Episode Transcript
Becca: Hello, and welcome to The Future is Sound, a partnership in hearing podcast brought to you by Oticon Canada. I'm your host, Becca Angel.
Thanks for joining me on my first podcast journey where we will chat broadly about all things hearing. We will launch fun new episodes every month. If you have any suggestions or comments, be sure to get in touch. Let's get started.
Hi, everyone and welcome to another episode of The Future is Sound. I'm your host, Becca Angel. I'm talking to you guys today from Squamish, British Columbia.
My guest today is my good friend, old classmate, and colleague, Melanie Monaghan. She is an educational audiologist based in Eastern Alberta. We actually graduated together from the audiology program at UBC. I guess it feels like many years ago now.
Mel has hearing loss, and she's had hearing loss from a young age. We're going to talk a little bit about her experience and also what she's been up to since graduating from school. Hi, Mel.
Melanie: Hi, how are you?
Becca: I'm good, thanks. Thanks for being a guest on the show.
Melanie: Of course.
Becca: It's been a while since I've seen you, but the last time was probably when I was visiting the area in Alberta and went for Mexican food or something.
Melanie: Yes, we did. There was [...] back then. It was fall.
Becca: Yeah. We're heading back into winter, but I don't get to see you as much anymore on that side.
You're an educational audiologist. Just for anyone listening that has heard that before but isn't super knowledgeable on what you do or what educational audiologists do on the day-to-day, can you fill us in a little bit on what educational audiology is and your role in Alberta?
Melanie: Sure. Educational audiologists definitely vary. It is in the province, country, or wherever. In Alberta, we have more of a consolidation model, so I work very closely with a teacher of the deaf and hard of hearing. I will also sometimes work with other teachers such as a teacher of students who are blind and visually impaired.
A teacher and a student will use complex communication devices, but for the most part, I work with a teacher of the deaf to help support children who have hearing loss in a school setting. Instead of getting plain technology, I will help the teacher use iPhone technology and collaborate with audiology clinics in dispensing an audiologist.
Becca: Typically, you guys are moving around from school to school and you're not really located in one place, is that correct?
Melanie: No. I believe we cover 13 different school districts in Alberta. We have a very large area that we cover.
Becca: How many are on your team? How many educational audiologists are you working with?
Melanie: Just one. Just me.
Becca: I want to say you're stretched thin. Lots on your plate. The kids that you're seeing in the schools and helping with their classroom technology and hearing aids have varying degrees of hearing loss as well.
This is kind of another topic in and of itself, I guess. Kids with profound hearing loss or children in school who are deaf are going to more mainstream schools now. Are you seeing the whole spectrum of different varying degrees of hearing loss for your kids’ caseload?
Melanie: Exactly. We cover preschool to grade 12. Like you said, it varies from [...] hearing losses to profound hearing losses.
Becca: I'm wondering how many kids would you say is on your entire caseload. I'm just curious.
Melanie: We have possibly 120 students on our total caseload.
Becca: Wow, it's a lot.
Melanie: It is growing every year.
Becca: That's a lot of students. I was definitely thinking of a smaller number. I remember you being really interested in this area even when we were in school, so it's really cool to see that you've made that dream happen for yourself.
Melanie: I'm really excited to have the opportunity here, and I feel very lucky because there are really not very many educational audiologists here in Alberta.
Becca: What about teachers for the deaf? I know you work closely with them, but how many teachers for the deaf do you work with? Are they a little more in surplus than educational audiologists?
Melanie: Not necessarily. In my experience, it is usually one teacher of the deaf to one educational audiologist. That's the case for my team as well.
Becca: I know you did a placement here in British Columbia. Do you remember it being quite similar?
Melanie: It was very different because in BC, when I did my placement, there were several teachers of the deaf, and there was one educational audiologist. She would do the more traditional testing. She was sometimes also fit like FM and DM systems. We don't do that in Alberta because clinical audiologists do that.
Becca: I assume lots of troubleshooting and stuff on your end.
Melanie: Definitely. We don't quite often recommend either technology for the classroom. That interferes with peripheral hearing technology.
Becca: Are you seeing that more? Are we getting mainstream classrooms equipped with more of these kinds of sound fields and stuff?
Melanie: Yes. It's a lot of work for us because we have to ask where to spend money, and sometimes, there'll be other systems in the room that are not compatible. It's a learning process for all of us.
Becca: I'm always learning. When I used to come and see you guys in Edmonton or in the area, I just remember, there's just always so many questions around what's compatible with what. It's a lot to keep track of.
Melanie: I know. We don't make it easier for you manufacturers, that's for sure.
