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Nature of the Work
* About half work in schools, and most others are employed by healthcare facilities.
* A master's degree in speech-language pathology or audiology is the standard credential.
* Projected?much-faster-than-average employment growth reflects the increasing number of people who will need speech-language pathology and audiology services.
Speech-language pathologists assess, treat, and help to prevent speech, language, cognitive communication, voice, swallowing, fluency, and other related disorders; audiologists identify, assess, and manage auditory, balance, and other neural systems.
Speech-language pathologists work with people who cannot make speech sounds, or cannot make them clearly; those with speech rhythm and fluency problems, such as stuttering; people with voice quality problems, such as inappropriate pitch or harsh voice; those with problems understanding and producing language; and those with cognitive communication impairments, such as attention, memory, and problem solving disorders. They may also work with people who have oral motor problems causing eating and swallowing difficulties.
Speech and language problems can result from hearing loss, brain injury or deterioration, cerebral palsy, stroke, cleft palate, voice pathology, mental retardation, or emotional problems. Problems can be congenital, developmental, or acquired. Speech-language pathologists use written and oral tests, as well as special instruments, to diagnose the nature and extent of impairment and to record and analyze speech, language, and swallowing irregularities. Speech-language pathologists develop an individualized plan of care, tailored to each patient's needs. For individuals with little or no speech capability, speech-language pathologists select augmentative alternative communication methods, including automated devices and sign language, and teach their use. They teach these individuals how to make sounds, improve their voices, or increase their language skills to communicate more effectively. Speech-language pathologists help patients develop, or recover, reliable communication skills so patients can fulfill their educational, vocational, and social roles.
Most speech-language pathologists provide direct clinical services to individuals with communication disorders. In speech and language clinics, they may independently develop and carry out treatment programs. In medical facilities, they may work with physicians, social workers, psychologists, and other therapists to develop and execute treatment plans. Speech-language pathologists in schools develop individual or group programs, counsel parents, and may assist teachers with classroom activities.
Speech-language pathologists keep records on the initial evaluation, progress, and discharge of clients. This helps pinpoint problems, tracks client progress, and justifies the cost of treatment when applying for reimbursement. They counsel individuals and their families concerning communication disorders and how to cope with the stress and misunderstanding that often accompany them. They also work with family members to recognize and change behavior patterns that impede communication and treatment and show them communication-enhancing techniques to use at home.
Some speech-language pathologists conduct research on how people communicate. Others design and develop equipment or techniques for diagnosing and treating speech problems.
Audiologists work with people who have hearing, balance, and related problems. They use audiometers and other testing devices to measure the loudness at which a person begins to hear sounds, the ability to distinguish between sounds, and the nature and extent of hearing loss. Audiologists interpret these results and may coordinate them with medical, educational, and psychological information to make a diagnosis and determine a course of treatment.
Hearing disorders can result from trauma at birth, viral infections, genetic disorders, or exposure to loud noise. Treatment may include examining and cleaning the ear canal, fitting and dispensing a hearing aid or other assistive device, and audiologic rehabilitation (including auditory training or instruction in speech or lip reading). Audiologists may recommend, fit, and dispense personal or large area amplification systems, such as hearing aids and alerting devices. Audiologists provide fitting and tuning of cochlear implants and provide the necessary rehabilitation for adjustment to listening with implant amplification systems. They also test noise levels in workplaces and conduct hearing protection programs in industry, as well as in schools and communities.
Audiologists provide direct clinical services to individuals with hearing or balance disorders. In audiology (hearing) clinics, they may independently develop and carry out treatment programs. Audiologists, in a variety of settings, work as members of interdisciplinary professional teams in planning and implementing service delivery for children and adults, from birth to old age. Similar to speech-language pathologists, audiologists keep records on the initial evaluation, progress, and discharge of clients. These records help pinpoint problems, track client progress, and justify the cost of treatment, when applying for reimbursement.
Audiologists may conduct research on types of, and treatment for, hearing, balance, and related disorders. Others design and develop equipment or techniques for diagnosing and treating these disorders.
Speech-language pathologists and audiologists usually work at a desk or table in clean comfortable surroundings. The job is not physically demanding but does require attention to detail and intense concentration. The emotional needs of clients and their families may be demanding. Most full-time speech-language pathologists and audiologists work about 40 hours per week; some work part-time. Those who work on a contract basis may spend a substantial amount of time traveling between facilities.
Speech-language pathologists and audiologists held about 87,000 jobs in 1996. About one-half provided services in preschools, elementary and secondary schools, or colleges and universities. More than 1 in 10 were in hospitals. Others were in offices of physicians; offices of speech-language pathologists and audiologists; speech, language, and hearing centers; home health care agencies; or other facilities. Some were in private practice, working either as solo practitioners or in a group practice. Some speech-language pathologists and audiologists contract to provide services in schools, hospitals, or nursing homes, or work as consultants to industry. Audiologists are more likely to be employed in independent healthcare offices, while speech-language pathologists are more likely to work in school settings.
