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Audiology Foundation of America – Mission Accomplished! Veronica H. Heide, Au.D.

“Never doubt that a small, group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."  - Margaret Mead

While many articles have been written about the transformation of our profession to a single degree designator, Au.D., my perspective as a former board member of the Audiology Foundation of America (AFA) and the Academy of Doctors of Audiology (ADA) is personal. It is personal because this was a change that started from the ground up – not from the top down. Many ADA members have spent the past twenty years embracing the mission of transitioning our profession to the Au.D. by tirelessly and financially supporting the work of the AFA. Many ADA members were early and enthusiastic supporters of the Au.D and served as AFA torchbearers, state leaders, and board members of various supportive state and national organizations. The ADA was the first professional organization to limit new membership to those who held this new degree. Out of this phenomenal focus of the energies of many we became one profession united under one degree, the Au.D. It is in tribute to all of these individuals that I dedicate this article – one among so many.

Who are we? TIMELINE: Prior to the Au.D., audiologists practiced with various degree designators including: M.Ed., M.S., M.A., M. Art., M.A.T., M.C.D., Ph.D., Ed.D., Sc.D., D.Art. and others. We were suffering from an identity crisis. Audiologists educated in Speech and Hearing programs were led to believe that it was, “publish or perish,” and that unless you became a research Ph.D., you were just going to “get a job” working for another professional such as an ENT doing “clinical audiology.” In addition, because there was no common degree among these programs graduating audiologists, the national membership organization, ASHA, deemed it necessary to create a post graduate Clinical Fellowship Year for new graduates to obtain clinical experience under the tutelage of another audiologist. Many of those who worked during those years know that if you didn’t have your CCC-A, you couldn’t get a decently paying job and many worked for less than the local truck-stop waitress during their CFY year to earn their CCCs.

Dr. Nancy Green writes, “The landscape of audiology was desolate before the Au.D., as evidenced by the fact that 50% of the profession had deserted it every ten years since the 1960s. The gene pool was confined to “speechandhearing” majors. The CFY “training completion” model kept salaries artificially low. The ENT/employee model saw audiologists treated as technicians, and it prevented them from discovering their true value in the marketplace as well. It still does, to some extent, but the Au.D. is changing that, too, by raising student expectations. Both students and young practitioners now have a future in a health care universe in which THEY have the power to control their own destinies. Their Au.D. training has taught these young practitioners to look “in” themselves for what is right, rather than meekly looking “up” to AAA or ASHA, hoping to be told what to do.”

TIMELINE: Why rock the boat? Why change: ASHA’s Code of Ethics in the early 1970’s forbid audiologists from dispensing hearing aids or even affiliating with any commercial enterprise. I recall that as a financially struggling graduate student looking to find a part-time job even vaguely related to the profession, I had to had to have the Chairman of the Department co-sign a letter of intent and send it to ASHA for approval before I could start a part-time clerical job in the office of a local hearing aid dealer (the one that the Speech and Hearing Clinic at the University sent all their patients to see to purchase their hearing aids). I had to take a job to earn some money because it took an extra semester to complete a Master’s Thesis (v.s. taking comprehensive exam) and I was told that if I ever wanted to be considered as a doctoral candidate, I would HAVE to complete a Master’s thesis.

Audiologists were unhappy with the aural habilitation process that consumers had to endure to obtain a linear amplifier with a tone and output control in the available hearing aids. Audiologists were educated in academia, and were told that they were scientists, not salesmen. They were trained in hearing aid selection methods developed during WWII by Carhart. This selection process included testing in a sound booth of aided and speech threshold and word recognition in quiet and (if time allowed) in noise. The winning hearing aid was then recommended for purchase and the client would take the recommendation to the local hearing aid dealer (preferred name at the time) for purchase. The client would come and go back and forth several times between the audiologist and dealer until the audiologist determined that the measurements in the sound booth showed that the client was meeting their fitting criteria. The client had little input in this process, and was caught in the middle between the audiologist, and hearing aid dealer and kept telling both professions that testing in a sound booth had little to do with real world success with amplification.

Charlie Stone recalls: From the day I graduated with my M.S. and started my first job I knew that Audiology could be so much more than being a button pushing pure tone-et. We provided services that would never be provided by MD's or Speech Pathologists and we served a population that needed us to guide them through the challenges of hearing loss and the emotional and personal struggles that accompanied it. I knew that we were the only professional that had the education and training to best serve these individual but we lacked the professional recognition to claim this territory as our own. We were the neglected step sister of the communication disorders family and were badly out numbered and therefore shuffled off to the side.

