I have been practicing audiology since 1996 and started out as a jack of all trades—seeing patients of all ages, providing a variety of diagnostic services, and fitting hearing aids to patients of all ages. Early in my career, I developed a strong interest in working with children with hearing loss and their families. While I had some opportunities to provide this service initially, I did not begin to exclusively see children until a job change in 2005 led me to an exclusively pediatric position. I was excited for this change as my desire to become a pediatric audiologist had blossomed significantly, and my caseload had shifted in this direction naturally over time along with my interests.
In 2005, I took a position in a university setting where I was not only providing pediatric audiology services but teaching doctor of audiology (AuD) students to provide best practice services and interventions. It became clear that pediatric audiology meant different things to different providers. We worked hard as a faculty to impart the need to adhere to guidelines published by our professional organizations, but our students reported that procedures were not consistent across their clinical placements and fourth-year sites. In addition, we had the task of teaching our students that good pediatric audiology was not strictly about audiology. We function as case managers, make referrals to other health-care providers, help parents deal with their emotions when their child is diagnosed, advocate for educational services for our patients, help families find funding for devices…the list is endless.
The scope of knowledge that is required to care for kids with hearing loss is immense. As I branched out and started a nonprofit pediatric audiology practice on my own, and then successfully merged this practice with another pediatric nonprofit organization, the need for quality audiology services for children remained apparent. Children are not little adults, and the skill set required to take care of their hearing needs is completely different. Until recently, there was no mechanism in place to ensure that providers have the knowledge to take care of this population.
In 2011, the American Board of Audiology (ABA) introduced the Pediatric Audiology Specialty Certification, or the PASC. I was pleased that a group of experts in pediatric audiology had come together to develop a standard for what pediatric audiologists need to know and contemplated taking the exam for a couple of years. I wanted a way to measure my own knowledge and take a look at areas where I could improve. I finally decided to apply and sat for the examination in 2013.
The PASC, like other ABA credentials, is voluntary. To apply and sit for the exam, you must be a licensed audiologist with a minimum of two years of postdegree professional experience. Of that work experience, 550 hours must be in pediatric audiology, with another 50 hours in pediatric case management. I completed the PASC application, downloaded the list of suggested study materials, and got to work.
The content areas evaluated by the PASC examination include the following:
- Laws and Regulations
- General Knowledge of Audiology
- Child Development
- Screening and Assessment Procedures
- Communication Enhancement Technologies
- Habilitation/Rehabilitation and Educational Supports
I spent a reasonable amount of time preparing for the exam, focusing primarily on areas that I didn’t use frequently in day-to-day patient care. For example, as a clinic-based audiologist, I needed to review some educational audiology concepts that I don’t use as frequently, such as how to complete a classroom survey.
Exam day came and I was surprised by the comprehensive and rigorous nature of the exam. The ABA partners with subject matter experts in pediatric audiology and with HUMRRO, a leading psychometric organization, to create and validate test items. The result is a comprehensive, statistically valid examination that allows demonstration of knowledge and expertise in the area of pediatric audiology. When I received notification that I passed the exam, I also received a breakdown of how I scored in each of the areas described above. This was a useful tool to identify areas of relative weakness and allowed me to focus on improving my knowledge in these areas through continuing education opportunities and independent reading.
In addition, ongoing continuing education is required to maintain the PASC that is well beyond what is required for a state license; there is also a minimum number of hours that must be obtained in pediatrics, a Tier 1 requirement, and an ethics requirement.
I took the exam initially as a yardstick to measure my own performance. However, I have been surprised at how well the PASC has been received in the medical community and among families of children needing services. When I received the certification, my practice notified all local pediatric providers to share information about the credential. We received positive feedback from many referral sources and gained some new ones in the process. Simply put, pediatricians and other referring providers want to ensure that their patients are receiving the best possible care from the most qualified professional.
Other health-care providers have a clear understanding of the rigor that is required to prepare for and pass a specialty certification exam and having this certification has had an impact on referral patterns. Our families were excited as well—some reported that they saw our PASC announcement posted at other health-care offices! They were happy to know that their child is receiving services from a provider that has taken that extra step to demonstrate their knowledge and is committed to ongoing education.