BuDetin of the Ameriam Academy of Audiology September/October 1994; Volume 6, Number 5

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American Academy of Audiolog) 1735 onh Lynn St.. Suue 950 Arhngton. VA 22209-2022

Non-Proht Organ1u llon US Po<>tage

PID Pennu 114 167 Houston. TX

Page

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MONTH OF I.IAIIUFACTURc SUICE JULY "92

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VERSION

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• A supply of supporting brochures and instructions

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The wax guard is the easiest way to keep a hearing aid clean. It prevents skin debris and most kinds of wax from entenng the sound bore of nearly any hearing aid . It ts easily applied by patients. Since it is disposable , they will return regularly for more. Patients will appreciate your help tn the protection of their investment, and you will have their ongoing business.

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Starter 1nlo on other s1de of card

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To place an order or to get information, call us toll-free (800) 872-8986

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Order your Ad•hear"' Wax Guard

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The wax guard is the easiest way to keep a hearing aid clean. It prevents skin debris and most kinds of wax from entering the sound bore of nearly any hearing aid . It is easily applied by patients. Since it is disposable, they will return regularly for more. Patients will appreciate your help in the protection of their investment, and you'll have their ongoing business. Circle No. 121 on Reader Service Card

Starter info on other Stde of card

Patents pend1ng Ad•hear IS a uademarl< ol Heanng Components Inc.

Seplember/October I 994 Volume 6. l umber 5

American Academy of Audiology " ... Of, By and For Audiologists"

I

EDITORIAL BOARD

Editor

Jerry L. Northern 4200 East Nimh A venue, Box 8-210

Denver, CO 80262 (303) 270-7856. FAX (303) 270-5084

Edirorial Ad1•isory Board

Fred H. Bess Bill Wilkerson Cemer

aslmlle. T.

armen C. Brewer Washingron Hospiral Center Washingron. D.C.

J . Michael Dennis Universiry OJ Oklahoma Medical Cemer Oklahoma Ciry. OK

Deborah Hayes The Children's Hospiral De111·er. CO

J ane 1adell Long Island College Hospiwl Brooklyn. NY

Michael !arion The Hearing Ce111er Camarillo. CA

Patricia McCarthy Rush Un iversiry and Medical Cenrer Chicago. IL

Karen likami ReSound Corporarwn Redwood Ciry. CA

H. Gusta' ~l ueller Puudre Valley Hearing Cenrer Fr. Co/lim. CO

Linda Ra kind JM Hearing Health S1. Paul. MN

Jane B. eaton Secuon Consulrams Arhens. GA

Brad tach Califomia Ear lnstitllle ar Sranford Palo Alto, CA

Steven J . taller Cochlear Corpormion Englewood. CO

Susan Whichard Lewis-Gale Clinic Roanoke. VA

BOARD OF DIRECTORS

President Robert W. Keith Unil·ersiry of Cincinnmi Medical Center Cincinnati. OH

Presidem-Eiect Carol Flexer. Ph.D. Uni1·ersiry of Akron Akron. OH

Past-President Lucille B. Beck V.A. Medical Center, Audtolor:.\ Washingron D.C.

Board Members-At-utr~e

Tenn Ending 1995

J ohn Greer Cla rk Hearcare. Inc Cincinnari. OH

Jame R. Curran Starkey u1borarories Eden Prairie, MN

J ames \ . Hall. ill Vanderbi/1 Balance & Hearmg Center

asln•ille. T.

Temt Endmg 1996 Bar ry A. Freeman Center for Audiolog)' Clarks1•ille. TN

Judith . Gravel AIIJert Einstein College of tl'/edicine

e11· York. Y

Gretchen A. yfert Arlington Hearing Celller Arlington. VA

Term Ending 1997 haron Fujikawa

Uni1•ersiry ofCalifomia ln •ine. CA

Deborah Hayes The Children's Hospital Denver. CO

Dennis an liet Audiology & Hearing Aids Yorba Linda. CA

Statement of Publication Policy : The Amencan Academy of Audiology publishes Aud1ology Today as a means of commumcaung 1nformat1on among ns members about all aspects of aud1ology and related top1cs

Audtology Today accepts contnbuted manuscnpts dealing w1th the w1de vanety of top1cs of Interest to aud1olog•sts 1nclud1ng chmcal actiVIties and heanng tesearch. current events. news Items. profess1onal•ssues. IOdiVIdual·•nslltutlon·organization announcements. entnes for the calendar of events and matenals from other areas w1th1n the scope of pract•ce of aud1ology Audiology Today welcomes feature articles. essays of professional op1mon, spec1al reports and leners to the ed1tor Subm1ss1ons may be subject to edltonal rev1ew and alteration for clanty and brevity Closing date for all copy 1s the 1st day of the month preceeding issue date.

All copy rece1ved by Aud1ology Today should be accompamed (when poss1ble) by a computer disk clearly •den11hed by author name. top1c t1tle. operating system, and word process1ng program. Subm.ned matenal w1ll not necessanly be returned. Spec1hc questions regard1ng submiSSIOn matenals should be addressed to Ed1tor, Aud1ology Today. 4200 E. N1nth Avenue, Box B-210, Denver. CO 80262

NATIONAL OFFICE

mcrican cadcmy of udiology 1735 onh L) nn St.. uitc 950

Arlington. VA 22209-2022 (703) 524-1923. (800) AAA-2336

FAX (703) 524-2303

Bruce Wardle. Executive Director Ellen Mostoller, A~sociate Director

Jenmfer Kerner. Membership Coordinator David Howard. Commumcauon Coordmator

The American Academy of Audiology is a prof essional organi:ation of individuals

dedicated to providing qualiry hearing care to the public.

We enhance the ability of our mernbers to achieve career and

practice objectives through professional development, education, research, and

increased public awareness of hearing disorders and audiologic services.

POSTMASTER: Send correspondence 10: American Academy of Audiology , 1735 Nonh Lynn Sl .. Sulle 950, Ar1Jngton. VA 22209·2022 Audiology Today ts published b1·monthly by Graph1c Communtcauons Group, The Umverslly of Texas-Houston Medtcal School. 6431 Fanmn, Houston, Texas n225. The annual subscnpuon price Is S55.00 tor libranes and 1nstttuuons and S35 00 tor tndiVtdual non·members. Add S 15.00 tor each subscnp110n ou1s1de the Unlled States. For subscnphon tnqu1nes, telephone (703) 524·1923 or (800) AAA-2336 Cla1ms tor undelivered cop1es mus1 be made Wlthtn tour (4) monlhs of publlcalton

Adven1s1ng Representative: Rtck Gabler, Anlhony J . Jannen1. Inc., Easl Holly Avenue, Pttman, NJ 08071' (609) 256·2300

Publlcauon of an adverusemenl tn Aud1ology Today does nol consUiute a guaranlee or endorsement of lhe quallly or value of lhe product or servtce descnbed 1here1n or of any of lhe representauons or cfa1ms made by lhe adveruser wtlh respecl 10 such product or serv1ce.

1994 by the Amencan Academy of Audiology All nghls reserved

ATTENTION

Call for Instructional Course Deadline Extended to October 7!

The dead line for propo al fo r Instructiona l Course and Faculty for the Academy' 7th Annual Convention ha been extended! The new deadli ne i now October 7 ! Submi ion to Michael Denni · at 800 N.E. 13th treet P522. Oklahoma C ity. OK 73 104.

The addre li ted on the Call for tudent R esearch Forum in the July/Augu t i ue of Audiology Today wa incorrect. T he correct addre 1 :

Pamela Burch-Sim Department of Speech Pathology and Aud io logy Tenne ee State Univer ity 3500 John Merritt Blvd.

a hville, T 37209

"What is an Audiologist?" The American Academy of Audiology is proud to introduce it\ newe t

profe sional publication. "What i an Audiologist?" Thb brochure is the fir t in a 'eries of materials for our national public education campaign to let every person in America know what an audiologi t i~ . and to make our profe~~ion synonymou~ with hearing care ·erYice~ for people of all ages. The "What i an Audiologtst?" brochure is a\'ailable 10 packages of I 00: 25 for members. 30 for non-members. Call DaYid lloward at Academy Headquaners: (800) 222-2336 for order~ and

mformation.

6th Symposium OTJ

Cochlear /mplaTJts iTJ Chilc:lreTJ

February 2-3, 1996

Fontainebleau Hilton Resort and Spa Mia mi Beach, Florida

sponsored by

University of Miami Ear Institute

This intensive two-d ay symposium is for Otolaryngologists, Audiologists, Speech Pathologists, Educators of the Deaf and other interested persons. Topics include genetics of deafness, implant design, evaluation of lhe deaf child, long-term results and educational outcomes.

For more information please contact

UNIVERSITY OF MIAMI SCHOOL OF MEDICINE DIVISION OF CONTINUING MEDICAL EDUCATION P.O. Box 016960 (D-23-3)- Miami, FL 33101

Tel: 305-547-6716- Fax: 305-547-5613

PRESIDENT'S MESSAGE

AAA Watches Washington ...

Continuing The Theme

A. you look back through the. e me~!>age . there arc everal re-emerging themes: Academy growth. our

early accompli hments. and our profe -.ional unit) . President pa-.t and pre ent auempt to keep member abreast of Academy activi tie-.. The last few is ue have focused on our current effon in area of Audiology Awarcne · and legi lati' e action. The. econccrns \\ill continue to preoccupy the office of the presidcnL and your Board of DirectOr'>. While we are managing .,everal mauer-.. it i our perception that Audiology A'' arene-.s and legi. lati ve action, including health care reforn1 are. in the words of Steven Covey. Jr .. both ''imponant and urgent."

othing will effect audiologic care in thi-. nation more in the nex t generation than v. hat i .., being wriuen into health care rcfonn at thi moment.

Continuing Education

One of the imponant member benefit!-. of the Academy i the continuing education that we offer. Our premier educational e,·ent i annual convention to be held in Dalla.., on M arch 30 to pril 2. 1995. Our next comention promi e!. to be another'' onderful success. I " rite their mes!.age on ugu 1 1st. 750 room. ha'e alrcad) been re ened. While ad' anced booking i!> a good idea. please do not worry about accommodations in Dal la . . We have re. en ·ed 2000 rooms and more are a\'ai lable in com enient location!>. The convention committee i.., hard at \\ Ork under the direction of Ro Rocl>cr. The deadline for in tructional course has been extended to October 7 to encourage more of you to submit Comention Proposal!>. You \ till ha\e a

fev. da).., to '>ubmit po-.tcr pre. entation!> and (for tho e "ho qualify) the '>tudcnt re ·earch forum. I ha' e '>trongly ">Upponed the student rel.earch forum in the past and urge )OUr suppon in having tudent'> and recent graduatel> ubmit their rc. earch for con ideration. Plea e check the Jul) / Augul>t i . ue of Audiology Today for detaib. Finally. detaib of our other continuing education program are being finali ted at thi writing. and v. ill be announced oon.

On Other Matters

To help us pres!> for needed hearing care rcfonn. the Academy ha employed the finn of 01 son. Frank and Weeds. P.C .. to lobby congre s in our behalf. This linn i a young. growing Wa hington. D.C. law firm that ha become a leader in the food. drug. and health care field incc its founding in 1979. They represent trade a ociation and major corporation!.. a well a!. many smaller companie :client who arc primari ly concerned v. ith program!-. and activitie of the Food and Drug Admini stration. among other . The Board of Directors feel that

Robert W. Keith

profe ional repre. entation in the nation· l> capital will enable us to effecti vely prcsem our ca e for audio logic care. Some of their activitie in our behalf will include providing information about political action and other method of influencing the lcgi lative proces to get audiology \en ice" covered. and to rcpre ent the interc. ts of audiologi t in legi lati ve and regulatory arena'>, 01 ·on. Frank and Weed!> will also a i t us in our Audiology Awarenc<, Campaign. To learn more about our lobbyi. t please lind the new regular feature of Audio/or:.' · Today called ··wa hington Watch" on page 16 and 17 of thil> i ue. M arl>hall M atz. and Chril>tina Marcus. lawyerl> with the 01 on. Frank and Weed firm. will update you on activities of the Academy in health care refonn and other legi lati\e activitie .

R 0 BERT W . K EITH. AAA Pre.fui e111. U1111'er\ if\ of Cillci11na11 Medical Ce111er. Ci11cinnaii. 0 11

VOLUME6 NO 5

I alluded 10 other mauer being managed by the Board of Directors. They include <.,uch thing a providing professional liability insu rance for member<, . inve Ligation method for offering continuing education units through the Academ). developing a position on cenilication of audiometric technician'). etc. The Board member talk with each other <,O frequently I ometime wonder whether the issue. we discu arc the ame ones that concern member . I urge you to be in

communication with my'ielf and memberc., of the board about your i'>sue . Our addre<, es are listed in Audiolor~y

Today. We "ant to be re~ponl>ive to you. but we need to know what i. on your mind.

A UDIOLOGY TODA Y 3

COMMENTARY

Hearing the Sweetest Songs* I'm deaf.' But that's not all I am.

BY ICOLETTE TOUS A I T

E ERY YEAR WHE1 I\\ A A CHILD, A MA, brought a b1g.

blad... qucaking machine to chool. When he discovered I couldn't hear all hi peep~ and queak~. he would get very

excited. The nur..e would dra\\ a c.:han with a deep canyon in it. Then I would listen to the squeak-. two or three time\. \\ hile Lhe aduh' - who were all acting \Cry. very nice- would watch me rai'e my hand. Sometime~ I couldn · t tell \\ hethcr I heard the queak or ju t Imagined them. but I liked being Lhe center of attention.

My parent~ 'aid I lost my hearing to pneumonia as a baby: but I knew I hadn't 1oM anything. one of my part had dropped off. Nothing had changed: if I wanted to li ten to Beetho\en I would put ffi) head between the peaker-. and tum Lhe dial up to 7. I could hear Jet at the airport a block awa). I could hear my mom when she \\as in the same room - if I wanted to. I could even hear Ill) cat purr 1f I put ffi) good ear right on top of h1m.

I \\a\n't aware of 1101 hearing until I began to wear a hearing aid at the age of 30. It shattered Ill) peace: shoe~ creaking. papel'l> cracJ....Iing. pencil~ tapping, phone' ringing. refrigerators hummmg. people crackmg J....nuckJe . cleanng throat\ and blowmg no e. 1 C31'l>. bike\. dog\. cat~. kid~ all ~eemcd to appear from nowhere and n) right at me.

But alter I got the heanng a1d. a bu me~' fnend 'aid. "You knov ... 1 icolette. you thmk you get away with not heanng. but you don't. ometlme in meeting you an. wer the'' rong que,tion. People don't know you can't hear. o they Lhink you're daydreaming. eccentric. <.,tupid- or JU'>t plain rude. It would be better to ju t tell them."

I \\Ondered about that then. and I till do. If I tell. I mk be1ng een a~ unable rather than disabled. Sometimes. when I \a) I can ' t

hear. the walter will tum to my compamon and ay. "What doc, \he want?" a\ though I have lo t my power of ~pcech.

If I tell. people rna) 'ee only my di~abllit). Once \Omeone i labeled "deaf." "crippled ... "mute" or "aged." that' too often all Lhe) arc. I'm a'' riter. a painter. a ~lapda~h hou\ckeeper. a gardener'' ho grow wondrou roses: ffi) hearing i ju~t part of Lhe whole. It ·~ a tender part. and you should handle it with care. But like most people '' ith a disability. I don't mind if you a k about it.

In fact. you hould a\k, because it's an Important pan of me, \Omelhmg m) friend' \ ee as part of ffi) character. My fnend Anne alw ay rest a hand on my elbow in parking lots. ince ~e' era I time,. dri,ers who assume that I hear them have nearly run me over. When

I hold my head at a certnin angle, my husband. I was con~tantly startled. unnerved. agitated­

exhau. ted I felL as though Inqui,IIorial Naz1~ man old World War II film were bummg Lhe s1de of my head with a mercile!t\ white spotlight. Under that on laught. I had to break dO\\n and confess: I couldn't hear. Suddenly.( began to d1scover many things I couldn ' t do.

••• Ma,on. will 'a) . "It's a plane" or "It' '> a ~1ren ... And m) mother love~ to laugh about the thmg~ I thottf(lll I heard: last week I ''as told that "the Minotaur' m the garden are getting out of hand." I Imagined capering bull men and I wa\ dbappointcd to learn that all we had m the garden were overgrown "baby tear.. ...

I'm also a writer, a painter, a slapdash

housekeeper, I couldn't Identify ound' One afternoon.

while lying on m) ~ide watchmg a football game a gardener ... ot hearing can be funny. or frustrating.

on TV, I kept heanng a n01se that sounded like m) cat playing w 1th a nexible-~pring doorstop. I checked. but Lhe cat wa~ a~Ieep. Finally. I happened to lift my head as the noi e occurred. Heard Lhrough m) good ear. the metalhc buv turned out to be Lhe referee· w h1stle

I couldn't tell where sound' came from. I couldn't find my phone under the bhzzard of papers on my de. k. The more it rang. the deeper I dug. I shoveled mounds of paper onto the noor and finall) had to track 11 down by following the cord from the wall.

