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Welcome back to another Hearing Matters podcast. This is an episode that our team has been looking forward to for a few weeks now. On this episode, we are going to talk all things pediatric audiology. And who better than the Dr. Kelsey Kerkhove joining us on the Hearing Matters podcast. She is a pediatric audiologist. Dr. Kerkhove, welcome to the Hearing Matters podcast.
Dr. Kelsey Kerkhove: Thank you for having me.
Blaise Delfino: So you have created quite the following on social media, using that medium to raise awareness of the importance of audiology, number one, but really what you love, pediatric audiology. So Dr. Kerkhove, what inspired you to become an audiologist? Because all too often, no audiologist really just wakes up one day and says, "I want to go treat hearing loss."
Dr. Kelsey Kerkhove: Yeah, you're absolutely right about that. It certainly wasn't my dream as a five year old little girl when someone asks you what you want to be when you grow up. And in fact, I really didn't know what an audiologist was until the beginning of college. I went to Purdue University and I started off as an undecided major. I felt a lot of pressure at 18 to decide what you want to do with the rest of your life.
And my sister, who is two years older than me, had a friend studying communication science disorders. I knew I wanted to work with people. I'm a natural extrovert and I get my energy from being around other people, so I knew that was the number one thing. And she said, "Hey, this major is about communication." I like science, math and people. And she said, "Why don't you check it out?"
So I took the intro class, I fell in love with communication science disorders. And then throughout undergrad as we got more and more exposure to speech pathology and audiology, because those are really the two directions you would go with that major. I'm a very solution oriented person so I like the side of audiology that there's a diagnosis and then you can help introduce families to a plan to help give them confidence to know that this isn't the ending point, this is a starting point.
And I fell in love with connection and connecting with people. I had someone ask, "Oh, why ears? Because it's a very niche field," and I'm like, "Well, while I appreciate our ears, what I really love about audiology and what I love about hearing is that our ears are really the gateway to connecting with people." And to me, that's the most important thing in life. If I couldn't do that and have the people around me, I'd be missing out on the thing I love the most. So that's what I really love about audiology is that our hearing allows us to connect with one another.
Blaise Delfino: Kelsey, it's really interesting you bring that up. In a recent conversation with a colleague of mine just this week, we talked about, of course, the difference between audiology, speech language pathology. And I actually went to school so I have my master's in speech language pathology, and I have my hearing instrument specialist license.
But my father's an audiologist. So growing up around hearing healthcare, it's like every dinner table discussion was about ears. And it's interesting that you bring that up with solution oriented. While both fields are so incredibly important, oftentimes, and what's very cool about speech path is that if you're working with a patient maybe who needs assistance with articulation, that can take some time.
Whereas with hearing loss, we know that you present with a hearing loss. These are your treatment options. And you often see some progress typically right away. Of course, you have that acclimation period, but the kiddos you're working with acclimate pretty quick. When we talk about audiology and the ear being the gateway to overall communication, well, the field is quite vast. So what inspired you to really specialize and focus on pediatric audiology?
Dr. Kelsey Kerkhove: Yeah. I loved the idea of working with families. So while I love kids specifically, I also love working with their parents, and I love connecting with them and giving them kind of the guidance in what can be a very scary time. We were talking earlier about identification of hearing loss starts at birth. It starts before you leave the hospital in some cases, in a lot of cases.
And to be able to guide parents through what can be an incredibly scary, lonely, overwhelming journey is the most rewarding process to me to give them that hope, encouragement, and an action plan. Because it is this overwhelming feeling of, "I don't know what this means. What do I do? I don't know any other child with hearing loss." So to be able to work with children and families as a whole has been the most rewarding aspect of my career so far.
Blaise Delfino: When you share with these parents that a child has a hearing loss, I mean, emotions are absolutely running high at this point. How, and to our fellow audiologists and pediatric audiologists, even students, Dr. Kerkhove tune into this podcast, we talk a lot about empathy, and what that is. It's the ability to see through another individual's eyes.
So when you're telling a parent, "Mr. And Mr. Smith, your child presents with hearing loss." Emotions of course are running high. How do you as a pediatric audiologist share this news? I'm sure when you first started, it was a little more nerve-wracking than now because you have a lot of experience now. But how do you kind of share this news and how important is empathy?
Dr. Kelsey Kerkhove: Oh, empathy is everything. And it's hard to answer your question because it's different every single time. And that's what I think is really important about sharing news like that, is kind of meeting the family where they are in that moment. So I can't say this is exactly how I do it because it really depends on the situation. I think sharing the information that you have, clearly.
