Kid Confidential-Behavior Disorders and Language Impairment in School-Age Children

Mayblog

 

In January, I read an article published in ASHA’s SIG 16 Perspectives December 2012 issue by Alexandra Hollo from the Department of Special Education, at Vanderbilt University in Nashville, Tenn., titled “Language and Behavior Disorders in School-Age Children: Comorbidity and Communication in the Classroom.”  She brought up some really good points that I think we, as SLPs, need to keep in mind when discussing, assessing and treating children who are labeled with behavior disorders.

Hollo discusses how often times children labeled with EBD (emotional and behavioral disorders) also have undiagnosed LI (language impairment).  According to this article, “Four out of five students with EBD are likely to have an unidentified language deficit,” which may result in children resorting to physical communication rather than effective use of expressive language to resolve issues.  In fact, it is estimated that 80.6 percent of students with EBD also have LI however, more than 50 percent of those LI diagnoses remain unidentified.  If staff members fail to recognize the child’s inability to functionally communicate, negative feelings and interactions between the student and staff members may result, which in turn negatively affects academic achievement. What is known about children with EBD is that they “have the most negative short- and long-term outcomes” (Hollo, 2012).

So what does EBD look like in children?  Well Hollo explains the two subcategories of EBD according to the DSM-IV, difficulties with internalizing and externalizing.  Deficits in internalizing include emotional withdrawal behaviors such as depression, anxiety or mood disorders.  Academic trends for these students with internalizing problems include high rates of absenteeism and low academic achievement.  Deficits in externalizing include disruptive behavior as in ADHD, ODD or conduct disorder.  Students with externalizing deficits tend to be more easily identified and receive services possibly due to the fact that their behavior is disruptive in the academic setting and can more easily be determined to interfere with learning.  Academic trends for students with externalizing issues:  disruptive behavior tends to interrupt and/or terminate instruction and therefore affect learning.  More importantly, it was stated that although students with EBD do perform similarly to those with other disorders on standardized tests, their academic performance tends to be BELOW that of other students with disabilities.

In addition to academic deficits, children with EBD also demonstrate deficits in language and social skills.  These children more often exhibit expressive language deficits rather than deficits in receptive language, and they tend to use simplified language within the classroom environment resulting in teachers grossly overestimating the student’s expressive language abilities.  It is important to note that based on Hollo’s research, the CELF and TOLD were the only two language tests that were able to consistently identify LI in children already diagnosed with EBD.

 

Socially, children with EBD tend to have negative teacher interactions, are often times rejected or victimized by peers, and struggle with use of effective conversational skills due to difficulties in initiating and maintaining friendships, problem solving deficits, and difficulties cooperating and collaborating with peers and adults.  In addition, students with EBD tend to be impulsive and struggle with the use of “inner dialogue” to effectively reason prior to responding to their emotions within various situations.  Their ability to control their emotions, follow directions, and transition between activities, classes and subjects is also affected.

Why is this information important for us as SLPs to know?  Well we must first be educated on the comorbidity between EBD and LI to effectively screen, assess, and treat these students.  We also have the responsibility to train staff members on the child’s communication and social skills deficits so as their behaviors may not be misconstrued.  We as SLPs can be instrumental in implementing linguistic supports for these children which include direct (i.e. teaching emotional language, using self-talk for regulation and problem solving skills, provide opportunities to practice negotiations with peers, etc.) and indirect instruction (i.e. collaborate with staff, train teachers on effective communication styles, teach use of slow rate of speech, etc.).  In addition, we can work with behavioral specialists to follow and enforce the behavioral supports that are deemed necessary to help students with EBD be successful in their daily environments.

So the next time you are in your weekly RTI meeting discussing a “problem child” or a “shy, quiet student,” pay attention, and keep in mind that EBD does not look the same in every child. Some behaviors may in fact be linked to language deficits.  Only we, as SLPs will be able to make that determination effectively in order to ensure students receive the services and support they require.

Note:  This entire article was not discussed in detail here.  I discussed the information I felt was important based on my personal clinical experiences.  I refer you to Hollo’s complete article in the December 2012 SIG 16 issue for further information and details.

