Finding the Right Fit: Educational Audiology Takes More Than One Counseling Direction Audiologists often have little coursework and practical experiences in the area of counseling aside from what may be labeled “information counseling.” For many, graduate work included only one course. Others had no classes in this area. During practicum, internship, and “residency” work, the audiologist supervising has the same background in ... School Matters
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School Matters  |   May 01, 2005
Finding the Right Fit: Educational Audiology Takes More Than One Counseling Direction
Author Notes
  • Jay R. Lucker, is an audiologist and SLP. He is an associate professor in the Department of Communication Science and Disorders at Howard University. Contact him at dr-j@ncapd.net.
    Jay R. Lucker, is an audiologist and SLP. He is an associate professor in the Department of Communication Science and Disorders at Howard University. Contact him at dr-j@ncapd.net.×
Article Information
Hearing Disorders / School Matters
School Matters   |   May 01, 2005
Finding the Right Fit: Educational Audiology Takes More Than One Counseling Direction
The ASHA Leader, May 2005, Vol. 10, 18-19. doi:10.1044/leader.SCM2.10062005.18
The ASHA Leader, May 2005, Vol. 10, 18-19. doi:10.1044/leader.SCM2.10062005.18
Audiologists often have little coursework and practical experiences in the area of counseling aside from what may be labeled “information counseling.” For many, graduate work included only one course. Others had no classes in this area. During practicum, internship, and “residency” work, the audiologist supervising has the same background in counseling as the student. It is important to understand that counseling is more than merely getting and giving information.
There are a number of different approaches. “Information counseling” can be described as sitting down with a client, asking and responding to questions, sharing test findings, discussing options, explaining educational program options, and helping other professionals understand children with hearing losses.
What is more important than sharing information, however, is being aware of clients’ emotional reactions. In “support counseling,” we listen, help children, their parents, teachers, and other school personnel deal with the reactions, and we provide support and guidance. Thus, the audiologist working with children in schools should provide both types of counseling.
Having worked in schools for many years, I found that without providing both information and support counseling, I could not reach my goals. I increased my knowledge and skills in these areas and learned that appropriate counseling by the audiologist is just as important as providing diagnostic services and hearing, sometimes even more important.
Choosing a Counseling Approach
To better understand counseling, consider different approaches. Often, audiologists have received training from a professional perspective, which views the audiologist at the center of the counseling process. In the professional-centered approach, the audiologist determines what information is presented and what decisions are made.
The benefits of such an approach are that the audiologist controls the time and information being presented. For example, if it seems a child needs a specific program or technology, the audiologist presents pertinent information. A major disadvantage of this approach is the lack of focus on the needs and wants of the child, the family, and other school personnel. Even if the audiologist truly believes a specific factor is appropriate for a child, the audiologist should consider the parents’ feelings about that decision. Additionally, the audiologist should consider the feelings of the child who is old enough to understand.
A second major disadvantage of a professional-centered approach is that the audiologist becomes responsible for making the decisions. Success leads to everyone involved getting credit. Failure leads to the audiologist being blamed for the decision. Furthermore, the child, family, and school personnel often claim no responsibility regarding the decision.
In contrast to a professional-centered approach is a client-centered approach. This approach views the client at the center, with others, including the audiologist, focusing their resources on the client’s needs, wants, and issues. In this approach, the audiologist listens carefully to what the client is saying. This approach may be useful for older elementary, middle school, and high school-aged children, as well as working with a specific parent or teacher.
The greatest benefit of this approach is that it leads to the client “owning” the problem and the decision. Children have issues and when we place the child in the center, we can focus on these issues and help guide the child.
Probably the greatest disadvantage to this approach is time. Since the client is the central focus, we need to listen to his or her wants, needs, desires, and help the client make informed decisions. This can take a lot of time. However, the child needs to learn to be responsible for his or her hearing loss and a client-centered approach begins to teach this.
An even more encompassing approach is a family-centered approach. This places all support personnel, including the audiologist, on the periphery. We can consider the child as having two families: the natural family (parents, siblings, grandparents, babysitters, etc.) and the school family (teachers and other school personnel).
In a family-centered approach, the concerns, feelings, and issues of each individual, significant member of the family must be considered. When presenting information, it is important to speak at a level understood by each significant family member. When asking questions, or gathering data, for example, include all family members. The greatest advantage is that this approach considers every person as important. Decisions are made when the family agrees to support the decision. The family shares all responsibilities and ownership of problems and decisions.
An example of the success of a family-centered approach is the following. Consider a child needing to inform parents and teachers that his or her hearing aids are not functioning. The child may learn to recognize when the aids are not working and inform an appropriate adult. However, in a family-centered approach, parents and teachers are taught how to recognize possible hearing aid problems and how to check if the aids are working. Siblings and other students in class learn to recognize that the child is not responding appropriately and can ask the child if the hearing aids are working. Thus, everyone takes ownership for what he and she can do to help the child.
Building on Groups
There are three services audiologists can provide to counsel children in schools. First, individual counseling is important. Second, peer counseling can help children with hearing loss share feelings, thoughts, and helpful hints with each other. It is important that children with hearing losses meet their “peers,” that is, other children with hearing losses. The third service is what can be called “mixed” groups. These are groups of grade level peers who have hearing losses as well as those who do not have hearing losses. It is important that children with hearing losses, especially those in integrated programs with both deaf or hard-of-hearing and hearing children learn to be more successful dealing with hearing children. Additionally, hearing children must learn to deal with those who are deaf or hard of hearing.
For very young children, play groups are a way for them to learn and share. Older children do well with structured as well as unstructured activities focusing on problem solving, dealing with differences, and issues that may come up. Children in high school work well with groups that focus on specific issues group members bring for discussion. What the audiologist needs is to learn group counseling skills. Being able to counsel individuals, parents, or even teachers and other school personnel is far different from working with groups of children. However, running such groups provides tremendous payoffs and can give the audiologist a wonderful feeling of accomplishment.
Working as an educational audiologist can be very rewarding. One of the most important duties of the educational audiologist is working with people. Having greater knowledge and experiences in counseling can lead to greater success.
Client, Professional, or Family-Centered Counseling Approach

Benefits and disadvantages vary depending on the counseling approach used. With a client-centered approach, the client “owns” the problem and the decision. When the audiologist is at the center, he or she controls the time and information being presented. With a family-centered approach, the family shares all responsibilities and ownership of problems and decisions.

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May 2005
Volume 10, Issue 6