Volume 18, Nu m b e r 4 - Audiology · Volume 18, Nu m b e r 4 ... Specific questions regarding...

2 AUDIOLOGY TODAY JULY/AUGUST 2006

V o l u m e 1 8 , N u m b e r 4 J U L Y / A U G U S T 2 0 0 6

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

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

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EDITORIAL BOARDE d i t o r

Jerry L. NorthernEditorial Office c/o American Academy of A u d i o l o g y

11730 Plaza America Drive, Suite 300, Reston, VA 2 0 1 9 0800-AAA-2336, ext 1058

j n o r t h 1111 @ a o l . c o m

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

Lucille B. BeckVA Medical CenterWashington, DC

Deborah HayesThe Children’s HospitalD e n v e r, CO

Jane MadellBeth Israel Medical CenterNew York, NY

Marsha McCandlessUniversity of UtahSalt Lake City, UT

Patricia McCarthyR u s h - P r e s b - S t . L u k e ’s Med CtrChicago, IL

H. Gustav MuellerVanderbilt UniversityNashville, T N

Georgine RayA ffiliated Audiology ConsultantsScottsdale, A Z

Jane B. SeatonSeaton ConsultantsAthens, GA

Steven J. StallerAdvanced Bionics CorporationS y l m a r, CA

Sydney Hawthorne DavisJoyanna WilsonElizabeth HargroveAcademy National Off i c eReston, VA

Gyl KasewurmProfessional Hearing ServicesSt. Joseph, MI

ED I T O R I A L AD V I S O RY BO A R D

Term Ending 2009Bopanna B. BallachandaPremier Hearing Centers1400 St. Francis Dr., Suite BSanta Fe, NM [email protected]

Kris English4033 Forbes TowerPittsburgh, PA [email protected]

Patrick FeeneyUniversity of WashingtonV.M. Bloedel Hearing Resrch Ctr.CHDD Rm 176, Box 357923Seattle, WA [email protected]

Term Ending 2007Karen A. JacobsAVA Hearing Center, Inc.Grand Rapids, MI [email protected] W. NewmanCleveland Clinic Desk A71 9500 Euclid AvenueCleveland, OH [email protected] Stern SolodarAudiological Consultants of A t l a n t a2140 Peachtree Road, #350Atlanta, GA [email protected]

BO A R D ME M B E R S- AT- LA R G E

BOARD OF DIRECTORSP re s i d e n t

Paul PessisNorth Shore Audiovestibular Lab

1160 Park Avenue West, 4NHighland Park, IL 60035

[email protected]

ED I TO R I A L STA F F

Term Ending 2008Debra J. AbelHearing Resource Center of Poway15525 Pomerado Rd., Suite E-1Poway, CA [email protected]

Carmen C. BrewerHearing Section, Neurotology Branch,Nat’l. Institute on Deafness & OtherCommunication DisordersBethesda, MD [email protected] C. WaldenArmy Audiology & Speech CenterWalter Reed Army Medical CenterWashington, DC [email protected]

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

ACADEMY MEMBERSHIP

DIRECTORY

ONLINE AT

www.audiology.org

The American Academy of Audiologyp romotes quality hearing and balance care by advancing the profession of audiologyt h rough leadership, advocacy, education,public awareness and support of re s e a rc h .

P re s i d e n t - E l e c tAlison Grimes

U C L A Medical Center200 UCLA Medical Plaza, Suite 540

Los Angeles, California 900953 1 0 - 8 2 5 - 5 7 2 1

a g r i m e s @ m e d n e t . u c l a . e d u

Past Pre s i d e n tGail Whitelaw

Ohio State University • 141 Pressey Hall1070 Carmack Road

Columbus, OH [email protected]

Today


Au d i o l ogy To d a y (ISSN 1535-2609) is published bi-monthly by theAmerican Academy of A u d i o l o g y, 11730 Plaza America Drive, Suite 300,Reston, VA 20190; phone 703-790-8466. Application to mail at periodicalspostage rates is pending at Reston, VA and additional mailing offices.

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INSIDE THIS ISSUE

POSTMASTER: Please send postal address and e-mailchanges to: Audiology To d a y, c/o Ed Sullivan, A s s i s t a n tE x e c u t ive Dire c t o r, American Academy of Au d i o l o g y,11730 Plaza America Drive, Suite 300, Reston, VA2 0 1 9 0 or by e-mail to s s e b a s t i a n @ a u d i o l o g y. o rg.

N ATIONAL OFFICEAmerican Academy of Audiology

11730 Plaza America Drive, Suite 300Reston, VA 20190

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

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

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

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

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

ext. 1046 • [email protected] Bongiorno • Director of Government Relations

ext. 1032 • [email protected] Devlin Culver • AAA Foundation Manager

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

ext. 1033 • [email protected] Gallow • Education& Standards Manager

ext. 1068 • [email protected] Feierstein • Receptionist

ext. 1000 • m f e i e r s t e i n @ a u d i o l o g y. o rgElizabeth Hargrove • Communications Coordinator

ext. 1039 • [email protected] Hernandez • Accounting Clerk

ext. 1061 • m h e r n a n d e z v @ a u d i o l o g y. o rgBill Kana • Information Systems Manager

ext. 1053 • [email protected] Kelley • Registration & Housing Manager

ext. 1037 • [email protected] Miller • Director of Reimbursement

ext. 1063 • [email protected] Oldenburg • Exposition Coordinator

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

ext. 1036 • m o l e k @ a u d i o l o g y. o rgLeza Owens • Staff Accountant

ext. 1045 • l o w e n s @ a u d i o l o g y. o rgErin Quinn • Membership Assistantext. 1051 • e q u i n n @ a u d i o l o g y. o rg

Christopher Rasmussen • Continuing Education Coordinatorext. 1043 • c r a s m u s s e n @ a u d i o l o g y. o rg

Vanessa Scherstrom • Member Benefits Coordinatorext. 1044 • v s c h e r s t r o m @ a u d i o l o g y. o rg

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

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

Kate Thomas • Health Policy Coordinatorext. 1048 • [email protected]

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

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

ext. 1038 • [email protected]

President’s Message 5Executive Update 10Membership Benefits 47

Washington Watch 48News & Announcements 53Classified Ads 60

A P P R E C I ATION IS EXTENDED TO S TARKEY LABORATO R I E S FOR T H E I R

S P O N S O R S H I P OF COMPLIMENTA RYSUBSCRIPTIONS TO AUDIOLOGY TO DAY

FOR FULL-TIME A U D I O L O G Y G R A D U ATE STUDENTS.

ON THE COVER

Volume 18/ Number 4

It is always a challenge to use the ear as the subjectof an art form. And, we know from years ofexperimenting with various approaches how difficultit is to create a new and intriguing view of theoften-not-so-beautiful human pinna. But for thiscover, we benefit from the talents of our wonderfulgraphic artists at Tamarind Design and Marketingin Denver who applied their talents and skills toproduce a beautiful extruded design from anordinary image of an ear.

Committee Charges & Chairs —July 1, 2006-June 30, 2007 12

Continuing EducationThe Current Content of AuD Curricula Online — M a rc Fagelson, George Panayiotou 14

LettersQuestions for the Ethical Practices Committee — Cyndy Fox 20

Answers from the Ethical Practices Committee 21

EthicsEthical Issues in Hearing Aids Revisited: A Survey 22—David B. Hawkins, Teri Hamill, Jane Kukula

AudiologyNOW2006 Wrap Up — Pat Feeney 32

2007 Program Committee 34

Marketing SceneIt’s All About Relationships — Gyl Kasewurm 35

American Board of AudiologyCI Specialty Certification Thrives — Sara Blair Lake 37

Accreditation and the ACAEAn Important Step Forward in the Evolution of the Audiology Profession 39— Angela Loavenbruck

A Moment of ScienceNew Concepts in Hair Cell Regeneration 42

— Mona Taleb, Kathleen Faulkner, and Lisa Cunningham

InterviewAn Interview with the Council on Academic Accreditation, 43

AT Speaks with CAA Chair, Amy Wohlert — Teri Hamil

ReimbursementNew Medicare Enrollment Requirements — Lisa Miller 51

HearCareersFinding an Employee…HearCareers and the Hiring Puzzle 59

any of myaudiology friends have beenasking me if I am ready toassume the presidency of theA c a d e m y. How do you getready? No one has written abook that identifies the step-by-step process necessary forguaranteeing desiredoutcomes. What I am readyf o r, though, is the challenge. I have been fortunate to work withGail Whitelaw over this past year. She has been a very inclusiveleader; an excellent mentor in many ways. She has given me theopportunity to understand the numerous issues impacting us as aprofession and as an A c a d e m y. New issues will arise during theyear while the complexities of the current ones may change, aswell. The challenge is to maintain a presence and impact change.The Academy is less than twenty years old, yet, the enthusiasmand drive of the membership is far more seasoned than one wouldexpect from such a young organization. Recently, Gail W h i t e l a w,Academy Executive Director Laura Doyle, and I met to rewritethe mission and goals for each committee of the Academy and tosecure compliance with our Strategic Plan. Our dedicatedcommittee chairs and members now have a clear understanding oftheir charge. This has created a cohesive committee infrastructureand makes it easier to identify when there is the need tor e o rganize current committees and/or create new ones to meet theon-going dynamic demands of our profession.

A healthy association is predicated on good communication.We have a strong Board of Directors dedicated to solving theissues and guided by the desires and vision of the membership.I welcome our newest Board members, Bopanna Ballachanda,Kris English and Patrick Feeney. The Board of Directors wantsto hear from you. Communicate your suggestions. Somechanges come easily while others seem like they will nevercome to fruition. In due time, there is nothing that this A c a d e m y

c a n ’t secure for its more than 10,000 members. Speaking of the Board of Directors, we are going to add a

new featured section to Au d i o l ogy To d a y. Each publication willhighlight two board members who will answer personalquestions. The purpose of this section is to “personalize” theBoard and to give each member the opportunity to show his orher fun side and to reveal personal interests. It is our desire thatthis “personal touch” will make it easier for you to engage aBoard member in discussion when together. This format wasused with the Academy Honorees at AudiologyNOW! 2006 andwas well received. Ultimately, we can feature committee chairs,members of the A c a d e m y, committee members, etc. to promotea connection between the membership and Academy leadership.Our intention is to foster interactions where none existed before.I hope you enjoy this new feature called Direct Access.

This year will be a busy one with ongoing discussions andstrategic planning regarding the Accreditation Commission forAudiology Education (ACAE), the American Board of A u d i o l o g y(ABA) and the American Academy of Audiology Foundation(AAAF). These groups have a great deal of commonality and thesecurity of our profession rests with their success. It often seemslike we are asking for money, but every financially soundprofessional association has an active and successful non-profitfoundation. The non-profit foundation is the financial conduit forimportant groups such as ACAE and ABA. It underwritesresearch projects, supports our Academy members affected bydisasters such as Hurricane Katrina and annually funds theMarion Downs Lecture , a forum for the most cutting-edgedevelopments in pediatric audiology. These are just a few of theprograms funded by our own A A A Foundation. Contributions tothe AAAF can be ear-marked (how appropriate for audiologists?)for a specific issue. Please give generously to the A A A F.

Resolution to the numerous issues facing the Academy canbe secured more judiciously through collegial partnering. I oftenread articles written from individuals in leadership roles withinother associations boasting to be the first to…or the only

AUDIOLOGY TODAY 5VOLUME 18, NUMBER 4

Paul Pessis, A u DP re s i d e n t ,American Academy ofA u d i o l o g y

Paul Pessis, A u DP re s i d e n t ,American Academy ofA u d i o l o g y

Paul Pessis

COME IN, THE DOOR IS OPEN…M


With a growing number of fourth yearexterns needing placements in theirfinal year, many clinical programsacross the nation arereceiving year-roundinquiries fromuniversities and stu-dents. At the requestof clinical programdirectors and in aneffort to bring greateruniformity to theapplication andselection process, thefollowing timelinewas developed by theAcademy’s ClinicalEducationSubcommittee andapproved by theAcademy’s Board ofDirectors. The time-line will not be ideal-ly suited for everyuniversity and every

clinical setting; however, movementtoward greater uniformity in applicationand placement should result in a more

timely and efficient process, beneficialto students, university programs, andclinical sites.

association to engage its membership to write letters.Sometimes being first may mean the association acted toosoon; first is not always right. Not engaging our members towrite letters may have been purposeful because it wasc o u n t e r-intuitive to our legislative strategies and had potentialto antagonize the agency receiving the letters. Securingsolutions to the problems facing our profession can’t beapproached as a contest. Combining our resources andworking together will allow us to look less fragmented andless vulnerable to our opposition. The Academy is the larg e s to rganization of, by, and for audiologists, but we do not existin a vacuum. Collegial partnering affords us the opportunityto speak with a single voice. A unified approach frustratesour opponents who thrive when we are conflicted within ourown profession.

I am pleased that the AuD is being recognized as the entrylevel degree for the practice of A u d i o l o g y. This is the resultof compromise by those in opposition who ultimately put theprofession first; another tribute to collegial partnering. T h i sd o e s n ’t minimize the Ma s t e r s ’ d e g r e e . Current practitionerswho hold a Masters’ d e g r e e have years of clinical experiencewhich provides the foundation for sound patient care. As wecomplete the transition to a doctoring profession, it is

essential that we meet society’s expectations ofprofessionalism. A doctor is a professional, not a title. Wi t hthe degree comes the responsibility of serving patients. T h evalue of the AuD lies in the education and the heightenedlevel of expertise afforded by that degree. To d a y ’s audiologistneeds to have a capacity for critical self-reflection thatpervades all aspects of practice, including being present withthe patient, solving problems, eliciting and transmittinginformation, making evidence-based decisions, performingtechnical skills, and defining his or her own values.Audiology programs have raised “the bar” in respect to

6 AUDIOLOGY TODAY

Academy Recommends Uniform Timeline for Fourth Year Externship Placements

EXTERNSHIP TIMELINE guideline

Student/Faculty Search Process

Application Period Open

Applications Submitted

Application Files Completed

Interviews

Offers Made

Offers Accepted Round 1

Follow-up Offers Completed

Externship Begins

Direct Access

M E E T T H E B O A R D O F D I R E C T O R S

Debra AbelHearing Resource Center of Poway15525 Pomerado Road, Suite E-1Poway, California [email protected]

M E E T T H E B O A R D O F D I R E C T O R S

Bopanna B. Ballachanda5720 Teakwood Trail, NEAlbuquerque, NM [email protected]

Direct Access


Laura FlemingDoyle, CAEExecutive Dire c t o r,American Academyof Audiology

Laura FlemingDoyle, CAEExecutive Dire c t o r,American Academyof Audiology

e have all been involved insome form of strategic planning, oftento only find the document proudlyplaced on the shelf after a great dealof effort in developing the plan. Itthen stays on the shelf collecting dustuntil it is pulled down and dusted offthree to five years later to see if anyof the plan was actually accomp-lished. That is not the case with theA c a d e m y ’s strategic plan.

When I had my first interview withthe Academy Executive DirectorSearch Committee in early 2001, Iwas handed a copy of a plan and wasquickly told, “This is our strategicplan but we hate it.” The first yearand a half that I was here, staffstruggled with how to accomplish thenebulous “goals” that were in theplan. It didn’t make sense to ourleadership and it certainly didn’tmake sense to the staff .

So in 2002, we found an incrediblefacilitator to work with the Board todevelop a working strategic plan -one that not only made sense but onethat had short-term and long-termobjectives with action plans forimplementation. Finally, afterreceiving feedback from A c a d e m y,membership as to what they wantedfrom their Academy followed bymany long months of deliberation,leadership and staff developed a plan

with which to work. Since its 2002implementation, this plan has playeda huge role in the growth and successof the A c a d e m y.In 2005, Academy leadership devotedseveral days of the Board’s time toreviewing and updating the plan tomake sure we were still headed in theright direction given the variousfactors and changes that had takenplace in the environment and theprofession of audiology since 2002. A summary of the most recent version

of this documentreflects the sixstakeholders tothe A c a d e m y ’svision, whichinclude: A c a d e m ymembers, Audiologists, OtherO rganizations, General Public,Industry and Leadership. Each ofthese stakeholders has one or moregoals associated with it. The goalsthen have two or more short-term andlong-term strategies linked to them

Laura F l e m i n gDoyle

WStrategic Planning

Mission, Vision, ValuesMission

The American Academy of Audiology promotes qualityhearing and balance care by advancing the profession ofaudiology through leadership, advocacy, education, publicawareness, and support of research.

VisionThe American Academy of Audiology’s vision is to beessential in the professional lives of audiologists byAdvancing the science and practice of audiology, andAchieving public recognition of audiologists as experts inhearing and balance.

ValuesIntegrity • Commitment • Excellence • Professionalism


which are then associated with specificaction items as to how the objectivescan and will be accomplished.

It is from these objectives and actionitems that your leadership hasdeveloped the committee charges, thusgiving the Committee Chairs definitedirection linked to the strategic plan. Itis the many entities of the A c a d e m yworking simultaneously on variousaspects of the plan that will ultimatelyallow us to reach our vision which is tobe essential in the lives of audiologistsby advancing the science and practice

of audiology and achieving publicrecognition of audiologists as expertsin hearing and balance in the mosttimely and cost effective manner.

This document is an instrument thatAcademy leadership and staff refer toon a regular basis to make certain thatwe are working in the direction thatwas developed as a result of your input.It serves to make sure no one leadercan come in and divert the A c a d e m y ’sdirection to accomplish their personalagenda. It is a document that has beendeveloped to ensure that each year as

the leadership changes, they willcontinue to work in the direction thatwas envisioned by Academy memberinput. It is our guidebook designed tokeep us focused on our primarymission, which is to promote qualityhearing and balance care by advancingthe profession of audiology throughleadership, advocacy, education, publicawareness and support of research.

And we will revise and refresh thisdocument again within the next fewyears without having ever put it on theshelf to collect dust.

Linkage: Vision, stakeholders, goals, and strategies

The following graphic illustrates the linkage of the Academy’s stakeholders to the vision, goals and strategies.


Honors – Sheila Dalzell Identify individuals who have been

of exceptional service to theAcademy and/or the profession andwho are deserving of awards.

Develop a slate of deservingcandidates who will be honoredpublicly during AudiologyNOW!

Coding – Kadyn Williams Identify and monitor the global

demands of coding.Provide input regarding needs for

coding changes and developstrategies to effect changes.

Communicate coding relatedinformation to members.

Develop Non Physician Work Poolpayment methodology and achieveacceptance of plan by CMS toreduce projected 21% cut inreimbursement.

Medicare Physician Fee Schedule:annual reimbursement policy(regulatory).

Electronic Medical Records andElectronic Health Records

Business Enhancement Strategies &Tools – Gyl Kasewurm

Assist audiologists in obtaining theinformation and resources requiredto manage all aspects for allaudiology practice settings.

Provide those resources throughnon-dues revenue publications andnetworking.

Education & Standards– Dianne Meyer

Identify and monitor issues relatedto audiology education andprofessional standards.

Develop processes, documents,databases, action plans, and otherappropriate mechanisms to help theAcademy maintain a proactive andsupportive role in the areas ofeducation and professional standards.

Oversee continuing education, AuDclinical education, AuD academiceducation, entry-level professionalstandards, and AuD student matters.

Education & StandardsSubcommittees:Continuing Education - Carole JohnsonAcademic Education - Marc FagelsonClinical Education - Jack Roush Audiology Professional Standards - Kris English Student Services - Carol Cokely

Education & Standards Task Force Task Force on 4th Year PaymentIssues – Alan Desmond

Ethical Practices Committee – Jane Kukula

The EPC’s primary role is to educateand increase member awareness ofthe Academy’s Code of Ethics andthe practical application of the code,rules and advisory opinions.

