 300, Reston, VA 20190.

To ensure that your donation goes to this ABA initiative, please enclose a note indicating that thedonation is restricted to the ABA National Examination in Audiology. Please make a similar notation onthe check. And once you have joined this part of audiology’s future, we will add your name to the ever-growing list of people to thank.

MANY THANKS...AND MORE

John greer clark, PhD, Chair

28 AUDIOLOGY TODAY

RESEARCHJoin the AAA Foundation Board ofTrustees as they recognize the recipientsof the 2006 Research Awards, the JamesJerger Awards for Excellence in StudentResearch and other Foundation fundedresearch grants at the PosterPresentation and Foundation ResearchReception. Posters will be available forviewing, and researchers will discusstheir current projects at this wine andcheese reception (cash bar). The Boardwill also acknowledge the work of the2006 Research Award recipients duringthis special event at 5:00-6:30pm onFriday, April 7, 2006.

Five top students will present theirresearch projects at the always-interestingStudent Research Forum at 12:00 noon-1:30pm on Friday, April 7, 2006. TheAAA Foundation will recognize theseoutstanding students as they discuss theirmost recent research. Boxed lunches willbe available in the meeting room.

EDUCATIONThe Marion Downs Lecture in PediatricAudiology will once again feature acutting-edge presentation on issuesrelating to the screening, diagnosis andmanagement of infant and childhoodhearing problems. The 2006 Lecture willbe presented by Albert Mehl, MD, theappointee from the American Academyof Pediatrics in Newborn HearingScreening. Look for more details on thisspecial presentation in Audiology Todayand other AudiologyNOW! materials.The Marion Downs Lecture is madepossible by funding from the AmericanAcademy of Audiology Foundation witha grant from the Oticon Foundation.

FUNDRAISING & FUN-RAISINGNew at AudiologyNOW! 2006!! TheAAA Foundation’s Happy Hour and aHalf reception will be held onWednesday, April 5th from 5:30-7:00pm.Enjoy drinks and hors d’oeuvres, listen to

the sounds of “Hearing Aid” and catch upwith old friends at this special cocktailhour event. In addition, the AAAFoundation Board will recognize donorswho make the Foundation’s workpossible through their contributions andsupport. All Foundation Leaders,Benefactors and Sponsors are invited asthe Board’s special guests. Tickets areavailable for $25.00 per person ($10.00for students).

The AAA Foundation is holding a specialexpanded Silent Auction atAudiologyNOW!2006. Look for specialone-of-a-kind items at the Auction in HallB Foyer of the Convention Center. TheSilent Auction will be open fromThursday, April 6th through Saturday,April 8th midday, and all AudiologyNOW!attendees are invited at no charge.

Come and bid on the perfect treat foryour family, your friends, your practiceor even yourself. You won’t want to missthis opportunity to find a bargain andsupport the AAA Foundation at the sametime! And don’t forget to stop by theAAA Foundation Booth in theAcademy Center to find out what youcan do to help make the Foundationvision a reality!

Proceeds from the Happy Hour and aHalf and the Silent Auction support theAAA Foundation’s mission to raisefunds for programs of excellence ineducation, promising research andpublic awareness in audiology and thehearing sciences. For more informationon any of these events, contactKathleen Devlin Culver [email protected].

AtAmerican Academy of AudiologyFoundation Focuses on:

LOOKING FOR THE PERFECTHOLIDAY GIFT FOR YOURSTAFF, COLLEAGUES ANDFAVORITE PATIENTS?Tired of wandering around the mall and fighting the shopping crowds?

‘Tis the season to purchase colorful AAAF Ear Bouquet Note cards!!!

These high quality, all occasion note cards are a gift everyone would love to receive! Eachbox of twelve comes in three assorted colors and is only $15.

And best of all, the proceeds from the sale of Foundation Notecards assists the AAAF as itworks to raise funds for research, education and public awareness in audiology and the hear-ing sciences.

We have elves working overtime in the Foundation office to make sure your order arrivesbefore the holidays. Go to http://www.audiology.org/store/gifts/ or contact Kathleen Culver ([email protected] or 703.226.1049) in the Foundation office to placeyour order today.

NOVEMBER/DECEMBER 2005


Corporate FriendsAllen Press

Energizer Battery Company

Framing Success, Inc.

The Shakespeare Theatre

Tamarind Design

TV Ears

2005 Corporate & Organizational Donors

As the holidays approach,

the AAAF Board of

Trustees reflects on the

valuable corporate and

organizational support it

has received over the past

twelve months. It is with

appreciation and gratitude

that the Board thanks

these corporations and

organizations for their

contributions to the AAA

Foundation’s successes

of the past year.

Founder’s Circle(donations of $2500 or more)

XXVIIth International Congress of Audiology

American Academy of Audiology

AVW-TELAV

Champion Exposition Services

Etymotic Research, Inc.

The Oticon Foundation

Phonak Hearing Systems

Siemens Corporation

President’s Circle (donations of $1000–$2499)

HearUSA

Knowles Electronics

The Oticon Foundation Matches Member Gifts in 2005

Did you know your contribution to the AAA

Foundation Annual Campaign went twice as far

in 2005?

The first $20,000 that was contributed to the

2005 Annual Campaign from the membership of the

American Academy of Audiology was matched

dollar-for-dollar by The Oticon Foundation.

This generous contribution from The Oticon

Foundation allows the AAA Foundation to double

the dollars used to support its mission of funding

research, education and public awareness in

audiology and the hearing sciences.

Many thanks to The Oticon Foundation for making

each member gift doubly valuable in 2005!!!

American Academy of AudiologyAmerican Academy of Audiology

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Whether you work in a hospital,

clinic or one-person office, to

be successful, you must have

a marketing strategy, and you

must implement it consistently.

While many find marketing intimidating, you don’t

have to be a creative genius to develop and imple-

ment a plan that will grow the business that you

own or work in.

The key is developing a marketing strategy that

forms a solid foundation for your promotional

efforts. Implementing promotional activities such

as print ads, direct mail, educational seminars or

even networking without a marketing strategy is

like buying curtains for a house you are building

before you have an architectural plan. How would

you even know how many curtains to buy or what

size they needed to be?

You can develop a strong marketing foundation by:

þ Defining your product or service: What is it

that your patients are really looking for? You may

be offering balance testing, hearing assessments

and many types of amplification, but your patients

are purchasing better relationships, improved

communication, increased productivity, enhanced

self esteem and a less stressful life. Your market-

ing efforts should promote the benefits of better

hearing. It’s not about who YOU are, but rather

about who the PATIENT wants to become when he

or she is able to hear better.

þ Identifying your target market: Everyone or

anybody might be potential patients. However, you

probably don’t have the time or money to market

to Everyone or Anybody. Who is your ideal

patient? Who does it make sense for you to spend

your time and money promoting your service to?

You might define your ideal patient in terms of

household income, age, sex, or geographic area.

For example, an audiologist who is a balance

specialist may decide her target market is men

over the age of 70 who live in a geographical area

within 10 miles from her office.

þ Knowing your competition: Even if there are

no direct competitors for your service, there is

always competition of some kind. Someone

besides you is competing for the potential

patient’s money. Why should the potential

patient spend his or her money with you? What

is your competitive advantage or unique selling

proposition?

þ Finding a niche: Is there a market segment

that is not currently being served or is not being

served well? A niche strategy allows you to focus

your marketing efforts and dominate your market.

For instance, you may want to specialize in dis-

pensing custom ear products, selling assistive

devices, tinnitus management or in providing

vestibular or auditory rehabilitation.

þ Developing awareness: It is difficult for poten-

tial patients to seek the services and products you

offer if they don’t even remember you or know

your organization exists. Marketing analysts gen-

erally suggest that potential patients will have to

be exposed to your practice or organization 5 to

15 times before they are likely to think of you

when the need arises, which often happens

unexpectedly. You must stay in front of your

patients consistently if they are going to remem-

ber you when that need arises.

þ Building credibility: Not only must patients

be aware of you or your organization, they must

also have a positive disposition toward you.

Potential patients must trust that you will deliver

what you say you will. Often, especially with large

purchases such as hearing aids, you need to give

patients the opportunity to “sample,” “touch,” or

“taste” the benefits associated with the product.

While some professionals reject this type of “try

before you buy” offer, time and experience has

proven that patients have often heard negative

comments regarding hearing aids and they are

hesitant to repeat what they feel will be a negative

experience.

þ Being Consistent: Be consistent in everything

you do. This includes the look of your promotional

materials, the message you deliver, the level of

service you provide, and the quality of the prod-

ucts you dispense. Some experts suggest that

being consistent is more important than offering

the “best” products and services. This in part is

the reason for the success of chains. Whether

you’re going to Little Rock, Arkansas or New York

City, if you reserve a room at a Courtyard Marriott

you know exactly what you’re going to get.

Before you consider developing a brochure,

running an ad, implementing a direct mail

campaign, or presenting an educational semi-

nar, begin by mapping a path to success

through the development of a consistent,

focused marketing strategy.

AudBlog


The Marketing Scene

Building Blocks to Successful MarketingGYL A. KASEWURM, AuD, Professional Hearing Services, St. Joseph, MI

“..there must be hundreds ofutterances of the word ‘audiologist’ on the cuttingroom floor in New York…”Welcome to the Blogosphere. Be sure to read AudBlog — President Gail Whitelaw’s weekly musings on the state of audiology and the Academy.



The Doctor of Audiology (AuD)degree has forever changed thelandscape of audiology private practice.As a unique brand for the profession ofAudiology, similar to Optometry (OD),Dentistry (DDS), Medicine (MD) andother well-known professions;consumers can generally feel morecomfortable in the knowledge that anAuD audiologist is educated to a certainstandard and offers skills commensuratewith other doctoral level professions. Intoday’s competitive world, mostprofessionals that provide products andservices to the hearing impaired areaudiologists. Current estimates suggestthat approximately 25% of audiologyprofessionals are now at the doctorallevel and more are graduating every day.A tremendous benefit for the professionwith a substantial upgrade of the skills,the AuD has been a successful andworthwhile undertaking by the wholeprofession. Although this newdesignator uniquely brands theprofession to consumers, it makes itincreasingly difficult to distinguish onecompetitive practice from another. Thisarticle considers the question, “When allaudiology professionals are branded withthe AuD, how does one practice standout among the others?”

