How were degrees of hearing loss first measured and determined?

Hearing regarding what is normal, etc. has ABSOLUTELY NOTHING to do with standard deviations.  The normal category was NEVER subjected to testing thousands of people with and without hearing loss and identifying a MEAN hearing value for normal and one standard deviation for the cut-off of normal.
During World War II, many veterans came home complaining of hearing loss.  It was decided to determine a NORMAL level of hearing.  Based on hearing science, it was identified two things:  One was that the dB scale is logarithmic and not linear, so means and SD cannot be used.  Second, it was measured that human beings identified a DOUBLING of loudness every 10dB (based on research done in the 1930s duplicated many times.  Whispered speech- the softest level of speech an AVERAGE person with normal hearing could detect and understand was at 30dBHL.  Thus, it was originally decided that normal hearing would be the first step BELOW a whisper meaning a person with normal hearing CAN hear a whisper and a person with the first level called a MILD hearing loss could barely detect a whisper.  Thus, the original CUT-OFF of normal was 25dBHL.
ASHA modified this YEARS  ago maybe in the 1960s.  It was decided to use half the loudness of a whisper rather than one step below a whisper.  A whisper is 30dBHL so half the loudness is 20dBHL.  Thus, it was decided that normal hearing would be UP TO 20dBHL.  The other decisions of mild, moderate, etc. were developed by a combined group of audiologists (more in the hearing sciences) and sound scientists and they identified the various categories with were then set by the American National Standards Institute or ANSI in the 1960s with the agreement that 20dBHL would be the cut-off of normal and the other categories as is.  ANSI and ASHA working with ANSI also identified that it would be best NOT to test hearing above 120dBHL since the thresholds of PAIN from hearing is 130dBHL so 120dBHL is half the loudness of pain.
Dr. Jay R. Lucker, Ed.D., CCC-A/SLP, FAAA

Certified/Licensed Audiologist & Speech-Language Pathologist
Specializing in Auditory Processing Disorders &
Language Processing Disorders
also
Professor
Dept. of Communication Sciences & Disorders
Howard University
Washington, DC
contact: 301-254-8583 or via this email address

How can you tell when you are nervous?

“When your heart becomes 2”

Recently in my clinic, my 5 year old patient was asked come back to his seat to work on phonemic synthesis. He had not yet seen my dog in the clinic at that time. As he hesitatingly came to sit at his seat he noticed my puppy and said, “My heart is 1 again!”. I was perplexed and asked him what he meant. He said, “You know when you asked me to come to do the sound game, my heart became 2, but when I saw Pinto, my heart became 1 again.”

Wow, only then I realized that he was anxious about doing the phonemic synthesis work, and probably felt like he skipped a heartbeat when I told him that it is time to work.

Dr.Kavita Kaul

Is Auditory Processing work rewarding

I was never trained in APD (undergrad, masters or doctorate. When I returned for my doctorate and expressed interest in APD, I was “pushed” toward vestibular training instead). Over the years, the longer I worked as an audiologist, the more time and energy I seemed to be spending trying to AVOID APD, as I did not feel very smart with it and in fact, was scared of it. I had tried talks at the usual conferences but it all seemed too complex and daunting. I jumped on the nay-sayer bandwagon just so I would not have to deal with APD.

Years later I took a new job as an educational audiologist and during my first year there, I started getting very nervous again about APD. The referrals were starting to stream in from the schools, there was talk of audiologists being asked to sit in on IEP meetings when APD was involved, particularly in litigious cases. Yikes! I better get educated. Some time after that I saw some registration papers floating around for a 2 day training on the “Buffalo Model Approach to Auditory Processing” in Chicago. I didn’t know what Buffalo had to do with APD, but as long as someone promised to teach me about APD, I was in! Plus, the training was being hosted by another special education cooperative in the area so I figured at the very least, I’d likely be among my “own” and in my own city.