Periodically review and update theCode of Ethics to which members arebound and produce advisory opinionsclarifying ethics principles and rules.(Changes to the Code of Ethics,policies and procedures and advisoryopinions must be approved by theAcademy Board of Directors prior toimplementation and publication.)

Formulate, review, update, andpublicize policies and procedures forthe review of complaints.

Review public and membercomplaints alleging unethicalbehavior by members. Adjudicateand determine appropriatedisciplinary action. (Decisions are subject to appeal tothe Academy Board.)

Government Relations – Alison Grimes

Achieve Direct Access.Achieve passage of Hearing Aid

Assistance Tax Credit Act.SOC codes: achieve appropriate

change in audiology laborclassification.

Pay For Performance: identifyquality measures and evidence basedpractices for audiology.

State Licensure: work with states tosupport changes to state licensurelaw per their request.

Telehealth Monitor:

• SGR fix• IDEA• Fraud and Abuse laws and

regulations• Social Security Administration

regulations• FDA policies related to hearing

aid regulations, cochlear implant,and other hearing devices (e.g.tinnitus maskers)

• FCC - Hearing Aid compatibility• FEHBP – hearing benefits• Other issues: Medicaid, OSHA,

Dept of Transportation(regulations), Aural Rehabilitation(coverage for treatment)

July 1, 2006 –June 30, 2007mm

Committee Charges


Government RelationsSubcommittees:Pediatric Audiology – MarilynNeaultState Licensure – Pam Ison

International Committee – Neil Clutterbuck and Linda Hood

Increase International membership inthe Academy and developorganizational affiliations in order toenhance the development of theaudiology profession worldwidethrough education, support ofresearch and increased collaboration.

Assess the Academy internationalmembership and advise the Board ofinternational member needs and valueadded benefits.

Membership - Rebekah CunninghamA main focus for this committee is to

be the “pulse” of the membership.Assess the Academy membership

through member connect, thebiannual membership survey etc. andadvise the board, other committeesand appropriate staff about memberneeds, value added benefits andmember attitudes and concerns thataffect a member-driven environmentthat fosters member involvement andleads to professional success.

Provide periodic review ofmembership criteria and procedures,and recommend changes that maybe required.

Program Committee – Sharon Sandridge

Organize and coordinate annualAudiologyNOW! program.

Attract high qualitysubmissions/speakers.

Design a program to be of interest toa wide cross section of audiologyspecialties.

Enhance the educational value of themeeting through innovative teachingmethods (i.e. interactive sessions).

Set the standard for learningopportunities, in conjunction with theEducation and Standards Committee.

Program Subcommittees:Community SupportDiscussion/Focus GroupsEmployment ServicesExhibitor CoursesFeatured SessionsLearning LabLearning ModulesResearch Posters/PodsStudent ResearchStudent Volunteers

Publications – Mike ValenteOversee Academy publications.Oversee content and creativity of

Academy web site.Recommend topics for future

publications.Review new publications prior to

publication.

Publication Subcommittees/Task Forces:Editing SubcommitteeWeb Development Task Force –Don Vogel

Public Relations Committee – Clarke Cox

Promote Audiologists to the generalpublic as the experts in hearing andbalance.

Promote Audiology to the medicaland allied health care professions.

Promote Audiology to include, butnot limited to, industry andassociations.

Promote the profession of Audiologyas a career option.

Research Committee – Sharon Kujawa

Promote research through membereducation and Academy ResearchAwards program.

Facilitate member awareness ofresearch by and for audiologists.

Review applications and selectrecipients of the Academy ResearchAwards funded by theAAAFoundation.

Maintain relations with alliedorganizations that provide hearingand balance research.

Promote research grant opportunitiesavailable through other organizations.

Facilitate opportunities formembers/mentor interactions andtraining.

State Network – Erin MillerFacilitate communication between the

states and the Academy, as well asstate-to-state.

Promote a robust national grass rootscommunity to support audiology.

Strategic Documents – Craig Newman

Oversee specific task forces, whichhave been appointed by the Presidentafter direction from the Board, todevelop specific documents.

Develop, finalize and monitorexisting (review) documentsincluding position statements,practice guidelines and white papers.

& Chairs


MARC A. FAGELSON, PHDAND

GEORGE PANAYIOTOU, BSEAST TENNESSEE STATE

UNIVERSITY AND

JAMES H. QUILLEN

VA MEDICAL CENTER,JOHNSON CITY, TN

The Current Content of AuD Curricula

The Current Content of AuD Curricula

s accrediting bodies mandate sets of

competencies that evolves over time

for practitioners, the academic and

clinical programs charged with didactic

e d u c at i o n , clinical practice, and student

e v a l u ation must keep pace with the field’s

dynamic scope of practice. G r a d u at i n g

audiologists must be competent health-

care providers capable of using existing

and emerging technology for the

d i agnosis and management of individuals

with hearing and balance disorders. T h e

responsibility for conveying essential

i n f o r m ation and providing cl i n i c a l

opportunities to practice with this

t e c h n o l o gy rests as it should with the

universities and their affiliated cl i n i c a l

p l a c e m e n t s . N ational organizat i o n s , s u c h

as the American Academy of Au d i o l o gy

(AAA) and the American Speech-L a n g u age-Hearing A s s o c i ation (ASHA),

must be sensitive to the dynamics of the

f i e l d ’s scope of practice.

Program applicants seek

i n f o r m ation from manys o u r c e s , and many sample

the Internet to identify

programs that meet both

their own criteria forg r a d u ate education as

well as the criteria

established by accrediting

e n t i t i e s . The compre-

hensive search of A u Dprograms of study and

posted curricula

presented below should

be considered a snap s h o t

of the field from the per-spective of a prospective

Fall 2006 AuD ap p l i c a n t .

We completed an

internet search of all

academic programs listed

as accredited by ASHA and ABA as of July1 , 2005 for information specifically

pertaining to available curricula. At the

time of the search, 59 programs had

posted curriculum informat i o n , all of

which were listed on the A c a d e m y ' swebsite as offering degrees. At the same

t i m e , 65 programs offering AuD degrees

were listed by ASHA as accredited,

approved with accreditation pending, o rp l a n n e d . T h e r e f o r e , the results reported

b e l ow represent a sample of 59 out of 65

a c c r e d i t e d , approved or planned

academic programs.

Courses found in each curriculum/program of study were entered in a

spreadsheet by name and tallied. S e v e r a l

course names were similar across

i n s t i t u t i o n s , although their names were

not identical. In obvious cases, t h e s ecourses were combined and the total

number of programs offering the courses

r e p o r t e d . For those cases in which the

similarity was less cl e a r, the courses were

reported separat e l y. Examples are

ADIDACTIC CLINIC

NUMBER OF PROGRAM CREDIT CREDITINSTITUTIONS LENGTH (YRS.) SEQUENCE HOURS HOURS52 4 Semester/Trimester 62-79 24-57

3 4 Quarters 112-157 * Not Available1 3 Semester/Trimester 90 24-452 3 Quarters 102-112 * 42-66 *1 4 Modules** 183.25 * 77 *

* Number of credit hours are converted from quarter to semester with differentaccounting methods across institutions.

** The module sequence most closely resembles but is not identical to, a Quarter system.

Table 1: Number of programs by length andsemester structure, and range of credit hours.

Figure A: Breakdown of courseofferings into the competencyareas employed by theAccreditation Commission foraudiology Education (ACAE) intheir Specific Curricular Standards


OnlineOnlineprovided below of both instances so that readers may draw their

own conclusions regarding the ap p r o p r i ateness of this method. C a r ewas taken to avoid counting a class twice when ‘similar sounding’

classes were offered by the same program. For example, o n e

program listed separately courses called,

“Business Manag e m e n t ” a n d

“Professional Issues” whereas in sevenother instances, programs listed one

course or the other.

Courses were then cat e g o r i z e d

with regard to the Standards

specified by the A c c r e d i t at i o nCommission for Au d i o l o gy Educat i o n

( A C A E ) . The ACAE specified that

students must display competence in

several areas of audiologic practice:

D i agnosis and Management (D & M),Fo u n d at i o n , P r o f e s s i o n a l ,

C o m m u n i c at i o n , Research and Clinic.

In this way it was possible to

determine the areas in whichprograms concentrate their curricula.

RESULTS AND DISCUSSIONThe objective of this brief report

is to provide an overview of course

offerings in programs offering theclinical doctorate in audiology. A

more thorough comparison of

curriculum consistency across other

fields that utilize clinical doctorat e s ,

such as optometry, physical therap yor pharmacology, would be valuable.

Another comparison of interest

would involve a thorough cross-

c o r r e l ation of program offerings

within the field of audiology thatconsidered course descriptions and

c o n t e n t . Such an analysis would

require more easily accessible

course descriptions and far morespecific information than was

available for this report.

COURSE TITLE N OTHER COURSE NAMES IN COMBINATION WITH:Amplification Systems I 59 Sensory Technology Speech Percept. (1)Audiologic Evaluation I 56 Diagnostic Audiology, Differential Lab (8)Pediatric Audiology I 56 Newborn Assessment Educational . (3)Electrophysiology I 56 Phys. Assessment, Clinical EP Seminar (1), Lab (6)Hearing Conservation 54 Industrial/Noise, Prev. & IdentificationAmplification Sys. II 54 Seminar in AmplificationVestibular Science I 46 Vestibular Diagnosis/ Vestibular Rehab (8),

Disorders/Treatment Tinnitus Mgt. (3)Audiologic Evaluation II 43 Advanced Seminar in Assessment Lab (6)Cochlear Implants 40 (Implantable) auditory ProsthesesElectrophysiology II 33 Adv. Phys. Assessment, Clinical EP II,

Perception and Cognition OAEs (1)Aud. Rehab. for Adults 27 Management of Adult Hearing Loss Amp. for Adults (1)Central AuditoryProcessing Disorders 26Aural Rehabilitation 26 AR across the Lifespan Lab (4)Aud. Rehabilitation for 24 Management of Pediatric Hearing Audiology in the Children Loss, Auditory Problems - Pedes Schools (2)Amp. Sys. III 22 Auditory Prostheses, Advanced Seminar Educational Audiology 18 CAPD (1)Tinnitus 9 Tinnitus Workshop (1)Vestibular Science II 7 Vestibular Rehab. (3), Adv. Seminar (1) Tinnitus Mgt. (1)OAEs 7Audiological Rehab. II 7 Advanced Seminar in ARCerumen Management 5Pediatric Amplification 5 Management of Pediatric AmplificationAud. Evaluation III 4Imaging Technologies 4Augmentative Comm I 3Pediatric Audiology II 2Sensory Technology I 2Newborn Screening and Management 2Pediatric/Adult Comm. Disorders 2

Table 2: Courses that would provide didactic instruction for the Diagnosis and Management competency as specifiedin the ACAE standards


Program Administration

Curricula were analyzed

with regard to the

academic courses offeredand academic credit hours

of the programs. The

programs considered in

these analyses were

exclusively AuD programs,but of course audiology

students may also pursue

the PhD or the ScD.

Discipline-wide trendswere also charted as

components of the

curricula were divided into

groupings based upon the

number of programs inwhich the courses

appeared. Credit hours for

many courses were

variable, and a follow-up

analysis that comparedcredit hours along

with course descriptions

would be valuable.

Table 1 contains a

breakdown of theprograms by program

length, the academic year

structure (semester or

quarter system), and the

didactic and clinic credithours offered in programs.

The vast majority (90%) of

the programs

operate as four-yearprograms on a

semester/trimester

schedule. Three programs operate as four-

year programs on a quarter system, while

two offer degrees through three-year,quarter system. One program offered a

three-year semester sequence of courses

and clinics.

Programs of Study: Competency AreasThe breakdown of courses in each

ACAE category appears in Figure A. By far,

audiology programs offer the most courses

in Diagnosis and Management (D & M) and

Foundation areas. Of the 113 total different

audiology courses offered, 84 (74%) werefrom one of these two areas.

Table 2 contains courses consistent

with the D & M competencies. More

courses corresponded to this category than

the other ACAE competencies. Severalcourses in this category featured multiple

or advanced sections. This category also

contained the only class that appeared in

all sampled curricula: Hearing Aids

/Amplification Systems I. Other coursesappearing in the vast majority (more than

90%) of the programs included intro-

ductory, or first semester Audiologic Evalu-

ation, Pediatric Evaluation, Electrophysi-

ology, Hearing Conservation and a secondor advanced course in Amplification. While

COURSE TITLE N OTHER COURSE NAMES IN COMBINATION WITH:Anatomy and 5 6 Bioacoustics, Physiologic Acoustics, Vestibular A&P (9), P h y s i o l o g y Biology of the Cochlea, Path. (1)

Physiological Bases of Sys.Hearing Science and 5 1 Fundamentals of Hearing Instrumentation (2)P s y c h o a c o u s t i c s M e a s u re m e n tI n s t r u m e n t a t i o n 4 1 Calibration (18), Acoustics (1)

Electrical FundamentalsMedical Au d i o l o g y 3 4Pathologies of the System 2 8 D i s o rd e r sSpeech Perc e p t i o n 2 7 Psychoacoustics (5),

Signal Processing (1)N e u roanatomy I 2 7 (Developmental) Neuro s c i e n c eS t a t i s t i c s 2 5 Biostatistics; Quant. In CDISGeriatric audiology 2 3 Aging Aural Rehabilitation (1)Psychological Aspects 1 9 Psychosocial Aspects of Hearing Loss Acoustic Phonetics (1)of Hearing LossP h a r m a c o l o g y 1 5 M i c robiology (1)G e n e t i c s 1 3 Development of Auditory SystemSpeech & Language Dev. 9Deaf Culture s 8 Deaf CommunityChild Speech/Language Dis. 7Speech Science 7S p e e c h / L a n g u a g e / R e a d i n g 7in Deaf & Hard of HearingSLP for the AuD Student 6Acoustic Phonetics 6Applied/Advanced 5(Acoustic) PhoneticsHearing Science II 5Hearing Sci. w/separate 4P s y c h o a c o u s t i c sAcoustics (stand alone) 4Anatomy & Physiology II 3 Genetics (1)N e u roanatomy II 3 Cortical ConnectionsA d v. Lang. Science/Phonology 3I n t roduction to Electroacoustics 2(separate from Amp. Sys I)N e u ro - O t o l o g y 2Dis. in Phonetics & Articulation 2Clinical Linguistics 2

Table 3: Courses that would provide didactic instruction for theFoundation competency as specified in the ACAE standard s .


it was expected that all audiology programs would provide

at least one course in Amplification, the lack in some

programs of introductory courses in audiology, Pediatric

Audiology, Vestibular Science/Diagnosis, andElectrophysiology was not anticipated. Upon review

of the curricula and available course descriptions,

however, it was clear that material from these

courses was incorporated in either undergraduateclasses (as was found in the three-year programs)

or covered in courses with other introductory

material (such as that related to professional

practice or ethics).

Table 3 contains courses that address theFoundation competency. These courses range from

Anatomy and Physiology to Instrumentation/

Calibration and courses in diversity, speech,

and language. Although courses are notidentified by all programs in these areas, it is likely

that the material is folded into most curricula at

some point. This eclectic set of Foundation material,

the stuff from which audiologists form their base of

knowledge, covers an impressive spectrum of topics. Italso suggests that many programs still prioritize the

inclusion of speech-language pathology coursework and

faculty in their training of audiologists. To further illustrate

the varied course options available, Table 4 contains the

courses from the D & M and Foundation Areas that werelisted in only one program.

Table 5 contains courses from the Professional area of

p r a c t i c e . As opposed to the D & M and Fo u n d ation areas,

few courses in this area appear in a majority of the programc u r r i c u l a . Of the eight courses, only two appeared in more

than half the curricula; the remaining six courses ap p e a r e d

in less than 10% of the programs accessed. T h e r e f o r e , it is

likely that most material from the Professional area is

folded into one or two cl a s s e s : Practice Manag e m e n tand/or Legal Issues.

Table 6 indicates that a strong majority of programs

(more than 80%) require a course in Research Design.

Statistics is folded into this course by name in five

programs. In practice, statistics appears as a pre-requisite for admission to many programs, and would

be folded into Research Design in several others. An

additional course in this area specified by five

programs is Evidence-Based Practice.

In terms of student research, 38 out of 59

COURSE TITLE A C A EAdult Language Disord e r s D & MAdvances in Audiologic Care D & MAmplification Systems IV D & MAssistive Listening Devices D & MAugmentative Comm II D & MCentral Auditory Processing Disorders II D & MCommunity Serv i c e D & MDeaf Cultures II D & MImmittance, Site of Lesion, D & M& Pseudohypacusis

Instrument Repair and Modification D & MIntraoperative Monitoring D & MM e a s u rement Techniques D & M(separate Eval Course)Principles of AR D & MVe r b o t o n a l D & MAdvanced Speech Science FAdvanced Speech/Lang Development FA u d i t o ry Perception by Hearing Impaire d FCommunication Interaction FE l e c t rophysiology III FE p i d e m i o l o g y FExperimental Audiology FH i s t o ry of Au d i o l o g y FSignal Pro c e s s i n g FStatistics II FTemporal Bone Anatomy F

Table 4: Courses that were listedin one program that wouldp rovide didactic instruction forthe Foundation (F) and Diagnosisand Management(D & M) standards.

COURSE TITLE N OTHER COURSE NAMES IN COMBINATION WITH:P ro f e s s i o n a l / L e g a l / 3 7 S t a n d a rds and Practice Clinic (1)Disability IssuesBusiness Management/ 3 4 Marketing, Clinical Mgt./ P r a c t i c e / L e a d e r s h i p Admin., Service DeliveryH e a l t h c a re In America 4 Ethics and HealthcareI n t roduction to audiology/ 4P ro f e s s i o nP ro f e s s i o n a l / L e g a l / 4 Seminar in Prof. IssuesDisability Issues IILeadership Seminar 1Marketing Concepts 1Occupational and 1Community audiology

Table 5: Courses that would provide didacticinstruction for the Professional competency asspecified in the ACAE standards.

JULY/AUGUST 2006

programs require students to complete a

research project, doctoral project, thesis,

dissertation, independent study, investigative

project, or capstone experience. In mostcases, students registered for at least three

course credits associated with this project.

Specific outcomes of student research

projects were not typically stated although

some programs cited state/nationalconventions and/or a requirement to submit

a manuscript for publication as goals

of the assignment.

Table 7 contains the courses intended to

support the Communication competencies.

Ironically, as audiology is a field in the

communication sciences, it appears that thisset of courses is the thinnest when

compared to the stated competencies. While

most programs include a course specific to

counseling, more than 20% do not have a

stand-alone counseling class. Further, only13 programs out of 59 offer a sign language

course by name. Certainly, sign is woven

into rehab, counseling, clinics and pediatric

classes, but it is surprising that so few

programs charged with the education of

hearing health care providers offer evena one-credit didactic class devoted

specifically to sign language.

Table 8 indicates that students are

expected to register for didactic credit

in clinical courses in only a fewp r o g r a m s . Slightly more than 10% of

the programs offer courses in

s u p e rv i s i o n . A course in Grand Rounds

was specified by seven programs,

although it is also likely that programsi n c o r p o r ate case review and

p r e s e n t ations at regular meetings

between students, s u p e rvisors

and/or faculty.Table 9 contains the options for

elective courses. 32 out of 59 sampled

curricula utilized elective coursework in

the program of study. Up to 15 credits of

elective coursework was required bythese programs offering the AuD degree.

Note that most courses in the list of

electives were offered as required

courses in other programs. Electives

would allow students the option to pick atrack (usually pediatrics or adult) in which to

concentrate their study and clinical

experience. However, this strategy would

appear to be at odds with the goals of

accrediting bodies that stress all studentsmust graduate with a basic set of

competencies.