WHAT IS DIFFERENT ABOUT NOW?Since audiology is on a mission to

become a doctoring profession in a veryshort time, many new clinicians havechosen to enter private practice and

compete with other audiologists thathave been there for many yearsproviding high-quality services toconsumers. Additionally, the past 10years has seen the rise of corporations or“networks” that consist of new practicesand those that have been purchased bycorporate conglomerates. Thesenetworks are mostly owned by hearingaid manufacturers that have a vestedinterest in obtaining outlets for theirspecific brand of products. Thus, assuggested by Smirga (2004), those fromwhom we purchase products to serve thehearing impaired use their profits todirectly compete with us in the marketplace. As indicated recently by Taylor(2005), consumers now assume that alldispensing professionals have access toroughly the same technology, if not thesame products. Further, most clinicians

have access to essentially the same testequipment and processes for servingpatients. It is easy to understand whysome feel that the provision of hearingaids and general hearing health care arelargely commodities. Commodityproducts are those defined ashomogeneous with little or no definitionand with little differentiation as to brandor place of purchase. Though a hearingaid product of a particular brand andmodel can be purchased from genericsources as a commodity, the services andpersonal touches and interactions,rehabilitative services and follow up thatcloak them are not. These are productsthat require personal services that mustbe provided by a knowledgeableprofessional that can interact with thepatient on a long-term basis. Therefore,the problem that faces the independentaudiology private practitioner is a newgeneration of competition comprised ofhearing aid manufacturers owned bymajor corporations, new AuDs, as wellas the traditional hearing aid dispensers.

THE BRANDING OF A PRACTICEAll of these competitors are

formidable, and it is essential that a prac-tice differentiate their “brand of audiolo-gy” from “other brands of audiology”offered in the same marketplace. The“brand of audiology” must stand out inthe consumer’s mind over all other possi-ble “brands” such as the new clinics, cor-porate clinics, and possible Internet pur-chases. This involves “branding the prac-

Brand YourPractice —

Not Just Your Degree

ROBERT TRAYNOR

The Business of Audiology ROBERT TRAYNOR, EDD

AUDIOLOGY ASSOCIATES OF GREELEY, CO

In the past, it was rather simple to distinguish an audiologypractice from others that served the hearing impaired. Armed with a higher education, audiologists could clearly differentiatetheir practice from the others that provided services by the type

of products, quality of service, expertise, follow up or other benefits. The dispensing of products in a clinical environment by those educated in the profession was refreshing and comforting to consumers.Competition was usually less qualified; and offered less complexservices and products, making the differentiation of an audiologypractice over the competition rather easy. As audiologists, we enjoyedreferrals from physicians and other health care professionals withoutmuch of a marketing effort. Of course, those days are gone forever.


tice” with a marketing campaign that will establish in the con-sumers mind that they have chosen the correct place to receivehearing care.

Branding, according to D’Alessandro (2001), is an oldbusiness practice that can be described as whatever theconsumer thinks of when he or she sees or hears yourcompany’s name. For example, what comes to mind whenone thinks of Mercedes-Benz, Sony, or Hewlett-Packard?Some of the best products worldwide have built strongbrands so that in the consumer’s mind the thought is ofquality, reliability, and customer service. If, for example,Acme Audiology, LLC is to be branded successfully as theplace for hearing care in a particular market, communicationsto the community must be ethically directed towardgenerating in the minds of prospective patients and othersthat the Acme Audiology, LLC “brand of audiology” is thebest brand of hearing care in the market area.

Consumers are bombarded by these market communicationsfrom the competition. It is difficult to brand a particular practice,as some corporations with huge marketing budgets useaudiologists with similar credentials to facilitate sales of theirproducts. Unless a clinic differentiates itself from others sellingthe same products, it will look the same to consumers who willsimply look for the best price. Referring to the differentiationissue, Kasewurm (2004) indicates that audiologists understandthe services they provide but often fail to promote the benefits ofthose services. It is just this creativity and aggressiveness that isinstrumental in the branding of a specific practice in anintensely competitive market.

For a better perspective on the competition, D’Alessandro(2001) presents the nature of competitive branding into fourdistinct categories:

BRAND COMPETITION – All competitors that are like me.This category, for example, would represent all AuD

audiologists that offer hearing care in the same market area.These competitors look exactly alike to the consumer, as theyhave the same “brand” for their credentials. In the consumer’smind, without proper market offerings, they would presume thatproducts and services for their needs could be obtained fromany AuD professional. Thus, it is not enough to brand thecredential; branding of the particular clinic is necessary toinsure success.

INDUSTRY COMPETITION – All competitors that look like meoffering hearing care.

Pertaining to the field of audiology, this would includedoctoral level audiologists (PhD, EdD, ScD) other than the AuDor otolaryngologists. Similar to “brand competition,” manyprofessionals appear to have the same capability to provideproducts and services to the hearing impaired consumer.Additionally, many consumers already have an establishedrelationship with a professional for their hearing care and it isnecessary to demonstrate that a practice can offer a reason tosever that relationship and establish a new one. Again, it is theintensity and the direction of the market offerings that caninsure the branding of the practice separating a particular clinicas the facility of choice.

FORM COMPETITION – All those in the same business.This category would include audiologists, otolaryngologists,

hearing aid dealers, drug stores, wholesale warehousecorporations, internet options and other establishments thatoffer hearing care or sell similar products. Form competitorsare those where considerable diversity may exist in the

capability to serve consumers. Branding apractice by a tasteful and ethical marketoffering that presents the type of hearingcare offered, can provide thedifferentiation needed by consumers.Indeed, it may be an ethical responsibilityto conduct market offerings that directconsumers to the most qualifiedprofessional.

GENERIC COMPETITION – All productsthat cost the same as hearing care.

Generic competition is experienced byall hearing care professionals. In thisinstance, patients weigh the costs ofhearing care against other more desirablerecreational activities, required services orproducts; such as, new cars, foreignvacations, cruises, appliances or otheritems. Since the majority of hearing-

AudBlog“… airplanes are great placesto discuss audiology…exceptwhen the passenger’s passion isclearly getting to Las Vegas ona Friday night.”Welcome to the Blogosphere. Be sure to read AudBlog-- President Gail Whitelaw’s weekly musings on the state of

audiology and the Academy.



impaired patients are retired, there is only a finite amount ofdisposable income which can be utilized for hearing care.Since many older patients are on a “fixed” income, a negativedecision to obtain hearing care may simply be an application ofbasic economics — the principle of “opportunity cost.” Thisprinciple suggests that there is only a finite amount of moneyand if the money is utilized to purchase an item, then thatmoney is not available to use for another purpose. It is asimple fact that the products we sell in our practices, especiallyhearing instruments, are expensive, often not funded byinsurance and compete for the consumer’s attention with otherproducts of similar value. Further, it is also well known thatconsumers want these other competitive products or servicesmore than those offered in our clinics. It is more fun and,sometimes, of more benefit, to take a cruise, go on aa foreignvacation, or purchase a car rather than obtain amplification.Thus, there are many products in competition for the samemoney, and it is the marketing campaign, and sometimes thespecific market offering, that will convince the patient to makethe more prudent decision.

While marketing is what builds your particular brand ofaudiology in the consumer’s minds, it is not easy to build agreat brand. D’Alessandro indicates that it takes an artistic

sense of proportion and timing as well as a ruthless willingnessto distinguish yourself from the competing brands and,hopefully bury, them in the process.

COMPETITIVE ADVANTAGENo matter which of D’Alessandro’s categories the practice

is part of, generating an audiology brand requires building acompetitive edge for the practice that will cause consumers tochoose this clinic over the others. A competitive edge issomething that this practice does better than any other in themarket area. When building this competitive edge, questionsto ask are “What do we do better than the competition?” or,“What unique proposition can we present to consumers?” Theanswers to these questions should consider how value is addedto the products and services provided by a practice.

REFERENCESD’Alessandro, D., (2001) Brand Warfare: Ten Rules for Building a Killer

Brand. New York: McGraw-Hill, pp xiii-xvi.Kasewurm, G., (2004). Marketing. In R. Traynor, Instructor, CAS 7308

Business and Professional Issues in Hearing Healthcare, University ofFlorida working Professional Doctor of Audiology Program, University ofFlorida, Gainesville, FL.

Smirga, D. (2004). Are we asleep at the wheel? The delicate future ofaudiology private practice in America. Feedback (15:4) pp 7-15.

The Business of Audiology


BACKGROUNDCongress authorized a report by the

National Academy of Sciences on noise-induced hearing loss and tinnitus associatedwith military service in Public Law 107-330.The study was sponsored by Department ofVeterans Affairs. Congress has expressedconcern on the prevalence of hearing loss andtinnitus associated with military service andthe cost of adjudicated claims for disability.Auditory disabilities (hearing loss andtinnitus) are the third most common disabilityby body system and represent ten percent ofall compensated disabilities. According to theVBA Annual Benefits Report for 2004, hearingloss is the most common individual disabilityand tinnitus is third most common individualdisability. The annualized compensation forhearing loss as a major disability was $660million and $190 million for tinnitus in 2004.