When I lived alone. I felt helples becau e I couldn' t hear alarm clocks. vulnerable because I couldn't hear the front door open and frightened becau'e I wouldn' t hear a burglar until It \\as too late.

Then one da) I mi!.sed a JOb 1ntervie\\ becau ... e of Lhe phone. I had gotten off the ubway 20 minute early, eager and dres ed to the nines. But Lhe address I had written down didn't e>.iM! I must have misheard 11. I earched the treet. becoming overheated. late and frantic. knowing that if I confe,~ed that I couldn't hear on the phone. I would make ffi) odd of getting hired even wor\e.

For Lhe first time. I felt unequal. di. advantaged and di abled. ow that I had something to compare. I knew that I had lost

\omething: not JU\t my hearing. bu t ffi) independence and my \ense of wholene~s. I had always hated to be 'een as infenor. o I ne\ er mentioned ffi) lack of hearing. Unhke a wheelchair or a '' hite cane. m) disability doc n't announce itself. For most of ffi) life. I cho~e to pass as abled. and I thought I did it quite well.

4 September/ October 1994

And once in a w h1le. 11 can be the cau~e of omelhmg trul) tran. cendent. One mommg at the hore I wa'

li tenmg to the ocean when Ma~on said, "Hear the bird?" What btrd? I listened hard until! heard a faint. unbirdlike. croaking ound. If he hadn't menuoned it. I would never have noticed 11. A !listened. <.,(owly I began to hear- or perhap imagine - a d1 tant \Ong. Did I reall) hear 11? Or just hear 1n my heart what he ~hared with me? I don't care. Song imagined are as .,,,eet as ong~ heard. and ~ong ~hared

are weeter ~till .

The sharing i what I want for all of us. We're all JU~t temporarily abled. and every one of u . if we live long enough. will become d1~abled in orne'' ay. Tho e ofu\ ''ho ha\e gotten there first can tell you how to cope w ilh phone<, and alarrn clock\. About w a) of holding a book. opening a door and leamng on a crutch all at the same time. And what it's like to give up in de pair on Thur-.day. then begin all O\er again on Frida) . because Lhere·, no other choice - and becau~e the ro~e are bcgmmng to bud in the garden.

The\e are conversations we all should ha\ e. and it'~ not that hard to begm. Just let me see your lips when you ~peak. tay in the 'arne room. Don't shout. And a~k what you want to know.

"From £1VSIV££K. "M) Tum". Ma) 23. 1994. page 10. New\­week, Inc. All rights re>crvcd. Reprinted by perrnL ~ion.

What is an Audiologist? I rece1ved the "What 1s an

Aud•ologl',t'l" brochure. and I am certain that the man on the CO\er i~ OT an audiOIOgl\1. I remember takmg the Texa., hearing aid licensure exam v. ith that pcr~on. who mformed me that he was a hearing aid "tcchmc•an"' at the Methodist Hospital Audiolog) Department m Houston, Te>.a . ll> it o important to present a "fair-ha1red boy" to the public that '' e are "illing to relegate women to the hlack and white photos on back pages" hile a non-audiologist male is put on the co' er''

It is frustrating to be in a profession dommated b) "omen and conunue to be accosted b) se\ISm at ever) tum. I have een good friends" llh excellent mmd~ and clinical sk1lls leave 1he practice becau<.e the) are sick of the "good old boy" network. One look at the A HA data on discrepancies in <;alar) between men and women is enough to make an) one SICk. I reahLe that we are lr) mg to anract more men to the field. but this is really a slap in the face.

I would hope that an orgamzation that claims to be .... Or. By and For Audiologist~" would have the guh to put a REAL one on thl\ very important handout which will. hopcfull)'. be seen b)' m1llions. We've got a long v. a) to go. bab).

Anna \lc, case-Lewis Bath. ME

Editor 's 1 ote: The abm·e letter wen fell/to Gretchl'n S\fen. Chmr of the AAA Publi< RelatlflfH Commll/ee for rep/\.

Dear Ms. Me case-Le'' 1~ : The "Whar is an Audiologist?"

brochure was developed by Jerr) orthem at the request of Lucille Beck. Academy President. m response to the need for a generic pamphlet describing the varied acth Hies 111 "hich audiologists are engaged. Due to budget and time constramts. we u ed photographs pro' ided by Jame~ Jerger. wh1ch he had used for the Baylor College of Medicme Au.D. Program brochure.

The photograph of the audiologi~t

Audtology Today welcomes comments from readers. Letters must be less than 250 words. Letters may be edtted for brevtty and clanty. LeHers to the Editor must include the writer's name, address and daytime telephone number. Send letters to Edttor, Audiology Today, 4200 E. Ninth Ave. Box 8·210, Denver, CO 80262 or FAX (303) 270·5084.

6 September/ October 1994

LETTERS TO THE EDITOR

engaged m heanng a1d dl'pen,mg was elected for the front cover because of our

desire to make the public aware that audiologiSts are pnmary dispenser, of amplification. ~e did not kno\\ that the male photograph was of a non-aud•olog•\t. However. as you must be aware. it is common practice to use models or ··set up" photographs for marketing purposes. This brochure 1s a1med at the general public: 11 is unlikely that anyone "ill knO\\ that the photograph ,., actually of a ver) professiOnal hearing aid technician who works in a med1cal school audiolog) cl1mc. It w~ simply coincidence that the CO\er photograph u<,ed happened to be of a male rather than a female. Four of the five photographs u<,ed in our brochure are of female-. .

The Academ) h~ focused on Audiology Awareness this year. and ''e now ha'e an acll\e Public Relauons Committee. We recogmte that we cannot1gnore that our member..h1p is compo ed of' arious groups and we are committed to gender and racial equality. If you are truly concerned that the AAA is still an "old boys network". I would urge you to become acuve m the orgam7ation.

Gretchen yfert Arlington. VA

Talk "Two" Hearing Aids For year, I have been trymg to get my

pauent to appreciate the' aluable d1fference between one hearing rud and tv. o hearing a1d\. It took me a long ume to tram my elf to ~peak \\lth a plural context to help build the case for bmaural amplification. An unbelievable amount of ume and journal page~ have been devoted to reporting the value of binaural amplification. Yet I conunue to read '>tatement\. m even the mo t up to date textbook~: a heanng md. fitting a heanng a1d, adJU'>ting to a hearing a1d, etc.

AI the AAA Richmond Convention general <,c~\lon the statement was made that ··The cure for sen\orineural hearing los' i a hearing aid." Reference to monaural amplification runs rampant throughout C. E' erett Koop ·., ne\\ \Ideo. in ~pile of the fact that he " a bmaural heanng aid \\Carer.

I would challenge all audiologists to con ciousl) change their spcakmg habits m an effort to better educate other<; on the 'a lues of bmaural amplification.

John Greer Clark Cincmnati. OH

Editor' .Vote: The jollmli11~ /el/(rll'us \ I!TII

w Dal'ld Ken ln. C ormm moner of the Food and Dru~ AdminiJtration. in re1pon.\e 10 a fu/1-pa'll' achertl.\ement publ11hed m the dailv ne1npaper of Akron. The Beacon J ournal prommmg the "Incredible WlmperXLnt wnmd amplificutum del'lce (which) qil'l!.~ Will mper heann~t for only S29.95".

Dear Dr. Ke\\ler: We have been folio" ing the ruling<, of

the Food and Drug Admim-.tratlon m regard~ to ad,erti.,ing in the hearing health care profess10n. Therefore. "hen we came aero. s th1s ad,ermement for the Whi<,perXLr" in our local unday new-.paper. we "ere appalled that the geneml population would be e-.:po-.ed to -.uch misinformation. Claims such as "hcanng a whisper at I 00 feet away ... "heanng like a '>Upcr hero". "hearing people loudl) and clear!) in the next room". "heanng a pm drop at fifty feet" and "never missing a word'' are all gro<,~ exaggerations.

The heanng aid mdustr) ha-, come under scrutiny by the FDA. yet advertising uch as thl\ " put1nt0 pnnt repeatedly Due

to thiS type of ad, we as audiologist\ are quesuoncd and forced to JU.,llfy the cost of a soph.s11cated heanng aid 'c"u' this ba"c amplifier

Unfortunately. the hearing impaired population is bcmg led to believe that the•r hearing lo\\ " a ''mple problem of lack of loudne">. 'ot only could the user of ,uch a de \'Ice do further damage to the1r heanng b) u mg these amphtier... the) rna) be unaware that med1cal or <,urg•cal mten cnuon m1ght be "arramed to help the1r hearing problem.

We hope that you '~ill concur w11h our arguments and will pur!>ue an aggressive stance agam" \Uch misleading and potentiall) damagmg fabnca11ons.

mcerel). Jody Lanca"er Jenmfer Van Hom-Lyman Lasa Brown Akron. 0 11

Audiologists Need Speech­Pathology License to Practice?

Dunng the pa\t I months. I have met and 'poken with A HA lobb) i't' and \taff on numcrou\ occasion, about re1mbur,cment and health care reform. La ... t year.ASHA attended an AAA Board meeung and were que\lioned about the1r cffon' to amend the Medicare Ia'', to mcludc Aud1olog) a.' a re1mbur...able profe\,1011. A HA ued th1' amendment to a hill \\hlch required Med1care carrier.. to purcha'e 3\\1\11\ e commun1cauon de' ices for 'pcech unpa1rcd paucnt~. The lci!l\lauon wa' defeated due 10 the high fi...ca l ~ote :. ...... ociatcd "ith the purcha~e of the equ1pmen1.

A I lA repre\entaii\C\ n01ed the need to repre,ent both group .... speech-language patholog) and audiO log). "hen mtroducing a leg1'lauve miuauve. In m) '1ew. the group' 1hould be \eparated \incc we are mdepcndent profe,!.ions.

Initially. as health care refom1 propo,al' were introduced 111 Wa\hington. the ··Rehablhtauon Secuon~·· of most bilb mcludcd ·· peech-Language Patholog) 'erv1ce\ and ;!Udiology:· La\t month. AAA Introduced 'pec1fic language to the enate Labor and Human Re,ource\ Committee chaired by Senator Kennedy. Initially. our language defining Audiology "a' rejected. We ''ere told that the recommended \ latutory language for re•mbur...cmcnt for rehahil1tative 'en ICC' de\cribed co\craec ~ ··outpatient ' pcech-language and audiolog) \en ice' for the purpo\e of attaining or re...roring \pcech··.

Our Academy submmed case studies which exemplified the difference ... between audiology and ~peech-language the rap) . We were \ucces~ful in having thi' language changed in commiuce.

ow. m m) \'ie". comes the most \enou\ ml\undemanding since the Academ) ha' been monitoring the health c:1re debate. The Hou ... e \ ay' and Mean\ Commmee ha~ amended and created a ne'' \lib-section to proposed committee bill that is ti tled. ·· pcech-Language Patholog) en ICC\: Audiology Sen ice,··

ubsection 3B read ... : ""The term ·qualified aud•olog1\l· ... (I) 1\ licensed as a speech-language

pathologist the state in which the indi\ 1dual fumi\he~ \uch !.en icc!.. or

(ii) in the case of an indi\ idual who

VOLUME 6. NO 5

LETTERS TO THE EDITOR

fuml\hc' \en ice' tn a State" lm:h doe' not licen'e '-peech-languagc pathologl\1\. Ia qualified aud10logt\l " a pcr...on '' ho) ha\ 'uccc"full) completed 350 clock hour.. of 'upen l'ed climcal pracucum .or ... upcn ised full -umc 'peech-language p:uholug) ... and completed a n:uional c\a1111nauon m ,pecch­languagc patholog~ .. : ·.

Th1' language will he changed. The Acadcm) ha' rct:uncd a lobh) ing lirm to monnor and amend leg .... l:lll\ c acu' IIIC\. Ju,t thmk. though. lithe Academ) wa' not monuonng lq!l\lat1on. aud10log) \\ Ould he a -.uh-,pec•alt) of 'peech-languagc p:nholog)'

BaiT) A Freeman Clark" llle. TN

International Sensory Aid Society

Dunng ~ Ia) of 1990. a group of \Cholar' met 111 ydne). Au\lralia for the fiN lntcmauonal Conference on Tactile Aid\. Hcanng Aid' and Cochlear lmplam~.

In the cour\c of that conference it wa~ decided that the group. and other intere.,ted paniC\ would meet b1annuall). rotating the meeting' among three conuncnt ... Au\tralia. 'orth Amenca and Europe The ... econd

conference in the \eric., wa' held 111 tockholm 111 Ma) of 1992. and the tlmd 111

Mmm1. Florida in May of 1994. l::.ach conference mcluded three days of paper pre,entatlon' on <,uch 10p1cs a' mnovative approachc' to deaf education U\lng tactile a1d\. ba-.c research on taculc ... en\111\ it}. comparam c \lUdiC\ of performance of 'ariou' scn\Of) aids (mcluding hcanng mds. cochlear Implants. and tactile aid\!. and methodological mquines.

The group. nO\\ called the International cnsory A1d~ oc•cty. 1<. adm1111\lcred b) a

'>lccnng commlllee wnh member\ from all three contmcms. A chairpcr...on coordinate~ each conference and <,en es a two-year term of office. The current chalrpef\on 1s Frans Con1n\ of the 1 etherland\. The fourth conference 111 the ~ncs IS to be held 111 the \pnng of 1996 111 int- 1ich•ehgc\lel. Holland.

I would in' ite any imere\led profe\\ional\ 10 JOIIl our soc1ety or make plan, to a11cnd our 1996 conference 111

Holland Addnional information rna\ be obtamed b) "mmg to D. K1mbrough Oller.

n1ver\ll) of Miami. P.O. Box 016 20. MCCD D-820. Miam1. FL 33 134.

D. Kimbrough Oller Mmm1. FL

Scott Haug Retreat The Tenth Annual Sco11 lfaug Ifill

Count[) Aud1olog) Retreat w 111 he held eptcmhcr 29-0ctober 2. 1994 at the Inn of

the H1ll' Re,on 111 beautiful Kcm die. Texa\. Kcm ille" located in the hcan of the Texas Hill Country. within ea\) dnvmg di,tance from both San Antonio and Au,un. The Retreat " well kno\\ n for II\ out\tandmg conunumg education opponunnic' and facult). coupled '' ith a 'anet) of mformal acti ' itics. \Uch a<, ca,ual group dming. nightl) ho,pltalit) suite\. dancmg. ,pecml entenammclll. and a genemu' allotmem of rela\ed outdoor 'ponmg e\cnh. \Uch J\

golfing and canoemg. Sco11 Haug was an oul\tandmg )Oung

chmcal audiolog1~1 from Au,tln. TX who died une,pcctcdly in 1984. lie loved people and our profcs-.on and ga'c to nmuch ume and encrg) He affected people and the profe\\IOn The Scoll Haug Foundation wa' established after hi\ death b) hi\ fncnds a' a non-profi t orgaml3tion "uh the goal of celebrating the things Scou held so dear. The Retreat was organited 111 1984 through much dedication and commitment frorr hi' friends: and the format. \ellmg and the quaht) of program and facult) are cho,en "nh care to reflect cott"' commnment to both profe,s1onal excellence and mh.:raction among friends and colleagues.

The l\\elve hours of contlllUinl! education arc designed for audiologi't'. heanng a1d dispen'>er .... ph) \!Clan,. manufacturers and other.. tn the hcanng health care profession.

For mformation comact: Celeste l lillin. President. coli Haug Foundauon. P.O. Box 2221. Austin. TX 7 76 . (409) 962-5796.

Call For Nominations • ommauons tor the offices of Prestdcnt­Elect and Board Member-at-Large olthe American Academ} of Audmlog} tor terms begmmng Jul) I. 1995. can be made by any member of the Academ}. All nominations from the member...h1p will be con idered by the NominatiOn\ Comminec. Please submit your nominauons b) October I , 1994 to: Lucille Beck. Chair. !';ommations Commmee. Amencan Academ) of Audiolog). 1735 !';.Lynn St.. Sunc 950. Arlington. VA 22209-2022.

AUDIOLOGY TODAY 7

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.l> t I

FEATURE ARTICLE

Evaluation of the Adult with Hearing Complaints and Normal Audiograms

We arc ccnain that for a number of )Cars a large number of Lhc md1' •dual ~ eeking audiological evaluation\ v.ere wondcnng if the audiolog1s~ te ting them didn ' t have

hearing problem~ them~clve\. Many of the c ind1vidual appeared m our clinic!> and offices with compl aint~ of hearing difficu lties that largely went unheeded. as rout ine peripheral asse~smcnts revealed .. normal heanng:· What we hope to do in Lh1s brief article i\ to incrca. c the av.arcnc~ of the audJOiogJcal community to the \Cry real hearing problem\ experienced b) \Orne mdiv1dual~ w1Lh normal audiograms. To accompli; h thb we a~k a number of question~ and offer our responses to these question\? Finally. a case is profi led which demon\ trates the existence of an underlying auditoi) proce . ing di\Order in an adult v.11h normal pure tone Lhre hold\.

