Exploring the Edges of Audiology: What I Learned from a Cognitive Training Center

TL;DR

Even when we apply our auditory processing interventions skillfully, even when the diagnostics are solid, the auditory training is targeted, and the low-gain hearing aids are well programmed, what if that still isn’t enough? This reflection explores how cognitive training, interdisciplinary models, and personal insight helped me understand listening, memory, and self-regulation in a new way for myself, my patients, and my family.

Rethinking My Scope as an Audiologist

As an audiologist committed to supporting individuals with auditory processing challenges, I recently began to question the breadth of my own clinical scope. Although there is a LearningRx center just 23 miles from my home, I traveled to Chattanooga at my own expense about a month after an initial conversation sparked by one of my frequent Facebook posts about low-gain hearing aids. The clinic’s owner reached out and connected me with their research audiologist.

Over two days, I was joined by a colleague who is a Deaf and hard of hearing communication advocate, a recent college graduate with full access to research journals, an EMT, an ASL interpreter, and a disability advocate who works alongside a service dog. Together, we observed sessions and engaged in thoughtful, curiosity-driven conversations.

Community and Clinical Leadership

I was particularly struck by Michelle Davis, the clinic director. Her community engagement includes hosting podcasts with financial professionals, collaborating with autism influencers on topics like primitive reflexes, and leading a TBI support group. None of this felt like aggressive promotion. It felt like bridge building across systems.

Although she is not a licensed clinician, she is a Board Certified Cognitive Specialist (BCCS) through IBCCES and leads a team of trainers with advanced cognitive credentials. Her clinic, LearningRx Chattanooga East, holds Board Certified Cognitive Center (BCCC) status and is consistently top-rated, with Google reviews averaging above 4.9 stars. It has ranked among the top five LearningRx centers nationally in four of the past five years. The center’s outcomes and reputation reflect a deep commitment to quality, consistency, and community-based care.

Parallels with the Buffalo Model

The LearningRx model reminded me of the Buffalo Model, a foundational framework within audiology developed by the late Dr. Jack Katz. Dr. Jack Katz, who passed away very recently, was a pioneering force in the field of auditory processing. His work earned him a wide following among both audiologists and speech-language pathologists around the world. His model emphasizes structured, clinician-guided auditory training, often targeting areas identified as decoding (accurate sound processing), tolerance-fading memory (understanding in noise and auditory recall), and integration (linking auditory input with language or motor tasks).

Like LearningRx, the Buffalo Model is delivered through intensive one-on-one support. However, while LearningRx follows a standardized curriculum across centers, the Buffalo approach allows for greater clinical flexibility. Doctoral-level audiologists can adapt it to individual needs, incorporating additional tools such as computerized auditory training (Acoustic Pioneer, Aria, CAPDOTS, SoundStorm, or Fast ForWord), as well as language, literacy, or executive function supports.

Both models rely on structured repetition paired with responsive human feedback. But Buffalo reflects the adaptive, clinician-led nature of audiology itself. Neither model replaces core audiologic care. Instead, they expand it by supporting the broader cognitive systems that make listening meaningful and sustainable.

From Clinical Curiosity to Personal Insight

These questions aren't just theoretical. They became deeply personal. I’ve seen the quiet toll of cognitive overload in my own family. My mother had a long history of depression and, looking back, I suspect her decline was also shaped by undiagnosed AuDHD. It wasn’t just hearing loss. It was a fragile processing system, layered with emotional exhaustion and the slow erosion of confidence. We don’t talk about that kind of slipping away nearly enough.

At LearningRx, I met a client who reminded me of my mother. She was the same age. That’s when I knew I needed to act.

I’ve now decided to invest in this training—not just professionally, but for myself, for my son, and for my father.

Supporting My Son and My Father

My son is AuDHD, gifted, and diagnosed with auditory processing disorder. He doesn’t have hearing loss, but he often functions like many children who do. He dominates conversations, monologues, and interrupts. These are all areas I struggle with myself. And frankly, at 50 years old, I’d like to find better ways to address them.

Is that because of the APD? The autism and ADHD? Or are these skills still developing and still buildable? We explored medication for him, but it didn’t bring the clarity or regulation we hoped for. I’ve spent years wondering if this is just his personality or something deeper. I don’t have a clear answer. But I see how hard he works to stay present in conversations. I see how quickly he loses the thread when he has to wait too long to speak.

We also tried low-gain hearing aids and a remote microphone. They helped in specific ways, and although they’re written into his IEP, we chose not to push the school too hard at the time. His challenges were mild enough that the fight didn’t seem worth it. That said, he’s open to trying again next year, especially if his new gifted autism program turns out to be a tough adjustment. Academically, he does well with support. But his social and executive function challenges have been significant enough that we wanted a program that addresses them more directly.

My father is 78. He spent much of his life as a federal judge and a Jewish cantor, roles that required intense cognitive and social engagement. These days, he enjoys time with his fiancée, watches TV, and takes long walks. He doesn’t seem nearly as challenged, but it’s hard to tell if he’s beginning to slow down. When I asked if he’d consider cognitive training, he didn’t hesitate. His fiancée, a former nurse, has been encouraging him to stay mentally engaged. He saw what happened to my mother. And maybe, like me, he wants something better.

Looking Inward

And for me, this visit was eye-opening. I found myself nearly falling asleep while trying to keep up with the visual and auditory tasks that the kids and adults were doing, timed to the second. It was exhausting. The room was filled with motion, timers beeping, and the sharp clicks of multiple metronomes interacting in overlapping rhythms. There were no visual separations—just one large, open space echoing with layered sound. Voices, footsteps, and mechanical cues all competed for attention. Every surface reflected sound, and every corner demanded awareness. There was nowhere to rest your eyes, and no acoustic break to regroup.

The energy was intense. It was structured and purposeful, but unrelenting. And it made me realize just how much I’ve been compensating all these years. I struggle with memory, focus, and fatigue even in environments where I’m supposed to be the expert.

This mirrored the very challenges I see in my son and those I now recognize in myself. The desire for better focus. The fatigue after conversation. The inability to hold on to a thought while someone else is speaking. It helped me understand why I interrupt, why I lose the thread. When memory is fragile, it’s hard to wait your turn. You speak not to dominate, but because the idea might vanish if you don’t.

These aren’t just patient struggles. They are ours too. And seeing that in myself reminded me how essential it is to stay humble, stay curious, and look at our blind spots with compassion.

Bridging Disciplines with Integrity

We don’t have to choose between disciplines. We can lead and learn. We can fine-tune hearing aids and build cognitive flexibility. We can treat the auditory system while supporting the systems that make sense of what we hear. We can stay grounded in science and still honor the human side of our work.

What I saw in Chattanooga wasn’t perfect. But it was dynamic, thoughtful, and deeply human. It reminded me that the most meaningful progress doesn’t always happen in controlled conditions. Sometimes, it happens in real-world spaces, surrounded by people who care.

And I think that’s exactly what our field needs more of.