Speech-language pathologists and audiologists help people who have speech and hearing defects. They identify the problem and use tests to further evaluate it. Speech-language pathologists try to improve the speech and language skills of clients with communications disorders. Audiologists perform tests to measure the hearing ability of clients, who may range in age from the very young to the very old. Since it is not uncommon for clients to require assistance for both speech and hearing, pathologists and audiologists may frequently work together to help clients. Some professionals decide to combine these jobs into one, working as speech-language pathologists or audiologists. Audiologists and speech-language pathologists may work for school systems, in private practice, and at clinics and other medical facilities. Other employment possibilities for these professionals include teaching at universities, and conducting research on what causes certain speech and hearing defects. There are approximately 106,000 speech-language pathologists and audiologists employed in the United States.
Speech-Language Pathologist and Audiologist Career History
The diagnosis and treatment of speech and hearing defects is a new part of medical science. In the past, physicians were not able to help patients with these types of problems because there was usually nothing visibly wrong, and little was known about how speech and hearing were related. Until the middle of the 19th century, medical researchers did not know whether speech defects were caused by lack of hearing, or whether the patient was the victim of two separate ailments. And even if they could figure out why something was wrong, doctors still could not communicate with the patient.
Alexander Graham Bell, the inventor of the telephone, provided some of the answers. His grandfather taught elocution (the art of public speaking), and Bell grew up interested in the problems of speech and hearing. It became his profession, and by 1871 Bell was lecturing to a class of teachers of deaf people at Boston University. Soon afterward, Bell opened his own school, where he experimented with the idea of making speech visible to his pupils. If he could make them see the movements made by different human tones, they could speak by learning to produce similar vibrations. Bell’s efforts not only helped deaf people of his day, but also led directly to the invention of the telephone in 1876. Probably the most famous deaf person was Helen Keller, whose teacher, Anne Sullivan, applied Bell’s discoveries to help Keller overcome her blindness and deafness.
The Job of Speech-Language Pathologists and Audiologists
Even though the two professions seem to blend together at times, speech-language pathology and audiology are very different from one another. However, because both speech and hearing are related to one another, a person competent in one discipline must have familiarity with the other.
The duties performed by speech-language pathologists and audiologists differ depending on education, experience, and place of employment. Most speech-language pathologists provide direct clinical services to individuals and 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. In a school environment, they develop individual or group programs, counsel parents, and sometimes help teachers with classroom activities.
Clients of speech-language pathologists include 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. Speech-language pathologists may also work with people who have oral motor problems that cause eating and swallowing difficulties. Clients’ problems may be congenital, developmental, or acquired, and caused by hearing loss, brain injury or deterioration, cerebral palsy, stroke, cleft palate, voice pathology, mental retardation, or emotional problems.
Speech-language pathologists conduct written and oral tests and use special instruments to analyze and diagnose the nature and extent of impairment. They develop an individualized plan of care, which may include automated devices and sign language. They teach clients how to make sounds, improve their voices, or increase their language skills to communicate more effectively. Speech-language pathologists help clients develop, or recover, reliable communication skills.
People who have hearing, balance, and related problems consult audiologists, who use audiometers and other testing devices to discover 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 device, and audiologic rehabilitation (including auditory training or instruction in speech or lip reading). Audiologists provide fitting and tuning of cochlear implants and help those with implants adjust to the implant amplification systems. They also test noise levels in workplaces and conduct hearing protection programs in industrial settings, as well as in schools and communities.
Audiologists provide direct clinical services to clients and sometimes develop and implement individual treatment programs. In some environments, however, they work as members of professional teams in planning and implementing treatment plans.
In a research environment, speech pathologists and audiologists investigate communicative disorders and their causes and ways to improve clinical services. Those teaching in colleges and universities instruct students on the principles and bases of communication, communication disorders, and clinical techniques used in speech and hearing.
