Monday, September 6, 2010

A Response to California Academy of Audiologists' Opposition to AB2072

This is a response to people who are seeking the other side of the story since there are always two sides. A debate is taking place in the blogosphere about the California Academy of Audiologists’ (CAA) opposition to AB2072.

A response to the California Academy of Audiologists’ (CAA) Letter to Assembly Member Mendoza:

1. The CAA maintains: “The Academy is concerned that our inability to come to agreeable language regarding the role of the audiologist in the educational process of a parent’s newly-identified hard-of-hearing newborns, is getting in the way of passage of a well meaning bill.”

FACT: from day one on March 4, when we first learned AB2072 was read for the first time on February 18, we communicated our concerns regarding preserving the ability of audiologists to make appropriate educational recommendations and without any conflict of interest. Supporters of Assembly Member Mendoza’s AB2072 are:
American Federation of State, County and Municipal Employees
California Academy of Audiology (the very CAA you all are reading about)
California Association of Private Special Education Schools
California Hospital Association
California Speech-Language Hearing Association Center
Echo Horizon School
Jean Weingarten Peninsula Oral School
John Tracy Clinic
Auditory Oral School of San Francisco

They were who discounted our experience and knowledge as they kept pushing this legislation hard over our protests. We requested to sit down with all concerned parties to develop amendments that all could agree with. NOTE: We were not invited to share input in the drafting of the original AB2072.

Our efforts to communicate our concerns and desire to participate in amending AB2072 were often disregarded as evidenced by documents posted on The latest amendment was offered on August 20, 2010, and CCA wrote their letter of opposition on August 23. We were as surprised by the favorable change of events as they were.

2. Is the CAA not concerned about deaf babies?

Not explaining ASL in further detail is a great disservice to the families of both Deaf and hard of hearing babies. “Information is power.” Why not share ASL with ALL families? Why wouldn’t audiologists want to empower parents with ALL information?  It is an ethical and moral obligation of the profession to share all information about ASL and spoken English.

3. The CAA maintains that: “Audiologists are highly skilled health care professionals who are trained to counsel parents regarding appropriate educational and treatment options for their hard of hearing children.”

FACT: only 8% of deaf and 15% hard of hearing children are reading at proficient (grade level) or advanced levels (above grade level).
(Source:  These results are 2007 numbers and are included here because they are the easiest to access without  data mining. Sadly, 2010 numbers are not meaningfully different.)

FACT: in math, only 10% of our deaf students and 18% of our hard of hearing students score at proficient (grade level) or advanced levels (above grade level).
(Source:  These results are 2007 numbers and are included here because they are the easiest to access without  data mining. Sadly, 2010 numbers are not meaningfully different.)

FACT: with over 200 university audiology programs in America, only one requires classes in ASL. 20 of those 200 programs offer ASL as an elective.

FACT: at San Diego State University (SDSU), the Communication Disorders Department has cut out their ASL program entirely.

Notice that this assertion only mentions “hard of hearing” children being the recipients of their “educational” counseling?   Was this a subconscious admission that they are beyond their scope of training for deaf children? Why the exclusion? 

It is important to understand that CDNIAS’ position is that audiologists are trained to test and diagnose hearing loss but are not trained or qualified to consult about language development and educational abilities.

4. The CAA maintains that: “An audiologist forced to review and counsel all available communication options…would be tantamount to a cardiologist discussing with parents of a heart transplant for a child found to have a heart murmur…”

FACT: in general, consulting parents about language development and academic abilities is not within the scope of training for their audiology profession.

FACT: ask the parents who did not get any consultation on ASL.

FACT: on behalf of CCA, lobbyist Barry Brokaw testified during the June 23 Senate Health Committee hearing that “…we [audiologists] think they [parents] should be informed of all the options.”

The glaring contradiction between the above two quoted assertions is a good indication that audiologists do not normally share ASL with families. Within the context of the letter, it is also disturbing that the analogy’s implication of being informed about ASL could be comparable to “heart transplant.”  Sadly, it is also a clear indication of their perspective and training – that they consider ASL an option of last resort. We have always maintained that “deafness” is a language and educational issue, far different from a “medical” issue.