What arc the 'ymptom~ reponed by the c ind1' •duals? Symptoms often mclude inordinate difficult) hcan ng in noi y or reverberant environments. difficulty learn ing a foreign language or technical cour\C\ where the vocabulary used i ~ largely unfamiliar. difficulty taking notes. difficulty follov.mg long complex direction\. d1fficulty hearing on the telephone. tinnitus locahtcd 111 the head a<. oppo!>ed to the car;. and lac!. of mus1c appreciation. Many of these !.ymptoms arc shared by individuab wi th cochlear hearing Impairments. but in the ind i vidual ~ under discus\ion cochlear function is normal with a fev. exception<. that wi II be dbcussed belov. . 8) far. Lhe m0\1 common complaint in the general population • .., difficulty heanng 111 noi e. v. hlle complam~ of difficulties learnmg foreign language\ and poor notctal.mg skills are much more common among students pursing postsecondary educational degree~.

Is this a new problem? We think not. Mo~t of U\ have alt!.cs. ed 1ndi' 1duaJ<. v. ith <.igni ficant complamt\ 10 the past. and more than lil.el) have on one or more occa\JOn\ dJ \ JnJS<.ed a chent that complained of hcanng difficulties becau~e the aud1ogram wa~ "norn1al. .. This wa\ not uncommon m the paM a' adequate te\ ting procedures and paradigm. were not availab le to readily uncover the~c dcficiLs. Howc,er. advance m clcctrophy iological a' well as beha' ioralte. t procedure over Lhe pa!tttwo decades ha'e pa, ed the v. ay for audiologJ\1\ to not on I) document the existence of such hearing problems, but al o to potentially idcntif) the ba\ il> of the difficult ies. und to tailor management programs to the individual needs of the client wilh such problem~. Also. the increa c in Lhe number of indh 1dual identified wuh th1~ t) pe of problem can be attnbuted to the pcr;1stencc of some md1\ idual~ to ;,eel. out addn10nal C\ aluatlon 1 f not sall~fied '' 1th the ongmal diagno'h- a situation that was not nearly as common in the past.

What il. the basis of the problem'! There docs not appear to be an) one ba.\i\ for the problem. There are in fact a number of potential ba;e v. hich mclude the follov.mg: ( I) ubtle subchmcal comprom1~c

of the peripheral hearing mecham m. (2) central auditOI) deficit<, related to a number of factor<, ... uch a\ frank neurological compromJ!.C. more subtle cerebral morphological abnorn1alit1es. and normal ag1ng proccsse~. (3) cognitive deficit\. (4) psychological/emotional

Submiued b.' J A E A. 8 A R A . Uni1-ersm of MassaclmseltJ. Amherst. and FRA K E. M U I EK. Darrmoruh-flitchcock Medical Center. Lebanon. NH

VOLUME 6, NO 5

deficit!.. (5) language differences. and (6) change~ in acou~tic environment. Recent!) . Saunders and Haggard ( 19 9) ha' c co1ncd Lhe term ob!.cure auditOI) dy function (OAO) to refer to the audHOI) difficulties experienced b) some individuab with normal audiogram~ whi le avoiding pecific pathophysiological connotation!.. In their discussion of the topic they identify orne. but not all. of the potential base~ outlined above. It is clear from our clinical experience\ that the underlying bases of the problems m Lhis group of individual' arc numerous and varied. In some of these individuals clear pathophy iological base:. can be establi bed. In other ca!>e . the deficits may be more difficult to link to a specific underlying etiological ba!.i!.. Moreover. in many indl\ iduals more Lhan one etiologic basi!. may be in' olved. For example. an indiv1dual v. ith a central audHOI) proce sing deficit may a),o have an auention deficu or a psycholog•cal/emotional problem.

When '>hould one test? We would recommend that funhcr tc Ling be pur!.ued in at leas t two instances. The fir\! is whenever a client pre\ent\ w1Lh auditory compla~nt. that are di<oproponionate to the measured threshold sensiu,.ity. Later \\C '~•II profile a ca'e of a young woman "ilh clinicall) documentable hearing deficit\ m 'Pile of normal pure tone Lhrcsholds. The second Jll!.tance where fun her te Ling is indicated invol ve the individual who return. repeatedly w1Lh Lhc same or similar (often ubtle) auditory complaint . A ca\C that comes to mind i a) oung indi' idual who" a\ repeated I) referred for audiolog•calte!.ting b) hi\ grade choolteachcf\ because of thc1r concern that he \\altn·t hearing quite right. This md1' idual wa<, tc\lcd each year for five years and on each occasion he wa:. dism•s~cd a\ having an aucntional or behavioral problem because his pcnphcral auditoi) as\e sment revealed .. normal .. hearing. When in the \ ixth grade we evaluated Lh1 )OUng man and agam found normal peripheral auditory function, ho,~ever. given the persistence of h1s referrals. " e pur!.ued a central auditory as c ment. The result' of this addi tional testing documented the pre ence of a central auditory processing di~order and result. of a subsequent computed tomography scan unco,ered the presence of a large tumor in,oh mg a ubstantial portion of Lhe right hemi phere. lntere!.tlngl). other than the ubtle hearing problem~. no other neurolog•cal deficit e;~. J,ted

which would have heralded the presence of the tumor in this case. Although this individual was a child and not an adu lt as b the topic of thi paper. h1s case clear!) demon. trates the importance of puf\mg further a..sse ... sment when pershtent auditOI) complamts exJ\1\ ­e\'en if they are mild in nature. Similar ci rcumstances can ai\O occur m adults. panJcularl) in cases\\ uh demyehnallng d1seases. '' here the fir 1 signs may be auditory deficits.

With all the possible bases hov. should I proceed? In <.orne ca ... es the ba..sis could be determined upon careful que!.lloning dunng an mitial audiological e\·aluallon. For example. a chent "ho prc,em' "ilh s•gmficant audit Of) complamts of recent onset ma) be ha' 1ng difficulty because of orne change in the acousllc environment. Al<,o. it may be possible to tease out Lhc difficulties of the individuah who\e fi rst language is not English a\ being related to hi!. lack of fam1 hanty wilh the phonological !.)Stem\ and hngui llc convention' of Engh\h ralher than some underlymg neurological or cognllJ\e bas1. . These difficultie. which may be compounded by noi\c may be 1den11fied b)

AUDIOLOGY TODAY 9

FEATURE ARTICLE

Frequency (kHz)

. 25 .5 1 2 4 8

0 1--

1 0 I-

2 0 ~

30f-

40 r-

50 1-

60 r-

7 0 1-

8 0 1-

90 - RE=70% B i naura l=74% 1 0 0 - LE=70%

Figure 1. The audtogram and speech recogmtion scores for a 19 year old female With stgnificant auditory complatnts. Note: Adapted from Neuroaudiology: Case Studies (p. 274) by FE. Mus1ek. J.A. Baran. and M.L Pinhelfo. San Diego: Stngular Publishtng Group, Inc., 1994.

~imply probing if the arne difficu lties are noted when li~tenang to a familiar peaker in one' native language. Observation of one's behavior during the interview and any reported h1 tOI') ol p-.ychmtric/ psychological problems may pomt to an milia! explorauon of a p ycholog1caVemouonal baJ.il> for the auditOI') complaints as opposed to an auditory basis.

If the mterview and ob ervauon~ of the indh 1dual fail to suggest an} of the base li ted above. then further auditory a. essments ~hould be undertaken. In our assessment. \I. e ' ' ould advocate a top down strategy: that IS. teslS of h•gher auditory function should be undertaken first unles~ there is some convincing evidence suggesting that procedure taping lower pon 1on of the auditOI') system should be completed. This evidence may include the pre cnce of \ Crtlginou ymptomatology, balance problems, and o forth. Otherw•~e. clinical

experience indicates that the ' :ll>t majorit) of the proce\Sing deficits identified in thi population are centrally mediated. Therefore. use of te lS ensit ive to dysfunction at this le, el \I. Ould be prudent. These could include behavioral tests such as dichotic speech tests and temporal patterning te t . a well as some electrophysiological procedures uch aJ. the middle latenc) re pon e and the late audnol') evoked potentiaL . If thc<.e te 1\ fail to elucidate the basis of the auditory problem~. then te lS such as auditory bramstem response. masking level differences. and other tests sensitive to dysfunCtiOn at the level of the brain tern hould be utilized. Finally. as there doe. appear to be ufficient evidence that in some of these individual\ ubclinical cochlear com prom be may exi t. then additional testing of

10 September/October 1994

cochlear fu nction rna) be warranted. Th1s could mclude otoacousuc em•ss1ons. as well as tests of frequenc) resolut ion and so forth .

Case Pre entation /li.\Wr\

Th1s woman was 19 ) ear. ol age ''hen ' ' c sa'' her for an aud1olog•cal evaluauon some ten years ago. 1 Atthat ume '>he '' as a sophomore in a <>mall private college and presented with significant auditory complaints. This young woman wa maintaining an A to AB H\ erage at a 'Cl') competiu' e college. Her primal') mouvation for seeking an e\ aluauon was a hope that \\e could pro' 1de her with some a's1stance m obtaining penn is 10n to take her quahf) ing exams for medical school on an unumed bas1s. The young woman reported s1gnificant difficult} hearing in no1se and followmg lectures but reported that she had developed a number of strategies to help her deal '' ith these defici t . he reponed that the course that \\ as giving her most difficult) was An I listOI'). '' hich '' as urprising in 'ie'' of her O\\n admisSIOn that '>he enJoyed an and cons1dered herself to be some\\ hat artbtic. There "as no signi ficant history of hearing or otologic problems. and no di agno~ed hl \tory of learning disabilities. I lowevcr. upon questioning. the young woman reponed that ~he had never learned to read cur.ive messages. nor could ~he " rite cur.ivel)­with the exccpuon of her name. he md1cated that ..,he had attended a pri' ate school for mo ... t of her academ•c trammg and that the teachers "gave up teachmg her to \1. rite'' in the founh grade. She has and continues to rely on printed text for reading and notetaking. Although she reads quite well. ~he does feel at a d•sad\antage on timed te..,t\ a ... ... he behe,es she 1S slo,,er because her audllOI') problems effect her ability to rcauditori7e the text she IS readmg. Aud1olog•cal EvaluatiOn Results of a pure tone thre.,hold te ... ung fell well w11h1n nonnal II milS lor both ears (Figure I ). Of concern. however. wa..'> a I 7 dB d1ffercnce between the pure tone average and the spondee threshold for each ear. Abo. of interest were word recognit ion '>COres of 70~ for both Carl>.

with a binaural score of only 74%. Since di fficulty hearing m no1se \hiS a primal') concern. additional pcech recogniuon te ung was conducted at 50 dB HL m the pre<,cnce of an •p..,ilateral while no1se (+ 10 dB Mgnal-to-noi<.c ratio). Scores of 16% and 8% correct Ident ification were noted for the right and left ear .... respecti vely. A number of beha\ ioral central tests '' ere admim\tered ( ee figure 2). Perfonnance was bilaterall) deprcs<,ed on two dichotic speech tests (dichotic rhymes and staggered spondaic words). a monaural low redundancy ... pcech test (compre sed speech) and two temporal pattern ing te..,ts (auditOI') duration patterns and frequenc) pattern sequences). In additton. te. t perfonnance was borderline nonnal for the right ear and mild I) depre ed for the left ear on a third dichotic <,pecch test (dichotic digits). In addition. auditory brain tern and late potenual \\ ere conducted. The earlier potentials were nonnal . while the later potent ial were detennmed to be borderline nonnal.

Commems The result\ document the "auditOI') difficult ic," thi woman is

C\.pcriencing. !though her peripheral hearing "ensitivity appears to be nonnal. there i strong e' idence of central im ol\ ement. Vinuall} her pcrfonnance on all the behavioral test W:ll> abnonnal. A somewhat unu'>ual finding in thb case is the poor word recognition scores even in quiet te't conditions. Although. w ch deficits arc unusual 1n cases of central auditory processing deficit. . the) can and do occur. What became apparent throughout the cour e of the

FEATURE ARTICLE

DR DO SSW cs A DP FPS

100 f-

90 /"\ -f-

80 f-- X f- 0

70 I- X 1- f-u w 60 - X 0: 0: f-0 u so 1- X 1-z t-

0 w u 40 I- 0 0: w Q.

30 f-- ---- X X f-

20 r-0

1 0 .__

0 0

0 Norma l Ra ng e

Figure 2. Behavioral centra/test results for the individual described m Figure 1. Test results are presented for the right (0) and leh (X) ears for three dichotic tests (DR = dichotiC rhymes, DO = dichotic digits, SSW= staggered sponda1c words), one monaural/ow redundancy speech test (CS = compressed speech), and two temporal patterning tests (ADP =auditory duration patterns, FPS =frequency pattern sequences). Note: Adapted from Neuroaudiology: Case Studies (p. 274) by F.E. Musiek, J.A. Baran, and M.L. Pinheiro. San Diego: Singular Publishmg Group, Inc., 1994.

evaluation was that this young woman relied on peechreading cues 10 supplcmcm her processing of auditory information .... hcnce her difficuhie' with Lhe Ar1 Hi tory course arc more under tandable. The instructor's Myle of teaching w:u. 10 u e slide~ w1Lh liulc room lighting. In this case this woman had 10 rely solely on her impoverished auditory abi lities to procc s the information being pre cntcd.

In addition 10 Lhc above test. she was seen for JQ testing and neurological evaluation. Her IQ fell within the normal range. but wa.' fell to be an underestimation of her actual intelligence ru, her auditory and reading deficits arc li kely 10 have affected performance. Result. of the neurological evaluation were csscmially normal. II was the neurologi. t's opinion that the reading. writing. and hearing difficulties were likely related to dysfunction in the common as ociation region where the occipital. temporal and parietal fibers converge. We were able to as ist this young woman in obtaining pcm1ission to take her qualifying exams in an untimcd fom1a1. She \ ucce sfully completed her undergraduate degree and went on to medical chool. We have recently learned that she hal> completed medical chool. The ca)>e clearly demonstrates that adult can experience significant auditory deficits even though peripheral hearing sensiti vi ty is normal. Moreover. the case demom.trates Lhat the presence of uch ~evere hearing and related learning problems does not preclude uccc sful completion of a postsecondary degree and entry into a demanding profession.

VOLUME 6. NO 5

Conclusion The e\'aluauon of the adult with normal peripheral hearing hut

\lgnificant auditory complaints " a challengmg. but rewarding endeavor. There arc many indi vidual~ with apparently ·•normal hearing:· who ha'e ' 'cry real auditory complaints. Man) of thc~c deficit~ can be documented by careful audiological testing. The Identification of thc\c deficit~ arc crucial to the management of the mdividual with such difficulties. In \orne cases. the symptoms may be <.igna lling underlying neurological comprombe, wch a\ in ca!-.e\ v. ith multiple ,c)erOSIS. In ~uch ca<oes appropriate medical management b mdicated. In other case~. documentation of the "realny" of the dcficns b ,ufficient. In such indi' 1duab ~elf-esteem and <oe lf-confidence are often restored immediately once a diagnosis i\ made. In other ca'e~. 'omc ~imple compensatory .,tratcgies rna) be all that i ~ needed.'' hilc 111 other case .. more comprehcn~ive management programs may be needed. However. none of these action~ can take place if "audnory complaint continue to fa ll on deaf car\:· /$."•/ Footnotes

1Thi case ha., been reponed in pan previous)) (Mu~iek. Baran. & Pinheiro, 1994. )

Author·~ ote: At this juncture we would like 10 mention that this young woman participated in a research tUd) . Therefore. more central auditory te. 1 were adminbtered Lhen would be routine)) admmi tered for clinical asse~sment. The entire 1e.,1 bauery is provided here for illustrative purpo~es only ru, it clearly demonstrates the severity and pcrvasivcnes~ of the auditory deficits that this young woman experiences.

Author·~ otc: Due 10 pace limitation~ we \\ill not be able to review Lhe test ~pcci fications and \coring procedures for each of the 'even behavioral tests adminiMered. The reader interested in our test protocol as well as original references for each of the tests ~hould refer to Musick. Baran. & Pinheiro. 1994.

References Mu"ck. F 1:.., Bamn. J A, & Pmhe.ro. M 1.. ( 1994). euruaud1olug~ Ca.<c \lUdic\

S•n D1cgo. Smgulnr Pubh\hmg Group. Inc aunde,...., G II • & ll•gga.rd . .\I.P t 19!19). The chmcal a.'-.e"men1 or obscure aud1IUI)

d~,runcuon Ear Jnd lkanng. 10. 2Q0.20X f1llman. T W. & Carhan. R. ( 19661 An expanded IC\IIor 'pccch dhcnmmauun

uuh11ng C 'C mono') llab1c worth 1\urthwcqem Umvcr<ll) Auduory Tc\1 No 6. Tcchmcal Report No A 1-TR-66-55. Brook~ A1r Fort:c BJ.\C. TX USAF School or Acro;pace Med1cmc

Address correspondence to: Jane A. Baran. Ph.D. Department of Communication Disorder~ University of Mas a~:huscll'

Box 304 10 Amherst. MA 0 1003-0410 Telephone: (4 13) 545-40 I 5 Fax: (4 13) 545- 1264.