Maria Del Duca, M.S. CCC-SLP, is a pediatric speech-language pathologist in southern, Arizona.  She owns a private practice, Communication Station: Speech Therapy, PLLC, and has a speech and language blog under the same name.  Maria received her master’s degree from Bloomsburg University of Pennsylvania.  She has been practicing as an ASHA certified member since 2003 and is an affiliate of Special Interest Group 16, School-Based Issues.  She has experience in various settings such as private practice, hospital and school environments and has practiced speech pathology in NJ, MD, KS and now AZ.  Maria has a passion for early childhood, autism spectrum disorders, rare syndromes, and childhood Apraxia of speech.  For more information, visit her blog or find her on Facebook.

ASHA’s Listen To Your Buds Campaign Brings Safe Listening Message to The 2013 International Consumer Electronics Show

LTYBCESBoothSm

Annette Gorey, ASHA’s Public Relations Specialist, works to get ASHA’s booth ready for the show.

More than 150,000 people may hear more about ASHA’s Listen to Your Buds campaign at this week’s 2013 International Consumer Electronics Show (CES) in Las Vegas. This marks ASHA’s fifth consecutive year as a CES exhibitor, and the ASHA Public Relations team couldn’t be more excited to spread the word about listening safely and preventing noise-induced hearing loss.

The Listen to Your Buds exhibit will be in the heart of the CES Digital Health Summit. And new this year, ASHA joins the show’s MommyTech Summit to connect with influencers, mommy bloggers, key children’s health and technology media and more. We’ll convey how Listen to Your Buds can help parents help young people use personal audio technology safely. As you probably well know, the parent blogosphere is more powerful than ever and growing fast. This is an increasingly important audience for our Listen to Your Buds campaign and outreach efforts.

The time has never been riper for a safe listening message. Spend a day with a toddler, elementary school student, tween or teen – or just walk around the mall, stand in line at Starbucks or stroll down the street – and you can’t help but see how kids are more connected to personal audio devices than ever before. Headphones have become a fashion item. The latest color iPod is in the hands of a six-year-old. Teens are at the gym listening to music. And this past holiday season, personal audio technology items were among the hottest gifts around. Now, in the wake of technology gift-giving and increased daily technology time, parents should monitor their child’s usage and volume levels and model safe listening behaviors – and the tips at www.listentoyourbuds.org can help.

We know even minimal hearing loss can affect children’s social interaction, communication skills, behavior, emotional development, and academic performance. Some parents are now realizing this, too. Eighty-four percent of parents are concerned that misuse of personal audio technology damages the hearing of children, according to the results of an online poll commissioned by ASHA last May. Parents also show overwhelming support for hearing screenings for tweens and teens—71% for 10- to 11-year-olds and 67% for 16- to 17-year-olds—according to a University of Michigan Mott Children’s Hospital National Poll on Children’s Health released just last month.

ASHA’s exhibit booth in the Living in Digital Times area has information about hearing loss prevention, warning signs of hearing damage, and how to find a local ASHA-certified audiologist using ASHA’s ProSearch. ASHA member and Las Vegas audiologist Dr. Daniel Fesler, CCC-A and Buds Coalition Musician Oran Etkin will be on hand to talk with attendees.

The Consumer Electronics Association (CEA), who puts on the CES each year, is among the Buds’ dozen dedicated sponsors; we joined forces in 2007. Recently, CEA President and CEO Gary Shapiro highlighted just how important the Buds message is. “As a longtime supporter of the Listen To Your Buds youth campaign, CEA represents companies that create audio technologies for listeners of all ages,” says Gary Shapiro, president and CEO of CEA. “We promote products, like noise-canceling and sound-isolating headphones, that help minimize outside sounds, and volume-controlled headphones that give control to parents of young children. New innovations are still to come that will help us practice and teach safe listening so that we can all listen for a lifetime.’”

Erin Mantz is a Public Relations Manager for ASHA.

Don’t Procrastinate, Advocate!

