A Conversation with Dr. Don Goldberg!

Join me for a repeat guest, Dr. Don Goldberg, CCC-SLP/A, FAAA, LSLS Cert. AVT, as we dive into the newly released Test of Auditory Functioning which is a criterion-based test for toddlers through school-age children who are deaf or hard of hearing available from Bluetree Publishing.  This episode will explore the who, what, why, and where behind this important testing protocol for professionals who work with individuals who are deaf/hard of hearing.  Be sure to visit the links to find out more about Dr. Don on episode 33 as well as where to order your own copy of the Test of Auditory Functioning.  

Where to Order:  https://www.bluetreepublishing.com/print/758-taf-test-of-auditory-functioning-book.html

Upcoming Webinar:  https://www.hearingfirst.org/learning/l/2426/overview

Recorded Webinar:  https://edaud.org/on-demand-webinar-taf/

_____________________

You can listen to this episode wherever you stream podcasts and at www.3cdigitalmedianetwork.com/empowear-audiology-podcast

For more information about Dr. Carrie Spangler- check out her Linktree at https://linktr.ee/carrie.spangler.

For transcripts of this episode- visit the podcast website at: https://empowearaudiology.buzzsprout.com

Transcript

Announcer: [00:00:00] Welcome to episode 68 of empowEAR Audiology with Doctor Carrie Spangler.

Carrie: [00:00:14] Welcome to the empowEAR Audiology podcast, a production of the 3C Digital Media Network. I am your host, Dr. Carrie Spangler, a passionate, deaf and hard of hearing audiologist. Each episode will bring an empowering message surrounding audiology and beyond. Thank you for spending time with me today and let's get started with today's episode. Okay. Welcome everyone. On today's episode of Empower Audiology, I have a returning guest with me, Dr. Don Goldberg, and I'm going to give you a little brief background about him. And I am also going to refer you to episode 33 of empowEAR Audiology, where you can listen and find out much more about Dr. Don's journey and his field, um, and his journey into the field of his work, um, in that episode. But to give you all a little introduction, he is a professor, a full professor at the College of Wooster in Ohio, and he is a member of the professional staff for the Section of Audiology and Hearing Implant Center at the Cleveland Clinic Foundation. He has published extensively, including being a coauthor of a book, book chapters, and other public publications he's presented both nationally and internationally. Dr. Don Goldberg is a fellow of ASHA, and he's also received the honor of the AG Bell Association. So today, I'm just excited to have Dr. Don Goldberg with me on the podcast. Um, and we're going to really be jumping into, uh, his release of the Test of Auditory Functioning by BlueTree Publishing. So, Dr. Don, welcome.

Don: [00:02:06] Thank you. Happy to be here, Carrie.

Carrie: [00:02:09] Yes. So I thought, um, the last time when we talked, uh, a while ago, you were in field testing for The Test of Auditory Functioning, and now it has been released. So I thought this would be a perfect opportunity, um, to touch base again and kind of share with our listeners a little bit about the Test of Auditory Functioning. So to can you give our listeners just a big overview, and then we'll kind of get into the details.

Don: [00:02:39] Sure, sure. Well, the big overview is um, having been a clinician as well as a professor for many years, I was always struck with there was one test many years back called the Test of Auditory Comprehension, not the TACL but the TAC. And essentially I had used that for 20 plus years and it no longer was available unless you were old like me, and or happened to own one of those big orange TAC. It came with a cassette tape. And essentially it was a wonderful measure of a hierarchical measure for children with hearing loss. And essentially I still have my TAC, but I knew that there was a need for something else for a variety of professionals. I happen to be an audiologist and a speech language pathologist, and as we got closer to release, we obviously needed to figure out who should we pitch this to. And I think of several professions educational audiologist, for sure. And in fact, the very first public presentation when it was finally in real easel form was at the Educational Audiology Association in the summer of last year. And then in the fall, it was available for purchase at ASHA. And we really want educational audiologists for sure, audiologists who happen to be in a position to probably have more time than they often times do for assessing beyond a SRT and a word recognition score or word discrimination, which is the wrong term.

