Introduction to the Todd Pod and Dr. Carrie Spangler
00:00:04
Speaker
Hello, and welcome to the Todd Pod, a podcast to support itinerant teachers of the Deaf and hard of hearing, SLPs, and other Deaf education professionals. I am Deanna Barlow from Listening Fund, and today we're talking about educational audiology with Dr. Carrie Spangler. Thank you for having me on the Todd Pod. I'm excited to be here. Thanks so much for being here.
Carrie Spangler's Journey in Audiology
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Carrie, can you tell everyone a little about yourself? Sure. I have been in the field of educational audiology for all of my career.
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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 ideology, 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
00:01:03
Speaker
life journey really steered me into the field of educational ideology. Yeah, absolutely. I feel like I've told you this before, but like the educational audiologist that my work are like my favorite people, like I seriously like I don't know what I would do without them. So I'm 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 like all of my problems. So
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It's really nice to have you as a resource here to talk with me so that everyone can listen for all your good information.
Role of Educational Audiologists
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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? Sure. So the educational audiologists, well, audiologists in general, they all have a right now, a doctor of audiology or AUD degree.
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so we all kind of had that common degree. But educational audiologists, I feel, are kind of the bridge between the clinic or pediatric audiologists and the school system. So when they go to their pediatric or clinical audiologists, they're really focused on their technology and changes in hearing and their hearing tests and
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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
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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.
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And they do that with specialized assessments or determining what kind of hearing assistive technology a student might need, depending on what they're fitted with at the clinical.
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or a pediatric audiologist and then to recommend different support services and resources and really advocate on behalf of the students so that we know that they have the best access that they can have within their school transitions and environment. 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?
Specialized Knowledge in Audiology
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That's a great question.
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I think the main thing is that when we get our degree in audiology, most programs don't focus a lot on education.
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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. It's a whole thing. Yeah, it's a whole thing. It's like a whole other 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
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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 be the hearing assistive technology piece and
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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 is set up is a really critical part of it because
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technology is great, but if it's not being used appropriately, then it really doesn't matter.
00:05:04
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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. 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 doesn't quite fit like the situation.
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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 and the specific kid and can like actually fit something that makes sense. Exactly. And then if you have more than one student, that staff are hard of hearing, that's coming in with a different type of personal technology.
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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.
00:06:25
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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?
Advocating for Audiologists in Schools
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Do you tie it back to IDEA or do you give them other rationale as to if you were trying to 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? I do. There's some great resources out there from the Educational Audiology Association.
00:06:51
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And even with the rights law, which is kind of a parent-driven web page that has information about what parent rights are. I feel like that is something that you have to bring up at some points in time because there's some special ed directors or coordinators that might not have the knowledge of what we do.
00:07:15
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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
00:07:42
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are able to market or share the job responsibilities and the scope of practice, it becomes more clear to them and hopefully everybody on the team will agree that this is an important part for our deaf and hard of hearing kids.
00:07:58
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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, OK, you have to call Phonak, get the serial number, mail it to them, let them know. And I just like 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, OK, great. Like they don't want to go through the logistics of trying to actually like
00:08:28
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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've realized 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. That'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. 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
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the aha moment for them that it's actually a very needed service and not a luxury, but something that they actually need to be in compliance. So that's what I've done. I appreciate you doing that too.
00:09:10
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One other thing that we've done in our area is we do have a really good relationship with our clinical pediatric cardiologist and they understand our role 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 to
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with the information. So that is another way I think districts have an opportunity when they hear it from the parents and realize, wait, we have to provide this. 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.
00:09:58
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While I have you here, whenever I have an educational audiologist, I always want to know what's new, what's coming up, what do I need to know. So what's new technology? Are you seeing pop up in the schools or the last couple years even? Because sometimes it takes a while for it to show up on my caseload.
Trends in Audiology: Cochlear Implants
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Do you have any tips or tricks for any of the new stuff coming up? Yeah, at least in our area.
