PHILADELPHIA-The City of Brotherly Love served as the inspirational backdrop for the 14th Annual Convention & Expo of the American Academy of Audiology (AAA), featuring dynamic speakers, innovative products, as well as consumer workshops and a host of other new programming ideas. The 2002 convention, held here April 17-20 at the Pennsylvania Convention Center, inspired clinicians, students and vendors as it brought to life its theme of "History in the Making."

"I came to get data and information on subjects that I do not get to learn about in my daily practice life," Beth Longnecker, MS, CCC-A, FAAA, on staff at an ENT office in El Paso, TX, told ADVANCE. "I got information in all different areas, especially about cochlear implants and additional information about testing protocol."

"My goal was to update my information and bring back more expertise in different areas," said Deanna Meinke, MA, CCC-A, FAAA, of Associates in Acoustics Inc. in Greeley, CO. She also was a presenter at the convention, addressing the topic of fitting practices for hearing protection. "I am helping audiologists get enthused about hearing protection for their clients."

Meinke took advantage of her trip to Philadelphia to teach a class of third graders at the Friends Select School how to protect their hearing.

Serena Marie Ross, MA, CCC-A, of Geisinger Medical Center, in Danville, PA, also had her sights set on gathering information on a variety of subjects, from marketing to auditory brainstem response and otoacoustic emissions.

"I had a course yesterday on amplification that had lots of good information on difficult fittings," she said. She also received information about a new FM system that is half the cost of other systems and is usable with any type of hearing aid.

"I'm bringing back to my practice other services we might be able to offer to expand our program," Ross stated.

AuD student Kim Shewack, of Bloomsburg University, in Bloomsburg, PA, made the trip to the convention in Philly "because I really wanted to see and learn about things that we just touch on in class. We discuss many topics briefly, but I don't get to see them first-hand or get a complete picture like here at the convention."

Her whole class attended the meeting, she said. "Since there are so many great, interesting sessions, we are all going to different ones and then we are going to meet to share all the extensive information. I was overwhelmed and amazed by the exhibit hall!"

Wende Yellin, PhD, CCC-A, an associate professor in Communication Sciences and Disorders at Northern Arizona University, in Flagstaff, proclaimed AAA 2002 "a good convention overall. My main goal was to visit the exhibit hall, do some networking, and check out the newest products. The exhibit hall is where everything new is coming out."

'Excellent Three Days'
In the exhibit hall, the Audiology Foundation of America (AFA) was enjoying a successful stint, according to Mary Wilson, managing assistant director. Many attendees interested in finding out more about the AuD, distance education and residential programs visited the booth, she said.

"It was an excellent three days," echoed Gail Moore, project manager of marketing for The Audiology Companies, based in Akron, OH. Company representatives provided information to convention-goers on the services offered by the buying group.

Micromedical Technologies Inc. offered attendees a copy of the 2002 Medicare Fee Schedule, which showed expanded reimbursement for vestibular testing. The company also debuted the BalanceQuestT computerized dynamic posturography platform, as a part of its turnkey balance center, and showcased EyeMaxT video software, for use with the VisualEyesT video electronystagmography (ENG) system, according to vice president Diane Miles.

A number of other companies launched new products at the convention, including Siemens Hearing Solutions, which premiered the TrianoT line of instruments; Unitron Hearing, which introduced UnisonT, the latest addition to its digital hearing aid line; and Bernafon Inc., which kicked off a controlled launch of the new Symbio hearing system.

The Symbio represents a "change in approach," Bernafon president Peter Van Nest told ADVANCE, as well as a new paradigm in which clinicians can stop thinking about channels and bands. The high-tech digital features a unified signal in a single-channel design system. The spectral characteristics of speech are maintained, resulting in more natural sounding amplification. Van Nest said the Symbio was designed for professionals and people with active lifestyles, such as attorneys and active seniors.

Association Goals
During the Opening General Assembly, AAA president Angela Loavenbruck, EdD, captured the spirit of Philadelphia by racing through the aisles to the podium in sweats and sneakers in her best Rocky impression.

After changing out of her athletic gear, Dr. Loavenbruck quoted poet Langston Hughes in her message to convention-goers: "There are ways of getting almost anywhere you want to go if you really want to go."

With a model of the city's historic Independence Hall as a backdrop, she promised the audience that during her next 15 months of tenure she will do her part to keep the professionalism of audiology on course by championing the AuD as a unifying degree, a full scope of practice for clinicians, direct access to patients, and a commitment to research. All of these goals-which she labeled collectively as the destination the profession should strive to reach-are to be obtained as defined by the code of ethics.

Getting to where the profession should go can't be done with diluted research programs, a lack of grounded students, or a code of ethics that's an "unheeded relic," she pointed out. To these ends AAA will collaborate with the Council of Academic Programs in Communication Sciences and Disorders to ensure students receive quality training to become researchers. In addition, a recent partnership with the Academy of Dispensing Audiologists and members of academia will establish rigorous standards for the AuD via the Accreditation Commission on Audiology Education.