Don: [00:04:17] Um, as well as that speech pathologist, our colleagues who have an isolated 1 or 2 children with hearing loss in their caseload, as well as teachers of the deaf. So a pretty broad market, if you will. And what I think I had as a driving force was to start with really the most basic level of listening, which would be for the purposes of this test, was just identifying long versus short. There needed to be a test for children, which is my primary, uh, uh, population that I'm typically seeing, including two month olds and above. And I also wanted to make sure that some of the critiques I had of the TAC were addressed in the TAF. For example, very few of our colleagues test in noise. Oftentimes, cochlear implant audiologists have very rigorous assessment. But many others are happy to get an SRT and do a word recognition test with pictures. And then if the kid doesn't have receptive vocabulary, they often say could not test. We really should never get around to saying we can't assess something about a child's speech perception ability. And there's lots more to the world than phonetically balanced words.

Don: [00:05:37] So that was why I put it together. And because there were few tests that in one measure, had it all in one unit. That's where I went with the TAF, starting with very basic levels of functioning and then ending with three subtests with competing noise. And we can talk about the details of the subtests, but the TAC would only test at zero signal to noise ratio. As you well know. That would be the speaker was as loud as the background noise. And that is not easy for a hearing person. And we elected in the TAF to go with plus ten plus five and end the TAF at zero signal to noise ratio. So I put together a lot of other thinking and measures in one measurement that we can get into. If you care to know about any of the details of subtests. But that was my driving force, and it's not on a cassette, it is on a USB. I guess I should dry hang it, you can't see it, but USB drive and then you can on um, really just download it to your computer and then work with the easel and the audio files, which are on the USB drive that you can put on your computer.

Carrie: [00:06:58] Okay. Yeah, that was a great overview of all those main components of the test. So, um, it sounds like there's different levels. People can purchase it through BlueTree and can they get it through Amazon as well, or is it just through BlueTree Publishing?

Don: [00:07:15] Well, there's a short period it was on Amazon, and I won't go into all the details of artificial intelligence, but because of one subtest being called male female discrimination, it was my daughter in law's voice and my voice to assess fundamental frequency. AI spit it out. We think that it sounded like I was discriminating males and females, and it violated the AI rules of Amazon, so they pulled it off. But I heard it's back. The safest bet is to be going through BlueTree, especially when we have updates of any changes in the USB drive, because that's where the manual and the score sheets are. So my recommendation is going through, um, uh, through BlueTree, not Amazon if it comes back or if it is back. And later on we can talk about if you're members of two different organizations, there is a discount through the end of 2024 for the Taff.

Carrie: [00:08:18] Okay. Well, great. So we got the easel, we got the USB. Can you share a little bit more about. You said there's different subtests, but you know, maybe get a little bit deeper into the different subtests and, um, how someone might want to look at that for testing.

Don: [00:08:37] Sure, sure. And one of my favorite components that evolved, uh, we share a particular kiddo. She made a YouTube video, I went to her home. And every subtest is demonstrated by one of our favorite kids, a bimodal kiddo. And you get to see a taste of 19 subtests. I had to get an older kid who would get to zero signal noise ratio, but we started with number one, where all she had to hear was, uh, vroom vroom for a fast car or hop, hop, hop. So she looked a little bored and yawned a little. But essentially, if you do go to BlueTree and it sounds like I'm trying to. I didn't do this to make money, but if you get it from Blue Tree, I get $0.10. But the real issue is that when you go to BlueTree, there are samples from the easel and you can see YouTube videos of the subtest. It really does start for a younger child or even an older child who has limited auditory abilities long versus short, high versus low. And then it moves to identifying a male versus a female, or a male versus a female versus a child's voice. And it really does move with some very, uh, kind of basic listening abilities, including just environmental sounds. But what I love is it also includes measures using the Ling six sounds. I am convinced most everyone knows those six sounds, but they may not understand why those six sounds exist. So you can find out a lot with the Ling six sounds. And then it moves to really a section of tests with learning to listen animal sounds, learning to listen vehicles, and a whole segment of pattern perception. For those of us who've been working for a while, I'm sure maybe most people should know the early speech perception, the ESP by Moog and Gears.

