Dr. Donald Goldberg Shares Historical Perspectives & His Professional Journey

Join me in a conversation with the accomplished Dr. Donald Goldberg as we have a discussion about the important history and work of the Joint Committee on Infant Hearing, the important work and collaboration between hearing healthcare professionals, educators, and families, and the positive impact of the fields, including how Dr. Goldberg ventured into the field. Dr. Donald Goldberg has his Ph.D., CCC-SLP/A, LSLS certified AVT, and is full professor at the College of Wooster (Ohio).  Dr. Goldberg is also a member of the Professional Staff for the Section of Audiology and Hearing Implant Program (HIP) at the Cleveland Clinic’s Head and Neck Institute.  Dr. Goldberg has co-authored a book, written numerous book chapters, published a range of research-based and clinical publications, and has been an invited speaker throughout the United States and Canada, as well as 16 other countries.  He was awarded the “Honors” of the AG Bell Association for the Deaf and Hard of Hearing in 2018 and became a “Fellow” of the American Speech-Language-Hearing Association (ASHA) in 2020.  Dr. Goldberg's most recent clinical work has been the field testing of the soon-to-be published "Test of Auditory Functioning" (BlueTree Publishing). 

For more information about Dr. Goldberg visit

https://wooster.edu/bio/dgoldberg/

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: Welcome to episode 33 of empowEAR Audiology with Dr. Carrie Spangler.
Carrie: Welcome to the empowEAR Audiology Podcast, which is part of the 3C Digital Media Network. My name is Dr. Carrie Spangler, and I am your host. I am a passionate audiologist with a lifelong journey of living with hearing challenges in this vibrant hearing world. This podcast is for professionals, parents, individuals, with your own challenges and those who want to be inspired.
Thank you for listening, and I hope you will subscribe, invite others to listen and leave me a positive review. I also wanted to invite all of you to visit and engage in the conversation on the empowEAR Audiology Facebook group. Transcripts for each episode can be found at www dot three, the number three, C digital media network dot com (www.3cdigitalmedianetwork.com) under the empowEAR podcast tab.
Now let's get started with today's episode.
Carrie: Welcome to the empowEAR Audiology podcast. I am so excited to introduce our guest today, Dr. Donald Goldberg, and I have him with me today, and I know we are going to have an interesting, vibrant conversation. Before I have him come live on the air I'm just going to tell you a little bit about him.
Dr. Goldberg is a full professor and the inaugural chair of the Department of Communication, Sciences, and Disorders at the College of Wooster. He is a PhD. He's an SLP. He's an audiologist. And he is also an ASL certified auditory verbal therapist. He is a part time member of the professional staff for the section of Audiology and Hearing Implant Program at the Cleveland Clinic’s Head and Neck Institute.
Goldberg is also a visiting scholar at the university of Newcastle's Royal Institute for Deaf and Blind Children and North Rocks, Sydney, Australia. And that was from December, 2014 through February, 2015. Dr Goldberg earned his PhD at the University of Florida in 1985. He earned his bachelor's degree and speech language pathology from the university of Florida and his bachelor degree in biology education from Lafayette College in Easton, Pennsylvania.
He has been a university college professor and the co-director of one of the largest cochlear implant centers in the United States. And as the former executive director of the Helen BB Speech and Hearing Center in Easton, Pennsylvania. Dr. Goldberg has co authored the book Educational Audiology for the Limited Hearing Infant and Preschooler, an Auditory Verbal Program.
And he has written numerous books, chapters, published a range of research-based and clinical publications, and has been an invited speaker throughout the United States and Canada, and to 16 other countries. He was awarded the honors of the AG Bell Association of the Deaf and Hard of Hearing in 2018 and became a fellow of the American Speech Language Hearing Association in 2020 and will be honored actually coming up this November at the ASHA annual convention in Washington, DC.
Dr. Goldberg's most recent clinical work has been the field testing of the soon to be published test of auditory functioning by Blue Tree Publishing. So I'm excited to introduce to all of our listeners today, Dr. Don Goldberg.
Well welcome Dr. Goldberg to the empowEAR Audiology podcast. I'm so excited to have you today.
Don: Thanks for the invitation. I'm happy to be here.
Carrie: Well, I always like to start out with how, if I know someone, how I paths have crossed, and I don't know if you ever, if you remember meeting me the first time
Don: time.
Well I know there's a Carol flexer, Denise Wray connection, and I don't know if it was something at school or social, but I can just envision you with those two wonderful friends going, oh, this is someone you need to know, Don. And my sense is they said, this is someone you should know. Okay. I think that's
Carrie: like, I think I might've been in graduate school when our introduction first occured
So I think our paths have crossed multiple times, way back and multiple times along the way. So it's, it's great to still be
Don: connected. Absolutely.
