Wednesday, May 15, 2013

Apd and audiologists

Hearing exam
Hearing exam (Photo credit: Wikipedia)

On picking an audiologist for APD


First, nearly all audiologists have their own test batteries from which they
select APD tests. There are guidelines as to which APD domains should be
included but not all children, nor adults for that matter, may be good
candidates for all tests.

Secondly, there are different approaches to intepretation. For instance, many
of us adhere to the model of interpretation suggested by Frank Musiek, Ph.D.,
one of the leading, if not THE leading audiologist who has done research and
developed APD tests. Dr. Musiek recommends an intepretation of individual
tests and their impact on the individual, which is the method used by a large
majority of audiologists. This model requires that one knows the neuroanatomical and
physiological correlates that are involved in the task being tested. There is
a quite different approach taken by Bellis and Ferre, which presumes that a
cluster of APD abnormalities represents a broader interpretation of deficits;
then there is the unique approach of Dr. Lucker, etc.

Third, it is important to determine if the audiologist has expertise in
working with pediatrics, in the cases where younger children might be evaluated. A
"pediatric" audiologist is one who has much experince working with a diverse
pediatric population so that children who are more challenging, may actually
be able to undergo APD testing. Many of us with such experience are very
comfortable using the APD tests with normative data for very young children,
in testing them.

Fourth, it is very helpful if the audiologist provides educational
recommendations and is familiar with supports available in an educational
setting. Audiologists who have spen time in schools and/or who have an
educational audiology background usually are more aware of the academic side
of APD. For those of us who have spent time in schools, knowing how the system
works, how IEPs are developed, and what it take to classify children, can be
extremely helpful. Many of us, myself included, work with advocates who help
implement our recommendations.

Overall, there may be different approaches to doing APD assessment. Recently,
the American Academy of Audiology (AAA) CAPD Task Force, of which I was a
member, developed CAPD Guidelines for audiologists. This document is on the
AAA web site and was meant to provide guidelines in the hopes that there would be
a more unified approach to doing APD work with children and adults. Our doctoral
education programs are now trying to include APD coursework to further this
unification. Salus University, formerly PA College of Optometry, has an
intense course (which I teach) as part of the AuD program.

What we audiologists need to be careful about is recognizing that there are
differences in the approach to identification of APD. Granted, some
audiologists are more experienced than others, but there is no "gold standard"
so we need to be careful about stating that some "correctly" do or do not
evaluate APD. Such differences also exist in the medical field in which one
oncologist treats patients one way and another may treat that same patient
with a different approach.

I will say that there is an effort to have audiologists who specialize in APD,
I'd suggest that when seeking an audiologist for an APD evaluation, that
several
questions be asked of the audiologist to help determine whether or not you
want
to have them work with your child.

First, nearly all audiologists have their own test batteries from which they
select APD tests. There are guidelines as to which APD domains should be
included but not all children, nor adults for that matter, may be good
candidates for all tests.

Secondly, there are different approaches to intepretation. For instance, many
of us adhere to the model of interpretation suggested by Frank Musiek, Ph.D.,
one of the leading, if not THE leading audiologist who has done research and
developed APD tests. Dr. Musiek recommends an intepretation of individual
tests
and their impact on the individual, which is the method used by a large
majority
of audiologists. This model requires that one knows the neuroanatomical and
physiological correlates that are involved in the task being tested. There is
a quite different approach taken by Bellis and Ferre, which presumes that a
cluster of APD abnormalities represents a broader interpretation of deficits;
then there is the unique approach of Dr. Lucker, etc.

Third, it is important to determine if the audiologist has expertise in
working with pediatrics, in the cases where younger children might be evaluated. A
"pediatric" audiologist is one who has much experince working with a diverse
pediatric population so that children who are more challenging, may actually
be able to undergo APD testing. Many of us with such experience are very
comfortable using the APD tests with normative data for very young children,
in testing them.

Fourth, it is very helpful if the audiologist provides educational
recommendations and is familiar with supports available in an educational
setting. Audiologists who have spen time in schools and/or who have an
educational audiology background usually are more aware of the academic side
of APD. For those of us who have spent time in schools, knowing how the system
works, how IEPs are developed, and what it take to classify children, can be
extremely helpful. Many of us, myself included, work with advocates who help
implement our recommendations.

Overall, there may be different approaches to doing APD assessment. Recently,
the American Academy of Audiology (AAA) CAPD Task Force, of which I was a
member, developed CAPD Guidelines for audiologists. This document is on the
AAA
web site and was meant to provide guidelines in the hopes that there would be
a
more unified approach to doing APD work with children and adults. Our doctoral
education programs are now trying to include APD coursework to further this
unification. Salus University, formerly PA College of Optometry, has an
intense
course (which I teach) as part of the AuD program.

What we audiologists need to be careful about is recognizing that there are
differences in the approach to identification of APD. Granted, some
audiologists are more experienced than others, but there is no "gold standard"
so we need to be careful about stating that some "correctly" do or do not
evaluate APD. Such differences also exist in the medical field in which one
oncologist treats patients one way and another may treat that same patient
with
a different approach.

I will say that there is an effort to have audiologists who specialize in APD,
joining together for the purpose of advancing our knowledge and research
interests, but also to help others know how to find us. It is Frank Musiek who
is spearheading this effort, a work in progress.
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