Speech-language pathologists and audiologists keep records on the initial evaluation, progress, and discharge of clients to identify problems and track progress. They counsel individuals and their families on how to cope with the stress and misunderstanding that often accompany communication disorders.
Speech-Language Pathologist and Audiologist Career Requirements
Since a college degree is a must for practicing this profession, make sure your high school classes are geared toward preparing you for higher education. Health and science classes, including biology, are very important. Mathematics classes and English classes will help you develop the math, research, and writing skills you will need in college. Because speech-language pathologists and audiologists work so intensely with language, you may also find it beneficial to study a foreign language, paying special attention to how you learn to make sounds and remember words. Speech classes will also improve your awareness of sounds and language as well as improve your speaking and listening skills.
Most states require a master’s degree in speech-language pathology or audiology for a beginning job in either profession. As of 2005, 47 states required speech-language pathologists to be licensed if they work in a health care setting, and 11 states require the same degree to practice in a public school. Typical majors for those going into this field include communication sciences and disorders, speech and hearing, or education. Regardless of your career goal (speech-language pathologist or audiologist), your undergraduate course work should include classes in anatomy, biology, physiology, physics, and other related areas, such as linguistics, semantics, and phonetics. It is also helpful to have some exposure to child psychology. Accredited graduate programs in speech-language pathology are available from 239 colleges and universities.
To be eligible for certification, which most employers and states require, you must have at least a master’s degree from a program accredited by the accreditation council of the American Speech-Language-Hearing Association (ASHA). According to the ASHA, as of 2012, audiologists will have to earn a doctorate in order to be certified. Currently there are more than 400 programs in speech-language pathology and/or audiology; however, not all of these programs are accredited. It is in your best interest to contact ASHA for a listing of accredited programs before you decide on a graduate school to attend. Some schools offer graduate degrees only in speech-language pathology or graduate degrees only in audiology. A number of schools offer degrees in both fields. Graduate-level course work in audiology includes such studies as hearing and language disorders, normal auditory and speech-language development, balance, and audiology instrumentation. Graduate-level work for those in speech-language pathologist includes studies in evaluating and treating speech and language disorders, stuttering, pronunciation, and voice modulation. Students of both disciplines are required to complete supervised clinical fieldwork or practicum.
If you plan to go into research, teaching, or administration, you will need to complete a doctorate degree.
Certification or Licensing
To work as a speech pathologist or audiologist in a public school, you will be required to be a certified teacher and you must meet special state requirements if treating children with disabilities. Almost all states regulate audiology and/or speech-language pathology through licensure or title registration, and all but six of those require continuing education for license renewal. In order to become licensed, you must have completed an advanced degree in the field (generally a master’s degree, but a doctorate is becoming the new standard for audiologists), pass a standardized test, and complete 300 to 375 hours of supervised clinical experience and nine months of postgraduate professional clinical experience. Some states permit audiologists to dispense hearing aids under an audiology license. Specific education and experience requirements, type of regulation, and title use vary by state.
Many states base their licensing laws on ASHA certification. ASHA offers speech-language pathologists the certificate of clinical competence in speech-language pathology and audiologists the certificate of clinical competence in audiology. To be eligible for these certifications, you must meet certain education requirements, such as the supervised clinical fieldwork experience, and have completed a postgraduate clinical fellowship. The fellowship must be no less than 36 weeks of full-time professional employment or its part-time equivalent. You must then pass an examination in the area in which you want certification.
Naturally, speech language pathologists and audiologists should have strong communication skills. Note, though, that this means more than being able to speak clearly. You must be able to explain diagnostic test results and treatment plans in an easily understood way for a variety of clients who are already experiencing problems. As a speech language pathologist and audiologist, you should enjoy working with people, both your clients and other professionals who may be involved in the client’s treatment. In addition, you need patience and compassion. A client’s progress may be slow, and you should be supportive and encouraging during these times.