All programs required some form of

comprehensive exams. The timeline for

comps was not always specified; however,all programs listed written comprehensive/

qualifying examinations as a requirement.

Nearly half the programs (26 out of 59)

indicated more than one set ofcomprehensive examinations was required

for doctoral candidacy and matriculation.

CONCLUSIONSProspective students, and ultimately the

p u b l i c , should expect our programs’academic coursework to support the

objectives and goals that accrediting

COURSE TITLE N OTHER COURSE NAMES IN COMBINATION WITH:R e s e a rch Methods I 4 8 Many variations w/ audiology Statistics (5)

Clinic Research & DesignR e s e a rch Pro j e c t 3 8 Capstone, Dissertation, Doctoral

P roject, Thesis, Investigative Pro j e c tR e s e a rch Methods II 9 Advanced Research DesignR e s e a rch Forum/Practicum 8 Analysis of Readings, Doctoral

T h e o ry and Researc hEvidence-Based Practice 5Lab Pro c e d u res in 1Audiology & Hearing Sci.

Table 6: Courses that would provide didactic instru c t i o nfor the Research competency as specified in the ACAEs t a n d a rd s .

COURSE TITLE N OTHER COURSE NAMES IN COMBINATION WITH:Counseling for CDIS 4 3 Rehab Counseling P rofessional Issues (2)Sign Language 1 3Multiculturalism in CDIS 8 Comm Dis Across Lifespan and Culture sSign Language II 2Clinical Application of ASL 1Clinical Masking 1Sign Language III 1

Table 7: Courses that would provide didactic instruction for theCommunication competency as specified in the ACAE standard s .

COURSE TITLE N OTHER COURSE NAMES IN COMBINATION WITH:Grand Rounds 7S u p e rv i s i o n 6 Advanced Pract. in Supervision

(Didactic Cre d i t )Clinical Studies in 2A u d i o l o g yClinical Issues 1Graduate Audiologist 1

Table 8: Courses that would provide didactic instruction forthe Clinic competency as specified in the ACAE standard s .

18 AUDIOLOGY TODAY


bodies set as priorities. As with many

other professions that require a cl i n i c a l

d o c t o r ate as the entry-level degree,

audiologists practicing in 2006 must be

invested in the graduates of May 2006,and onward, for the profession to

s u rvive in a recognizable form into the

next generat i o n . S i m i l a r l y, p r o g r a m

directors must acknowledge the

essential components required toprovide the didactic coursework to

support clinical practice. Access to

distinct clinic populations and unique

faculty specializations should beexploited when possible. H ow e v e r, it is

u n av o i d a b l e , as the scope of practice

and technology serving A u d i o l o g i c

practice evolves, t h at programs and

a f f i l i ated clinics will have to weigh thecost of specialization against standar-

d i z ation in the training of audiologists.

There should be no doubt that the

results of this survey would have been

different one year ag o ,

nor should there be any

doubt that the results will

be different next year.

Program directors should besensitive to the changing needs

of prospective students, and web-

masters must accurately depict

their curricula in

public domains.

REFERENCES1. Accreditation Commission for

Audiology Education (2005).Accreditation Standards for the Doctorof Audiology (AuD) Program.(www.acaeaccred.org)

2. Council on Academic Accreditation inAudiology and Speech-LanguagePathology (2005). Draft Standards forAccreditation of Graduate EducationPrograms in Audiology and Speech-Language Pathology.

COURSE TITLE A C A EC o u n s e l i n g CEarly Interv e n t i o n D & MN e u ro s c i e n c e / N e u ro a n a t o m y FLaw and Policy BB u s i n e s s BEducational audiology D & MSpecial Pro b l e m s N AIndependent Study N AHealth Care Mgt. BM a r k e t i n g BAural Rehabilitation D & MLegal Issues BFunctional Brain Imaging D & MIntraoperative Monitoring I D & MIntraoperative Monitoring II D & MP re s b y c u s i c s FEthics in Researc h RP h a r m a c o l o g y FASL III CEducation of the Deaf FDeaf Culture FHearing Aid Assembly and Repair D & MS t a t i s t i c s FP s y c h o l o g y FBusiness Management B

Table 9: The options forelective courses.


ne of the sessions at the recent AudiologyNOW! (“Has the Ethics Board Gone Too Far: WhatWere They Thinking,”) involved the Ethical

Practices Committee (EPC) presenting the 13cases brought before them this year anddiscussing their decisions. Based on thecomments made during the session, I want to

discuss the criteria used by the EPC in theirdecision-making process.

What is legal versus what is ethical? Itwas especially disconcerting to me that in every

one of the 13 cases, phrases such as “after agreat deal of discussion,” “after considerablethought,” “we felt that…,” “we assumedthat…,” “it seemed like…” were used.

Understandably, every case was complex. Myquestion is “Where is the attorney?” The EPCreached a final decision regardless of whetherthe complaint was a legal matter or ethical issue.

In my opinion, and considering that each of our50 states have laws that regulate professionaland business practices, the EPC has no businessmaking the determination between ethics and

legality. The first person to see these cases anddecide if there is an ethical or legal issue shouldbe an attorney who specializes in ethics. Then,and only, then, should the EPC discuss those

cases determined to be issues of ethics.What is the fundamental parameter used

to determine if something is ethical orunethical? As indicated by some of the cases

presented, the debate over the hearing aid andequipment manufacturers’ relationships withaudiologists continues. The EPC chair said therule of thumb that should be applied was, “If this

was published on the front page of the New YorkTimes, would you want your patients to see it andwhat would they think?”

Let’s apply this analogy to the following

dilemma: What if it were published on the frontpage of the New York Times that the AmericanAcademy of Audiology (AAA) accepts money fromhearing aid manufacturers and equipment

manufacturers to support the AAA nationalconvention? In addition to this “donation,”(although disclosed as “commitment levels” and

not dollar amounts), the manufacturers are alsoexpected to pay rent for space in the exhibit hall.Would this be construed as a Conflict of Interest?I feel that the EPC would vote resoundingly “Yes.”

Or we could use a different approach; one ofpragmatic logic rather than sensationaljournalism. I understand that a major part of theAcademy annual operating expenses are

generated by the annual convention. If all tieswere severed as would be indicated by theanalogy used by the EPC, how would theAcademy raise the revenues needed for operating

expenses? Will the convention registration beincreased to provide that money or willmembership fees be increased or both? Perhapsthe convenience of buses running between hotels

to the convention center will become a memorywithout a sponsor? I suppose that otherconvention sponsored activities such as internetaccess in the convention hall, immediate

registration of CEUs, ice cream breaks, and themessage center would be eliminated. We wouldhave to return to our own briefcases, paper, andpens without exhibitor sponsorships. Will the

attendees be allowed to participate inmanufacturers’ parties or dinners that are heldfor customers? And, no more box lunches?

If members are unable to obtain continuing

e d u c ation by using hearing aid unit sales to helppay our registration fees, hotel or airfare expenses,I predict that the annual convention attendance willd e c r e a s e . M a ny private practitioners do not hav e

income for travel and continuing educat i o n , u n l i k eour colleagues who are supported by theire m p l oyers such as university, e d u c at i o n a l , m i l i t a ryand VA audiologists. These colleagues likely hav e

paid vacation time and/or personal leave days andthey do not suffer a loss of income by being absentfrom work. So as convention at t e n d a n c ed e c r e a s e s , we may see fewer exhibitors, c r e at i n g

additional decrease in revenues for the A c a d e m y.Because of the violation of Academy ethics in

partnering with manufacturers to buy equipment

based on hearing aid sales, h ow will the smallp r i v ate practitioner afford the new equipmentt h at may cost as much as $8,000-$11,000? If older technology is used or new diag n o s t i c

techniques are omitted, will members face ethicsv i o l ations? Although the chair of the EPC saidt h at the committee is not “telling us” h ow to dob u s i n e s s , I heartily disag r e e . EPC is limiting our

ability to stay abreast of new technology andcompete with large practices and clinics withbigger budgets and even university cl i n i c a lprograms whose annual budgets are not based

in total on their net revenue.It is with some irony that the A c a d e m y

awards CEUs for instructional classes offered onmanufacturers’ incentive trips. I believe that

there is a fear that industry intera ction with theaudiologist will somehow taint our morals;c o n s e q u e n t l y, we and ultimately our pat i e n t s ,must be protected. When did manufacturers

became “the enemy?” I thought we were allcommitted to the same basic principle of helpingthe hearing impaired. Because audiology is stillnot a household word, we actually hav e

digressed into agreeing with this thinking orbeing afraid of it. Our relationships andpartnerships with manufacturers ultimately willhelp our pat i e n t s .

Life is not black and white; life is gray andeach of us decides where we need to or want tod r aw the lines. I believe that i t is an individualdecision and not one fo r others to regulate or to

l e g i s l at e . I think the EPC has gone too far ind r awing the lines and audiologists will sufferfrom our fear of impropriety. Do not legislate allof us because of the 1% or less who will choose

d i f f e r e n t l y. Let the 99% of us who arecomfortable with our e thics continue as we are.

Cydney Fox, Los Angeles, CA

QUESTIONSFor The Ethical Practices Committee

O

Letter to the Editor


he Ethical Practices Committee (EPC) understandsand appreciates the concerns raised by Ms. Fox inher recent Letter to the Editor. She asked: “What islegal versus what is ethical?” and “What is the funda-mental parameter used to determine if something isethical or unethical?” Further she raises questionsregarding the educational relationship manufacturershave with audiologists and the financial impact ofchange on business practices.

What is legal versus ethical? Ethical and legalpractice issues are not mutually exclusive; someunethical practices are clearly illegal. For example,providing kickbacks to a physician for referrals is ille-gal as it violates the Anti Kickback Law. This is also aviolation of the Code of Ethics Rule 8b “Individualsshall not engage in dishonesty or illegal conduct thatadversely reflects on the profession.” The EPC proce-dures require complaints involving potential violationof state or federal laws to be reported to the appro-priate governmental agency. The EPC does not adjudi-cate issues of law. Releasing a complaint to legalauthorities does not prohibit the EPC from adjudicat-ing potential violations of the Code Of Ethics. Legalcounsel is available as needed and the value of legalcounsel is in advising on complaints with potentiallegal implications and procedural issues. Further,attorneys Hahn (2005) and Liang (1999) have provid-ed legal opinions regarding business practices towhich some audiologists continue to cling. The EthicalPractice Guidelines on Financial Incentives FromHearing Industry Manufacturers was drafted to assistaudiologists with practicing in an ethical manner, fol-lowing the guidelines will also assist in practicing inlegal manner. A copy of the guidelines can bereviewed and downloaded at www.audiology.org/

Conversely, there may be issues that have nolegal ramifications, but are unethical. For example,consider an audiologist who is able to provide servic-es but refuses to provide services to a patient whocould benefit simply because the patient purchasedhearing aids elsewhere. This is not illegal, but unethi-cal in that it violates Rule 1a “Individuals shall notlimit the delivery of professional services on anybasis that is unjustifiable or irrelevant to the need forthe potential benefit from such services.” The role ofthe EPC is to deliberate and adjudicate ethical issues.The “fundamental parameter” used to determine ethi-cal versus unethical is the Code of Ethics. Just as in

a legal court of law a jury must look at the availableevidence and determine if the law was violated, theEPC reviews available information to determine if theCode Of Ethics has been violated.

Ms. Fox also raised the issue of continuing edu-cation credits and vendor trips. Manufacturers havea responsibility to train audiologists regarding theirproducts and software. Product training trips areacceptable. Many manufacturers also offer othertypes of educational activities. As of May 2006, whenapplying for CEUs manufacturers are now required toattest that product training and other educationalactivities will not be held in conjunction with an eventthat does not comply with the Ethical PracticesGuideline for Financial Incentives from HearingIndustry Manufacturers.

Further, Ms. Fox challenges the financial impactof change. As we examine the profession, previouslyaccepted practices are challenged. Heretofore, it mayhave been considered acceptable practice to enterinto agreements with vendors to assist an independ-ent practitioner in outfitting a new practice. In yearspast, banks and other financial institutions may nothave considered a private practice in audiology agood financial risk. From an ethical perspective, dis-pensing decisions may be influenced by the relation-ship with the vendor. From a financial perspective,where is the sense in having hearing aid manufactur-ers keep a portion of what is paid for hearing aids inan account where the manufacturer determines howit will be spent? Certainly, an accountant would rec-ommend that audiologists pay less up front keepingthe money in their own practice. Often fear ofchange can lead to over-reaction; there is no evi-dence that changing these practices will result infinancial hardships. On the contrary, many audiolo-gists in all settings practice in accordance with theguidelines and thrive.

Independent governance and skilled service tosociety are hallmarks of an autonomous profession.As an autonomous profession audiology must regu-late the professional behavior of audiologists. We areobliged to evaluate past and present professionalbehaviors and business practices, how these prac-tices are viewed by the public and the professionalimage they project. Hawkins (2002) revealed thatconsumers view some of these practices very differ-ently than audiologists. As audiology enjoys increas-

ing public recognition and trust as an autonomousand self-regulating profession, the need for a sharedcommitment to upholding the highest standards ofprofessional behavior increases. Ethical behavior byaudiologists, whether they are Academy members ornon-members, is governed by following professionalbehavior standards as stated in the Code Of Ethics.The Code Of Ethics is the profession’s proclamation tothe public announcing the behavior patients canexpect from the profession.

Culture change takes time. Consider that 25years ago, smoking indoors and in any location wasacceptable, even in the sound booth while testing.Today this is no longer acceptable and in many caseseven illegal. This is also true of ethical practice, asaudiology continues to grow in autonomy previouslyaccepted practices are no longer appropriate.Continued growth requires careful, deliberate androbust discussion and planning. Moving towardsethical practice is a long-term commitment toasserting that audiologists can stand the test ofexternal examination and scrutiny, whether by thefront page of the New York Times or a visit by amember of the 60 Minutes team.

Audiologists are obliged to dispense products thatare in the best interest of the patients based inscientific evidence, not the need to achieve a monthlysales quota. Changing and rethinking how we dobusiness is an essential part of our professional grow t hand autonomous rank. It must result in ways andmeans that do not present or create the perception thataudiologists have compromised their most importanto b l i g ation to the hearing impaired, to serve them byplacing their needs and interest first, through the ap p l i-c ation of current scientific know l e d g e , free and inde-pendent of enticements. There remains no doubt thateven the appearance of inap p r o p r i ate relat i o n s h i p sd a m ages audiology as a whole as it lowers the public’sperception of the integrity of the profession.

REFERENCESHahn, R., Abel, D., Kukula, J., and Members of the Ethical Practices

Board (2005)Audiologists Beware…And Be Aware of Conflicts ofInterest. Audiology Today, 17(4), 34-35.

Hawkins, D., Hamill, T.A., VanVleit, D. & Freeman, B.A. (2002)Potential conflicts of interest as viewed by the audiologist andthe hearing-impaired consumer . Audiology Today, 14(5), 27-33.

Liang, B., (1999). Fraud, Abuse and Professional Ethics in a World ofProvider Distrust. Audiology Today, 11(4), 25.

ANSWERSFrom The Ethical Practices Committee

T


n the last five years, the American Academy of A u d i o l o g y(AAA) and the Academy of Dispensing Audiology (ADA) havemade major efforts to educate their members about theirrespective Codes of Ethics and how they should be interpreted inlight of relationships with hearing instrument manufacturers.These efforts began in 2001 when an A A A Presidential Ta s kForce was formed to make recommendations about how theAcademy should proceed on a variety of issues related topotential conflicts of interest (COI). Based upon therecommendations of this task force, the A A A Ethical PracticesCommittee (EPC) and A D A leadership developed a set ofguidelines that were endorsed by both A A A and ADA. T h e s eguidelines were published in the May/June issue of A u d i o l o g yToday in 2003 for member comments. Following member input,The Ethical Practices Guidelines for Financial Relationships withHearing Industry Manufacture rs was adopted by the A A A a n dthe ADA, thus providing direction for audiologists on theseissues. The Guidelines reaffirmed the A A A Code of Ethics, Rule4c “Individuals shall not participate in activities that constitute aconflict of profession intere s t ” and gave some specific examplesof conflicts of interest. At that same time, then A A A P r e s i d e n tAngela Loavenbruck embarked on a series of talks and seminarsto educate the membership about the importance of these issues.The A A A EPC also started systematic efforts to inform themembership and raise its awareness of the importance of COIthrough state and national convention presentations and frequentarticles in Au d i o l ogy To d a y.

The 2001 A A A Presidential Task Force considered the resultsof a survey of 42 hearing-impaired consumers and 182audiologists (Hawkins, Hamill, Van Vliet and Freeman, 2002)before recommending that EPC develop guidelines. This surveypresented 17 situations and asked the respondents to react to eachon a rating scale ranging from “clearly unethical” to “nothingwrong.” Given the recent educational efforts to raise awareness ofCOI issues, the EPC requested that this same survey beadministered again to determine if audiologists’ views on COIhad changed. This article discusses the findings.

M E T H O DAll active members of the A A A were solicited directly by

email in February 2006 and invited to participate in the survey.Participation involved visiting a website, logging in, andspending approximately ten minutes responding to the survey.The survey was completed by 1,633 A A A members. Forcomparison purposes, the results from the Hawkins et al. (2001)study of 42 hearing-impaired consumers and 182 audiologistswill be included.

The 17 situations from the questionnaire given to theaudiologists are noted within Figures 1-17. Respondents wereasked to rate each of the activities in one of four categories: 1. “I think there is nothing wrong with that practice.” 2. “While not unethical, that practice may not be in the patient’s

best interest. I would be more comfortable working with aprofessional who did not engage in that business practice.”

3. “I think this business practice is highly suspect and certainlyborders on unethical.”

4. “I think this business practice is clearly unethical.”

On the figures that are shown in the Results section, these fourcategories will be shortened into the following descriptions: 1)Nothing Wrong, 2) Better If Not Done, 3) Borders on Unethical,4) Clearly Unethical.

The content area of the various questions can be described asfalling into one of four areas: 1) business incentives from hearingaid manufacturers, 2) entertainment, small gifts, and visits frommanufacturer representatives, 3) CEU events sponsored byhearing aid manufacturers, and 4) business practices. It should beemphasized that inclusion of an activity in the survey does notimply that the EPB considers that activity to be unethical or toplace the member in a COI, and in fact some of the activities areconsidered acceptable given the 2003 guidelines.

R E S U LT SThe survey results are shown in Figures 1 – 17. A c h i - s q u a r e

analysis of each question was performed to determine whetherthe distribution of responses was significantly different for 1) the

David B. Hawkins, PhD,Mayo Clinic, Jacksonville, FL,Teri Hamill, PhD,Nova SoutheasternU n i v e r s i t y, Ft. Lauderdale, FL and Jane Kukula, AuD,Advanced AudiologyConcepts, Inc., Euclid, OH Ethical Issues in Hearing I


Aids Revisited: A Survey 2002 audiologists versus the 2006 audiologists, and 2) the2002 consumers versus the 2006 audiologists. These resultsare analyzed below in terms of the groupings of thequestions described above.Business incentives from hearing aid manufacturers

Figures 1 – 4 show the results for the four questions thataddressed business incentives from hearing aidmanufacturers. There has been a significant shift in opinionfrom 2002 to 2006 among the audiologists on the questionof accepting cruises and gifts from manufacturers. Morerespondents indicated that it is not appropriate to acceptgifts or cruises in exchange for purchase of a certain numberof hearing aids (Figure 1, chi-square, p<.0001). Forexample, 30% more audiologists found this practice“clearly unethical” in 2006 and the percentage who found“nothing wrong” dropped from 32% to 17%. Interestingly,the distribution of responses for the 2006 audiologists and2002 consumers was not significantly different (p<.20).

