Interview with Nancy Creaghead Ph.D., ASHA President

TOPIC- America's Hearing Healthcare Team Initiative (AHHTI).
AO/Beck: Hi Dr. Creaghead. Thanks for taking time out of your busy schedule to speak with me today.

Creaghead: Hi Dr. Beck. My pleasure. Thanks for inviting me.

AO/Beck: For the readers who might not be familiar with you, I'd like to mention that you are the new president of the American Speech-Language-Hearing Association (ASHA) and that you have held that position since the beginning of the year. Additionally, I should note that you received your doctorate from the University of Cincinnati in 1978, in Speech-Language Pathology.

Creaghead: Yes, that's correct.

AO/Beck: I'd like to discuss ASHA's announcement from last week, regarding ASHA withdrawing from the AHHTI (America's Hearing HealthCare Team Initiative). Could you please review that situation with me?

Creaghead: Certainly. As you know, ASHA entered into talks with the AAO-HNS (American Academy of Otolaryngology - Head and Neck Surgery) in July of 2001 regarding the AHHTI. It was in September, 2001 when the AAO-HNS announced our participation with the program at their annual meeting that was held in Denver. We were happy to work with the members of the AHHTI to explore and develop a communications plan to help the public understand that assistance was available for hearing and balance problems. However, from the beginning, in working with the AAO-HNS and the International Hearing Society (IHS) we recognized that there could be some challenges. We were prepared to work together and seek solutions to these issues. However, we were also prepared to remove ourselves from the program if we could not come together and agree on definitions of the participants consistent with legislation and regulation and on policies and procedures or if the program appeared to not be in the best interest of audiologists and the public they serve.

AO/Beck: Very good. And then last week the announcement went out that ASHA had decided to withdraw from the AHHTI. Can you tell me what were the specific events that initiated ASHA's withdrawal from the AHHTI?

Creaghead: From the beginning we said that the AHHTI had to support audiology as an autonomous and independent profession and the definition of the audiologist that we endorse and we thought we were all heading in the same direction on those issues. As you know, we did make some progress regarding autonomy and the independence of the profession with the AAO-HNS regarding the definition of audiologist and the multiple points of entry into hearing healthcare service. However, because of the different perspectives of the three organizations, ten months later we were still discussing definitions and public professional portrayals. For example, a definition of otolaryngologist was recently suggested by the AAO-HNS, which included their supervision of hearing and balance tests and implied supervision of audiologists. We felt that was not accurate, and we could not support that definition. Additionally, AAO-HNS put forth a definition that did not identify the otolaryngologist's unique role as a medical doctor, and we felt that was not helpful to the public either. So basically, we communicated to the AAO-HNS and the HIS that these definitions were problematic and they were not appropriate for the public, and that they did not accurately define the unique and specific role of audiologists on the team or their roles and responsibilities. So all-in-all, we decided that after ten months of working on definitions, that the basis of a public awareness campaign had not yet been firmly established, and that the best thing to do was to part.

AO/Beck: Frankly, I was surprised to learn about the difficulty regarding definitions. In the 1996 ASHA Scope of Practice it was very clear. The ASHA Ad Hoc Committee on Scope of Practice in Audiology stated Audiologists are autonomous professionals who identify, assess and manage disorders of the auditory, balance and other neural systems. Additionally, the same 1996 statement said Audiologists provide comprehensive diagnostic and rehabilitative services for all areas of auditory, vestibular and related disorders.

Creaghead: Correct, and those were the definitions that we started with, and needed to see recognized in the final AHHTI statements for the AHHTI initiative to progress.

AO/Beck: Has ASHA left the door open to continue or re-establish future discussions with IHS and the AAO-HNS regarding possible public awareness campaigns in the future?

Creaghead: We are always willing to work with responsible national and local groups to promote better hearing objectives. I made that point very clear to the presidents of both the AAO-HNS and the IHS. We are willing to work with them and with other organizations on issues of mutual interest which would increase the quality and quantity of services provided to persons with hearing and balance disorders.

AO/Beck: Does the withdrawal from the AHHTI open any doors or opportunities regarding the relationship between ASHA and the AAA?

Creaghead: We have always had an open-door policy with the AAA and we're hopeful that we can work with them as members of the same team pushing forward the agenda of better hearing and public education and knowledge of hearing healthcare. We are extremely open to working with AAA on many fronts and we look forward to doing so.

AO/Beck: Is ASHA planning public awareness campaigns for audiology in the future?

Creaghead: We are highly supportive of public awareness campaigns and we believe these serve the best interests of audiologists and most importantly - the public that we serve. Recently ASHA has had terrific successes with PSAs (public service announcements) in print and on TV that have generated over ten million dollars of free broadcast and marketing support for audiology and communication disorders. We will definitely continue these efforts.

AO/Beck: Dr. Creaghead, thank you again for your time and for sharing your thoughts on these matters with us.

Creaghead: Thank you too, Dr. Beck. We appreciate the opportunity to address these matters on Audiology Online.