AUDIOLOGY TODAY II

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SPECIAL REPORT

Illusions and Audiology: What Can the McGurk Effect Tell Us

About Communicative Function

This article describes a unique field of re5earch in the area of bimodal COIII/IIImicotions and the imeraction oj.~ensory syste11u. The McGurk Effect illustrates a phenomenon in ll'hich differing t•isuol and audiwry inplll.\ results in 11/le.lpected illusion. The interaction between t•isual and auditory input leads 10 distortion in comprehen fion OJ a result of non-corresponding inp111. Although thi\ area of re~>earch is will in a preliminary stage, further im·estigation may ret•ealnew infonnation abo111 auditory processing.

H uman . peech . ru. a fo rm of communication. • ~ primarily perceived through the aud itory cha nnel. Conseq uently. audio logist have a tendency to examine the audi tory ystem

in i o la tion. a' if it were independent of the other ~en~ory sy terns. However. the perception of mo t speech ac~ is depende nt on in fom1ation proce~. ed

throug h multiple systems. pan icularly vision. This dependency o n other ~en\ory \yMems

become\ more critical to the l i~tener \\hen the ~peech ~igna l is degraded duri ng production. presented in the presence of noise. or incorrectly perceived d ue to a hearing loss and/or cemral auditory proces\ing di,ordc~. Accord ing to

Summerfield ( 1987). the role of' is ion in

Inter en o ry Interaction

lnter!>en~ory interaction is defined a~ the perception of an event. when measured in one ensory modality. is changed in ~ome manner d ue to concu rrent stimulation in one or more of the other 'cn~Of)'

moduli tie~. O ne of the more common fonns of intcrscn!>ory interaction. is the ventriloqui rn effect. Thi occur\ when visual and auditory cues are presented in a manner to provide di\crepant information about spatial location. When faced with this di crepant 111formation. ob. ervcrs tend to hear the ~ound to be near or at ih !:teen location. The nece\l>ary conditiOn\ for the evaluation of intersen ory

interaction are (Welch & Warren. 1986): • The measurement of the nature of the percepuon of an event

\ ia one modality ( uch as the percepuon of a stimulus word during

most word recognition testing). and

• The mea ure ment of the perception of 1he same event via the same modal ity while another modality i being stimulated

imultaneou. ly. If the perception by mean. of the primary modality diffe~ as a function of

the presence or ab e nce of the \econd modal ity. then intersen ory interaction

occur . Theories o f inter en. ory interaction

assume that the sen. ory modalities are

speech perception i to ( 1) direct the auditory analyses to the primary \peech signal rather

than other aud itory s ig nal. in the envi ronment . (2) provide segmental

information con\idcred red undant to tho~e c ue p rovided acou tically. and (3) pro\'ide complementary information to tho. e cue provided acousticall y. For example. a li stener

" Intersensory mteracbon may lead to unexpected

functional!) differentiated in imponant ways

both physiological!) and perceptually: however. they also as umc 1hat1 he senses are organi1.ed in a manner that infonnation

presented to multiple rnodalitic' interacts to

affect I he overall proces ing of a panicu lar sen ory event. An example of ho''

S S ..

can perceive that a speaker i happy ba. ed on audi tory cue' a lone (Murray & Am ott . 1993) but this perception i. s trong!) re111forced when the liMener see a mile on the speaker'\ face.

The pu rpose o f thi s anicle i~ to . umrnarLw \Ome of the research regarding how the perception of speech in one modality (audition) can be in n uenced by concurrent activi ty in other sensor) modalities.

Specificall). what is the role of inte~en Of)' interaction or bimodal perception in commun icati \e fu nc tion? W ith the increasing complex ity of aural rehabil itation model . questions regarding the ro le and scope of visual and audiovisua l effect!> on speech perception become an integra l pan of the clin ical crvice in audiology (GagnA. 1994 ). e\ era! theoretical models have been propo,ed to addre s the e ffec ts of rnu lt irnodal speech perception (Braida. 199 1: Massaro. 19 7a. 1987b. 1992: S ummerfield . 1987. 1989).

Submiuedby MI C H AE L K. W Y E. lndianaUnh·ersity School of Medicine and M A R Y J 0 GR OTE. IVichita Swte University.

VOLUME 6. NO 5

stimulation in two modalities can affect auditory funct ion i. provided in a tudy by

Froehlich. Collet. C hana!. and Morgon ( 1990). The\e authors found that the transient e\oked otoacoustic emissions in some

subject were ignificantl y decreased during a visual ta\k. Although the effect wa!> not fou nd in the majority of their subject~. the intersensory interaction was con-.istent over time in those subject for \\hom the effect occurred. Using rnagnetoencephalographic (M EG) recording' to determine the conical area where bimodal effects occur for speech ~t i mul i . Sams et al.. ( 1991) found distinctly different

magnetic fie ld maps and wavefom1s between matched and unmatched bimodal presentations of speech ti muli across their adult -.ubjccts. They concluded that it is possible to affect the processing of

\peech sound. in the human auditory conex by vi,ual input. Early \tudic~ b) Binne, Montgomery. and Jachon ( 1974) a

well a. Dodd ( 1977) provide suppon for intersensory anteraction of audi tory percept ion. Binnie and his colleagues fou nd that when CV -.yllables were presented bimodally to normal hearing adu lt\. the

'isual cues greatly reduced the number of peech recognit ion error~. panicularl} fo r "place of aniculation" error~. u ing eve words and

normal-heanng adolescent;,. Dodd ( 1977) reponed ~•rn•lar re ults indicati ng that \'h.ion decrea ed the error patterns d ue to confusion

AUDIOLOGY TODAY 13

SPECIAL REPORT

regarding the place of aniculation. In addition. numerous authors who measured Lhe peechreading capabilities for ubjects with hearing lo s have reponed that the bimodal pre~entation of timuli (audition and vi ion) yield the highest peechreading ~core when compared to the ·cores obtained from measures u ing pre entations via a single modality (Danhauer. Garnett. & Edgenon. 1985: Erber. 1972; Garstecki, 1983). It appears Lhen that multimodal pre. entation of speech yields the highe t intelligibi lity. However. the multimodal pre entation of peech also can lead to an inter ensory bias in what i perceived when di crepancies occur between what is heard and what

een.

Intersensory Bias Intersensory bias for peech occurs when the listener's

immediate respon e is influenced by one or more modalitie when di crepant event occur aero the e modalitie . The magnitude of the intersensory bias is influenced by stimulu and respon e variables (Welch & Warren. 1986). Stimulu variable~ include variou~ structural characteri tic uch as the degree of Lhe tructural di crepancies aero the stimuli within each modality. Re ponse variable include those biase introduced by the ob erver proces including the ob erver· pecific and general experience with bi ensory event . the ob erver' s cognitive as umptions regarding the unitarine s of the distant event Lhat are being perceived, and the degree of attention directed to the two or more modalitie during the perceptual proce . One mean of studying hO\\ intersen ory bias influences multimodal perception b to examine the MeG uri.. Effect (also known as Lhe McGurk Illusion).

The McGurk Effect When Lhe audio recording of a speaker pre enung a syllable

initiated by one consonant i ynchronized wilh a video recording of the speaker presenting a syllable init iated by a suitably different con onant. many observers will perceive a yllable initiated by a consonant that is not represented in Lhe individual modali ty alone. For example, when an auditory lb I is presented simultaneously wilh a visual/g I. a Lhird syllable /d I often is perceived. This is known as Lhe McGurk Effect (McGurk & MacDonald, 1976; MacDonald & McGurk. 1978). In many listeners. they are not aware that a discrepancy even existed and often need to have each modality pre ented in isolation to convince them Lhat their percept was an illu ion. The McGurk Effect is present for bimodal presentations running in either visual/place direction: however. Lhe reciprocal of what wa presented earl ier. an auditory /ba/ coupled with a visual/gal does not produces a perceived /da/. but rather a perception of an extra consonant./bga/.

The effect i quite Lrong and nearly unavoidable for many listeners whereas Lhe perception of a few li teners to thi di crepant timuli pre en tation simply are biased to one modality- more often

to Lhe aud itory percept. It has been elicited over a range of variables such a the loudness of the pre entation. the phonemic content of the speech. Lhe emant ic appropriatenes of the peech. the age of the listener. and the native language of the li tener (Dekle. Fowler. & Funnel l. 1992: Fowler& Dekle. 199 1: Green & Kuhl. 1989. 1991; Green, Kuhl. & Meltzoff. 1988: Kuhl . Green. & Meltzoff. 1988: Kuhl & Me ltzoff. 1988: Ma saro & Cohen. 19 3: Seki yama & Tohkura. 1991: Takata & abelek. 1990). The McGurk effect remain present for many li teners even when a male peaker i paired with a female face (Green. Kuhl. Meltzoff. & Stevens. 1991) or when the speaker i

14 September/October 1994

presented in an invened (upside-down) position. Similar effects abo are een with nonspeech auditory stimuli (Kuhl. Williams. & Melt.wff, 1991 ). Although when the unitarine s of the ob erved event i violated. such as v.hen Lhe syllable are imultaneou ly heard and seen in an onhographtc forrn (spelled). the effect IS absent (Fowler & Dekle. 1991 ). The effectts also absent in adults v. ilh left hem1sphere le ions uggesting a left hemisphere pecialization for the phonological integration of what is heard with what is seen (Campbell. Garwood. Franklin. Howard. Landis. & Regard. 1990).

Electrophy iological l easures of the l\lcGurk Effect Several recent s!Udie have attempted to u e

electrophysiological measure to provide an objective measure of human peech perception and the re ults have been quite promi ing when using unimodal timuli (Kraus, McGee. Sharma, Carrell. &

icol. 1992: Krau et at.. 1993: Sharma. Krau . McGee. Carrell, & icol, 1993). At this Lime. very few studie have used

neurophysiological measure to inve tigate human speech perception using bimodal or eros modal paradigms. Sam .. et at. ( 1991 ) s!Udied Lhe magnetoencephalographic (MEG) recordings of ten adults to determine the conical area where bimodal speech perception ta ks were integrated. Vi ual lka/ wa paired imultaneou ly wilh auditory /pal 16% of the time, the remaining presentation~ were matching auditory/visual pair. of the e CYs. They reponed that the matched bimodal stimuli respon. e re em bled Lhose Lhat can be elicited by "any kind of abrupt ound" and were located in the supratemporal auditory conex. The non-matched bimodal timuli elicited a di tinctly different wavcfom1, staning at 180 msec. recorded above the supratemporal auditory concx from Lhe matched stimuli in even of their subjects. The experimenter · concluded Lhat bimodal presentations of speech information "may have an entry into the human auditory conex" and that "neuromagnetic respon es to acoustically identical but perceptuall} different auditory stimuli indicates that it i po ible to affect the processing of speech sounds in Lhe human auditory conex by visual input."

In her recent doctoral dissenation. Grote ( 1994) used Mismatch cgativity (MM ) to inve ligate whether an event-related potential

could reflect difference between bimodal presentation of peech ·yllable in a conjugant condition (matched auditory and visual stimuli) from those peech yllables in a di conjugant condition (di crepant auditory and visual ~limuli eliciting the McGurk effect). All 15 of the young women in thi tudy had normal hearing and had indicated a strong tendency to perceive the McGurk effect, even with rapid rates of presentation. Although there were large inter ubject differences in the latencie and ampli!Udes of the MM re ponses for all ubject . MM re pon es were obtained for all ,ubject in both condition . An analy i of Lhe waveforrn indicated no significant or distincti ve difference between the two conditions aero or within subject . However. preliminary analy i uggc t that the conditions may have cau ed changes earlier in the wavefom1s, speci fically in the

I or d components.

Hearing Lo and i ual Biasing A expected, when adults were asked to rcpon what Lhey heard

when presented with conflicting multimodal presemation of speech timuli. their perception were dependent on Lhe integrity of their ensory sy tem . A !Udy by Walden. Montgomery. Pro ek and

Hawkins ( 1990) provided evidence that hearing-impaired li tener rely more on visual information in a bimodal presentation than

SPECIAL REPORT

nonnal-hearing individuals. even when audit ion for nonnal-hearing listeners is degraded by the presence of noi e. That is. people who experience a reduced auditory input over time become visually oriented. Thdr conclu. ion~ were ba ed on u~ceptibility in an informational paradigm \\ here added amb1gu1ty mthe auditOI) chan ne l lead~ one to re ly on the channel with less ambiguity. which in thi s case was vision. Using an experimenta l paradigm similar to the McGurk Effect. a videotape of a male subj ect saying /ba/ wa presented in ~ynchrony with a to tal of founeen CV random pre en tat ions created electronically to sound clo e to e ither /ba/./da/. or /gal but not quite. The ir subject we re in tructed to identify what they heard to what ounded mo t like /bal. /da/ or /gal. onnal heari ng ubjects were still able to make the selections based on what was heard and not een quite well when listening in quiet. The hearing-impaired ubjects indicated a visual bias of /bal. that i . choo ing /ba/ more often becau e that was what was seen. A similar bias wa indicated by the nonnal-hearing group listening in the presence of noi c. but not as much.

In a second experiment . the same founccn auditory stimul i were pre emed while a male !.peaker simuhaneously presented a visual repre entation of saying /gal. Subjec t were to choo e between /bal.

/da/ and /gal in relauonship to what they heard. Vi ual bia ing wa evident for all listening situations. onnal-hearing listeners rarely cho e /ba/ as they clearly did not . ee /bal. However, when the visual stimu li clearly showed that the peaker did not !.ay /ba/ as there was no vi ible lip clo in g. the number of time the subject!. chose Ida/ or /gal (the only other poss1ble cho1ces) was about the arne. Heanng­impaired listeners were often able to make the line visual distinctions between Ida/ and /gal more accurately. According to Walden and hi colleagues ( 1990). this may ha\e been due to a propensity for hearing­impaired listeners to learn to rely on visual cues O\er time as auditory input i degraded due to the hearing los .

The result of the Walden et at. ( 1990) study ugge t that the visual bia~i ng in the peech perception of adults with hearing loss takes place naturally over time. Their results indicated that older adult!. w1th nonnal peripheral auditory and vi. ual systems tended to respond to the McGurk effect in a much more robu t manner than did younger adult. and children. In addition, the older adults with mild to moderate hearing losses and no history of speechreading training tended to have a greater tendency to perceive the vi ual timuli in isolation much more frequently than did their matched control with nonnal hearing. Thi would suggest that a comprehensive model of aura l rehabilitation for adul ts should include mea ures of multi modal speech perception in order to address this type of visual bias ing and how it might effect the efficacy of treatment.

Conclus ions The perception of peech is, in most ca es. a muhimodal event.

The lis tener i pre ented with a multitude o f cue from a varie ty of ource aero s a number of modalities. It is a dynamic and robust ystem. In l>pite of the advance~ in technologic to improve the

perception of the auditory ignals. peech perception will continue to be strongly influenced by the visual processing of speech events. Consequently, audiologists must move beyond a unimodal approach to aurol rehabi litation to fu lly addre the communicati ve needs of the ir pat ients. '\

References Bonmc CA. Montgomcl) AA. Jacbon PL ( 1974). Auditory and visual contnbutlon< to

the perceptiOn of com.onanls J !>iJI!erlr Hear Res 17· 608-618

VOLUM E 6. NO . 5

Bmtda LD ( 1991 ). Cn1'~modal mtegmlion m the rd.:ntrlicauon of con,onanl s.:gmenl' J E.rpumr~tllal PS)clr 43i\!3J: 647·677.

Campbell R. Garwood J, Frnnkhn S. Howard D. Lltndr< T. Regard' M I 1990) Ncurop~ycho logtcal studtc' of auditOI)-\I<ual lu<ion tllustons. Four cu.-.c "udres and lhctr tmphcauons Nrumpnchnlogw 28: 7 7·802

Danha""r JL. Garnett C \1, Edgenon BJ I 191!5) Older pen.on\ pertonnancc on JudiiOI'). ''sual. and audiiOI')·'t>ual pre><!ntnuon\ of the Edgenon and Danhilucr '\()n>cn>c Syllable Te>t £Dr Hear 6: l9l·197

Dekle OJ. Fo" ler CA. Funnell MG. ( 1992). Audro' r<ual mtcgrauon m pcrccpuon of real word< Pucept Psycht>llhy.< 51: 355·362.