It's important not to inundate them with so much language and overwhelm them with audiology jargon. I think it's important to clearly share the information that you're finding and then take a pause, give them a moment, read the room, read the parent. And if you can see the emotions setting in, it's okay to say... If they're with a spouse or a support person, sometimes they need a minute. It's okay to say, "Here's a box of tissues. I'm going to step outside and I'll come back in a few minutes," if that's what they need.
Sometimes I'll say, "I can answer as many questions as you want," but it depends on if they're ready for that information right away. Oftentimes, I'll give them my phone number and say, "Why don't you call me tomorrow? Why don't you call me tonight? You can email me any point in time. Text me, call me. I'm here for you at any point if you need a moment to soak this in."
When you're diagnosing an infant with hearing loss, it's a two hour appointment. This parent has just taken off time from work or left their other child at home with a babysitter to bring their newborn to an appointment, struggled for two hours to get their newborn to sleep and eat in an unfamiliar environment. It's really not the most optimal place to hear news like that.
So already kind of tensions are high. So I think it's just really important to empathize with that parent and see what they need in the moment. If they need more information, I will sit with them as long as I can to answer. Some parents want to know everything, which is amazing, and I will answer as many questions that as I can. Some parents need a moment to let things set in, and then we can connect later on. So it's really dependent on the situation and on the family itself.
Blaise Delfino: Well, thank you for all that you've done and continue to do for the field of pediatric audiology. Having treated adults with hearing loss and some experience working with children who present with hearing loss, those are often the most fun patients to work with because the children's mindset is often they look at the technology like, "This is my superpower," and that paradigm shift of looking at this in a positive light.
And of course, with the adult population, they have an inkling of, "Yeah, I probably present with hearing loss," while working with infants and children who present with hearing loss, they don't really have that comparative data. Maybe some, maybe if you're 10 or 11, you do. But you are specialized in this area that really focuses on that objective testing, reading the data, then implementing that empathy. So it's really a balancing act.
Dr. Kelsey Kerkhove: It's an art and a science, I would say.
Blaise Delfino: Absolutely. So parents, of course, will need time to grieve and love the fact that you create this access to you as the audiologist, because at that point in time, they're really needing to digest this news. What steps do you take to ensure that these parents really have the tools that they need to help their child throughout this new hearing journey?
Dr. Kelsey Kerkhove: Yeah. And again, those tools are unique to every situation. I had initially said audiology, I enjoy audiology because I'm a solution oriented person. I don't think that hearing loss is a problem. I think undiagnosed hearing loss is a problem. So without that that information, you're not able to equip families with the tools that they may need to connect and communicate with their child.
So when it comes to hearing loss, the tools will vary. If parents choose American Sign Language as their route of communication for their child, that's a perfectly beautiful choice. And now it's about connecting them with support groups, with schools, with classes, so that child can be inundated with sign language the same way they would be with spoken language.
If a family chooses to pursue spoken language for their child, whether it's hearing aids or cochlear implants, it's same thing, equipping them with the tools that they need to be successful. And it's hard because when you have an infant, parents will say, "I think about what will their wedding day look like?"
They have all these moments that flash before them when their child is diagnosed with hearing loss of, "Well, will they ever get married? Will they ever play sports?" You can't help as humans wonder about the unknown. And I think as an audiologist, our job is not just to diagnose and share information, it's really to give parents the tools and the steps that they need to take one day at a time to get to that future foresight, to know that their child is going to be so happy, so successful, and they really can do anything.
And understanding that, I know it can be hard to see that right now, and there's a lot going on, but let me just help you today. What can we do today to get you one step closer to tomorrow to that future self that they're thinking of. So I think it's helping them with one step at a time without the overwhelm as well.
Blaise Delfino: Oftentimes, the patients you are working with, they're essentially going through a development of speech and language. And if these patients and these kiddos are unable to monitor their own speech or hear the speech of others, their parents, then over time their speech and language could be adversely affected. How important, through your experience, has the team approach been between you and the speech language pathologists?
Dr. Kelsey Kerkhove: I think it's incredibly important, and that's why audiology and speech pathology have been partnered together for as long as I've known. We definitely work very closely together. And there are speech pathologists that specialize in treating children with hearing loss to make sure that they know exactly what to look out for at certain stages of their development and to also, we'll work together.
And if the speech therapist says, "Little Johnny is having a hard time pronouncing his S's," then that's something that as an audiologist, I can go in and look at the hearing devices and objectively look to make sure he's getting enough access to sound, to be able to produce the S or the sh sound. And it's amazing that collaboration, how it really helps a child, and it really does make a big impact.