Rotunda at the U.S. Capitol, Washington DC

Photo by Tadson

The typical student in Communication Sciences and Disorders wears many hats. These may include student, clinician, graduate assistant, and about a million others that vary from person to programs, alike. One hat, which should be worn by all CSD students, is that of an advocate for our profession.  Sometimes, as students, it may feel as if our voices get lost in the cacophony of noise in the professional world.  There are over 12,000 members of NSSLHA. If we come together, our voice can be heard and we can make an impact on the future of our profession. It is never too early to begin advocating for the careers and the clients we will spend a significant portion of our lives helping.

TODAY, September 19, is NSSLHA’s 2nd Annual Virtual Advocacy Day! Virtual Advocacy Day provides a mechanism for students to learn just how easy it is to become an advocate. Through this event, and others, we are establishing a way for all NSSLHA members to learn how to correspond with their elected representatives at both the state and national level. Coming together, our message will become loud, and make our voices heard. This will benefit the profession at large and the patients whose lives we impact. Imagine the impact of senators and representatives receiving hundreds of e-mails all on the same topic during the same day. This will certainly peak the curiosity of a legislative assistant whose grandmother recently had a stroke, or nephew was just diagnosed with autism. During the Executive Council’s “hill visits” in the spring, we have seen firsthand the impact of educating the members of congress.

This year, there are three key national issues we are stressing: IDEA Funding, Medicare Therapy Caps, and the Hearing Aid Tax Credit Bill. More information is available about each of these bills at the ASHA Advocacy Center. You can also search for local legislative issues relevant for an individual state. Professionals, we encourage you to join with us for this day of advocacy. Collaboration between students and professionals is critical. You serve as our role models and mentors and we will one day join you as peers in professional careers. We encourage you to stand with us and write your elected officials as well!

You can participate in 5 simple steps:

  1. Visit the ASHA Take Action Center.
  2. Select the “Students Take Action” link to view additional information on key issues.
  3. Edit the letter to your liking. The more personalized information and stories you provide the more effective the communication.
  4. Enter your contact information in the fields to the right of the letter. Based on your address, the system will automatically identify your members of Congress. Make sure to identify yourself as a student and insert your school name.
  5. Select “Send Message” and you’re done!

 

Caleb McNiece is 3rd year doctoral student in Audiology at the University of Memphis. He received his B.A. in Communication Sciences & Disorders and Spanish from Harding University. He is a trainee on the US Department of Education funded project, “Working with Interpreters,” at the University of Memphis. Caleb serves as the Region 3 representative to the NSSLHA Executive Council chairing the Social Media Committee and as President of the University of Memphis NSSLHA Chapter.


Rene Utianski is a Doctoral Candidate in Speech and Hearing Science at Arizona State University and a Research Collaborator at Mayo Clinic-Arizona. She received her B.A. in Speech and Hearing Science and Psychology from The George Washington University and her M.S. in Communication Sciences and Disorders from Arizona State University. Rene serves as the Region 9 Regional Councilor on the NSSLHA Executive Council and is the 2012-2013 Council President.

ASHA/NSSLHA Student Hill Day 2012

ASHA/NSSLHA Student Hill Day 2012 was a success!  On April 2nd 2012, the NSSLHA Board, along with over 100 fellow speech-language pathology and audiology students had the opportunity to meet with our state representatives and senators on Capitol Hill to discuss legislature important for the future of our profession.  With the help of the ASHA Federal Advocacy team, over 250 visits were conducted to bring audiology and speech-language pathology issues to the offices of those who represent us.  This means that students are impacting how these offices think about our services.  We were able to talk about what we do, the individuals who makes our jobs so special, and what legislation would truly allow us to help others more efficiently and effectively.  Even as students, we can impact federal legislation, which affects the future of our profession.

ASHA provides an abundance of information regarding current legislation and how each of us can get involved at the state and federal level. Even if a visit to Capitol Hill is not an option, a letter, email, or phone call is a great opportunity to let your Members of Congress know what’s important to his/her constituents.  You can visit the ASHA Take Action Center for more information.  It is never too early to begin advocating for our chosen professions.  Even as students, we are also voting members and we can have an impact on how services are rendered.  If you are interested in participating in future Student Hill Day visits, please contact Caroline Goncalves with the Federal Advocacy Team at ASHA at cgoncalves@asha.org .