Dodd B ( 1977). The role of 'tMon m I he perception of <peech. Prrctpllon 6 31-40. erber NP ( 1972) AudriOI'). v"ual. and audrlory-\tsual rccognttlon of consonant< b)

chtldrcn "rth normal and tmpatrcd hcnnng J Speech Hear Res 15. 407-412 Fo"lcr CA. Dekle OJ ( 1991). LISlemng \\llh t)c and hilnd CrO>\-modnl

contnbulrons to speech percepuon . J E.xpenmenwl Pnch 17· 816-828. Fruchhch P, Colle! L. Chana!. JM. ,\!organ. A ( 1990). Vanabth t) of the mnucncc ol

a' 1>ual tru.~ on the acltve mtcromcchanical propen rc< of 1hc cochlea Bram Res 508: 286-288

GagnA JP 1 1994). Vi,ual and audrovisual 'peech percept ron trutmng: Ba;,tc and applied rc'iCarch needs. J At"ad RehabAud 27(Monogmph Supplement): 133- 159 GaNec~t. D. ( 1983). Aud11ory. ' tsual. and combmed aud llory-vi<ual speech

percepuon m )OUng and e lder!) adull5 J Aclld Rehab Aud 16: 22 1·233 Green Kt>. Kuhl PK ( 1989). The role of vrsual mfonnauon m the proce>\lng of place

and manner features m speech perccpuon. Percept Psclrophys 45· 3+-12. Green KP. Kuhl PK. ( 1991 ). lntcgrnl processtng of vtsual place cue' and audiiOI)

'oictng tnfonnauon dunng phoneuc perceptron J E:lpenmental Psw:h /Iuman Pucept Pufnnn 17 278-288.

Green KP. Kuhl PK. ,\lelllolf AN ( 19 8>. Facto" affc.:ung the inlegmlr()n ofaudttOI) and' "ual mfonnalton m <pecch: The cffecl of 'U" cl envrronmcnt. J Acoumca/So<· Am 84 155.

Green KP. Kuhl PK. Mellloff A • Steven~. EB ( 1991 ). lntegrntlng <pecch mfonnatlon across tnl~c~. gender. and scnSOI)' modnh1y· Female face' and male votcc< m the McGurk effect Puupt P.schoph)'.f 50: 524-436.

Grolc MJ. ( 1994 ). E•·o~~d Pntenttals Dunng Btmodal Spe«h Puuprum Unpubh<hcd Doctoral Dt~SCtUltiOn. WichtLl Stole Unl\·crslly. Wtchltn. KS

Kmu' '· Mc:GeeT. Shamul A. Carrell T. 'lrcol T ( 1992). ~h,match nc~atl\11) e\cnt­related potenual ehcned b) pccch ~Ltmuh Eor H~ar 13: 158-164

Krau' N. Mrcco AG. Koch DO. McGee T. Carrell T. Sharma A. Wtet RJ. Wcmganen CZ. ( 1993). The mtsmalch ncgall\'11) contcnl e'o~ed potcnual ehc11cd by 'peech m cochleat-~mplanl usc~ llellr R~uarch 65: 118-124

Kuhl PK. \lcluoff A.' ( 1988). The b1modnl percepuon o f speech m mfanq SctMce 218: 1138· 11-ll

Kuhl PK. Wtllirun<. KA. \leluofl. AN. ( 1991 ). CI'O\O·modal speech perccptton tn aduh< and tnfanls usmg non,pccch audiiOI) ~tlmuh J E.xpenm~ntal Pnch Humnn P~rcept Prrfomr 17 829·8-10.

Murray IR. AmottJL ( 1993). Toward the Stmulatlon or emotion m <)nthetl• 'pccch A n:\le\Oo of the literature on human vocal emouon J Acous11cal St){' Am 93 I 097·1108. McGur~ H. MacDoltllld J ( 1976). Heanng hp> and !>Cetng vorccs Nature 264·746-

748. MocDonald J. McGur~ II ( 1978). Vt>ual mOuen.:co. on <pccch perceptiOn procc,>e<

Percept Pnchophy.< 2-1 253-257 Ma-..'>l!ro OW ( 1987a). Catcgoncal pantuon A luuy logrcal model of catcgonzauon

behn\•tor tn · Hamad S, ed Categorical Puapwm. Tht Groundwar~ tif Cogmtwn ·cw Yor~ Cambndgc Unrverstt) Press. 25J-283 Mru."'ro OW (1987b) Speech pucepllan by enrand ne A paradt~mfor

ps.\·c·holo}ltcal mqutT). lhllsdale. . J.. Lawrence Erlbaum A <Socrates 1\ la.<'>llro OW ( 1992). Broademng the domam of the fuuy logrcal model of percepuon

In: Pte~ IlL. Van den Broc~ P. Kntll DC. ed\. Ca}lmlltln · Conupwal and ~fetlllldologicallssuu \\ ~hmg1on. D. C. Amcncan p,ychologtcal A\M>Ctatton

Mns'>l!ro OW. Cohen MM ( 1983). Evaluation and m1cgmuon of '"ual and auduory mfonnatlon tn speech percepuon. J Expenmemal Pnch 9: 753-77 I

Soon' M. Aulanko R. Hamalatncn M. Han. R. Lounnsmnn S L. StmolaJ ( 1991 ). Seemg 'pccch Vl\ual mfonnalton from hp movemcnl5 modrli"' activuy tn lhe human auduory cone~. Veurnsn Le11ers 127· !41-1-15.

d1yama K. Tohkum Y (1991). McGuti.eflccl tn non· Enghsh ll\lene"' Fev. nsual effect~ for Japanese subJCCI< heanng Japane<e '>liable< ofh1gh auditory tntelhgtbrht) J Acouwral Soc Am 90: 503·509.

S hamta A. K.rnus • McGee T. Carrell T , Nicol T ( 1993). Acoustic 1crsu' phonelrc n:pre«:ntallon of >pccch 3> re0ected by the nt"rruttch negativity C\•Cnt·relaled polentla( I:EG Clm v~,.raplnsial 88· 64-7 1

Summerfield. Q ( 1989). Vr<ual percepuon of phonetic gesture>. In \llaurngl) IG. cd lftldularrt\ anJ the Motor n.~on· of Speech Pur~ptwn. Htllsdale. NJ l..av.rcncc Erlbaum A~tation" 117·137

Summerfield. Q. ( 19S7J. Some pn:hmrnnnc> to" compn:hcn>~vc .1ccount of audro­"'unl \peech perceptio n In Campbell R. Dodd B, cd~ . flet~mrg b1 £1~. London: l...:twrence Erlba um A~soctalcs. 3·51 Tn~atn Y. abelc~ AK. ( 1990). English consonant recogmuon m not'iC and rn

re\erberatron by Japanese and Amencan lt\tcncr>. J At:allSIIcnl SO(· Am 88. 663-666 Walden BE. Pros.:~ RA. Montgomcl) AA. Scherr CK. Jones CJ ( 1977). Effects of

tr.unmg on the v1sual recognttton of consonants J Spu< h flet~r R~J 20 130 145 Welch RB. Warren 0 11 (1986). lnterscn..ory tnlemcuons. In: BoffKR. Kaufman L.

Thoma.< JP. eel.. Handlmo~ of P~rt:"eprwn and llllmOII Perfomrnnce: Volume I. Sensory Procc«c' and PerceptiOn. ew York: John Wr ley and Sons. 25 1-36.

AUDIOLOGY TODAY 15

./"'"'... I

I I

n

Who Is Olsson. Frank and Weeda? 0/uon. Fran~ and \Veeda. P.C . i1 a

\\'aslungwn. D.C.. /au finn rhm lw.l rc•c·emh become legtslafll't! mw1sel to AAA. The firm reprewm.1 clients bt'fclre Congres.1. Federal and Stare agencier. and the Federal Court\. 0/Hon. Fran~ and ll'eeda has Tl•O area1 of fpecwll:arion: Food and Drug/Healll1 Care and Food. 1 utrtrwn and A s:riculrure. The firm H COII/I .lei ro a number of corporation\, including pharmaceuflcal. mccine. and medical dence ma111t[acrurers and di.ltrtburors. and trade associations mcludinf( the arwntll A.uocimton of Plwmwcewical Mamifacrurers and the• American School Food Sen·ice Assocwttml. 0/Hon. Frank and \Veeda has been acfll'e 111 the legi:,/aril·e arena includinf{ /egislllftl'l' dmfrinf< and lobb\lng.

Marshall L Mm: spent sen?n yean on Capiro/ Hill- fi1·e as General Colmst•l fO

the U.S. Senate. Select Commiuee on 1 wririan and Human eeds. and then ru·o

1cars af Special Counsel ro the Senme CommiHee on A f{rtntlmre. wrirwn and l·orelfn. While on Capuol Hill. Mr. Mm: de1·eloped a rpecwlry 111 the area of food and nwririon. Since join ing 0/.rson. Fran~ and

\\'eeda he has broadened his area lt/ e1perrire and ha1 applted Ius le~islaflre 1killr w the Food and Drug Admmmrarwn and health care.

Chris Marku.1jomed Olsson. Fran~ and \Veeda in /992. She H a graduate of the Collef(e rtf \Villiam and Mary and rhe Un11'erllfy of l' 1r11111ia School of Lou. u here she 1mr a Food and Drug Lit" Scholar for 1991-92. Ms. Marku.1 IUtmemher of horh the Virr:i11ia and \Vtnlun!~Um. D. C. Bar A r wciarions.

SubmiHed b,· M ARS H ALL L. M ATZ. ESQ . (//1(/C HR IST I A M . M AR K U . ESQ .. Ol1son. Fran~ and IVeeda. P.C .. 1\fmlrmr:ron. D.C.

16 September/October /994

WASHINGTON WATCH

Health Care Reform

I n Augu~t 199-1. \ a'hington i' focw,cd on health care reform. A~ Congre ~and the Prc"dcnt a~ptrc to tad.le one of the mo't dtflicult and 1mponant legislau' e task' of the 1990\. Ill\ cructal for AAA and it member-, to be 111\0ived 111 the legtslall\e proce\\,

upponmg the mclus10n of hearing care service' in the health care benefit\ package that '' under de,elopment.

Hearing care ~el'\ icc<. (i ncluding pre,enu'e and rehabilitathe audiology ~ervice<. and hearing aid' for chi ldrenl ha' e been included. to' arying degree~. in four dtfferent bill'> crafted b~ 'eparate committee'> of Congre<.'>. The mo<,t fa, arable language comes from the en ate Labor and Human Re ... ource' Commmee - chat red by enator Edward Kenned~. of Ma sachusett~- which 'pcctficall) co' er-. cenain audiolog) '>en ice' in it<. benefit~ package. The Congre'-'tonal leadcn.hip mu~t now combine the four committee bills and other very di1er..t: refom1 propo,al' into a -.ingle piece of legi'>lation that will be acceptable to a maJOnt) of the cnatc and the Hou'c of Rcpresentati,cs. and to Prcstdent Clinton. Acuve ad,oca<:) of heanng care coverage. therefore." ill pia) an all -tmponant role in the next <,e,eral month'

AAA has taken 'igmficant 'tep to promote the co' eragc of hearing care ~el'\ icc''" pan of health care reform. The A eadem) recently ~c nt the letter repnntcd on the next page to the following member~ of Congre"'· "ho ''ill be kc) player<> in crafting the Congre<."omtl "leadcr<,htp" bi ll : Hou e of Representati,·e : Majonty Leader Richard A. Gcphardt CD-MOl Chairman Sam M. Gibbon' CD-FL) Chaim1m1 John D. Dingell CD-MI ) Chairman Will iam D. Ford CO-Mil Chaim1an Joseph ;... toakle) CD-MAl

cnate: Majorit) Leader George J. Mitchell CD-MEJ Senator Thoma<, A. Da<,chle CD-S D) Senator David Pryor (D-AR) Chatrman Daniel Patrick 1oynihan ( D- Y J Chatrman Edward M. Kennedy (D-MA J ~linorit) Leader Bob Dole (R-KS ) Senator Bob Pack,,ood CR-ORl

enator John H. Chafec ( R-RI ) Senator Da\ id F. Durenburger (R- 1 )

cnator John C. Danfonh (R-MOJ

Although AAA ha' made a ~trong begtnmng 111 <.upponing hcanng care coverage for the Amen can public. gi,·en the magnitude of the legi~latl\e ta~k Congre~' face-. and them) riad or chotec it will have to make. 11 i~ extremely imponant that a; man) AAA member, and allied organitation~ a~ po;;ible al\o \end letter to the li ted Congre;sionalleaders. Representat ive-. from indi' tdual member,· di,trict . or other lcgblatOr \\ ith a \pcctfic tntcre<,t 111 hcanng care. are tmponant targets of heanng care advocacy. too. AAA member\ <,hould feel free to paraphra~c ho all letter-. aren't tdentical) and pcr\onali7e AAA·, letter to Congre<,<.. Mo<,t important I). member; ~hould WRITE! The addre;,-. for all mcmbcr\ of the Hou<.e of Representative<, b :

The Honorable _ _____ _ U .. House of Rcpre<,cntati\C'-\ a\hmgton. D.C. :w: 15

The addrc..' for all member' of the Senate b : The Honorable _ _ ____ _ U. . cnate \\ a<,hmgton. D.C. 205 10 If\\ e all " ork together. AAA and it. member\ can promote the inclu,ion of heanng care

- ju-.t like 'i\lon care or dental care - sci'\ 1ces 111 the emerging health care reform package.

WASHINGTON WATCH

<JE" r

~~} .~ ·~

July 15. 1994

The Honorable Rtchard A. Gephardt Majority Leader U.S. House of Reprc~entative Washington. D.C. 205 15

Re: Hearing Care en ices/Health Care Refonn

Dear Mr. Gephardt: The American Academy of Audiology (AAA) is the national

profe ional organillltion repre enting health care practitioners who specialiLe in the evaluation and treaLment of people with heanng to . I am wntlng on behalf of AAA to urge the 10clu ton of comprchen\ive heanng care ~ervice for children and adult 10 the health care rcfonn package the Congre is crafting. Specifically. AAA recommends incorporation of the following language 10to the btll being crafted by the Congres ional Leaden.hip.

··ctintcal Prevenuve Services" Plea e 10clude: "Routine ear and hearing examinations and

diagno i for defect in hearing for children and adult as pan of a clinician \tSit. Hearing examination' for newborns for the prevention, identification. and management of hearing dt . orders in children."

"Outpatient Rehabtlttauve Sen tce " Please include: "Outpatient audiology therapy:·

" Hearing Care" Please include: a. ··coverage- The hearing care described

in thi section b routine hearing exams. diagnosis. and management for defects in hearing ...

b. ''Limitation - Hearing aids are covered for individuals up to age 18 when recommended by a physician or audiologi t.''

Hearing loss can have ignificant ps)chological. ~ocial. educational. and occupational consequence . Health care refonn hould guarantee effective hearing care for all citizen . Thank you

for your consideration. Please call with any que tions that you or your '>taff ma) have.

Sincere!). Roben W. Kei th , PhD President. American Academy of Audiology

VOLUME 6. NO 5

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COMMENTARY

Audiology and the Americans with Disabilities Act

Lilune DeWme

T he American\ 11 llh Dl\.lbil lliC\ Act !ADA I 1'- \\CII under 11a} . The la11 charge' the federal go1emment \\ uh the re,pon~ibihty for enforcmg the 'tandard' and prm 1\ltln, 11

~ct~ fonh. H011 e1er. there arc no ''A DA pollee·· to mor11tor 11 h1ch faci lit ie' arc in compliance. Educ:Jtlon regarding the pro1 1\IOn\ of the ADA·~ needed for ALL Amenc:~n,. c'pec1all) for aud1olog•''' AudJologJ'-1\ need to learn the ADA and mtorm the1r heanng-1mpa1red pallent<Jchenh ahout 11. helpmg to change th1' legJ,Jauun 1nto )J, 1ng )a\\ .

The ADA pro1 1de\ A CCI::. IBILITY for Amenca·, -B million di,:~blo.:d people. It expand' ect1on 50-1 of the Rehabilitation Act ot 1973. 11 h1ch prohibll'> d•,cnmmauon againr.t ··qualified·· md11 1duaJ,. The la11 guarantee' acce" for people 11 llh dJ\abil111e' 1n

cmplo) ment. public accommodation. tran.,ponauun. \tate and local go1emment \Cf'ice,. and h.:: lecommumcauon' The ADA detinc'> a d•,abled per~on a!> one 11 1th a ph) \I Cal or mental1mp:urmcnt. a record of 'uch an 1mpa1rment. or one regarded a-. ha1 mg \Uch ;m 1mpa1rment.

