Read the full transcript here

In this episode, Dr. Saperstain speaks with Dr. Karen Muñoz. Dr. Muñoz is an audiologist of many years and department head and professor of communicative disorders and deaf education at Utah state university. Dr. Karen Muñoz specialized in the administrative, educational, and research fields of audiology after spending many years as a clinical practitioner. She also started the Hear to Learn  (Oir para aprender) program which is a website with many resources for parents of children who are deaf or hard of hearing.

This week on the All About Audiology podcast:

• 9:15 – Parents are the key to how intervention is going to go for their child. And what I would like parents to really embrace is how essential they are.

• 12:35 – Oftentimes audiologists want to focus on the technical stuff. We got a lot we do have to care about and we have to care about what’s happening with the parent and their thoughts and feelings that can interfere with what goes on every single day that they’re with a child

• 15:50 – The resources that bridge the hearing care team and the parents.

• 20:00 –  Even when parents get a “hearing aid care kit”  too often, they don’t use it, or don’t know what to do with it.

• 23:05 –  How parents can make informed decisions. 

• 27:10 – And I think as ethical professionals It’s about having those conversations about what are their underlying thoughts, feelings, and questions. That’s where we focus our efforts to be, that support for the families and helping them get what they need

• 29:30 – We are in a really key position to make sure they have the information that they need, we are not in the position to tell them what they have to do, but we’re there to help them have confidence!

For more resources and research visit:

All About Audiology Website 

All About Audiology Facebook group  

All About Audiology Instagram

And the Prodana pay-it-forward platform here: https://prodana.org/practioner/lilach-saperstein/audiology-counseling–dr–lilach-saperstein

Guest’s links:

Hear to Learn

• H.E.A.R retreats
• Language first
• Peach questionnaire
• Little Ears questionnaire

• Mallorie Evans

Transcript:

Dr. Lilach Saperstein:

Welcome back to the All About Audiology podcast. I’m your host, Dr. Lilach Saperstein, and this is the show where we talk about audiology in ways that really actually matter to you. 

If you are a parent of a deaf or hard-of-hearing child or you’ve just come into the world of Audiology, welcome to the show! There is an entire library of 86 plus episodes on all different topics. So go ahead to allaboutaudiology.com, put whatever search term you are dealing with, a hearing test, hearing aids, cochlear implants, any particular kind of diagnosis that you want to look into, maybe we’ve done an episode on it. And also as well as educational topics, advocacy topics, so you have lots to look at in the library at allaboutaudiology.com with full transcripts and show notes for each of the episodes. So definitely make use of the search bar there. 

Also, before we jump into today’s episode, I want to thank you all so much for being listeners and supporters of the show. To become a supporter of the show and help with production costs and transcription costs and editing costs then you can become a patron at patreon.com/allaboutaudiology, and that really, really, really helps. Even a small contribution is so appreciated. 

And lastly, I would like to invite you to join the mailing list so you are kept up to date about the upcoming H.E.A.R retreats that we run every so often online, which is an incredible gathering of parents from around the world talking about the real-life aspects of raising deaf or hard of hearing child. What really comes along with that processing… our own emotions, our own journey around this, as well as processing and helping our kids becoming really powerful self-advocates as we learn to advocate alongside them. 

The support in their community is really beautiful. So to get updates on upcoming events, you can of course follow me on social media at @allaboutaudiologypodcast on Instagram, and on Facebook in our parenting Facebook group, as well as joining the mailing list which is a surefire way to hear about updates and new upcoming episodes. 

Okay, enough of that. I would love to introduce today’s guest, Dr. Karen Muñoz, is the department head and professor of Communicative Disorders and Deaf Education at Utah State University. She is an audiologist of many years, as well as a researcher and I really am so glad that we’ve connected, and that she is coming on the show to talk about the parent-centered and patient-centered approach, person-centered approach. I mean, we all know that there are a lot of terms in audiology, about hearing aids and the different parts of the ear and all the different testing that we do and all of our acronyms, ADRs and OEEs, and all the different things that can become really mumble jumbled and… what are we even talking about at the end of the day and beginning of the day, we have to be really focused on the people the actual child or patient family in front of us. And I really love that that is her focus because that is something that I’m so passionate about and I want to learn more about the researchers who are doing so much incredible work in this field. So without further ado, I present the conversation that I had with Dr. Karen Muñoz. And of course, there will be full show notes and links to everything we talked about at allaboutaudiology.com. Thanks for listening, here we go!