Becca: That's okay. I think it's a positive because obviously, technology is changing a lot and things are becoming, in theory, easier to use but not without complications. Bluetooth is a whole can of worms these days. It's like, oh, it's gonna be easier to connect, it's all wireless, and everything, but you're probably not seeing that. It's probably creating more headaches than the opposite.
Melanie: Yes and no. I am very grateful that I don't have to work with the FM systems, but I had [...] because no one wanted to use those.
Becca: That's a good segue. We'll come back to where we see the future of educational audiology going, but I mentioned just in your intro that you weren't born with hearing loss. You've had hearing loss since you were about three years old.
Maybe tell us a little bit about what happened and your experience growing up with hearing loss like that.
Melanie: Sure. I definitely have a bit of a unique history. I was deafened at 2 ½ years old because I had meningitis. The vaccine was not available for children that young at the time, so I received my first implant on the right side about six months later when I was just over three years old. I had three failures on that side.
Becca: Just to interrupt, what year was that? What year did you get your first implant?
Melanie: It was in 1991. It was the same year of the premiums for our pediatrics in [...].
Becca: I was gonna say was it approved? You would have been one of the firsts probably.
Melanie: I was, yeah. The [...] prototypes have improved a lot since then, and I also had other changes when I had meningitis. I had a lot of cochlear ossification, so [...] was not very successful. I received my [...] when I was 16 years old, and because it's a little bit later when I received that one, I didn't hear it as well as when I was a toddler for the first time on the right side.
Becca: It's all coming back to me. From the time that you were implanted at 3 ½, and then it failed 3 times, were you hearing at all? Between 3 ½–16 when you had the left implant, what was that like?
Melanie: That's a very good question. I actually did extremely well with the first implant. I had my first failure when I was 5 years old and the second when I was 10. I heard really well from 3–10 years old with those implants, and then I didn't hear so well from age 10 to age 16 because they were not able to fit the whole implant into my cochlea.
Becca: It's just a portion. I know you have siblings. You have a sister.
Melanie: And a younger brother as well.
Becca: Were you going to regular school then too? I'm thinking about a 10-year-old who's having trouble hearing with normal-hearing siblings in a regular school. That must have been really tough.
Melanie: It was tough. I had a full-time educational assistant—basically a family at the time—when I was doing Kindergarten to Grade 12. They were pretty good signer. It's not that they had an interpretation, but they definitely provided some sign support.
Becca: Deciding at 16 to get implanted, was that a family decision? Did you have a big say in wanting to do that? It probably would have been pretty scary.
Melanie: It was definitely my decision. I can't see myself choosing differently because I did not have a strong deaf identity at the time. As you know, cochlear implants were very controversial in the '90s. I've never had the opportunity to be fluent in ASL and to immerse myself in deaf culture. I always consider myself to be hard of hearing.
I have my friend who had cochlear implants, my family who has normal hearing, and a school friend who was normal hearing, so it's a really easy choice for me.
Becca: I guess you grew up more or less in the hearing world despite having a profound loss and really probably struggling a lot of the time.
Melanie: I have an opportunity here to learn more about the deaf culture and be more fluent in ASL. I can always pursue that now, but it's much harder to learn a language as an adult.
Becca: I know. I remember we had ASL interpreters in our class for you and another classmate. I remember just wishing that I knew ASL. It was something that I don't even really remember knowing much about growing up. It's not something that is really introduced. At least it wasn't introduced to me when I was in school.
I actually had a friend whose mom was deaf when I was in elementary school, and I remember they were signing. That was my only introduction to it at a young age, which is interesting to think about because it is a language. It's almost like unless you're exposed to it a lot, you honestly don't really even know that it exists in a way.
I had a family on the podcast recently. Her daughter is a twin. She's five now. She was maybe not born with hearing loss, but she was diagnosed with hearing loss at age three as well. She can wear traditional hearing aids.
They were curious about not necessarily deaf culture but just curious about other forms of communication if the hearing loss was to get worse and the hearing aids were to break. She wanted to immerse herself in a different culture.
How do we go about learning ASL? I just thought it was really a good idea. I was like, I think you guys should definitely do it. It's a fun thing to do as a family. I feel like we should encourage that.
Melanie: I agree with that. There are way more other options now. There are all kinds of deaf and hard-of-hearing organizations where people can take classes and meet other people who have hearing loss. We didn't have that in the '90s.
Becca: How old were you when you first met your first friend that also had hearing loss?
Melanie: That was when I was first diagnosed just before I was implanted. My parents took me to a camp where there are families who have deaf and hard-of-hearing children. That was where we met my current best friend, Tyler, who also has hearing loss and a cochlear implant.
Becca: I think I've met Tyler once.
Melanie: You did. It was fun.