Don: [00:10:38] Well, that's a wonderful measure. I've adapted some of the subtests of one versus three syllables Spondee recognition, and including getting to single words not unlike WIPI and NUCHIPSmeasures. There's identifying one word in a field, two critical elements, like a dirty shoe versus a picture that has a clean shoe and a dirty boot and a clean boot. Moving on up to sequencing and listening comprehension. And those are really, I think, the heart of some of the really good information. All of it will provide you with guidance of where you need to work. No child would ever be administered one through 19 based on guidelines in the manual. If you have a child who is able to do basic pattern perception, you might jump specifically to, let's say, subtest ten, where it's one versus three syllables. If you have a child who is able to do something like a  NUCHIPS or a WIPI, you could jump through just one critical element. Um, for a lot of the kids, I'm really interested in seeing how they do in noise to help justify. Although I don't think we need to justify that every kid should have a remote microphone in the classroom. But if you could show a child having trouble with noise, sometimes school districts are willing to say, oh, they're such good listeners. Well, it's hard to be a good listener when you're in a room full of kids and the teacher is not six inches from their head. So essentially, I have often times used tests with competing messages to really help say they're wonderful. But it's not so easy for any of us with competing messages. So I know I'm talking to the choir, but a remote microphone is non-negotiable for our children in the classroom.

Carrie: [00:12:42] Uh, definitely. And. Yeah. So. I love what you said about you're not going to do all 19 subtests. And friend that we both share. Um, that was in your video. I'm sure, um, could have really started at a, at a later level, but for purposes of demonstration, she did all 19. Do you kind of suggest like. You said that, you know, if you know where their level is, kind of start. Maybe what, like a level behind where you think they are so that you can kind of make sure that that's where they're, they're at. And then you then you go until they max out or when would you stop, I guess is my question. Yeah, a wonderful question.

Don: [00:13:28] So essentially, like a lot of tests, you can start at a sub-test and hopefully you're at a basal level that there's success. So essentially um, with the earliest subtests, I think you can just do it and quickly realize this is too hard or too easy for them, and you don't want kids crying. But essentially, if you were to start at, let's say, one critical element, you would want them to pass that sub test and then just move to the next sub test. The general criteria is to have at least two consecutive subtests passes, and then you get credit for all the previous subtests. And to stop when you have two successive or excuse me, two consecutive fails. But if you have a kid and you go to plus ten and they really break down in noise, I'm not going to torture a kid to do one more subtest. For each of the subtests, we're looking for an approximate 70% pass criteria. It does vary because sometimes there are nine items or ten items or even 15 items. It's all in the, uh, score sheet of what's criteria is for passing. If they haven't passed, you can go backwards, which is the nature of establishing a basal and you can use your judgment. Okay. We really are at a fail. That's a really poor score that we absolutely should stop, but that is available. Um, when I did the field testing, um, I would usually know from walking down the hallway, um, that I think this kid probably could go to number blank. And then if I was wrong, I'll go backwards. The average administration time, I didn't keep all the data on every kid, but I would say most administration times, if you start appropriately, should be approximately 10 to 15 minutes. Okay. And that's pretty good. In the busy caseload of speech pathologists and educational audiologists, it is.

Carrie: [00:15:31] And that sounds like you can get a lot of great information in that 10 to 15 minutes of time. So with all of that information, what do you what what goes next like, I mean, does it depend who's giving the test or how do you use that information.

Don: [00:15:52] Right. Well, I see two primary functions of administering the TAF. One is it is not norm reference, norm referencing and standardization with kids with hearing loss is a massive project because of all the variables age of onset, use of technology, age of the child and input. But the real takeaway is you get a criterion baseline data point. The maximum score is 200, so you'd be able to get a score and on a yearly basis re-administer the test. You have a general idea then of I should start at Blankety blank number, and that way you'd be able to demonstrate growth in auditory abilities on a yearly basis. So from a IEP and a justification of our services, it really does provide a yearly longitudinal comparison of child A to child A.  But what I'm planning to do and I can't promise it's next year. But as I retire from teaching, my goal is a companion document that would give examples of okay, when a child breaks down with basic sequencing, what are some of the therapy activities that you can do to not teach the test, but to teach the task. I was trained by Helen Beebe years and years ago, and what I found a good clinician does is not use a test for a number or a standard score alone, but knows where the child breaks down is a segue to where we need to reinforce. If you have a child not doing environmental sounds, then go out on listening walks or get some simulations of in various environmental sounds.