Carrie: And I also like to ask my guest is how they actually got into the field of you speech pathology and audiology. Do you have a backstory
Don: to that? Well, at the risk of people finding the real deal on Don Goldberg, I went to a little college called Lafayette college, north of Philadelphia.
I wanted to be a veterinarian. And my first semester, keeping in mind, I have a PhD and I'm a professor. My first semester of college, I got a 2.64 GPA really bad. So I knew I was never going to get into med school or vet school. So I was checking out my options and this is not a negative cause I love teachers, but I started taking education classes as a minor.
I was a biology major. I graduated, but I took an education minor. I had no money, no car. So they placed me at an elementary school, close to the college. I walked from the college to this elementary school. And in that kindergarten class was Robert. I figured out the other day, Robert is probably in his fifties now, but a six year old changed my life.
He had two body aides on a harness. He went to this little shack of a building called the Helen Beebe speech and hearing center. My first acquaintance with anyone with hearing aids was Robert. And I assumed because I volunteered for the rest of my time at the Beebe center that all deaf kids listened and talked.
That was my start in this world of. Going to college, not sure what I wanted to do. And now I tell freshmen don't get us 2.64 mathematically. It's really bad. But the real issue was I then applied to grad school and I didn't even know which one I wanted to do. And when I went to the university of Florida, they said, do you want to go and speech, or do you want to go in audiology?
And I went, what's the difference? I don't know. And they said speech pathology. Work with people and audiologists work with machines. So I picked speech, language pathology, and all along. I wanted to work with kids who were deaf. And essentially when I got back to my doctorate, I then also took audiology, but I did learn speech pathologists and audiologists work with people and some machines, but a five-year-old changed my life.
Carrie: That's amazing. So all of those little pitfalls along the way, ended up being a good move and a long and fulfilling
Don: career. And even to go to Lafayette, I had no idea. People from around the world came to Eastern Pennsylvania. Helen Beebe was described as the crazy lady on college hill because she was teaching deaf kids from the 1940s.
When hearing aids just started. That many kids had a little residual hearing that could be trained. She was the crazy lady thinking a deaf kid could listen and talk. And at the same time she was doing that Doreen Pollack was doing that in Manhattan. Before she moved to Denver, these two grands who have changed my life, we're doing the exact kind of therapy and they never even met till years later.
Carrie: Yeah, that's amazing. And you said you volunteered at the Helen Beebe center, but you also. Work there as
Don: well. Yeah. During college I volunteered and I think it was novel. That's some boy from the college, some male came to the speech and hearing clinic. And I went down to the University of Florida because Helen Beebe was a speech language pathologist.
After I got my master's degree and worked in the schools and became certified, I went back to the Beebe Center. Learned about what I didn't know they were doing. Apparently there are behavioral objectives when you work with a child, I just thought you played old maid and concentration memory. And then I got my doctorate worked for a few years and ultimately did go back to the Beebe center as their director of audiology.
And then shortly thereafter became their executive director until moving out to Ohio. When my wife got her job at the Cleveland Clinic.
Carrie: Yeah. Wow. That's amazing to have that experience there too. Cause you are able to integrate it into a lot of other things along the way, but you also wear another hat as a professor.
So can you share a little bit about influencing the future of our profession at the college of Wooster?
Don: Right. Well, my wife grew up about 20 minutes from here in Lodi, Ohio. We used to come down to Wooster for the movie. When we came home at Christmas, the only thing they had in the north end of town was a movie theater.
So I knew there was Wooster. I never knew there was a college. Sharon got the job. Dr. Sharon Sandridge got her job working with Craig Newman at the Cleveland clinic. And I kept my step son back in Easton without his mother. I had Nicholas because we got married and I had a step son and he stayed with me.
And then I went. I think Nicholas, I love being your stepfather, but you need to live with your mom. He went to Ohio and I worked for one more year while they were out in Ohio. And I went, I got to find a job and literally just fate again. An opening came about at the college of Wooster, someone who was retiring after 30 years.
And I didn't even know Wooster was a school. And I've been here for off and on. I've worked here over 20 years, but I did take a five-year break to run the cochlear implant program at the Cleveland clinic with Peter Marsh, Pete Weber, who is a cochlear implant and one of cochlear implant surgeons in the past. So it was fate that got me to Wooster.
It's a diamond in the rough. It is a fantastic. Undergraduate only program at this point in time, over 30 of my students have either earned their AuD. Or have gone on to be currently in a doctor of audiology program. So tons of AuD students have come out of this program. Stacy Lim came out of this program and anyone can learn that our weird connection to the Beebe center Wooster.
And now one of my greatest friends. So anyway, with Wooster, we have speech pathology and audiology, but many of our students don't know which to do. So even if they go into and I'm a dual, so I have to like both, but even if I go or have students going into master's in speech, language pathology, I want them to be that SLP, who isn't afraid of an audiogram, can interpret the audiogram.