Becca: Super fun. That's really nice that you had that early on. Some people might say in high school or something.
Melanie: My parents were always really good with encouraging those connections. I actually had several friends who had implants when I was in elementary school, and those friendships just continued.
Melanie: That's nice. It's good that they did that.
Melanie: That's very important. I think it was [...] FM systems. I found that highly embarrassing, and I said, no more FM until I went to grad school at UBC. They showed me the [...], which is much smaller. It's very similar to what Oticon has now. It's much smaller and much more discreet.
I don't want to admit that to my students very often because I want them to use their DM systems, which is the newer version of FM. I definitely understand how embarrassing it is when you're a teenager. You don't want that extra attention to yourself.
Becca: It makes sense. I think that we're trying to take away that stigma, so we want to avoid using words like, oh, like, you're not going to see it, it's going to be super discreet, or no one's going to notice. We want to be able to talk about hearing loss more in the sense that it's actually really common and not something that we need to hide.
Melanie: That's a very good point. I'm seeing that with hearing devices as well because people are much more willing to experiment with colors. We're seeing people who have dark hair. They're wearing red cochlear implant processors which is what I have. When I was in school, I always went for the brown color because I was trying to hide it.
Becca: Do you think social media has had a positive impact on that? I think it does, but what do you think? I just feel like so many videos and advocates for hearing loss can be broadcasted a lot easier on these platforms, and it can be a really good thing for the industry.
Melanie: Definitely. That's something that I didn't have when I was growing up either. Even on popular TV shows like The Bachelor and Love Island UK, there were these two gorgeous girls who had cochlear implants. I was like, wow, if I had seen that in high school, it would make such a big difference.
Becca: It's pretty amazing. As negative social media can be for teens and adolescents, it can also be a really positive thing too when it's used in the right way to advocate for things like that.
I can't really remember from school, but do you think you were a big advocate for yourself growing up, or would you have liked to have been a better advocate and done things differently?
Melanie: I could have definitely been a better advocate. I was pretty shy when I was in school, and I also definitely relied on the adults around me to advocate for me, so that's something that I've tried to work on with my students now because it's just so much easier when you grow up knowing how to do that as opposed to having to learn it when you leave home for the first time.
Becca: What do you think the industry can do or even me as a normal-hearing person who is an audiologist who has immersed themselves in this industry? I'm always wondering how I can be a better advocate too for not just hearing loss but obviously the topic of hearing loss today. What do you think we can do better to advocate for colleagues that have hearing loss?
Melanie: Something that I've definitely come to realize is that even though I do this for a living and I advocate for my students every day, it's incredibly hard to advocate for myself. I would say I still struggle with feeling guilty if I have to ask for something, so probably the biggest thing that people with normal hearing can do is just to listen to us and speak up if they identify a weakness somewhere.
For example, if you're going somewhere and you see that there are no interpreters and there's no captioning, perhaps you could suggest that.
For example, a lot of the Alberta COVID updates did not have live captioning. They had interpreters but not live captioning. I emailed them about it, but it'll make more of a difference if more people also emailed about it.
Becca: It seems so obvious now, but it's not always so obvious at the time. It's just making ourselves more in tune with what should be obvious. I think we've gotten a little better lately. Big thanks to you guys too.
I remember that we had one of our original virtual symposiums and probably didn't have an ASL interpreter. The captioning was probably really bad, didn't work, and failed. I remember that you had gotten in touch with me to say I basically couldn't participate because I couldn't hear and see what was going on.
I think you are a pretty good advocate for yourself. But the Internet makes us do better too because I think we've made big improvements in terms of having ASL interpreters and captioning as a default for a lot of our symposiums now which is not something that used to be the case, which is too bad because it's 2022, but as long as we're always making improvements, I think that's the most important.
Do you think COVID and the pandemic had a real impact on these types of things where you're on these virtual meetings and they don't have accessibility there?
Melanie: Yes. As difficult as the pandemic was or is, we got everyone wearing masks and it's hard to hear. I did feel that it was also a blessing because it really forced a lot of the virtual platforms such as Google Meet, Microsoft Teams, and Zoom to step it up because previously, it was just Google Meet that had captioning and it was not very good, but now it's much better. Other platforms also have that automated captioning.
Becca: The Zoom one is pretty good.
Melanie: It is quite good.
Becca: We touched on this just briefly before. Some of the positive changes that we've seen in a culture that you think is helping is obviously, they're having more people with hearing loss as participants on shows and stuff to increase awareness there, but what else do you think has been a really positive change in the more recent times for kids with hearing loss?