Focus on Ethics
The issue of ethics is on the agenda as well. A AAA Presidential Task Force, created during the tenure of David Fabry, PhD, recently examined the code of ethics for the organization and discovered that there were discrepancies between what the code said and the attitudes some audiologists had toward unethical behavior. These discrepancies were revealed through a questionnaire that asked clinicians, students and consumers to judge various scenarios as being ethical or not.

AAA will exhort audiologists to adhere more closely to the code, so the profession will reap the benefits of a higher level of esteem bestowed upon it by decision-makers in the federal government.

Fourteen founding members of the academy took to the stage during the General Assembly to demonstrate how the organization had been established on the basis of groundbreaking ideas in 1988. James Jerger, PhD, led an exploratory meeting of 32 clinicians at Baylor College of Medicine, in Houston, TX; and out of that meeting grew AAA, an organization "of, by and for audiologists," said Jerry Northern, PhD. Dr. Jerger was the first president of the academy, and the first convention was held in 1989 on Kiawah Island, SC. Nearly 570 attended the inaugural event.

Today, AAA boasts more than 7,000 members, said Ross Roeser, PhD. The preliminary attendance figure for this year's convention was 6,400. "My relatives even know what an audiologist is now," he quipped.

The roots of the doctor of audiology degree go all the way back to that first meeting in Texas.

"Dr. [David] Goldstein provided a moment of revelation by suggesting the AuD," said Anita Pikus, AuD. His talk of a common doctorate in audiology for the profession was quickly backed by Leo Doerfler, PhD, "one of the true founders of the profession," Dr. Pikus added.

More than 600 audiologists have earned the AuD to date, and there are 20 residential programs in existence, said Dr. Roeser. "How did we do?" he asked, marveling at the status that the still-growing organization and profession have achieved.

Tan Speaks on BOR
Author Amy Tan, who spoke at the convention, also knows about determination. Tan, who has branchio-oto-renal (BOR) syndrome, told of the courage of her 10-year-old niece, who also has the condition, which is characterized by any combination of malformations of the ear, cysts in the neck, hearing loss, and malformations of the kidney.

"I'm very lucky that I haven't had much wrong," said Tan.

The only BOR-related problems she reported were a cupped external ear and the use of just one functioning kidney. However, her niece, who was diagnosed with mild hearing loss at the age of 5, has seen her hearing ability decline. She has been fitted with hearing aids and currently wears bright blue ones.

"She hopes [people] will notice and know to adjust their speech," said Tan, to the applause of the audience.

Her young niece struggles with a hearing loss "that is likely progressive," said Tan, as well as the negative attitudes of pre-teens. "Kids are starting to make fun of her," lamented the author. "I worry about her hearing and self-esteem."

For the last two years, the young girl has talked about getting a hearing dog to make her aware of aural information for safety, but most programs don't consider giving hearing dogs to children until they're 18.

"She wants to feel safe at night and know when a car approaches. I'm determined to get her a hearing dog," said Tan, who vowed to hire a trainer independently if the conventional route fails.

Tan is familiar with other issues related to hearing health as well, saying of her relatives, "We are the family you serve." Her mother-in-law has a hearing loss, for which she wears a hearing aid, and her husband's grandmother was profoundly deaf in her old age.

Tan initially worried that her husband had some hearing loss, since she noticed him behaving inappropriately to her requests, but he was given a clean bill of hearing health by Robert Sweetow, PhD, a friend of the author. Instead, she learned her husband has "selective hearing loss, which is progressive and untreatable," she joked.

Update from CMS
Another speaker during the General Assembly was Dennis Smith, director of the Center for Medicaid and State Operations, which is part of the Centers for Medicare & Medicaid Services (CMS). Since the attendance of Tommy Thompson, secretary of the U.S. Department of Health and Human Services, at last year's AAA meeting, progress has been made in creating a uniform definition for audiology for Medicare and Medicaid and supporting direct access to patients for audiologists.

"The news will be reserved for now," Smith said; but he acknowledged that current standards should be revised. "It's time we update these things," he said, noting that the rules under review are more than 30 years old.

The convention also teemed with featured sessions, workshops and educational seminars.

Don Vogel, MS, and Jack Wazen, MD, of Lenox Hill Hospital in New York City, presented a featured session on sudden sensorineural hearing loss, outlining a number of unique components of this sudden and puzzling condition. By partnering as audiologist and physician, the senior audiologist and chief of neurotology were able to successfully clarify identification and management issues.

Dr. Wazen discussed various causes and treatments, while Vogel, who experienced sensorineural hearing loss first-hand, addressed the audiologist's role in diagnosing, treating and counseling patients.

The sudden onset of hearing loss is "a real medical emergency to the patient," Vogel said. "They are not going to know what's going on. Your patient is going to feel fear. I felt fear."