The study project was assigned to theInstitute of Medicine (IOM) and involved thefollowing study tasks:• Identify sources of hazardous noise

exposure in military service• Determine levels of noise necessary to

cause hearing loss or tinnitus• Review data on hearing loss and tinnitus

among former service members • Assess whether or not noise-induced

hearing loss can have a delayed onset orcan be progressive or cumulative

• Identify risk factors for noise-inducedhearing loss and tinnitus

• Identify when military hearing conservationmeasures were adequate to protect hearingof service members

• Review service medical records forcompliance with requirements foraudiometric surveillance

IOM appointed thirteen experts and threeIOM staff for the study. The committee had fivemeetings and multiple conference calls over 16months. There were three public meetings withpresentations from VHA, VBA, congressionalstaff, representatives of military services, andindividual veterans. The committee reviewed

published literature, data and reports frommilitary services, analyzed published data onhearing, and collected and analyzed data onaudiometric testing from veterans’ servicemedical records. The committee applied ahierarchy of evidence quality in judging studieson hearing and tinnitus.

STUDY FINDINGSThe most important findings of the IOM

study were:a. Military service members were exposed to

hazardous levels of noise sufficient to causehearing loss and tinnitus.

b. There was no scientific basis for delayedonset noise-induced hearing loss, i.e.hearing normal at discharge and causallyattributable to military noise exposure 20-30 years later.

c. Without audiograms at beginning and endof service it was difficult or impossible todetermine with certainty how much of aservice member’s hearing loss was incurredin or aggravated by military service.

d. There was no scientific basis forpresumption, i.e. predicting who will beexposed and who will suffer hearing loss ortinnitus by period of service or occupationalspecialty, which was the main reason forthe IOM study).

e. Hearing tests were limited before 1970 andcompliance with hearing testing andmonitoring was poor even after 1970 whenpolicies were in place.

f. Certain test frequencies (6000 Hz) werepredictive of noise exposure.

g. Age adjustments and allocation formulaebased on population data cannot be appliedto individuals.

The committee found that hazardous noiselevels are and have been present in militarysettings since WWII and included weaponssystems, ground vehicles, ships, aircraft,communications equipment, and industrial-type activities. Noise exposure occurred duringtraining, routine operations, and combat. Noiselevels were sufficient to cause hearing loss and

tinnitus. Exposure was unpredictable in onsetand duration. The risk of noise exposure wasconsistent with OSHA regulations (85 dBA fora time-weighted eight hour day). With anexposure limit of 85 dBA, the risk of noise-induced hearing loss is 15%. In other words,15% of service members would suffer materialhearing loss. Material hearing loss is theaverage hearing thresholds at 500, 1000, and2000 Hz. Significantly greater injury couldoccur at more susceptible frequencies (3000,4000, and 6000 Hz) and might very likely becompensable under the VA schedule. Given thenoise levels the committee found, there was ahigh probability of noise-induced hearing lossassociated with military service. Hazardincreased as the time-weighted average noiseexposure increases. However, damage riskcriteria were based on studies of industrialnoise that were more constant and less intensethan noise levels associated with militaryservice. Many military noise sources are highintensity and impulsive. Many exceedpermissible levels of impulse noise (140 dBA),even for one exposure. The committee foundthat there was no complete catalog of noiseexposure (noise dose) for weapons systemsand military settings.

The committee concluded that withoutaudiograms at beginning and end of service itwas difficult or impossible to determine withcertainty how much of a service member’shearing loss was incurred in or aggravated bymilitary service. The committee found few nolongitudinal studies on hearing in servicemembers.

PRESUMPTIONCongress’ intent in ordering the study was

to establish a basis for presumption.Presumption is mechanism whereby certainconditions are presumed to exist whether orevidence exists in service or medical recordsthat condition were incurred in or aggravatedby military service. Presumptive conditionsinclude tropical diseases, chronic diseases,conditions associated with prisoners of war,and conditions associated with herbicide

Noise and Military Service: Implications for Hearing Loss and Tinnitus

CLINICAL UPDATE


exposure. The committee found that it was notpossible to predict which service members, byperiod of service or by occupational specialty,will be exposed and which will suffer hearingloss or tinnitus. Data was not sufficient todetermine susceptibility altered by exogenousfactors such as solvents, carbon monoxide, orsmoking, etc. or endogenous factors such asgender, race, or age, etc. The prevalence ofhearing loss in military service warrantsconsideration of presumption, at least forcertain veterans. VBA considers hearing lossto be presumptive if identified within one yearof discharge. The committee found no studieson tinnitus in military personnel and virtuallyno monitoring or assessment of tinnitus. Thestudy provided little scientific information orguidance on presumptive tinnitus.

LATE ONSET HEARING LOSSThe committee did not find sufficient

evidence to determine whether or not noise-induced hearing loss developed long aftercessation of noise exposure. Essentiallongitudinal studies have not been done.However, anatomical and physiological dataon recovery (animal studies) suggested that itwas unlikely that delayed effects occur. Themost pronounced effects on hearing weremeasurable immediately after noise exposure.

AGE-RELATED HEARING LOSSThe committee found that few studies of

cumulative noise exposure have been done.No studies of military tinnitus have been done.Studies of military hearing loss had a highdegree of individual variability. The committeefound significant limitations in population-based estimates of noise- and age-relatedhearing loss (ISO 1999 and ANSI S3.441996). The committee concluded that applyingthese population data to individuals wasinappropriate. Therefore, applying agecorrections or allocating the relativecontributions of age-related and noise-inducedhearing loss in disability claims wasinappropriate.

MILITARY TESTINGThe study found that hearing testing was

limited before 1970. The reason that Congresswas interested in the effective date ofaudiometry and hearing conservation was toestablish a point before which presumption

might apply. The assumption was that afterthis point, service members would havehearing tests to demonstrate they did or didnot have hearing loss. As IOM foundsignificant non-compliance even after 1970,this assumption does not appear to be correct.Nevertheless, more modern claims (after1970) have a higher frequency of calibratedaudiometry than older claims. The committeeconcluded that military hearing conservationprograms were not adequate to protecthearing. The only way to diagnose hearingloss is by case history and diagnosticaudiology. The committee found limitedeffectiveness of hearing protection andhearing conservation programs. Noise-induced hearing loss was two to five timeshigher than acceptable standards in industry.There was poor compliance with audiometrictesting and monitoring.

OPERATIONAL NEEDS FORDEPARTMENT OF DEFENSE

The committee recommended a number ofimprovements for Department of Defense:a. Increase use of hearing protectionb. Monitor tinnitusc. Audiograms for all new members at all

basic training sitesd. Separation audiogram for all memberse. Explore VA participation (Benefits Delivery

at Discharge)f. Include 6000 Hz and 8000 Hz in all

audiograms for detection of noise-inducedhearing loss

g. Improve compliance with annual monitoringand follow-up

h. Improve data collection, reporting, tinnitustracking, hygiene component (dosimetry)

i. Give VA access to hearing conservation data

IMPLICATIONS FOR AUDIOLOGYLate Onset Hearing Loss. The study found

that there was no scientific basis for delayed orlate onset noise-induced hearing loss, i.e.hearing normal at discharge and causallyattributable to military noise exposure 20-30years later. In cases where there were entranceand separation audiograms and such testswere normal, there was no scientific basis forconcluding that hearing loss that develops 20or 30 years later is causally related to militaryservice. Therefore, audiologists have no

scientific basis for concluding that delayedonset hearing losses exist.

Age-Related Hearing Loss. The IOM reportfound significant problems with applying ageand noise exposure population data toindividuals. It is not appropriate to make ageadjustments or attempt to allocate the relativecontributions of age or noise to hearing loss.While standards do exist for estimating age-related and noise-induced hearing loss, thesestandards will not be used in VA exams oropinions. It is also not appropriate to apply ageadjustments in making decisions abouteligibility for hearing aids.

Compensation Exams and Opinions. Thepoor compliance with military hearing testingand monitoring programs increases thelikelihood that service members will not onlysuffer hearing loss or tinnitus but also maynot have audiograms to demonstrate thathearing loss or tinnitus was incurred in or wasaggravated by military service. A key findingof the study was that an audiogram and a casehistory were the only ways to diagnosehearing loss. It is difficult or impossible todetermine with certainty how much of aveteran’s hearing loss was acquired duringmilitary service without audiograms at thebeginning and end of military service. In theabsence of such testing, VHA audiologists andphysicians will be faced with increasingnumbers of clinical opinions, c-file reviews,and appeals. In the absence of definitiveevidence, such opinions must be based onprobabilities and inference. Such opinions canonly be made after a careful review of theevidence (medical and service records). The IOM study also presents Audiology withan opportunity to review exam procedures forhearing loss and tinnitus in light of scientificfindings. The IOM study found virtually nomonitoring of tinnitus in the military. Becausetinnitus is a subjective condition, it isadjudicated largely on patient report. Becauseof variances in exam procedures and clinicalopinions, Audiology will identify ways toimprove the quality of exams and clinicalopinions. Guidelines already exist forconducting C&P exams and writing clinicalopinions. We continue to receive complaintsabout variances in practice and non-compliance with national policy. In some

CLINICAL UPDATE


cases, the actions of audiologists haveresulted in unnecessary appeals and concernsby high-ranking VBA and VHA officials andCongress. Over the next several months, wewill issue additional guidance and training.This is perhaps a good time to review theHandbook on Standard Procedures and BestPractices for Audiology Compensation andPension Examinations, particularly fordescribing tinnitus. Managers should ensurethat all audiologists consistently apply theguidance and report exam findings usingaccepted formats using templates such asQUASAR, AMIE, or CAPRI. DoD Collaboration. The results of the IOMstudy present VHA and VBA withopportunities to collaborate with theDepartment of Defense. The Benefits Deliveryat Discharge (BDD) Program is an excellentexample of joint cooperation and seamlesstransition. In this program, service membersreceive VA benefits counseling and dischargephysicals that conform to VA compensation

exam protocols. Any condition noted duringthe physical is therefore service-connected.This program reduces the cost ofadjudication, reduces redundant exams,establishes a definitive record of injuries orconditions while the service member is still inactive service, and makes it easier for servicemembers to receive compensation for service-related disabilities. Presumption. The study found no scientific orequitable basis for presumption. However, thestudy concluded that noise levels weresufficient to cause hearing loss and tinnitus.Military studies showed a high incidence ofmilitary noise exposure. VBA benefits datashowed that hearing loss and tinnitus wereamong the most common service-connecteddisabilities and claims for these conditionswere increasing rapidly. VBA noted that thisdemand was not driven by a desire forcompensation (most hearing loss claims atrated at 0% or 10%) but by a desire foraccess to specialized VA services, including

hearing aids. Congress indicated an interest inpresumption by occupational specialty, butthe IOM report concluded that this was notfeasible. VBA or Congress may consider otherways to determine presumption based oncertain occupations most likely to be noiseexposed, evidence of combat or simulatedcombat, theaters of operation, service-connected disability for other combat-relatedinjuries, instrumentalities of war, awards forcombat, special operations, or valor, orenrollment in hearing conservation programs.Presumption would reduce costs ofadjudication, reduce the number of appealsand opinions, and make it easier for veteransto seek compensation for disabling injuriesincurred in service.

