33: Educational Audiology with Dr. Carrie Spangler
Dr. Carrie Spangler discusses advocating for educational audiology, what’s new with equipment, and tips for collaborating with the ed aud!
Resources Mentioned:
Carrie’s email: empowearaudiology@gmail.com
This podcast is brought to you by:
transcript episode 33: Educational Audiology with Dr. Carrier Spangler
D: Hello and welcome to the TOD POD, a podcast to support Itinerant Teachers of the Deaf and Hard of Hearing, SLPs, and other Deaf Education Professionals. I'm Deanna Barlow from Listening Fun and today we're talking about educational audiology with Dr. Carrie Spangler.
C: Thank you for having me on the TOD POD I'm excited to be here.
D: Thanks so much for being here, Carrie! Can you tell everyone a little about yourself?
C: Sure. I have been in the field of educational audiology for all of my career about 24 years and I love what I do. I work with students from preschool until they graduate from high school. I am in Ohio so the midwest states and in addition to being a professional in educational audiology, I also have a lifelong journey of growing up with hearing loss and I currently I have a hearing aid and a cochlear implant. So my life journey really steered me into the field of educational audiology.
D: Yeah, yeah, absolutely I feel like I've told you this before but like the educational audiologists at my work are like my favorite people! I seriously I don't know what I would do without them. So really happy to have an educational audiologist on the podcast because like you guys are just so helpful and you have so much information and I feel like you fix all of my problems. So [LAUGH] it's a really nice to have you as a resource here to talk with me so that everyone can listen for all your good information. So, just to get started, can you explain the role of the educational audiologist and how it differs from a private audiologist or the Teacher of the Deaf?
C: Sure, so the educational audiologist, well audiologists in general, they all have a right now a Doctor of Audiology or a AUD degree. So we all kind of have that common degree. But educational audiologist I feel are kind of the bridge between the clinic or pediatric audiologist and the school system. So when they go to their pediatric or clinical audiologist, they're really focused on the technology and changes in hearing and the hearing test and all of the medical clinical things that need to happen. But you and I both know that we don't live in a soundproof environment and that they spend a lot of time at school. And so that educational audiologist really is that individual, a professional that can provide a full spectrum of hearing services for all children in that educational setting. So they can still diagnose, manage, and treat hearing and balance disorders. But in addition to that, they are an important part of that multidisciplinary team to facilitate listening and learning and communication access throughout that school environment and they do that with specialized assessments, or you know determining what kind of hearing assistive technology a student might need depending on what they're fitted with at the clinical or a pediatric audiologist and then to recommend different support services and resources and really advocate on behalf of of the student so that we know that they have the best access that they can have within their school transitions and environment.
D: Yeah, what kind of specialized knowledge would an educational audiologist have versus a clinical audiologist or a private audiologist who doesn't go into the schools?
C: That's a great question. I think the main thing is that when we get our degree in audiology, there's most programs don't focus a lot on education. And you and I both know being in the public school system, that there's this whole thing called IDEA, Individuals with Disabilities Education Act.
D: Yep. It's a whole thing. [LAUGH]
C: And yeah, it's a whole thing. It's like a whole other like degree and having at least in the United States if you're listening, having that knowledge of our federal regulations and our state regulations and knowing you know how that impacts the student is really critical in that environment. I think the other thing that the educational audiologist has a lot more knowledge than maybe a clinical audiologist would in the hearing assistive technology piece. And although the pediatric or you know clinical audiologists have the knowledge of digital modulation systems or a remote microphone. They don't understand or know how that is being utilized within the classroom environment. So being able to really look at functional listening or classroom acoustics or you know how the classroom set up is a really critical part of it because technology is great, but if it's not being used appropriately then it really doesn't matter.
D: Yeah, I've been in situations where there hasn't been an educational audiologist and the clinical audiologist will write a recommendation for a type of HAT system because in the absence of an educational audiologist, I certainly cannot recommend it, um it's out of a TOD scope to do that. So I need an audiologist to recommend a HAT system but they're not in the building. So it's kind of sometimes like putting a square peg in a circle hole like it it doesn't quite fit like the situation, especially if there's like co-teachers or like I don't know like they change classes like there's so many like factors that I'm like I wish they could just come here and look at this and that's where I feel like the educational audiologists really shine is that they actually come and look at the specific room in the specific kid and can like actually fit something that that makes sense.