I became disenfranchised and disillusioned and dejected and was convinced that I needed to change professions. While teaching at the University of North Dakota I was able to take 6 credit hours per semester at no charge so I completed my pre-Dentistry, and pre-Optometry undergraduate courses over the next 3 years and actually applied for acceptance at the School of Optometry at Pacific University in Forest Grove Oregon. Luckily I was offered an educational Audiology position at a hearing aid company and decided to give it one more chance. It was about the same time that ADA broke ranks with ASHA and started dispensing. I attended one of the first meetings as a representative of this manufacturer and say a new and energized group of audiologist that saw the profession the same way I did or at least a closer resemblance of what I envisioned it to be.

Than a few short years later I had entered the private practice venue with a highly regarded dispenser who saw the future of dispensing would be in the hands of audiologist if they played their cards right.  With his encouragement and mentoring I developed many of the business skills I lacked in my academic training and I was off and running.  Although the mainstream Audiology community did not concur with my career path it felt right and I was in control of my patients and my recommendations for their care.  

My support group with the ADA where like minded individuals would meet and share their ideas and successes in practice with anyone who would listen and most of us were all ears.  It was this group who saw Audiology as a totally separate and autonomous profession that conceived the notion to elevate our profession to a new level with additional educational requirements and a more independent nature.  This was just what I wanted to hear so I got involved in this grass roots movement with visionaries the likes of Leo Doerfler and David Goldstein. In order to accomplish the impossible ADA formed a foundation (AFA) to move the profession toward the professional Doctorate Degree as its point of entry degree.  The rest is history but I truly believe I would not live long enough to see this reality.  It goes to show that if enough people truly believe in something that will be for the betterment of the patients we serve as well as the profession as a whole there is no obstacle big enough to stop it from happening.  

TIMELINE: March 1976 - “The Professional Doctorate in Speech Pathology and Audiology: A Discussion of the Issues” Chicago conference organized by Douglass Noll and David Goldstein

David Goldstein recalls, “The idea for the formation of the AFA came to me from a presentation by Don Peterson, Ph.D., dean of the Graduate School of applied and Professional Psychology at Rutgers University who had started the first PsyD program at the University of Illinois. He discussed how the practicing psychologists formed a council to improve education by developing a professional doctorate to be offered at the state-funded university campus in Newark, NJ. When Rutgers found out about these efforts, they changed their mind about the professional doctorate (previously against it) and decided to offer the degree first. It was the bottom-up movement led by a practitioner’s organization that changed the profession of psychology, and that became embedded in my thinking about the Au.D.”

TIMELINE: Out of frustration over the lack of control over the outcome for their patients, many audiologists either continued in their jobs, left the profession altogether (50% left the profession after ten years), or started their own practices that included the dispensing of hearing aids. At the time, dispensing hearing aids for profit was deemed a violation of the ASHA code of ethics. Pressure from the audiology practitioners and like minded academics who were involved in the Legislative Council of ASHA resulted in an uproar documented in all the professional journals of the era. From 1973-1976 proposals were brought to AHSA’s Legislative Council to provide an ethical path for audiologists to dispense hearing aids. In 1978, ASHA wrote a series of rules by which audiologists could ethically sell hearing aids. In the ASHA rules, the audiologists would bill for their professional services and sell the hearing aids at cost through a remote clearing house.

The Tipping Point or How the U.S. Supreme Court Ruling Changed Audiology: On April 25, 1978 the U.S. Supreme Court ruled on an anti-trust suit against the National Society of Professional Engineers, “…alleging that petitioner's canon of ethics prohibiting its members from submitting competitive bids for engineering services suppressed competition in violation of § 1 of the Sherman Act.” ASHA was immediately notified that its rules about hearing aid dispensing by its members were now illegal. This single action had a profound effect on our profession. Now, like-minded audiologists could ethically and legally gather to discuss the process of hearing aid selection and fitting. Out of this need, came the formation of the Academy of Dispensing Audiologists, with founding president, Leo Doerfler, in 1977. The early years saw the growth and involvement of 50 to 200 dedicated audiologists interested in changing the scope of practice of the profession. Over the next ten years, this organization of audiologists who were largely practice owners took deliberate small steps that would ultimately change the profession.

