Significant Points
- 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.
Nature of Work
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, computers, 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 a variety of causes including
trauma at birth, viral infections, genetic disorders, exposure to loud
noise, or aging. Treatment may include examining and cleaning the ear
canal, fitting and dispensing hearing aids or other assistive devices,
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
measure 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.

Working Conditions
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.

Employment
Speech-language pathologists and audiologists held about 105,000 jobs
in 1998. About one-half provided services in preschools, elementary and
secondary schools, or colleges and universities. Others were in offices
of speech-language pathologists and audiologists; hospitals; offices of
physicians; speech, language, and hearing centers; home health agencies;
or other facilities.
Some speech-language pathologists and audiologists are self-employed
in private practice. They contract to provide services in schools,
physician’s offices, 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.

Training, Other
Qualifications and Advancement
Of the States that regulate licensing (44 for speech-language
pathologists and 49 for audiologists), almost all require a master’s
degree or equivalent. Other requirements are 300 to 375 hours of
supervised clinical experience, a passing score on a national
examination, and 9 months of postgraduate professional clinical
experience. Thirty-six 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 235 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 115 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. According to the American
Speech-Language Hearing Association, as of 2007, audiologists will need
to have a bachelor’s degree and complete 75 hours of credit toward a
doctoral degree in order to seek certification. As of 2012, audiologists
will have to earn a doctoral degree in order to be certified.
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.

Job Outlook
Employment of speech-language pathologists and audiologists is
expected to grow much
faster than the average for all occupations through the year 2008.
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 growth in health services would be even faster except for
Federal legislation imposing limits on reimbursement for therapy
services that may continue to adversely affect the job market for
therapy providers over the near term. Because of the effects of these
provisions, the majority of expected employment growth in health
services will occur in the second half of the projection period.
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 will rise due to the increasing use of contract
services by hospitals, schools, and nursing homes. In addition to job
openings stemming from employment growth, some openings for
speech-language pathologists and audiologists will arise from the need
to replace those who leave the occupation.

Earnings
Median annual earnings of speech-language pathologists and
audiologists were $43,080 in 1998. The middle 50 percent earned between
$34,580 and $55,260 a year. The lowest 10 percent earned less than
$27,460 and the highest 10 percent earned more than $80,720 a year.
Median annual earnings in the industries employing the largest number of
speech-language pathologists and audiologists in 1997 were as follows:
| Hospitals |
$44,800 |
| Offices of other health care practitioners |
44,500 |
| Elementary and secondary schools |
38,400 |
According to a 1999 survey by the American Speech-Language-Hearing
Association, the median annual salary for full-time certified
speech-language pathologists or audiologists who worked 11 or 12 months
annually was $44,000. For those who worked 9 or 10 months annually,
median annual salaries for speech-language pathologists were $40,000;
for audiologists, $42,000.

Related Occupations
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.

Sources of Additional
Information
Disclaimer: Links to
non-BLS Internet sites are provided for your
convenience and do not constitute an endorsement.
State licensing boards 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.
Information from: http://stats.bls.gov/oco/ocos085.htm
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