So You Want to be a Forensic Audiologist?
Dr. Tom Thunder is an audiologist and acoustical engineer based outside Chicago. After obtaining his audiology degree, Tom completed post-graduate training in acoustics at the Illinois Institute of Technology. As an adjunct faculty member at Northern Illinois University, Salus University, and Rush University, he teaches courses in audiology, acoustics, psychoacoustics, and noise. Before teaching, he owned an audiology practice for 18 years where he conducted hearing examinations and dispensed hearing aids. Outside of teaching, he consults on hearing and noise issues, works on forensic cases, and conducts audiometric testing seminars. His current field of interest is the use of induction loop technology in overcoming adverse acoustics. Tom is a member of the American Academy of Audiology, the National Hearing Conservation Association, and the Acoustical Society of America. He is a past-president of the Illinois Academy of Audiology and the Chicago Regional Chapter of the Acoustical Society.
1. What is forensic audiology and how did you get into the profession?
The term “forensic” is a sexy term to use at parties, but it’s the proper term because it means “of or relating to matters at law.” So if you add audiology to it, it simply means applying what you know about hearing science and audiology toward legal issues. Forensic work is a more of a willingness to work in the legal system than it is a specialty. For example, I have extensive background in acoustics, psychoacoustics, and noise. So I work on cases that involve occupational or environmental noise, audibility, speech understanding, alarms, and the effects of noise. I refer cases that involve specialties like pediatrics, vestibular issues, CAP testing, or cochlear implants to other colleagues.
2. What is a typical case like?
Some of the cases I have worked on include:
- An NFL football player accused of rape during an after-prom sleepover. The question was the credibility of a teenage witness who said she could hear zippers and clothes being thrown around a washroom when she was upstairs in a closed bedroom.
- A fire in a high-rise building killed six people. At question was why the two security guards never responded to emergency phone calls from people trapped in the stairwell.
- A home is searched for drugs because of what the police claimed they heard. The audibility of the speech they claimed to hear was questioned because the house was near a noisy highway and the police were outside listening to a phone conversation through a closed window.
- A worker is crushed by a moving machine. The defendant said the worker should have heard the machine based on sound measurements taken by an industrial hygienist. But most of the equipment in the plant was not operating at the time he made his measurements, so the effect of masking was not accurately assessed.
- A snowmobile rider is struck and killed at a railroad intersection despite the fact that the locomotive horn was 100 dB at his position. Testing revealed that his snowmobile, at 105 dB, was louder.
- A retired Army Colonel with a noise-induced hearing loss is struck and killed by a garbage truck despite the fact that the back-up alarm was working. Did his hearing loss prevent his ability to hear this alarm?
- A school rejects the request of a parent with a hearing impaired child to acoustically treat his classroom. An architect says the room was satisfactory because he could hear just fine.
- A lady jumps from a 2nd floor hotel balcony because she locked herself out of her room. She broke both her legs and complained that the staff ignored her cry for help when, in fact, we discovered that she was not likely heard.
While all these cases were unique in circumstance, they all involved issues of hearing loss, auditory masking, speech recognition, and signal detection. Clearly, these are issues best addressed by audiologists or those in the field of hearing science.
3. What do/did you like about working in forensic audiology?
I enjoy the uniqueness of each case and the investigative nature of the work. With each case, I am allowed to research the literature, which strengthens my understanding of concepts in our field. I also enjoy the ability to “solve” cases by applying principles of hearing science and audiology. In many cases, my impression is confirmed and the answers are obvious – at least to someone in our field. But in other cases, like the snowmobile case, the evidence led me down another path. While the result was contrary to what the attorney had hoped for, he appreciated my expert opinion and entered settlement talks with that knowledge in hand.
4. What are forensic cases like?
In the discovery stage, attorneys try to determine the facts and circumstances of the case to be tried before the court. They do this through interrogatories – written questions directed to the parties involved – and document requests – which is something we as audiologists frequently encounter when you get that subpoena to appear in court at a certain date with all of your records on a patient. This is the stage where experts are often engaged. Here is where they review the records to develop opinions to better support a case.