Isn't afraid of technology. And as you can relate. Lots of audiologist know their hearing aids. I want all audiologists to also know about typical speech development, typical language development, and we got to work collaboratively. I know this is an interview with me, but I can't not shout out. The summit ESC is a beautiful model of this preschool program, three or four of the best educational audiologists I ever have met.
I told a family of a baby move to Hudson Ohio. You'll get Carrie as your educational audiologist. They have a baby who is just implanted yesterday. The youngest kid ever implanted at the Cleveland clinic, seven months old. There'll be eight months and four days. And they bought a house in Hudson because ESC and what you all provide is that collaboration of working with an implant team, speech, language pathologist, and someone on your team, or more than one person, who's a LSLS cert AVT ED.
We need to work collaboratively and not be in our silos. I have so much and so proud of those speech pathologists who may not work often with hearing impaired kids, ever respect for audiology and vice versa. So I guess if I was to look, reflect on Wooster, lots of stimulating thesis students, I said I would retire when I got to 300.
Well, I've done 285 thesis students. Cause everyone does a thesis. Yeah, it sucks the marrow out of my bones, but it is so reinforcing and I missed it When I spent five years, full-time at the clinic. I wanted to come back to this incredible institution and I'm, it's not easy to retire. So I'm going to do phased retirement.
Carrie: Well, that's amazing that you've had that impact on, so. The students along the way and just kind of gave him that foundation for what they're going to go to next. Right. And and I appreciate what you said about the summit ESC. And I tried there because I I'm proud of everyone there. And like you said, you know, speech pathology and audiology and teachers of the deaf need to be collaborating together.
And we all bring a different lens and perspective to the picture and that's what our kids deserve in order to be successful in whatever they want to do. Yeah. So I learned, you know, how you have the little background with Stacey Lim and knowing her from a young age and, and college and on, I feel like that's my Carol Flexer and Denise Wray.
They were knew me from a younger age and got to see me through. Cool and still have that, but I saw those two together and I was like, that is a perfect match to have the audiologists and speech pathologist working hand in hand. And that's really like what you said needed to happen in order for our kiddos have used it to do well.
Don: Right. And I think the other component is I work with so many kids at the early end. My most common, cause I have a limited caseload at the clinic I triaged and have all the babies and anyone on the CI track. And I used to say, cause obviously Carol Flexer and I have done research on graduates who are adults.
I used to refer to my three and four year olds at the clinic as graduates because they're at or above. They're hearing peers for receptive and expressive language. Their auditory skills are through the roof. Their speech intelligibility is fantastic. I, for a short period was saying, they're my graduates and they're four years old.
And the downside of that is they're never truly graduates. There's still. Preschool and kindergarten to enter. They still have to go through so much, but they're oftentimes at, or above their hearing peers. But we know from the LOCHI study in Australia, sometimes there's some plateauing at eight or nine.
And quite frankly, how does a three or four year old graduate from anything? There is a lifelong of listening and development. So if it turns out I see them every three months or every summer to do some assessment before they go on to fourth grade or fifth grade, they never really truly leave. And I like to think I can be their coach.
I have really evolved. And I think I'm still a decent clinician, but I think I was more full of myself early on. I was trained by Helen Beebe. I know how to do this now. I so respect the parents and what they do. Not that I didn't before, but they're the change agent. They go home with the kids. I have great toys and I give them cookies, but I'm just a coach.
Alexander Graham Bell on his tombstone says, teacher. He didn't say he invented the phone. He's buried in Nova Scotia and on his tombstone, he wanted to be remembered as a teacher. I too. And I'm not comparing myself to AG Bell, but it's just the idea that I hope people remember me. I hope as a gifted teacher of a lot of different constituencies, but when I'm working with those babies, I am their coach.
I'll be your coach and your clinician. And then down the road, we can be friends. I can go to Stacy Lim's wedding. I can go to AuD externs weddings, but our intervention intervention is very different, but it evolves because they did the hard lifting. I was their coach.
Carrie: Yeah, and we need good coaches along the way, because when we become adults, we still, there's still a lot of lifelong learning that goes on because your environment changes and your job and everything else changes.
So there's always going to be more learning, but to have good foundational coaches is important.
Don: And that's true of parenting as well. I have a 40 year old and three granddaughters, but our relationship is in a different scheme because of the years of in pass. But you know, when I lost my parents, my dad and mom were like 95 and 92.
I was an orphan at like, in my fifties, it's sort of like parents are forever and our parents still go through all sorts of cycles of grief. And I remember someone say, well, my kid learned to drive a car or would my kid with hearing loss, go to the prom? And now it's sort of like, I didn't know where the question came from at the time, but there are those ups and downs no matter how together we all are.