Imagine the impact we can have if the Student Hill Day gets bigger and bigger each year?  Speak out and be heard by those who represent you and take charge of our professional future!

 

Ellen Crowell Poland, AuD/PhD Student, East Carolina University NSSLHA Executive Board Member-at-Large and Caleb McNiece, AuD Student, University of Memphis NSSLHA Executive Board Region 3 Councilor, wrote this piece for ASHAsphere. 

 

Habilitation – What it is And Why it Matters to You

Most of us are familiar with the term rehabilitation and are comfortable with our role in providing “rehab” services.  Habilitation, on the other hand, may be less common. I don’t know of many SLPs who consider themselves “habilitation providers.” Audiologists may be somewhat more comfortable with the term as providers of aural habilitation, but not in other contexts.

So, what is habilitation? Basically, we are talking about services that help a person learn, keep, or improve skills and functional abilities that they may not be developing normally. Still not clear? Contrast that with services that help a person improve skills that have been lost after a stroke, head injury, illness, or other cause. The latter is rehabilitation – regaining lost skills or functioning. Habilitation refers to services for those who may not have ever developed the skill, such as a child who is not talking as expected for his or her age.  Adults can also benefit from habilitative services, particularly those with intellectual disabilities or disorders such as cerebral palsy who may benefit from services at different points in their life to address functional abilities.

Why the focus on distinguishing habilitation from rehabilitation? Anyone who has dealt with private insurance for a person needing habilitative services likely knows the answer. If you look closely at coverage descriptions for many insurance plans, you’ll likely see language specifying that services like physical therapy or speech-language pathology will be provided when skills have been lost due to illness or injury. This language automatically restricts payment for services to those who haven’t had a stroke or suffered an illness, including most children who don’t have a specific diagnosis underlying their speech, language, swallowing, or hearing problems.

Habilitation is getting national attention right now due to the implementation of the health care reform law. Part of the law stipulates that insurance plans offered through the state exchanges and Medicaid programs must provide services in 10 categories of essential health benefits (EHBs), including the category of rehabilitation and habilitation services and devices. ASHA has been anxiously awaiting the regulations regarding the EHBs and has been working particularly hard on ensuring adequate coverage for habilitative services through the Habilitation Benefits Coalition. The concern centers primarily on the fact that habilitative services are not common in “typical” employer plans, upon which the EHBs are to be based, and this lack of clarity around what habilitative services are and how they should be covered could result in continued difficulty with reimbursement for these services.

Recently, the Department of Health and Human Services (HHS) issued the Essential Health Benefits Bulletin in lieu of regulations. This bulletin is offered as guidance, but does not have the power of a regulation. Essentially, the bulletin gives the states the responsibility of determining EHBs, allowing for greater flexibility and customization to each state’s unique needs. Some highlights from this bulletin include:

  • States will have flexibility in choosing their benchmark plan and will have to supplement that plan with any of the EHB categories that are lacking
  • Plans cannot discriminate based on age, disability or life expectancy, but no specific guidance on this is offered
  • If a state doesn’t choose a plan, the default plan will be the largest small group plan based on enrollment
  • States will have to submit their choices to HHS for approval
  • Self-insured group health plans, large group plans, and grandfathered plans will not be required to cover essential health benefits at this time
  • Comments on the pre-rule bulletin are being accepted until January 31, 2012

When addressing habilitation specifically in the bulletin, HHS acknowledges that these services are less well-defined and that confusion exists over what exactly is covered by such a benefit. They have proposed two options for situations where the state chosen benchmark plan does not include habilitation. These include:

  1. Habilitative services would be offered at parity with rehabilitative services — a plan covering services such as PT, OT, and ST for rehabilitation must also cover those services in similar scope, amount, and duration for habilitation; or
  2. As a transitional approach, plans would decide which habilitative services to cover, and would report on that coverage to HHS. HHS would evaluate those decisions, and further define habilitative services in the future (p. 11)