5. The CAA maintains that: “The CAA does not believe AB2072…is in the best interests of the children and families that audiologists serve…and they are our primary concern.”

FACT: only 8% of deaf and 15% hard of hearing children are reading at proficient (grade level) or advanced levels (above grade level).
(Source:  these results are 2007 numbers and are included here because they are the easiest to access without  data mining. Sadly, 2010 numbers are not meaningfully different)
FACT: in math, only10% of our deaf students and 18% of our hard of hearing students score at proficient (grade level) or advanced levels (above grade level).
(Source:  these results are 2007 numbers and are included here because they are the easiest to access without  data mining. Sadly, 2010 numbers are not meaningfully different)

Their primary concern? Really? Seriously? We have a lot of soul searching to do if they actually believe their consultation has been foundational in serving the academic abilities of our deaf students.  Our students lack language skills, and the tragic results of that are reflected in their dismal reading and math scores.

6. The CAA maintains that: “Further, we must preserve the ability of the audiologist to make appropriate, family-centered recommendations regarding habilitation of their patients.”

Family-centered? Why not child-centered? Who is the “patient”? Deaf babies need to be seen beyond the framework of a “medical patient” perspective.  We need to move away from the medical point of view to a language and educational approach for true “habilitation” of deaf and hard of hearing babies.]

7.   The CAA maintains: “As audiologists we are trained in spoken speech and language development as well as different sign languages, including ASL.”

FACT: with over 200 university audiology programs in America, only one requires classes in ASL. 20 of those programs offer ASL as an elective.

Beyond the statistically low numbers of programs’ inclusion of ASL classes, if the audiology programs really wanted to have its students to become trained in American Sign Language, then they would require their students to also need to take other beneficial classes such as Deaf Studies, Deaf History, and ASL literature.

While audiologist may be “aware” of the language and communication options, sadly they are NOT TRAINED.  Their scope of work, which is what constitutes their license, does not include ANY knowledge or training in ASL for the vast majority of audiologists.

8. Yes, the the CAA's audiologists are being asked to give the brochure to ALL parents whose baby passes the screening as having some form of hearing loss. We want this! The CAA apparently does not.

FACT: Children’s expressive ability in sign language reinforces spoken language development. (Yoshinaga-Itano, 2006; Volterra, Iverson, & Castrataro, 2006)

FACT: Babies can express themselves through sign earlier than through spoken language. (Goodwyn, et al., 2000; Schick, 2003)

FACT: Deaf children perform higher level in both ASL and English due to early and consistent visual access to language. (Israelite & Ewoldt, 1992)

FACT: Fluent ASL speakers are superior in academic achievement, reading and writing, and social development. (Singleton, Supalla, Litchfield, & Schley, 1998; Snodden, 2008; Strong & Prinz, 1997; 2000)

We should be asking why they would not want to share information about ASL. It is a moral and ethical obligation of the audiologists to share all information about ASL. We also know “information is power.” So, why would audiologists not want to empower parents with ALL information?

9. They (the CAA) are correct on one point: due to some last-minute political maneuvering behind scenes, the restriction placed on the audiologists was tighter with the 8/20 amendment. The CAA says they do not object to discussing all communication options, but this statement conflicts with their letter to Mendoza where they clearly say they cannot counsel on all communication options!

10. The CAA maintains: “…However August 20th amendments that you requested be inserted into AB2072 requiring audiologists to review and counsel all parents regarding all treatment options are, in our view, professionally inappropriate, and frankly would result in additional parental confusion.”

FACT: The bill as amended, actually says:
This bill would require the audiologist to note in the newborn's or infant's record that the parent has received the informational pamphlet and, during the course of evaluation and treatment, to inform and counsel the parent of all available communication options.” 

Informed decisions require being informed. So, why would not audiologists want to empower parents with ALL information?

11. The CAA maintains that: “One of the biggest problems we feel the bill does not address is our families who use total communication as their option.”

FACT: Only American Sign Language and English can be considered languages.