A free searchable version of the report isavailable at the following website:http://www.iom.edu/project.asp?id=20024

Extend Your 15 Minutes of Fame

with Members in the News!

HAVE YOU RECENTLY BEEN FEATURED IN A NEWSPAPER OR MAGAZINE ARTICLE,

OR BEEN INTERVIEWED ON RADIO OR TELEVISION?

If so, we want to let the Audiology communityknow! The new Members in the News area of our

web site (www.audiology.org/professional) is agrowing archive of our members shining momentsin the press. This is a great opportunity to let other

audiologists know how what you are doing topromote audiology. To have a newsworthy tidbit

included, please e-mail [email protected] withthe information you would like posted.

CLINICAL UPDATE


Washington can be a very complicated place. During thisfall season, we are simultaneously dealing with the verytechnical questions raised by the proposed Medicare

Physician Fee Schedule (MPFS) and, at thesame time, the larger questions posed byhealth care reform. With regard to theMPFS, it is important, indeed vital, that welook behind the numbers of the CMS propos-al to make sure that CMS understood theconsequences of a 2l% decrease in Medicarereimbursement over the next four years, aswas proposed. On direct access, however, itis important that we paint the big picture witha broad brush to make sure that the Congressunderstands our position clearly. TheAmerican Academy of Audiology supports:(1) direct access, (2) lower costs, and (3)consistency.

Perhaps one of our most difficultchallenges in Washington, DC is to coach a professional onhow to reduce their entire life’s work into a five-minutestatement that can be easily understood and comprehended byCongress and, thereby, impact federal policy. The Newsweekarticle can help us do that if we use it correctly, not withstand-ing our professional reservations. “We” were on the cover ofNewsweek. That is a big deal in political terms, and we shouldfeel free to use it whenever possible. Further, the Academymust begin to plan accordingly to provide hearing healthcareservices for the oncoming 78 million Americans who willexperience hearing loss in just a few years. Not only do weneed to consider how to provide the necessary services, but wemust plan our politically actions with equal care and concern.

The number 78 million will help us find political leaders tosupport and carry forward our issues. That impressive numbershould also help us identify more co-sponsors for directaccess to audiologists. Further, we need to think about whothese 78 million people in the US are, where they live andtheir accessibility to reach qualified audiologists. How do weidentify these constituents (without violating their privacy)and perhaps organize these consumers into political allies?This Newsweek cover story has opened some new doors for usand provided us increased entry to Congress and other federalagencies, but we all have much work ahead of us to takeadvantage of this unique opportunity.

WWASHINGTOASHINGTO NN WWAATCHTCHHEARING: A NATIONAL NEWS MAGAZINE COVER STORY

Marshall L. Matz, Olsson, Frank and Weeda, PC, Washington, DC

A few months ago, “Hearing” made it as the main coverstory in Newsweek magazine (June 2, 2005). NumerousAmerican Academy of Audiology members expressed concernabout issues and topics presented in the articleand particularly noted that it did not mentionthe important and key role played by theprofession of audiology. From our goals ofpolitical perspective, however, the article wasa home run!

The very first sentence in the Newsweekarticle noted: “More than 28 millionAmericans have some degree of hearingloss, a number that could reach 78 millionby 2030.” That’s 78 MILLION AMERI-CANS! Think about that number as a politi-cian, not as an audiologist. That is the typeof number, representing American citizensacross the country, that demands respect.Any issue, especially a health issue, thataffects 78 million people gets legislators’ attention.

Since the publication of that amazing Newsweek coverstory, the Academy has been using the article in all of our lob-bying visits on Capitol Hill. We are quick to point out to themthat, “The goal of our proposed legislation, is to make it easi-er for those 78 million Americans to get access to qualified,licensed hearing care.” Newsweek provided us with a greatopening sentence that really gets attention. Our goal is to keepCongress focused on the big picture. Legislators are inCongress because they (usually) understand the big picture.Members of Congress cannot be experts on all the specificsubjects that come before them, but usually they understandthe policy implications of the larger point.

We believe that Congress needs to understand that because78 million Americans will be affected by hearing loss by2030, the federal government should be leading the way infacilitating access to hearing care. At the moment, somefederal agencies support direct access to audiologists;however, some agencies are not on board yet. That is a pointCongress also understands. If the Department of VeteransAffairs and the Office of Personnel Management say thatdirect access to qualified audiologists works efficiently andmakes sense economically, then direct access should alsowork in a beneficial manner for senior citizens dependent onMedicare.


An official grand opening ceremonyfor the Vanderbilt Bill Wilkerson Centerfor Otolaryngology and CommunicationSciences was held on September 16,2005 in Nashville, TN. An appreciativecrowd composed of donors, universityadministrators, staff and faculty, currentand former students and friends of theBill Wilkerson Center were on hand toview the ribbon-cutting, listen to speak-ers and tour the new $65,000,000 state-of-the-art (and sciences) facility. TheBill Wilkerson Center became theVanderbilt Department ofHearing and SpeechSciences and was partneredwith the VanderbiltDepartment ofOtolaryngology in the early1990s, and more recentlyjoined forces to becomepartners in the new 45-story facility located in thesouth tower of theVanderbilt Medical CenterEast building.

In contrast to JoniMitchell’s well-knownlyrics, “They paved para-dise to put up a parkinglot,” the new Center “para-dise” consists of more than160,000 square feet ofspace, and was constructedin a Vanderbilt medicalcenter parking lot following groundbreaking in 2001. The $65,000,000 facil-ity will encourage interdisciplinarystudy, collaboration and experimentationin all of the speech, language and hear-ing sciences, and otolaryngology spe-cialties, as well as the latest in teachingenvironments including flexible class-room and computer spaces. The newcenter includes 23 custom-designedsound-treated rooms that are fullyequipped with the newest and latest sci-entific and clinical equipment, includinga 3-story anechoic chamber and a high-tech reverberation room for researchpurposes. The extensive clinical facili-ties include a hearing aid dispensary fea-

turing four spacious andfully-equipped fittingrooms, the NationalCenter on ChildhoodDeafness and FamilyCommunication, and acomplete vestibular eval-uation department includ-ing a Risk of Falls center.The new Center has 249employees with164 in theDepartment of Hearingand Speech Sciences and105 in the Department ofOtolaryngology. Of the164 DHSS employees,there are 32 faculty/staffin audiology/hearing sci-ences with 17 PhDs, 4

AuDs, 11 hold master’s degrees.Historically, the idea for a compre-

hensive community hearing and speechcenter originated in the mind of Dr.Wesley Wilkerson, an ENT specialist, in1942 after hearing Louise (Spencer’swife) Tracy speak about educational suc-cesses with her profoundly deaf son dueto early intervention techniques. Dr.Wilkerson becomes determined to createa place where any child with hearingloss can come to learn to communicatethrough oral teaching methods. He real-ized the essential need for a to establishsuch a program in Nashville, as thereexisted no other referral facility than thestate school for the deaf located 200

miles away. The Center was ultimatelynamed in memory of Wesley’s son, Bill,who was lost his life during World WarII in 1945. Wesley Wilkerson organizedthe “Tennessee Hearing and SpeechFoundation” in 1949. The Foundationopened a clinic in an old fraternity houseon the Vanderbilt campus in 1951, andnamed Freeman McConnell as the firstdirector of the Bill Wilkerson Hearingand Speech Center. Dr. Wilkerson wasalso instrumental during these years toinstitute a training program for hearingand speech professionals with VanderbiltUniversity resulting in the first class ofgraduates in 1953.

From 1953 through 1956, theCenter’s Board of Directors committedthemselves to the establishment of a newcenter building. During 1956, groundwas broken and a building project toconstruct a center of some 35,000 squarefeet was completed in 1958 at a cost of

Grand Opening of New Vanderbilt Bill Wilkerson Center

The newVanderbilt BillWilkersonCenter forOtolaryngologyandCommunicationSciences islocated on floors6 through 10 inthe South TowerBuilding ofVanderbiltMedical CenterEast.

Fred Bess, Director ofthe new center atVanderbilt, cuts theribbon at the GrandOpening celebration.

FreemanMcConnellserved asDirector of theBill WilkersonHearing andSpeech Centerfrom its con-ception in1951 throughhis retirementin 1976.

NEWS&announcements

Continued on next page


just under one million dollars. The BillWilkerson Center was considered themost state-of-the-art clinic of its kind inthe world – in fact, it was the first build-

ing ever built as a speech andhearing center and featured inarchitectural journals for itsresearch laboratories and ane-choic chamber. In the 1960s theCenter established a Parent-Infant Training program andhoused the Nashville PublicSchools Hearing ImpairedPreschool.