Everything goes through 3 stages. First it is ridiculed; second it is violently opposed and finally accepted as self evident. - Arthur Schopenhouse.

ADA Conference on Professional Education (CPE) – October 7-8, 1988-Chicago IL The significance of this conference was that it was organized by practitioners, not academics. The purpose was not to explore options to improve the quality of the audiology training programs. With the changes in scope of practice and the type of practice that many were pursuing, many audiologists were frustrated with the lack of change in the academic environment. Audiology students were still being trained in two-year Masters programs to look for jobs, not to practice a profession. The consensus of those who attended this conference (list Conference Attendees and Glenn Tecker as facilitator in a sidebar) was that audiology had to become a doctoring profession under a unifying degree designator (see details – proceedings – on AFA’s website – still up). The need for an organization to help nurture this idea was apparent.

Darrell Micken recalls, “I remember having lunch with David G. in Tucson one time while we were both on the ASHA Legislative Council and discussing the need for the clinical doctorate in audiology. I watched roots beginning in ADA and remember the attempts by "forces" to stop and then steal the process for their own. (Thanks to Darrell for the two quotes - Schopenhouse and Ghandi

There are 2 kinds of people. Those who do the work, and those who take the credit. Try to be in the first group, for there is less competition there.– Mohandas Gandhi

TIMELINE -April 1989: Out of the ADA sponsored CPE, came the formation of the Audiology Foundation of America. The AFA was governed by a Board of Directors who gave generously of their own monies to work on its behalf. All of the Board members paid their own expenses to attend the quarterly three-day intense meetings in Chicago.

David Goldstein writes, “ I was founding chair of the AFA board and George Osborne, DDS, Ph.D. was Vice-Chair…We decided to invite only doctoral level audiologists to be on the founding board of the AFA (because) we felt that having directors with doctorates would blunt some of the expected opposition (to a professional doctorate).”   These recognized leaders of the profession came from all walks of professional life.   While the founding Board members (see sidebar) were all Ph.D. audiologists, many were involved in their own practices (see Appendix listing all the AFA Board members – terms served – many were ADA members and ADA Board members).  How were a small group of dedicated individuals going to transition an entire profession to a single degree designator?  

Torchbearers: Organized under David Goldstein at AFA, audiologists from around the country were recruited to become torchbearers in their states. They gave presentations about the Au.D. at state meetings, contacted regulatory officials in their states about the new degree, helped educate other audiologists and universities about how they could prepare and transition to this new degree that represented the profession under one title, Au.D. We needed not only to transition new professionals to the Au.D., but a path for existing practitioners to transition to the Au.D.

Susan Paarlberg was hired in August 1994 as executive directory of the AFA. She recalls, “I had seen an ad in the local paper for an administrative director for the AFA. Through a mutual friend I was introduced to David Goldstein and we talked in general terms. I was teaching management classes part-time at Purdue at the time and thought, that this additional part-time position might be interesting. After listening to David describe what he wanted to accomplish, I said, “You don’t need an assistant, you need an executive director to run things.” As many of you know, David can be very persuasive and he enlisted not only me, but recruited then Purdue Ph.D. student, Nancy Gilliom to work part time at the AFA office. We had additional help for a year from Maureen Davisson (She and her husband went on to work for Newt Gingrich) and the three of us shared two desks.” Susan state, “I believe that I brought a business perspective to the AFA. There was so much passion in the people that were on the Board. I helped remove some of the emotion from the discussions and helped keep us focused on the mission of the AFA: What are the obstacles? How can we direct ourselves to the goal?” She continues, “I also feel that there was clarity of leadership. Each chair was great that way. They kept all our eyes on the goal.”

We were fortunate to have had Susan’s direction and continuity of leadership for the entire life of the organization. No other audiology organization has had the privilege of this continuity of leadership.

TIMELINE: In February 1995 in Atlanta, 200 audiologists met in Atlanta for the Au.D. Standards and Equivalency Conference organized by AFA and co-sponsored by ADA and AAA. Many ADA members were present and participated, and voiced their opinions on various obstacles facing the profession’s transition to the Au.D. Audiologists representing all facets of the profession participated.

Mike Thelen recalls, “I did fly to Atlanta in February of 1995 with a sense of optimism, hope and pride in my profession. It had been almost 6 full years since the Au.D. movement was officially and joyously launched at ADA in May of 1989. It was at that ADA that I became a "torchbearer" in body and spirit. I still possessed the excitement and the electricity that I felt at that very special ADA convention. The S&E conference was impressive, in the attendees and organizational representation assembled. The meeting was facilitated by Glenn Tecker whose took those present through a clear, concise, process that distilled "consensus" from a group that prior to the conference, I felt would be as successful as herding cats. I came away charged up. I was ready for the battles that inevitably lay ahead.”

