Knowledge and Skills Required for the Practice of Audiologic/Aural Rehabilitation

Official statement of the American Speech-Language-

Hearing Association (ASHA). 

Pediatric Auditory Habilitation

Click HERE to read the American Speech Language and Hearing Association's Document on the:

Knowledge and Skills Required for the Practice of Audiologic/Aural Rehabilitation, which was approved by the ASHA Legislative Council and is an official statement of the American Speech-Language-Hearing Association (ASHA). 

The document was prepared by the Working Group on Audiologic Rehabilitation in response to a charge from the American Speech-Language-Hearing Association's Executive Board to update the Association's definition of and competencies for aural rehabilitation document.

Adult Auditory Rehabilitation 

Knowledge and Skills for Audiologists Providing AR Services

Basic Areas of Knowledge

Audiologists who provide AR services demonstrate knowledge in the basic areas that are the under-pinnings of communication sciences and disorders. These include the following:

1. General Knowledge
   1. General psychology; human growth and development; psychosocial behavior; cultural and linguistic diversity; biological, physical, and social sciences; mathematics; and qualitative and quantitative research methodologies.
2. Basic Communication Processes
   1. Anatomic and physiologic bases for the normal development and use of speech, language, and hearing (including anatomy, neurology, and physiology of speech, language, and hearing mechanisms);
   2. Physical bases and processes of the production and perception of speech and hearing (including acoustics or physics of sound, phonology, physiologic and acoustic phonetics, sensory perceptual processes, and psychoacoustics);
   3. Linguistic and psycholinguistic variables related to the normal development and use of speech, language, and hearing (including linguistics [historical, descriptive, sociolinguistics, sign language, second language usage], psychology of language, psycholinguistics, language and speech acquisition, verbal learning and verbal behavior, and gestural communication);
   4. Dynamics of interpersonal skills, communication effectiveness, and group therapy

Special Areas of Knowledge and Skills

Audiologists who provide AR have knowledge in the following special areas and demonstrate the itemized requisite skills in those areas:

• III. Auditory System Function and Disorders
  1. Identify, describe, and differentiate among disorders of auditory function (including disorders of the outer, middle, and inner ear; the vestibular system; the auditory nerve and the associated neural and central auditory system pathways and processes);
• IV. Developmental Status, Cognition, and Sensory Perception
  1. Provide for the administration of assessment measures in the client's preferred mode of communication;
  2. Verify adequate visual acuity for communication purposes;
  3. Identify the need and provide for assessment of cognitive skills, sensory perceptual and motor skills, developmental delays, academic achievement, and literacy;
  4. Determine the need for referral to other medical and nonmedical specialists for appropriate professional services;
  5. Provide for ongoing assessments of developmental progress.
• V. Audiologic Assessment Procedures
  1. Conduct interview and obtain case history;
  2. Perform otoscopic examinations and ensure that the external auditory canal is free of obstruction, including cerumen;
  3. Conduct and interpret behavioral, physiologic, or electrophysiologic evaluations of the peripheral and central auditory systems;
  4. Conduct and interpret assessments for auditory processing disorders;
  5. Administer and interpret standardized self-report measures of communication difficulties and of psychosocial and behavioral adjustment to auditory dysfunction;
  6. Identify the need for referral to medical and nonmedical specialists for appropriate professional services.
• VI. Speech and Language Assessment Procedures
  1. Identify the need for and perform screenings for effects of hearing impairment on speech and language;
  2. Describe the effects of hearing impairment on the development of semantic, syntactic, pragmatic, and phonologic aspects of communication, both in terms of comprehension and production;
  3. Provide for appropriate measures of speech and voice production;
  4. Provide for appropriate measures of language comprehension and production skills and/or alternate communication skills (e.g., signing);
  5. Administer and interpret appropriate measures of communication skills in auditory, visual, auditory-visual, and tactile modalities.
• VII. Evaluation and Management of Devices and Technologies for Individuals With Hearing Impairment (e.g., hearing aids, cochlear implants, middle ear implants, implantable hearing aids, tinnitus maskers, hearing assistive technologies, and other sensory prosthetic devices)
  1. Perform and interpret measures of electroacoustic characteristics of devices and technologies;
  2. Describe, perform, and interpret behavioral/psychophysical measures of performance with these devices and technologies;
  3. Conduct appropriate fittings with and adjustments of these devices and technologies;
  4. Monitor fitting of and adjustment to these devices and technologies to ensure comfort, safety, and device performance;
  5. Perform routine visual, listening, and electroacoustic checks of clients' hearing devices and sensory aids to troubleshoot common causes of malfunction;
  6. Evaluate and describe the effects of the use of devices and technologies on communication and psychosocial functioning;
  7. Plan and implement a program of orientation to these devices and technologies to ensure realistic expectations; to improve acceptance of, adjustment to, and benefit from these systems; and to enhance communication performance;
  8. Conduct routine assessments of adjustment to and effective use of amplification devices to ensure optimal communication function;
  9. Monitor outcomes to ensure professional accountability.
• VIII. Effects of Hearing Impairment on Functional Communication
  1. Identify the individual's situational expressive and receptive communication needs;
  2. Evaluate the individual's expressive and receptive communication performance;
  3. Identify environmental factors that affect the individual's situational communication needs and performance;
  4. Identify the effects of interpersonal relations on communication function.
• IX. Effects of Hearing Impairment on Psychosocial, Educational, and Occupational Functioning
  1. Describe and evaluate the impact of hearing impairment on psychosocial development and psychosocial functioning;
  2. Describe systems and methods of educational programming (e.g., mainstream, residential) and facilitate selection of appropriate educational options;
  3. Describe and evaluate the effects of hearing impairment on occupational status and performance (e.g., communication, localization, safety);
  4. Identify the effects of hearing problems on marital dyads, family dynamics, and other interpersonal communication functioning;
  5. Identify the need and provide for psychosocial, educational, family, and occupational/vocational counseling in relation to hearing impairment and subsequent communication difficulties;
  6. Provide assessment of family members' perception of and reactions to communication difficulties.
• X. AR Case Management
  1. Use effective interpersonal communication in interviewing and interacting with individuals with hearing impairment and their families;
  2. Describe client-centered, behavioral, cognitive, and integrative theories and methods of counseling and their relevance in AR;
  3. Provide appropriate individual and group adjustment counseling related to hearing loss for individuals with hearing impairment and their families;
  4. Provide auditory, visual, and auditory-visual communication training (e.g., speechreading, auditory training, listening skills) to enhance receptive communication;
  5. Provide training in effective communication strategies to individuals with hearing impairment, family members, and other relevant individuals
  6. Provide for appropriate expressive communication training
  7. Provide appropriate technological and counseling intervention to facilitate adjustment to tinnitus;
  8. Provide appropriate intervention for management of vestibular disorders;
  9. Develop and implement an intervention plan based on the individual's situational/environmental communication needs and performance and related adjustment difficulties;
  10. Develop and implement a system for measuring and monitoring outcomes and the appropriateness and efficacy of intervention.
• XI. Interdisciplinary Collaboration and Public Advocacy
  1. Collaborate effectively as part of multidisciplinary teams and communicate relevant information to allied professionals and other appropriate individuals;
  2. Plan and implement in-service and public-information programs for allied professionals and other interested individuals;
  3. Plan and implement parent-education programs concerning the management of hearing impairment and subsequent communication difficulties;
  4. Advocate implementation of public law in educational, occupational, and public settings;
  5. Make appropriate referrals to consumer-based organizations.
• XII. Hearing Conservation/Acoustic Environments
  1. Plan and implement programs for prevention of hearing impairment to promote identification and evaluation of individuals exposed to hazardous noise and periodic monitoring of communication performance and auditory abilities (e.g., speech recognition in noise, localization);
  2. Identify need for and provide appropriate hearing protection devices and noise abatement procedures;
  3. Monitor the effects of environmental influences, amplification, and sources of trauma on residual auditory function;
  4. Measure and evaluate environmental acoustic conditions and relate them to effects on communication performance and hearing protection.