Speech-language pathologists identify, assess, and treat persons with speech and language disorders while audiologists assess and treat hearing impaired individuals. Because both occupations are concerned with communication, individuals competent in one area must be familiar with the other.
Speech-language pathologists identify and treat speech, language, and swallowing disorders resulting from conditions such as total or partial hearing loss, brain injury, cerebral palsy, cleft palate, voice pathology, mental retardation, faulty learning, emotional problems, or foreign dialect. They also counsel patients and families about communication disorders and how to cope with the stress and misunderstanding that often accompany a communication disorder.
Counseling may involve little more than reassuring the client that the problem is not unique, or it may involve working with the entire family to recognize and change behavior patterns that impede communication and treatment. Counseling may also include giving the family therapeutic techniques to use at home.
Speech-language pathologists use a variety of tools, including audiovisual equipment and computers, to treat speech and language problems. Tape recorders and spectrographs, for instance, are sometimes used to record and analyze speech irregularities. Clients unable to hear their own speech or voice problems can often detect them when listening to a recording of their own voice. For individuals with little or no speech, speech pathologists are also involved in selecting and teaching the use of devices and techniques designed to help them communicate. Such devices include gesture communications boards, electronic automated systems, sign language, and gesture systems.
Audiologists identify, assess, treat, and work to prevent hearing problems. In one of the basic tests, audiologists use an audiometer to measure the loudness at which sound at various frequencies becomes audible to the patient. After instructing the individual being tested to signal whenever a sound is heard, the audiologist adjusts the audiometer to emit sounds at various intensities and pitch levels. The results are assessed and then used to render a diagnosis and determine a course of treatment. This may include the fitting of a hearing aid, providing instruction in speech reading, or recommending the use of telephone and television amplifiers, among others.
The duties of speech-language pathologists and audiologists vary. Most, however, provide direct clinical services to individuals with communication disorders. In speech, language, and hearing clinics, they may independently develop and implement a treatment program. In private medical centers and other facilities, they may be part of a team that cooperatively develops and executes a treatment plan.
Speech-language pathology and audiology personnel in schools may also help administrators develop individual or group programs, counsel parents on prevention, and assist teachers with classroom activities. Speech-language pathologists and audiologists also do some administrative work, such as record keeping on the initial evaluation, progress, and discharge of each client. Such documentation is used to pinpoint problems, track client progress, and justify the cost of each treatment when applying for reimbursement.
Working Conditions:
Speech-language pathologists and audiologists spend most of their time at a desk or table in clean comfortable surroundings. The job is not physically demanding, but the attention to detail and intense concentration needed can be mentally exhausting.
Speech-language pathologists and audiologists who work on a contract basis may serve several facilities, requiring consider-able travel time to deliver services in such settings as nursing homes, home health agencies, or widely scattered schools.
From a personal standpoint, a great amount of satisfaction can be gained from seeing a client improve; lack of progress, on the other hand, can be very frustrating.
Employment:
Speech-language pathologists and audiologists hold thousands of jobs across the country. Almost one-half are in elementary and secondary schools and colleges and universities. The remainder is in speech, language, and hearing centers, hospitals, nursing homes, offices of physicians, and outpatient care facilities. Some are in private practice, working either as solo practitioners or in a group practice with other types of professionals such as physical and occupational therapists.
Sometimes an experienced speech-language pathologist or audiologist works as a full- or part-time contractor providing a wide variety of clinical services to nursing home residents or home health clients. Others work as consultants to industry. They conduct workshops, test noise levels, do research, or act as advisers to manufacturers of equipment used by individuals suffering from hearing or speech and language disorders.
Training, Other Qualifications, and Advancement:
A master's degree in speech-language pathology or audiology is the standard credential in this field. All States require a master's degree plus 300 hours of clinical experience to qualify for reimbursement from Medicaid, Medicare, or private insurers.
Individuals with bachelor's degrees are sometimes allowed to provide services in public schools. These individuals must receive a practice certificate from the State educational agency and are usually classified as special education teachers rather than speech-language pathologists or audiologists.
Many colleges and universities offered master's programs in speech- language pathology and audiology. Courses include anatomy and physiology of the areas involved in hearing, speech, and language; acoustics; psychological aspects of communication; and how sounds and words are produced and how people hear. Graduate students also learn how to evaluate and treat speech, language, and hearing disorders and receive supervised clinical training in communication disorders.
Those with a master's degree can acquire the Certificate of Clinical Competence (CCC) offered by the American Speech-Language-Hearing Association. To earn the CCC, a person must have a master's degree, complete a 9-month internship, and pass a national written examination.
Along with the necessary academic and clinical requirements needed to become a speech-language pathologist or audiologist, individuals should be able to effectively communicate test results, diagnoses, and proposed treatment in a manner easily understood by their clients.
Speech-language pathologists and audiologists need to approach problems objectively and to advocate for the needs of their clients and their families. Considerable patience and com-passion are also needed since a client's progress may be slow.
With experience, some speech-language pathologists and audiologists move into solo practice; others become directors or administrators of services in schools, hospitals, health departments and clinics. Still others focus on research.
Job Outlook:
Employment of speech-language pathologists and audiologists is expected to increase faster than the average for all occupations. Their employment in the health care industry is projected to grow much faster than the average for all occupations, while in education it is expected to grow only as fast as the average.
Demand in the health care industry will increase as a result of several factors. Because hearing loss is strongly associated with older age, the very rapid growth in the population age 75 and over will cause the number of hearing-impaired persons to grow very rapidly. In addition, baby boomers are now entering middle age, when the possibility of neurological disorders, which may have associated hearing, speech, and language impairments, increases.
Speech and hearing clinics, physicians' offices, and outpatient care facilities are expected to provide many new jobs, largely due to anticipated expansion of rehabilitation programs to treat individuals suffering from such conditions as stroke or head injuries. Demand for speech-language pathologists and audiologists is also expected to rise in nursing homes and home health agencies, in response to the needs of the aged.
The number of speech-language pathologists and audiologists in private practice, though small, is likely to rise sharply. Encouraging this growth is the increasing use of contract services by hospitals, schools, and nursing homes. Contract services provide these industries the flexibility of purchasing services on an as-needed basis.
Growing demand in educational institutions will result from a modest increase in elementary and secondary school enrollments and the needs of a growing number of multicultural and multilingual students, as well as a recent amendment to legislation guaranteeing an education to all handicapped children.
Related Occupations:
Speech-language pathologists and audiologists specialize in the prevention, diagnosis, and treatment of speech, language, and hearing problems. Workers in other rehabilitation occupations include occupational therapists, physical therapists, recreational therapists, and rehabilitation counselors.