Of the States that regulate licensing (44 for speech-language pathologists and 47 for audiologists), almost all require a master's degree or equivalent. Other requirements are 300-375 hours of supervised clinical experience, a passing score on a national examination, and 9 months of postgraduate professional clinical experience. Thirty-four states have continuing education requirements for licensure renewal. Medicaid, medicare, and private health insurers generally require a practitioner to be licensed to qualify for reimbursement.
About 230 colleges and universities offer graduate programs in speech-language pathology. Courses cover anatomy and physiology of the areas of the body involved in speech, language, and hearing; the development of normal speech, language, and hearing; the nature of disorders; acoustics; and psychological aspects of communication. Graduate students also learn to evaluate and treat speech, language, and hearing disorders and receive supervised clinical training in communication disorders.
About 120 colleges and universities offer graduate programs in audiology in the United States. Course work includes anatomy; physiology; basic science; math; physics; genetics; normal and abnormal communication development; auditory, balance and neural systems assessment and treatment; audiologic rehabilitation; and ethics.
Speech-language pathologists can acquire the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) offered by the American Speech-Language-Hearing Association, and audiologists can earn the Certificate of Clinical Competence in Audiology (CCC-A). To earn a CCC, a person must have a graduate degree and 375 hours of supervised clinical experience, complete a 36-week postgraduate clinical fellowship, and pass a written examination.
Speech-language pathologists and audiologists should be able to effectively communicate diagnostic test results, diagnoses, and proposed treatment in a manner easily understood by their clients. They must be able to approach problems objectively and provide support to clients and their families. Because a client's progress may be slow, patience, compassion, and good listening skills are necessary.
Speech-language pathologists and audiologists may work in a variety of settings, including schools, hospitals, health departments, clinics, and private practices. Some members of these professions also serve as clinical supervisors for student clinicians, professors in universities and colleges, or conduct research.
Employment of speech-language pathologists and audiologists is expected to increase much faster than the average for all occupations through the year 2006. Employment in health and rehabilitation services will increase as a result of advances in medical technology and growth in the elderly population. Because hearing loss is strongly associated with aging, rapid growth in the population age 55 and over will cause the number of persons with hearing impairment to increase markedly. In addition, baby boomers are now entering middle age, when the possibility of neurological disorders and associated speech, language, and hearing impairments increases. Medical advances are also improving the survival rate of premature infants and trauma and stroke victims, who then need assessment and possible treatment.
Employment in schools will increase along with growth in elementary and secondary school enrollments, including enrollment of special education students. Federal law guarantees special education and related services to all eligible children with disabilities. Greater awareness of the importance of early identification and diagnosis of speech, language, and hearing disorders will also increase employment.
The number of speech-language pathologists and audiologists in private practice, though small, is likely to rise sharply due to the increasing use of contract services by managed care, hospitals, schools, and nursing homes. In addition to job openings stemming from rapid job growth over the 1996-2006 period, some openings for speech-language pathologists and audiologists will arise from the need to replace those who leave the occupation.
Median weekly earnings of full-time salaried speech-language pathologists and audiologists were about $690 in 1996. The middle 50 percent earned between $560 and $880. The lowest 10 percent earned less than $440 and the top 10 percent more than $1,160.
According to a 1997 survey by the American Speech-Language-Hearing Association, the median annual salary for full-time certified speech-language pathologists was $44,000; for audiologists, $43,000. Certified speech-language pathologists with 1 to 3 years of experience earned a median annual salary of $38,000; licensed audiologists with 1 to 3 years of experience earned $32,000. Speech-language pathologists with 22 years' experience earned a median annual salary of $52,000, while audiologists with comparable experience earned about $55,000. Salaries also vary according to geographic location and type of employment facility.
Speech-language pathologists specialize in the prevention, diagnosis, and treatment of speech and language problems. Workers in related occupations include occupational therapists, optometrists, physical therapists, psychologists, recreational therapists, and rehabilitation counselors.
Audiologists specialize in the prevention, diagnosis, and treatment of hearing problems. Workers in related occupations include neurologists, neonatologists, acoustical engineers, industrial hygienists, and other rehabilitation professionals.
State licensing boards in each State can provide information on licensure requirements. State departments of education can supply information on certification requirements for those who wish to work in public schools.
General information on careers in speech-language pathology and audiology is available from:
American Speech-Language-Hearing Association, 10801 Rockville Pike, Rockville, MD 20852. Homepage: http://www.asha.org
Information on a career in audiology is also available from:
American Academy of Audiology, 8201 Greensboro Dr., Suite 300, McLean, VA 22102.
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