C: Exactly and then if you have more than one student that’s deaf/heard of hearing that's coming in with a different type of personal technology, you add a whole other factor into what the school is doing so having that person, and the other thing is you know idea it's a mandated related service. So having that person on the team, especially if technology is involved is really critical.
D: Yeah, so going off of that, is that something you tell districts when you're trying to explain to them why they need an educational audiologist? Do you tie it back to IDEA or do you give them other rationale as to if you were trying to um fight, or if a TOD for example was trying to argue for educational audiology in their district, is that something you bring up with them?
C: I do. There are some great resources out there from the educational audiology association and even like with the Wrightslaw which is you know, kind of a parent driven web page that has information about like what parent rights are. I feel like that is something that you have to bring up at at some points in time because there's some special ed directors or coordinators that might not have the knowledge of what we do. But from a TOD perspective or educational audiology perspective and we know that this is a lower incidence disability area and so they may not have had a student within their district for a while and they don't understand what you know the the rights are and what the services are for that student. So being able to inform them is is really important. And a lot of times when you kind of are able to market or share the job responsibilities and the scope of practice, it becomes more clear to them and and hopefully everybody on the team will agree that this is an important part for deaf and hard of hearing kids.
D: Yeah I've had sometimes it takes something breaking for them to realize that they need an educational audiologist. Like something breaks so they call me and I say okay, you have to call Phonak, get the serial number, mail it to them, let them know and I’m telling them all this and they're like what? And I'm like or you could get an educational audiologist like here's the information and then that's like ok, we'll do that, I'm like okay, great. [LAUGH] Like they don't want to go through the logistics of trying to actually like deal with the equipment especially when they don't understand what they're working with. So unfortunately, sometimes it comes to that. But I do I realize that if I step back and don't do what I'm not supposed to do and I'm like well that's not my job. It's out of my scope of practice like I'm happy to tell you what company to call, I'm happy to tell you where the serial number is on the equipment. Um, but that's as far as I can, I can do. But I can connect you with an educational audiologist and that has been like the aha moment for them that it's actually like a very needed service and not a luxury but something that they they actually need to like be in compliance. So that's what I've done, for better or for worse. [LAUGH]
C: Well I appreciate you doing that too. [LAUGH] One other thing that we've done in our area is we do have a really good relationship with our clinical pediatric audiologist and they understand overall and they know they can't come out to the school and do what we do because they don't have the time to do that and they have really taken the lead on empowering parents too with the information. So that is another way I think districts have um, an opportunity when they hear it from the parents and realize wait, we we have to provide this.
D: Yeah, and I do think a lot of them come around, especially once they have a TOD on the team and they realize how important it is that is something that becomes obvious over time that it is very needed and important. Okay so switching gears a little bit while I have you here. Whenever I have an educational audiologist I always want to know like okay like what's new like what's coming up like what do I need to know. So what's new technology are you seeing pop up in the schools? Or like the last couple years even because sometimes it takes a while for it to like show up on my caseload. Do you have any like tips or tricks for any of the new stuff coming up?
C: Yeah, at least in our area, I mean right now I feel like um, the two companies that are really pediatric focused are Phonak and ah Oticon and they both have remote microphones system that are great systems that can be you know, paired and fit for each individual student. I think what we're seeing too is some of the challenges of criteria changing with like Cochlear Implants and we're seeing kids who have maybe single sided deafness coming in with a cochlear implant, like what do we, what's the best way to make sure that they have an improved signal to noise ratio.
D: Yeah, that's so interesting you say that because I seeing that a lot too now like not that single sided deafness is more common but getting implanted a lot more common now even younger too. So they're going into school with an implant and that must be an interesting audiological challenge for a HAT system if you have one you know like how is there a best practice for using HAT with those students or is it individual?
