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Long thread. These are great questions. I’ll do my best to answer them... https://twitter.com/MarieCoppola68/status/1357698935205355524
We have a FB group for audiologists and AuD students “with hearing loss”. It includes a wide mix of perspectives. Group members might identify as deaf, hard of hearing, person with hearing loss, hearing impaired, etc. The group is international with most members in the U.S.
There are just under 450 members of that group right now. Just anecdotally from my own experience, I’d say that the majority of group members are hearing aid users and have less severe hearing levels. There are people with CIs too, but far fewer of us.
Another number: at the American Academy of Audiology’s annual conference, we have a Deaf and Hard of Hearing Audiologist and Student meeting. Around 30-50 people come. These are all U.S. audiologists and AuD students. This is our picture from the last time AAA was in person.
Also, the 2020 Audiology Student Census had 418 respondents from 83 AuD programs in the U.S., and one of the questions it asked was about hearing status. This table has the reported numbers. From these results, in 2020 there were 9 students who use 2 CIs, 4 who use CI+HA, ...
...4 who use a single HA, 29 who use 2 HAs, and 13 who have a diagnosed hearing loss but don’t use amplification (which likely means less severe rather than more severe hearing levels based on who I know). You can find all of this here: https://www.audiology.org/audiology-today-julyaugust-2020/student-speak-count-starts-here-2020-audiology-student-census
Anecdotally and based entirely on my own experience: the majority of DHH audiologists and AuD students are non-signers with hearing levels somewhere in the range that would be aidable with HAs for speech understanding.
But I do know other DHH audiologists who sign. I wrote this article with a good friend and colleague of mine who is also a deaf CI user and signer (third author), and a current AuD student in her final year who has unilateral HL (second author): https://www.audiology.org/audiology-today-novemberdecember-2020/working-effectively-audiology-students-who-are-ddeaf-or-hard
Another friend of mine did her AuD capstone project on the issue of support for DHH AuD students, and the numbers that she got have some good insights to this question. She also got a lot of great qualitative data from DHH AuD students about experiences.
Here’s Part 1 of her work: https://journals.lww.com/thehearingjournal/Fulltext/2020/11000/Accessible_Audiology_Education__Examining.6.aspx?fbclid=IwAR39A2EXKTLVSpm36OuwfIENsljhtKEFQ1GbXpW2IwmO6flDpqwdhAT4Da4
The above project addresses the kinds of support that current DHH AuD students find helpful. But there may also be DHH undergrads who would make good audiologists but might not be applying to AuD programs. I want to find out more about that. No info to give on that right now.
Making it through an AuD program as a deaf person with CIs is not easy. I’m grateful for audiologists and others who supported me. I did have support, but it wasn’t universal. The following are my suggestions for supporting DHH AuD students so that they stay in their program:
Audiologists who are clinical and academic instructors for AuD programs or off-campus preceptors could be more open to accommodations. Plenty of examples of these in my article a few tweets above. This is a difficult issue because some accommodations require extra time.
In audiology clinic settings, there’s not always time to be spared. DHH AuD students need faculty and off-campus support from audiologists who can help them figure out creative ways of implementing accommodations while still being efficient in work. It’s hard, but it can be done.
Another issue is conflicting feedback about accommodations. When I was an AuD student, at times one preceptor would suggest a new accommodation, I would try it, and another preceptor would tell me that the accommodation was inappropriate because of how much time it required, ...
... what it required the client/patient to do, or some other reason. The best preceptors worked with me closely to help me determine what worked best for me. If I made a mistake that was probably due to my deafness, they discussed it with me in a non-shaming way.
Together, we figured out what to do next time that thing happened. But the preceptors that I didn’t do well with made assumptions about my behavior and my mistakes that were due to deafness. Example: I would miss something that was said and respond inappropriately...
...to what I did hear because I didn’t have all of the information. The preceptor would assume that the issue wasn’t deafness-related and that I just had social skills deficits. What I needed was preceptors who wouldn’t jump to those conclusions and would take the time...
...to discuss the situation with me without negative judgement. I did get that from some, but not all. Another need that I had was directness. Some of my preceptors were direct with me when I made a mistake due to deafness and others were not.
Indirectness led to a few times when a preceptor assumed that I wasn’t working hard enough. No one can work on something that they aren’t aware of in the first place. I appreciated preceptors who would tell me directly: “We need to find a new way for you to do this task.”
There were also times when my ability to do audiology was questioned because I couldn’t do something that’s not even an essential task: something that an audiology assistant/tech can be trained to do. I’d really encourage audiologists to think about what is and isn’t essential.
As for non-audiologists who want to encourage DHH students to pursue an AuD: connect these students with a DHH audiologist who has been there as a student and knows the challenges and how to navigate them.
Encourage them to apply to programs that have successfully educated DHH students. Encourage them to ask in interviews what experience a program has with this and what kind of support they provide: what are the faculty and preceptor responsibilities vs. student responsibilities?
Another issue is that students themselves aren’t prepared for the kinds of accommodations they will need in audiology settings. Students often know the accommodations they need in other life situations, but audiology settings from the audiologist side are a whole new world.
Even if the student is excellent at self-advocacy and getting their needs met in the classroom, and even if they’ve had many audiology appointments as the client/patient, there is no way of knowing exactly what they will need on the audiologist side of clinic until they’re there.
Many students get into an AuD program and then find out that they have no idea how to get their needs met within the role of clinician in an audiology setting. Sometimes, students drop out of programs for this reason. This is why mentoring from a DHH audiologist is so important!
Encourage DHH students who are interested in audiology to consider applying to AuD programs. But it’s likely that they’ll encounter surprises in both the application process and their first year in the program. This shouldn’t be sugarcoated. What they’re about to do isn’t easy.
Encouragement alone, though, isn’t enough. The system, as it is now, isn’t built to support them. They need to know that upfront, but they also need to know that support is available and where they can get it.
And briefly on the other part of the question about SLPs: I’m the wrong person to ask how many DHH SLPs there are because that’s not my profession and I don’t know many DHH SLPs myself. If I find that info anywhere, I’ll share it.
Oh, and how could I have forgotten this?! The Association of Audiologists with Hearing Loss now has a website. Refer your interested students there to see examples of DHH audiologist publications about our experiences https://www.audiologistswithhearingloss.com