So communication and the team approach when treating children is invaluable. As an audiologist, I couldn't do it all myself. It definitely is the teachers, the speech therapists, other educators involved and other family members also involved in the child's life to be able to help support them to be able to develop that speech and language.
Blaise Delfino: What I think is so important, and of course, I think we're both on the same mission of number one, raising awareness of the importance of treating hearing loss, but also raising awareness of our field in general. Because oftentimes not many individuals know what an audiologist is and what they do.
So this of course is a platform, Dr. Kerkhove, which we're able to raise awareness of the importance of treating untreated hearing loss, and especially when it comes to hearing aid fitting. So let's say the parents opt into the treatment option of fitting their child with hearing aids. And I think there's a common misconception that is currently out there.
Because the advertisements that you typically see are hearing aids, they're RICs receiver in the canal. And those are not an option for pediatrics on the road to better speech and hearing until a certain age. If parent who is listening right now, they have a child who needs hearing aids being fit with the correct technology, with that ear mold, because I'm sure you've seen some instances maybe where children weren't properly fit. This is really important that we kind of raise awareness of this.
Dr. Kelsey Kerkhove: Yes, absolutely. I have experienced that, and I do think it's incredibly important for children to be treated by a pediatric audiologist. Because the treatment plan for a two year old versus a 70 year old is incredibly different. Not just the style of the hearing aid, not just the ear mold, but also the output. We had talked about just previously what are we looking at when we collaborate with the speech therapist.
We have to make sure that that child is getting enough access to sound at certain pitches or certain specific sounds, so they're able to produce speech. And as we know with children from birth to three, those are a critical language learning years. And after three, it makes it much more challenging for those children to develop their speech and language skills on par with their peers.
Absolutely it can be done. It may just take a little bit more work. Their brains aren't quite as adaptable as they are at a year old. So making sure that child has the proper amount of access to sound, the proper fit of the ear mold, the proper hearing aid to optimize all listening environments for them is so, so important.
And I definitely strongly advocate for children to be seen by a pediatric audiologist. Because although another audiologist who treats adults can certainly provide hearing aids for a child, but I don't necessarily think they have the specialized training to make sure that children are getting the access to the sound that they need.
And also the holistic support. Like I talked about, it's really important for me as a provider to provide this holistic type of support, not just dispense hearing aids, but educate and explain and support and empathize with these families as they're walking through the process. So I definitely would strongly recommend if you're a parent out there with a child with hearing loss and hearing devices that they are followed closely by a pediatric audiologist.
Blaise Delfino: And Dr. Kerkhove, you have a blog. I've reviewed your blog, and one of your most recent articles was about the importance of using and utilizing a remote microphone. Now before we get into that, I think it's important that we set the stage for our listeners tuned in, especially the parents tuned in right now you have, if hearing aids are the treatment option that the pediatric audiologist, you, Dr. Dr. Kerkhove, recommend.
You have your hearing aids and then you also have accessories that assist in increasing speech understanding and that's also going to assist with speech and language development. Now this accessory called the remote microphone actually increases signal to noise ratio by up to 12 dBs, which for speech and language development is incredible. In your recent article, you of course wrote about the importance of using a remote microphone with your child's hearing aids. Tell us why this is so important.
Dr. Kelsey Kerkhove: Yeah, absolutely. So I think it's important to know that hearing aids do not fix hearing loss. I think that's a common misconception is that they think, "Oh, they have hearing aids, they're going to be fine." And hearing aids, while they provide a lot of benefit, they aren't perfect. So there are certain situations, especially for children where they can really benefit from an increased signal to noise ratio.
And for the parents out there who are curious what a signal to noise ratio is, think if you're in a classroom and the teacher is talking to your child directly in front of them and kids are playing in the background, the noise is all the chaos happening, the toys clanking, the kids screaming and laughing in the background, and then the signal is the teacher's voice.
If the teacher is very close to your child, then their voice is going to be louder and ideally it will be louder than all of the chaos and the noise in the background. The further away the teacher gets from your child, the quieter their voice becomes and it starts to blend in with that noise. But we still want your child to be able to hear the signal or hear the teacher.
So remote microphone technology, like you had mentioned, it increases basically the volume of the speaker that you are trying to hear from in especially noisy environments. So I do think remote microphone technology can hugely benefit children in really challenging listening situations.