Figure 2 shows that audiologists have a different viewwhen the manufacturer rewards the buying of hearing aidswith money deposited into an account to be used forequipment or CEUs or other business expenses. Both todayand in 2002, the majority of audiologists found the practiceacceptable, while 85% of the consumers had found thepractice unethical or bordering on unethical. While over50% of audiologists retain the view that there is nothingwrong with this incentive, and some 10-12% retain thebelief that it is clearly unethical, there was a significant shiftin the degree to which the remaining audiologists viewedthe practice (p<.001), with more now considering thepractice as bordering on unethical. Audiologists consider itmore problematic when the incentive is equipment purchasein exchange for agreeing to purchase a set number of aids inthe next year (Figure 3). The consumers held similar viewsfor both the reserve account and the agreement to purchasehearing aids to repay the equipment purchase. Again, thedistribution of opinions of audiologists changedsignificantly with more finding it unethical (p<.001) to

A hearing instrument company has a new promotion. For everyhearing instrument sold, the audiologist will earn one “credit”. Theaudiologist can redeem credits for products ranging from thoseoffered in a clothing catalog to a cruise to the British Virgin Islands.

A hearing instrument company has what it calls a“professional development plan.” For each hearinginstrument sold, the manufacturer places money into aninvestment account that is redeemable for the purchase ofequipment, book, CE workshops or other business-relatedexpenses. The audiologist joins the plan.


accept equipment for hearing aid purchases; however, thecurrent audiologists’ opinions still differ significantly fromthose of the consumers (p<.001). The perception of thepractice of receiving money or a traveler’s check from amanufacturer for hearing aids purchased is summarized inFigure 4 and is virtually identical to the answer for thecruise/gift question (Figure 1). The audiologists have clearlybecome more concerned about this activity as a significantshift has occurred (p<.001) and the opinions of theaudiologists in 2006 are now similar to those of the consumersin 2002 (p<.10).

Entertainment, small gifts, and visits from manufacture rre p re s e n t a t ive s

Figures 5 - 10 show the results for six questions thataddressed entertainment, small gifts and visits frommanufacturer representatives. The results in Figures 5 and 6show that there is little concern about the practice of salesrepresentatives visiting audiologists and bringing small itemssuch as pens and notepads. There has been no significantchange in the opinion of audiologists over the last four yearson these two practices (p<.43 and p<.13, respectively). W h i l econsumers are also rather accepting of these practices, there isstill a significant difference (p<.001) between the consumersand audiologists, with a small minority of consumers showingsome reservations about any sales visit.

S i m i l a r l y, if the sales representative visits and brings lunchor takes the audiologist out to lunch to discuss products(Figure 7), approximately 85% of audiologists see no problemand opinions regarding this practice have not changedsignificantly from 2002 to 2006 (p<.36). The consumersremain different from the 2006 audiologists (p<.001), withonly 45% seeing nothing wrong with the practice. When theaudiologist and spouse are taken to dinner and products areonly briefly discussed (Figure 8), more concern is seen by allgroups. Audiologists have become significantly moreconcerned since 2002 (p<.001) and the 2006 audiologists arenot significantly different from the consumers (p<.051) withrespect to this issue.

Figures 9 and 10 show the results for the two questionsaddressing entertainment at conventions. When an audiologistattends a party that is open to everyone (Figure 9), an

An audiologist needs a new piece of hearing aid equipment.He or she could borrow the money and arrange a plan througha bank. Instead, the audiologist accepts a hearing instrumentm a n u f a c t u r e r’s offer of this equipment in exchange for buyinga defined number of hearing instruments within a year.

A hearing instruments company sales representative makes apersonal visit to the audiologist to discuss the devices that thecompany sells. The audiologist listens to the salesperson.

A hearing instrument company offers a promotion whereby theaudiologist receives a $100 traveler’s check for each high-technology hearing aid that is purchased. The audiologist takesadvantage of this off e r.


A hearing instruments company sales representative visits thea u d i o l o g i s t ’s office and brings pens, pencils, and notepads withthe name of the new product on it. The audiologist accepts.

overwhelming 93-95% of audiologists report nothingobjectionable. While most consumers seem to approve of thisactivity as well, the distributions are significantly diff e r e n t(p<.001), with 33% of consumers expressing some concern.When the party is by invitation only, the majority of audiologistsin 2002 and 2006 still approve (76 and 74%, respectively).Continuing the trend of consumers being more conservative inethical issues, significantly more concern (p<.001) is seen by theconsumers on this question as well, with only 36% seeing nothingwrong with this practice. Although the audiologists’ change inopinions on the question of parties has been modest, it did reachstatistical significance (p<.01 for each question.)

CEU events sponsored by hearing aid manufacture r sFigures 11 and 12 show the results for two questions related to

CEU events sponsored by hearing aid manufacturers in the localtown of the audiologist. When the audiologist attends a company-sponsored, state-approved workshop in town (Figure 11), 97% ofaudiologists see no problem and this view has not changed in thelast four years (p<.62). When meals are offered along with theCEU events (Figure 12), the consumers are more bothered, asevidenced by the “nothing wrong” percentage dropping from 86%to 64% with the addition of meals. The percentage of audiologistsapproving when meals are added remains high (92-93%) and hasnot changed in four years (p<.95). Consumers and audiologistsremain different in their responses to both questions (p<.001).

The hearing instruments sales representative visits the audiologistover the noon hour and takes him or her to lunch, or the represe-ntative brings in lunch for the audiologist and staff. They discussthe company’s line of products.

A hearing instruments sales representative takes theaudiologist and his/her spouse out for dinner. The salesrepresentative only briefly discusses the company’s products.

An audiologist goes to a party at a professional convention sponsoredby a hearing aid manufacturer. The party is open to all audiologistsregardless of whether they dispense that brand of product.


problem with the practice, down from 26% in 2002 (p<.001).While the distribution of responses for the audiologists in 2006and consumers in 2002 are quite similar for this situation, thed i fference is still statistically significant (p<.01).Business practices

Figures 15 shows the results for the issue of using hearingaids from one manufacturer because of a volume discount whenthe audiologist believes this brand is a good one. While very fewrespondents thought this practice was clearly unethical, somereservations are obviously felt by all three groups. T h eaudiologists did change significantly (p<.01) from 2002 to 2006,with more seeing a problem with this practice. The consumersagain expressed more problems with the practice (p<.05).

The results are similar when the practice of purchasing afranchise and dispensing a single line of hearing aids almostexclusively is presented. Figure 16 shows the results and while itis clear that the majority see nothing wrong with the practice, 40-50% of all groups express some concern through their answers.Again, the modest shift in opinion and the difference between2006 audiologists and consumers reached statistical significance(p <.001 and p<.025, respectively).

The issue of receiving a commission on the sale of hearingaids is addressed in the remaining question and is shown inFigure 17. The audiologists are not different from 2002 to 2006(p<.20) and while the majority see nothing wrong, 45% see somereason for concern about the practice. The consumers aresignificantly different from the 2006 audiologists (p<.001) andclearly are concerned, as only 10% see nothing wrong withreceiving a commission for hearing aid sales.

D I S C U S S I O NThe 2003 Ethical Practice Guidelines on Financial Incentives

f rom Hearing Instrument Manufacturers reminds audiologiststhat the interests of the patient must come before the financialinterests of the audiologist. If a business practice has theappearance of conflict of interest, it must be avoided, even ifthere is no actual conflict of interest. Stated another way, justbecause an audiologist on introspection believes an incentivedoes not affect his or her judgment does not mean that it isappropriate to accept that incentive.

A COI exists when an arrangement has any one of threefollowing three characteristics: 1) a kickback, a quid pro quoarrangement, a gift of money or other item of value tied to thepurchase of a product, 2) a gift of value even when not tied tothe purchase of a product, and 3) an arrangement which has theappearance of a benefit to the audiologist. An added concern isthat under certain circumstances these activities are not onlyunethical but can be illegal. Hahn et al. (2005) stated “Under theFederal Anti-Kickback Statute…it is a felony for any person(including an audiologist) to knowingly and willfully solicit or

An audiologist goes to a free, state-approved continuingeducation seminar offered by a hearing aid manufacturer.The seminar covers the features of the company’s newproducts, and instructions on fitting the hearing aid. Theseminar is held in town.

All groups expressed more concern when a company-sponsored CEU workshop is out of town and themanufacturer pays the audiologist’s expenses to attend.Figure 13 shows the results when the expenses are paid forthe audiologist and Figure 14 when a spouse attends aswell. When only the audiologist attends with expensespaid, slightly over half of the audiologists see nothingwrong, with the percentage dropping from 66% in 2002.This represents a significant shift for the audiologists(p<.001) and again, the consumers are more concernedthan the 2006 audiologists (p<.001). When the spouse alsoattends at the expense of the manufacturer (Figure 14),only 16% of the audiologists in 2006 reported seeing no

At the annual audiology convention, the audiologist attends adinner party that is by invitation only. The audiologist was given theinvitation by the area hearing instruments sales representative.


receive remuneration, directly or indirectly, overtly or covertly,in cash or kind, in return for purchasing, leasing or ordering (orrecommending purchase, lease or ordering) of any item orservice reimbursable in whole or part under a federal health careprogram” (p.34).

This survey indicates a large change in audiologists’ o p i n i o n sabout the most blatant conflicts of interest: accepting gifts andcruises in return for hearing aid purchase. While half ofaudiologists find this clearly unethical, which is the position ofthe A c a d e m y, audiologists’ opinions on the acceptability ofprofessionally related gifts in exchange for hearing aid purchasehas not changed as markedly. Consumers viewed the ethics ofaccepting cruises or business equipment in exchange for hearingaid purchases similarly. Regardless of whether equipment ispurchased from funds deposited into an account as a reward forpurchasing hearing aids, or whether a loan is repaid bypurchasing a given brand of hearing aids, about half of theconsumers find this clearly unethical. Because the consumercould reasonably question whether the motive of the audiologistfor selling a brand was to fund office equipment, the conflict ofinterest guidelines prohibit this practice. A p p a r e n t l y, manyaudiologists continue to justify the “greater good” of thebusiness-related incentives. The problem that arises is that the“goodness” of the gift, e.g., hearing aid fitting hardware oreducation, gives an appearance of “goodness” to the transactionbut in actuality this can be considered a money launderingscheme. Regardless of the “goodness” of the gift, theaudiologist is still accepting a gift that is of value. It is the valueto the audiologist, regardless of potential benefit to the patient,that creates the appearance of a COI.

Same situation as above in #13, but this time thecompany also pays the expenses of the audiologist’sspouse, who is not a hearing health care professional.The audiologist and the audiologist’s spouse attend.

A hearing instruments company sponsors an approvedcontinuing education conference in New York City. Theconference discusses the fitting of the company’s line ofhearing aids, and how to determine which product will helpwhich patient. An audiologist from Florida is invited andattends. The hearing instruments company pays theaudiologist’s expenses.

While the Academy strongly supports the use of state-of-the artequipment and the funding of continuing education, it isrecommended that the audiologist negotiate up-front hearing aiddiscounts from manufacturers rather than engaging in covertbusiness arrangements. Discounts should be reflected on them a n u f a c t u r e r’s invoices and passed on to those third-party payerswho reimburse actual costs. This offers legal protection, as failureto disclose the true cost of goods (e.g., if a Medicaid aid purchasewas rewarded) is a violation of the Federal Anti-Kickback statute.

A company offers a free continental breakfast and buffet lunchin addition to a CEU approved course.The audiologist attendsand eats the offered meals.

Volume discounts are not considered a conflict of interest solong as the discount is not predicated on dispensing a set number ofhearing aids. Negotiating a lower price is a widely acceptedbusiness practice that permits a practice to be financiallysuccessful, well equipped, and ultimately offer lowered costs ofgoods and services to patients. Practices such as purchasingdiscount offers with backend discounts, kickbacks and other hiddenfinancial incentives originated from the hearing aid dispensermodel and are not appropriate for a professional delivery system.F u r t h e r, this is illegal in that the audiologist is “covertly” acceptingindirect remuneration as described by Hahn et al. (2005).

Audiologists had similar opinions about volume discounts andpurchase of a hearing aid franchise. Consumers did not stronglyobject to either practice, but found the franchise to be moreacceptable. This may be because the consumer walking into afranchise has full knowledge that a single brand is dispensed,while volume discounts are not generally disclosed.

Manufacturer training on use of products and software iscrucial. The conflict of interest guidelines advise audiologists thatmanufacturer representatives’ o ffers of business related itemsvalued at less than $100, offered when a representative visits apractice to discuss products, can be ethically accepted, as canbusiness lunches. A u d i o l o g i s t s ’ opinions on this have notchanged markedly; most agree with the Academy position.S i m i l a r l y, the Academy views open-invitation parties atconvention as ethically acceptable, a view that is also supportedby the membership.

Entertainment that has “strings” attached is not consideredacceptable according to the conflict of interest guidelines. T h eexample scenarios in this survey were the non-business dinnerinvitation that includes the audiologist’s spouse and the invitation-only convention party. There has been more change ina u d i o l o g i s t s ’ beliefs that the non-business dinner with the spouseis unacceptable, with nearly half finding that unethical orborderline unethical. There has been less acceptance of the ideathat an invitation-only party for the company’s best accounts is anunacceptable reward. The Academy position is that this is aconflict of interest, as it is a reward for past business that isintended to create a social obligation that patients may view ascompromising the objectivity of the audiologist.

This same rationale applies to company-sponsored training.The Academy prefers that audiologists not accept travel expenses


An audiologist is an employee for a clinic. The audiologistreceives a salary, plus a commission based upon the dollaramount of hearing instruments sold.

An audiologist has purchased a hearing aid franchise from acompany with a well known name, one that advertisesnationally, one that consumers easily recognize. The sign onthe door indicates the brand name. The audiologist dispensesthis product line almost exclusively. The audiologist only usesanother manufacturer’s product when there is no franchiseproduct that can meet the client’s needs.

An audiologist finds that Brand X is at least as good asother brands. By purchasing Brand X hearing aids almostexclusively, the audiologist gets a 20% volume discount;therefore, the audiologist predominantly uses this brand.


if training must be held out of town, but recognizes thatmanufacturers sometimes will find it educationally necessary andmore economical to conduct training in a central location. Inthose cases, the audiologist is permitted to accept travel expensesand meals; however, it would not be acceptable to permit themanufacturer to provide entertainment expenses or spousal travel.There has been a recent trend among manufacturers to off e rtraining trips outside of the country. Although the A c a d e m yviews product training as a responsibility of manufacturers andsupports regional and national product training activities, there isa problem with product training activities which take audiologistsout of the country. While at times a product training trip outsideof the country may be as cost effective as in the United States,audiologists still need to be aware that the appearance ofextravagance creates a conflict of interest. The survey resultsshow that most audiologists are now in agreement. Almost 75%found it unethical or borderline for a manufacturer to fly theFlorida audiologist and spouse to New York for training, whichcompares to 69% of the consumers who held that view.

The conflict of interest guidelines did not specifically addressthe practice of audiologists receiving a commission for the sales ofhearing aids, but the survey has shown a slight change in howaudiologists view this practice. Physician and lawyer Bryan Liangaddressed this issue in his invited presentation at A u d i o l o g y N O W !2006 in Minneapolis. He views a sales-volume incentive system asentirely inappropriate and a clear conflict of interest, but believesother forms of incentives can be entirely ethical. Receiving acommission based on a percentage of the sales price creates aconflict of interest because the patient may question the motivebehind the recommendation. Receiving a work-based incentive is amore acceptable means of rewarding productivity. That is, if anincentive system rewards all forms of productivity equally, it isethical. Liang suggested a system where diagnostic testing hasvalue units and fitting/ dispensing has value units (that are not basedon the product prices). In such a system, a practice may decide toaward more value units to some forms of dispensing, such as to newusers or children, because of greater work involvement, but wouldnot be free to reward an activity more simply because it is moreprofitable, such as selling a high-end digital hearing aid over a mid-range digital aid. Liang counsels that the incentive plan should bearranged in advance and applied equally to all employees, in whichcase it models the relative value unit incentive plans offered tophysicians, which are widely accepted.

C O N C L U S I O N SThe 2006 survey of audiologist’s opinions of the ethics of

relationships with manufacturers shows that audiologists areincreasingly of the opinion that accepting gifts or cruises isunethical, which was the major focus of the A c a d e m y ’s 2003guidelines on relationships with manufacturers. While changes

were also seen in viewpoints on the more subtle, but stillunethical, practices such as the acceptance of equipment in returnfor hearing aid sales, it is clear that further member education isrequired. The Academy has recently published Ethics inAudiology: Guidelines for Ethical Conduct in Clinical,Educational, and Research Settings and AudiologyNOW! 2006o ffered 8.5 hours (.85 CEUs) of continuing education in ethics.These efforts may foster further evolution in the beliefs ofaudiologists about the impact of conflict of interest on thedoctoring profession of audiology.

R E F E R E N C E SAmerican Academy of A u d i o l o g y. (2003). Ethical Practice Guidelines on

Financial Incentives from Hearing Instrument Manufacturers. A u d i o l o g yTo d a y, 15(3), 19-21. (Available online at h t t p : / / w w w. a u d i o l o g y. o rg /p r o f e s s i o n a l / e t h i c s /)

Hahn, R., Abel, D., Kukula, J., and Members of the Ethical Practices Board (2005)Audiologists Beware…And Be Aware of Conflicts of Interest. A u d i o l o g yTo d a y, 17(4), 34-35.

Hamill, T., Ed. (2006). Ethics in Au d i o l ogy: Guidelines for Ethical Conduct inClinical, Educational, and Research Settings. American Academy ofAudiology: Reston, VA .

Hawkins, D., Hamill, T.A., VanVleit, D. & Freeman, B.A. (2002) Potentialconflicts of interest as viewed by the audiologist and the hearing-impairedc o n s u m e r. Audiology To d a y, 14(5), 27-33.

Liang, B. (2006). Ethical issues facing audiology: Law and professionalism.Now Session Presentation at the American Academy of Audiology A n n u a lConvention, Minneapolis, MN.


Thumbs Up!The reviews are in, and AudiologyNOW! 2006 was asmashing success! As the new name of the Academy’sannual convention implies, AudiologyNOW! is a state-of-the-art meeting in a perpetual state of reinvention and discovery.Two weeks after AudiologyNOW! in Minneapolis, I wasmeeting with Sharon Sandridge, the 2007 Program Chair fora debriefing meeting at Academy headquarters to review whatworked and what didn’t at AudiologyNOW! 2006. We beganthe work of enhancing AudiologyNOW! 2007, and developeda timely focus of Hearing Loss Prevention.

What were my favorite moments at AudiologyNOW! 2006,you might ask? Well my first thrill was seeing the giant “A”hanging above the registration area. After working with theProgram Committee and Academy Staff for over a year, itwas a wonderful symbol of the “A” effort they devoted to theproject. I had another thrill during the newly formattedGeneral Assembly hearing Gail Whitelaw and Paul Pessiscount down Audiology’s Top 10 events of the last year. It

was also a thrill to learn about innovation from a master ofinnovation, John Sweeney, who summarized his talk at thereceiving end of a knife-throwing act. Talk about cutting-edge stuff! (Check out this link to re-live the moment:http://events.streamlogics.com/avwtelav/audiology/apr06-06/index.asp).

Speaking of cutting edge stuff, did you catch the Legends ofAuditory Science session? William Brownell, Peter Dallos,Robert Galambos and Jozef Zwislocki enchanted the audi-ence with stories that ranged from the history of auditoryresearch to the most recent developments in our understand-ing of cochlear function. It was a magical moment, but staytuned: AudiologyNOW! 2007 will have…..its own Legends!