C: I think ah it's at least with my experience it's been very individual. So you know but going in there and again like assessing the classroom, assessing the student, doing like functional listening assessment. Some of my kids I found with cochlear implant on one side that I've tried like maybe a Roger Focus on the good ear and then they have like the receiver on that cochlear implant side so that they had that binaural input coming in. They love it that way.
D: Yeah.
C: Other kids are like that's too much and I just like it coming to my cochlear implant side. Some of them are like I just like it coming to my good side, and then some of them are they would rather just have a classroom audio distribution system. So it is really individualized and I think being able to go in and especially with older kids giving them the opportunity to try it, different configuration, report on it, share back with us, doing functional listening assessments with those different conditions to determine which one really is the best best fit for them. And it might change over time.
D: Yeah, have you noticed anything with you know how like a lot of the hearing aids have like the receivers that are like inside them now. Have you had any like particular challenges with those? Do you remove them at the end of the year? Like kind of what are, how are you handling that? Because a lot of um, that's a challenge for a lot of people I talk to. [LAUGH]
C: It is especially when there's one of us serving like a multiple districts and everybody seems to start at their school year on the same day right.
D: And everyone wants you there on day one. [LAUGH]
C: And you're like if I could clone myself today it would be really great. I struggled with that too this past year. I ended up keeping receivers and a lot of the kids hearing aids and technology for the reason of the beginning of the year.
D: Mhmm.
C: If there was a student that I knew maybe was going to get upgraded or moving or possibly not come back with the hearing aid the next year, I would make a special trip out to remove the receiver so that we would have them physically in order to kind of take it through the next school year. But overall I kind of left it in there and we would notify the family and then our local you know pediatric hospital saying hey just a note that most of the kids who have hearing assistive technology, their receivers are still within their hearing equipment. So if you end up sending it out of the summer for anything please make note of that when you send it in.
D: Yeah, that's a good idea to involve them just to make sure everyone's kind of up to date on what's happening. [LAUGH]
C: Exactly I know on their form now it says like for their hearing aid for me to say they receiver installed and they can you know check that box. So I just check the box because more than likely those probably a receiver installed.
D: Probably. I feel like for the longest time most of the troubleshooting issues I had had to do with audio shoes and receivers. So are you noticing a big reduction in troubleshooting issues now that they're integrated or is there are there just different problems now?
C: I have found that it's been less with not having audio shoes and the connections and things like that. The kids also are much happier.
D: Yeah.
C: There's like one less step of and the beginning of the day where they don't have to take their hearing equipment off and and put on an audio shoe and and do all of that kind of troubleshooting at the beginning of the day. They just come in, a lot of times they're still connected because they haven't connected to any other kind of network so they just get it, do a quick check and they're off to their first class or or their class during the day. So I feel like it's alleviated five minutes of their day by being able to connect directly.
D: Yeah, yeah, I just feel like I used to get a call I don't know at least maybe not once a day but at least a couple times a week from a teacher being like it's not connecting. And I'm like did you turn it on turn it back off? Did you unplug the receiver and plug it back in? [LAUGH]other like.
C: Right? Yeah, did you change the battery? [LAUGH]
D: I'm like, yeah before I drive over there, please tell me you tried to change the battery. Um and I just feel like I don't have like a lot of those problems are like not as big anymore. What other, do you notice is there any other problems that are common with maybe implants or BAHAs or anything that you tend to get calls from your TODs or your teachers about fixing?
C: Yeah, so I've had I feel like sometimes with my younger kids especially the remote microphone that are made for like the cochlear implants for example, like a mini mic though seem to be more challenging as like staying connected. And they don't have as long of a range as you know some of the technology that's made directly for like school support such as like the Edumic and like the Roger Touch Screen those seem to be easier to get connected and stay connected. Whereas like our BAHAs and you know some of the the cochlear implants, our choice is whether it's sound field or a remote mic but I am hesitant to put the remote mic on some of my younger kids who aren't going to be able to report what is happening.
D: Yeah.
C: Because they do disconnect a lot and I don't know if they're getting the signal or not and I can't follow them around all day.
