Audiologist’s Journey: From Client to Clinician Karen MacIver-Lux Features
Features  |   February 01, 2008
Audiologist’s Journey: From Client to Clinician
Author Notes
Article Information
Hearing Disorders / Hearing Aids, Cochlear Implants & Assistive Technology / Audiologic / Aural Rehabilitation / Professional Issues & Training / Speech, Voice & Prosody / Features
Features   |   February 01, 2008
Audiologist’s Journey: From Client to Clinician
The ASHA Leader, February 2008, Vol. 13, 18-35. doi:10.1044/leader.FTR2.13022008.18
The ASHA Leader, February 2008, Vol. 13, 18-35. doi:10.1044/leader.FTR2.13022008.18
Karen MacIver-Lux was introduced to audiology and speech-language pathology at a tender age—just shy of 4 years old, after being diagnosed with a hearing loss. She has used her personal challenges to create a career to help others with hearing loss as an audiologist and a certified auditory-verbal therapist. MacIver-Lux received her bachelor’s degree in communication disorders from Purdue University and her master’s in audiology from Akron University. She now directs the MacIver-Lux Auditory Learning Services in King City, Ontario, Canada. An internationally known consultant, author, and lecturer, she offers her perspective on being an audiologist with hearing loss to interviewer Gayla Hutsell, Indiana State Early Hearing Detection and Intervention coordinator and director of ASHA Special Interest Division 9, Hearing and Hearing Disorders in Childhood.
Q: What were your first experiences with audiology and speech-language pathology services?
I was diagnosed with a moderate-to-profound sensorineural hearing loss at 3 years, 11 months of age. Later it was changed to severe-to-profound. Immediately after the diagnosis, my mother had me fitted with powerful behind-the-ear hearing aids, and then found a speech-language pathologist willing to help me learn to listen and communicate using spoken language in the most natural way—a precursor to auditory-verbal therapy. As I grew older, the SLP focused more on my articulation, and I also continued to develop my listening skills and spoken communication with the help of a clinician who focused on that technique. So I was aware of the benefits these three professions offered from a very young age.
Q: What do you remember about your first audiologist?
I was somewhat awestruck by him. He was the professional who provided me with the hearing aids, which literally turned my grey world of silence into a colorful and wondrous world of sound. Being able to hear and listen to sound with appropriately fitted hearing aids had a very positive impact on my life.
My audiologist seemed a lot of fun when I was very young, but as I got older, the visits seemed to be more fun for my mother! I missed playing with the “conditioned play audiometry toys” and was disappointed when he insisted I was too old for them. He involved my mother in all aspects of my audiologic management. It was important to him that I received maximum benefit from my hearing aids, that speech was as intelligible as possible, and that I had optimal access to all frequencies of the speech spectrum. Hearing aid verification measures were mandatory at every visit, and my mother gave copies of the results to my SLPs and teachers. If there were hearing aids that could perform better or provide more gain, he informed us of our options. He always “raised the bar” when it came to hearing technology and he did so in partnership with the other professionals who worked with me. His commitment was evident. Most importantly, however, he treated me as a child who could hear!
Q: When did you first get interested in pursuing audiology as a career?
It wasn’t until I was 14. My initial decision was driven by a desire to look after my own hearing care—anywhere, at any time. Midway through a Florida vacation with my family, the tubing in one of my earmolds cracked and the feedback was horrendous. I couldn’t hear. My parents found a hearing aid clinic, but it didn’t have the appropriate tubing. The next clinic had them, but the audiologist and dispenser weren’t available. So I thought, if I were an audiologist I’d know how to do this myself.
The more I learned, the more interesting audiology became. I was fascinated by the medical dimension and enjoyed working with babies and very young children. I felt that my personal experiences growing up with a hearing loss in a mainstream setting would encourage the children and families with whom I could work.
Q: How did audiologists and SLPs influence you practically and philosophically?
They all gave me the confidence to pursue a career in audiology and auditory-verbal therapy. With a hearing loss, I was concerned about being taken seriously as a clinician. Many people tried to steer me away from audiology. Whenever I felt discouraged, however, I could always count on my audiologist for support and encouragement.
Q: What were your biggest challenges as an audiology student with hearing loss?