Don: [00:17:42] That's a tricky one, because your cell phone sounds different than my cell phone. But the real takeaway is it was built to be comparison of a child, and also guide a clinician or direct others who are doing the therapy of we need to work on basic listening comprehension. And listening comprehension is not just answering questions, but I also hope. To if I keep at it. Work to develop listening comprehension. That also goes to even higher level skills. Listening in noise is a good higher level skill. But what about listening and being able to conclude what's the main idea of the story? To learn vocabulary that's embedded in the story. When I'm telling you about a nocturnal animal, I hope the kid would know from context. That's an animal who hunts at night. So those are some of the takeaways that it's not to get a number. In fact, the number may be the least interesting part. But where can we go with the breakdown? And literally if you have a child not doing pattern perception, you're going to be needing to intervene before you can just get to word identification in a field. So that's where I'm thinking. And quite frankly, being a clinician who still sees kids every week, I think that's part of why I did this. I need to now work on such and such based on breakdown.

Carrie: [00:19:14] So, so criterion reference that you're comparing that kid to that kid that, um, for auditory skills development, what would you say? You work mainly with kids, but what would you say the age range would be and the population that you would want to be testing? Right.

Don: [00:19:33] It's such a great question. And if you hadn't asked, I'd want to make sure you heard it. I really had a wide range of children. My youngest kids who were successful in the administration were two years old. They were in parent infant programs. I do also have a superstar two year old, but he got to go really high. But the problem when I was field testing is it wasn't on an easel. It was all on the computer screen and they didn't know me. I was in four continents, so they were on a parent's lap, and if they weren't willing to touch the screen to show me their answer, that was a problem. Most kids in their twos get around to pointing to pictures, so I'm hoping the youngest would likely be two year olds. But I think if you are their clinician, you'll be much more successful. They may need to be older, but in my very extensive field testing and I've been doing the TAF on a lot of my older kids because I'm just dying to know how do they do with plus ten plus five and zero? I have yet to have anyone under 13. That's the oldest I've ever administered it. No one under 13 has ever gotten 100% of the final subtest items, so it appears to be a fairly wide range.

Don: [00:20:58] But interestingly enough, I have two subtests that you could administer to an adult. One is the first subtest of long versus short. The adult is not going to listen to a race car and a bunny. Go hop, hop, hop. But they go ah versus ah ah ah. We do have some late adult uh, later deafened, I mean, excuse me later implanted and long term deafened individuals that really may not get long versus short. Similarly with the Ling, the subtest of the Ling also includes an adult subtest where they're not pointing to an ice cream cone for um, but they're pointing to the M for that sound. So I'm not developing this for adults, but it is adaptable, and we are needing to realize not everyone gets an implant early. Not everyone has immediate amplification. So if you have a child with multiple disabilities or late identified late access to technology, this could go above a 13 year old. But the primary field testing was for 2 to 13 and I must go on record. Not every two year old gave me much information, but I tried.

Carrie: [00:22:17] Yeah, well, at least you can get a somewhat of a baseline and you can document it. And then a year later when you go back, you hopefully get more information and you have that comparison. Right.

Don: [00:22:30] And interestingly enough, I got great feedback from educational audiology colleagues at EAA. Some people asked, well, could you do it with tele administration? The concern would be the decibel level of presentation has to be preserved. And will a child, unless the clinician on site has the easel? I think there's some challenges, but someone said, could you just administer a voice? It was not developed to be administered live voice. There's a calibration tone, which you must do before the initial administration of any subtests, not each one, but the initial administration of your test time. Youtube video shows calibration. So if there's anyone out there going, I don't know how to calibrate, you can do it pretty easy with downloading a sound level meter or having a sound level meter, but you could practice with a child live voice and just make sure you noted that subtest one was administered live voice, not with the audio file at 76 DBA, and then maybe six months later you could administer it using the audio file. So I'm not against practice to make sure the child can do the task. But for a reliable and valid measure, you really are not going to be teaching the test. But and the test was not developed to be done live voice. But I had a really pretty impaired kid, and we went right to male on my voice for to make sure that the child could point to the male character. And then we tried male versus female on the audio file. We didn't give anything away.