00:10:22
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I mean, right now I feel like the two companies that are really pediatric focused are Phonak and Oticon. And they both have remote microphone system that are great system that can be paired and fit for each individual student. I think what we're seeing too is some of the challenges of criteria changing with cochlear implants. And we're seeing kids who
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Speaker
have maybe single-sided deafness coming in with a cochlear implant. What's the best way to make sure that they have an improved signal to noise ratio? Yeah, that's so interesting you say that because I've seen that a lot too now. Not that single-sided deafness is more common, but getting implanted is a lot more common now. Even young too.
00:11:14
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They're going into school with an implant, and that must be an interesting audiological challenge for a hat system. Is there a best practice for using a hat with those students, or is it individual? I think, at least with my experience, it's been very individual.
00:11:32
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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've bound with cochlear implant on one side, like I've tried like maybe a roger focus on the good ear, and then they have like the receiver on the cochlear implant side so that they had that binaural input coming in. They love it that way.
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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 was really individualized. And I think being able to go in and especially with older kids,
00:12:21
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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 fit for them. And it might change over time.
00:12:39
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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 what are how are you handling that because a lot of that's a challenge for a lot of people I talked to.
00:12:59
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It is, especially when there's one of us serving multiple districts and everybody seems to start their school year on the same day. And everyone wants you there on day one. 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
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for the reason of the beginning of the year.
00:13:30
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If there was a student that I knew maybe was going to get upgraded or moving or possibly not come back with the hearing aids the next year, I would make a special trip out to remove the receivers so that we would have them physically in order to take it through the next school year. But overall, I left it in there and we would notify the family and then our local pediatric hospital saying,
00:14:00
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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 over the summer for anything, please make note of that when you send it in. Yeah, that's a good idea to involve them, just to make sure everyone's kind of up to date on what's happening. Exactly. I know on their form now, it says, like, for their hearing aid form, it'll say, is there a receiver installed? And they can, you know, check that box.
00:14:29
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So just check the box because more than likely there's probably a receiver installed. Probably. I feel like for the longest time most of the troubleshooting issues I had had to do with audio issues and receivers. So are you noticing a big reduction in troubleshooting issues now that they're integrated or are there just different problems now?
00:14:50
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I have found that it's been less with not having audio shoes and the connections and things like that. The kids are so much happier. There's like one last step in the beginning of the day where they don't have to take their hearing equipment off and put on an audio shoe 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
00:15:17
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So they just get it, do a quick check, and they're off to their first class or their class during the day. So I feel like it's alleviated five minutes of the day by being able to connect directly.
00:15:34
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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 again? Did you unplug the receiver, unplug it back in?
00:15:51
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Did you change the battery? Yeah, before I drive over there, please tell me you tried to change the battery. And I just feel like I don't have like a lot of those problems are like not as big anymore. What other like, 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? Yes. So I've had
00:16:16
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I feel like sometimes with my younger kids especially the remote microphones that are made for like the cochlear implants for example like a mini mic those 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 edu mic and like the roger touchscreen those seem to be
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easier to get connected and stay connected. Whereas our Bauhaus and some of the cochlear implants, our choice is whether it's Soundfield 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.
00:17:05
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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.
00:17:15
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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 doesn't 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 as a TOD can work on teaching them to advocate when it's not working because
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I mean, this is with obviously like a roger system, not with a mini mic, 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 audiologists. Because 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 they
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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 good solution for some of the kids that are just starting to be able to do it, but not 100% able to report yet.
00:18:14
Speaker
But I feel like my older kids who are like middle school, high school, who are good users, like just last week, one of my students was upgraded to like the Baja six and she's in high school and I got her set up with the 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.
00:18:41
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phone app to and turn muted and unmuted if the teacher forgets to do it. So it does have a real good application. It just depends on the student.
00:18:53
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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. 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.
00:19:23
Speaker
Yeah, well it's nice that that's an option. It is, yeah. Alright, so when we're working with the educational audiologist, what can we as the TODs do to support the educational audiologist?
Collaboration Between TODs and Audiologists
00:19:37
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Like what information would it be helpful for us to give you when we communicate with you? 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.
00:19:49
Speaker
I feel the same about our 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 complement 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.