Exploring Speech-Language Pathologist and Audiologist Career
Although the specialized nature of this work makes it difficult for you to get an informal introduction to either profession, there are opportunities to be found. Official training must begin at the college or university level, but it is possible for you to volunteer in clinics and hospitals. As a prospective speech-language pathologist and audiologist, you may also find it helpful to learn sign language or volunteer your time in speech, language, and hearing centers.
According to the Occupational Outlook Handbook, there are about 96,000 speech-language pathologists and 10,000 audiologists employed in the United States as of 2004. About one-half of speech-language pathologists are employed in education, from elementary school to the university level. More than half of audiologists work in physicians’ offices and medical facilities. Other professionals in this field work in state and local governments, hearing aid stores (audiologists), and scientific research facilities. A small but growing number of speech-language pathologists and audiologists are in private practice, generally working with patients referred to them by physicians and other health practitioners.
Some speech-language pathologists and audiologists contract to provide services in schools, hospitals, or nursing homes, or work as consultants to industry.
If you want to work in the public school systems, the college placement office can help you with interviewing skills. Professors sometimes know of job openings and may even post these openings on a centrally located bulletin board. It may be possible to find employment by contacting a hospital or rehabilitation center. To work in colleges and universities as a specialist in the classroom, clinic, or research center, it is almost mandatory to be working on a graduate degree. Many scholarships, fellowships, and grants for assistants are available in colleges and universities giving courses in speech-language pathology and audiology. Most of these and other assistance programs are offered at the graduate level. The U.S. Rehabilitation Services Administration, the Children’s Bureau, the U.S. Department of Education, and the National Institutes of Health allocate funds for teaching and training grants to colleges and universities with graduate study programs. In addition, the Department of Veterans Affairs provides stipends (a fixed allowance) for predoctoral work.
Advancement in speech-language pathology and audiology is based chiefly on education. Individuals who have completed graduate study will have the best opportunities to enter research and administrative areas, supervising other speech-language pathologists or audiologists either in developmental work or in public school systems.
The U.S. Department of Labor reports that in 2004 speech-language pathologists earned a median annual salary of $52,410. Salaries ranged from to less than $34,720 to more than $82,420. Also in 2004, audiologists earned a median annual salary of $51,470. The lowest 10 percent of these workers earned less than $34,990, while the highest 10 percent earned $75,990 or more per year. Geographic location and type of facility are important salary variables. Almost all employment situations provide fringe benefits such as paid vacations, sick leave, and retirement programs.
Most speech-language pathologists and audiologists work 40 hours a week at a desk or table in clean comfortable surroundings. Speech-language pathologists and audiologists who focus on research, however, may work longer hours. 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.
Speech-Language Pathologist and Audiologist Career Outlook
Population growth, lengthening life spans, and increased public awareness of the problems associated with communicative disorders indicate a highly favorable employment outlook for well-qualified personnel. The U.S. Department of Labor predicts that employment for speech-language pathologists and audiologists will grow faster than the average through 2014. Much of this growth depends on economic factors, further budget cutbacks by health care providers and third-party payers, and legal mandates requiring services for people with disabilities.
Nearly half of the new jobs emerging through the end of the decade are expected to be in speech and hearing clinics, physicians’ offices, and outpatient care facilities. Speech-language pathologists and audiologists will be needed in these places, for example, to carry out the increasing number of rehabilitation programs for stroke victims and patients with head injuries.
Substantial job growth will continue to occur in elementary and secondary schools because of the Education for All Handicapped Children Act of 1975 and the Individuals with Disabilities Education Act in 1990 and 1997. Such laws guarantee special education and related services to minors with disabilities.
Many new jobs will be created in hospitals, nursing homes, rehabilitation centers, and home health agencies; most of these openings will probably be filled by private practitioners employed on a contract basis. Opportunities for speech-language pathologists and audiologists in private practice should increase in the future. There should be a greater demand for consultant audiologists in the area of industrial and environmental noise as manufacturing and other companies develop and carry out noise-control programs.