Carrie: [00:24:16] Yeah. No that's good. And kind of the expand a little bit more on administering the test. Um, it is recorded, but for those, does it need to be in a sound booth. Where can you do the testing?

Don: [00:24:30] Well, as you can see from the YouTube, we did it in our friend's dining room. I would encourage a quiet area, so her little sister had to be quiet in the background. But the real takeaway is it was not developed to be in a sound booth. It could be a clinician space, be it an educational audiologist or teacher of the deaf or even a teacher could be administered if they have some experience, and I would experience doing it with a one of your own kids or a older child, just to get used to going to the subtests and the subfile for the playing the audio clips. But the real takeaway is it was not developed to be routed through an audiometer. It could be, but there is no need a quiet space and making sure that from the calibration tone that's embedded in the audio files, that you get to 76 DBA where the child is sitting. So you just position the computer and the space chair and put the sound level meter at the child's head. And there, you know, vary your volume control to get to that. Always administration at the same intensity level.

Carrie: [00:25:49] Okay. And I guess, um, another question would be. Uh, what are some of the challenges that you've kind of heard from people out in the field, like giving the test or, um, follow up with it?

Don: [00:26:06] Great, great. And I keep asking for more and more feedback. And I have an email where you can send me questions not just to the college or the hospital. Um, but the real takeaway is I have had good reports on the images. They absolutely are beautiful illustrations. The, uh, illustrator, um, is in China and didn't speak English, so it was quite interesting to giving her feedback about the various images I took into consideration DEI, diversity, equity and inclusion. That there are various individuals of color. Uh, and there are really pictures that I think when I'm going buck, buck, buck for a chicken, they'll know that's the picture of a chicken and they'll hopefully understand my bok bok bok is a chicken. So I have good feedback of the images. I would say I purposely, um, because of, uh, issues of developing, uh, test design. It is color coded on the right side of each image. So you'd be able to flip to what other whatever subtest you need to go to. It doesn't have tabs, but it's color coded, which turns out to be very helpful. I would say that the one thing that does probably take the most kind of practice is making sure on your computer, you can easily navigate to audio files, the listing of the subtests, and some of the subtests to a practice items.

Don: [00:27:37] So it's really a matter of getting to be able to navigate. And this almost 70 year old, if I'm able to navigate some of the audio files, I know everyone else can. But the real takeaway is there's a little kind of I use the word kind of, uh, kind of quirkiness until you really are great with your finger getting to the right audio file. But the flipping, the scoring in general has been well received by folks out there. And literally, with the exception of this, is almost humorous from a speech pathology standpoint. I now know there are no skunks in Australia. There is a story about a skunk, but I like to think everyone will identify that black animal with a white stripe is a skunk, and you do need to take into consideration. All of my field testing was on English speaking kids, including kids in Israel, as well as, um, you know, I had a lot of kids who are bilingual Spanish speakers in Texas, but English was a language they could understand or it wouldn't be appropriate. But when you do things like the Ling sounds, my English, not New York accent, but I am from New York.

Don: [00:28:50] My English of the production of vowels will be a different production than you might find in different parts of the world, so I'm alerted to the skunks and that my vowels don't quite sound like all the vowels in Australia. Um, and we aren't yet figuring out the exact solution, but it might be that we might be able to rerecord with other speakers. You know, long term. It'd be great that this was in Spanish, great if it was in Mandarin. But, um, I'm not going to live long enough to do all that, I don't think. But we certainly could do a Ling subtest with a rerecording. Um, but, you know, geographic, uh, accents are kind of hard to conquer throughout the whole world. But it was very interesting. I didn't know that in England, they really don't have that many railroad crossings like we have in the US. But the good news is the picture of the railroad crossing doesn't influence them getting the right answer. When the story talked about a car stopping at the train intersection. So you learn a little things culturally to be sensitive to.