Out of this conference came one proposal for practitioners to complete their Au.D through Earned Entitlement. This would allow a critical mass of existing practitioners to make the transition quickly and had been successfully employed in other professions such as physicians, lawyers, and dentists in the past.

Mike Thelen recalls, “When I presented the results of the S&E conference to the audiologists of Wisconsin, I expected verbal discussion. However, the hostilities took a physical turn from a now retired PhD who poked her finger in my chest and told me that I was not much more than a trouble making malcontent and that this "stupid" idea would never go anywhere especially, earned entitlement. My heels were dug in and she simply had unwittingly steeled my resolve.”

It was also at this meeting that the Joint Audiology Commission was formed to establish a new accrediting program for Au.D. training programs. ASHA and AAA insisted that the Au.D. had to be earned at a university program – but no program existed. In order to have a new degree that current practitioners could transition to, we needed to have a curriculum and an existing Au.D. residential program to which audiologists could meet an equivalent degree. A generous donation from a practicing audiologist provided the initial endowment to Baylor to start the first Au.D. program.

David Goldstein: For me personally, establishing a mechanism whereby existing experienced practitioners could become Doctors of Audiology without abandoning their practices was the right thing to do. For 40 or 50 yrs. professors in the academic community had been blocking it. Leo Doerfler (professor and past president of ASHA) and other founding AFA board members were insiders who elected to become outsiders. These individuals elected to step out of their professorial comfort zones to move the profession forward. This caused an outrage in the academic communities, “Au.D. as a professor?”

Sharon Lessner recalls, “ I still remember having breakfast with David Goldstein at the 1988 ASHA convention in Boston. During that meal he explained what had occurred at the ADA sponsored 1988 Chicago conference. When he described the Au.D., I immediately knew that the degree was what audiology needed and that this was a model that I wanted to institute at The University of Akron. David came to talk to our faculty in February of 1989. He spoke to the entire faculty and it happened to be on a Saturday. Getting everyone to come to a meeting on a Saturday was truly amazing and it was the start of many similar meetings for David as he and other AFA members spanned out to spread the word about the Au.D. By April 1989 we had the first proposal for an Au.D. program written and ready to be submitted.

Judith Horning writes, “Having been a torchbearer since 1988, I’m so proud of what AFA and our profession have accomplished. I was honored to be invited to the Board of Directors in 2007 and then to serve until the final dissolution. It’s hard to imagine that over half of the country’s audiologists who now hold the clinical doctorate in audiology would have done so without the AFA’s support, encouragement, foresight, and, of course, the EPAC.

ASHA Lawsuit – Tides turn Attorney and former AFA Board member Bob Gippen wrote, “The favorable settlement of litigation between ASHA and the Audiology Foundation of America (AFA) in the late 1990s allowed the Au.D. to gain a firm foothold as the profession's entry level common degree designator, from which it has made its substantial growth to date. While the parties fought in court over the Au.D. credential, two regionally-accredited Au.D. degree distance learning programs were established to fully accommodate existing practitioners. The settlement of the litigation in 1999 prevented any challenge to those programs and included ASHA's explicit recognition of the objectives of the Au.D. movement.” As part of the negotiations, ASHA agreed to reaffirm its continuing support for the transition of audiology to a doctoral level profession. It also agreed to support the Au.D. degree when conferred by a regionally accredited institution, as well as the use of distance learning mechanisms and the granting of reasonable academic credit for demonstrated competencies by Au.D. programs. ASHA agreed to support the use of the degree and titles Au.D., Doctor of Audiology, Dr., and Doctor by those who obtained degrees from regionally accredited institutions, and expressed its appreciation to those working toward the establishment of Au.D. programs.” Note to Nancy: I feel that Bob Gippin’s complete work should be in a separate appendix. It is such an important ruling and victory by AFA. Young audiologists today think the Au.D. was the brainchild of ASHA or AAA! This is one of the only documents discussing what really happened and it is buried on the AFA website (who knows how long it will be up and running). I think it needs to be published somewhere or moved to the ADA website.

