10 Things I Wish I'd Known Before Becoming a Pediatric Audiologist

By Zoë Boxer, AuD, CCC-A, and Nicole Pain, AuD, CCC-A

Congratulations! You made it! You’re graduating with your doctorate in audiology and are ready to begin your career as a pediatric audiologist. Or you’ve been an adult audiologist, but each time you saw a pediatric patient, you knew it was your true calling. You’re ready to take the leap!

Pediatric audiology is (in our opinion) the most fun and rewarding of all the branches of audiology—but also one of the most challenging. We’ve been practicing for 3 years and 5 years, respectively, and there are many things we wish we had known before beginning our careers. The following 10 items are what we believe to be the most important:

1. Get Experience

As a pediatric audiologist, it’s essential to have experience with pediatrics and be comfortable working with multidisciplinary teams. Apply for a pediatric externship, or find a way to work in another pediatric capacity (e.g., working in a daycare setting, volunteering with children, working as a newborn hearing screener). Gaining experience in a pediatric externship will allow you to see various patients with challenging cases, work with multiple disciplines, and see patients presenting with fundamental cases that will prepare you to become a well-rounded pediatric audiologist.

Be sure to start looking for a pediatric externship early. Many facilities have a specific time of year when they recruit externs, and they often recruit a full year in advance. Research those sites that offer pediatric audiology or that are housed in large pediatric hospitals. Finding the right opportunity may take you to a new state or location, so don’t be afraid to leap at the right one. Working with multidisciplinary teams (e.g., the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program) before your externship will prepare you for working in a large pediatric center. This experience will also look great on your future resume.

2. Keep Learning

Take advantage of every learning opportunity during your externship, clinical rotations, or current job. Hands-on practice is the best way to learn in pediatric audiology.

  • Ask to observe multiple audiologists during your rotations or training. It can be helpful to see how several audiologists do things.
  • Don’t be afraid to ask questions!
  • Always ask for feedback—sometimes, constructive criticism can be the best form of feedback.

3. Shine in Your Interview

Interviewing for a pediatric audiologist job is not just about your skills but also about your personality, resilience, and willingness to learn. Make sure to show off these aspects of yourself in your cover letter and during the interview process.

4. Get Your Licensure and Certifications

The process you must follow to obtain your state licensure and licensure times can vary greatly from state to state. Make sure that any location where you’re interviewing knows that you’re actively pursuing licensure—and that you will be efficient in obtaining any certifications (e.g., your ASHA Certificate of Clinical Competence!).

5. Make a Good Impression

It’s vital to build strong relationships with your colleagues. They’ll be your friends and support system, and they’re the only other people who will know exactly what you’re going through!

  • Know that you’ll always be arriving early, staying late, and putting in the extra time.
  • Little things you do will get noticed by your colleagues and your bosses (e.g., turning on the booths, offering to help your colleagues when available, cleaning rooms, being prepared for the day).
  • You may be younger than many of the parents you work with, and it’s essential to build trust through your overall professionalism, how you conduct yourself, and your knowledge and skills.

6. Trust Your Skills and Instincts

It can be challenging to transition from a student or new hire to working solely on your own. Trust your training and knowledge! Seek support when you need it, and give yourself a little grace as you make the transition. Remember, things are not always like the textbook. We have many stories from our combined 8 years of working where nothing turned out as we thought it would.

7. Focus on Family-Centered Care

You’re a part of a team that includes the patient and the parents/caregivers, extended families, pediatricians, speech and developmental therapists, teachers, other medical providers, and more. The team often consists of more people than you thought possible. In pediatrics, it’s crucial to focus on family-centered care rather than just patient-centered care.

8. Be a Team Player

You may work closely with physicians from multiple specialties, including ear, nose, and throat (ENT) physicians. It’s essential to use effective communication to relay mutual patients’ results and recommendations—and ensure that you’re on the same page. Remember to always look at the big picture when working with children who have medically complex conditions. Often, these cases never go as planned. It’s important to stay calm, change your game plan as needed, and be adaptable.

In addition, working in the inpatient world can be challenging. Many patients have conditions that are medically complex, and completing a hearing test is not always a high priority in comparison with other challenges the patient may be facing. Early detection of hearing loss is important; however, additional situations may be occurring in the child's medical care that delay testing. You’re a part of a larger team of providers working together to serve the patient and family best.

9. Think Outside the Box!

The results may not be black and white. Often, we must piece together test results or complete multiple sessions to get the whole picture. Every day, you’ll need to think on your toes, be creative in the booth, and change your game plan on the spot.

A good strategy is to complete an entire test battery so that you won't miss anything. Always investigate anything that seems off or abnormal. Small things can make a big difference in diagnosing hearing loss. For example, if you only complete 226-Hz tympanometry for an infant—and forget to complete 1,000-Hz tympanometry—you may misinterpret the infant’s middle ear status. Suppose you don’t split your alternating run into rarefaction and condensation during an Auditory Brainstem Response (ABR) evaluation or don’t complete Distortion Product Otoacoustic Emissions (DPOAE) tests. In that case, you may misdiagnose a child with a hearing loss rather than with Auditory Neuropathy Spectrum Disorder (ANSD).

10. Find Healthy Outlets to Relieve Stress

Working in pediatrics can be incredibly rewarding but also emotionally draining. It’s important that you find healthy outlets through which to process your emotions and increase your resilience. You’ll be managing your caseload and navigating various work dynamics that can have an unexpected toll.

Bonus Tip: Celebrate!

Celebrate all the victories all the way. Like, when patients complete their testing, when families come to you for a second opinion, when patients achieve full-time hearing aid use, or when you’re able to obtain specific results on a child with a medically complex condition. Celebrate every milestone!

You may have the classic YouTube videos of a baby hearing for the first time. You’ll see some of these reactions; however, not all reactions will be like this one. A child may cry, laugh, smile, or not react at all. Be sure to counsel families on this—and celebrate any reaction!

Your families appreciate you and all your hard work, even if they can’t always show you.