As parents of a kid with hearing loss, or just as parents, your kid went off to OU. That was dramatic. My kid, his grant, his youngest kid going to kindergarten, that was traumatic to me. And I'm sure she's doing just fine in kindergarten, but we have those cycles. And I think too often we think that our families have reached acceptance.
That cycle for all of us is a cyclical nature and we can be angry and we can think, and even acknowledge to our kids, pardon the expression. But some of our kids, you can say it must really suck to be the only kid wearing an implant or having the only one in the class with hearing difference. But most of our kids, if we crowned them well.
They are proud of what they are. And those little, little increments of some of our kids with multiple disabilities, I'm more proud of a kid putting their lips together and doing a bilabial. Then my superstars who are off to Harvard, I'm proud of everyone, but some of those kids with multiple disabilities, I probably have learned more about growth and perseverence.
And how hard families work as a team with lots of dedicated team members. Yeah.
Carrie: And kind of circling back a little bit. Can you just share a little bit about your role at the Cleveland clinic with the hearing
Don: implant team? Sure. When I started at the Cleveland clinic, I left my tenured position at the Cleveland clinic to be the co-director of their implant program.
Part of the attraction was Peter Weber, who is a great surgeon. He's now in New England. I was tired of driving from Brecksville, Ohio down to Wooster. It's an hour and at five 30 in the morning in the snow, it's not a fun drive. So I left, but I really thoroughly enjoyed build Excuse me, building the program.
We were at a point where we were doing about a hundred implants a year. We were in the, certainly the top 10 biggest and busiest cochlear implant programs in the United States. So it was very positive, but I still was a clinician. I was still seeing the kids, but I so missed Teaching college students and I actually missed those independent study thesis.
So then when the implant program moved from one family health center to the main campus, I was a little overwhelmed at how big the Cleveland clinic is and the opportunity developed that I could go back to the college of Wooster. And oftentimes what happens is when you tell someone you're leaving. But you've done such a good job.
You can't leave. So I wheeled and dealed and I made the College of Wooster agree that I could still see patients at the clinic. A lot of them are on my breaks and on Saturdays. And I asked the Cleveland clinic, would it be okay that I saw some patients, but I couldn't keep up the caseload I had. So both sides agreed and I have the perfect combination.
I see college students stimulated by their thesis activity. Some of those thesis use kids that might be patients and at the Cleveland clinic. I don't have two year olds and three-year-olds like at the Beebe center, happy to have a two year old come to therapy. I have five week old kids and the Cleveland clinic.
Has really grown with many cochlear implant surgeons and a larger group of dedicated and talented cochlear implant audiologists for programming. But I am primarily getting to your question. I primarily see all CI candidates. For a speech language and auditory communication eval. So I weigh in as a speech path audiologists type person on the CI team.
It's called the HIP program, hearing implant program. And essentially I triage. Some of the patients for ongoing therapy. So it's primarily a, a busy clinic day of lots of assessments. And typically the youngest kids become part of my every other week or once a month caseload. And then others are every two months, every three months, but I can't get away.
And the little one who had surgery yesterday at seven months, I have known him since he was five weeks old about To get his hearing aids. And one day he may be getting consultative services from the summit ESC. Cause he's going to be just fine, but still need support. They'll always need support assistive technology.
Gotta be there. Non-negotiable right,
Carrie: right. Yeah. There's we, we don't live in a very quiet world, so, and our classrooms, definitely not quiet. So there's always going to be accommodations and accessibility that we have to look at, but I, I
Don: okay. Right. And we're doing lots of studies looking at teachers and even teachers of the deaf and educational audiologists and speech people.
A lot of people really are not completely comfortable with the broad needs of the kid. The slp oftentimes is very comfortable doing artic therapy, but less comfortable with auditory. Kind of auditory skills building and oftentimes it's the auditory that will develop into wonderful language and speech skills.
The teachers today, most general ed teachers have very limited or no educational experiences coursework in working with kids with hearing impairment. 80% of our kids are mainstreamed in schools and for some teachers they've had lots. For some it's their first kid. So all of us have to be working collaboratively and essentially many people, if they were honest, they would say not quite sure what to do with this kid with hearing loss.
My favorite was what if the coil came off? And I'd go, well, you put the coil back on the magnet, you know, essentially technology scares people and essentially these kids need that team of individuals working together. So, you know, it's definitely a world of teaching the teachers and teaching the related professionals that are working with our kids
Carrie: Right. And then your point about like, you know, some have a bunch of kids or have had multiple kids and some, you know, had one, but then you have the teacher that had a kiddo 20 years ago and then has one there. I think you're looking at a different kid. Then, you know, the 20, 20 years ago because of technology, which kind of brings me to another point, cause I know you have been on multiple committees and organizations, but one being the joint committee on infant hearing and you know, that has a long, important history, like dating.