As one can see, the issue of appropriate coverage for both rehabilitation and habilitation services is going to come down to state-level debates and decisions. ASHA will continue to monitor developments and take action, when appropriate, but the burden of the work will likely fall to the state associations and members within each state. If this issue resonates with you, we encourage you to contact your State Advocate for Reimbursement (STAR) and state association to assist in any advocacy efforts. Individuals requiring speech and hearing services, regardless of etiology, have a right to services to help them function as independently as possible. We have a tremendous opportunity now to ensure appropriate coverage for habilitative services as an essential health benefit. This is your chance to have a real impact on the future of health care.

Amy Hasselkus, M.A., CCC-SLP, is associate director of health care services in speech-language pathology at ASHA. She is also currently enrolled in a Masters degree program in communication at George Mason University, with an emphasis on health communication.

Get involved! Why? Because I say so!

I’ve been struggling to write my last post about the 2011 ASHA Convention. What could I possibly have to say that would sum up my experience? Should I be funny? Light hearted? Should I try to send a message? Reach out?

ALL OF THE ABOVE?

That’s the one!

I discovered something about myself while I was at the ASHA Convention. I really like the administrative side of things. It’s been sneaking up on me – an interest in policies, positions, procedures, politics (whew – what an alliteration!) But there it is. Can’t be denied. I just really enjoy knowing what is going on, how it affects me, how it affects my clients – and you’d think this would be the case with everyone.

However, I discovered something else at ASHA as well – a sort of apathetic, passive, bystander effect among CSD professionals when it comes to legislative and regulatory issues. Obviously this isn’t necessarily the rule, and I truly hope it is the exception. But there seems to be this sense that issues which go outside of our clients and our place of business, go beyond us overall.

I attended a lecture entitled Advocacy 101: Add Your Voice, which was presented by ASHA’s Government Relations and Public Policy Board (Regina Grimmett and Shelley Victor.) The description was as follows:

  • This session is proposed by the Governmental Relations Public Policy Board (GRPP) to promote advocacy as related to legislative, regulatory, and other public policy activities affecting the professions. Presenters will explain strategies for self-advocacy, illustrate data use for advocating issues, and demonstrate strategies for meeting legislators/government officials.

After the lecture, learners would be able to:

  • describe their role in professional grassroots advocacy at the local, state, and/or national levels.
  • define advocacy–its goals, types, and benefits of grassroots advocacy efforts
  • advocate for specific federal and/or state issues that affect the professions of speech-language pathology and audiology.

To me, this sounds like pretty important stuff. At the undergraduate and graduate level we are taught that advocacy is within our scope and is our responsibility. Usually we think of that in terms of advocacy for our clients, but this was quite obviously in regards to US. We like our jobs, yes? We like funding and support, yes?

There were probably 15 people present at this lecture. 10,000+ attendees at the ASHA Convention. Fifteen people who wanted to learn more about how to protect our jobs, advocate for ourselves, and interact with people who can make or break us.

Now, I get it. We go to ASHA to learn how to best support our clients (oh, and to see our best CSD buddies). Holding the client paramount – this is our duty. But how can we hold our clients paramount if we don’t have the IDEA/ESEA/Medicare/Medicaid funding to do it? How can we hold our clients paramount when our professions are being threatened by a poor economy and an administration that doesn’t acknowledge our existence? How can we hold our clients paramount when our credentials aren’t universally recognized as a benchmark for licensing and other professional standards? This presentation was two hours. Two hours out of your three day ASHA schedule could have been dedicated to learning how to stand up for yourself and your colleagues.

We have to help ourselves, to help our clients (kind of that whole “Put your oxygen mask on first” thing.) And I would guess that 15 people can’t do it all. We cannot continue to assume that someone else will get to it. We cannot continue to run our professional lives with a “want something done – give it to a busy person” philosophy. We are ALL busy but, we are ALL accountable.