The ··•mpa•rment·· mu\1 'ub,tanuall) limit a maJOr hie ac111 11~ 'uch a' hearing. \\ alking ... eemg. 'peal-mg. brcathmg. lcammg. \\ orl-.mg. and caring for one.,clf. Protccuon al'o co1 er' l':lrner\ of H.l. V. 1 1ru' and indi1 iduals ' ' 1th temporal) dJ\abil lt ie., . Although the ADA co1 cr-. those 11 ho have 01 crcome drug and alcohol problem\. 11 e'l:pre\\1) c-.clude' current u'er.. of Illegal drug'

Pre,•dent Bu\h \lgned the ADA 1nt0 lav. 111 Jul) 1990. but m<hl of II\ rcqUJrcmenh became effect I\ c 111 199:! or 1993 Th1' all011 ed bu,mc\\e\ and 'tate and local gm emmenh 111ne 111 learn lh pnll 1\ Jons and to budget for II\ requ irement, . mall bu,ll1e\\e\ 11cre allo11ed e'en more umc

The Equal Emplo) mcnt Opponunuie' Commi\\Jon ( t:.£:0 ) 1\ rc\pon\lble fort he enforcement of Tule I v. h1ch became ctlectll e for bu.,me\\e' v.uh 15 or more empiO)CC' on Jul) 26. 199-1 Tule I proh1b1t' dJscnm111a11on on the ba'•' of di,ablluy b) emplo)er,. cmpiO) ment agenc1c\. and labor orgamtatJOn\ Tulc I became effecme 111 Jul)' 199:! for bu,Jne"e' 11 uh 25 or more emplo)CC\.

• Title I protects qualified dJ,abled job applicant\ or 1\UrJ,er' 1n

regard to application procedure,. hiring. advancement mcnt or di\charge. compensation. benefit,. JOb training. and nthcr h!rr11\. condlliOil'-. and pri1 ilege' of crnpiO) mcnt. A .. quail tied .. d1,abled per~on meet~ job-related requirements and can perlorm c"cnual tuncuon' 11 1th or l>vllhout rca,onable accommodauon .. E\\cntwl JOb functiOn,·· are tho,e \\ h1ch arc fundamental to the JOb.

A .. rea~onable accommodation .. rna) include mat..mg tacii111C~ accc,~iblc: re\tructuringJob duuc ... : chang1ng \\Or!.. hour~. modlf) 1ng cxammauon~. trainmg rnatcnah. or pollc1e~; bu) 1ng cqu1prncnt 1\uch a' a'~l\lll'e listening dc1 ICC\ or -.pecmltelephoneq, or rno<hf) 111g eXJ\IIng eqUipment: and pro1 1d111g qualified reader' and Interpreter' The rea,onablc accommodation 'hould not rc\ult 111 .. undue hard\hlp .. ~•gnificant difficult) or c-.pen\e A fe11 of the factor, 11110hcd 111

Submiued b.' L AUR IE D E W I E. Commumcmum Trai!JIIIf?/

Con\ulrmg Service\. Cm'IIII(Um. liY

20 September/October 1994

dc term111111g undue hard\hlp are. the \1/C of Lhe ernpiO)Cr. the financwl re,ource\ of the parent compan:r (if there 1\ one). and the nature and co\1 of the propo~ed accommodation. An ernplo)er I\ not requ1red to recogn1Le a d1,abll ng condition. The ernplo)eC or applican t mu~t Identify h1\/her dJ,abil ity and request a re;J'i<>nable ac:comrnodauon 111 order to reCCI\C it.

Title I aho proh1b11' hara"rnent or an) other forn1 of dJ,cnrmnauon aga111'1 qualified 111d11 1dual becau\e of h1.Jher rehliiOn\hlp or a\\OCiallon 11 11h a per\on \\ 11h a kn011 n dJ,abllll) . The term' .. relauon,h•p or a.,.,ocmuon .. refer to farnil) rclauon~h•P' and ;HI) other ~OCHJI or bu\me" relauon\hlp or a\<.OCJallon. The Technical A\\btance Manual on the Employment Pro' b1on' CT11le I 1 of the ADA pr01 1dC!> an e-.ample: .. An cmplo)er rna:r not refu'e to h1re an 111d11 1dual becau\c the 111d11 1dual ha<. a spou,e. ch1ld. or other dependent 11 ho ha' a d1\abllll) . The emplo:r er rna) nOt a<.~ume that the 111d11 1dual v.lll be unreliable. ha1e to U'>C lea1e umc. or be awa) from 11ort.. 111 order to care for the farnll) member 11 ith a di\abllll~ :· Ho'' c1 cr. an ernplo) cr., not obligated to pro11de a rca\onable accommodation to a nondi\:Jbled md11 1dual Another example \late\. .. The ADA does not requ1rc that an employer pr01 1de an employee '' ho 1\ not d1~ablcd 11 1th a mod1fied 11 ork \Chedule a' an accommodation. to enable the employee to care for a <,pou'e or child 1111h a d•,abllit) ··

' ) mbol of cce for Hearing- Impaired People

• Title II . v. hich i'> enforced by the .S. Depanrnent of Ju\lice and c1ght federal agcnc1e\. affect\ public 'en ICC\ and tran,ponauon and proh1b1t' tate and local go1cmment' from dJ,cnmmaung again'-l d1'abled people. Go1cmmental dcpanment~. la11 enforcement agcncJC\. public hbrane~. uncmplo) ment office'>.

v.elfarc office,. and counroorn-.. etc arc mcludcd under Title II a<. I' tran..,ponauon pr01 1ded b) public tran'll authoritJe\. commuter rail au thonue ... and Arntral.. .

Title II ~peci fic5 that go1ernment agencie' mu't pr01 1de ..auxlllal) aid\ and services:· The\e include a 11 ide range of \en icc' and de\Jces 111cluding. but not lumtcd to: a\\JSII\C listemng de1 1ces and') \tcm .... qualified 1111erpreter,. notetal..er... 11 ritten rnatenal,. tclccornrnun•cation dc1 1ce' !TTY' \1. telephone hand,et amplifier,. telephone' compatible '' 11h hcanng a1ds. 1 Jdeote'-1 d!\pla) '· computcr-:uded tran\cnpuon \Cr>viCC\. clo\ed capt1on decoder\. and open and clo ... cd captiomng. tate and local go,cmmcnt rnu\1 g1\C pnrnal) con\1derauon to an 111d111dual"' <,pecific accommodation rcquc't. wherea\ pri1atc bu,me"e'. tho,e affected by Title Ill of the ADA. arc on I) 'trongl) encouraged to do \O.

Tille II e\tend' protection to people '' llh dJ\abllllle' 111 man) agenc1e' th;ll were not co1 cred b) Section 50-1 of the Rehabilitation Act of 1973 becau~e the) d1d not rccc11e federal fund111g. In the pa\1. heanng-1mpa1red people could not U\C ecuon 50-Ito file a complaint \\hen denied '>Jgn-languagc interpreter ~en ice~. for e"~:ample. 11 hen the) ''ere needed for counroom procccd111gs. 011 deaf and hard-of-

COMMENTARY

hearing people can rei> on the ADA to pro' 1de them With equal acces~.

Though most of Title ll took effect m January 1992. Amtrak and commuter rai l {including thei r stations) have variou' compliance dates. State and local governments. regardles' of ~11e. '"ere co\ered b) emplo) ment nond1 cnmmauon as ol Januar: 1992.

• Title Il l. in effect ince January of 1992. i~ enforced b) the Depanment of Justice. It prohibits di crimination on the ba is of di ability in place~ that serve the public. or ··public accommodations:· Public accommodations include reMaurants. hoteb. public transit \tat ion . cinemas. schools. pons faci l i t ie~. 100s. mul>eums. shopping center . doctor · and Ia" yer · office .. etc. All ne\\ place of public accommodation and commercial facili tie'> must be designed and built 10 be accessible to per:.ons with di abi lities.

e" faci lities include those which applied for bui lding pern1 ih by state or local governmentS after January 26. 1992. and those with a fi rst cenificate of occupanc) issued after Januaf) 26. 1993. Ponion. of publ ic accommodations or commercial faci lities altered after Januaf) 26. 1992. are required 10 be acce\sible and usable b) individual with di abilitie . ''to the maximum extent feasible:· Private club and religiou groups do not fall under Title Il l. (**Hospitals and other facili ties operated by religious groups receiving Medicare payments or other federal monies are covered b) Section SO-t: con equentl). the) too must accommodate di,abled people.)

Title Ill i of pamcular mtere 1 to deaf and hard-of-heanng people and those who serve people wi th hearing loss. Secuon 36.303 specifies that pubhc accommodations must prov1de auxiliary aids and services to communicate effective I) with cuqomers. clienh. patients. or panicipant~ with di abilities affecting hearing or speech. Becau e hearing loss i an invi ible di ability. heanng-impaired people must ask. for as~i uve technology or services neces~ary to communicate effectively. lnfonnation about these technologies and services should be available from Audiologist . It's imponant for Audiologists to encourage hearing-impaired people to ask for auxiliary aid' and services. even if the) don't ee signs adven1smg the1r avallab1ht). (Some busine ses have panially complied" 1th the ADA and purchased assistive listening systems. yet fail to place s1gnage. as requi red b) the law. near ticket windows or entrances.)

Telephone en•ice

• Title I requi re. the Federal Communication\ Commi. ion (FCC) to enforce ADA regulations regarding telephone sen•ice. This section requi res telephone companies to make telephone sen ice~ acce s1ble for per on "ith speech and/or hearing impainnent'>. The) do this through telecommunication rcla)

l>ervice . which provide a communication a sistant \\ ho has both a TTY and a voice transmi sion telephone. The relay operator receive. a mes age from one pan y. tran. fonn the message into the other pan y' fonn of communication. then passes it along. Interstate and intrastate telecommunication relay -.en•ice~ were required no later than July 26. 1993. Title IV also requi res the clo ed captioning of all

VOLUME 6. NO 5

public sen1ce TV announcements produced or funded by a federal agenc).

Bu\ine\S owners. management. and employees of public accommodation\ must learn ways 10 accommodate all of their patron~. All employer<, need to examme the1r hmng practices and modll) them as requ1red b) the ADA. Audiologl\1~ need to learn the ADA and teach the1r patients/clients abou111. Kno" ledge gained from learnmg the law. coupled with its distribution and application. will result in positi'e changes. These changes. no mauer how mall. will renect the desi re to move tOward a shared vision of equal ity and acce sibilit). A\'\

References "ADA Acce"tbtht) Guideline> for Butlding' and P.lcihuc,, L:.S An:hiteciUrol and

Tran,ponauon Barner. Compliance Board.'' Frdcrnl Rt'l/tlrrr. Fnda). Jul) !6. 1991 \merrn m< ll'ttlt Orwhtllll<'<. Pracucr nnd Ct>mplta!IC<' \Iammi. Chap1cr ~. Publ1<

Accommodation•. L.'l")er> Coopcramc Pubh<hong. 1991 "Amencan~ "nh 01\abthlle' Act In Bncf. Focu' on Emplo) mcnt, Public

Accommodauon,, Tron,ponauon. Tclecommunocauon,," f~tlaal Rt'~ntu. Pan' I. II. Ill. I\ . and\. Fnda) Jul> 26. 1991

A rrchmcal 4mnanu {/mwal nn th~ Emplmmt'nt Prmmon< (Tttlc /J nJ thr \DA. Equal Empln) ment Opp..>rtunll) Comm"'oon. Janu:tl) 1992

"Fact Sheet on: Emplo) ment En1roncc Medocal Exammauon. Arc the) Beneficial and Legal".'' The l'rc<idenl'' Comrnoucc on Emplo) mcnt 01 People "nh 01\abthuc,, Sept. 20. 1991

"Fact' Aboul Dt..abohl)." The Pre,odent', Commottec: on Employment ol People "llh Dt\llbthlle\, \ larch 1992

Pubhc La" 1 01-~~6. "An ·\cl. pp IJ~ · 18-1. Ft'dt'ra/ R£~/SI<r. Jul) 211. 1990.

:i For legal advice. contact an auorney 'pccializing in the ADA or call the ational Center for Law and the Deaf. Gallaudet University: (202) 651-5373 (VffDD).

..J For addiuonalmfonnation. comactthe followmg agencies:

Equal Employment Opponunit) Commis~ion Office of Legal Counsel: (202) 663-4177.

U.S. Dcpanment of Justice ADA Hotline for questions mvolving pubhc accommodauon provi. ion of the law: (202) 514-030 I.

U.S. Architectural and transponation Barriers Compliance Board: (202) 271-5434.

AUDIOLOGY TODAY 21

makes Quick Check a fast .and e¥y way .to determine if tbere·s a problem with the h~in~ aid or just the battery. lfs also an ideal way to carry ~are hearing aid batteries. For ease and convenience. it's an 'Open. and -shut case.

Energ~ e:; ~

Auditory Society Meets The annual meeting of the American

Audtto ry ocict) wa~ he ld in conj unction with the XXII International Congres~ of Audiology in Halifax. 0\3 cotia. Approximate!) 140 AuditOI) ociet) mcmben. auendcd the one-da) ~e ~ ton"' htch tncluded traditional re~earch presentation~. a ~pecial ~ession on the diny patient. as well a'

scientific po~tc~. The 1994 Carhart Memon al Lecture wa' presented by Moe Bergman who spoke on " Audiology-A 20 th Century Odyssey" . Bergman ts current!) Professor of Audtology at the acklcr chool of Medicine in Tel-Aviv UniveNity in l\ rael.

Auditol') Societ) President. Deborah I lay c .. announced the pre . entation of a Life­Ttme Achte,ement honor a"'arded earlier thts year to Kenneth Berger. In addiuon. Ro. s Roeser was honored as he stepped do" n from 22 yeaN of sen ice to the American Auditory Society a.s Secretary-Treasurer and member of the Executive Board. Wayne Staab has been appotnted the new Secretary­Trea.surer. and continues to en·e a.~ ednor of the Amerrcan Audiwry Soetet) Bulletm.

American Auditory Society Pres1dent, Deborah Hayes. congratulates Moe Bergman from Israel. Bergman IS the 1994 Carhart Memorial Speaker.

Audiology Today Will publish news of organizational and mdividual member's ac1JV1t1es and honors, as well as top1cs of general mterest. Subm1ss1ons may be ed1ted for brev1ty and clanty. News and Announcements must include the wnter's name. professional affiliation, address and daytime telephone number. Send to Edllor, Audtology Today, 4200 E. Ninth Ave. Box B·210, Denver, CO 80262 or FAX to (303) 27D-5084.

VOLUME 6, NO 5

News & Announcements

USA Board Member Dav1d Lilly (left) and George Mencher (right), President of the Halifax. Nova Scotia meetmg, workmg at the lntemallonal Congress of Audiology m Halifax.

International Audiology Congress

A world-w1de assemblage gathered tn ova Scoua during July for the XXII

International Congress of Aud1ology. orne 600 delegate~ representing 49 countnes gathered to paruc1pate tn 4 maJor round­table discus,1ons. vie\\ 40 scientific po'ters and lbten to :!30 free paper pre. entauons. The largest contingents tncluded 165 delegates from the host count!) Canada and 139 registrants from the United States. George Mencher erved as the International Congress President and "'~ re pons1ble for the orgamzauon of the meeung.

In add1uon to numerou. opportumue~

for sc1enufic Interchange. an ou~tand1ng

\OCia l program provided for entertainment and tours of the beautiful ova Scotia landscape. The grand opening cere mon) fea tured the parade of nag and the peclally commiSSioned class1cal mu 1c p1ece. "T innitu.,·· \l.nllen by Jo hua Fe ltman. a young composer of contemporal) music. Gerhart Salomon of Den marl.. and President of the International ociety of Audiology. presented an award to i\larion P. Downs as the 1994 Me mber of Honour.

The XXIII International Audiolog) Congress IS held every other year and is ne \t '>cheduled fo r Bari . hal) from the 16-20 of June. 1996. The Director of the c1enufic Program b Profes. o r Antonio Quaranta. Audiology-Otolog) Center. Unhersit) of Bari . Policlinico- P.Zla G. Cesare. II. 70124 Bari. Italy.

Jon Shallop embroiled m a lobster battle (above) while Jeff and K1m Danhauer enJOY local cuisme (lower photograph) at the "Down East FestJva/" at the lntemalional Audiology Congress m Nova Scotia.

Pediatric Speech Perception &

Amplification Conference

D ecember 16, 1994

The Lex tngton Center, Inc.

Center for Rc earch m peech anJ Hearing cience of CU Y

The ew York League for People with Hearing Lo

.7eatured c5peakers Jame F. Jerger, Ph. D. u an W. Jerger, Ph.D.

RicharJ C. eewa ld, Ph.D.

For mforrnation/ regi rrauon

call Mart Bakke at (71 ) 99- 00 ext. 333

AUDIOLOGY TODAY 23

HEAR NOW! Audiologl'>l\ are JOinmg force~ "' ith a

national non-profit orgamLallon. HEAR 'OW man effort to recycle heanng a1ds and

pro, ide hcanng a1d :lS\1\tance to children and aduh~ '' ho cannot afford the technology the) need. A reque\1 for u~ed heari ng aid for HEAR OW was recently memioned 111 the nationally\) ndicated t\nn Lander column. kicl..mg off HEAR ow·s "Help Amenca Hear .. carnpa1gn des1gned to ra1~e public awarene "of IS uc <> regarding hearing los'>. hearing help. and the efficac) of recycling u cd hearing ::uds.