In 1996, the Bill WilkersonCenter began a capital cam-paign to expand the existingbuilding. During this period oftime, the Center became the VanderbiltDepartment of Hearing and SpeechSciences and was partnered with theVanderbilt Department ofOtolaryngology. The two departmentssubsequently became the Vanderbilt BillWilkerson Center for Otolaryngologyand Communication Sciences and dis-cussions began regarding the need for anew building. An aggressive capitalcampaign was undertaken, led primarilyby the current Director, Fred Bess,Professor and Chair of the Departmentof Hearing and Speech Sciences,Vanderbilt University, who ultimatelyobtained more than approximately $15million in gifts, donations, grants andpledges, to get the new center construc-

tion underway. The story of the Vanderbilt Bill

Wilkerson Center for Otolaryngologyand Communication Sciences reflectsthe dedication of a vast number of out-standing professionals and lay Boardmembers deeply involved since 1942.The professionalism established byFreeman McConnell, and continued byFred Bess since 1976 through the pres-ent, has set the standard through theyears for graduate training in hearing,speech and language, and serves eventoday as the model Center of Excellencein the provision of clinical communica-tion services.

Grand Opening of New Vanderbilt Bill Wilkerson Center continued from previous page

NEWS&announcements

The main entrance of the BillWilkerson Center which servedNashville and Vanderbilt Universityfrom 1958 through 2005.

FreemanMcConnelperformsearlyvestibularbalance testwith apatient.

U.S. DEPARTMENT OF EDUCATION RELEASES NEW BROCHUREOUTLINING OPTIONS FOR DEAF AND HARD-OF-HEARING CHILDREN

The U.S. Department of Education has issued a new brochure for parents explaining the full range of options, includingcochlear implants, for deaf and hard-of-hearing children. This marks the first time the Department has published guidance oncochlear implants, implanted devices for severe to profoundly deaf individuals.

“The brochure will improve the information provided to parents to help them make important decisions about their child’shearing health,” said Donna L. Sorkin, Vice President, Consumer Affairs for Cochlear Americas, and an active advocate forearly intervention in hearing health. “It addresses the full range of options, including the benefits of cochlear implants forappropriate children, so that more parents will become aware of this remarkable technology. This guidance is a milestone onthe path to early intervention, universal newborn hearing screenings, and broader insurance coverage of cochlear implants.”

The brochure fulfills a policy directive from Congress issued as a result of the Congressional reauthorization of theIndividuals With Disabilities Education Act (IDEA) in December 2004. IDEA provides access to services and education forfamilies and children with special needs.

Entitled “Opening Doors: Technology and Communications Options for Children With Hearing Loss,” the brochure isdistributed by state early intervention programs and is on the U.S. Department of Education Web site at:ww.ed.gov/about/offices/list/osers/products/opening_doors/index.html.


NEWS&announcements

Members of theIndependent HearingAid Fitting Forum(IHAFF) conducted aunique conference

designed to “Teach the Teachers” as an aid to move graduate educationalprograms toward excellentamplification education.

A sub-group of IHAFF memberspresented “what” they teach and “how”they teach amplification in various AuDprograms. The conference wasconducted as an educational activitywhere expert teachers from around thecountry could listen to presentationsand share their expert methods duringdiscussions and poster sessions. Theconference was held June 17-18 withmore than 30 AuD programs sendingfaculty and clinical supervisors.Several manufacturers also sentindividuals involved in education, and anumber of recent graduates attended.University of Pittsburgh faculty, KrisEnglish and Elaine Mormer, dealt withthe logistics, and several manufacturers(Phonak, Starkey Labs, EtymoticResearch, Microsonic, and Qualitone)donated funds to assist in keeping theregistration fee reasonable for ouracademic colleagues.

Patricia McCarthy opened theconference with a motivational keynotespeech that set a challenging andcooperative tone for the meeting.IHAFFers Robyn Cox, Ruth Bentler,David Hawkins, Gus Mueller, MichaelValente and Catherine Palmer tookturns discussing content areas alongwith the readings, class activities,homework, laboratory activities andevaluation procedures that might beused in amplification courses. Betweentalks, attendees were assigned topics to

discuss and report back on to the group.This allowed for an exchange of ideasbetween attendees and conferencefaculty. Fifteen posters provided excel-lent lunch-time conversation. HarveyAbrams chaired the poster session sub-mission process. Although attendeesworked hard each day, time was carvedout for the “Audiology Family Feud”event hosted by the conferencemoderator, Gus Mueller.

Attendees left the conference with acomplete CD of all of the conferencepresentations as well as a compilation ofall of the teaching materials used by thepresenters. The University of Pittsburgh

plans to continue the “Teach theTeachers” conference during alternateyears. Each year will have a new focuswith conferences related to contentareas, teaching methods, evaluationmethods, integrating didactic and clini-cal work, etc. The next conference willbe in June 2007 and will focus on AuralRehabilitation.

The IHAFF group includes DennisVanVliet, Gail Gudmundsen, GusMueller, Ruth Bentler, Dave Fabry,Robyn Cox, David Hawkins, MichaelValente, Larry Revitt, Margo Skinner,Lucille Beck, Michael Marion, RobertSweetow and Catherine Palmer.

IHAFF Hosts “Teach the Teachers” Conference“Teach theTeachers” facultyincluded (standingfrom left) MichaelValente, HarveyAbrams, GusMueller, CatherinePalmer, RuthBentler, Robyn Cox;(seated from left)David Hawkins, PattiMcCarthy, KrisEnglish and ElaineMormer.

Gus Mueller servedas emcee for the“Audiology FamilyFeud,” with gamejudges PattiMcCarthy and MickMcNeil. The "X Girls"were University ofPittsburgh AuDstudents whoprovided notificationfor wrong answers.


NEWS&announcementsTRICARE ANNOUNCESCOVERAGE OF HEARING AIDSAs of September 1st, active duty military family members (ADFMs) whomeet specific hearing-loss requirements, will be eligible to receive hearingaids (including services and supplies) as a TRICARE health benefit. Thisbenefit is extended to ADFMs as part of the National Defense AuthorizationAct (NDAA) for Fiscal Year (FY) 2002. Previously, hearing aids and serviceswere only available to those beneficiaries who were in the Program forPersons with Disabilities (PFPWD). The FY 2002 NDAA provision allows forcoverage of a hearing aid to ADFMs diagnosed with a “profound” hearingloss. With the assistance of service physicians and audiologists from boththe Department of the Defense and Veterans Affairs, TRICARE establishedseparate hearing-level thresholds or adults and children.

The criteria for an adult ADFM to qualify for hearing aids and services are:• 40 decibel (dB) hearing loss (HL) or greater in one or both ears when

tested at one of the following frequencies: 500, 1000, 1500, 2000,3000 or 4000Hz; or

• 26dB HL or greater in one or both ears at any three or more of thosefrequencies (mentioned previously); or

• A speech recognition score less than 94 percent

The criterion for children of active duty service members to qualify forhearing aids and services is: • 26dB HL or greater hearing threshold level in one or both ears when

tested in one of the following frequency ranges: 500, 1000, 2000, 3000or 4000Hz

Eligible TRICARE beneficiaries will receive all medically necessary andappropriate services and supplies, including hearing examinations adminis-tered by authorized providers that are required in connection with this ben-efit. The TRICARE Beneficiary Handbook indicates that eligible beneficiarieswho suspect they or a family member may have a hearing loss shouldschedule an appointment with their primary care manager or medicalprovider for an examination. Beneficiaries will then be referred to an audiol-ogist for any necessary tests.

PASSAGESPASSAGESPASSAGESThe Academy Board of Directors approved the following Fellows forLife Membership: Henry Tobin & Carolyn V. Young

Linda Hood, PhD, recently accepted a position at VanderbiltUniversity where she is Professor, Department of Hearing andSpeech Services and Associate Director of Research at the NationalCenter for Childhood Deafness and Family Communication. Hood,a past-president of the Academy, was a research audiologist at theKresge Hearing Research Laboratory at LSU Health Sciences Centerin New Orleans since 1982.

Tamala Bradham, PhD, has been appointed Assistant Professor inClinical Research and Associate Director of Clinical Services at theNational Center for Childhood Deafness and Family Communicationat the Vanderbilt Bill Wilkerson Center in Nashville, TN. Bradhamholds a PhD from the University of South Carolina.

William Dicknson, AuD, is the Hearing Aid Product Line Managerand Assistant Professor of Hearing and Speech Sciences at theVanderbilt Bill Wilkerson Center in Nashville, TN. Dickenson com-pleted his AuD at Central Michigan University in 2004.

Patrick Murphy, MA, Research Audiologist with Sonic Innovationsin Salt Lake, UT, passed away suddenly in August from a heartattack. Murphy received his MA from SUNY in 1995. In additionto his passion for audiology, Murphy was a musician who playedsaxophone with several small group bands during recent Academyconventions.

Maurice “Ed” Popejoy, MA, passed away September 1, 2005 athis home in Yorba Linda, CA. Popejoy, a 1972 graduate of Cal StateUniversity Long Beach, was well known and respected in theSouthern California audiology community. Ed worked in a variety ofsettings throughout his career, including Rancho Los AmigosNational Rehabilitation Center; private practice; the House Ear Clinicin Los Aangeles; and finally with HEARx in Fontana, CA.

Richard Krug, PhD, a retired professor of Audiology from theUniversity of Colorado (Boulder), passed away in May 2005 at theage of 83. Krug received his MA in audiology at NorthwesternUniversity in 1951 and his PhD from the University of Oklahoma in1960. In 1951, he was the first clinical audiologist of the newlyformed Bill Wilkerson Hearing and Speech Center in Nashville, TN.Krug taught in the Department of Speech, Language and HearingSciences at the University of Colorado from 1963 until 1987 andserved as chairperson for seven years. His areas of interest were inthe provision of services for deaf individuals and forensic audiologyto industries involved in hearing conservation.

Richard Dickerhoof, AuD, passed away at age 59 in September2005 in Canton, OH. A graduate of Kent State University,Dickerhoof earned his AuD in the Pennsylvania College ofOptometry Doctoral of audiology program. Dickerhoof worked forthe past 20 years in an ENT office following a stint with the StarkCounty Department of Education.