00:20:16
Speaker
because a lot of times as a TOD, you are seeing the kids a little bit more frequently than we are. Usually. Yeah, even if it's itinerant, even if you're only seeing them every couple of weeks, you still probably have your finger on the pulse a lot more than what we do. So I think anything that you can do as far as doing a listening check and keeping track of
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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, okay, is it technology? Is it 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,
00:21:06
Speaker
little like, you know, learning to listen kinds of kids, or maybe they just got a cochlear implant, your documentation of like auditory skills hierarchy is so important, especially for like mapping, then we can kind of relay that information over to the pediatric clinical audiologist too, if they need to be any changes that way. And I think
00:21:33
Speaker
a lot of times you are more involved in the interprofessional team or the multidisciplinary team at the school. So when there is like an evaluation coming up or an IEP meeting coming up, making sure that you rope us back in and say, oh, let's make sure that we have the educational audiologist involved in case there's any updates and changes that
00:22:01
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need to happen to. I love being able to collaborate with the TOD for just 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 kids?
00:22:23
Speaker
Yeah, absolutely. I feel like on my end, logistically, I always write down the serial numbers of everything so that way if there is an issue or something is lost, I can just email them the serial number instead of saying one of the receivers is missing. I don't know which one.
00:22:43
Speaker
Yeah, that's very helpful. If I could save him a trip, you know, and you don't if something is missing, you kind of need to write it down before it goes missing. That 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 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
00:23:08
Speaker
where if 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 things that I take for granted that I have because I'm there every week. You guys go to so many buildings. There's no way, even if you've been there before, that you can
00:23:30
Speaker
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 and 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'm only been there once a month and I don't remember where anything is.
00:23:50
Speaker
But just I try to front load 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 collaborative. So I try to front load all that 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. You're just able to do what you need to do. If I need to get us a room, whatever. I try to do that ahead of time. And I feel like that's something that I have found helpful for collaborating.
00:24:19
Speaker
Yeah, that's definitely helpful. Because 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? Especially I feel like this time of year is like, extra crazy. Yes. Yeah. All right. Is there anything else about educational ideology that maybe I didn't ask about that you think it would be helpful for the TODs to know about?
Resources and Awareness for Audiologists
00:24:45
Speaker
You have asked so many good questions. I do want to say maybe just a little shout out 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 TODs as well.
00:25:04
Speaker
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, with TODs and just kind of that scope of practice and advocating for the needs along the way. But
00:25:25
Speaker
I think you've covered everything really from a short podcast kind of way, but I agree that our roles are so intertwined in great ways and they really benefit the students. So continuing to collaborate and advocate on behalf of
00:25:50
Speaker
both professions is really going to be what is best for our students who are in the school systems. 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.
00:26:05
Speaker
That's fine, this is like our first day. You could go Google it, look at everything they posted in October, and all those resources will be there for you. They'll have been there for months, probably. And then next year in October, you'll know that it's going to be another Educational Audiology Awareness Week.
00:26:22
Speaker
But I do think that's a helpful tidbit if you need educational audio information. Could you say the name of the organization again? It's EAA, or Educational Audiology Association. Okay, yeah. So just having that as a resource, I think, is really helpful. Just knowing where to search on the internet sometimes when you need information can be really helpful. Yeah, definitely.
00:26:45
Speaker
Speaking of finding information on the internet, where can everybody find you online if they have questions, want to connect? Sure. So I can share my email with everybody if they want to reach out to me through email. So probably the best email would be, or I can just send it to you if you want that. I'll put it in the show notes.
00:27:08
Speaker
Okay, that would probably be easier. But I also, like you have a podcast as well, and it's called empower your ideology. And you can find that anywhere you listen to your podcast, because just like your role of an itinerant to D,
00:27:26
Speaker
you're in the car a lot listening to podcasts along the way. So if 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.
00:27:42
Speaker
Yeah, that's how me and Carrie first met originally, as I guessed it on her podcast, like what, like three years ago? Like it was a long time ago. 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.
00:28:05
Speaker
Yeah. And so you were able to share with the audience, like, how do I advocate for a TOD to be on the team? So if you go to the Empower Audiology
00:28:16
Speaker
podcast, then you just scroll all the way back and you'll find the one that I was on. If you don't get enough of my voice from this podcast and you want more. All right, 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 listen to Todd pod.com. I am Deanna at listening fun and we'll see you next week. Bye.
00:28:46
Speaker
Thank you for having me.