HEAR , OW. based 111 Den,er. Colorado. ha., pro' ided nearl) 00 hearing a1d<. <.O far th1 )Car 10 ch1ldren and aduh h' mg mall pam. of the L'nited States. The e umated ' alue of de' 1ces and en ice~

prov1ded <.O far th1s )Car totals O\er 560. . Bem1ce Dmner. audiolog1 1.

founded the orgam/auon 111 19 and ince that ume has coordinated the effom of hearing aid manufacturers. and audiologist to pro' 1de O\ er 2 mllhon dollar-. 10 hearing health care as i. tance.

HEAR OW worh 111 partner hip" ith audiologist\ from C\ery ~tate in the nation. representing a w1de 'ariet:v of hearing health care setung~. AudiOlogiSt<. " ork 111 pannenh1p "'1th HEAR ~0\\' b) donating the1r professiOnal \Cf\ 1ces 10 qualified HEAR. 0\\' heanng a1d recip1entl.: and b) donating used heanng mds to HEAR :-.10\\' for recycling. Comribuuon~ of used hearing aids 10 HEAR OW are full) tax deductible. For more mformauon call toll free ( 00) 64 -B27

- Submwed hv Linda Henry Demer. CO

Research Grants Available The auonal Organi~ation for Hearing

Rel.earch " ill a"' ard grams of approximately -.000 each. pnmanl) 111 the form of eed

money. for e\plorauon 1010 10no' ati\ e research areas 111 the pre' enuon. cau~e and cures of heanng los<. and deafne s.

Rc earchcrs and climc1ans qualified in the field of audi!Of} ~c1ence rna} appl) . Gram upport 1s genera II) prO\Ided for one )Car. The deadhnc for subm1s ion of apphcauon<> 1'- October I. 199-t For addiuonal mformauon and application materials. contact The auonal Organizauon for Hearing Research. 225 Haverford Ave ..

arberth. PA 19072 (61 0) 664-3260.

24 September/ October /994

WHAT'S HAPPENING?

New Hearing Journal HmHlod Academ1c Publishers

announced the 10augurauon of a new JOUrnal for heanng '>CICnllsl\. The eduor "Ill be Peter Dallos. Auduory Physiolog) Laboratof). 1 orthwe\tern Umversity. 2299

orth Campus Dri, e. Evan\lon. IL 6020 . The fir~t i"ue "ill be available during the fa ll of 199-l

Auduon Neuro.\Cil!nce \\Ill be dedicated to keeping pace\\ uh rap1d ad,·ance<> 1n the field Audunn NeurosCience " ill publish ongmal. authontath e re earch 111 the form of full length paper . hort commumcation\. and h1gh qua lit) re' iew<> of audit of) neuro,cience research. The JOurnal 1 orgamzed around 10p1c' d1' 1ded 11110 SC\Cn secuons.

.J cell and molecular b1olog)

.J de' elopmem and pla~IICH)

.J peripheral <.)<.terns

.J central y terns

.J computauonal neuro.,cience

.J beha' ioral neuro,cience .J neuroetholog) The. e secuon<. ha\C been elected to

reflect the mo~t acu'e constituent area~ of heanng \Cience. and 10 pro' ide the highe~t re' ie" \tandard\ and optimal publication ~en 1ce to Ill\ e ugator., b) anracting. e,·aluaung. and dl\~emmaung the late 1 ad' ances m audllof) neuro clence.

Addmonalmformauon IS available from the ednor or from Han\ ood Academic Pubh~hers . 20 To,~n Center Dme. Langhorne. PA J90-t7. (2 15) 750-2642.

State Licensure Meeting The Nauonal Counc1l of State Board~

of Exammers for peech-Language Pathology and Aud1olog) and the Flonda A'1soc1ation of peech-Language Patholog1~1 ., and Audiologi'" \\ill sponsor the 7th Annual Con ference on Liccn'>ing Issues: ''Licen'lurc: Consumer Advocacy Through Health Care Refom1:· The conference \\Ill exam me consumer·., accc\\ to quaht) health care. con.,umers advocating for con,umer-.. health care reform - the Flonda expenence. and a nauonal O\ef\ iC\\ of licen mg the prof e. s1on<. of '>peech­language patholog) and aud10log) . peakers mclude usan \\'h1chard. AudJOiogi'>t. Salem. Virgm1a. Rebecca Cohen. Execume

icc-Pre 1dem of the CulLen Advocac) Center. Deb1 Tucker. ecrctaf)- Trea\urer of the CH17en Ad,ocac) Center. Connie L) nch . D1rector of the State Pohc) Di' i'>ion of ASHA and Melindu Harrison. President of the Flonda Assoc1a11on of peech-Language Pathologist'> and Aud1olog1st ....

The Conference\\ ill be held October 7-9. 199-l at the Cf}stal City Iamon. Arlington. Vi rgmia. Information regarding regiMrauon and program detail\ rna) be obtained by contacung Kenneth Gi'>t. Execum e ecretaf). 1 auonal Council at P.O. Box 326. \\'ellsburg. \\'V 26070.

- Subnuued b1 Geor~e Punu Loulst·ille. K>'

1~1------------------ln-. -~--e-m_o_n-.a-m------------------1~1

Kenneth W. Berger {The field of audiology lo 1 an out tanding leader with the recent p~!.mg of J K~nneth Berger who died of cancer on May I 0. 1994. Berger w~ the Director of Audiology at Kent State Univer ity from 1962 until his retirement in 1982.

Ken Berger is moM well known for hi career work with hearing aids. He was the author of one of the first texts on amplification. The Hearing Aid: It 's Operation and Det·elopmem publi hed in 1970. Audiologists have benefited greatly from Berger'. rationale of fining hearing ruds with the well knO\\n "Half-Gam Rule" which carrie hi name. In 1966 Berger e tabli hed the fir. 1 heanng a1d museum which became hi avocation for more than 25 years. The Kenneth Berger Hearing Aid Museum and Archives i~ hou ed at Kent State Univer ity. With about 2700 hearing aids the mu eum i the largest collection of hearing aids in the world and i a repo itory for technical data. adveni ing and patent related to hearing aids and variou amplification de' ice .

Ken Berger wa.l. a World War U Army captam who wa awarded the Bronze Star. Heal o erved during the Korean War in the A1r Force as a band director. Hi other major awards included honors by the Philippine School for the Deaf. President 's Medal from Kent Stale University. Who's Who in America. First Annual Out tanding Alumni Award in Audiology from Southern Ill inois University. Recently. Berger received the Lifetime Achievement Award from the American Auditor) Society. Berger will be mi ed by hi family. friend . colleague and audiologists around the world.

~----------------------------~

Academy of Dispensing Audiologists (ADA) 1994 Conference

The Academ> Of Dispen~mg Audiologi•as (ADA) will hold it~ annual meeting. " Reach For Excellence: Heat p Your Pmcticc In The De en". at the Ri' iera Resort and Racquet Club in Palm Spring . California. October 12-16.

The lmemauonal > mpo\ium on Amplification For Children w 1th Auditor> Deficitl>. with an mtemational facuh). will " dovetail'' with the ADA meeting. ~Ianing on Tue da). October II at the same resort .

pecial rates arc available to those attending both meetings.

The ADA meeting will feature ses ions on Cerumen Managemem and Recreational Audiology. with emphasi. on unde~tanding and becommg involved in the political proce. s that will soon determine the future of audiolog) A~ alwa)s. ADA ses ions will focus on pmcucal1nformauon that can be put to immediate use in climcal practice.

Top1cs at th1s meeting mclude: The Effects of auonal Health Care Plan~ on Audio log). Medical Considemuons m the E .. aluation of the Older Patient. Federal Ami-Kickback Leg1 lation. How to Handle Hearing A1d Return . Buildmg Patiem Loyally. Marketing Batteries. ervice Delivery in ur;ing Homes and Retiremem Ceme~. Infection Control m the Modem Audiolog) Office. and Workmg with Managed Care Systems.

In addition to the regular session • special hands-on v.orkshop. on otoacou tic em1s ions and assistive li temng de' ICC~ wIll also be presented along with "hot topics" from manufacturer::. and programmable technology update .. An expan he exhibit area will feature the latest in product and services. with program time planned for Interaction with e\hlbllorr..

A usual. several "fun" events will be featured. including celebrity emertainment. de en party, the ADA Olympic between manufacturer and audiologiM!t and a special Children· Olympics. The Olymp1c acti vitie and other "health promoting acti\ ities" will be directed by 01> mpic athlete Jim Ryun and hi wife. Ann. On-site recreational option<, are exten<,I\C and there i'> easy acce s to the famous golf courses in the area.

For more mformation contact: ADA Headquarters. 300 Millwood A venue, Columbia. C 29205. (803) 252-5646. (800) 4-15- 629. Fax (803) 765-0 60.

WHAT ' S HAPPENING?

ew Stamp To Honor Dr. Virginia Apgar

ob tetric to try 11 out. The fir..t sc1enulic publication of the technique was in 1953. A l though there was some re iMance initially

Virginia Apgar. MD. will be 1mmonali£ed v. 1th a 20-cent commemor­aU\C stamp to be 1 sued at the annual meeting of the Amencan Academ) of Pediatrics in October. 1994. Every bab) born m a modem ho'>pitalthroughout the world receives an Apgar core. a technique developed by Virginia Apgar ( 1909-1974).

to the u<,e of th1s "mple procedure. the Apgar Score has become the accepted lnLemauonaJ tandard.

Dr. Apgar first planned the core to be done at one minute after binh a!. a guide to the need for resuscnauon. Othe~ began to mea ure the core at later time interval~ to e' aluate ho\~o- the bab) re~ponded to

Although 1n1Uall) trained as a surgeon. Dr. Apgar became an obstetric anesthe 1ologist. one of the earliest women to spec1alize in th1s area. Her de,elopment of the Apgar

core reportedly occurred one morning in 1949 at breakfast in the ho pi tal cafetena. A medical "udent aid something about the need for a standardiled way

rr";;;;";;;;";;;;r;;;;;WJ reSU\Citation. E\entuall)'. the 5-mmute Apgar core wa~ found to be a valuable predictor of mona lit) in the neonatal period.

V1rginia Apgar wa, a gifted medical school

toe' aluate nev. born . Apgar a1d. "That' easy! You'd do 1tth1s wa) ... She p1cked up the neare t p1ece of paper (a sign that said. "Please bus your own trays") and JOtted down the nov. v. ell-known fi, e pomt~ of the Apgar Score She then da!thed off to

profe"or. For many yea~ ~he had a distinguished career"' ith the M arch of D imes"' here she was re<,ponsible for directing

research mto the cause . pre' enuon and treatment of birth de feel . She IS considered b} many to be the founder of perinatology.

ller work 1s well-known b} audiologists \1.-ho use the Apgar Score ru one of the major high mk indicators for deafne 'm mfant\

rHEARING HEALTH SERVICES, NC., the natiOn's lead1ng heanng health care proVIder, currently has several openlflQS for AudiOiogosts 1n Flonda. Working as pan of a team. you Wlll be respons1ble for manag1ng a free stand1ng d1spens1ng offiCe. PreVIous dispens1ng expenence 1s necessary. As an Aud1olog1st Wlth Heanng Health Services. Inc. you Wlll enJOy a competitiVe salary program, performance based 1ncentives, comprehensiVe benefits whteh 1ndude health 1nsurance. paid dues, continUing educatiOn and tra1mng as well as excellent opponunrty for advancement For consideratiOn, contact George S Osborne, PhD at (61 0) 992·3300, or send your resume to: Heanng Health Services, Inc .• 1018 W. N1nth Avenue, Sune 310, King of Pruss.a PA 19406. Fax (610) 992·3392 EOE

POSITION WANTED by CCC·A, aud & heanng aid dispenser liCensed Seekmg mediCal selling, full· or possible part-lime. Exper. 1ncl. extenSIVe ABA, ENG, Real Ear, heanng aid filtlngitroubleshooung Evelyn Redtree. (502) 451-9057

DIRECTOR OF AUDIOLOGY: Manager in large. non-prof1t, PSB­accred center FuU range of seMCeS 1ndud1ng, heanng a1d dispense. aural rehab. OAE, ENG, and ABA. Modem, well eqUipped faCility DIVerse populatiOn, both adult and chtld. Oppoltunny for chmcal research. ComprehenSIVe benefits, liberal vacatiOn and holiday allowance. Salary from SSS,OOO base, plus performance 1ncen11ves. Must hold CCC-A and be eltg1ble for CA liCensure. Prefer m1mmum 5 years chmcal and adm1n. expenence. Will consider MA. prefer PhD. Send resume or call O.T Kenworthy, PhD, Executive D1rector, Prov1dence Speech and Hearing Center 1301 ProVIdence Avenue. Orange, CA 92668 {714) 639-4990.

AUDIOLOGIST: Audllology CFY posrhon avaJiable at Mayo Clime 1n JacksonVIlle. FL Twelve montn appointment. Opponunrty for expenence 111 audiOlogiCal evaluations. heanng aid selectJon and <hspens1ng. ENG. posturo­graphy, ABR, and cochlear Implants Send resume, two page descnptron of Interests and career goals, and three letters of recommendation to

DaVId B. Hawltms. PhD, AudiOlogy SectiOn, Mayo CliniC Jacksonvtlle, 4500 San Pablo Rd., JacksonVIlle, FL32224

WANTED-AUDIOLOGISTS Resumes be1ng accepted for audiOlogists to jo1n factory· supported pnvate pracbces around the country Ideal candidates must possess a MA degree 1n Aud1otogy and be certified (CCC· A) 5 or more years expenence 1n evaluating, filling and diSpensing heanng rnstruments is preferred Please send resume, salary and locabon requ1rements to: Nu Ear ElectroniCS 10070 Mesa R1m Road San D1ego. CA92121

POSITION IN AUDIOLOGY: An opportumty to wor1< 10 a sett1ng that has a wide vanety of ped~atnc and adult pauems. Potenbal for mvolvement 1n the latest aud1olog1C procedures InCluding all evoked potenilal measurements. otoacoushc emiSSIOnS, central auditory testmg and programmable heanng aids. Contact. Frank Mus1e AudiOlogy. Dartmouth­Hnchcock MediCal Center, Lebanon. NH 03756.

The Food and Drug Adm1mqrauon (FDA) held puhhc hcanng'> on June 17 and 28. 1994 on a drah rc..,earch protocol to be U'>Cd b) heanng a1d manufacturer' to \Ub,tantiate pcrfom1ance claim'> regarding heanng aid pcrlonnance. lndh 1duah \\ 1th expcnence 111 hearing re\earch and pcr,om repre,cnung the heanng ;ud mdu\tf) pre\entcd te\timon) on the draft protocol to the Ear No\c and Throat De\ ice' Panel of the FDA. Thl'> panel. \\ h1ch mclude' aud10logi ... h. otnlaf) ngologi'>h. and cngmeer... '>erve' a' an ad\ 1'01) group to Lhe FDA. •\ •\A member.. Lucille Bed. .. PhD.

J ohn Greer lark recei\'ed the 1994 DiMingubhed Alumnus Award from the Depanment of Communication ciences and Disorder~ at the Uni\ er<;it) of C1ncinnau. Clark w~ recogniLed for his contribution' to the profe'>~IOn of Audiology and Speech-Language Pathology nationally and in the '>tate of Ohio.

Chris tine Vicente h~ JOined Heanng llealth Service'>. Inc. as Manager and Director of the new Largo. Flonda office. Vicente wa' fonnerl) a clinical aud1ologi't at the Central Florida Hearing and Speech Center in Lat...eland. Florida.

Vernon Larson retired from the VA Medical Center in Augusta. GA. Larson ha'> accepted a teaching po'>ition at East Tenne~see State Univer..ll) 111 John,on City. TN.

Christine Yo hinaga-lla no \\3\ recentl) recognited by the Universll) of Colorado with the 1994 Equity and Excellence Award for Ethmc Plurality. Thi' I'> a \ tudent iniuated honor for her effon~ on behalf of ~tudent' for acce'>'>lbilll). teaching and l>Cholarly '>kill ...

Carl Crandell of Lhe Callier Center for Communication Di order~ accepted a facu lt) po~lllon 111 Audiolog) at the Uni\er<;ity of Florida. He ma) be addressed

26 September/ October /994

WHAT'S HAPPENING?

Ro,, Roe,er. PhD. Jud) Schafer. PhD. and Don Wonhington. PhD arc member' of the panel. FoliO\\ mg te,llmOn) b) rcprc\entatl\ e\ ol mdu'>tr) and heanng re\carch arena. the panel di'-CU'>\ed each 'ection of the propo,ed protocol and made ... ugge,uon' for the FDA Ill con,1der pnor to the promulgation ol a final protocol.