Carrie: [00:30:03] Yeah, I'm sure that was a huge challenge when you're kind of basically doing an international like study, you know, data collection and the pilot of the test, and then you find all these little nuances that happen in different countries.

Don: [00:30:20] Yeah. And actually one of my favorite was in field testing. We had a few questions that showed emojis. Kids are so into emojis. But to be on the safe side, because I would point out that's a happy face. And that was a sad face. And that's an angry face. I have labeled each of the emojis with the term, so there's no confusion about frightened versus, you know, sick, you know, a green face emoji with someone who is sick. So that was interesting. And because of generational issues, I even needed to label the grandfather and the grandmother, keeping in mind they're not always called grandfather grandmother. But you know, a lot of people have pretty young looking grandfathers. I didn't want that to be confused with a youthful parent versus a grandparent in one of the images that they're identifying. So I learned a lot about just things that sometimes you never would think about because of the feedback from the kids who would look quizzically at this image going, I'm not sure which emoji you're talking about. So things have been updated before it went into the easel.

Carrie: [00:31:29] Okay. Yeah, just kind of going back to a question that I should have asked you at the beginning, for how long did it take you to do all of this? Because that is like a huge undertaking. And I know you've been talking about it for several years now, and it's been stirring in your brain for longer.

Don: [00:31:49] Well, it's funny because when it did come out, my favorite image that was reposted by Karen Anderson and her website was, it's finally here. And a lot of people go, yeah, it's finally here. Um, the actual assembling of the images, which, you know, took some time from our illustrator and, uh, uh, China. It was right before the pandemic and a sabbatical that I was getting all the images for the whole test. So that was probably a six month time period of approving the hierarchy of the images. The field testing was on another sabbatical, and I almost was trapped in Australia because it was literally the spring break that the pandemic came to us. And I guess I could have stayed in Australia for months, but I got home on the last plane before it would have been quarantined, but from me. Tired at the pandemic last two Decembers ago, I was in Seattle with Robert O'Brien, and literally the transfer of the images, the recordings that were done at a hospital setting in a recording studio. It came out between December of 22, and then we were meeting and that following summer that it turned into this easel with the audio file. So the ending went faster than the preliminary. But I've been musing about hierarchy of listening function probably my whole whole career. And I've always loved this TAC but I knew we needed an update, and it's an update. And some in my mind to say the least. With all due respect to the TAC developers and Karen Anderson, who is one of the greatest cheerleaders going, Don, you got to do this TAF and other people saying you were talking about standardizing the TAC, where's yours? And it was a multi year process slowed down by the pandemic.

Carrie: [00:33:56] Well, now it's in full form. So that's the exciting part of it. And, uh, people can get it too. Is there anything that I forgot or didn't ask you that you think listeners need to know about the, um, Test of Auditory Functioning?

Don: [00:34:14] Sure. I guess the two is. And this is not me being a salesman, other than I want people to benefit that if you are a member of EAA, you can go to the EAA website. And they have a recorded webinar that I did, I believe, in October. Uh, no, actually it was springtime. Um, I have a webinar from March and you can down or you can sign up and watch the webinar. And that was, uh, March of this year. And essentially, if you're a member of EAA, there's a 10% discount for the rest of the year to order it. And note I believe the code, but please check with the EAA folks. It was EAA 2024, uh, if you're a member. Similarly, with AG Bell, there's a 10% discount on all of BlueTree's material, including the TAF with AG Bell 2024. So that could be very helpful. Um, and I would also say if you're uncertain, you can get the links for the YouTube video and see the easel in action. It's a great picture of my friend doing every subtest, but, uh, the best site would probably be BlueTree publishing.com. I always embarrass because I don't always say that correctly, but I'm almost sure that's correct. Um, it's, uh, Blue Tree, one word publishing, and they're based in the state of Washington, so I'd say those would be helpful resources. And again, don't be afraid about the calibration. Uh, you can download sound level meters, for example, from NIOSH for free. And, uh, you know, I welcome questions and I also welcome feedback. In fact, I just was talking with one of Carrie’'s very esteemed colleagues in educational audiology, and she said she, you know, was having a little trouble with getting the audio files.