Welcome, Dr. Karen Muñoz! To the All About Audiology podcast. It’s so wonderful to have you here. And I would love to start by having you introduce yourself and tell our listeners who you are. 

Dr. Karen Muñoz:

Well, thank you for inviting me. It’s nice to be here with you and to meet you. I’m an audiologist. I work in Utah I’ve got a varied history. I started audiology as a clinical practitioner, many many years ago, and then transitioned more into teaching research and now administration, so I’m at Utah State University currently.

LS:

And it’s so interesting that you have that trajectory. We definitely have a lot of students listening to this show, communication disorder students from around the world, and lots of times they are looking at their options, “what my career is going to look like?” And I always encourage people that, even if you choose something, that doesn’t mean that’s your life forever. There’s so many options and opportunities. 

So you started clinical what made you interested in moving into research in academics?

KM:

That’s such a great question, and people ask me that a lot, you know, because it’s such a little bit of an unusual path. And, you know, I really enjoyed working in the clinic and as I worked… I worked clinically for about 20 years, and during that time, I ended up focusing more on pediatrics as I went along. But when I got my degree, it was a master’s degree, and then the AUD came along. So it’s honestly that, that prompted me to look at this because I thought “Well, should I go back and get my AUD or, you know, what, what do I want to do?” And at that point in time, somebody had suggested to me that I look at a research degree. So it wasn’t any grand plan that I ever had along the way. It was an opportunity that showed up and I happen to work at a university at the time Supervising graduate students, you know, in the clinic, so I worked with students for a long time, I loved working in the university and the department chair at that time, when he raised that opportunity, it wasn’t even something that had occurred to me. So I started to look into it and I thought “oh, this is a path that I wouldn’t have thought of”. And what appealed to me about it is that it opened up additional doors. I already knew I liked working clinically. I actually didn’t even have a plan to change what I was doing. I was just going to go back and get the degree and have it enhance, you know, like my clinical work. But it really changed things in a whole lot of ways for me, and that I could never have anticipated and I’ve loved every minute of it. But that’s what prompted me to do it.

LS:

Would you say that when there’s, I guess, a misconception that people who are in their “ivory tower”, and they’re in university that they’re not actually interacting with patients, but, would you say that that is accurate to your experience with research or…?

KM:

I would say that it’s not as accurate as people clinically, you know working in so many different settings, think that it is. I have a lot of years working in the university in different capacities and it’s such a focus to say what’s clinically applicable, you know, what is it that’s best practice, clinically applicable, what you really should be going for. Not because it’s extra, but because it’s what comprehensive care looks like. I know that’s been a big part of everything I’ve been exposed to. So my experience is not an out-of-touch “ivory tower” (Laughs)

LS:

For sure, and I think maybe if anything, you probably think about the clinical care more than a clinician who also is taking on so much of administration and time schedules and cleaning the tips, you know, even they felt like… So of course there’s someone whose entire focus is thinking about creating the evidence-based practice that isn’t practiced. Let’s call it a symbiotic relationship. (Laughs)

KM:

You know, just thinking about evidence-based practice is such a great, like, foundation for all the different things that we do. And so I do have the fun now of being able to look at my research through that lens. So I think a lot of the clinical work that I did really has fed my interest, and my focus, and the things that I do as research, in a really meaningful way for me. And so I’ve just had a lot of fun with how that has kind of just grown and evolved over time. I couldn’t have planned it, let me put it that way, but it’s been very fun. (Laughs)

LS:

So I wanted to switch gears a little bit into speaking directly to our parents who are listening, parents of children who either get diagnosed with hearing loss or didn’t pass the newborn hearing screening. That’s a lot of people in that part of the stage. That’s when they start the Googling and come to the podcast, and other parents who are further along and have sort of a lot of information and are now navigating advocacy and education placements and communication questions and they’re sort of in that tornado. (Laughs) And then, so I think the parents at different stages, would wonder what kind of information you as a researcher wish they could know, just like, “please, everyone should know this”, this is your chance. (Laughs) Just speak to, let’s say, 5000 or so, people who listen to this. (Laughs)

KM:

Well, the thing that I really wish they would know, is that they are such an important part of the process. Like they are the key piece of the intervention and, you know, just kind of to qualify it. I work primarily with parents of young kids, so. you know, like birth to, say, early school age, maybe kindergarten, first grade. So my focus is very much on that parent that is just key to how intervention is going to go for their child. They’re with them every day. They know what works best for them. They know what’s not working. They are essential. And what I would like parents to really embrace is that, how essential they are. That they have important things to share with their audiologist or anyone on their hearing care team that they have insights, observations, needs that matter. I think sometimes as audiologists we overfocus, not that we should under focus this (Laughs), but we tend to focus mostly on what’s happening with the child. And we think that “of course the parents are going to do what they need to do and it’s going to just all come together” and parents need help as well. You know, they’re learning new things. They’re doing things they never even knew existed before… the support that they need is greater than, I think, typically what audiologists realize. So I’d like parents to know that, ask for what they need. Speak up, ask questions, if you’re not getting what you need, get another opinion. I’d like them to feel that empowerment and that equal weight of that partnership to drive it as well. Because I think sometimes as a patient or a parent, we’re willing to accept what we’re told by the expert, and they are just as much the expert as we are. We can’t do it with either part of that partnership.

LS:

Everything that you just said made my chest a little warm and made my shoulders come down a bit (Laughs). I felt that in my body. This is my entire platform and what the all about audiology podcast is about and how I found you because of all the research that you’ve written about the importance of the parent involvement and family-centered approach, because that’s what I noticed clinically and working with families like we were speaking totally different languages on the audiology side and the parent’s side of both. Like well, how do I make sure that my child’s siblings don’t feel left out? Or how can they be part of the process? And people asking things like “does this mean that we can’t do certain family activities that we would have done or we do with other kids and can’t do with this child?” That’s not necessarily an audiology question, but it’s what’s on their mind. It’s what they’re coming with. You know, this hearing aid is making a terrible sound and they’re very focused on one issue that they’ve come in for it but behind that is why do we even need this? And are they really on board with doing this hearing aid intervention or… So all of those conversations is where my interest came in and what I’m doing so much with parents because that’s what I am so on board with. So thank you for saying that. That’s very validating for my work. But for our listeners, I really want everyone to take that, hear it again. You are so important.

KM:

One of the things that you said that I just kind of wanted to point out that matters so much is what are those underlying issues that they’re facing? What are they feeling? What are their emotions? What are those internal things that can get in the way of doing the intervention that they’re caring about, you know, they’re there because they want to help their child nobody’s going to want to help their child more than they do. But that doesn’t mean things can’t get in the way. And oftentimes audiologists want to focus on the technical stuff. Is the hearing aid program dry? Is the hearing stable? We need to check in, see if anything’s changed, what’s happening with the middle ear? Are they having an infection right now? We got a lot we do have to care about and we have to care about what’s happening with the parent and their thoughts and feelings that can interfere with what goes on every single day that they’re with a child. And if we’re not going to talk about it with them, who is? who else is going to talk about these things with the parent? They’re going to sit with it. They’re going to feel these things. They’re going to have those doubts, those fears, those feelings, whether or not we talk about it, but if we don’t talk about it, they’re going to have more power within their day-to-day life than if we do talk about it. Just that fact of letting it be part of the conversation is really therapeutic and can reduce the barriers that those kinds of things cause and so I think one of our challenges and things as an audiologist we should do is not be afraid to talk about how people feel and their emotions and the psychosocial aspect of it. And it’s okay to ask, it’s okay to go there. And yes, it is our role, because I think I hear that a lot. “That’s not really my role”. Parents don’t want me to do that. And everything I’ve learned does not support that. (Laughs)

LS:

Yeah. And also a big thing that I say often, also to our audiology colleagues listening, that if it seems like well, I can’t do that, I don’t have time and there’s just like the tension. There’s so much to do, that it’s also okay to say, “Hey, there’s audiology resources that are doing the counseling side of it outside of the clinical”, even though it would be awesome if it was always integrated. The work that I’m doing with parents is… I’m not their clinical audiologist at all, in fact, I’m probably in a different country, with so many of my international clients. But the things that we’re talking about is the parents journey, the parents questions, and that’s equally if not as more of…. I’m not going to quantify it, but it’s awesome, it’s important and it shouldn’t be neglected. So for the parents to hear sometimes your audiologist will do that, and sometimes you’ll get that elsewhere or maybe through mental health support, or maybe through school counseling, or wherever else, someone on your team or in your life can offer that support. And maybe we can integrate it more, like trying to come at it from all ends.