The FDA.' prnpo,al wa' de\·eluped 'pec1ficall) to addre" the i''uc of 'pccch pcrl-onnancc 111 mme. but rna) aho tlC u'cd a' a guide for cunducung re,earch 10 '>Uppon other perlonnancc claim\. The prowcol pre\ented b) the I Di\ e\\enuall) requ1res blinded. random11ed. controlled 'tudic' to e\ aluatc an} new technolog). circuli. or heanng a.d for\\ h1ch manufacturer' ma) mat...e pcrl-onnance claim<;. pcc11icall). the

at the Depanment of Commumcation Processe~ and Di~ordcr!.. 37 Dauer Hall. Um\ef'>it) of Florida. Gaines\ Ill e. FL 32611.

Roger Kasten retired from Wichita State Uni'e~it). He moved from h1~ posnion as a re~earch aud iologi'>t at Gallaudet Unher..it} to accept an appointment at WS U 111 1971 \\here he ser,ed on Lhe facult) for more than 23 year... He i' a Fellow of ASHA and was at the We~tem

Auwalia In titute ofTechnology in 19!!1 -82. He receh ed the 1986 Belt one Distingui hed Teaching Award 111 Audiolog) foliO\\ mg nomination from h1' studenL\. Kasten I'> a noted author 111 the areas of clin1cal hearing aids.

Larl')' Higdon wa\ elected to the ASHA E-.:ecuti\e Board 111 the ne1\l) establi hed po>ition of Y1ce Pre~1dent for ProfessiOnal PracLice~-Audiology. Higdon b 111 pn\'ate practice in Au~tin. TX and also \erves a' Director of Legislauon for Lhe Texas

peech-Language-llearing A \\OCiation.

anford ( and) ) Gerber retired from the Uni\ersll) of Califom1a at Santa Barbara after 29 years of service. Gerber will move to Spokane. W A to become Cha1r and Vi'>lling Professor 111 the Depanment of Communicati\e D1sorders at &!stem Washington Uni,ersit)

protocol addrc" stud)' snes. suhJCCt selection cntena. o,uh1ect mclus10n and e\CIU'>IOn criteria. stud) design<,. stud) tests. qual It) control. and 'tall\llcal anal),., of data . Manufacturers\\ ill be rcqu1red tu u'c the protocol as a gu1delme and 'ubm11 chmcaltrial results to the FDA lor appro\ al prior to being a litH\ cd to mat...e claum. The'c protocols arc -,pecificall) de\igm:d to 'uppon manufacturer-; claims regard1ng pcrlonnance of the heanng a1ds. and arc not meant to pruh1b11 the dc\elopmcnt or di'>tnbution ol ne\\ tcchnolog). 'o long a' no pcrt.onnancc claims arc made.

The protocol proposed b) the FDA \\as not wnhout contro\er'>). pamcularl) w 11h regard to the practl~.:al•mplemcntatlon of the re\C<lrCh stUdies. The number of \UbJeCh. U\C Of smgle· '>UbJCCI des1gn. transfer ol research result' between manufacturer\. uw of ObJCCtl\e \ er,uo, '>UOJCCth C mca,urc' Ill pcrfonnance. and 1"ues of "acchmalltalltlll .. \\Cre debated. A'> an C\ample of the 1\\Ue'> disCU\sed. the que'>tlun was ral\ed as to \\ hcther the result' of a stud) \\ h1ch demonstrates imprO\Cd speech recogmuon pcrl-ormance 111 bact...ground nOI'>C for pcNm' with moderate hcanng lo" could be generahted to per,ons w nh m1ld or se\ ere heanng loss. If gener<llllation to other population'> \\Ould not be aiiO\\ed. then 'tudics usmg a \arict) of hearing lo's populauons would be required

Tesumon) b) B)ronTan. FDA compliance officer. generated pan1cular concern from both the panel and the aud1cnce. He \tated that the use of mdependent research. such as repnnted journal anicles. amounts to labeling. and therefore \\as 'UbJCCt to scrulln) b) the FDA. In other \\Ord\. manufacturers will nOt he able to di'>tribute JOUrnal reprint'> with hearing md product'>. unless Lhe claim'> in those reprints ha\e met ~~1th the apprO\ al ol the FDA.

The FDA will re\ 1e\\ both the puhhc tesllmOn) and panel recommendations and produce a final regulation for substantiation ul perfonnance cl<llm,. Alter de\clopmcnt of a document. the regulations will be re\ 1e\\ ed b) FDA attome) '·and then ~entto Office ol \lanagemcnt and Budget for fun her re\ 1e\\ . As such. no date for di,tribution of the l1nal regulation has been sent

'iuhmmed h1 fan \\ uulmt/1 Chan. Audio/og_\ Coalllton

Solved! The Case of the Disappearing Earmolds!

.\ II mer the count~. tbpen~er ha' e been reponmg that \\·e~tone earmold-, were dhappearing before their \t'~ eyes• \\'e put our ' uper -.leuth~ on the <.a'-L .• md It '' a-.n t long hdore '' e -.oh ed tht~ haftlmg m\ ... te~. Tum-. out. the butler dtdnt do it. .. we dtd~ It., our ne\\ ill cone Conceal Technology, a re,·oluttOna~ nt:\\ proce~' '' hich leb you <.hoo:-e from a number of tltfferent tint. m our -.uperb \\"-I -.ilicone earmold materi.tl. You can speci~ color... that approximate -. i..\ common ... kin tone:-.. \\ hich make your pattent\ earmold-. 'inu.tll~ ths,tppear '' hen the~ re '' orn~ Ctll or '' nte for your free

L-~----~-=--~--L---~

throne Conceal Technolog~ Y'tem. that let you compare \\~-1 color to \'Our patient" -.km tone m -.econd'>. \\'-1 '>ilicone 1~ J\ ,ulable m hell. half

w·c!~Wllt: \ 11111</11<: Srlrcon. Collct!tll Technulug;. ')'lr.:nt tdll pur )Oil on rh.: rrm/111 mort? 'di!Sjlt?d erN omen.

~hell. and canal '>tyle'> for 13m .. 1. well a' '"·im ,tnd ' ound mold 'tyle-.. o ohe the m~ -.te~ of flattering. ,tlmo-.t im bible earmokb ... and be a hero to

your cu-.tomer ... "ith \\'e:-.tone" ilicone Conceal Technology. It\ dementa~. \\ abon•

~ LABORATORIES. INC.

f).~~~~ uvu/tllrkeajm·lmll.hun·tmtlmm~ all the hdpjirl ,,.rz·rw• mrd pmdua' mml­ahlr'frll/11 W ,._,/t•lll.'. dmf!ll.> t1 IIIII<' ,,. uti/ rv/1-jm•

L>hOTJ!One' m Color.oc' 'pnn::, 1\.tbnulOo. ''" ., .• n n Jltl \\ J'' n).'l• n

PO Box 1)100. Colorado pring-.. CO o093i - 19 i-10-9333 HOO i1i -)0- l

\lcmher \Juurul \w "' '" ~ I·.Jnnold l.:lhorJ!• •n<" • I• ·u r I kann,: ln•mur~ • \ar• m.ol lkanm: Con.,.,ruuon \'>OCU!I n • lm~nuuonalll<-ann)! ·~ ' • \JII<'Il<.Jn \ud tu" .. ~" • \.o11nrul \w>C13llnn ul \lu•IC \krdum•

HOUSE EAR INSTlTUTE "' CARE COORDINATOR OF CLINlCAL SERVICES

The CARE Center of the House Ear Institute is seeking a manager of e ljnieal services. The CARE Center focuses on research and clinica l services related to hearing disorders in infants and children. The CARE Clinic is a major pediatric cochlear implant center , hearing aid dispensa ry and provides a full range of audiologic diagnostic services , as well as speech-language pathology and psychology. This is a challenging position in an exciting, rapidly g rowing major research center.

A successful cand idate will have a minimum of 5 years experience in clinical aud iology and administration, and a Ph.D. o r master 's degree in Audiology or Hearing Science. Excellent sala ry and benefits. Please contact:

C ecilia Gratias, Assistant to Yvonne Sininger, Ph.D. , Direc tor

Children's Auditory Research and Evaluation Center House Ear Institute

(2 13) 353-70 17

We are an

VO LUME 6. NO. 5

AUDIOLOGIST THE UNIVERSITY OF TEXAS AT DALLAS

CALLIER CENTER FOR COMMUNICATION DISORDERS

The School of Human Development seeks an Audiologist at the assistant professor level. May consider appointment at the Associate level for exceptionally qualified person. Teaching and research interests preferably in the areas of amplification and/or pediatrics. Teach undergraduate and graduate courses including Ph.D. level. Excellent research laboratory and clinical facilities available at the Callier Center for Communication Disorders. Adjacent to the University of Texas Southwestern Medical Center and several large hospitals. CCC-A or eligible for CCC-A strongly preferred. Review of files will begin November 1, 1994 and continue until an appointment is made. Send letter of interest, vita, and names of three references to: Academic Search #557, The University of Texas at Dallas, P.O. Box 830688 MP12, Richardson, TX 75083-0688. The University of Texas at Dallas is an EEO/AA employer.

AUDIOLOGY TODAY 27

CALENDAR OF EVENTS

mc rican A ead em) of O to la ryngolog_v-Head and eck urgery Annual om cntion cptember 18-::!1.199-l: San D1ego. CA: Contact AAO- HNS National

Office. One Prince trce t. Alexandria. VA :!231-l (7 13) 683-5100

5th Annual Excellence in Hearing Conservation cminar September 22. 199-l: Anaheim. CA: Comact Michele John,on. -131 Ea,t Locu\1. #202. De\ Momc\, lA 50309 ( "15! 2-13- 155

Colorado eadem~ of AudiologJ A nnual Convention September 29-0ctober I. 199-l: Breckenridge. CO: Contact CAA. P.O. Bo\ 51 I. Grccle). CO 0632

Scoll Ha ug Fo und ation Ret reat cptember 29-0ctober 2. 199-l: Kemille. TX. Contact cou Haug

Foundauon. P.O.Bo' 2221. Au,un. TX 7 76

E1 G Tc t Interpreta tion a nd Diagno i eptember .30-0ctober I and October 1+-15. 199-l. Ch1cago. IL: Comacl

IC 1cdical Corporation. 2227 Hammond Dr .. Schaumburg. IL 60 173 ( 00):! 9-2150

Minimal Heari ng Loss in Children and Adults: Clinical Problems and !\1anagcmcnt Solut ions September 30-0 ctobcr I. 199-l. Southfield Ml: Henry Ford Hospual Conl:lcl Cr:ug 'c,,nwn (3 13! 76-32 0

Ia ryland Academ~ of udiol og_v Annual Conference October 6-7. 199-l: Annapoli-;, ID: Contact Caroline Aland. 530 I Ritch1e H\\ ) .. e\cma Pari... t-ID :!11-16 (-110) 647-7795

International ong res fo r Hearing Aid Acous ticians October 6- . 199-l. W1e•badcn. Germany: Contact l.Jnion Der Horgerate­Akusul..er c. V. Gc chaft 'telle. Po,tfach -1006. D-55118 Main£. Adam­Darri lion- tra.,,e 32. Du, e ldorf. German~

I ue in Lang uage and Deafness October 7-9. 199-l: ebrasl..a Cit~ . E: Contact BO)'> To,,n Nauonal Research Hospital. 555 orth 30th Street. Omaha .. E 6 131. (-102) -19 -67-19

Human Central Auditory Pathway a nd Bra in Dissection October 7- 10. 199-l: Ne'' Orlean•. LA: Contact Sue Ma on. Kresge Heanng Re;carch Laborator). LSU. 2020 Gravier St .. #A. c~' Orlean•. LA 70112 (50-l) 568--1785, E\t. 2-13

Academy of Dis pens ing Audiologis ts Annua l Convention October 10-15. 199-l: Palm pring•. CA: Contact ADA Admmi\lrati•e Office. 300 . M1llwood A\ e .. Columbia. SC 29205 ( 00) -l-15- 629

Interna tional ~ mpo ium on Amplification for Children with Aud itory Deficits October 11-13. 199-l. Palm pnng,, CA: Contact Academ) ol D1spen"ng Aud10log1~l\. 300 t-. 1illwood A'e .. Columbia. SC 29205 ( 00) -l-15-8629

~lanagement o f th e T innitu Pa tient October 1-l -15. 199-l : Iowa Cit). lA; Contact Regina Ti'or. The Uni\ Cr'-llY of Iowa. 2-19 Iowa Memonal Umon. Iowa Cit). lA 52242 (319) 356-2-171

28 September/ October 1994

!\ lid\\ est Audiolo~ Confe rence October 21-::!::!. 199-1: Cmcmnau. O H. Contact OhiO Academ) of Aud1olog). P.O.BO'\ -l-15. Wc~tcn1lle. 0 11430 I (513) 661-HEAR

Interna tiona l Cochlea r Implant. peech a nd Hearing ympo ium October 24-2 . 199-l: Melbourne. Australia. Contact Cochlear Corporation. 61 ln,eme'' Dri\e East. #200. Engle\\ood. CO 80112 (800)523-5798

American peech-Language-Hea ri ng A ·socia tion Convention o'ember 18-21. 199-l: e" Orlean~. LA. Contac.:l AS HA Comcnuon•.

10 01 Rocbi llePike.Rocbllle MD 20 52.(301)897-5700

Ne" Per pectives on Real- Ear 1\ lea urement in Hearing-Aid Fittings December 3--l. 199-l : 'e" Orlo.:an-.. LA: Contact uc :'\la~on. Kre,gc Hcanng Re earch LaboratOI"). L U. 20::!0 Gra' 1er t .. #A. :-\C\\ Orleans. LA 70112 (50-l) 56 --17 5. E'\t. 243

Interd isci plinary eminar on Diagnostic and Rehabilitative Aspects of Dizziness and Balance Disorders December 7-11. 199-l: Demer. CO: Contact Jane \\'elb. Pro,per ;\leniere

OCICt). 300 E. Hampden A\ e .. #-101. Englc"ood. CO <303178 --1235

Pedia tric peech Perception and Amplifica tion Conference December 16. 199-l: Cit) Un1,e rsll) of 'e" Yorl.. Graduate School Contact Mall Bal..ke. The Le~mgton Center. 30th A\ C. and 75th treet. Jacl..son Heights. 'Y 11370(71 ) 99-8 OO.eJ.t333

1995 M eetings As ociation for Research in Otola ryngology ·lidwinte r ·leeting February 5-9. 1995: 1. Petersburg Beach. FL: Contact ARO Bu~mc-. Office. Suite 202. 431 Ea~t Locu~t 1.. De~ Mome\. 10 50309

Colorado Otology-Audiolog_, Conference Februa11 25- t-.larch -l. 1995: Brecl..enndgc. CO: Contact Colorado Hearing Foundation. -1200 East Nmth A' e .. B-210. Den, cr. CO 0262 ( 303 )270-7856

Internationa l Confe rence on Pre\'ent ing :'l:oi e- lnduced Hearing Lo :">larch 2::!-25. 1995: Cincinnati. OH. Contact , HCA E\ccuti\e Director. -131 Ea~t Locust. Suite 202. Des 1omes. lA 5030 I

Interna tional ~·mpo ium on Recen t Adva nces in Otit is 1\ ledia June -l- . 1995; Ft. Lauderdale. FL; Contact UP:'\1 C Conference :0.1anagement. 3 II O' Hara treet. Pimburgh. PA (412)647- 126

5th Interna tional Tinnitu eminar July 12-15, 1995: Portland. OR: Contact the American Tinnitu~ As'>OCiation. P.O. Box Bo' S. Ponland. OR 97207-0005 (503) 1-l -99 5

Futu re American cademy of Audiology Nationa l Convention :

Dallas, TX March 30-April 2. 1995 Lowe Anatole Hote l Ro ~ Roeser. Chair

alt Lake C ity, T Apri1 17-2 1. 1996 Salt Palace Convention Center

0 N I

ANNOUNCES ITS F INEST PRODUCT - C USTOMER S ERVICE All n ew de livery pac kage · yet a no the r p o ' c rfu l feature of Omni 2000

l.nlum ~·d l. tc.:~·pl.tt~· c.k:~tgn l nu~:a,~:d b:lll<.:r> door ~" mg t.td tu' \ lit rophonc.:· "md .tnd c.:k'hn~ , fl tdd <:IH.:mic..tlh -~·tdl~:d m.ttt~· fm"h ,urf.tc.:c.:·

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DJ,tonion. lligh Pel\\ cr urt uit '' ith t\\ o kll\ t: I'Jik·r, \ lli\ 1: l.cm Cut .md \ell\~· lllgh Cut P2000 CkJ._, I) "ith mput or output '1gn.tf pro<.~'"li1J.t .llld up to 'i'itJB g.lln. f l1\iro2000 - rt~'\ Jbl\.' tlur.lllOil-b • .-.c.::d c.:omprc.:•,,JOI1 \\llh rdt:.l'<. tllllL'' lx·t\\t:t:ll

J!l- tOO Jmi!J,t:u>nd.., K;~\12000 - ThrL'c.:' , t.l).!l.' fo.. - \ \ 11"" nHnpr~·.....,•on dt:..,Jgnt:d to .unphl\ onl~ ... o tt ... ou n d'

0MNI HEARING 5YSTIMS

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