D: Yeah, that's what my educational audiologist has said too that for younger kids it doesn't make sense because they can't tell us if it does disconnect and what we've done for a couple of kids who are like almost ready is they still have their sound field and they have the personal receivers. So even if we miss it like they're still getting the sound field and we can work, or I as a TOD, can work on teaching them to advocate when it's not working because, I mean this is with obviously like a Roger system not with a minimic. But they can start to advocate that their ear level receivers aren't working and I found that like that's the kind of thing I never would have thought of like that's why we need educational audiologist. Um, because I I thought that was so great because then they still have the accessibility of having the sound field but we're also starting to teach them to take some responsibility and a lot of the time they are getting that ear level input which they really need for some of those noisy classrooms. I thought that was a really like good solution for some of the kids that are just starting to be able to do it but not like a hundred percent able to like report yet.
C: But I feel like my older kids who are like middle school high school who are good users like just last week um one of my students was upgraded to like the BAHA 6 and she's in high school and I got her set up with a you know mini mic and she was like this is great like loves it but she's in a different environment where she has a lot more control. She can control it through her phone app to and you know turn muted and unmuted if the teacher forgets to do it. So it does have a a real good application. It just depends on the student.
D: Yeah, is the mini mic usually though part of their personal equipment like that's not a school based item that's like or is that purchased by the school? Because usually I feel like the mini mic, at least the kids that I work with, it's one of their cochlear implant accessories.
C: It is one of the ones that they can choose. For this particular student she did not choose that as an accessory. So this we ended up as the school ended up purchasing it. Because she was older and that was going to be the way she was going to get that improved signal to noise ratio.
D: Yeah, well, it's nice that that's an option.
C: It is yeah.
D: Alright so when we're working with the educational audiologist, what can we as the TOD do to support the educational audiologists? Like what information would it be helpful for us to give you when we communicate with you?
C: That's a great question and I just want to say too, I know at the beginning you said like I can't live without my educational audiologist [LAUGH] I feel the same about TODs in the schools too. It's kind of like peanut butter and jelly right? Like they just kind of go together. But I feel like we compliment each other in so many different ways and we've already kind of talked about like how we have these different roles as well. I think one is like having your phone number and like being able to text each other like right away and keeping each other informed is really helpful. Because a lot of times as the TOD you are seeing the kids a little bit more frequently than we are.
D: Usually. [LAUGH]
C: So yeah, yeah, even if it's itinerant, even if you're only seeing them every couple weeks you still probably have your finger on the pulse a lot more than what we do. So I think anything like that you can do as far as doing like a listening check and keeping track of you know if they're at the age where they're still doing like you know ling sounds or those types of things if you're seeing any changes like reporting that over to us so we can be like ok is that technology, is that hearing, do we need to get ahold of their clinical pediatric audiologist in order to report that. I think all of that information is so critical if they're like little like you know learning to listen kinds of kids or maybe they just got a cochlear implant, your documentation of auditory skills hierarchy is so important, especially for like mapping then we can kind of relay that information over to their pediatric clinical audiologist too if they need to be any changes that way. And I think a lot of times you are more involved in the inter-professional team or their multidisciplinary team at the school. So when there is like a ETR coming out or like an evaluation coming up when an IEP meeting coming up, making sure that you rope us back in [LAUGH] and say oh let's make sure that we have the educational audiologist involved in case, there is any updates and changes that need to happen too. I love being able to collaborate with the TOD for just like bouncing off ideas about the kids, difficult situations that might come up with, whether it's the teacher or the student themselves, how do we brainstorm together with different solutions that might be best for the kid.
D: Yeah, absolutely I feel like on my end like logistically I always write down the serial numbers of everything, so that way if there is an issue or something is a lost, I can just email them the serial number instead of saying like one of the receivers is missing like I don't know which one [LAUGH]
C: Yeah, that's very helpful.
D: I feel like if I could save them a trip you know, um and you don't if something is missing you kind of need to write it down before it goes missing. Now it was a bigger problem when there were a lot of just like Roger X receivers floating around all over the place, not as big a problem now. But I've lost I've lost a few, not me, but my my students have lost a few in their day so just having those written down. And then also I'm just kind of in the habit of when I am meeting, or if like the educational audiologist is coming to visit one of my kids, I will email them where to park, where the classroom is, the classroom number, the teacher's name, just like things that like I kind of take for granted that I have because I'm there every week but like you guys go to so many buildings...