KM:

I think that’s exactly it. I think it can and probably should be more than one source. You know, parent-to-parent support is a big one that oftentimes parents don’t know how to get connected with other parents and I often hear about how they feel like they’re the only one or they’re so alone, you know, so some parents are awesomely connected. Some parents don’t even know there is a way to do that. So I think you’re right. This should be a lot of different approaches to be able to support the parents, not just one single one. 

LS:

Can you talk to us a little about “Hear to Learn”? 

KM:

Yes

LS:

We will definitely have the link in the show notes. Don’t forget!

KM:

Well, it’s interesting, because when I started down my research path, you know, I started exploring like, “well, what are professional practices for different things?” So I looked at infant diagnostic testing, I looked at hearing aids counseling, all of this. What are we, as professionals, doing? Then at the same time, I was looking at what are parents challenges? What are they struggling with? and what do they need? And so I was kind of looking at both sides of the coin to understand what’s what. And that led me to this place of needing resources that were really kind of bridging the hearing care team because it’s more than audiologists, it can be speech-language pathologists, deaf educators, others that don’t know as much maybe about the hearing aids that their patients are wearing, you know, but yet they’re doing intervention or intervention with them. And then there’s the parents learning all these things at home. So it kept coming back to me about a need for training and resources. And I can actually remember when I got the idea for the hear to learn resources, I was at a triple-A conference in, I think it was San Antonio actually, and saying “there are not enough resources for Spanish-speaking parents”. So I was just really keying in, on that there’s just not much there and it really fired me up to try to understand what was out there. So we did some literature reviews, and website reviews, and… there just was not much out there. So in 2017, we launched our website called hear to learn with the whole goal of it being resources that help parents learn how to act on the things that they’ve talked about with their audiologist or their early interventionist. So we have a lot of tutorials, like kind of how-to tutorials, learning tutorials, to help parents bridge that… “okay, I know about checking the hearing aid. I know I’m supposed to check the hearing aid. I don’t remember what to do with these tools they gave me”, that’s just one example. And then, they also… the children if they’re learning spoken language, they need to be integrating language throughout their day. They know they should be doing this, but “how do I act on it?” There’s a whole bunch of fun activities, you know, that they can download and do. So we got it started basically, in the thought of helping to bridge the parents, kind of empower them at home, for the things that they’re doing. And one other thing that was really driving me with the videos is, over time I’ve really noticed how we teach mothers pretty much exclusively, so these videos can also be this bridge for people that can’t come to the appointments and can’t hear it directly. I think it can take some weight off the mother and support her in working with other people too. So that was kind of the vision behind it.

LS:

Wow. You know one of the things I talk a lot about for parents to consider is that when your audiology is just showing you something, or how to put it in, take it out… pull out your phone, take a video, then send that video to everyone on the care team, send it to grandma, send it to the babysitter so that they know what this is. That’s not always feasible. So it’s an idea it can be helpful at some appointments. But I love the idea that it’s there. it’s so organized, the website is so user friendly, everything is there. And I also love that you are not only saying what to do, but why it’s important. We talked about that ” buy-in” getting the parent to like be in on the journey with you and know that the things you’re recommending are for a reason for benefit. Just because we feel like it. What’s the goal? What are we trying to get to? So I think all of that is really helpful to parents to know they have a website, literally. (Laughs)

KM:

And the idea that you raised, like, filming it in the appointment, I’ve heard that a lot and I think it’s an amazing idea. One of the things that’s hard though, I think, at the time of the appointment is: parents can often feel emotional or overwhelmed at those appointments. So they might not even think of it and then if the audiologist doesn’t even mention it or facilitate it, it can easily not happen and at the same time with how they’re feeling and an appointment is going to impact how much they remember. So you know, I really liked the idea of bridging even if you had more people there, I can’t tell you how many people I’ve talked to, that, you know, they get the care kit so that they can take care of their hearing aids. And then it’s like “yeah, I got one of those. I’m not sure where I put it”, “yeah, I have it but I don’t know what to do with it”, and you know that they were taught, you know, the chances of them not being taught I think would be really, really low. But I would say like 90% of the people in our studies when we’re looking at it, too often don’t use it, don’t know what to do with it. If they use it, they use some of it but they don’t know what everything is for. The frequency of checking the hearing aids is very rarely daily, you know, for young kids and we know that the hearing aids are gonna malfunction and I really don’t believe that it’s not because someone didn’t talk about it with them. I think it’s that speaks to how big of an ask some of this learning is to take it and integrate it.