Thus while many young Au.D. students are being taught that ASHA supports the Au.D., it was only as a result of this lawsuit that they were forced to support the Au.D.degree transition. This also resulted in competition between academic programs to switch to an Au.D. program and not to be the last program to change.

Nancy Green notes, “Academicians, AAA, and ASHA would have you believe that it was they who made the Au.D. possible, and now that it’s a reality, they seem to be scrambling to take the credit for the transformation of the profession, but make no mistake. All of these groups had to be dragged, kicking and screaming, to the Au.D. by the AFA, and none of them would have made any progress toward that goal without the constant cattle-prodding efforts of the AFA, and the ubiquitous support of the ADA.

Former AFA director, Tom Morris recalls: I'll never forget the phone call I received early in 1998. It was from AFA director Darrel Micken, and he invited me to join the AFA board - what an honor!! I attended my first meeting in Chicago in May of that year. Over the next few years, It was a great pleasure associating and working with AFA directors and staff, and we made tremendous progress during those years. I'm fascinated by the way a dedicated and focused group of individuals persevered towards a goal, with the understanding that continual reassessment and changing of tactics is a necessity when taking on such a task as the evolution of an ENTIRE PROFESSION.

One major tactical adjustment occurred when, following ASHA's suit against us regarding EE, we abandoned the promotion of the AuD credential and proceeded wholeheartedly toward the distance education concept for current practitioners. And talk about success…We now have not one, but two independent (non-speech and hearing) schools of audiology which are associated with very prestigious, long established, private universities, and each has a residential four-year program for new students as well!

TIMELINE: – ASHS launched its distance program (transitional Au.D. program or T.AU.D.) in 2000 with a class of 33 students. ASHS first class of residential Au.D. students arrived in 2002. August 2000 ASHS holds first Au.D. Graduation ceremony. May 2001: SPRUCE GREEN chosen as our new professional color for Au.D. HOODS (Last green color available for a doctoring profession). University of Florida, Nova Southeastern, Central Michigan – MAKE SURE WE MENTION ALL THE PROGRAMS

George Osborne wrote a note to the first graduating class of PCO – School of Audiology George Osborne, PhD 3/20/2001 11:02:36 AM To the First Graduating Class: Cathleen A. Alex, Au.D., Veronica H. Heide, Au.D., Kay D. Krebs, Au.D., John C. Miles, Au.D., Valerie F. Parrott, Au.D., and David Chin, Au.D.

I am so very proud of each of you for the statement you have made for your profession and the professional model that the PCO School of Audiology represents. Your spirit of cooperation throughout the startup and development of this very new distance education experience has been the inspiration for our instructors and staff. Thank you! Graduation will be a busy time. It is the busiest week-end of the entire year for Philadelphia as several institutions hold their ceremonies that week. You are forging new ground - not only as graduates of a unique distance education program but as Au.D. graduates from an institution that has only offered vision related programs for nearly 90 years. Protocol at PCO is being challenged and changed. The foundation for the first "first professional degree" in audiology is being established. You will be the first graduates in the country to wear the "Spruce Green" hoods that will represent Doctors of Audiology.

The AFA propelled its torchbearers and directors into action sending them to state and national meetings to explain the Au.D. transition and its importance to audiologists. The EPAC was put into place as a method of giving practitioners credit for knowledge earned over the course of their professional careers so that they would know what coursework was needed to earn their Au.D. Model licensure laws were drafted and proposed. A new national exam for audiologists who had completed their Au.D. degrees was written and proposed for acceptance to AAA. The ACAE was funded and supported by ADA and AFA. Mary Wilson brought on in 2001 to help with accreditation and to develop a patient satisfaction program. Becky White came on about this same time and worked for AFA for 9 years. Tracy Harding came on to help with writing articles and press releases to spread the word and coordinate information.

Ken Lowder, third Chairperson of AFA and one of the first graduates of the Un University of Florida distance Au.D. program (and first Au.D. to hold the position) writes, “During my term as Chair, the Au.D. progressed from a slight possibility to a fait accompli. This was most emphatically not an accident, but the result of the dedicated work and financial support of many audiologists both within the AFA and by our supporters in the profession. I might add that without the additional significant support that we had from industry, I believe that our effort would have fallen short.