Pretty far back for early identification and intervention and follow-up, but can you just share a little bit about how you became involved with the joint committee on infant hearing and what your role is?
Don: Sure. And if anyone listening to this is going to be an ASHA. The joint committee on infant hearing is going to be in the audiology row of the ASHA convention.
And I'm definitely willing to respond to people's email. If you share that information. The joint committee is probably the greatest, one of the greatest honors I've ever had. I serve as the ag bell representative to the joint committee on infant hearing the quote permanent members are ASHA, AAA American academy of audiology.
Ag bell is one of the founding members along with CED, which is the council of education of the deaf, which includes culturally deaf representatives, which is really important. And then two medical groups. It includes rep to representatives of all groups from the American academy of otolaryngology, head and neck, sir.
Surgery. So to docs and to pediatricians from the American academy of pediatrics and the last permanent, it sounds like the United nations, then the other permanent member of JCHIare the directors of speech and hearing in all of the states. So health and welfare, it's an indifferent agencies in government, but essentially their nickname is the dips.
And I can't even tell you all the letters. Those folks, but they're the members of joint committee. So it works in a consortium of sorts. We have supportive other folks, including NCHAM and CDC and and NICD. But the working group has oftentimes been known to release committee statements, which aren't there they're advisory.
They're not law, but US and many other countries look to the JCHI statements. The kind of gold standard of how to work with the implementation of universal newborn hearing screenings, which they were instrumental about and also just the early intervention. So essentially we meet at least twice a year.
Face-to-face pre COVID. We're about to meet again at EHDI in the spring. So we get to see each other, and then we've had lots of zoom calls and team calls, but essentially it is so good to have those individuals at the table. And the most recent release was a joint statement in November, 2019. They have a 42 page statement.
A three or four page executive summary. And there've been several developments. It took many years to development, develop it because you need a lot of people to agree from kind of divergent backgrounds. We needed to make it as evidence-based as possible. But I would say. Two of the most important recommendations are people I assume are familiar with 1, 3, 6, 1 month, three months, six months, one month to have the screening done by three months of age to have follow-up diagnostics, OAE, or AABR our ABR diagnostics and six months for intervention.
For me, intervention is not slapping a hearing aid on this kid with hearing loss, but intervention, early intervention, state programs, private agencies, et cetera, for the states that are compliant and reaching 1, 3 6, which is not all 50 states. We aspirationally recommended 1, 2, 3, 1 month, two month, three month.
One month universal screening, two months follow up diagnostics to confirm the screening results and three months intervention. This is how I would like our future to go one day. So everybody in 97% are screened in a hospital unless there's some other reason. One day should be our target cause once I leave the hospital, you sometimes can't get those kids back.
Now two months is not a bad idea. There's literature from David Luterman and others. The families should probably take home and love that baby that they didn't expect was going to fail. But two months is really too many months for a lot of families who might be at least at a point to come back to the hospital for the diagnostic, the newborn diagnostic
At the Cleveland clinic, we do two newborn diagnostics to confirm hearing loss, that little boy who had his implant yesterday, he came, met four or five days and he came at 16 days and he was on his way long before two months. So let's move its downward and three more. I am so happy to have any kid who has been diagnosed with a hearing loss, even if they come without their hearing aids, yet that they can meet someone to say the sky's the limit for your baby.
With the exception of kids with multiple disabilities, I am completely comfortable to say. All of your hopes and dreams can be realized for that little baby you're starting early. You're getting technology that is transformed their audibility. They are getting into early intervention programs that teach the parents the sky's the limit.
And as you may know, that is been my, it has been a mantra. I actually have a kid named Sky. Anyway. So the sky's the limit and her big sister was one of my early patients as well. So at the same time, the 1 3,6 is 1, 2, 3 is aspirational. That's an important development. I want to make one quick comment that as much as we're aware that because of UN UNH, UNHS, Because of all the things I talked about, technology and intervention, many families are going to, going to elect or select a listening and spoken language program.
Most of our kids have two hearing parents, but I want to make it very clear. I am so proud to have been a fall, a past president of AG Bell. I am so proud to be a little. But people need to know. I actually know how to sign. I actually teach a class that's to sign or speak or sign or talk. We have to be respectful of our culturally Deaf people, culturally deaf individuals who may elect for their child.
To learn ASL and be, bibi. Bye. I just want all families to know the options exist and just like, there is no one size fits all. Not every kid will be a listener and spoken language user for a variety of reasons. And not that many people who have hearing parents get hearing parents who are fluent. To give a really strong language model in sign, but if a family elects and they deserve to have that option to elect ASL or a bibi program, I just strongly recommend that they become fluent to get the best language model in.