The American Academy of Audiology has launched a brand new health pro-gram exclusively for members. As the cost of insurance continues to esca-late for individuals and companies, it will be to your benefit to use theAcademy’s health, life, long term care, disability and critical illness coveragefor you, your family and your employees. By using our association healthprogram, you can use the buying power of the Academy to receive lowerrates, special underwriting consideration for pre-existing conditions, and toenroll in plans available only to members. Once you sign up for anAcademy health or benefit program, your coverage cannot be canceled oryour rates increased due to medical conditions.

Contact the Academy’s health and benefit programs office and let them helpyou design better coverage and make cost cutting recommendations thatwill allow you, your family, and your employees to continue their coverageinto the future. The Academy’s health programs will allow you to tailor aplan to meet your needs and budget without sacrificing quality insuranceprotection. For questions or more information please contact the Academy’shealth and benefit programs office by emailing [email protected] calling (888) 450-3040. You can also check out their website athttp://www.associationpros.com/assoc/AUDIO/.

New Health Benefit forAcademy Members


NEWS&announcementsNCRAR Hosts Aging Conference

The VA National Center forRehabilitative Auditory Research(NCRAR) held their second internationalconference titled, “The Aging AuditorySystem: Considerations forRehabilitation.” The meeting was held inPortland on September 22-23 with afocus on the necessary relationshipbetween clinical research and clinicalpractice. A committee composed ofElizabeth Paffenroth-Leigh, NancyVaughan, James Jerger, Terry Wiley andSandra Gordon-Salant helped select sub-ject topics, speakers, scholarship winnersand reviewed poster proposals. Themeeting was organized by GabySaunders, Carolyn Landsverk, NancyVaughan and Elizabeth Leigh-Paffenroth

with support from thePortland Veterans AffairsMedical Center, the VA’sOffice of Research andDevelopment and theRehabilitation Researchand Development Service.

The invited facultyincluded Moe Bergman,Emeritus Professor at theSackler School ofMedicine of Tel-AvivUniversity, who presentedthe keynote address, “TheOldest Old: NewResponsibilities for Us?”Other featured speakersincluded Jack Mills, James

Jerger, Sandra Gordon-Salant, Arthur Wingfield,Kathy Pichora-Fuller,Pamela Souza andTherese Walden. Some200 registrants partici-pated in the conference inwhich each session wasfollowed by a livelyquestion and answerpanel discussion moder-ated by Stephen Fausti,Director of the NCRAR.The proceedings of theconference are to be pub-lished in a future issue ofSeminars in Hearing.

Harry Levitt(left) pro-vided theintroductionfor NCRARKeynoteSpeaker,MoeBergman.

James Jergersummarized thebehavioral studiesof auditory aging.

Stephen Fausti, Directorof the NCRAR, welcomesconference attendees.

Sandra Gordon-Salantdescribed her researchprojefcts in speech per-ception and auditorytemporal processing inelderly listeners.

The NCRAR Program Committee included (from left) Elizabeth Leigh-Paffenroth, Nancy Vaughan, Gaby Saunders, Carolyn Landsverk andStephen Fausti.

A panel discussion featuring (from left) James Jerger, David Lilly, SandraGordon-Salant and Terry Wiley.


NEWS&announcements

Deafness in Disguise: Concealed HearingDevices of the 19th and 20th Centuries

The Washington University School of Medicine Bernard BeckerMedical Library announce the release of a revised digital exhibit,Deafness in Disguise: Concealed Hearing Devices of the 19th and 20thCenturies, at www.beckerexhibits.wustl.edu/did/index.htm.

Deafness in Disguise features historic hearing devices that were hid-den as everyday items during the 19th and 20th centuries, rare books onspeech and hearing and related archival material. Created for viewers ofall ages and backgrounds—from the layperson to the scholar—thisrevised exhibit combines images of hearing devices, rare books, photo-graphs, illustrations, advertising literature and patents to provide aunique glimpse into the history of deafness and hearing impairment.

The Deafness in Disguise digital exhibit contains nearly 300 addi-tional digital images of hearing devices and archival material, andincludes new sections such as Marketing of Hearing Devices, aTimeline, an Image Gallery, and a Resource section. The Deafness inDisguise digital exhibit was executed through a retrospective metadatagrant project funded from the federal Institute of Museum and LibraryServices through the Library Services and Technology Act administeredthrough the Missouri State Library. In addition, a physical exhibit islocated in the lobby of Washington University School of MedicineBernard Becker Medical Library. For more information contactBarbara Halbrook at [email protected] or 314.362.2786.

An exemplary AuD student at CentralMichigan University, Irene Okeke, takesclasses online from her home in New Jersey,interrupted routinely by her travels to Nigeriato set up the country’s first audiology center.A native of Nigeria and a US citizen, shetravels to spread the good news about hear-ing and health care. In addition, she has aprivate practice in Maplewood, New Jersey,is married and has five children. Since theNigerian Army Audiological Center wascommissioned in 1998, news about it hasspread on national television and in newspa-

pers. The center is the first one of its kind inthe West African sub-region. Okeke serves asthe Center’s director and has embarked onchallenging projects to screen hearing withinthe Nigerian army, air force, navy and civil-ians as well as creating awareness abouthearing health care. The center providescomplete audiological evaluations, includingENGs, OAE, ABR measurements, ear moldfabrication and hearing aid fitting andrepairs. She travels back and forth to Nigeriaon a regular monthly basis. Her future plansinclude trying to improve newborn hearing

screening, hearing conservation practices anddeveloping curriculum to train audiologists inNigeria. Although the word ‘audiology’ wasalien to Nigerians, she is working to make ita common word, especially in the militaryenvironment. Audiology has transcendedfrom the United States to a developing coun-try like Nigeria and has changed the lives ofmany in hearing health care. Okeke holds anundergraduate degree in zoology fromRutgers University and a master’s degree inaudiology from Montclair State University,both in New Jersey.

AuD Student Delivers Audiologic Services to Nigerian Armed Forces

POSITION STATEMENT ONAUDIOLOGY ASSISTANTS

CURRENTLY UNDER REVIEW

The Academy’s newest Position Statement on theAudiologist’s Assistant has been posted in the

Academy Documents area of www.audiology.organd is ready for review and comment. Please take

time to read the statement and e-mail your commentsto Craig Newman at [email protected] or mail them

to the national office: American Academy ofAudiology, Attn: Sydney Davis, 11730 Plaza

America Drive, #300, Reston, VA 20190.

If you would like to have this Position Statementmailed to you for review, please call Sydney Davis at

the National Office at 1-800-222-2336, ext. 1033 or by e-mail at

[email protected]. All comments and sugges-tions must be received by December 15, 2005.


NEWS&announcements

The 13th Annual Illinois Academy of Audiologyconvention will be held at the Hotel Intercontinental onthe Magnificent Mile in Downtown Chicago, January 26th-28,th 2006.

An outstanding faculty has been organized includingTerry Zwolen speaking on the audiological managementof cochlear implanted patients, James Henry will presenta full-day session encompassing the areas of tinnitusevaluation and treatment, Jane Madell will address themultitude of specialized needs of pediatric patients, andTim Hain will discuss the medical perspective on dizzi-ness and vestibular issues. Kris English will present“Why is it So Hard to Ask for Hearing Help?Counseling Strategies in Audiology,” and Bryan Liangwill return for a discussion of “Audiology andProfessionalism – The Intersection of Ethics and Law.”In addition, an extensive exhibit area will be availablealong with a fun social program. Visit www.ilaudiolo-gy.org/workshops.htm for up-to-date programinformation and registration forms.

13th Annual Illinois Academyof Audiology Convention

STARKEY HEARINGFOUNDATION’S GALAThe Starkey Hearing Foundation held its annual “So the World May

Hear” Awards Gala on August 20 in St. Paul, Minn., and raised a

record $4.5 million. The event, which annually recognizes individuals

for their significant humanitarian contributions, this year honored

Garth Brooks’ Teammates for Kids Foundation, the late Olive

Osmond, founder of the Children’s Miracle Network, the Wayne

Gretzky Foundation, and the Richard Schulze Family Foundation.

The spectacular evening included performances by Trisha Yearwood,

singer/songwriter Michael Bolton, and pop and stage performer

Donny Osmond. The Starkey Hearing Foundation graciously thanked

the more than 1,500 attendees and the corporate sponsors that made

the evening possible. Since 2000, the Foundation has provided more

than 115,000 hearing aids throughout the world.

—Submitted by Sugata Bhattacharjee

“Phonak U” The second annual meeting of “Phonak U,” an educational

conference held exclusively for students in residential AuDprograms, was held at Phonak’s US Headquarters in Warrenville,Illinois. This year, 275 AuD and PhD students, representing 51graduate programs from across the US. The program wasdesigned to augment the experience gained in their educationalprograms and clinical rotations through a series of lectures,workshops, and “hands-on” experience with hearing aids, FMsystems and real-ear measurement equipment.

Students were able to customize their experience by creatingtheir own program schedule by selecting from the array of courseofferings. The interactive format also included lectures given by adistinguished group of Phonak employees and guest faculty,including David Fabry, Barry Freeman, Alan Freint, PatriciaGans, Richard Gans, Ron Gleitman, Gyl Kasewurm, SergeiKochkin, Catherine Palmer, Paul Pessis, Joseph Smaldino andRobert Sweetow.