While total communication does not have any formal protocols for its structure or use, it is, at best, a visual supplement to spoken English.  Auditory/oral English (and correspondingly, its visual supplements) are represented.

12.  The CAA maintains: “We believe the panel and the costs incurred but (sic) the State is not necessary as there are brochures out there that are non biased and include all options, including ASL and SEE sign. We also believe at this point the bill is so far from its original intent that we cannot support, nor do we think given the polarizing options on the panel that the process will be arduous.”

COMMENTARY: Actually, the brochures originally promoted by the sponsors of the bill were heavily biased toward the auditory/oral approach.  That is why a panel is necessary so that all misinformation will be corrected. Auditory/oral English (and correspondingly, its visual supplements) is represented on the panel.

13. The CAA maintains: “Because we too felt this bill was getting into a political battle rather than about communication and educational choices we asked to be removed as the primary pamphlet distributors and asked that the educators hand out the pamphlet but we would be happy to answer questions regarding anything in the pamphlet or direct the parent to the appropriate agency or reference material. This was rejected by the author. Hope this clears up some of the misconceptions….”

Political? All along, it had always been a political battle.

Audiologists have been manipulating AB2072 all along. They have never objected once; they even insisted on being on the advisory panel. Doesn't this conflict with the content of the CAA letter? Guess they did not anticipate that the restriction would go through, and now they are not happy about being supervised to do their job the RIGHT way.

No more saying, "ASL should be used as a last resort!"

We FINALLY have ASL EQUAL to their oral approach.

We have a long way to go toward working together to benefit the DEAF and HARD of HEARING CHILDREN and their families.


  1. I still do not trust an audiologist!

  2. Thank you Marla,

    I hope to read more of your future blogs.

    I don't trust Mike McConnell, he wants to destroy the ASL Community.

  3. Wow! Great rebuttal of the points! I hope Mike McConnell reads this!

  4. It looks like San Diego State University (SDSU), the Communication Disorders Department would have to resume their ASL program.

  5. Welcome to the blogosphere!!!

    Julie Rems-Smario

  6. You bring up quite legitimate points. What I am wondering though, is there any way that one could compare test scores between the various communication modes? For example, I would imagine one may be able to acquire various state test scores from various deaf schools? Altho I also understand that some states do not even post the test scores of there state schools for the deaf. If it is proven that ASL-based programs show higher test scores, in reading, math, etc., than other communication modes, then it would be very easy to stand by those results and flaunt them in the legislators faces. Until that happens, unfortunately, odds are that the power of lobbying will go a long ways in determining the direction that legislation goes. I look forward to reading more of your blog postings.

  7. Way to go Marla! Thanks for doing this!

  8. Valhallian, you asked a valid question, and it deserves a thoughtful response. Can't do that while my family is waiting for their dinner! I would like to ask around some people your question, and get back to you in a couple of days.

    I appreciate your leaving your comments.

  9. The Oral Option schools such as Oralingua do not publish their STAR scores, because the schools are small enough to escape the reporting requirement (in theory, this is because it would show individual failures). However the failures quietly flushed out of the expensive oral option schools DO go on to lower the STAR scores of their subsequent schools, including the state schools for the deaf.

    See: and search for "STAR" to see Oralingua restate this excuse for why they don't have to demonstrate whether or not their expensive method of teaching actually works or not.

    Why not aggregate the scores across Oral Option Schools?

    - Linda

  10. Hi Marla,

    Candy is spouting off with another convoluted rant, this time claiming that your own post was unclear, and going on to blame you for misunderstanding the audiologists' role, due to some quotes from the ASHA document that Mike posted.

    The thing she neglects, however, is that Mike quoted the OTHER audiology agency lobbying for AB 2072... The CSHA (the California state agency under tha ASHA) still SUPPORTS AB 2072. Only the CAA (the state agency of the American Academy of Audiology) has reversed its position.

    It seems that Candy is blaming YOU for the Audiologists' own confusion. Some still support it along with the Oral Option schools support, and some have decided against it.

    Maybe we need to ask both groups of audiologists to settle on a role for the audiologist in all this, THEN argue where the "FAIL" really is?

    - Linda