So in the JCIH deliberations, we're always talking about the idea of a listening and spoken language. Or a visual spatial option. So it's a very balanced statement and I think it is important to know that is foremost in our conversations. And then last thing that I'm proud of in the JCHI statement, I'm not always a big believer in a medical model of doom and gloom and pass and fail.
But the recommendation was made instead of when a kid does not pass UNHS. That we say they failed. It is no longer to be pass/refer it's to be worded, pass, or fail. There has been a reducing number, but too many of our kids are lost to follow up. And it's sometimes how they're told, oh, your kid, probably if we did this again, they'll probably pass or maybe there's fluid in their ear.
We didn't get it all out. And if you hear that, are you going to be rushing for the newborn diagnostic? But if the very first test besides PKU testing, it's the very first test a baby has his hearing and you hear the F word that they failed. You may have more likelihood following a medical model to get the children to come for.
Follow-up at an earlier date. So one of our hopes and we'll know for more longitudinal data. Is have we done a service by saying fail versus refer in my heart of hearts? I believe we did do the right thing. I was totally supportive of that. And my wife who does quite a lot of auditory electrophysiology, she'll do some kids at one year old, two year olds and sedated ABRs we go back, the kid had failed or referred universal newborn hearing screenings.
They were told to come back and then at one or two, they're not talking. And then we find out a unilateral loss or a significant loss. I wish you had come earlier, but it is what it is. We take a kid from that place and we move forward. Yeah. And
Carrie: hopefully that'll be good, but I know the pediatricians I involved with JCIH , but again, I think they're another stopping point along the line where you know that they may not be.
Stressing the importance of that. Follow-up and, but maybe it would change if they see this fail on the page rather than a refer.
Don: And they're important gatekeepers as are other physicians, some kids don't go to pediatricians, the GPs, the family practitioners, even the doulas who might be delivering a kid in Vermont in the home.
It'd be great to get them doing OAEs. For those kids who aren't born in hospitals, Vermont just happens to be the state with the largest number of in-home birth. Someone did a thesis on that at the college of Wooster. So I knew not just cows and Ben and Jerry. It's a lot of home births. Yeah.
Carrie: Yeah. So another key component.
Well thank you for your service and that committe and your step you've been on that committee for a while. Right. But
Don: he started the position statement came out in 2019. I think I came on board in 2015 when we thought it would be done in a year. So 2015 to now. And the other member of AG bell representative is Meredith Sugar, who is a mom.
She's an attorney by training and she's a mom of a bilateral cochlear implant user flying off the charts. And I think a middle school or about to go to high school. And essentially she's a very talented person, former president of ag bell, but we get the parent perspective from that ag bell member. And one of the parent members from CED has two teenage.
bi-bi kids. So it's nice to have two parents who are always there to be that monitor of all those trained professionals in audiology and speech learners, pathology and educational of deaf and pediatrics and ENT. We need to hear from the parents. As Doreen Pollack said our child's first and most important teacher.
So thank heavens for Meredith and Stacey Abrams service on the JCIH.
Carrie: Yeah, parents are the most powerful people in that child's life. So they always will be. Oh, so another thing that I know that you've been working on is a new diagnostic test called the test of auditory functioning. And I know it hasn't been formally released yet, but do you want to share with our listeners a little bit
Don: about that?
Sure. I've had several sabbaticals and I typically have gone, done, gone to Australia for most of my sabbatical. So on one sabbatical, I kind of evaluated a auditory quote hierarchy. And then my last sabbatical I was able to, after quite a lot of work, I was able to get funding to field test this test of auditory functioning in Israel in the United Kingdom.
In San Antonio, Texas in Atlanta, in Cleveland, and a real height. Did I say Jerusalem? Israel, Jerusalem, Israel, where there's AV, Israel, AV UK. And my last trip right before. Was at the shepherd center in Sydney, Australia. So field testing of 125 plus kids from two to 13 years of age, the only test that had even come close to what I have in my test was a test of auditory comprehension, which you can't even get.
And just as an aside last Thursday, my only copy of the test of auditory comprehension, which came on a CD. And then I put it on a C came on an audio cassette, then they put it on a CD was stolen from outside my office. So whoever out there at the children's hospital of Cleveland clinic stole my orange TAC, give it back because my test is not ready to go yet, but I do have.
 a Binder . You're not going to be able to view it, but it starts 19 subtests. I plan to not give it away, but probably charged. I don't know, $25. I'm going to, I didn't do this for money. This was the culmination of my life of teaching, listening to children, with hearing children, with hearing loss and being able to quantify.
