Educational Audiology Scope of Practice

The purpose of the EAA Scope of Practice statement is to identify and describe areas that are unique to the practice of audiology in education settings. Accordingly, this statement should inform educational licensure requirements for school-based audiologists, local school district educational audiology practice (NASDSE, 2018) as well as Au.D. and post-graduate professional development coursework in educational audiology. This statement expands on the audiology scope of practice statements of the American Speech-Language-Hearing Association (ASHA, 2018) and the American Academy of Audiology (AAA, 2004).

Educational audiology has continued to evolve from early definitions, providing greater clarity and definition to the scope of practice for audiologists providing services to students in educational settings. A primary goal is to ensure that all deaf and hard of hearing students, regardless of eligibility status, have full access to communication, specifically, auditory information, in their learning environments. To do so requires that children are identified, appropriately assessed, receive counseling and other support services to address their hearing status and educational needs, provided with appropriate hearing assistive technology and assistive technology services, and that their personal and assistive hearing technology is monitored regularly to ensure that it is functioning properly.

The specialized practice of audiology in education settings was first described in the 1965 Joint Committee Report, "Audiology and Education of the Deaf" (Ventry, 1965). The role of audiologists in educational programs and the qualifications and competencies needed to provide audiological services to children in educational settings were the two major areas of discussion of this committee. Key roles of audiologists included:

• Complete audiological evaluation of children related to their admission to the educational program
• Annual assessment of children's hearing, including an interpretation of the result to the teacher
• Hearing aid selection, orientation, and maintenance
• Application of knowledge about speech perception and speech pathology to the speech problems of deaf children
• Inservice training to help keep teachers abreast of new techniques and new information
• Parent counseling
• Evaluation, application, and selection of the amplifying systems and equipment used in the school
• Liaison between the school and the college or university training program or community speech and hearing center

The recommendations of this report influenced the definition of audiology in the first federal education disability legislation, the 1975 Education for all Handicapped Children Act, PL 94-142, now known as the Individuals with Disabilities Education Act (IDEA, 2004).

IDEA 2004 Definition of Audiology (34 CFR 300.34(b))

1. Identification of children with hearing loss;
2. Determination of the range, nature, and degree of hearing loss, including referral for medical or other professional attention for the habilitation of hearing;
3. Provision of habilitation activities, such as language habilitation, auditory training, speechreading (lip-reading), hearing evaluation, and speech conservation;
4. Creation and administration of programs for prevention of hearing loss;
5. Counseling and guidance of pupils, parents, and teachers regarding hearing loss;
6. Determination of the child's need for group and individual amplification, selecting and fitting an appropriate aid, and evaluating the effectiveness of amplification.

Educational Audiologists deliver a full spectrum of hearing services to all children, particularly those in educational settings. Audiologists are trained to diagnose, manage and treat hearing and balance problems. Educational audiologists are members of the school multidisciplinary team who facilitate listening, learning and communication access via specialized assessments; monitor personal hearing instruments; recommend, fit and manage hearing assistance technology; provide and recommend support services and resources; and advocate on behalf of the students. Educational audiologists provide evidence for needed services and technology, emphasize access skills and supports, counsel children to promote personal responsibility and self-advocacy, maintain student performance levels, collaborate with private sector audiologists, help student transitions and team with other school professions to work most effectively to facilitate student learning (www.edaud.org).

School-Based Educational Audiologists refers to educational audiologists who provide services to students as school employees or via contracted onsite services.

Students with all levels and types of auditory impairments including auditory neuropathy, unilateral or fluctuating hearing levels, or an auditory processing deficit, require the expertise of an educational audiologist. In addition, students with learning disabilities, reading/literacy difficulties, attention problems, and those struggling with English as a second language may benefit from the educational audiologist's knowledge of how listening and learning are impacted by noise and classroom acoustics. Educational audiologists should support these students whether they receive special education and related services under IDEA or services through Section 504 of the Rehabilitation Act (1973).

The work of school-based educational audiologists may vary from one educational setting to another. However, professional practices must address the areas identified within IDEA under audiology: screening, assessment, amplification, habilitation, counseling, and prevention (34CFR300.34(c)(1)); assistive technology and assistive technology services (34CFR300.5-.6 & C); and routine checking of amplification devices and external components of surgically implanted medical devices worn by children in school (34CFR300.113). Based on professional scopes of practice in audiology (AAA, 2004; ASHA, 2018), speech-language pathology (ASHA, 2007), and deaf education (CEC, 2018), the audiologist is the only professional that is qualified to fit and verify hearing aids and personal hearing assistance technology.

Through collaborative partnerships, educational and clinical audiologists work together to promote the most appropriate hearing technology and support services for each child or youth they serve. Providing ongoing consultation to the school nurse on screening programs, the speech language pathologist for communication strategies, or a classroom teacher regarding acquisition of the phonemic information critical to literacy -- are all part of the scope of practice of the educational audiologist.

As part of the educational team, educational audiologists interact directly with parents, as well as general education teachers, teachers of the deaf/hard of hearing, nurses, and specialized instructional support personnel (e.g., speech-language pathologists, LSL specialists, educational interpreters, psychologists, social workers). The efforts of educational audiologists to improve access to auditory information in learning environments address a fundamental need for all students to be able to hear, and understand, with or without visual supports, in the classroom. This expertise is unique from that of other professionals whose focus is from an academic, social-emotional and/or speech language perspective. Together, the educational audiologist and other professionals comprise a team prepared to effectively address the needs of students with hearing, listening, and auditory processing difficulties.