Some specifically, like I had mentioned, the classroom, having the teacher easily clip that microphone onto to their shirt so your child doesn't have to fight over the background noise to know exactly what the teacher is saying. Another great environment is sports. So if your little one's playing soccer, they're at soccer practice and the coach is yelling, "Go that way, go that way," and they're standing 10 feet away, they may not hear the coach.
So if that coach has the microphone clipped to his shirt, then his voice will go directly to your child's hearing aids and they won't ever miss a minute. Another situation where I strongly advocate for remote microphones is if you're going on a walk with your little one and they're in a stroller, they're sitting in that stroller, they're facing away from you, there's a canopy over their head,
And you're wanting to share with them, "Look at the birds, the trees, the..." Whatever it is that you see that you're wanting them to experience as well. But without visual cues and with that barrier over them, they're probably going to have a harder time hearing you. So remote microphone technology can work great in those situations as well.
Blaise Delfino: We are huge fans of the remote microphones. And you bring up such a great point, especially when you're going on a walk and your child is in a stroller because that canopy is acting as barrier. So during graduate school, one of my professors, she used an FM system every single day, which was incredible.
Everyone in the class could really understand her. It was great for her vocal hygiene. Share with us, Dr. Kerkhove, what an FM system is and why this is also important to utilize in the classroom for children who do have hearing loss, but even for children who may have central auditory processing or who have normal hearing but struggle in a noisy situation.
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Dr. Kelsey Kerkhove: Yeah. Absolutely. So for children with hearing loss and even children without hearing loss, there's something known as listening fatigue. So if you're in a lecture and you're struggling to hear your professor or your teacher and you're having to strain that entire time, you're going to be exhausted by the end of the class and you're probably going to miss a lot of valuable information because of that extra effort.
So children with hearing aids, they have to work harder to make sure that they're hearing that proper signal over noise. And even if there isn't noise in the background, sometimes these microphones that teachers are speaking into aren't necessarily great clarity or great quality. So if we can do what we can to support children to reduce the listening fatigue, basically that effort that they have to put forth to hear and understand what's going on, the FM system can really help in that environment.
Whether it's just an additional microphone and speaker situation so everyone in the class can get a better and more clear signal or if it's the teacher with a microphone that streams directly to their hearing needs, either one are really going to help them. I wear glasses most of the time and the days that I forget my glasses at work, while I can still see, I move a lot slower, I make more mistakes and I'm exhausted at the end of the day.
I would imagine children with hearing loss experience something similar. While their hearing aids, they can still hear, but if we can improve that quality, that signal to make life easier, that's sort of what I like to remind people is my job is to do everything I can to make your life easier. So let's work together and do that. And I think an FM system is a great tool to do so.
Blaise Delfino: Dr. Kerkhove, I'm so happy that you brought up the glasses analogy, because while glasses and hearing aids of course are so different, it's the same concept. I wear glasses as well, I should be wearing them right now, but the days that I don't wear them, headaches, I feel fatigued, I definitely make some spelling errors and emails, that definitely happens.
But I'm so happy that you bring that up. And we could have an entire episode about FN systems and assistive listening devices. Like I said, you run a very successful social media platform. You have a blog. For the parents tuning in right now, even the students tuned in right now, or maybe there's audiologists who are interested in starting to specialize in pediatric audiology, where can we find your resources to help our patients hear life story?
Dr. Kelsey Kerkhove: That's very kind of you. Thank you. So I was inspired to start my social media page and my blog. It's something I've been thinking about for the last year. I realized in conversations with colleagues and also trying to put myself in the shoes of my patients is that when you work in a large medical center or a busy clinic, is that sometimes because of the demand, we don't always have, unfortunately the time, the amount of time we want to be able to spend with our patients in those really difficult moments.
Because we have a busy schedule. And I always thought to myself, "If I was a parent and I just received that news, the first thing I would do is go online." I mean, I know everyone says don't go Google it, but I would go, I know would go Google it. Looking online and trying to put myself in the parent's shoes, what terms would they be searching for?
What resources would they be searching for? And I found, although there was a lot of information out there, to me it felt as an audiologist even hard to navigate through. And sort of in this post COVID era, I feel that people are a lot more open to the idea of connecting online. I know I certainly am.
So I wanted to create a space to basically be able to provide clear, concise, digestible, and encouraging information for families. And even go a step further because I realize that knowledge is power and not every place in the country has access to pediatric audiologists. And or maybe they're in an eight hour drive away.
Or maybe they feel that they don't have the time that they need to, within that hour appointment with a crying baby, to digest the information that they really want, or they don't know what questions to ask. There's so much. I was trying to put myself in the patient's shoes and think, what can I do better? What can we do better as audiologists to help support families through a very unfamiliar and scary process?