My hearing loss raised questions. Some professors were skeptical—which surprised me. I’d assumed audiologists and SLPs would be intimately familiar with the challenges of hearing loss (they were) and solutions (they were not). I realized I had to listen to their concerns, and then address them one at a time. During my undergraduate studies, for example, my professors thought my hearing loss might prevent my completing a phonetics course and articulation/language practica. I solved those two issues by we ing my personal FM system. I was offered an assistive listening device, note-taking services, and practical advice to help me become an effective advocate for myself. I also had copies of my classmates’ notes for all my courses to ensure I had accurate course notes.
During my graduate studies, we discussed options to administer speech discrimination tests effectively. Would my speech be clear enough to present the words accurately? How would I hear if the patients responded correctly? To solve the first problem, I used only recorded word lists—a more accurate method anyway! To address the second problem, depending on the child’s age, I asked the child or the parent to write the child’s responses. This method proved to be an excellent tool, which I continued to use in my clinical practice.
Another concern was my ability to do listening checks with hearing aids. I insisted that hearing aids are best checked in a hearing aid test box, or with electro-acoustic analysis. This is an effective way to analyze the function of hearing technology.
Overall, honesty and open communication with my professors were keys to my success as a student and clinician. I made a lot of progress in the university setting. In college I helped children who were deaf or hard of hearing learn to listen and use spoken communication. I wanted to work closely with parents, guiding them to help their child reach his or her highest communication potential.
After graduate school, I worked part-time as an audiologist at a health clinic and full-time as an auditory-verbal therapist at the Learning to Listen Foundation under the direction of Warren Estabrooks, who was my auditory-verbal therapist when I was young and is now my mentor. He is sensitive to the challenges that my hearing loss may present, but he expects me to overcome these creatively so that my hearing loss is viewed as an asset.
He has had the greatest impact on my professional growth.
Q: What are some highlights of your career as an audiologist and educator?
Although I’ve received awards, the highlights of my career are the accomplishments that children make in their own lives. Once when I was signing autographs at the launch of We Learned to Listen—a collection of stories written by adults with hearing loss—an 8-year-old boy confidently approached me and introduced himself. I realized he was one of the “babies” I had worked with who had overcome severe respiratory and other difficulties. It was a great feeling to have been a part of this young man’s journey in becoming the confident listener and communicator that he is today.
Q: How do patients, clients, students, and parents react to you as an audiologist or educator with a hearing loss?
Usually I’m the first person with hearing loss that my patients, clients, students, or parents have ever met. Parents often are surprised to learn that I have a severe-to-profound hearing loss. This surprise is quickly followed by questions about my hearing loss. Children are curious when they see my hearing aids, but this curiosity quickly passes. I don’t know if they feel a special kinship with me, but I do believe that children with hearing technology understand the importance of hearing aids and cochlear implants—but that they quickly move to other important things like playing and having fun. That’s the way it should be—they should be children defined by the joys and experiences of their lives, not by hearing loss.
Before I begin an assessment or treatment session, I always tell my patients that I have a hearing loss. To help smooth communication, I ask them to wear a transmitter, make sure they face me, and ask them to repeat or rephrase the question if I don’t answer appropriately. I also reassure them that steps will be taken to ensure they receive the best audiologic care.
During auditory-verbal therapy sessions, I use my personal FM system. I videotape many sessions, but parents’ active participation is most valuable to me. If any uncertainty exists about what the children hear or say, the parents are the best listeners and speech models. Parents often find it helpful when I explain which speech sounds I had difficulty hearing. It’s okay to miss the occasional comment or question—even clinicians with typical hearing don’t catch everything. I can’t stress enough how important it is to use humor when there is a communication breakdown—it goes a long way in easing the potential tension created by the uncertainties of hearing loss.
Karen MacIver-Lux can be reached at
Karen’s Career Tips

This excerpt from my chapter in We Learned to Listen summarizes my advice for young adults considering any career:

Creatively overcome obstacles

Have mentors and heroes as role models

Inspire others by your example

Listen to your heart

Develop relationships through the language of possibilities

Respect those who give honest and constructive feedback

Earn opportunities, don’t expect them.

Never give up

Submit a Comment
Submit A Comment
Comment Title

This feature is available to Subscribers Only
Sign In or Create an Account ×
February 2008
Volume 13, Issue 2