Those audiograms that say CNT could not test and mostly means the audiologist didn't know what to do to figure out the lowest level of detection. So we have presence and absence long versus short, high versus low fundamental frequency with hello there. My name is Reagan. Hello there. My name is Reagan. My granddaughter is recorded, beautiful pictures, but for my granddaughter, she gets to say, hello there.
My name is Reagan. So it's the same sentence. And they're picking. I have to find it I'll be a much more fast seal, but the person hears each sub test as a calibration tone, they hear the audio. So it's all from auditory and they would pick my daughter-in-law's voice, my voice, or my granddaughter's voice.
It moves on to things like the ESP. So I took all the best from all the tests, the ESP, we have pattern perception. We have spondee recognition. We have word identification with bees syllables, but the big point is it moves hierachy. I did learn two year olds. Don't do too well. They are really, even though they like computers, they're having some trouble, but three-year-olds on their Ling sound assessment.
There's learning to listen, animals, learning lists and vehicles, sequencing, listening comprehension. And one of my objections to the TAC, which I've collected data on for 25 years. They hit the kid with zero signal to noise ratio, which is a great thing to do. Testing and noise. Very few tests are very few audiologists, even tests at varying signal noise ratios, but for profoundly deaf kid
To hear a speaker where the noise is as loud as the speaker. That's a little bit much, all of us have trouble at zero signal noise ratio. So I have my final three subtests at plus 10. Plus five and then zero to signal, to noise, signal to noise ratio. So it's going to be computer driven. It has calibration tone each sub test.
It will be, and this is the tricky part that's taking me a little while long with COVID. The kid will be able to touch the screen and that will give the, keep the score and advance to the next picture versus. Kind of mouse driven assessment and field testing. And I would say I have kids with implants, kids with hearing aids.
I have bi-modal kids. I have several bone anchored kids. It is for any technology and it's a criterion based of every year. You could administer the appropriate subtests and be able to demonstrate auditory development and auditory growth from. Initial assessment to next subtests, next assessment. And how much farther they go?
No kid got to ceiling, but the oldest kid was 13. And the reason why I originally said two to 12, that 13 year old just turned 13 and he had his bar mitzvah in Jerusalem. And he's my oldest kid who moved from the Cleveland clinic to Jerusalem. Obviously an English speaker and he's my oldest kid. And most times I would stay, it would go up to really high performing kids who are 10, 11, and 12.
And anyway, a very proud development of, I think, a professional who has worked with lots of deaf kids through the years and really has a good sense of. Where do they break down? And the real true test of real true test of a test is where they break down. It then gives us direction of where to intervene.
If you have a kid who is not even able to tell long versus short. You can't be doing learning to listen sounds. If their auditory skills are needing to really develop long versus short and as kids get new technology, as kids get better as listeners, they are going to move through many of the higher subtests getting to listening comprehension at zero signal noise ratio.
So I named it the TAF, the test of auditory functioning, because after many conversations with Norm Erbert. Who is co you know, classic auditory training book in 1982. He critiqued me every time I went to Australia, he was concerned that people said hierarchy. It's more than just a hierarchy of detection to comprehension.
We have kids who might be identifying, but they still need to detect some kids. You have identification, they can do some things in comprehension. You just don't knock off detection. And stick it discrimination. So the triangle of a hierarchy, I have been using the terms level, term levels of auditory functioning, hence the name of the test.
So that's my crowning glory. I'm not planning to die or retire yet, but I am hoping that this can be circulated to teachers of the deaf speech pathologist. You don't need a sound room. You just need a sound level meter, and we will get really important data. But the auditory ability of children from three to 12 who have hearing loss, no matter what their technology
Carrie: Yeah, that sounds amazing. So, well, it'd be like on an iPad or computer that you download or how has, how does that work?
Don: Some of the bugs have to be worked out. The first one is to make sure it can be driven in, by touch of a mod, a monitor of sorts. I'm anticipating that I'm less inclined to think it will be an app to go to an iPhone, but it will probably go to tablets and tab.
Monitors of sorts that we'll be able to really collect the data because there are also issues I had to think about. Cultural sensitivity in the images. Well, you also need to think about people's motoric ability and also you're very good. Would you get very different data potentially on an iPhone versus the size of the monitor?
So there are a lot of variables, but because it's criterion based, my main reason for not standardizing is. That is a humongous job. So many variables with hearing loss, but more importantly, we have so many variables with the technology they're using. And as you know, some of our kids are hearing aid kids who then become implant kids, or they become bi-modal kids.
So I elected this to be a useful test. Hopefully. Very accessible for usage and administration. And probably that will just be able to really move on to get data. So every year we can find out how the kid is doing. Yeah. And would you
Carrie: suggest every year, would you suggest before that, depending on the, like where they're at with their technology.
Don: I think it might depend. I mean, I certainly want to quantify things like Ling sounds, learning to listen associated sounds that one, those are almost kind of training modules, but the real heavy duty items that have identification of words, two critical elements, sequencing and listening comprehension.