Want to know more about advocacy, for you and your clients? Contact ASHA-PAC. Contact your state association. Go to the ASHA website.  Contact your SEAL.  Contact your State Liaison. Become a Grassroots Captain. Start early by encouraging students, interns, CFs, and newbies to get involved! There are a million resources and you can get to them while you sit in your office chair.

Listen, I’m not saying run for president or Occupy ASHA – just don’t stand by. Do what you can, or at the least support people who are trying. While you’re thinking that someone else may do it, someone else may be thinking that YOU will do it.

I loved every second of the ASHA Convention, and I hope when I attend in the future that I see more presentations about government relations – and I hope to see more of you there.

NP: The Zombies – Time of the Season

 

(Samantha is one of the official ASHA Convention bloggers! Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

Samantha Weatherford, B.A., is a second-year, speech-language pathology graduate student at Missouri State University in Springfield, MO.  She writes about speech-path and grad school on her blog, so to Speak. Does she think it is a coincidence that the first ever ASHA Convention was in St. Louis, MO, her beautiful hometown, and she chose to be an SLP? NOPE. FATE.

Making a Change: It Starts with Students

“Something happens here” is the motto at The George Washington University, where I began my journey in speech and hearing. As a student who never took a political science or international affairs class, I can attest that something happens there for everyone. Being in the heart of Washington, DC, I was constantly inundated with politics; more importantly, the air was filled with passion and the motivation to help facilitate change. I walked away from college with a deep understanding that everyone has a role to play in making the world a better place. This is likely what encouraged me to join the NSSLHA Executive Council in the first place!

Each spring, the NSSLHA Executive Council partakes in “Hill Day,” where we have the opportunity to speak with Senators and Representatives about current, relevant legislation affecting the disciplines of speech- language pathologists and audiologists, as well as the individuals who utilize our services. Going back to DC each spring to participate in such an empowering activity reminds me of how important it is for all of us to be knowledgeable and active in politics (not just the traditional political junkies).

I felt it was important to continue to spread this message and encourage our student members to take an active role in advocating for the professions and the patient populations that we serve. Embracing the generation of technology, a virtual advocacy day seemed like the perfect opportunity to raise awareness and participation in advocacy activities.

I think I can say without hesitation that the first annual NSSLHA Virtual Advocacy day was a huge success. In total, students from more than 50 NSSLHA chapters joined together to send nearly 1,000 letters to Capitol Hill. The letters urged Congress to protect federal programs that serve individuals with communication disorders from budget cuts.

This event is in line with a larger agenda of the NSSLHA Executive Council to get students involved early on in their careers. This includes becoming active members of their state associations and informed about local issues that may affect their careers and the wellbeing of individuals who utilize their services.

If you have any feedback on your students’ involvement in the Virtual Advocacy Day, or suggestions for ways in which we can facilitate student involvement, please do not hesitate to contact me at nsslha.region9@gmail.com. I hope you will keep the spirit of this one day alive and write your members of Congress today at ASHA’s Take Action Center, http://takeaction.asha.org/asha2/home/.

Rene Utianski is the Regional 9 Regional Councilor, and immediate past Vice-President, of the NSSLHA Executive Council. She is a doctoral student at the Arizona State University, working in Dr. Julie Liss’ Motor Speech Disorders Lab. Her research focuses on understanding the temporal-spatial cortical activation patterns associated with processing degraded speech.

OSHA Policies on Noise Control and What You Can Do To Help

Sign - Hazardous Noise May Cause Hearing Loss

Photo by dabdiputs

Many of you know by now that the U.S. Department of Labor/Occupational Safety & Health Administration (OSHA) has recently made and then withdrawn an interesting policy change. Back in 1983, just after OSHA had issued the final version of the hearing conservation amendment, the Agency sent out a notice to its inspectors not to enforce the noise standard’s requirements for feasible engineering and administrative controls until workers’ time-weighted average exposure levels exceeded 100 dBA, and even then only if the other elements of the hearing conservation program, specifically hearing protectors, did not adequately protect them. This policy stayed in effect for 27 years although voices from ASHA, NHCA, labor unions, and other organizations protested. The result has been that the use of engineering noise control in this country has virtually disappeared, at least in the workplace. The situation in the general environment isn’t much better because EPA’s Office of Noise Abatement has been closed since 1982.

