Clarke pediatric/educational audiologist Lauren Keller, AuD, CCC-A, FAAA, graduated from St. John’s University with her PhD in audiology, May 2020.
Audiology is a critical component of Clarke’s services. The Clarke team works closely with audiologists—on site and through partner organizations—to keep exams and assessments up to date, maintain the integrity of hearing technology and ensure children have the moment-to-moment access to listening and spoken language they need to succeed. Because with reliable access to sound, a child can keep up with peers, follow classroom instruction and feel confident in their ability to connect with others.
Just as important, but perhaps less obvious to parents and teachers, educational audiologists like those at Clarke also help with the pragmatic skills kids need to gain confidence and autonomy regarding their hearing loss and hearing technology.
In fact, in a 2021 article, Dave Gordey, director of Pediatric Audiology & Research at Oticon, a leading hearing aid manufacturer, notes that the audiological clinic (and by extension, the audiologist) is an ideal resource for promoting self-determination in children with hearing loss. He asserts that audiological care with a counseling perspective provides opportunities for children to practice pragmatic and social skills, becoming more confident about managing their hearing loss.
The audiological services a child needs to succeed vary depending on several factors. “Every child is unique, and their audiological services will reflect that,” says Lauren Keller, AuD, CCC-A, FAAA, pediatric/educational audiologist at Clarke New York. “There are many factors that affect which services they need and how often: Whether their hearing loss is unilateral or bilateral, if they use a CI [cochlear implant] or a hearing aid, etc. And 40 percent of children who are deaf or hard of hearing have other disabilities that may impact how often they need to be mapped or what other services they would benefit from,” she adds.
Audiological Services Designed to Adapt with the Child
For school-age children, audiological needs evolve as they develop and as their learning and social environments change.
Lauren notes that in a mainstream school environment, it’s important for children who are deaf or hard of hearing to regularly see an educational audiologist to ensure they have the best access to sound. “We can make adjustments to help reduce the signal-to-noise ratio and enable their best hearing in the environment,” she says. Signal-to-noise ratios measure the difference (in decibels) between the sounds the device user wants to hear (the signal) and everything else (the noise). For example, in a classroom setting the “signal” might be the teacher’s voice and the “noise” would be the surrounding ambient sound.
Clarke audiologists are keenly aware of the changing needs of children who are deaf or hard of hearing as they develop. “With younger children, we’re teaching them independence,” says Lauren. “They need to be familiar with their equipment and how it works, as well as how to self-advocate.” To advocate for themselves, they must recognize what they need to feel comfortable and access sound in any particular setting. For example, a student will know they need a seat away from a loud heating vent or that the teacher needs to re-sync their hearing assistive technology (HAT), as well as how to express these needs to the teacher. Audiologists at Clarke help students by role-playing these scenarios and giving students an opportunity to rehearse how they’ll ask for and explain what they need, practicing how they can answer follow-up questions as well.
As students mature, the skills they need also become more complex. “For older children, other factors come into play where the audiologist can help build on the skills they learned when they were younger,” says Lauren. “For example, are they playing a sport and need to hear the coach on the field? Or is a high school student headed to college and their first lecture hall class?” In those different listening environments, audiologists can help determine which HATs will work best.
Audiology Is More than Technology
Besides ensuring that hearing aids, cochlear implants and HATs are working properly, Clarke audiologists also help with the pragmatic skills children need to gain confidence and autonomy regarding their hearing loss and hearing technology.
“At Clarke we strive to have our children be confident and independent about their hearing loss. A lot of what I do is educate children that, yes, some people have hearing loss and some don’t and it’s not a good or bad thing,” says Lauren. “They’ll have these skills for the rest of their lives. We want them to know that they can do what anyone else can do with some modifications or accommodations.”
Lauren recalls an experience she had with a young preschool student at Clarke. He wears hearing aids, and since children grow fast, needed to get fitted with new ear molds regularly. He disliked the process, which involves letting impression material sit in the ear canal for several minutes to make a cast so the hearing aid can be custom fit.
“I started pushing into Noah’s speech sessions weekly in November  to help desensitize Noah to the earmold impression process,” Lauren says. “Denise Guamanzara, Noah’s speech-language pathologist at Clarke, used play, social stories and consistent exposure in order for Noah to be able to tolerate the process. I enjoyed the collaborative effort and team approach to make Noah successful. After four months of working on it, he was successfully able to have earmold impressions taken without being sedated,” she says.
For younger students in early intervention, teaching those skills requires intensive family involvement—initially. The goal is to gradually minimize the family’s role as the child learns to self-advocate and manage their hearing equipment.
“There is a lot of parent education at first and that transitions to teaching more independent skills,” says Lauren. “The goal is to move from what mom and dad do, such as changing batteries, to the child taking on more responsibility. We love to hear, ‘Look what I can do by myself with my hearing aids.’”
Visit our website to learn more about Clarke’s Audiology Services.
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