Both: [LAUGH]
D: Like there's no way. Even if you've been there before that you can like remember where everything is I'm assuming because I can barely remember and I'm there all the time, especially especially if it's like a high school or a middle school where they're like huge and I'm like okay go up this set of stairs then go this way. Because there's nothing I hate more than walking like wandering around a high school trying to find my kid because I've only been there once a month and I don't remember where anything is. But just I try to frontload that. So if I know they're coming obviously if they don't tell me they're coming I can't help them but most of the time they do because it's you know collaborative. So I try to frontload all that like logistical information for them because one obviously they like it, it's helpful and two it just makes the whole visit go smoother, you don't waste time like you're just able to like do what you need to do if I need to get us a room like whatever. I try to do that ahead of time and I feel like that's like something that I have found helpful for like collaborating.
C: Yeah, that's definitely helpful because I like you said I go to so many buildings and sometimes I'm like where am I today, what district am I in, what building am I in, who am I supposed to be seeing. [LAUGH]
D: Especially I feel like this time of year is like extra crazy. Yeah.
C: Yes.
D: Yeah alright is there anything else about educational audiology that maybe I didn't ask about that you think it would be helpful for the TODs to know about?
C: You have asked so many good questions. I do want to say maybe just a little shout out and that educational audiology awareness week is going to be the middle of October, starting October 12th through the 16th. Educational Audiology Association has been a friend with TOD's as well over the years and we welcome all of our related service professionals to kind of join us so there's going to be a lot of information that's coming out that week that will be helpful I think.
D: Yeah.
C: With TODs and just kind of that scope of practice and advocating for the needs along the way. But I you know I think you've covered everything really that from a you know, a short podcast kind of away. But I agree that our roles are so intertwined in great ways and and they really benefit that this student. So continuing to collaborate and advocate on behalf of both professions is really going to be what is best for our students who are in the school systems.
D: Yeah, absolutely. I'm pretty sure by the time this podcast actually goes out those resources will all be available because we will be well past October.
Both: [LAUGH]
C: That's fine.
D: But you could go Google it looked at everything they posted in October and all those resources will be there for you. They'll been there for months probably.
Both: [LAUGH]
C: And then next year in October you'll know that it's gonna be another Educational Audiology Awareness week.
D: Yeah, but I do think that the helpful like tidbit to if you need educational audiology information that that what was the could you say the name of the organization again?
C: It's um EAA or Educational Audiology Association.
D: Okay, yeah, so just like having that as a resource I think is really helpful just like knowing where to search on the internet sometimes when you need information can be really helpful.
C: Yeah, definitely.
D: Speaking of finding information on the internet where can everybody find you online if they have questions want to connect?
C: Sure, so I can share my email with everybody if they want to reach out to me through email. So I'm probably the best email would be or I can just send it to you if you want that.
D: I'll put it in the show notes.
C: Ok, that would probably be easier. But I also um like you have a podcast as well and it's called EmpowEAR Audiology and you can find that anywhere you listen to your podcast because just like your role of an itinerant TOD you're in the car a lot listening to podcast along the way. So if there's um, you want to listen to another podcast that is similar that has different topics related to Deaf and Hard of Hearing I would love for you to join me there so you can find me there.
D: Yeah, that's how me and Carrie first met originally is I guested it on her podcast like what like three years ago like it was a long time ago isn't that crazy?
C: It was, it was. You were like one of my first guests and I wanted to have a TOD on the podcast because like I said your role is so critical and sometimes it's hard to explain what it is.
D: Yeah.
C: So you are able to share with the audience like how do I advocate for a TOD to be on the team.
D: Yeah, so if you go to the EmpowEAR Audiology podcast then you just scroll all the way back and you'll find the one that I was. If you don't get enough of my voice from this podcast and you want more.
Both: [LAUGH]
D: Alright Carrie thank you so much for being here today. We really appreciate you sharing all of your information about educational audiology. As always I'll link everything we talked about and the transcript below in the show notes and at listentotodpod.com I am Deanna at Listening Fun and we'll see you next week. Bye!
C: Thank you for having me!