What were your favorite things about AudiologyNOW! 2006?You were given the opportunity to complete an online, post-AudiologyNOW! survey of your experiences. The followingis a sample of your favorite things. Can you find Waldo?

Favorite Things— Patrick Feeney, 2006 Program Chair

• N e t w o r k i n g • The session about stem cell re s e a rc h • T h equality of the presentations, the variety of topics, the depth

of knowledge and personal case studies • The gre a tp resentation by Kathleen Campbell on her recent work ino t o p rotective agents • Exploring the Hearing Solutions •I enjoyed the ease of registration and selecting courses• The exciting topics presented in Learning Modules andN O W ! S e s s i o n s • Seeing my professors that I haven’t seenin a long time • Cutting-edge education on innovationsthat came out since I finished school • I enjoyed each

session I attended and learned something new • D a n g e ro u sDecibels was an entertaining session • Wa l d o • E a rned 2.15

C E U ’s • Liked interactive mixture of sessions in with thetypical lecture style form a t • Interacting with pro f e s s i o n a l s

and students from all over the world • I’m a first year AuD studentand I learned so much from this convention that I will be able to use not only in therest of my education but in my future career of audiology • Always learn new thingsto incorporate into my practice • Manufacture r’s tour • Audiology Solutions and thekeynote speaker at the General Assembly • I loved the intellectual stimulation andfocus on key issues happening in our field • Oh, the box lunches were gre a t!


WRAP-UPTH E BO X OF F I C E N U M B E R S A R E I N!With 3,893 attendees and 3,172 exhibitors, a grand total of7,065 experienced the first-ever AudiologyNOW! culminatingin the highest attendance number in the past five years!

Primary Work SettingClinic 14%College or University 15%ENT/Physician Office 13%Hospital 11%Manufacturer 6%Military/VA 3%Primary/Secondary School 3%Private Practice 27%Other 8%

Specialty Area(Attendees were able to select morethan one Specialty Area)

Diagnostics 32%Disorders 14%Hearing Conservation 8%Hearing & Balance Sciences 7%Practice Management 8%Treatment 31%

Years in AudiologyProfession

Student 8%1-5 Years 17%6-10 Years 16%11-15 Years 11%16-20 Years 13%21-24 Years 11%25+ Years 24%

Highest DegreeAuD 26%BA 4%BS 3%EdD 1%MA 21%MD 1%MS 18%PhD 13%MBA 2%Other 7%International 4%

InternationalRegistrantsInternational Attendeeshailed from 54 countries!(Countries with 5 or more attendees)

Argentina 24Australia 32Brazil 39Canada 162China 69Columbia 43Denmark 109France 31Germany 53Ireland 7Israel 5Italy 28Japan 108Korea 7Mexico 33Netherlands 16New Zealand 21Norway 18Portugal 6Scotland 9Singapore 8South Africa 7Sweden 8Switzerland 46Taiwan 9Turkey 9United Kingdom 77Venezuela 7

Thumbs Down!

Challenge: Overbooking Situation at Hyatt Minneapolis.A few attendees experienced an unpleasant surprise at check-in: the Hyatt was overbooked and, even though they had aconfirmed reservation, the hotel was relocating them toanother hotel.

S o l u t i o n: U n f o rt u n a t e l y, the Academy cannot control the actionsof its vendors. However, we can “fight” for our attendees who“book-in-the-block.” In other words, attendees who madere s e rvations through our housing re s e rvation system and weret u rned away by the Hyatt Minneapolis Hotel were compensatedfinancially for 1) free room at another hotel, 2) taxi money, and 3)money for phone calls. Anyone who had made a re s e rv a t i o nd i rectly with the Hyatt Minneapolis Hotel—booked out of theblock—and was turned away was given nothing. The Academyencourages you to continue to re s e rve hotel rooms through ourhousing system so the Academy can help protect you, shouldan unfortunate situation arise. Book-in-the-Block!

Challenge: Not enough rooms in the block. Some at t e n d e e scommented that there were not enough hotel rooms in theblock or that when they went to re s e rve a hotel room short l yafter the opening of the housing process, all of the pro p e rt i e sw e re booked. Potential attendees re s e rving rooms immediate-ly—even before re g i s t e r i n g — c reate this phenomenon.

S o l u t i o n: To better manage the number of hotels rooms beingre s e rved, the convention registration and hotel re s e rv a t i o np rocess will be linked sequentially. Attendees will first re g i s t e rto attend AudiologyNOW! 2007. Upon successfully completingthe registration process, the attendee will be directed to a web-site for re s e rving a hotel room.

Challenge: PreviewNOW! did not list all of the sessionsand/or some did not receive it. At the suggestion of Academymembers, the submission deadline was moved later in 2005 forAN! 2006 to capture the most current re s e a rch and topics. As aresult, the later submission dates precluded those sessions fro mmaking the deadline for the mailing of the pre l i m i n a ry program.

S o l u t i o n: Sessions with invited pre s e n t e r s — F e a t u red Sessions,L e a rning Labs and Focus Gro u p s — a re listed in Pre v i e w N O W !The complete list of sessions will be available online in early2007, including a downloadable .pdf version. The Academy isworking with the Itinerary Planner vendor to further improve thes e a rchable itinerary system.

Over 13,000 copies of PreviewNOW! were mailed to curre n tand potential Academy members. If you did not receive one wesuggest confirming your current address by e-mailinge q u i n n @ a u d i o l o g y. o rg .


2007 Program ChairSharon A . S a n d r i d g eS A N D R I D G E S @ c c f . o r g

Community SupportRobert Tr a y n o rr m t r a y n o r @ a o l . c o m

Discussion/Focus GroupsPatrick Fe e n e yp f e e n e y @ u . w a s h i n g t o n . e d u

Employment Serv i c e sLinda Guenettel i n d a . g u e n e t t e @ u c o n n . e d u

Exhibitor CoursesTodd Rickettst o d d . a . r i c k e t t s @ v a n d e r b i l t . e d u

Featured SessionsJudith S. G r av e lg r av e l @ e m a i l . c h o p . e d u

Learning LabsRichard “ D i c k ” D a n i e l s o nr i c h a r d . w. d a n i e l s o n @ n a s a . g o v

Learning ModulesPatricia B. K r i c o sp k r i c o s @ c s d . u f l . e d u

Research Po d i u m / Po s t e r sMarc Fag e l s o nf ag e l s o n @ e t s u . e d u

Student ResearchPatricia McCarthyPat r i c i a _ A _ M c C a r t h y @ r u s h . e d u

Student Vo l u n t e e r sMona Klinglerm k 2 @ u a k r o n . e d u

Student RepresentativeBrandon Lichtmanl b r a n d o n @ n s u . n o v a . e d u

The 2007 Program Committee metrecently in Denver to begin planning

AudiologyNOW!. Members of theCommittee, being carefully watched

over by the Big Blue Bear, include (fro mleft, back row) Todd Ricketts, Marc

Fagelson, Patrick Feeney, DickDanielson; (from left, front row) Patricia

Kricos, Paul Pessis, Sharon Sandridge( P rogram Chair), Judith Gravel, Linda

Guenette, Mona Klingler, RobertTr a y n o r, Patricia McCarthy and Brandon

Lichtman (student member).

Program Committee begins their work....

AudiologyNOW! 2007 Program CommitteePlease contact the appropriate subcommittee members if you have suggestions or questions.

GETTING READY FOR

2 0 0 7

in DENVER

At right....The2007 Program

Committeechecks out theBig Blue Bear

sculpturepeering in

the window at the

ColoradoConvention

Center.

Cheryl Kreider Carey (left), Deputy Executive Director ofthe Academy with responsibilities for conventions, expo-sition and education activities, is shown above in a busystrategy planning moment for AudiologyNOW! 2007with Sharon Sandridge, 2007 Program Chair.


The term “ r e l ationship marketing” refers to building solid relat i o n-ships with patients that will last for a lifetime. The goal of rela-tionship marketing is not unlike the one that you have for family

or good friends. I t ’s not about having a “ b u d dy - b u d dy ” r e l at i o n s h i pwith patients and colleag u e s , but rather it’s about creating a bond thatwill last a lifetime. Retaining patients and referral sources meanskeeping them informed and connected with you or your organizat i o n .If you don’t, they will slip away and eventually no longer be yourp at i e n t s , just as friends don’t stay friends if you don’t communicat eand show interest in them.

Despite the goal of developing “ p atients for life,” m a ny audiologistsonly communicate with their patients when they want to inform themof new technologies. I liken this to only inviting family and friends forevents associated with gift giving. S o , if you want to develop a long-t i m e , meaningful relationship with someone, w h at should you do?

Take time to get acquainted - When a new patient visits your prac-tice or organization for the first time, make them feel welcome. Ta k esome time to introduce them to the staff and show them the facilitybefore you start testing. Let them know that you are pleased theychose your facility for their hearing healthcare. Patients have achoice of providers so thank them for choosing Y O U . If your facilitys e rves refreshments, ask the patient and their guest if they wouldlike a cup of coffee or water and some cookies while you gat h e rsome informat i o n .

Give them your undivided attention – During the initial interv i e w,a l l ow the patient time to share their story and make notes of the keypoints so you will remember them during future visits. Be a good lis-tener and make sure you have ample time scheduled so you don’th ave to rush. When you are with a pat i e n t , t h at person should be theO N LY thing on your mind. A successful practitioner is usually a busyp r a c t i t i o n e r, but reports and walk-in patients should never get in theway of devoting your full attention to a patient who has scheduled anappointment with you.

Repeatedly share information – Once the patient has left youro f f i c e , you should send information on a regular basis. A good firststep is to send every new patient a thank you note. Let the pat i e n t

k n ow how much you enjoyed working with them and that you lookforward to an ongoing relat i o n s h i p . I t ’s great to share the most recentproduct developments but make sure this isn’t the ONLY informat i o nyou share with pat i e n t s . I n clude updates on the staff and the educa-tional progress they have made. Think about sharing information viaemail and/or printed newsletters. Postcards are also great ways tosend brief messages to pat i e n t s .

Show them you care – It’s paramount that you notice when pat i e n t sfail to come in for a long period of time, and this will require a meansof tracking patient visits. This type of data will enable you to followand actually predict patient behav i o r. When a long-term patient failsto visit your office, it becomes obvious that his or her relat i o n s h i pwith you has changed. You need to let the patient know that yourecognize their absence and that you are concerned. If you only call ap atient when you want them to buy something, they may feel like youonly care about selling them something.

Recognize their accomplishments – Patients appreciate it whenyou remember their birthdays, special anniversaries, or significantevents in their lives like the birth of a child or grandchild or a jobpromotion. Think how special you feel when a friend sends you acard out of the blue. Patients have similar feelings. Remember toacknowledge the death of a patient by sending the family asympathy card.

Since patients are living longer and acquiring hearing loss at youngerag e s , the importance of developing lifetime relationships with pat i e n t sis becoming more valuable to a business. When you want to form alifetime relationship with a pat i e n t , go the extra mile to make themfeel welcome and take every opportunity you can to make them feels p e c i a l . Tr e at every patient as if they are a special friend that youwould hate to lose. Live by the motto, “Love your patients and themoney will follow. ” ( N ag e n )

R e f e r e n c e sC a m p b e l l - A n g a h , D . Come Again? Why Upgrading Patient Te c h n o l o gy Increases

L oyalty and Sales. The Hearing Journal. 2 0 0 6 ; 1 3 ( 5 ) : 7 8 - 7 9 .N ag e n , B . Love your patients and success will follow. A u d i o l o gy To d a y.

2 0 0 5 : 1 7 ( 4 ) : 4 0 .N o v o , J . Drilling Dow n : Turning Customer Data into Profits with a Spreadsheet.

B o o k l o c k e r. c o m , I n c : S t . Pe t e r s b u r g , F L . 2 0 0 4 .

Gyl Kasewurm,AuD,

Co-Chair, American

Academy of Audiology

BEST— Business

Enhancement Strategies

and Tools Committee

It’s All About Relationships


EDITORIAL

Spoken Words versus Spoken LanguageJames Jerger

ARTICLESNormative MultifrequencyTympanometry in Infants and ToddlersLauren Calandruccio, Tracy S.Fitzgerald, and Beth A. PrieveSimultaneous Acute Superior NerveNeurolabyrinthitis and BenignParoxysmal Positional VertigoDavid A. Zapala, Shane A. Shapiro,Larry B. Lundy, and Deborah T. Leming

Effects of Adult Aging and HearingLoss on Comprehension of RapidSpeech Varying in SyntacticComplexityArthur Wingfield, Sandra L.McCoy, Jonathan E. Peelle,Patricia A. Tun, and L. Clarke CoxSpontaneous Recovery of SuddenSensorineural Hearing loss:Possible Association withAutoimmune DisordersJeffrey J. DiGiovanni andPadmaja NairSequencing versus NonsequencingWorking Memory in Understandingof Rapid Speech by Older ListenersNancy Vaughan, Daniel Storzbach,and Izumi FurukawaImproving Speech Intelligibility inBackground Noise with anAdaptive Directional MicrophonePeter J. Blamey, Hayley J. Fiketand Brenton R Steele.

Coming this month in JAAA

AUDIOLOGY TODAY 37VOLUME 18, NUMBER 4VOLUME 18, NUMBER 1

CI Specialty Certification ThrivesMembers of the ABA

Board of Governors

Patricia Kricos, Chair

James Beauchamp

Bettie Champion Borton

Bruce Edwards

Steven Sederholm

Don Vogel

David Zapala

American Academy of Audiology Board of Directors LiaisonTherese Walden

Public MembersJ. Thomas & Sondra King

Past Chair & Ex Officio MemberJohn Greer Clark

S t a ff Director Ex Officio MemberSara Blair Lake

For ABA information contact:American Board ofAudiology™

11730 Plaza America DriveSuite 300Reston, VA 201901-800-881-5410

S a ra Blair Lake, ABA Sta ff Dire c to r, Re ston, VA

IBOARD CERTIFIED IN AUDIOLOGY™

n 2004, after several years in development, the Cochlear Implant Specialty Certification Ta s k

Force of the American Board of A u d i o l o gy™, together with a nationally recognized educat i o n a l

and testing consultant, completed work on an examination that represents the first of its kind in the

f i e l d . The content of the examinat i o n , designed to assess a core body of knowledge representative of

audiological practice in the field of cochlear implants, is the result of a nationwide job analysis. The job

analysis surveyed audiologists working with cochlear implant pat i e n t s , to identify knowledge considered

important to practice. The examination was developed in accordance with the content outline by the

combined effort of qualified subject matter experts, i n cluding Committee Co-Chairs Patricia Chute

and Cheryl DeConde Johnson, as well as testing professionals.

The ABA first offered the examination in March 2005, following the 10th Symposium on Cochlear Implants

in Children in Dallas, Texas. Since that time, ABA has offered the examination on four other occasions in

venues across the US including Washington, DC; Scottsdale, AZ; Valencia, CA; and Minneapolis, MN.

The ABA is pleased to report that at the conclusion of the first year and one-half of the program, t h e r e

are now 53 Board Certified Audiologists with a Specialty in Cochlear Implants. This represents about

13% of the estimated US audiologists who specialize in cochlear implants. In the future, the A B A

plans to offer administrations of the examination in conjunction with each year’s A u d i o l o gy N O W !

convention and following the biennial Symposium on Cochlear Implants in Children. A d d i t i o n a l l y,

if a state academy of audiology or other group would like to offer an administration of the

e x a m i n ation in its geographic area and has a sufficient number of candidates interested in

taking the examinat i o n , the ABA will work with the group to hold such an additional

a d m i n i s t r at i o n . Those interested should contact the ABA office.

The ABA is in the process of redesigning and updating its website (anticipated

date of completion is Fall 2006) and a new feature will spotlight those

professionals holding the Cochlear Implant Specialty Certification.

This credential is important as it will assist both hearing health

professionals and consumers in identifying those audiologists

who have demonstrated that they possess knowledge

representative of professional practice in this highly

specialized area of audiology.


rofessions, most often through their professionalassociations, have a number of critical imperatives as theyattempt to balance their responsibilities to the public andsociety in general and to their practitioners. Through avariety of self-regulatory functions, professions definetheir scope of practice and the body of specializedknowledge, skills and competencies that must be masteredprior to entry into the profession. In American highereducation, accreditation of higher education institutionsand specialized programs within those institutions isvoluntary. Through voluntary accreditation, societyattempts to ensure that the services provided to its citizensby various professions meet self-imposed standards ofquality and are delivered with integrity. The self-regulatory process prevalent in North America is unique –in most countries throughout the world, national ministriesof education perform this quality assurance function. Inthis country, while accreditation is voluntary, it oftenserves as a gatekeeper for federal funds and therefore mustbe responsible to the public for institutional performancein accredited programs. In the Audiology profession,standard development and accreditation is undergoing anhistorical change, which places it firmly in the forefront ofstate of the art changes in the accreditation process.

For the past 20 years, and most certainly over the past 10years, Audiology has evolved into a distinct and uniqueprofession. In its early development, Audiology waslinked academically to speech-language pathology, aprofession whose educational model and political agendahad become increasingly mismatched. As this mismatchbecame more noticeable, audiologists joined together toform two new national organizations that could betterserve their needs. The Academy of Dispensing

Audiologists (ADA) was formed to represent theburgeoning interests of those audiologists who weredispensing hearing aids and starting practices. TheAmerican Academy of Audiology (AAA) was formed tobe a voice of, by and for audiologists alone. Through theleadership of these professional organizations, oureducational and training model evolved from one whichstressed classroom education and student teachingassignments to educational models that stress integrationof classroom and clinical education. Rather thansystematically devaluing clinicians, the profession’s moveto doctoral education with a distinctive designator, theAuD, increases the value placed on clinical education andthe practitioners who deliver these services. Our evolutionhas aligned the AuD degree with the attainment ofknowledge, competencies and skills needed to enter theAudiology profession.Our licensure laws are slowlyfalling into line with the new realities of our profession.All of these developments are steps toward the autonomyof the Audiology profession.

The development of both academic standards for universityprograms and professional practice standards foraudiologists represents the underpinnings of our profession.Our development into a doctoral entry-level profession hasmeant that these standards had to undergo a critical revisionto coincide with the change in entry-level degreerequirements. Throughout our history, the process ofstandard development and the process of accreditation ofAudiology programs have been closely tied to A S H A’scertification program. A S H A’s accreditation standards havedemanded that students be prepared for the A S H Acertificate and have permitted supervision only fromindividuals who have also purchased the A S H A c e r t i f i c a t e .

AngelaLoavenbruck, EdD

Past Chair, Accreditation

Commission for Audiology

Education, Washington, DC

AngelaLoavenbruck, EdD

Past Chair, Accreditation

Commission for Audiology

Education, Washington, DC AccreditationAccreditationAn Important Step

in the

P

Angela Loavenbruck recently completed a term as the Chair of The A c c r e d i t ation Commission for A u d i o l o gyE d u c ation (ACAE). The ACAE is developing programs to provide the profession of audiology with standards ofa c c r e d i t ation by which all audiology programs can be measured. The proposed standards define thee x p e c t ations of the ACAE with regard to an accredited professional audiology (AuD) degree program and providea framework for a program’s self-study process. Additional information is available at www. a c a e a c c r e d . o r g .


and the ACAE:and the ACAE:ForwardEvolution of the Audiology Profession

Universities have been required, as part of theaccreditation process, to list the A S H A m e m b e r s h i pnumbers of all faculty, staff and off-campus audiologistswho provide supervision. A S H A’s standards structuredid not permit input from Audiology professionalo rganizations, nor from audiologists who chose not topurchase the A S H A certificate. In addition, A S H Astandards failed to differentiate sufficiently betweenMasters level preparation and doctoral preparation andwere based on practice survey data which had not beenupdated. Finally, the A S H A accreditation standardsincluded PhD programs designed to prepare researchersrather than specifically recognizing the AuD as theentry-level degree for the practice of A u d i o l o g y.