Don: [00:36:09] And I think that's nothing reflecting her. I have trouble, and I have pretty good experience with the audio files. But once you're once you're flying with the delivery and you're in the right subtest, which is guided by the manual, um, you definitely can do this in a fairly short period of time. And I'd say the last item, um, our mutual friend Carol Flexer gave me a wonderful review, so please feel free to read that. But I think she was being critical. And she said the idea that this really has been long awaited to meet a need. But quite frankly, um, I think it's one of those tests that I hope people value and will be important in their clinical practice. And what better to actually have someone who actually is still seeing those kids in that age range? Um, and, you know, I'm obviously very proud of the work it took, but I'm more proud that more colleagues who might not have learned much about auditory development now have a measure and can really, uh, have a dialogue. I would want to also mention that the Hearing First organization is doing wonderful, wonderful LSL and audiology webinars and courses. And I think through the middle of August, I'm pretty sure I have that right. You can sign up for a four week seminar I'm doing for hearing first about assessment and auditory development. And not just that you sign up for my course, but tons of incredible pediatric audiology offerings as well as LSL training. Uh, so Hearing First would be another resource to be aware of.

Carrie: [00:37:54] Okay. And what I can do and the show notes is I can link um, the EAA website for the webinar and AG Bell as well as Hearing First, um, and then I if you want, I can put your email in there, um, that you want people to get Ahold of you if they have any questions or feedback. Um, we can definitely link all of that up in the show notes.

Don: [00:38:17] And the manual and the score sheet and script are all on the USB. But in the meantime, I'll also provide you with the list of, uh, Ella and her YouTube, because essentially one through 19 are in different segments. Um, and I think although they're very brief segments, you really will get a sample of the sound as well as the easel and that, uh, how hard she worked to go from 1 to 19 in her dining room.

Carrie: [00:38:51] Oh, good. Well, I am so glad that we had the opportunity today. To get together on this podcast and really dive a little bit deeper into the Test of Auditory Functioning and how it can be used for, you know, a variety of different kids, um, from just the early listeners to maybe, um, late listeners who are going to be considering getting cochlear implants or hearing aids and just to kind of figure out, hey, what are some good IEP goals or therapy goals that we want our kids who are deaf and hard of hearing to get to next. And this is a great tool to, um, figure that out and benchmark and then come back to to see where the progress has gone. So thank you, Dr. Don, for doing if I.

Don: [00:39:35] Could, just as you're talking, I've thought of one other thing. From a population standpoint, children with every possible technology were part of the field testing, including two implants, two hearing aids, bimodal soft band kids, a fair number of kids with microtia and atresia that were using soft bands. And I would make the note that I did my dissertation research at a school for the deaf in Florida. And essentially, sometimes people are shocked to wow, you went to a place that there's a lot of signing. I look forward to people acknowledging that some of those children at schools for the deaf, which always will have a role, are also kids who may be getting cochlear implants and those kids or just even wearing some technology. Not all that. Those kids also have auditory potential. And essentially the idea of an auditory verbal therapist reaching out to our colleagues at schools for the deaf may sound surprising, but it's with great sincerity every technology. If you're totally not auditory, this would not make much sense. But we do have kids that people just need direction to demonstrate. They can hear a male versus a female voice. They can do a high versus a low, and where they are, they can move forward. And that's really how I look at every child. We all have our stars and I'm always proud. But sometimes those more involved kids who make the small gains might really be the ones we should take the greatest joy in. And I made that quite sincerely about all children with various degrees of hearing loss.

Carrie: [00:41:18] Yeah, yeah. No, that's a great point to bring up that it really can be used for, for all kids. And it gives us a benchmark for moving forward, um, in auditory development. So sorry for.

Don: [00:41:30] That late late Add.

Carrie: [00:41:32] Yeah that is great. Thank you. But um, again, it is always great to connect with you and find out what is happening. And I really appreciate your time today on the EmpowEAR Audiology podcast.

Don: [00:41:46] Thank you. Appreciate it.

Announcer: [00:41:48] Thank you for listening. This has been a production of the 3C Digital Media Network.