Despite the monumental change to audiology that the Au.D. has fostered, there remains more to be done in order to cement the change in stone. First, the profession needs to upgrade and modernize state licensure laws to more accurately reflect the profession as it exists today. Our state licensure laws were written many years ago when audiologists were the step-children of SLP's. Enacting necessary changes will likely be a long-term endeavor. Next, the profession's attempt at independent accreditation has to date been less than successful. All but two of our training programs still exist within liberal arts graduate programs, not professional schools. Going forward, our agenda as a profession is clear. But I see no real attempt by our professional organizations to work for change.

Throughout it all the ADA supported the AFA fundraising at its annual meetings by providing time in the schedule for the annual golf outing and the annual art auction. On one such occasion the professional auctioneer was in an auto accident and unable to be our auctioneer. Deborah Price (one of the first graduates from the ASHS distance program) stepped up to the podium and did such a fabulous job that she became our annual auctioneer as well as the last Chairperson of the AFA.

“Future students may never know what battles were fought on their behalf in the twenty-two year war over the Au.D., especially now that the AFA has declared victory for the profession and sheathed its swords,” Nancy Green writes. That’s OK, because those battle-hardened but weary warriors who served in the trenches for such a long time deserve some respite. They didn’t join the Au.D. Army for money, titles or awards. They fought because the profession needed the Au.D., and because there wasn’t any other organization with guts enough to fight for it. The AFA had a secret weapon…the will of the people. It was the grass roots support of the AFA from practitioners that ensured that the Au.D. would become THE degree for the profession. Thanks to the AFA and the ADA, audiology practitioners now control the profession of audiology, not the membership organizations, and that’s as it should be…destiny…fulfilled.

Who will pick up the sword? Who will hold the academic community accountable to the practitioners? Who will carry the torch for the next generation?

"No pessimist ever discovered the secrets of the stars or sailed to unchartered land, or opened a new doorway to the human spirit." Helen Keller

Bibliography:

AFA Position Paper, The American Academy of Audiology and the Professional Doctorate (Au.D.), July/August 1991.

Celebrating the Au.D.: A Profession Transformed 1988-2008, The Hearing Journal Supplement, October 2008 Vol. 61.

Caccavo, Mary T. Au.D. Update: October 1998, Academy of Dispensing Audiologists.

Caccavo, Mary T. et.al., The need to establish a Doctor of Audiology (Au.D.) Degree, Compiled by the Indiana Speech-Language-Hearing Association ad hoc Au.D. Committee. 1991.

Cunningham, David R. and Windmill, I., The Au.D. Degree: Clinical Instructors Wanted, Audiology Today, July/August 1991, 18-20.

Curran, James R., The Au.D. and Hearing Aid Dispensing, Au.D. Brief; Audiology Foundation of America, August 1991.

Englemann, Larry, Transition to a Doctoring Profession: A Common Sense Approach, Feedback, Vol. 5, No. 3, 1994.

Feldman, Alan S., The Au.D. Degree: University Perspective, Feedback Winter 1991, 27-31.

Flexer, Carol, The impact of the Au.D. on Audiologists who are employed in school settings. Au.D. Brief; Audiology Foundation of America, February 1991.

Goldstein, David P., The Doctor of Audiology Degree (Au.D.) and Professional Education, Au.D. Brief, AFA, Novemeber 1990.

Goldstein, David P. Au.D. Degree: The Doctoring Degree in Audiology , ASHA, April 1989, p. 33-35.

Harford, Earl R., Professional Education in Audiology; Audiology: Practice Management, Hosford-Dunn, Roeser, and Valente Ed. p. 17-34.

Humes, Larry E. and Diefendorf, Allan O., Chaos or Order? Some Thoughs on the transition to a professional doctorate in audiology, AJA, 1993, p. 9-15.

Lowder, Kenneth L. Audiology Student Licensure, Audiology Foundation of America Position Paper, August 2003/revised May 2006.

Lowder, Kenneth L. NAFDA Membership Policy, AFA Position Paper; June 2000. Paarlberg, S. et.al., The AuD: It’s a key to independence, The Hearing Journal, January 2003, Vol. 56, p. 28-32.

Proceedings: Academy of Dispensing Audiologists Conference on Professional Education, October 7-9, Westin Hotel O’Hare, Chicago, IL 1988.

Proceedings of the Au.D. Standards and Equivalency Conference, February 24-26, 1995 Atlanta GA. Smith, Kenneth E., Au.D. Update, Academy of Dispensing Audiologists, 1996.

Windmill, Ian M. The Transition of Audiology to a Doctoral Level Profesion: Implications for University and Faculty and Programs, Audiology Today, Vol. 5, #4, 1993.