There is the concern about learning, learning the task. So I've never told the kid and I've given the TAC. A thousand plus times I can go through practice items, which are also on the TAF, but I've never given kids the correct answer to the actual test items because you don't want the kid to remember. Oh yeah.
Don said that was about a chicken hatching, an egg in 21 days. So essentially that's the caution on probably the preference for anniversary testing, because you could have a kid learning. The answers with too many administions. Yeah,
Carrie: no, that sounds amazing. And I, I can't wait to get my hands on it once it gets published, because I know as an educational audiologist and being in our program like those just, you know, we write an IEP goal.
Based on the evaluation that we give and to be able to have a tool like this, to evaluate, and then be able to write good IEP goals and objectives based on areas of need based on the assessment is going to be very helpful.
Don: And I actually think educational audiologist. We'll very much be interested in this.
I'll make sure I come to an EAA convention. But also that speech language pathologist who just didn't have much experience working with these kids, will try this out. And I assume one of the accompanying documents might be a manual to give some suggestions, but I've never believed in cookbook therapy, but at the same time, people just, they want to do the best job.
And I think sometimes people revert to artic therapy because they're not quite sure how. Incrementally and appropriately do learning to listen work. So kids get better and better. So if this can lead to better services for our two and three-year-olds on up all more power to it. And I never did this with the idea of, I got a test.
I mean, some of the test. I mean, I buy tests, including speech and language test. Some of the tests are like $500 and then you pay a buck for each form. This was not to make money. It was really to share, I guess, a lifetime of good work. With wonderful teachers starting with Helen Beebee, my parents and Helen Beebe.
And I learn from the young AuD extern. I learned from my undergrads that one of the gifts of our professions is we learn from others and I will never be so proud of I'm the experienced old man in auditory verbal. I hope I'm a better clinician at seventy. Then I am at 67 today. And what I was when I didn't know what the heck I was doing, thinking SLPs played old maid and memory concentration.
Cause that's the only thing I remember besides they could never hear E and speech pathologists play card games. So why not go to grad school at the university of Florida to learn how to play card games, go to the beach and surf. Angel's not by the water. I forgot to look at a map before I went to Gainesville, Florida.
Carrie: Well, thank you for all that you've done and, and share with our profession too. Cause I, I know I that's the gift of giving back, right. That we learn and to be able to give back, is there anything that I didn't ask you that you wished I would have.
Don: That is a great question. I guess my takeaway two real themes.
It's not the device and I think we're too often thinking implant in all well, implant in unbelievable audibility. But work is still needed. The access to sound is easy. I was friends with Dan Ling and Dan Ling would say, it's easy with an implant. And I said, Dan. I am so respectful of you, but that message is powerful.
But what if you have the kid, when it isn't easy and you get the impression it's all about the device, can you stop saying it's easy with, because of the technology? So it's not the technology. And I think the other thing in a way, I think. Our relationship and my respect for your colleagues in your ESC.
And as I interact with a lot of speech people who are afraid of audiology and vice versa, I hope our goal we'll always come back to that child, that child of a family that really didn't sign up for a kid with hearing loss unless there's some other sibling. It's not what people necessarily were expecting, but if we break down our silos of I'm the master SLP, or I'm the.
There's a lot of people that are not LSLS that still can do really good auditory teaching. I want more people to be LSLS, but you don't, it's not your degrees and it's not your initials. It's this breaking down and getting away from silos and that final theme of the skies, the limit. I know that Robert taught me.
Oh yeah, everybody who's deaf or wears body aids listens and talks. Robert might've been an exception in 1974 when I started, but we have more kids who can be the sky's, the limit. And even our kids with multiple disabilities. It's that kid compared to him or herself, because it is kind of cool. When we work with the most intriguing and cool kids and I have to be careful.
I'm so excited about a five week old and it's like Don, You could be given the wrong image to this family. They're not that happy that there's a hearing loss, but I hope the enthusiasm just like Carol and Denise were for you. And literally Beebe was for so many others. You take the attitude that until proven differently, that kid can go to the moon and more and more of our kids are going to the moon.
And that's pretty darn special.
Carrie: It is, well, I want to just thank you for being a guest today on the empowEAR podcast. And I agree, I think our kids, the sky should be the limit for them and to be able to be a coach and what collaboratively like it together outside of our silos is really the way to go.
So thank you, Dr. Goldberg, Don for being on here today. I so appreciate
Don: it. Thank you. And thanks for everyone who might've listened and feel free. They can best get in touch with me with D Goldberg ERG at Wooster Dot EDU rooste
Carrie: I will put that in the show notes too. And then they will be able to click on your email and get ahold of you as well.
Don: Sounds good. Thank you.
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