A wide variety of educational topics were covered, includingan extensive offering of adult and pediatric amplification topics,sessions on vestibular diagnosis and treatment, aural rehabilita-tion, cerumen management, forensic audiology, ethics andpractice development. In addition, students participated in “roleplay” exercises designed to simulate real-world interactions,discussed interviewing skills, professional issues, and had theopportunity to improve their earmold impression and modifica-tion, hearing aid programming and clinical verification skills. —Submitted by David Fabry

ORIGINAL AUDIOLOGISTS’VERSION VERSION

12 drummers drumming 12 eardrums drumming

11 pipers piping 11 codes for typing

10 lords a-leaping 10 tones a-beeping

9 ladies dancing 9 ladies dizzy

8 maids a-milking 8 aids a-squealing

7 swans a-swimming 7 circuits dimming

6 geese a-laying 6 geezers waiting

5 golden rings! 5 E-A-R rings!

4 calling birds 4 spondee words

3 French hens 3-color pens

2 turtle doves 2 sterile gloves

And a partridge in a pear tree. And a cartridge in an HP.

THE TWELVE DAYS OF CHRISTMAS(As Seen Through The Eyes of an

Audiologist)

Monica Grant,AuD Champaign, IL

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NEWS&announcementsThe International Evoked Response Audiometry Study Group

(IERASG), founded by Hallowell Davis in 1967, held its 19th biennialsymposium for the first time in the Caribbean, on the tropical island ofCuba. More than 140 clinicians, scientists, and students, from 24 dif-ferent countries, working in the field of objective hearing assessmentwith brain physiological measures, met from June 12-16 in Havana.The 2005 Havana meeting combined advanced topics and cutting edgeinformation in hearing science in a wide range of topics from basicresearch to more clinical and applied studies, with a number of socialactivities. The free running Mojito (rum-based) cocktails and the won-derful Cuban music contributed creating a warm and cordial atmos-phere among participants to facilitate scientific interchange. The sci-entific program was supplemented with excursions to “Las Terrazas”coffee mill, the San Juan River and a visit to Old Havana.

The meeting opened with the Hallowell Davis Memorial Lecturedelivered by R. Carlyon from the MRC Cognition and Brain SciencesUnit in the United Kingdom. It was followed by a number of originalcontributions and lively discussion on the topic of cochlear implants,brain plasticity in deaf and deaf-blind subjects, retrocochlear hearinglosses, and auditory neuropathy. Other keynote presentations weredelivered by T. Picton, of the Rotman Research Center in Toronto, “TheQuest for an Objective Audiogram” and David Stapells, from the

University of British Columbia, who spoke on “The Use of AuditoryEvoked Potentials in Conductive Hearing Loss.” A hot topic for discus-sion was on the advantages and caveats of a new technique for objec-tive hearing assessment: the fast rate (70-110 Hz) ASSR. There wasmuch debate on technical aspects of evoked response audiometry,such as calibration and types of stimuli, AEP extraction methods, auto-matic detection and objective evaluation of hearing aids in the work-shop presented by E. Laukli, R. Thornton, M. Don and S. Purdy .

The finale of the scientific program was a round table presenta-tion, “Towards a comprehensive hearing screening protocol,” wherespeakers discussed many issues such as the measures of screeningperformance (M. Hyde, Canada), the challenge to get an appropriateevidence base (A. Davis, UK), the techniques used for the character-ization of the residual hearing (B. Cone-Wesson, USA), the need toadapt screening protocols to local constraints as in the Middle Eastexperience (H. Pratt, Israel) and the 20-year long term outcome of theCuban hearing screening program (M.C. Perez Abalo, Cuba). The lat-ter event was also an excellent opportunity to share with the scientif-ic community the results of both clinical audiology and hearingresearch in Cuba, as well as the importance of technology (softwareand hardware) development.

International Evoked Response Audiometry Study Group Meets in Cuba


ILLINOISAssistant Professor, Audiology: Tenure TrackIllinois State University • Normal/Bloomington

The Speech Pathology and Audiology Department invites applications for anine-month Tenure Track Faculty Position beginning August 15, 2006. The depart-ment has a newly established Doctor of Audiology program that will begin Fall2006. The position requires an earned Doctoral degree or for the candidate to rea-sonably expect to complete their doctorate by August, 2006, CCC-A, and eligibilityfor Illinois licensure. Responsibilities include undergraduate and graduate teach-ing, research and service. All areas of expertise will be considered. Priority areasinclude electrophysiology, diagnostic evaluation, and amplification.

Initial Review of Applications will begin January 15th, 2006 and continue untilthe position is filled. To assure full consideration, please submit a letter of applica-tion, curriculum vita, graduate transcripts and three letters of recommendation byJanuary 15, 2006 to: Walter J. Smoski, Ph.D., Department of Speech Pathologyand Audiology, Campus Box 4720, Illinois State University, Normal, IL. 61790-4720. Illinois State University is an equal opportunity/affirmative action universityencouraging diversity.

Research AudiologistWidex Office of Research in Clinical AmplificationWidex Office of Research in

Clinical Amplification (Lisle, IL) has an immediate opening for a research audiologist/ scientist. Reporting to the Director of Audiology, your responsibilities include pro-viding audiological research for the benefit of hearing impaired individuals in addi-tion to supporting the company's product line.

This position would entail research and development of amplification systems;assisting in the design, data collection and documentation of research studies;and developing and refining rehabilitation and outcome measure protocols. A PhDin Audiology, Hearing Science, Engineering, Behavioral Science, or related field isrequired. Clinical experience is not required.

All responses will be viewed with the strictest of confidence. Kindly forwardall resumes, cover letters with salary requirements to: Francis Kuk, PhD, WidexOffice of Research in Clinical Amplification, 2300 Cabot Drive, STE 415, Lisle, IL,60532, [email protected]

Widex is an equal opportunity employer. We are committed to providing equalopportunities for employment and advancement without regard to an individual’srace, religion, national origin, age, sex, sexual orientation, marital status, disability,or any characteristic protected by local, state, or federal law.

OHIOAssistant/Associate Professor of Audiology

The University of Akron seeks qualified applicants for Assistant/AssociateProfessor of Audiology. Duties: teaching doctoral and undergraduate students inclassroom, serving as a clinical preceptor for doctoral students, advising, provid-ing institutional service, engaging in personal research, facilitating studentresearch. Qualifications: earned doctorate in Audiology, eligibility for Ohio licen-sure; ASHA CCC; experience in classroom and clinical teaching; record of scholar-ly activity. To apply: Send letter of intent, resume, and three reference letters toAudiology Search, attn. Dr. Sharon Lesner, School of Speech-Language Pathologyand Audiology, Akron, Ohio, 44325-3001. Information: [email protected] of applications begins Nov. 30, 2005, and continues until position is filled.

NEW ZEALANDAudiologist Position in New ZealandHearing Professionals is seeking a qualified Audiologist for a full-time position

focussing on adult rehabilitative audiology.We are located at the top of the South Island, surrounded by mountains and

the sea with a variety of opportunities available to those who enjoy outdoor activi-ties. We are keen to work with an individual who displays enthusiasm for excellentservice and who would enjoy playing a key role in our small team.

Applications from Full Members of an Audiological Society would be welcome. Jill Beech MNZAS, Hearing Professionals Limited, 24 Nile Street, Nelson,

NEW ZEALAND, Phone: (+64 3) 548 2323, Fax: (+64 3) 548 2324, Email: [email protected]

CLASSIFIED ADS

www.mayoclinic.orgFor more info, visit our website at

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AudiologistMayo Clinic in Rochester, MN, is looking for an experienced audiologist to join our large and expanding audiology practice. Anexceptional career opportunity exists for the selected candidate towork in a clinical setting with children and adults. Applicants shouldhave in-depth knowledge and clinical skills, excellent communicationskills, and a strong desire to succeed. The audiologist will be partof a team of professionals who provide quality health care servicesin diagnostics, newborn hearing screening, vestibular/balanceassessment, and hospital services. The audiologist will assumeand manage a full and varied caseload of patients of all ages, participate in quality improvement programs, and continually updateprocedures to maintain a best practice program.

To qualify for this position, individuals must possess a graduatedegree in Audiology and have a minimum of 1-2 years' experience inaudiology. Must meet requirements for Minnesota State Audiology Licensure. Mayo Clinic provides a competitive compensation package including salary, health benefits, vacation, professionaltravel, relocation, and tuition reimbursement.

To apply or for more information about Mayo Clinic and Rochester,MN, please visit http://www.mayoclinic.org/jobs-rst and reference job posting #5391. Please submit a cover letter and resume to be considered for the position.

Mayo ClinicBecky Stolp - Human Resources 200 First Street SW, Rochester, MN 55905 E-mail: [email protected]

© 2005 NAS(Media: delete copyright notice)

Audiology Today3.375" x 5"BW

For information about our employment website, HearCareers, visit www.audiology.org/hearcareers. For information or to place a classifiedad in Audiology Today, please contact Elizabeth Hargrove at [email protected] or 1-800-AAA.2336 ext. 1039.

Please remit invoices reflecting IO number AND 2 tearsheets to: Patriot Advertising, Inc.,

Attn: Accounts Payable, 2501 S. Mason Rd. Suite 263, Katy, TX 77450

Client: Arkansas Children’s HospitalPub: Audiology TodayInsertion Date: Jan/Feb 2005Section: Help WantedCost: $236.00

File: 110805audiologyAccount Rep: Tim RungeRate: $200 net colorSize: 1/4 pageInternet: N/C

Insertion Order # ARK002

For questions regarding this insertion order, please contact: Tim Runge,

Director of Recruitment AdvertisingPhone: 832-239-5775 Fax: 832-553-2599

EOE

AAUUDD IIOOLLOOGG II SSTT ((CCOOCCHHLLEEAARR IIMMPPLLAANNTT ))Audiology at ACH is fun! Our Cochlear Implant team is growing and we are seeking an experiencedAudiologist to provide services to children who are deaf or hard of hearing. Our program uniquelyincorporates child, family, audiologists, speech pathologists, social workers and physicians in acoordinated effort to help every child reach his or her full potential. • Prior cochlear implant and pediatric experience required; Ph.D. or Au.D desired.• Ability to work with multiple implant devices and various programming strategies needed.• Primary focus on younger implant candidates and recipients.• Secondary interest in Educational Audiology, Research or other compatible area preferred.• Independent thinker who loves kids and is motivated by working with families.• Offers incredible possibilities for professional growth in a fun, energetic clinical atmosphere

with 24 speech and hearing professionals.