And so I also, on top of the blog, have created consulting packages. So they vary from one on one consult to sometimes it's just, can you explain my child's test results? What is conductive hearing loss and what... Not just what is it, what is the impact of it? What are the options I have for my child? Or, hey, my child was diagnosed with permanent hearing loss and parents are feeling overwhelmed and maybe need a little bit support.
Or even one step further. Sometimes parents can come to the appointment or mom can come, but dad can't make it. Or grandma babysits the baby during the week, but grandma doesn't understand how to use the hearing aids. How can we educate grandma or the babysitter? How can we get the whole family involved and take some of that pressure off just the mom or just the dad to do it all?
How can we really hold their hand, walk them through the process, let them know what to expect during a very unexpected time? I felt like that's the care that parents deserve when going through that process. And unfortunately in a busy clinic, we don't always have the bandwidth to do that. So with the consulting packages, it varies from weekly phone calls to direct text access.
You can text me anytime day or night and I'll get back to you. We can FaceTime after your child's hearing aid fitting so I can go over how to put the ear mold in and take it out, how to clean the hearing aid, some of the things you just can't absorb, like I said, in a quick appointment with a crying baby.
And then on top of it, I thought, okay, the blog would be a good place for parents to start. So I would just sort of listen and questions that would arise during my day to day at work, I would put that into a blog and think about if I had met someone who was at the start of this process, what is some valuable information?
And I thought if I could put it all in one place, make myself accessible to the parents that could really benefit from it, it could help parents get the joy back in a time that can feel very overwhelming. Because you only have so much time with your newborn or with your toddler or your elementary school child, whatever it is.
And if that time is fleeting and you're overwhelmed with the emotions that come with having a child with hearing loss, how can I help you get that joy back and let you know it's going to be okay? So that's sort of the inspiration behind the blog and the social media, because like I said in the beginning, I really love connecting with people. That's what makes me the happiest. So if I can find parents to connect with and help them through the process, then it's a win-win for us both.
Blaise Delfino: We are super excited to continue to support your platform. And for our listeners tuned in right now, we are going to link Dr. Kerkhove's blog and social media handles to help you help your patients throughout their hearing journey. And we love the fact that you are implementing this telehealth, tele-audiology approach. We have access today, and that's so important.
And we just admire the fact that what you're doing is you are duplicating your skills and you're specialized knowledge to work for you the hours that you are not physically in the office. And you're absolutely right, when patients, well, when the parents, I should say, are told that their son or daughter presents with a hearing loss, they need to digest that and then they can go home and do that by reading your blog.
They have resources at their fingertips. And we're just so excited to continue to stay in touch with you, Dr. Kerkhove. We're so excited to hear about the many success stories that you have with your patients. In closing, is there anything that you'd like to share with parents listening right now, students and or hearing healthcare professionals tuned in right now about pediatric audiology or about the platforms they can connect with you?
Dr. Kelsey Kerkhove: Yeah. You can definitely connect with me on Instagram or through my website. And you're welcome to send me a message or schedule a call. I'd love to just be a resource for you. I think I saw in one of your questions earlier it said, what is the first step you would tell a parent to take if their child was diagnosed with hearing loss? And I thought about that.
And honestly, the first step is reach down and give your child a big hug and let them know and let yourself know it's going to be okay. Before all the appointments, before all the Googling, before all the information that comes at you, the first step is reach down and give your baby, your child a big hug. Because that's the, really the most important part of the process is that that child is loved. And you're doing that, then you're doing enough. The rest we'll figure out together.
Blaise Delfino: Thank you so much, Dr. Kerkhove for joining us on the Hearing Matters podcast. We so appreciate this.
Dr. Kelsey Kerkhove: Thank you for having me. This is a lot of fun.
Blaise Delfino: You're tuned in to the Hearing Matters podcast, the show that discusses hearing technology, best practices and a growing national epidemic, hearing loss. Today we had pediatric audiologist, Dr. Kelsey Kerkhove. Definitely be sure to check out the links in our show notes. And if you have any questions, feel free to send us an email. And until next time, hear life story. Thanks again for tuning into The Hearing Matters podcast today.
I'm your host, Blaise Delfino. And on behalf of our entire team, thank you so much for the support. Truly, it means so much to us. Head on over to the Apple Podcast app and share your thoughts. What did you like most about this episode and what do you like most about our podcast? Five star reviews are always appreciated. And also head on over to Instagram, hit that follow button and let's connect, and as a team, we can continue to help our community hear life story.