LS:

I would like to recommend to our listeners on both sides of the desk, if you will, that something you can do is actually take a breath, a moment, a pause between informational counseling of what’s happening, what we’re doing, testing or whatever. And then do actually take that moment to say now I’m going to show you something that you will likely want to remember. Now’s a good time to take a video. If there’s someone else that came with you and they’re in the waiting room, bring them in this part and actually make an emotional delineation between parts of appointments. And I would also recommend taking like a little check-in break, taking a breath which takes, you know, 20 seconds, but it’s very meaningful like nervous system regulation too.

KM:

Yeah, I agree with you. I think the check-in part of that, like how are you feeling about this? Would this be a good time to have someone so in here or take a video of this? How are you feeling? you know. I think that checking in and making sure that you’re providing the things, kind of what they want and need, at the time they need it. 

I think one pitfall, sometimes, that we can fall into as audiologists, I know I did, you know, when I look back (laughs) at practice, is, you know, thinking I have to share all the information at the beginning right or at one time or in a certain way because I want them to have everything that they need to know. But when we do that we’re not taking into account how they’re taking it in, how they’re understanding, how they’re feeling, what’s most important to them, at that point in time, we’re kind of following our own agenda, inadvertently, without making what they need part of the agenda. So those are some things I’ve learned over time, about what does it even mean to have a shared agenda in the appointment and why does that matter?

LS:

That’s really helpful, I think. So yes, I want to also ask, if you talk also about the big question, like, “let’s just touch the elephant in the room” of audiology, that a lot of parents are questioning about sign language and communication modality educational placement. That whole side of the decision-making  You know, we’ve talked a lot of the device side

KM: 

Yes!

LS:

But these are big questions that parents come in with as well.

KM:

They do and so you know, a few steps back to like that diagnostic time, where the hearing loss has been identified and the parents are now facing a whole lot of things they weren’t expecting to face, They don’t understand what they don’t know. I think we would all agree we want parents to make informed decisions about the directions that they go and the things that they learn, and what they can take on. And the only way we can do that is by making sure that they do get information to make these decisions along the way. They may have reasons to change decisions as they go depending on how their child is progressing. So we really want strongly informed parents, and I know different states have different systems that support helping to educate parents. So I think it’s really important to know what parents are receiving so that you can help support what they get. So the right referrals happen at the beginning. We’re doing lots of referrals at the beginning. You know, when a hearing loss is identified, are they getting the referrals that are going to help them have all the education that they need about communication modalities, options, how do they want to communicate? what do they want to do? do they know how to connect with other parents? they’ve gone to the doctor… there’s a lot of referrals going on there. So I think it’s also important to know that that’s not a single conversation. And that’s kind of where some shared agenda can come in. Now, there are lots of different things that you’re going to be looking at, learning now, what’s most important to talk about today? you know, and knowing that you’re kind of coming back to it and we avoid that kind of temptation of the fire hose of information that we feel at that point in time because we want them to know everything some of it can get lost. It is important to know like, for our hear to learn website, because my area of expertise is with spoken language, It’s geared toward the parent that’s decided they want spoken language. So we had to put some boundaries around what we developed and what we do. And so that would be like, a parent’s decided they wanted to go there, here are resources that are strong about that. But we don’t provide things at the time of identification and decisions and all of that because I feel like that’s like a whole nother website of resources. (Laughs)

LS:

Right. 

KM:

But your question is really important. And I think as audiologists it’s important that we don’t shortchange that conversation with parents about the things that they want to know about, understand as they navigate it. Some parents are going to want Sign Language some parents aren’t, it isn’t about what’s right or wrong, good or bad, needed or not needed. It’s what that family needs and what they want, and helping them to access the best experts and best resources for what it is that they want that align with the goals that they have. That’s where we want to be with it.

LS:

And I think one of the issues that parents talk about a lot is getting so much conflicting information, and they don’t really know which person or which one of their various referrals is the one that knows it the best or… and that’s accurate, also a reflection of what is happening in the field.

