Speech-language pathologists assess and treat persons with speech, language, voice, and fluency disorders; audiologists assess and treat those with hearing and related disorders.
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 speech quality problems, such as inappropriate pitch or harsh voice; and those with problems understanding and producing language. They may also work with people who have oral motor problems that cause eating and swallowing difficulties.
Speech and language problems may result from causes such as hearing loss, brain injury or deterioration, cerebral palsy, stroke, cleft palate, voice pathology, mental retardation, or emotional problems. Speech-language pathologists use special instruments, as well as written and oral tests, to determine the nature and extent of impairment, and to record and analyze speech irregularities. For individuals with little or no speech, speech-language pathologists select alternative communication systems, including automated devices and sign language, and teach their use. They teach other patients how to make sounds, improve their voices, or increase their language skills.
Audiologists work with people who have hearing 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 other tests of the nature and extent of their hearing loss. Audiologists may coordinate these results with medical, educational, and psychological information, make a diagnosis, and determine a course of treatment. Treatment may include examining and cleaning the ear canal, the fitting of a hearing aid, auditory training, and instruction in speech or lip reading. They may recommend use of amplifiers and alerting devices. Audiologists also test noise levels in workplaces and conduct hearing protection programs.
Most speech-language pathologists and audiologists provide direct clinical services to individuals with communication disorders. In speech, language, and hearing clinics, they may independently develop and carry out a treatment program. In medical facilities, they may work with physicians, social workers, psychologists, and other therapists to develop and execute a treatment plan. Speech- language pathology and audiology personnel in schools also develop individual or group programs, counsel parents, and assist teachers with classroom activities, to meet the needs of children with speech, language, or hearing disorders.
Speech-language pathologists and audiologists 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 about 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 and audiologists conduct research on how people speak and hear. Others design and develop equipment or techniques for diagnosing and treating problems.
More than one-half of speech language pathologists and audiologists work in schools.
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 and there may be frustration when clients do not improve. 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 73,000 jobs in 1992. About one-half provided services in preschools, elementary and secondary schools, or colleges and universities. More than 10 percent 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; and other facilities. Some were in private practice, working either as solo practitioners or in a group practice.
Some experienced speech-language pathologists or audiologists contract to provide services in schools, hospitals, or nursing homes or work as consultants to industry.
A master's degree in speech-language pathology or audiology is the standard credential in this field. Of the 43 States that regulate speech-language pathologists and/or audiologists, all require a master's degree or equivalent; 375 hours of supervised clinical experience; a passing score on a national examination; and 9 months of post-graduate professional experience. For licensure renewal, 23 States have continuing education requirements. Medicaid, Medicare, and private insurers generally require a license to qualify for reimbursement.
In some States, people with bachelor's degrees in speech-language pathology may work in schools with students who have communication problems. They may have to be certified by the State educational agency, and may be classified as special education teachers rather than speech-language pathologists or audiologists. Recent Federal legislation requires speech-language pathologists in school systems in almost every State to have a minimum of a master's degree or equivalent. All States require audiologists to hold a master's degree or equivalent.
About 230 colleges and universities offered master's programs in speech-language pathology and audiology in 1993. Courses cover anatomy and physiology of the areas involved in speech, language, and hearing; the development of normal speech, language, and hearing and 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.
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, have 375 hours of supervised clinical experience, complete a 9-month post-graduate internship, and pass a national written examination.
Speech-language pathologists and audiologists should be able to effectively communicate test results, diagnoses, and proposed treatment in a manner easily understood by their clients. They also need to be able to approach problems objectively and provide support to clients and their families. Patience and compassion are important because a client's progress may be slow.
With experience, some salaried speech-language pathologists and audiologists enter private practice; others become directors or administrators of services in schools, hospitals, health departments, and clinics. Some become researchers.
Employment of speech-language pathologists and audiologists is expected to increase much faster than the average for all occupations through the year 2005. Some job openings also will arise from the need to replace speech-language pathologists and audiologists who leave the occupation.
Employment in the health services industry will increase as a result of several factors. Because hearing loss is strongly associated with older age, rapid growth in the population age 75 and over will cause the number of hearing-impaired persons to increase markedly. In addition, baby boomers are now entering middle age, when the possibility of neurological disorders and their associated speech, language, and hearing impairments increases. Medical advances are also improving the survival rate of premature infants and trauma victims, who then need treatment.
The number of speech-language pathologists and audiologists in private practice, though small, is likely to rise sharply by the year 2005. Encouraging this growth is the increasing use of contract services by hospitals, schools, and nursing homes.
Employment in schools will increase as elementary and secondary school enrollments grow. In 1986, Federal legislation guaranteeing special education and related services to all eligible children with disabilities, while originally designed for school-age children, was extended to include children from 3 to 5 years of age. This legislation will also increase employment in day care centers, rehabilitation centers, and hospitals.
Median annual earnings of full-time salaried speech-language pathologists and audiologists were $36,036 in 1992. The middle 50 percent earned between $27,404 and $42,120.
According to a 1992 survey by the American Speech-Language-Hearing Association, the median annual salary for certified speech-language pathologists with 1 to 3 years experience was about $29,050; for certified audiologists, it was about $28,000. Speech-language pathologists with 16 years or more experience earned a median annual salary of about $41,300, while experienced audiologists earned about $45,000. Salaries also vary according to geographic location.
Speech-language pathologists and audiologists in hospitals earned a median annual salary of about $33,916, according to a 1992 survey conducted by the University of Texas Medical Branch.
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.
Reprinted with Permission of U. S. Department of Labor