Imagine.. Seeing smiles like this every day.

Imagine.. Changing children’s lives

Imagine.. A career at Arkansas Children’s Hospital

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880000 MMaarrsshhaallll SSttrreeeett,, LLiittttllee RRoocckk,, AARR 7722220022PPaattttii MMaarrttiinn:: eemmaaiill:: mmaarrttiinnppff@@aarrcchhiillddrreennss..oorrgg


AUTHORED ARTICLES

Bankaitis, A.U. InfectionControl in the Audiology Clinic:Frequently Asked Questions.17:5, 17 – 19.

Bankaitis, A.U. Hearing Aids:Lick ‘Em and Stick ‘Em? 17:6,12-13.

Carmen, R. Who are MoreResistant to Hearing AidPurchases…Women or Men?17:2, 22-23.

Cunningham, L. and Friesen,L. A Moment of Science:Update on CisplatinOtotoxicity. 17:2, 29.

Cunningham, L. and Friesen, L.A Moment of Science:Predicting Hearing AidAcceptance. 17:4, 25.

Cunningham, L. and Friesen, L.A Moment of Science: CentralAuditory Processing in Mice.17:6, 11.

Gans, R. and Roberts, R.Understanding Vestibular-Evoked Myogenic Potentials(VEMPs). 17:1, 23-25.

Gross, A. Insert Earphones forOccupational HearingConservation Testing. 17:6,21-24.

Eichwald, J., Gaffney, M.,Ross, D. The Importance ofReporting All Results ofPediatric Diagnostic AudiologicEvaluations. 17:3, 17.

English, K. and Zoladkiewicz.AuD Students’ Concerns AboutInteracting with Patients andFamilies. 17:5, 22-25.

Fligor, B. and Cox, C. Risk toHearing from Personal StereoSystems. 17:2, 18-19.

Friesen, L. and Cunningham, L.A Moment of Science: Cats withCochlear Implants? 17:1, 38.

Friesen, L and Cunningham, L.A Moment of Science: CanSound Exposure ReduceHearing Loss? 17:3, 21.

Friesen, L. and Cunningham, L.A Moment of Science. AfterOME Recovery, is AuditoryTemporal Resolution Affected?17:5, 11.

Johnson, C., Danhauer, J andKarns, S. New Adventures onthe Information Super Highway:Audiologists’ Uses of theComDisDome. 17:2, 25-28.

Kasewurm, G. Interview witha Legend: Ira J. Hirsh. 17:1,26-27.

Kasewurm, G. The MarketingScene: Marketing ThroughYour Employees. 17:2, 53.

Kasewurm, G. The MarketingScene: Marketing Yourself.17:3, 28.

Kasewurm, G. The MarketingScene: To E or Not to E – TheDilemma of E-Mail Marketing.17:5, 41.

Kasewurm, G. TheMarketing Scene: BuildingBlocks to SuccessfulMarketing. 17:6, 31.

Margolis, R. Viewpoint:Automated Audiometry:Progress or Pariah? 17:2, 21.

Metz, M. Viewpoint: Marchingin Step: Audiology, DirectAccess, Health Insurance,Hearing Aids. 17:5, 15-16.

Metz, M. Viewpoint:Continuing Education: WhatWere They Thinking? 17:6,25.

Nagen, B. The MarketingScene: Love Your Patients –and Success Will Follow!17:4, 40.

Nilsson, M. The Application ofTechnology to Hearing Aids.17:1, 40-42.

Olusanya, B. Can the World’sInfants with Hearing LossWait? 17:4, 10-11.

Thunder, T. and Hallenbeck, S.Science Fairs: A Road toRecruitment? 17:5, 32-33.

Traynor, R. The Business ofAudiology: To Incorporate or Notto Incorporate? 17:1, 43 – 45.

Traynor, R. The Business ofAudiology: EmployeeManagement in the AudiologyPractice. 17:2, 46 – 49.

Traynor, R. The Business ofAudiology: Accounting 101 forAudiologists – The Basics.17:3, 45 – 49.

Traynor, R. The Business ofAudiology: Accounting 102 forAudiologists – “The Numbers.”17:4, 36-39.

Traynor, R. The Business ofAudiology: FinanceConsiderations in AudiologyPractice. 17:5, 42-45.

Traynor, R. The Business ofAudiology: Brand YourPractice – Not Just YourDegree. 17:6, 33-35.

Turner, C. and Gantz, B.Combined Acoustic andElectric Hearing for SevereHigh-Frequency Hearing Loss.17:3, 14-15.

Sharma, A. The Clinical Use ofP1 Latency as a Bio-Marker forAssessment of CentralAuditory Development inChildren with HearingImpairment. 17:3, 18-19.

Steiger, James. Viewpoint:Signs of a MaturingProfession. 17:5, 10.

Swanepoel, D., Hugo, R. andLouw, B. Infant HearingLoss – Silent Epidemic ofthe Developing World. 17:4,12-15.

Swanepoel, D., Hugo, R. andLouw, B. Infant HearingScreening in DevelopingCountries: Rethinking FirstWorld Models. 17:4, 17-19.

Waltzman, S. ExpandingPatient Criteria for CochlearImplantation. 17:5, 20-21.

Zapala, D. and Shaughnessy,K. The ENG CaloricControversy – Which is theBetter Stimulus: Water or Air?17:1, 20- 21.

LEGISLATIVE-REIMBURSEMENT

ISSUES

Abel, D. ReimbursementUpdate: Inquiring Minds Wantto Know. 17:3, 22 – 23.

Chappell, J., Matz, M. andHahn, R. Washington Watch:Pay-For-Performance andAudiology. 17:5, 47 – 48.

Freeman, B. and Lichtman, B.Audiology Direct Access: ACost Savings Analysis. 17:5,13-14.

Matz, M. Washington Watch:The 109th Congress. 17:1, 48.

Matz, M. Washington Watch:Direct Access Continued.17:2, 51.

Matz, M. and Scheufele, J.Washington Watch: MoneyTalk$. 17:3, 42-44.

Matz, M. and Hahn, R.Washington Watch: A New(and Hopefully Better)Medicare Appeals Process.17:4, 32-33.

Matz, M. Hearing: A NationalNews Magazine Cover Story.17:6, 40.

Mazzeo, L. ReimbursementUpdate: My Road toAutonomy. 17:4, 28 – 29.

Solodar, H. and Chappell, J.“Welcome to Medicare” 17:1, 49.

PROFESSIONAL TOPICS

Beauchamp, J. AmericanBoard of Audiology.Practice/EmploymentMultiplier. 17:2, 42.

Beauchamp, J. and Miller, E.American Board of AudiologyAnnounces New Initiatives.17:5, 37.

Borton, B., Borton, T. and Cox,C. The Marketing Scene:Marketing Audiology toPhysicians. 17:1, 11.

Clark, J.G. American Board ofAudiology: Thank You andMore. 17:6, 27.

Chute, P. and Johnson. C.American Board of Audiology:Specialty Board Certification inCochlear Implantation. 17:1, 14.

Chute, P. American Board ofAudiology: Cochlear ImplantSpecialty Examination Debuts.17:4, 30.

Doyle, L.F. Executive Update:It’s Not Your Father’sConvention. 17:1, 8.

Doyle, L.F. Executive Update:Be Heard During Convention2005. 17:2, 8.

Doyle, L.F. Executive Update:Inside the Beltway. 17:3, 10.

Doyle, L.F. Executive Update:Planning a Strategy for theFuture of Audiology. 17:5, 9.

Doyle, L.F. Executive Update:Audiology and Katrina. 17:6, 8.

Gans, R. President’s Message:The Price of Autonomy inDollars and Sense. 17:1, 6-7.

Gans, R. President’s Message:Washington DC Welcomes theProfession of Audiology – BeThere! 17:2, 6-7.

Gans, R. President’s Message:Promises to Keep and Miles toGo. 17:3, 6-7.

Solodar, H. Annual Treasurer’sReport. 17:1, 10.

Whitelaw, G. President-ElectConvention Address: TheAcademy Comes of Age. 17:3, 8-9.

Whitelaw, G. President’sMessage: Creating a Cultureof Advocacy. 17:4, 6-7.

Whitelaw, G. President’sMessage: Hearing andListening. 17:5, 6-7.

Whitelaw, G. President’sMessage: Playing Well WithOthers. 17:6, 5-7.

AMERICAN ACADEMY OF

AUDIOLOGY DOCUMENTS

A Question of Ethics:Marketing Support and Costof Instrument Guidelines.17;1, 46.

A Question of Ethics: Ethics orProfessionalism? ConventionEthics. 17:2, 44-45.

A Question of Ethics: Real LifeLegal Complications andConflicts of Interest. 17:5, 35.

Automated Hearing Testingand Oto-Technician Training.17:1, 55.

Clinical Report: Noise andMilitary Service: Implicationsfor Hearing Loss and Tinnitus.17:6, 37-39.

Ethical Practice BoardAdvisory. Statement on theUse of the Term “Doctor” inAdvertising. 17:2, 45.

Ethical Practice BoardAdvisory. Use of the Term“AuD Candidate” DeemedInappropriate. 17:2, 45.

Ethical Practice Board Advisory.Audiologists Beware!…And BeAware of Conflicts of Interest.17:4, 34 -35.

Position Statement: TheAudiologist’s Role in theDiagnosis and Treatment ofVestibular Disorders. 17:1,17-19.

Technical Report: Hearing AidCompatibility with WirelessDevices: What Hearing HealthProfessionals Should Know.17:4, 20- 21.

Whistleblower Policy.17:2, 59.

Audiology Today: Author Index – Volume 17, 2005

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