Day 1 in Chicago on the BM approach, there stood Jack Katz. Hmmm…he couldn’t be the same Katz from the “Katz book,” as we so affectionately called our “purple audiology handbook” in school. Right? Wrong. It WAS the same Katz. WOW! This was like meeting a movie star…only BETTER! By the end of Day 1, I was hooked on APD and hooked on Katz. I couldn’t get enough of this Buffalo stuff. My head was spinning (in a good way this time). “Simple and Effective,” Katz repeated over and over. Excellent! I love simple. After Day 2 it was time to return to work and share my newfound knowledge, expertise and excitement. Few caught my APD bug, however, but they were happy to let me “be the expert” and take all the referrals. So, I did. I bought the CBT for my clinic and the therapy book and materials I bought for myself, personally. Therapy would come later maybe for the job, but I wasn’t going to sit back and wait.

The referrals continued to come to me and I followed exactly what Jack told me to do with the BM tests. I did all 3 and carefully analyzed each. But with each case, I found myself emailing Jack asking, “well, what about this…and that..and what if…?” Jack responded to me each time and I was so grateful for that but I knew I needed more; something was still missing. I found too many blank spots in my memory of the 2 day training in Chicago and when I returned to my notes/slides, I was missing the details I felt I really needed now after using the 3 BM tests on many different children. I don’t play the lottery but my luck came in when Jack happened to mention to me about another 2 day training on the BM that was taking place in Kansas City. He offered me a spot in the “observation area” in his office if I wanted to see him doing therapy with some kids. It was a no brainer. I packed my bag and my husband and we drove to KC. I re-introduced myself to Jack and I also met Sarah Zlomke there as well. She, too, graciously offered me a spot in her “observation chair.” Oh!! Ok! Now I see BM in action with the experts! Let me try it. I went back and rearranged my office furniture just like Jack and Sarah had their furniture. (I’m still working on my Oscar look-alike.)

I did more and more evaluations. I was really getting the hang of it now. Except…yikes!! Everyone has APD? Is that true? Uh oh, am I doing it wrong? And what is this IX and IW on the summary sheet? Wait, what part of the brain is this and how bad is bad and…am I sure? How do I really know? Wait, here is someone who doesn’t look APD on the tests but he sure sounds like APD from the parent and school reports. What do I do with him? And this lead me to…ADVANCED SSW Workshop in HOTLANTA, GA! The third time is the charm…Jack will be able to make it all “simple and effective” again for me.

Day 1 in Atlanta. What? I missed the “observation seat” in Christa’s clinic???? Boo hoo. No problem, this life story about the SSW has me too engrossed to think about anything else. Chasing potential subjects that looked paralyzed and with a scar on the skull down the hall..?? Wow, this is good, really good. Now here comes the BRAIN talk. Uh, oh..did I mention I never took neuro either in school? Leave it to Jack to take the complex and put the “simple” in it. Ok, now let’s plug all those parts of the brain and brain function into the SSW. Voila! Site of Dysfunction test! BM categories. Academic/behavior problems. AND……TREATMENT! So..let’s do this.

Pick the right analysis (NOE, TEC, Traditional), look at all the qualifiers, don’t forget to adjust for young kids and difficult to test (split half rules) and gosh darn it…just GET IT RIGHT! By Hook or by Crook, Jack says.

Maybe the APD component is being underestimated. Maybe it is being overestimated. No worries. Do the treatment. “The proof is in the pudding.” Don’t be fooled and don’t dismiss it. Just do it…and don’t forget the jumping jacks, breaks and lots of humor.

Thank you for mentioning the Woodcock-Johnson.

The tests and treatment—the go together…

“Like rama lama lama ka dinga da dinga dong Remembered forever As shoo-bop sha wadda wadda yippity boom de boom Chang chang changitty chang sha-bop That’s the way it should be.”

Advanced in Atlanta filled in all the missing pieces. Reading about the SSW was like watching my favorite movie, “Somewhere in Time,” with Christopher Reeve. Except this was with Christa Reeves! Yes, sir, Dr. Jack, let’s protect the tests, the author, the audiologist, and the patient. Get the training! You will not regret it.

Thanks to all of my SSW friends for a fantastic, fun-filled, enlightening learning experience. I’m ready for more BBQ any time now!