KM:

I mean, what’s really, really unfortunate is, and we’ve had it in the field for decades now, you know, it’s a long history of conflict between, should somebody go down a road where they’re, you know, a bilingual-bicultural, and the main language is ASL and the family learns ASL, is it a spoken language, technology, cochlear implants… I think where, as a field, we need to go, it’s not this either or they aren’t good or bad, right or wrong. It’s what’s best. I mean, I love Hands and Voices has a saying something like “what’s right is what’s right for your family”, I’m not getting it exactly right, but that’s really truly where we want to be. If a family wants to learn ASL and make that the direction they go, we want them to get the best support that they possibly can. You know, we don’t want to be in the position of saying “no, but you really need this”, you know, we are all naturally going to have biases because we’re experts in what we do. But that doesn’t have to be that we’re trying to convince people to do things because of what we do. And I think as ethical professionals, we can walk that line, that that’s a very doable place to be. It’s about having those conversations about what are their underlying thoughts, feelings, and questions. Unfortunately, there are going to be times when people are given information to scare them or to coerce them. And it’s a very unfortunate place for families to be when that happens, and I’ve seen it over and over and over again. And we don’t want families to have that on top of what they’re already experiencing. But we do know that it will happen. So I think the thing we can control is our own communication. And that’s where we focus our efforts to be, that support for the families and helping them get what they need. And that they get solid evidence-based information as they’re working through their questions and thoughts on it.

LS:

I’m going to definitely link and point people to an episode with Mallory Evans, who’s an audiologist that focuses a lot on the implicit bias in audiology, towards auditory oral, that is the field, and how lacking the parent information is about the need for accessible visual language for, you know, the most appropriate or accessible thing for children who do not have access to auditory input would be visual language. But many parents don’t even ever get that perspective, because there’s no deaf adults on any of their teams in their early identification process. And so, just knowing that sometimes we say that a parent would have the information to make a choice, but do they actually have all the information? So that’s a really great conversation I recommend people listen to, and also I’m a big student of the “language first” from Kimberly Sanzo, who also does a lot of work on sign language as the accessible option for language learning and how so much of audiology and auditory-verbal and SLPs are focusing on spoken language, whereas that is one way of communicating of many.

KM: 

Yeah, I mean, I think that for any of us in anything that we’re facing in life, we want to have the full information that helps us make our decisions. But we don’t always know what those things are. If you’ve never encountered something like most of the parents that are having their baby identified with hearing loss, haven’t encountered this, haven’t thought about it. And so we are in a really key position to make sure they have the information that they need. We are not in the position to tell them what they have to do, to coerce them, to judge what’s important to them and their choices, but we’re there to help them have confidence basically, in those choices that they make and to make sure they get really good support for whatever those choices are. You’re going to have parents that are going to go in so many different directions. They may just want spoken language, they may just want sign language, they may want some combination of the two, but how do we monitor progress and where they’re going that’s meeting their goals? You know, it’s just an ongoing thing we talk about and look at and process that won’t be that you shared a pamphlet and all is good. These are deep hard conversations that they’re processing. And it’s something that I think occurs over time. So I do like getting back to your point of those check-ins with people. There are lots of ways we should check-in, you know, with where they are because just because we talked about something doesn’t mean we’re really done with that.

LS:

Totally. Everything is an ongoing conversation. And I really find that a big thing, at least online, in the Instagram community, there’s this term that people are using a lot of “The Inbetweeners” that they are maybe using technology for their auditory access as well as involved heavily also in a signed communication.

KM:

And what I think is really important, like, if I were a parent, you know, and I didn’t know what I don’t know, is like “what is it that I really have to care about for my child to be successful with spoken language?” right? What are those key things that shouldn’t be happening? And same thing, if I want my child to have really great literacy in sign language, in this direction, what is it that’s really important for me to know and do there? Because I think that’s where the success of that individual child can come out because I think we can be lulled inadvertently into, let’s just give everybody everything and this is the best case scenario. But if we’re losing those key things that make them be successful or support that success, I should say, in whatever modality it is, we haven’t done anyone any favors. So if you’ve got a child, yep, they’ve got their technology, whether it’s a hearing aid or an implant, but it’s not programmed appropriately. It’s not being used consistently. We haven’t given them audibility, and that’s an illusion that they have what they need for their success in an auditory environment. If we’re saying that we want to go ASL, but the parents or the key communicators in that child’s life are not signing at a sufficient level to support the literacy growth of that child, what are they not supporting in that literacy growth? What needs to happen for that to really do the outcome that they want? And so one thing I do think is really important is that we don’t lose that depth of expertise in both of those areas, to really support parents. I mean, I work in this tiny little sliver, you know, of intervention and it’s like, it’s so tiny, you’d think that I’d have been done with it years ago, but it’s about hearing aid use, you know, and management. And there’s so much work that parents need to be able to do for that child to have auditory access that supports spoken language development and it doesn’t just happen because we taught them gave them tools, told them what to do. It takes so much more, and so that just replicate that kind of work on the parents across all these different things. And that’s the work on the parents, you know.