Melanie: In 2020, American Girl released their first doll that has a physical disability. She wears a hearing aid in one ear. I thought that was very cool. I actually had the opportunity to take that doll to a kindergarten classroom, and as soon as I pulled it out, the student with hearing loss just lit up. She was so happy to see this doll that also had a hearing aid. It was beautiful to see. Barbie also just came out with a doll that had hearing aids as well.
Becca: Oh, really? Is that newer? I didn't know about the Barbie one.
Melanie: Yeah. It's called Barbie Fashionistas #187. We've actually been recommending to all of our elementary schools that have students with hearing loss to purchase one because it's only $11. It's so cheap.
Becca: And so easy to implement. I think Lego as well. We had done a couple of little Lego people with hearing aids and glasses. It was so minor, but these big companies like American Girl, Barbie, and Lego just implementing a small change can make a huge difference for some of these kids.
Melanie: I love that. It really promotes self-acceptance, and it also normalizes our disability.
Becca: As we try to wrap up—more or less, I think it's been almost 30 minutes—I was just wondering about tips and things from your perspective on what makes a good audiologist or hearing care professional. In your experience, you've obviously been through a lot with your hearing and probably seen lots and lots of different healthcare professionals. What's your take on some takeaways for being a good clinician?
Melanie: I like that question. I will say probably definitely a sense of empathy, a willingness to listen to a patient's concerns and the family, and being open-minded. We always see in my job that if you've met one person with hearing loss, you met one person with hearing loss. You should never take what applies to one person and generalize it to others.
Becca: It's funny you say that because Olivia Meriano who we had on the podcast on one of the first episodes said the exact same thing about Down syndrome. She's like, if you've met one person with Down syndrome, you've met one person with Down syndrome. It applies across all disabilities. She said the same thing.
Melanie: I love that. It's so true. The last thing I was going to say is just be open-minded because not everybody chooses the same medication modality, or they might not want to wear hearing aids or cochlear implants. They might only want to only wear them sometimes, but I think that's hard for us. I know it's hard for me because I always want to wear it all the time, but wearing it sometimes is better than nothing if they want to wear hearing aids or cochlear implants. I try to be open-minded about that.
Becca: I completely agree. I think we want to fix everything sometimes. Just know that maybe not everything can be fixed 100% all the time, so a little is better than nothing for sure.
I guess my last question would just be about your hopes and dreams for educational audiology. You're obviously very busy, and you have a huge caseload. I'm sure that applies across provinces. I don't think you are alone in feeling that way and how busy you are. In a perfect world, what improvements would you make and how can you see it improving in the future?
Melanie: There's not a whole lot of [...] for these services, and I would love to consistently apply it if there was more funding for it, not only in Alberta but all provinces because it's kind of a niche.
Actually, I shouldn't say that, but it's called a lower-incidence disability for a reason. There are not very many students who require our services in the whole picture. That's how schools see it and that's how the government sees it, so it would just be nice if there was more funding for services and if there was an educational audiologist and a teacher of the deaf to work with the students. Sometimes, there's only one or the other, and they can fall through the gaps.
Becca: Pertinent timing considering what's happening in Ontario right now to be recording this just with all the educational assistance and stuff walking off the job. It's sad that there's not more support from the government across each province. Even though it's happening in Ontario very much, it could happen here or in Alberta too.
Melanie: I think it's easy to see how much it costs in the short term, but if you only look at that, you're also ignoring the long-term benefits because people who are deaf and hard of hearing have one of the highest rates of unemployment. We can change that by providing these services when they are in school.
Becca: A hundred percent. It's like anything about preventive measures. Anything you do after the fact always costs more money. Look at the pandemic. We were so unprepared for that.
I listened to a podcast recently. I forget the term now but just a leader who's in a preparedness mindset versus a reactive one. I think it applies to this too. The more we can do for kids at a younger age to help them prepare for the future, advocate for themselves, and all of that in the long term is a better investment.
Any last thoughts on your behalf?
Melanie: I guess I could say that going back to advocating for people who have hearing loss, I think it'd be good if we could ever give more patience. Not a lot of people realize this, but it's even more offending for ASL interpretation because a lot of people who are normal hearing assume that people who are deaf and hard of hearing all know ASL, and that's actually not the case. Most of us are not trained in ASL. A lot of us require accommodations like hearing loop systems. Those things are unfortunately not always funded, I think partly because of that lack of awareness of the various needs of people who are deaf and hard of hearing.
Becca: It makes sense. I didn't know that. That's a tangible thing we can take away.
Thank you again for coming on.
Melanie: Thanks for having me. That was really fun.
Becca: Hopefully, we'll see you soon.
Melanie: Sounds good. You too.
Becca: Thanks for listening. Don't forget to like, subscribe, or leave us a review. You can also register for our partnership in hearing community website using the link in the description below.