As our evolution proceeded, it became clear that ourAudiology professional organizations had theresponsibility to create and monitor our profession’sstandards, both for individual practitioners and for theeducational institutions that prepared audiologists. Ifthese organizations were truly to represent theprofession and its practitioners, they had to developstandard setting and accreditation mechanisms ratherthan continue to cede these vital functions to otherprofessional organizations.

Throughout its history, A A A has called for thedevelopment of independent standard setting bodieswhich were supported by all Audiology professionalo rganizations, rather than being controlled by a singleo rganization. In a 1994 letter to Kenneth Moll, Chair ofan A S H A “Joint Committee on Accreditation”, thenA A A president Lu Beck recommended that “joint”committees should indeed have representation and votingrights for all interested parties, that accreditation shouldbe carried out by an entity which was separate from anysingle organization and that accreditation of A u d i o l o g yeducation should be administered by an accrediting body

which is separate from oneaddressing speech-languagepathology issues.

In the years since then, A A Ahas initiated many efforts toform an independentaccrediting body.

In 2003, thedevelopment of a newaccreditation body, the

Members of the Accreditation Commissionfor Audiology Education shown aboveinclude (from left) Angela Loavenbruck(past- chairperson), Ian Windmill(Chairperson), Doris Gordon (ExecutiveDirector), Catherine Palmer, LindaSeestedt-Stanford, Lisa Hunter,George Osborne and CynthiaEllison. Not shown are membersJames McDonald (Sec-Treas), TedWendel, and Donna Burns-Phillips (Public Member).


Accreditation Commission for Audiology Education(ACAE), was accomplished jointly by A A A and A D A .Funding has been provided by both of these membershipo rganizations along with some initial funding from theAudiology Foundation of America. The A c c r e d i t a t i o nboard is made up of practitioners and academics, and aunique web-based accreditation program has beendeveloped specifically for AuD programs. ACAE is anindependent non-profit organization whose accreditationmission is to recognize, reinforce and promote highquality performance specifically in AuD educationalprograms through a rigorous verification process. In2004, ACAE engaged the services of LiaisonInternational, Inc/Academic Management Systems tobegin work on the development of an interactive, web-based accreditation system that would allow educationalprograms seeking accreditation from ACAE to completevirtually all aspects of the accreditation process online. Inaddition to the enormous time savings of this innovativeprocess, programs would easily be able to retrieveimportant national data about applications, enrollments,graduation rates, student achievement, and other dataimportant to academic programs. Programs would also beable to share generic data with their Deans, Provosts andPresidents, as needed.

There are two major components of the ACAEComputerized Accreditation Program (CAP). The firstcomponent is an automated online accreditation processconsisting of four parts:

1) an accreditation home web site for standards, policiesand procedures;

2) a program management database;

3) electronic surveys which form a data warehouse anddata retrieval system for each program;

4) an ACAE self-study website to be used by each programas it proceeds through the accreditation process and apost-visit assessment web site.

The second component consists of competency assessmentmetrics that will be offered to AuD programs for their usewith student and program evaluation. The metrics will beused to assess student learning outcomes at several stagesthroughout their education, defined in terms of particularlevels of knowledge, skills, abilities and competencies thata student has attained during the AuD program.

The ACAE Board of Directors began the process ofwriting the educational standards for accreditation inearly 2003, with review and comment requested from

innumerable experts from external agencies ando rganizations. After 18 months, a draft set of Standardsand request for comment was distributed to 16,000audiologists via web sites (AAA, ADA, A FA a n dACAE) and hard copies were also sent to eachacademic program and to numerous external groups.After review of comments, the standards were adoptedby ACAE in March 2005. Simultaneously, A C A Ebegan the process of obtaining recognition as a newaccrediting body for AuD programs from the UnitedStates Department of Education.

Two AuD programs (CID-Washington University andCentral Michigan University) volunteered to serve asBeta sites to test the CAP system before launching it toother academic programs. The beta sites have greatlyassisted ACAE in streamlining the web-based process.Both programs have completed the first phase of CAP,the completion of eight surveys, and have begun the self-study process. In addition, ACAE held its first sitevisitor training session in April 2006. Ten additionalprograms have expressed strong interest in the A C A Eaccreditation process.

As might be expected, the development of a newaccreditation body has created controversy. Audiologyprograms that exist within Speech-Language Pathologydepartments are concerned about the need to undergo twodifferent accreditation processes. Others are concernedabout the ability of the Audiology profession to fund a newaccrediting body. Funding is of course an issue.Accreditation is an expensive process. At this time,funding from the Academy and ADA continues. TheACAE Board and Executive Director, Doris Gordon, areactively pursuing foundation donors for this critical effort.

The Academy has also created an Education Committeecharged with developing professional practice standardsfor entering audiologists. In addition. ABA has begun theprocess of creating a new national exam to replace thePraxis exam currently used by all licensure boards. As anAccreditation body, ACAE’s function is to be informed bythe profession’s definition of the knowledge, skills andcompetencies which define an audiologist, and to use thisdefinition in its academic standards. This three prongedeffort by ACAE, Academy's Education Committee, andABA finally put the Audiology profession in control of theessential components of its autonomy. For moreinformation about these efforts, visit the following websites: www.acae.org, www.audiology.org,www.AmericanBoardofAudiology.org.


Confused about which CPT code is most appropriate? When to use a modifier?Which diagnosis code is correct? The Academy’s new re i m b u r s e m e n tCD/Manual takes the mystery out of re i m b u r s e m e n t .

Applicable to all practice settings, Capturing Reimbursement p rovides muchneeded direction and guidance to help you master the reimbursement side ofa u d i o l o g y. From coding to collections… from payment policies to federalregulations, this essential manual will help you achieve optimal reimbursement.

Developed by the American Academy of Audiology’s Coding andReimbursement Committee.

Reimbursement Got You Rumpled? Capturing Reimbursement: A Guide For Audiologists

O rder online at the Academy Store :

w w w. a u d i o l o g y. o rg / s t o re

Capturing Reimbursement isavailable as a CD-ROM (Members:

$150) or CD-ROM with Manual(Members: $175). NOTE: Thismanual does not list codes.

• Reimbursement• Medicare• Coding Correctly• Documentation• Practice Management

• HIPAA• Stark Law & Other Federal

Regs

• Plus easily customizableforms and tools!

JULY/AUGUST 2006

Hearing loss is often caused by death of haircells in the inner ear. Common causes ofhair cell death include ag i n g , noise toxicity,

certain chemotherapeutic drugs and geneticc o n d i t i o n s . Consequences of loss of hair cells inthe inner ears are hearing and balance impair-m e n t s . U n f o r t u n at e l y, hair cells in the inner earof mammals are not regenerated after injury.T h e r e f o r e , the hearing loss that results from haircell death is permanent. M ature hair cells aresaid to be “terminally differentiat e d ,” m e a n i n gthey do not divide. Recent evidence suggestst h at a gene called retinoblastoma may representa key regulat o ry element that could help“ u n l o c k ” hair cells and allow them to undergocell division and thereby to regenerat e .

The retinoblastoma protein (pRb) is the geneproduct of the tumor suppressor gene RB1, t h efirst tumor suppressor gene to be cloned (Fr i e n det al., 1 9 8 6 ) . The protein derives its name fromthe malignancy retinoblastoma, which resultswhen both alleles of the RB1 gene are mutat e d .Retinoblastoma is the most common childhoodcancer of the eye (Finger et al., 2 0 0 2 ) .

W h at is a tumor suppressor? As the names u g g e s t s , the function of a tumor suppressor isto prevent a cell from becoming malignant.Different tumor suppressor gene products canachieve this function via different mechanisms.The mechanism by which retinoblastoma func-tions involves the suppression of proteins thatpromote cell cy cle progression. The general cell

cy cle consists of 4 stag e s : 1) The G1 phase (firstg r owth phase), during which the cell is metaboli-cally active and carries out its functions, 2) the Sp h a s e , during which DNA is duplicated such thateach daughter cell has the right amount ofgenetic material to undergo cell division, 3) theG2 phase, a second growth phase, and 4) the Mp h a s e , m i t o s i s , during which the cell divides intotwo identical daughter cells.

At several stages in the cell cy cl e , there are“ c h e c k p o i n t s ” to ensure the integrity of the cell.If any serious error is detected in the cell’s DNA,it is the role of the tumor suppressor to stop thecell cy cl e . In this way, cells with damaged DNAare prevented from dividing, and the format i o nof a tumor is suppressed.

The retinoblastoma protein (pRB) plays animportant role in regulating the expression ofproteins that control the checkpoint at thetransition between the G1 and S phases ofcell division.

A recent report by Sage et al. (2005) exam-ined the effects of deleting the retinoblastomagene on hair cells in mice. They investigat e dwhether hair cells could divide when pRb isa b s e n t . They showed that preventing theexpression of pRb in the inner ears of immat u r emice lead to an increased number of hair cells,i n d i c ating that pRb plays a role in cell cy cl earrest in hair cells. These data further show thatmammalian hair cells, even “terminally differen-t i at e d ” o n e s , can reenter the cell cy cl e , and new

hair cells can be generated from preexistingo n e s . Fi n a l l y, the new hair cells derived fromthese cell divisions were shown to fully differen-t i ate into functional hair cells.

As the results indicat e , pRb plays a key rolein regulating the cell cy cle of mammalian hairc e l l s . The most immediate implication of thesefindings is the possible generation of a largenumber of hair cells that could be utilized instudies for investigations of hair cell differentia-tion and regenerat i o n . Further studies investigat-ing the manipulation of this gene may offerinsight into the development of potential thera-pies aimed at inducing hair cell regeneration inhumans with hearing loss. H ow e v e r, m a ny addi-tional intensive studies will be required to reachthis ultimate goal. As Taylor and Forge (2005)point out in their comment on the paper by Sag eet al., pRb should only be inactivated temporarilyto cause hair cell regeneration to a desiredd e g r e e , and it would then have to be reactivat e dto stop cell division. O t h e r w i s e , hair cells wouldcontinuously divide, which is characteristic oft u m o r s . Last but not least, S age et al. carried outtheir studies on hair cells from very young( n e o n atal) animals. H e n c e , it is still uncl e a rwhether the inactivation of pRb would producethe same effect on the cell cy cle of mat u r e(adult) hair cells.

BI B L I O G R A P H Y:S ag e , C . , H u a n g , M . , K a r i m i , K . , G u t i e r r e z , G . , Vo l l r at h ,

M . A . , Z h a n g , D . , G a r c í a - A ñ o v e r o s , J . , H i n d s , P. W. ,C o r w i n , J . T. , C o r e y, D . P. , and Chen, Z . P r o l i f e r ation ofFunctional Hair Cells in Vivo in the Absence of theRetinoblastoma Protein. S c i e n c e 3 0 7 ( 5 7 1 2 ) : 1 1 1 4 - 8 ,2 0 0 5 .

Fr i e n d , S . H . , B e r n a r d s , R . , R o g e l j , S . , We i n b e r g , R . A . ,R ap ap o r t , J . M . , A l b e r t , D . M . , D ry j a , T. P. A Human DNASegment with Properties of the Gene thatPredisposes to Retinoblastoma and Osteosarcoma.N at u r e 3 2 3 ( 6 0 8 9 ) : 6 4 3 - 6 , 1 9 8 6 .

Fi n g e r, P. T. , H a r b o u r, J . W. , and Karcioglu, Z . A . R i s kFactors for Metastasis in Retinoblastoma. S u rvey ofO p t h a l m o l o gy. 4 7 ( 1 ) : 1 - 1 6 , 2 0 0 2 .

Ta y l o r, R . , and Fo r g e , A . Life After Deaf for Hair Cells?Science 3 0 7 ( 5 7 1 2 ) : 1 0 5 6 - 8 , 2 0 0 5 .

New Concepts in Hair Cell Regeneration

Mona Taleb, BS Medical University of South Carolina, Charleston, SC

Kathleen Faulkner, MS University of Washington, Seattle, WA

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

42 AUDIOLOGY TODAY


Q Could you provide us with an overview ofregional accreditation and accreditation by theCouncil on Academic A c c reditation (CAA)?

A Since 1965, the Council on A c a d e m i cAccreditation (CAA) (or its antecedents) hasgranted and monitored accredited status for

audiology and speech-language pathology programs at 265d i fferent colleges and universities. The CAAis what’s knownas a specialized accreditor because we concern ourselvesonly with entry-level professional preparation programs inaudiology and speech-language pathology (SLP). There aremany other specialized accreditors, such as the A c c r e d i t a t i o nBoard for Engineering and Technology (ABET), the NationalCouncil for Accreditation of Teacher Education (NCAT E ) ,and so on. Regional accreditors are the six organizations thataccredit entire institutions of higher education. Regionalaccreditation is extremely important for institutions becauseit is required for access to many types of federal funding. T h eC A A only accredits programs that are housed in regionallyaccredited institutions.

Just to keep things confusing, there are also nationalaccrediting bodies that accredit for-profit institutions, althoughsome for-profits have regional accreditation, too.

Accrediting agencies can be accredited, too. The CAA i scurrently recognized by both the Council on Higher EducationAccreditation (CHEA), which creates and monitors qualitystandards for accreditors, and by the US Department ofEducation, which grants recognition to regional, national, andspecialized accreditors that meet their recognition criteria.

Professionals in our disciplines are often confused aboutthe difference between the job of the American Speech-Language-Hearing Association (ASHA) Council for ClinicalCertification (CFCC) and the CAA. The CFCC creates andmonitors standards for i n d i v i d u a l s who engage in clinicalpractice and certifies those individuals who meet currentstandards. Similarly, state licensure and other credentials,such as those from the American Board of A u d i o l o g y™ a n d

public school certification programs, are awarded inrecognition of an individual’s ability to meet the standards ofthose agencies. The CAA, on the other hand, creates andmonitors standards for p ro f e s s i o n a l e d u c a t i o n. CAAstandards encompass entry-level degree programs’ a d-ministrative structure and governance, faculty suff i c i e n c yand qualifications, academic and clinical curricula, studentpolicies, student and program assessments, and programresources. Our focus is on programs, not individuals.N a t u r a l l y, we expect entry-level programs to prepare theirstudents to become credentialed professionals, so we payclose attention to certification and licensure standards ands t u d e n t s ’ ability to meet those standards.

The CAA is an entirely autonomous agency in termsof creating and applying standards, and all theacademic members of the CAA are elected directlyby the accredited programs. The current CAAstandards contain an explicit list of the knowledgeand skill areas in which we expect programs toprepare their students for practice in audiology.New accreditation standards are undergoing afinal round of peer review, and thoseproposed standards include separatecurriculum sections for audiology andspeech-language pathology, each withits own knowledge and skillsinventories.

In the past we simply referredto certification standards for theknowledge and skills, but thenew proposal makes it clearthat the CAA is responsiblefor determining whatprograms need to providefor their students. The CAAis undertaking a “practiceanalysis” in the coming

Teri Hamill, PhD Nova Southeastern

University,Fort Lauderdale, FL

Teri Hamill, PhD Nova Southeastern

University,Fort Lauderdale, FL

Interview with the Council on Academic AccreditationAT Speaks with CAA Chair, Amy Wohlert

Interview with the Council on Academic AccreditationAT Speaks with CAA Chair, Amy Wohlert

The Council on Academic Accreditation of the American Speech-Language and Hearing Association is the independent body that accredits entry-level academic programs in Speech-Language Pathology and Audiology. The current chair, Amy Wohlert, PhD, CCC-SLP, is also Dean ofGraduate Studies and Vice Provost for Graduate Education at the University of New Mexico. Dr. Wohlert agreed to clarify some issues ofaccreditation with Teri Hamill, Associate Professor at Nova Southeastern University, who conducted this interview on behalf of Audiology Today.(www.asha.org/about/credentialing/accreditation/CAA_overview)

JULY/AUGUST 2006

year so that we can update the knowledge and skillrequirements for education in both professions.

Q C A A’s fees for a c c reditation are quite low incomparison to other a c c rediting bodies andthe fee mentioned by the A c c re d i t a t i o n

Commission for Audiology Education. How has CAAbeen able to keep the fees so reasonable, and do youbelieve that the current fee structure will be re t a i n e d ?

A The CAA is responsible for generating 40% ofits operating budget. We review fees everythree years to make sure that we honor that

commitment. The remaining 60% of our budget comesfrom ASHA, because the membership recognizes that thequality control provided by accreditation is a significantbenefit for members, students, and the public. We hope tomaintain that financial relationship because it creates ana ffordable process for programs while allowing the CAAfull autonomy to carry out its mission.

Q Can you outline the major recent changes ina c c reditation, considering that most of usgraduated from master’s programs and are

used to tallying clock hours? What are the majorchanges since the 1993 standard that called for 2 7c redits of basic science and 36 credits of pro f e s s i o n a lcoursework, 350 clock hours, and the CFY?

A Your question relates mainly to recent changesin A S H A certification standards, butaccreditation standards will be changing, too.

We are mandated to review the standards regularly. T h ecurrent CAA accreditation standards went into effect in1999, and we expect to finalize a new revision this year,for implementation in 2008.

The proposed accreditation standards emphasizequality indicators, rather than numbers. For example, thedraft that is now being peer-reviewed says that thecurriculum must be sufficient to allow students to acquirethe knowledge and skills listed in the standard. We giveimplementation guidelines suggesting that for a clinicaldoctorate, this usually means four years of graduate studyincluding at least 12 months of full-time clinicalexperience, interspersed appropriately in the curriculum.Because programs count credits in many ways, it did notseem as useful to try to define an adequate curriculum interms of credit hours. However, students must be awarethat certification and licensure standards have their ownrequirements, which can differ from state to state andagency to agency, and those standards may indeed specifycertain numbers of credits and hours of clinical contact.

The KASA (Knowledge And Skills A c q u i s i t i o n )Summary Document is a CFCC form used to track ani n d i v i d u a l ’s acquisition of the knowledge and skillsrequired for A S H A certification. CAA standards stipulatethat programs maintain some sort of tracking system fortheir students, showing each student’s progress through thecurriculum and their progress in preparing for certification,licensure, and any other appropriate credentials. Manyprograms use a form based on the KASA to do this, but theC A A does not require programs to do so.

Q So, programs no longer have to off e r Xhours of diagnostics coursework, Y hours oft reatment coursework. But am I re m e m-

bering correctly that doctoral programs must have atleast 75 semester hours, of which 65 semester hours areof didactic instruction, in order to be accre d i t e d ?

A In the current (1999) CAA standards, doctorallevel programs must offer a minimum of 75post-baccalaureate credit hours, plus an

aggregate of at least 52 weeks (fulltime equivalent) ofsupervised clinical practicum. Regardless of the numberof credits or clock hours, the current accreditationstandard also states that the curriculum must be suff i c i e n tin breadth and depth for graduates to achieve theknowledge and skills outcomes identified for entry intoindependent professional practice. In the proposal forrevised standards, we wish to focus on the crucialoutcomes rather than on numbers of credits, which maynot be reliable quality indicators.

Last fall, the CAA circulated a proposal for standardsrevision that specified 75 didactic hours, including nomore than 10 thesis/dissertation hours and excludingclinical practicum hours, but the feedback we received ledus to make further revisions of that proposal. We are nowcirculating an amended proposal in which we havereplaced credit hour rules with duration guidelines, asdiscussed in the last question. We will evaluate theresponses from this latest round of peer review at our nextC A A meeting in mid-July 2006, when we hope to vote ona final version. The peer review survey www. a s h a . o rg /p e e r-review/Standards-GradPrograms.htm was openthrough June 18, 2006. The CAA can also be contacted bye-mail at [email protected] .