LS:

I really like that approach and for people to be able to think of the question, not so much, which direction do we want to go, but what is required of us and our environment for that, to enable, to support, and reach that outcome?

KM:

Yeah, you know, we want those children to have access to absolutely every opportunity that they can and we all know that if we go years down the road and just to use auditory access as an example, and they haven’t had it, that’s going to have that cascading effect on their language development, which is going to impact how they do academically in school, and we don’t get those years back. And so it just really matters as we go along which whatever it is, we want them to, the children, to have the abilities and the access to everything that they can do well, and so sometimes, a parent can’t do everything, you know, that’s a tall order and that’s okay if they don’t. I think we don’t want parents to feel guilty about how they’re approaching this with their child. We just want them to be really good at what they do. (Laughs)

LS:

Can you talk a little bit about ling sounds? Have you done some work on that where… I tell you where this is coming from, Sometimes people say “well, my child responds and can discriminate between ling sounds, and therefore we’re in the clear, everything’s, you know, target reached”, but could it be that that is a bare minimum of audibility that we’re trying to get to, but really, there’s way more that we can be testing, or like, things that parents can be looking out for, to say, we’re in a good place.

KM:

So you know, that sort of going more into a little bit of the intervention stuff that isn’t as much of my expertise but there’s no way that I would think that was enough, and that I was there and I was good. There’s so much more comprehensively that we have to be checking and looking at about what a child is able to do with what they hear. And you know, one of the underutilized parts of audiology and pediatric audiology is validation. So if you think about, you know, just even the questionnaires parents can fill out at home like, you know, the ”Peach” or the “Little ears”, things like that, that helped them look at what’s happening with audition in everyday environments. One wish I would have is that that would be more integrated into audiology practice. A lot of pediatric audiologists are not including the validation piece of it. I think that we need multiple types of information to determine how a child’s doing auditorily, multiple…

LS:

Those are great resources I definitely recommend. We’ll link them and I want parents to take a look at those questionnaires because they asked very functional questions like Does your child turn to their name? or when there’s sounds around them, you know, what is their reaction to various kinds of sounds, close, far, speech, noise, all different things like that, to really get a sense of their behavior around sound as well.

KM:

Yeah, so complex, and there’s so much to look at that, we really need to look at so many angles, to have confidence and I wouldn’t be confident with just a single angle.

LS:

Right, and so let’s not say “oh, they can hear six distinct sounds, the end”(Laughs)…. the beginning. Okay, so this is so fun. I think we can keep talking forever. It’s really nice. You know, when you find… when I discovered your work and reached out to you to invite you to the podcast, I knew that parents would have good insight from your work and your approach like the clinical together with academic, focusing on their particular experience. So for parents to know that there are so many people out there thinking about you, really (Laughs), and your experience and how this goes for you from lots of different areas. So would you have some words of encouragement or advice to our listeners to hand off this episode?

KM:

Well, I think that, you know, there is just so much promise and so much opportunity. So for the students listening, there are great things that you can do, I would say pay attention to how to be a person-centered audiologist, person and family-centered, you will go far and you will help the people you’re working with so much more, if you broaden and look at things through that lens. And for the parents, your kids are going to do great, they have you you are there for them and you have a lot of resources that you can reach out to. And when you get farther down the road and you look back you’ll say “yeah, I wish I knew that they were gonna do so good”. You know, I was really worried, you’re gonna feel better as time goes on and just really partner with the professionals that you work with, they are there for you and you’re better together.

LS:

Awesome! Thank you so very much for your time and expertise. We’ll have all of the links to today’s conversation in the show notes as well as a full transcript. This is the All About Audiology podcast. Thank you for listening!

The post All About Finding The Resources That Best Fit Your Family – Episode 91 with Dr. Karen Muñoz appeared first on All About Audiology.