Auditory processing disorders (APDs) were the focus of a presentation by Maxine Young, MS, CCC-SLP/A, who educated attendees on various considerations when treating children with APDs and other learning disabilities. She discussed a number of case studies to illustrate the need for thorough and accurate treatment and multidisciplinary management.

Zen of AR Groups
"The Zen of AR Groups" was the title of a presentation by Patricia Kricos, PhD, CCC-A, from the University of Florida in Gainesville, and Sharon A. Lesner, PhD, CCC-A, of the University of Akron in Ohio. They delineated the advantages of providing aural rehab in groups and offered strategies for the audiologists who lead them.

"Peer groups are absolutely wonderful," Dr. Kricos said. "They can share with each other and give each other tips. It's nice to be with others who are struggling and learning how to use their hearing aids."

William Shapiro, MA, CCC-A, and J. Thomas Roland, MD, of the Cochlear Implant Center at New York University School of Medicine, and Patricia Rothschild, MA, CCC-SLP, from the League for the Hard of Hearing, discussed "An Interdisciplinary Approach to the Difficult Cochlear Implant Patient."

Dr. Roland outlined the candidacy criteria and evaluations for potential implantees and discussed challenges facing the patient and clinician. Shapiro touted the benefits of interoperative monitoring with young children, saying it "gives us a head start when programming for the first time. Programming really begins on the day of surgery."

"Assessing Auditory Behavior in Infants and Toddlers" was the title of a lecture by Jack Kile, PhD, professor emeritus at the University of Wisconsin in Oshkosh. He said parent questionnaires and interviews yield important information that clinicians can use when performing the assessment, noting, "Moms are usually right."

Satellite Meetings
The day before the start of the AAA Convention, satellite meetings were held by the Association of VA Audiologists (AVAA) and the National Association of Future Doctors of Audiology (NAFDA).

"This has been a very exciting time for us," stated AVAA president Douglas Noffsinger, PhD.

Audiologists associated with Department of Veterans Affairs (VA) facilities have seen significant growth in demand for hearing-related services, said Lucille Beck, PhD, national director of the Audiology and Speech Pathology Service for the VA. Hearing aid utilization among veterans increased from over 70,000 in 1996 to more than 241,000 last year.

Hearing loss is among the top three service-connected disabilities treated by the VA, she pointed out. The VA hopes to continue to improve wait times for visits and find ways to prevent veterans from making unnecessary trips for batteries and repairs. To achieve its goal of moving health care as close to the veteran's home as possible, the VA will employ home care and telemedicine.

More VA Services
The VA also is pushing for the ability to dispense digital hearing aids and plans to explore the possible need for more veterans to get cochlear implants, Dr. Beck said. "We want to raise the level of consciousness on this. Is the VA providing access to new technology as much as they should?" Currently, the administration implants about 38 veterans a year.

The VA already is a large employer of the nation's audiologists, and she predicted that even more will be needed to work in this setting, noting that 36 percent of the veteran population is over 65, compared to 17 percent of the general population.

There will be greater opportunity to work with patients who have both vision and hearing impairments, Dr. Beck said of this growing population. "I don't think any of us are prepared for the increase in the number of people with dual impairment."

During the NAFDA meeting, Delbert Ault gave an update on the current status and future directions of the AuD movement. He reported that 22 master's-level audiology programs are closing before the transition period ends and the AuD becomes mandatory.

Consumer Workshops
Consumer workshops were a new addition to the AAA convention for 2002. The association ran three large ads in the Philadelphia Inquirer to promote the workshops to area consumers. Approximately 70 were on hand to hear from audiologists practicing in the Mid-Atlantic region. In addition, assistive listening devices were on display for people to view and try out.

The Academy of Dispensing Audiologists (ADA) plans to make a similar offering at its fall meeting in Palm Springs, CA, according to Dr. Johnson.

"I think we're going to keep it as an institution at AAA and ADA," he said. "Audiologists talking about what they do serves to solidify their position with consumers."

Danielle Campbell is Associate Editor of ADVANCE. She can be contacted via e-mail at dcampbell@merion.com. Nicole Klimas and Kerri Waldowski also contributed to this article.

Jerry Northern, PhD, a founding member of AAA, spoke on the development of the organization. Fourteen of the original 32 founding members took part in the program.

Author Amy Tan was the keynote speaker for the 2002 convention.

Dennis Smith, director of the CMS Center for Medicaid and State Operations, said progress has been made in creating a uniform definition for audiology for Medicare and Medicaid and moving toward direct access.

Recipients of 2002 Honors of the Academy included (from left) Paul Kileny, PhD; Jane Baran, PhD; Gary Jacobson, PhD; Linda Hood, PhD; Julia Roskamp, MA; and Gergory Spirakis, AuD.

Convention-goers were serenaded by Mummers at the General Assembly. These festively costumed string band ensembles are a Philadelphia New Year's tradition.

ADVANCE Photos by Danielle Campbell