QWhen must programs ensure that allgraduates earn a doctoral degree (ratherthan a master’s) in order to re t a i n

a c c re d i t a t i o n ?

44 AUDIOLOGY TODAY


A The profession of audiology has determined thatthe clinical doctorate is the appropriate entry-level degree. Because the CAA wants to ensure

that graduates of accredited programs are appropriatelyprepared to begin practice, we will no longer accreditm a s t e r’s programs in audiology after December, 2006.

Q You mentioned that CAA standards call foracademic instruction in the full scope ofpractice of audiology, and that there are

specific lists of the needed knowledge and skill sets tobe mastered. What clinical experiences must bep rovided? For example, can an accredited pro g r a mp rovide students with academic knowledge, but noactual clinical or lab experience in a given area, e.g.v e s t i b u l a r assessment, or a u d i t o ry intervention gro u pt reatment?

A The CAA standards (both the current and theproposed) state that the curriculum must bes u fficient to prepare students to begin

independent practice across the full depth and breadth of thescope of practice. The standards list the specific knowledgeand skills that must be addressed in the curriculum. Clinicalexperience is an important part of the educational process,and the CAA expects programs to demonstrate that everystudent has access to coursework and clinical opportunitiesadequate to acquire both knowledge and practical skill inevery listed area. Because the scope of practice evolves, theC A A must conduct regular practice analyses and update thestandards accordingly to ensure that our requirementsremain consistent with the scope of practice. We plan tobegin new practice analyses in both audiology and SLP i nthe coming year.

Q I think this one’s a critical issue, so let me bes u re I’m understanding you here. If ap rogram provided instruction on vestibular

evaluation, but its students had no clinical practicum, orif a program did not make provision for students toa d m i n i s t e r a formal aural rehabilitation program, thenthe program would not qualify for a c c re d i t a t i o n ?

A It is not adequate for a program to provide onlyopportunities to gain knowledge in an area; theprogram must provide sufficient opportunities to

develop the requisite skills, too. If a program does notprovide students with educational experiences that areadequate to achieve entry-level independence in all theknowledge and skill areas listed in the standard, then theprogram would not be in compliance with that accreditationstandard.

Aural rehabilitation and balancedisorders are among the listed knowledgeand skill areas.

Q P re v i o u s l y, all diagnosticexperiences had to be dire c t l ym o n i t o red for at least 50% of the

evaluation, while all treatment hours were at least25% supervised. Is this still a re q u i re m e n t ?

A The proposed CAA standards state that “theprogram must demonstrate that the natureand amount of supervision is determined and

adjusted to reflect the competence and growth of eachstudent.” The current standards have a similar statement.Certification and state licensure standards may include moreexplicit regulations for minimum amounts of supervision, sostudents and program directors should be familiar with thosestandards, too.

Q The current standard 3.1 states “thecurriculum (academic & clinical education)…is sufficient to permit students to meet

A S H A - recognized national standards for e n t ry intothe profession.” A S H A c e rtification re q u i res thatclinical experiences are supervised by an audiologistwho is A S H A c e rtified. Must a program ensure thatall students have the equivalent of 1820 hours ofclinical experience from a CCC-A p re c e p t o r ?Would it be acceptable if students who wish toattain certification be provided that opport u n i t y(placement with CCC-A p receptors), whilethose who do not hold that care e r goal bepermitted to extern with a non-CCC-Ap re c e p t o r ?

A The proposed accreditationstandards indicate thatsupervision must be provided

by qualified individuals and allowstudents to achieve the professionalcredentials they desire. Statelicensure regulations andcertification standards are morespecific about the qualificationsof supervisors/preceptors usedfor their purposes and aboutthe number of hours required.

For CAAaccreditation, aprogram must showthat students are able


to achieve common professional credentials and that allsupervision is conducted by individuals who haveappropriate qualifications—which means appropriateexperience and education, as well as appropriate licensureand/or certification. The CAA requires evidence thatsupervisors/preceptors used for hours counted towardsA S H A certification have CCC-A, and supervisors/ preceptorsused for other purposes have the credentials appropriate forthose purposes—which might not include CCC-A.

Faculty and staff who do not provide direct supervision ofstudents for the purpose of A S H A certification hours do notneed to hold the CCC-A. However, it is important that theprogram provides evidence that it has sufficient access tosupervisors/preceptors who have appropriate qualifications,including CCC-A, so it is clear that students can choose topursue certification as well as other credentials.

Q As you have mentioned, the new standards areoutcomes based, where student competenciesa re evaluated and tracked. Am I correct in

believing that curre n t l y, the university faculty provide theinstruction, and then the university faculty assess thee ffectiveness of the instruction in each of the student skilla reas — there is no longer a CFY re p o rt or o t h e r form ofstudent evaluation by someone outside the university thatis re p o rted to either CFCC or CAA? This is an area ofconcern to me – I believe there is no individual studentvalidation of skills by anyone outside the university. Ithink a weak program could verify student performanceusing their own (weak) standards.

A The CAA monitors the ability of programs toprovide students with the required knowledgeand skills. Thus, we look at objective outcome

measures such as the percentage of students in a programwho pass the Praxis examination. We also require thatprograms seek evaluation by people outside the program,such as alumni, employers, and clients, in order todetermine if their students in general are considered to bewell prepared to begin independent practice. Accreditedprograms must not only compile this information, but alsoshow that they evaluate the results and use them forplanning program improvements.

I don’t know if the CFCC has plans for externalevaluation of individual students’ clinical skills.

Q You mentioned the Praxis exam (some mayrecall it as the NESPA). Must students pass the Praxis exam for a program to

retain accre d i t a t i o n ?

A The percentage of students who pass the Praxisexam each year is one of the outcome measuresthat accredited programs report annually to the

CAA. Programs whose pass rate falls below the nationalaverage pass rate (currently, about 80% of students who takethe Praxis exam in Audiology and SLP pass) are asked toexplain the reason for the low rate and show their plans forhelping students to be successful. A low pass rate for anumber of years in succession would certainly be a cause forconcern, but the effect on accreditation status would dependon a variety of factors.

Q How often is the Praxis audiology examupdated? Who writes the questions?

A The Educational Testing Service (ETS) owns,administers, and updates the Praxis exams. T h eaudiology exam questions are continuously

updated by a team of subject matter experts (audiologists).

Q Do you know when it was last updated, and hasC A A evaluated the current test, which servesas a significant means of evaluating the

university programs?

A The audiology exam questions are continuouslyupdated by a team of audiologists, and the ETSperforms regular tests of the validity and

reliability of its examinations. The CAA does not evaluatePraxis examinations, but we do listen to programs’ i n p u tabout how well or poorly Praxis exam results reflect theirsuccess in educating students.

Q Is CAAA developing any formativeexaminations, or is this solely the re s p o n s i b i l i t yof the university pro g r a m ?

A At this time, the CAA has not discussed thepossibility of developing any formativeexaminations to be used by all programs.

P e r s o n a l l y, I think the idea has merit for accreditation as ameans for programs to calibrate their success in deliveringeach stage of their curriculum.

Q A re there any points I didn’t cover that youwould like to addre s s ?

A Your readers have probably heard enough fromme at this point, but I hope they will let me knowif there is anything I didn’t cover, or any points

that are still confusing. Thanks for giving me the opportunityto talk with you.

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Pam Furman,Marshall Matz,

Bob HahnOlsson, Frank &

Weeda, PC, Washington DC

ust when you thought you knew all of the letters….H H S , C M S , O M B , POTUS (President of the United Stat e s ) , h e r e

comes another one: SOC Codes. They are actually quite important.SOC stands for Standard Occupational Classificat i o n . The Office ofM a n agement and Budget (OMB) in the White House designate SOCcodes after being proposed in the Federal Register and open to publicc o m m e n t . A notice has just been published in the Federal Register t ostart the process of reconsidering the current cl a s s i f i c at i o n s .

The SOC Codes are binding on the entire federal government andthey have an effect on the private sector as well. Audiologists arei n cluded in the SOC designat i o n , but not exactly as we would like.

The Academy participated extensively in the last revision of the SOC,and submitted comments on four separate occasions, November 17,1995; May 3, 1996; September 4 , 1997; and October 9, 1 9 9 8 . In ourc o m m e n t s , we made two requests:

Fi r s t , we asked that audiology be recognized as a distinct profes-

s i o n , s e p a r ate from speech-language pat h o l o gy.

S e c o n d , we asked that audiology be taken out from under the sub-

heading “29-1120 T h e r ap i s t s ,” and placed in a separat e , s t a n d - a l o n e

c at e g o ry under the main heading.

OMB responded favorably to our request that audiology be cl a s s i-

fied separately from speech-language pat h o l o gy and that change was

m a d e . H ow e v e r, OMB did not make the other change we requestedeven though therapy is only one part of what an audiologist does. We

continue to believe that audiologists should be taken out from under

the subheading “ T h e r ap i s t s ,” and placed in a separat e , s t a n d - a l o n e

c at e g o ry. It is our hope that this change will be made as part of the

current SOC revision process, and we will be asking our leadership, at

the State and national level, to participate in the process with a letter.

J


HI S T O RY O F T H E AC A D E M Y’S PA RT I C I PAT I O N I N T H ESOC PR O C E S S

The American Academy of A u d i o l o gy participated extensively in thelast revision of the SOC during Carol Flexer’s presidency. Since the final-i z ation of the 1998 SOC, the Academy has continued to interact withOMB and the Bureau of Labor Statistics in an effort to renew our secondr e q u e s t , i . e ., removal of audiologists from the subheading “ T h e r ap i s t s ”and placement in a stand-alone cat e g o ry under the main heading.S p e c i f i c a l l y, on January 26, 2 0 0 0 , we raised this issue in a letter toK atherine K. Wa l l m a n , Chief Stat i s t i c i a n , O M B . In addition, on May 10,2 0 0 0 , we met with Paul Bugg, an OMB economist, and Stephen Tise ofthe Office of Research and Planning, Bureau of Health Professions,Health Resources & Services A d m i n i s t r at i o n , Department of Health andHuman Serv i c e s , to discuss the A c a d e m y ’s concerns regarding the cat e-g o r i z ation of audiologists as “ T h e r ap i s t s . ” On June 14, 2 0 0 0 , we sent aletter to the Standard Occupational Classification Po l i cy Committee( S O C P C ) , requesting that this cat e g o r i z ation issue be addressed. Fi n a l l y,on October 27, 2 0 0 4 , we sent a letter to OMB requesting that thischange be made during the next revision of the SOC.

In the A c a d e m y ’s view, cl a s s i f i c ation of audiologists as “ T h e r ap i s t s ”

is inaccurate because it fails to reflect the full range of services we arelicensed to perform. According to OMB, “ o c c u p ations should be cl a s s i-fied based upon work performed, s k i l l s , e d u c at i o n , t r a i n i n g , l i c e n s i n g ,and credentials.” When these factors are considered, we think itbecomes clear that audiologists do not belong under the subheading“ T h e r ap i s t s . ” By way of comparison, we note that optometrists are cl a s-sified in a separat e , stand-alone cat e g o ry : “29-1040 Optometrists.”With regard to overall skills and type of work performed, audiologists aremost similar to optometrists, among the professions listed in the SOC.

YO U CA N HE L PWhile the SOC issue can be seen as a dull, technical mat t e r, it is our

hope that you will agree it is an important matter and that you willrespond with a letter to the Bureau of Labor Statistics and help continueto move the profession in the correct direction. Letters should be sentt o : M s . Anne Louise Marshall

Standard Occupational Classification Revision Po l i cy CommitteeU . S . Bureau of Labor Stat i s t i c s2 Massachusetts A v e n u e , N . E . , Suite 2135Wa s h i n g t o n , DC 20212E m a i l : s o c @ b l s . g o v

Standard Occupational Classification Codes Revisited


hree years after publishing the proposed rule, the Centersfor Medicare and Medicaid Services (CMS) published a FinalRule (Federal Register, April 21, 2006, p. 20754) whichrevises Medicare enrollment requirements that affect allproviders and suppliers who currently bill the Medicare pro-gram and wish to maintain their Medicare billing privileges,as well as those who wish to become new enrollees in theprogram. Those who have “opted out” of the Medicare pro-gram are not affected by the rule. The new requirementswent into effect on June 20, 2006.

CMS has incorporated a number of enhancements andchanges to clarify the enrollment process and to reduce theburden imposed on the provider and supplier communities.The final regulation makes Medicare enrollment requirementsmore uniform and standardizes existing enrollment require-ments that have been used by the various Medicare contrac-tors that process and pay claims.

S p e c i f i c a l l y, the regulation requires that new and existingproviders and suppliers complete and submit a Medicareenrollment application. Individual or solo practitioners (butnot incorporated) must use the CMS-855I form to enroll orchange their enrollment information. To enroll as a group orcorporation, fill out the CMS-855B form. Individual practi-tioners who wish to reassign benefits to an employer or grouppractice must fill out CMS-855R form.

Once enrolled in the Medicare program, providers and suppli-ers are required to report any changes in their enrollmentinformation within 90 days, with the exception of change inownership or control of any provider or supplier, which mustbe reported within 30 days. If a change of ownershipinvolves a change in the entity’s tax ID number, a new enroll-ment application will generally be required. Suppliers ofdurable medical equipment, prosthetics, orthotics and supplies(DMEPOS) are also required to report enrollment changeswithin 30 days to the National Supplier Clearinghouse.

All providers will be required to revalidate their enrollmentinformation every 5 years. CMS may also request off - c y c l erevalidation to certify accuracy of enrollment information,and conduct unannounced site visits to ensure that providersare meeting their enrollment requirements.

A significant change to the new Medicare enrollmentapplication is the requirement of the National ProviderIdentifier (NPI) and a copy of the NPI notificationfurnished by the National Plan and Provider EnumerationSystem (NPPES). While it is true that providers andsuppliers are not required to use their NPI in all electronictransactions until May 23, 2007, in order to build andvalidate a crosswalk in a timely manner and assure timelypayment of claims by the deadline, Medicare is requiringsubmission of the NPI with the enrollment application.Furthermore, the NPI Final Rule does not prohibit any healthplan, including Medicare, from requiring providers and sup-pliers to submit their NPI prior to the compliance date.

The new application also requires that providers and suppli-ers receive payments through the Electronic FundsTransfer (EFT), as mandated under the A d m i n i s t r a t i v eSimplification provisions of the Health InsurancePortability and Accountability Act of 1996.

CMS may deny, revoke, or temporarily deactivate aprovider or supplier’s enrollment for reasons set for thein the regulation. For example, if a provider or sup-plier does not submit any Medicare claims for 12consecutive months, or fails to report a change inenrollment information as required, CMS maydeactivate the provider or supplier’s enrollment.

To read the full summary of the Final Rule onMedicare Enrollment, please visit theA c a d e m y ’s web site at w w w. a u d i o l o g y. o rg /p r o f e s s i o n a l / m e m b e r s / m e d i c a r e /. Tolearn more about the Medicareenrollment process, including themailing address and telephonenumber for the contractor servingyour area, visit the CMS web siteat w w w. c m s . h h s . g o v /M e d i c a r e P r o v i d e r S u p E n r o l l /.To download the application,click on “EnrollmentApplications” on the leftside of the page.

TLisa Miller • Director of Reimbursement, American Academy of Audiology


AFA Awards Otoscopes toAuD StudentsOver 100 AuD students recently participated in theAudiology Foundation of America (AFA) new “Clued-In toAudiology” otoscope program, which tested the students’knowledge of the history of their profession. Students wereasked to read four articles detailing information on the histo-ry of the AuD degree and audiology’s transition to a doctor-ing profession. They were then required to pass a short quizon the material before being awarded an otoscope. The pro-gram was opened to all third-year AuD students in four- y e a rAuD programs. Seventy-eight NAFDA students participatedin the program, and received their otoscopes from A FAD i r e c t o r / Treasurer Veronica Heide, during a special presenta-tion at A u d i o l o g y N O W in Minneapolis. A FA was presentedwith a “Friend of NAFDA” award in recognition of its sup-port of students. Funding for the “Clued-In to A u d i o l o g y ”otoscope program was provided by the Hal-Hen division ofWidex, which supplied over $11,000 in otoscopes in supportof the A FA and AuD education. The A FA is a non-profitfoundation founded in 1989 to lead audiology’s transition toa doctoring profession with the AuD as its unique designator.Its vision includes the goal of changing state licensure toincorporate the AuD as the basic criteria for practice.

NEW Academy ServiceHow’s your hotel contractnegotiation? Ask an Expert!Want to free up your time to practice audiology? Use

the expertise of the Academy’s staff to negotiate that peskyhotel contract. Listen to audiologist Erin Miller’s experience:

“The Ohio Academy of Audiology (OAA) was strug-gling with contract negotiations with the hotel of choicefor our biennial Ohio Audiology Conference. We contact-ed AAA to see if they could provide any advice that mightassist our efforts. Not only did they provide advice butthey also offered to handle these negotiations for theOAA. The OAA was relieved that we had experts helpingto negotiate our contract and believe we received excel-lent advice about location for the event and will now havea hotel staff that is willing to work with our group. Iwould recommend this service to any of the state acade-mies who are trying to negotiate these contracts them-selves. It really will give your group piece of mind thatyou have received a fair price and all the amenities thathotels offer other similar sized groups.”

For a nominal fee, this expertise is now available tostate audiology organizations as well as related audiologyorganizations. For more information, [email protected].

Engineering andHearing EnhancementConferenceThe Rehabilitation Engineering Research Center onHearing Enhancement (RERC-HE) in conjunctionwith Gallaudet University and New York University-School of Medicine will hold a three-day conferenceaddressing the aural rehabilitation needs of a d u l t sand exploring the evidence base for current ande m e rging practice. The meeting will take placeSeptember 18-20, 2006 on the Gallaudet UniversityC a m p u s . Visit www. h e a r i n g r e s e a r c h . o rg forconference and registration details.


In conjunction with theCongressional Hearing HealthCaucus, the Academy co-sponsoreda May 18, 2006 Hearing HealthScreening and Issues Forum held inthe U.S. Capitol Building on CapitolHill. The event resulted in over 50Hill staff members receiving a hear-ing screening. Rep. Jim Ryun (R-KS),chief sponsor of H.R. 415 theHearing Health Accessibility Actserved as a keynote presenter alongwith Reps. James Walsh (R-NY),Mark Kennedy (R-MN) and CarolynMcCarthy (D-NY). Local Academymembers Ken Henry, AnnArrazcaeta and Michael Rairighprovided hearing screening servicesfor the event.

Hearing Health Screening and Issues Fo r u m

Congressman James Walsh (R-NY) receives a hearing screening fromAnne Arrazcaeta, AuD, an audiologist and member of the Academy,at the Hearing Screening and Issues Forum held on Capitol Hill onMay 18th. Rep. Walsh is a cosponsor of H.R. 415, the Hearing HealthAccessibility Act and chief sponsor of H.R. 5250 the Early HearingDetection and Intervention Act of 2006. (photo: ASHA©2006,Alice Cabrera Elspas)

New CDs Available of Published JournalsThe Auditory and Vestibular Dysfunction Research Enhancement AwardProgram at the VA Medical Center, Mountain Home, TN announced thethird and fourth in a series of CD-ROMs that contain selected portionsof the audiology literature. These CD-ROMs contain volumes 1-15 ofthe Journal of the American Academy of Audiology (1990-2004), select-ed copies of Audiology Today, volumes 1-30 of Scandinavian Audiology(1972-2001) and Supplements 1-54 of Scandinavian Audiology (1971-2001), and Danavox Symposia, 1-20 (1969-2003).