Another form of discovery is the IME, or independent medical exam. Insurance companies and law firms use the IME term in a general sense. What they really want is a professional with a scope of practice that can address the issue at hand. Generally, they want a professional opinion as to the severity of the problem, the diagnosis, the causation, the best course of treatment, and the patient’s MMR - or maximum medical recovery (that is, with treatment, when and how much improvement can be expected).
Take for example a person who loses hearing from an airbag that inflated spontaneously. An attorney calls you and wants you to perform an IME. By reviewing past audiograms and documents, could you state that the likely cause of the hearing loss was the airbag? Could you also state that such a loss from acoustic trauma doesn’t always result in a classic noise-induced hearing loss pattern and that it may take up to 6 months to know how much of the loss is permanent? Could you state the prognosis with amplification and address the treatment for tinnitus?
5. What are some challenges of working in forensic audiology?
The hang up most audiologists have is… the legal system is not asking us to be 100% certain [of the conclusion]. For expert testimony, the criterion is “a preponderance of evidence that is more likely than not.” This is why your reports should include the phrase that your opinions are “based on a reasonable degree of audiological certainty.”
Remember also, when forming your opinion, you can rely on self-reported patient histories. Why? Because that is what you would normally do in the course of your day-to-day practice. Also, you do not have to be the one to have examined a patient to give an opinion. You can rely on data generated by experts in other fields and by tests conducted by other audiologists.
Nobody wants to go to trial. It’s time-consuming, costly, and unpredictable. No matter how good your lawyer thinks his/her case is, it can always take a twist. As the late Dr. Dave Lipscomb told me, if an audiologist spends enough effort on the front end writing a good report, then chances are the case will settle. According to a study of 445 randomly sampled cases that used an expert, 70% were resolved after the report was issued. Another 18% were resolved after the deposition. So only 12% actually went to trial. A case can settle any time before the verdict is delivered.
6. What inter-professional roles do you play?
Frankly, I can’t think of a single case where I didn’t work with an attorney. Cases can span workers compensation, administrative law (such as the EPA), constitutional law (such as OSHA and the ADA), tort law (such as injury, product liability, and wrongful death), and criminal matters. By working with attorneys, I have gained a great deal of respect for our legal system and the training and skill that lawyers possess.
7. Any tips for students wanting to work in forensic audiology?
I used to think that the guy with the longest resume and the most books written was the best for a trial. Not necessarily so. That’s because jurors are people. And people have emotions and preconceived ideas. In the spirit of the acronyms we use a lot in audiology, I have another one for you. It’s called F-O-R-E-N-S-I-C. If you have these traits, you would make a great expert witness.
- Jurors relate to experts who are Friendly. In other words, they are personal and genuine.
- Experts need to be Objective. Advocacy is for the attorney. Objectivity is for you.
- You need to be Reputable. You can bet that the opposing side will be checking your reputation.
- Be Enthusiastic. Your ability to teach a jury is critical. If you could enthusiastically explain to your neighbors what a hearing loss is, what hearing aids do, and how noise affects the ear, you would make a good expert.
- Experts need to be Neutral. Your conclusions must be reached independently and based on all available data.
- Self-Esteem. You must be proud to be an audiologist before you can demonstrate the confidence of an expert.
- Show Integrity. You commitment must be to knowledge and truth instead of client and cause.
- Finally, you must be Current in your field. This means continually updating your knowledge and skills through professional societies and regular attendance at conferences.
Based on the forensics course I taught at Salus University, here are the most common tips we discussed.
1. Don’t guess at an answer. If you don’t know something, say you don’t know. We are not computers. If you don’t remember, say you don’t remember. There is nothing wrong in that.
2. If you are not sure what is being asked, ask for clarification. Questions can often sound complicated and convoluted. Simply ask the attorney to repeat his question or break it up into separate questions.
3. Answer only the question that was asked. Stay within the scope of the question…don’t volunteer extra information as that will only spawn more questions.
4. Listen carefully to the question and wait until the entire question is asked before answering. Too often we anticipate a question and end up answering something that was never asked.
5. Finally, be truthful. It’s OK to answer a question that may not be favorable to your side. In the end, just like in any sports game, it’s who scores the most points, not who shuts out an opponent.