One of the arguments against the 1983 policy change is that OSHA implemented it without going through the public rule-making process, so its legality has been questioned. Another argument is that this policy is contrary to all other OSHA health and safety regulations, where engineering and administrative controls are the primary methods of hazard reduction. During this period, however, there were some major court cases, the outcome of which required OSHA inspectors to perform cost-benefit assessments if they issued citations for lack of noise control. So while the other industrialized nations have developed quieter products and processes, the American workplace remains noisy. In Europe and Australia noise control technology has greatly outpaced the U.S., as has the protection of workers against noise-induced hearing loss. Some American manufacturers market quiet products in Europe and noisy ones at home. The OSHA noise standard lags behind those of the rest of the world in other respects. Out of some 25 nations, there are only 2 that use the OSHA 90-dBA permissible exposure limit (India and the U.S.) and four that use the 5-dB exchange rate (Brazil, Colombia, Israel, and the US). Most others have adopted a limit of 85 dBA or below and the more protective 3-dBA exchange rate.

In more recent years additional litigation has taken place, going as far as the U.S. Supreme Court, which struck down the necessity of a cost-benefit analysis. Consequently, on October 19th of last year, OSHA published in the Federal Register the intention of changing its current policy by redefining the word “feasible” as it relates to the noise standard as “capable of being done.” The Agency did say that if a noise control remedy threatened an employer’s viability (the capacity to remain in business), it would not be considered feasible. OSHA encouraged the public to comment on the proposed change with a deadline of Dec. 20th 2010, which has since been extended to March 21st 2011.

ASHA, along with NHCA and Council for Accreditation in Occupational Hearing Conservation (CAOHC), signed a coalition letter to Dr. David Michaels, the OSHA Director, supporting the recent policy change and requesting that the Agency continue to make improvements to the existing regulation. We later followed up with detailed reasons for our support, including the facts that workers are continuing to lose their hearing despite alleged compliance with the hearing conservation amendment, they often fail to wear their protectors or use them improperly, hearing protectors can have an adverse effect on communication and the perception of warning signals, and engineering controls can actually be less expensive in many situations because they are one-time rather than annual expenses. Also, there are many options available to OSHA to ease any resulting burdens on employers by giving long compliance times, exempting small businesses, and providing technical assistance.

Within a few weeks of its publication, there was a firestorm of objection from major business associations, such as the U.S. Chamber of Commerce and the National Association of Manufacturers, claiming that the policy change was not needed and that it would have an adverse effect on jobs. These groups maintained that employees were sufficiently protected with hearing protectors and other elements of the hearing conservation program. They conveyed the impression to their members that OSHA would crack down on them immediately (an impossibility), that the policy applied to workers exposed to noise levels over 90 dBA, when in fact it’s TWAs (averages not levels, resulting in far fewer overexposed workers). They also maintained that this was something new rather than something that had been an integral part of the noise standard since 1971!

Also around this time President Obama issued an executive order directing the agencies to reexamine the need for regulations, and certain members of Congress took a negative interest in OSHA’s proposed policy change. As a result, OSHA withdrew its policy on January 19, 2011, stating that this process required “much more public outreach” and that they needed to examine other alternatives. They would, however, review all comments that arrived by March 21st and some time after that hold a stakeholders meeting.

ASHA members should consider submitting comments on these issues to OSHA. Mail three copies to the OSHA Docket Office, Docket no. OSHA 2010-0032, U.S. Dept. Labor, 200 Constitution Ave. NW, Washington DC 20210.

Further information:

Dr. Alice Suter has been active in the field of occupational hearing conservation for 40 years, during which time she worked at the U.S. EPA, OSHA, and NIOSH, and more recently as a consultant.  At OSHA she was a senior scientist and manager of the noise standard.  Although she is a strong proponent of hearing loss prevention programs, she believes that these programs must include measures to control noise at the source for them to be effective.