The American Academy of Audiology, through Joyanna Wilson,Publications Manager, and Jerry Northern was instrumental in thedevelopment of the JAAA project. Einar Laukli (Tromsø, Norway) andStig Arlinger (Linköping, Sweden) were responsible for makingScandinavian Audiology available. Arlinger and the Medical Library atthe VA Medical Center, Long Beach, provided most of the ScandinavianAudiology materials. The Danavox Symposia materials were providedby Nikolai Bisgaard, Senior Vice President for Intellectual Propertiesand Industry Relations GN ReSound (Taastrup, Denmark). The follow-ing graduate students and assistant research audiologists contributed tothe project: Christine Powers, Nina King, Kelli Chaulk, Tash-MarieOlinger, Christopher Burks, Laura Fleenor, Wendy Cates, and Jeff Py.

The CD set may be obtained by sending a priority mail stamp ($3.85)along with a mailing label, and your e-mail address to Richard Wilson,Audiology-126, VA Medical Center, Mountain Home, TN 37648.

NationalHearingConservationAssociation2007 AnnualMeetingThe National HearingConservation Association(NHCA) will host its 32ndAnnual Conference, February 15-17, 2007, at the Hyatt RegencySavannah, Georgia. For moreinfo, please visit www.hearingconservation.org.


International Society ofAudiology Scholarships The Executive Committee of the International Society ofAudiology (ISA) and the A. Charles Holland Foundationare pleased to announce our second biennial scholarshipwinners. Four students have been awarded $1000 schol-arships to attend the XXVIIIth International Congress ofAudiology to be held September 3-7, 2006 in Innsbruck,Austria. The scholars were selected by the ISA ScientificCommittee based on mentor recommendations and themerit of their research. Students will attend and presenttheir research at the Congress. Stig Arlinger, Chairmanof the ISA Scientific Committee, announced the follow-ing students as the 2006 Scholarship winners: JulieMartinez Verhoff (USA), Vicky Zhang (Hong Kong),Srikanta Mishra (Southampton, UK) and Alma JanethMoreno Aguirre (Cuernavaca, Mexico). Informationabout the XXVIIIth ISA Congress can be obtained bylogging on to www.isa-audiology.org.

2006 Scott Haug Foundation RetreatIn the days of old, as adventurers pulled up stakes seek-

ing a fresh start, three letters were often found etched on oldhomestead doors to reveal where they were headed: GTT…GONE TO TEXAS! The Scott Haug Foundation invitesyou to get out of town and head to Texas on September 28t h

through October 1s t for the 22n d Annual Scott Haug HillCountry Audiology Retreat. Our new meeting location isThe TBarM Ranch and Resort in New Braunfels, Te x a s ,located 30 miles outside of San Antonio, and 45 miles fromof Austin. Once there, you’ll get to experience Texas stylelearning, fellowship, and the fun of all the family-friendlyactivities offered on-site.

The Scott Haug Foundation will host an educational slateof outstanding speakers including Richard Seewald, GusM u e l l e r, Tomi Browne and Robert Tu r n e r.

So post the GTT! sign on your office door and join us aswe learn practical ways to improve our professional lives,enjoy spirited discussions with colleagues, and take time tohave some fun in the spectacular Texas Hill Country. Vi s i tw w w. s c o t t h a u g . o rg. for conference details and registrationinformation. Reservations with the TBarM Ranch andResort can be made directly by calling (800) 292-5469.

Current Provost BecomesGallaudet University’s Second

Deaf PresidentJane K. Fernandes, Gallaudet UniversityProvost since 2000, was introduced on May 1,2006, as Gallaudet’s ninth president.

She will take office in January 2007.Fernandes will replace long-time Gallaudet

president, I. King Jordan, who made history in 1988 becomingthe first deaf person selected to lead a university when he wasnamed Gallaudet’s eighth president. Jordan announced hisretirement in the summer of 2005 after more than 18 years aspresident. Jordan will retain the title “President Emeritus” andwill continue to assist the new president and the university.

A native of Worcester, Mass, Fernandes attended publicschools. She is a graduate of Trinity College (Connecticut),earning a BA in French and comparative literature, and theUniversity of Iowa, where she earned an MA and PhD incomparative literature. After graduating from Iowa, she workedfor Northeastern University before coming to Gallaudet as chairof the Dept. of Sign Communication. She later moved to Hawaiiwhere she established the Interpreter Education Program atKapi’olani Community College and served for five years as thedirector of the Hawaii Center for the Deaf and Blind.

In 1995 she returned to Gallaudet to become the vicepresident for the Laurent Clerc National Deaf Education Center where she and her team developed innovativecurriculum, materials, and teaching strategies for schoolsserving students who are deaf throughout the nation. Last year,more than 450 schools had adopted the Clerc Center’smethods. Fernandes has authored and co-authored numerousscholarly publications, and will soon be sending her new book,Signs of Eloquence: A Study of Deaf American Public A d d re s s(with James Fernandes) to press. Gallaudet University is theworld leader in liberal education and career development fordeaf and hard of hearing undergraduate students. Gallaudet islocated in Washington, DC, where it was founded in 1864 byan act of Congress, and its charter was signed by PresidentAbraham Lincoln.


Randy Morg a n, CEO ofWestone Earmold Labs, passedaway on June 6 at his ranchoutside Woodland Park, CO.M o rgan had been battling braincancer over the past severalmonths. Randy Morgan guidedWestone as President and CEOfor the last 20 years. His visionand leadership helped propel

Westone from a small earmold lab to one of themost recognized and respected firms in the hearinghealthcare industry. Morgan worked personallywith thousands of audiologists during his lifetime,and was a strong supporter of the A m e r i c a nAcademy of A u d i o l o g y. His presence and creativi-ty will be maintained at Westone Labs, and he willbe missed by his many audiology friends.

F rederick N. Martin r e t i r e dfrom his faculty position in theCommunication Sciences andDisorders at The University ofTexas at Austin, where he hasserved since 1968. During hisoutstanding career, Martin, a

prolific writer, authored more than 150 publicationsin books, monographs, chapters and journal articles,and presented about 100 conference and conventionpapers. Martin won the Teaching Excellence Aw a r dof the College of Communication, the GraduateTeaching Award, and the A d v i s o r’s Award of theE x - S t u d e n t s ’Association of The University ofTexas, and the Beltone Award for OutstandingTeaching in A u d i o l o g y. He received the “CareerAward in Hearing” in 1997 from the A m e r i c a nAcademy of Audiology and is a Fellow of ASHA.

Paul R. Kileny has receivedthe prestigious PresidentialCitation from the A m e r i c a nOtological Society. Kileny is aprofessor in the Department ofOtolaryngology and theDepartment of Pediatrics andCommunicable Diseases at theUniversity of Michigan Health

System, as well as director of Audiology and Electro-physiology and the Hearing Rehabilitation Program.

You can make a donation to the AAA Foundation inhonor, or in memory, of your colleagues at

www.audiologyfoundation.org.

S O U N D W A V E S

VanVliet Runs ForA A A F o u n d a t i o n

Audiologist, AAA Foundation Board memberand runner, Dennis VanVliet, ran andcompleted his first marathon on June 4 in theSan Diego Rock-n-Roll Marathon. Thisaccomplishment is special because VanVlietran to raise money for the AAA Foundation.VanVliet’s supporters pledged over $1,200 forhis effort, meaning that Dennis raised $46 forthe AAA Foundation for every completed mile.


The Illinois Academy ofAudiology (ILAA) Boardof Directors and the ILAAScholarship and HonorsCommittees announcedthe names of the 3rdannual AuD ScholarshipAwards. These awardsare presented tooutstanding studentswho are in at least theirsecond year of study inan Illinois audiologygraduate program.Selection is based onthe potential for thestudent to make asignificant contributionto the field of audiology;demonstrated academicaccomplishment andintellectual ability; andreview of the applicant’scharacter, school andcommunity activities,personal motivation, andleadership potential.The 2006 scholarshiprecipients are MeganMulvey and MagdaleneSikora from RushUniversity and Lia Ferroand Darrin Worthingtonfrom NorthwesternUniversity.

Lia Ferro

DarrinWorthington

MeganMulvey

MagdaleneSikora

ILAA Awards StudentScholarships

FL O R I D A AU D I O L O G Y LI C E N S U R ELAW MO D I F I E DThe Florida Senate Bill 0370 was signed into law by the Governor

on June 7, 2006. This bill modified the current language in theaudiology license law to require the doctoral degree for audiolo-gists applying for a new license after Jan. 1, 2008. Persons with aMaster’s degree must have had the Master’s conferred prior to Jan.1, 2008. Current practitioners with a Master’s degree are grandfa-thered into the law and do not need to earn the Master’s degree.The modified law defines the educational requirements for newapplicants by competencies rather than clinical clock-hours andspecific coursework.

The modified law changes the educational requirements forAudiology Assistants to a high school diploma or its equivalent andBoard approved on-the-job training. A complete text of the law(SB 0370) can be found at: www.flsenate.gov/Welcome/index.cfm?CFID=1462549&CFTOKEN=30634769.

MANAGEMENT OF THE

TINNITUS PATIENTThe 14th annual conference on Management of the TinnitusPatient will be held at the University of Iowa, Sept. 21. Theconference is intended for audiologists, otologists, psychologistsand nurses who provide clinical management services forpatients with tinnitus. The purpose of the conference is toreview current evaluation and management strategies for thetreatment of tinnitus. Special guests of honor are Dirk DeRidder from the University of Antwerp, Belgium, AnthonyCacace from Albany Medical College, New York and Paul Davisof Curtin University of Technology, Perth, Australia. Otherinvited speakers are Roger Juneau and David Fagerlie, as wellas the University of Iowa staff including Marian Hansen, RichTyler, Paul Abbas, Catherine Woodman and Anne Gehringer.For program and registration and information visit ww.uihealth-care.com/depts/med/otolaryngol.


IMPORTANT NOTICE for Masters’ Degree StudentsAttention Audiology MastersStudents and Professors!EFFECTIVE JANUARY 1, 2007, applicants for membership in theA c a d e m y, who are 2007 or later graduates entering the field ofa u d i o l o g y, must hold a Doctoral degree with a major in audiolo-gy from a regionally accredited institution of higher learning.

2006 or earlier graduates may apply with at least a Mastersd e g ree. The Academy strives to be an inclusive org a n i z a-tion, and as such, we want to make you aware of thisimpending policy change.

Masters’ students graduation in 2007 or later, you are cur-rently eligible for student membership in the Academy. Ifyou join now, you will be guaranteed that the new policywill not exclude you from membership in the future. Foran application, visit our website at www.audiology.org.Complete the application, and be sure to have a Fellow ofthe Academy sign the sponsor’s portion. Time is runningout! Please contact the membership department at 800-222-2336 if you have any questions.

GlaxoSmithKline Partners withAudiology Aw a reness CampaignTo shed some light on the issue of hearing loss inAmerica, the Audiology Awareness Campaign (AAC)and GlaxoSmithKline (GSK) Consumer Healthcare,makers of Debrox, (ear wax removal product) havepartnered to educate consumers who may be slowlylosing their hearing and think there is nothing they cando to prevent or treat it. The AAC has joined withGlaxoSmithKline Consumer Healthcare to get theword out to consumers about hearing healthcare bycreating Caring for your Ears and Hearing, an informa-tional insert to be placed inside Debrox packaging.Starting in July of 2006, more than 670,000 packagesof Debrox will include the insert — Caring for YourEars and Hearing — that will educate consumers onkey hearing health issues including lowering your riskfor hearing loss, maintaining proper ear hygiene andinformation on where to turn for hearing healthquestions and concerns. The initial distribution willinclude more than 10,000 pharmacies and retailoutlets nationwide. For additional information visithttp://www. audiologyawareness.com.

Ethical Dilemma? The Academy’s New Book Can Help!

C E Us AVA I L A B L E

Brand New CEU Opportunity! Up to1.1 CEUs can be earned by reading theGreen Book. For more informat i o n ,i n cluding Learner Outcomes andA s s e s s m e n t s , see the Green Book CEUProgram Web page atw w w. a u d i o l o gy. o r g .

Please note that the Green Book CEUProgram can also be used to meet A B Ar e c e r t i f i c ation requirements. To earnABA Tier 1 CEUs (required for A B Ar e c e r t i f i c ations after January 1, 2 0 0 8 ) ,a minimum of three hours needs to besubmitted at the same time. In additionto having the ability to earn Tier 1C E U s , you can also fulfill the A B Athree-hour ethics requirement (requiredin a three-year certification period) byreading the Green Book. For morei n f o r m ation contact the ABA ata b a @ a u d i o l o gy. o r g .

If you own or work in an audiology practice, conduct audiological research, or teach audiology students, youhave no doubt encountered ethical dilemmas that were difficult to reason through on your own. We encourageyou to take Ethics in Audiology as a guide along your professional journey.

Ethics in Audiology is available to members for $45.00 and to nonmembers for $75.00. A 10%bulk rate discount is available for orders of 10 or more. To order online, visit the Academy Website at w w w . a u d i o l o g y . o r g. For more information, contact Elizabeth Hargrove, CommunicationsCoordinator, at e h a r g r o v e @ a u d i o l o g y . o r g or 703-790-8466, ext. 1039.

A colleague appears to have a problem with alcohol. You are increasingly suspicious that he is starting to drinkaround 3:30 in the afternoon. You confront him, and he admits that he is having problems. You tell him you areobliged to report him. He begs you to wait. He says he will enter treatment and that, in fact, he has been to AA atime or two but keeps falling off the wagon: “Give me six months. I’ll be clean by then.” Should you report him, orshould you give him the chance he requests? Would your response be different if he were your employer?After reading the Academy’s new Ethics in Audiology (© 2006), you will havethe tools you need to approach this and many other difficult ethical dilemmas.

To meet the growing need for prac-tical advice on common ethicalissues faced by audiologists, t h eA c a d e m y ’s Ethical Practices Boardhas authored a book on the subjectentitled Ethics in A u d i o l o gy : G u i d e -lines for Ethical Conduct in Clinical,

E d u c at i o n a l , and Research Settings( a f f e c t i o n ately referred to as “ t h egreen book” for its green cover).Written in a concise and accessibles t y l e , c h apter titles incl u d e“Standards of ProfessionalC o n d u c t ,” “Ethics in A u d i o l o g i c a lR e s e a r c h ,” “ R e l ationships withHearing Instrument Manufacturers,”“Ethics of Professional Communi-c at i o n ,” “Child and Elder A b u s e ,”

“Ethical Issues in Practice

M a n ag e m e n t ,” “Ethical Consider-

ations in Supervision of A u d i o l o gy

Students and Employ e e s ,” a n d

“Ethical Issues in A c a d e m i a . . ” A n d

as if all this relevant and timely

i n f o r m ation weren’t enough, up to

1.1 Tier 1 CEUs can be earned by

reading and answering questions

about the book.

VOLUME 18, NUMBER 4

osting a job is a key service offered through theAcademy’s year-round employment service,HearCareers. Although it is key, it is just the begin-ning as far as features go.

Employers who post on HearCareers also receive:

• A Searchable Database of Over 200 Resumes • Low Competitive Advertising Rates • A Database of Candidates Working Only in the

Field of Audiology • The Ability to Create a Resume Agent

– Alerts you to candidates that match your search criteria!

• The Ability to Post Jobs Instantly • No Limit on Your Job Description Length • The Ability to Link Your Company’s Website to

Your Job Description • Customer Service/Help • The Ability to Track All Job Search Activity • A System That is Easy to Use • Salary Information

When you decide to advertise a position onHearCareers, you will first need to create a Loginname. A password to your account will be emailed toyou. Once logged into your account you have a vari-ety of flexible services at your fingertips. Start with adescription of your company. You can edit this at any-time. This is especially handy if you add a new officeor have an address change. If you are not the onlyperson who posts vacancies for your company, youcan add other users to your account.

Next you will be prompted to fill out your billing con-tact information. If you happen to be the person incharge of tracking payment and you forget to turn inan invoice, you can log into your account and viewyour payment and purchase history. Not only can youview invoices, but you can email them to others rightfrom your account.

HearCareers not only tracks your current companyand billing information, but it also tracks informationabout potential candidates for your job. You willimmediately be able to see which applications youhave and have not viewed. HearCareers also recordshow many people viewed your job listing; how manyapplied; how many job seekers emailed your job tofriends; and how many applicants came from a JobAgent. Check out the “Statistics” link for any jobyou have posted to view this information. All of thesefeatures without even touching on the main reasonyou opened an account with HearCareers in the firstplace…to get the word out about a job vacancy.

To get the word out, you will need a good jobdescription. If you need to go into great detail forspecific job requirements, take as much space as youneed. Once you have written your job description,you have the ability to fine-tune it at anytime.HearCareers will also keep a record of all the jobsposted on your account. Once the job post period isover, you can easily go back and repost a position ifany of your job openings have not been filled. Justcopy it from your records and repost. Why rewritethe entire job?

If you need your job to really stand out, make it a“ F e a t u red Job.” When you “feature” a job, not onlyis it in bold and starred, but it also appears on thejob seeker sign-in page. A job seeker doesn’t evenhave to search for a job to see the listing of“ F e a t u red Jobs.”

HearCareers is the whole package— It tracks yourcompany information, billing, applicants, resumes, the job itself and allows for multiple account users.Make sure you utilize everything your Academy’semployment service has to offer. Remember, youneed all the pieces of HearCareers to solve the hiring puzzle.

HEARHEARCareersCareersFinding an Employee…

HearCareers and the Hiring PuzzleP

AUDIOLOGY TODAY 59


MICHIGAN

AUDIOLOGIST – Director of Clinical Instruction andAudiology Services, Division of Audiology, CentralMichigan University (CMU). Full-time, 12 month, at willposition beginning August 1, 2006 (start date negotiable).

Responsibilities: Administration of a multi-facetedaudiology clinic involving on-campus, as well as several off-campus, educational, residential and adult-care facilities;coordination and participation in clinical instruction, coordi-nation of externships for AuD students; direct patient care;marketing and public service activities.

Qualifications: Required: Doctoral Degree inAudiology; CCC-A; minimum of 4 years of audiologic clini-cal experience, with evidence of recent practice; excellentoral and written communication skills; student clinicalsupervision; demonstrated competency with amplification;evidence of strong interpersonal and organizational skills;eligible for, or hold Michigan audiology license.

Desirable: Three years administrative responsibilities;experience with cochlear implants, evoked potentials, andassessment/management of balance disorders.

Applications will only be accepted online atwww.jobs.cmich.edu. For further information contact G.Church, P.D ([email protected]), Search Chair,989-774-7301.

Applications will be accepted until the position is filled.Review of applications will begin immediately.

CMU, an AA/EO institution, strongly and actively strives to increasediversity within its community (http://www.cmich.edu/aaeo/)

CLASSIFIED ADS For information about our employment website, HearCareers, visit www. a u d i o l o g y. o r g / h e a rcareers. For information or to place a classified ad in Audiology To d a y, please contact Elizabeth Hargrove at e h a r g r ove @ a u d i o l o g y.org or 1.800.AAA.2336 ext. 1039.

Author’s Clarification:F rom the “Meet the Media – The iPod News Fre n z y ”a rticle published in the Vol. 18:3 (May-June, 2006) issueof Audiology To d a y, Brian Fligor points out that Table 1sound pre s s u re levels were taken from “stock earbuds.”Audiologists should understand that significantly diff e r-ent sound levels will be obtained with diff e rent ear-phones, depending on earphone sensitivity and on earacoustics, used with personal music devices.

August 15, 2006

Pack Your Lederhosen in September!

Volume 18, Nu m b e r 4 - Audiology · Volume 18, Nu m b e r 4 ... Specific questions regarding...

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