Interview with John Bernthal Ph.D., President of American Speech Language Hearing Association (ASHA)

AO/Beck: Good evening Dr. Bernthal, it is a pleasure to speak with you.

Bernthal: Hi Doug, great to speak with you too.

AO/Beck: I'd like to kick this off by learning a little about you. My understanding is that you are a speech-language pathologist?

Bernthal: Yes, that's correct.

AO/Beck: Besides being the current president of ASHA, where do you work and how long have you been there?

Bernthal: I am a professor at the University of Nebraska-Lincoln (UNL). I've been here 17 years, and am chair of Special Education and Communication Disorders, a department that was formed by the merger of two departments several years ago.

AO/Beck: How many full-time audiologists do you have on the faculty?

Bernthal: We currently have five FTE allocated to the Audiology division; T. Newell Decker, Ph.D. - Electrophysiology Audiology, Steve Boney, Ph.D. - Aural Rehabilitation, Tom Carrell, Ph.D. - Hearing Science, Speech Perception and Jody Spalding, M.A. - Clinical Audiology. In addition, we have a Ph.D. level position open and also a couple of part-time individuals.

AO/Beck: What are the audiology degrees offered through UNL?

Bernthal: We offer M.S. and Ph.D. degrees at present. We have forwarded a proposal to the university to offer the Au.D., and that is moving forward.

AO/Beck: Very good. Let's move into the ASHA realm if we can. Tell me, please, how many audiologists are currently in ASHA, and of that number, how many are dually certified in speech-language pathology (SLP) and audiology?

Bernthal: There are approximately 13, 780 audiologists that are ASHA members, and 1,397 of them are dually certified. Of the almost 1,400 who are dually certified members, I don't know how many are practicing audiologists or SLPs, or if they practice in both areas.

AO/Beck: That's an interesting point. Ever since I got my master's, in the mid 1980s, I have known a handful of people who have been dually certified. Can you tell me a little about the advantages of being dually certified?

Bernthal: I don't think being dually certified is a strategy I would recommend for most individuals. There is so much to learn in both professions and a real challenge to keep up in one profession! There may be some advantages for individuals being dually certified if they practice in areas that cut across both professions. Early in my career, I was interested in both areas and obtained both certifications. I think dual certification provides one with a perspective about both professions but think it is extremely difficult to maintain currency in both areas. Most dually certified individuals actually practice in one or the other profession.

AO/Beck: Very good. Let's move on to accreditation. Is ASHA accrediting Au.D. programs?

Bernthal: There is confusion on this issue and I'm glad you brought it up. Let me try to explain. ASHA is the recognized accrediting agency for entry-level graduate degrees in the profession of audiology. ASHA's Council on Academic Accreditation (CAA) is recognized by the U.S. Department of Education and the Council for Higher Education Accreditation and is authorized to accredit entry-level graduate programs. So, post-baccalaureate entry level Au.D. programs are eligible for CAA accreditation and several such Au.D. programs hold CAA accreditation. Following the last skills validation study in 1994, the members of the Standards Council (which no longer exists), based on the study and the unanimous vote of audiologists on the Council, established the doctorate as the entry into the profession of audiology. Since entry level would be the doctorate, standards for both certification of individuals and accreditation of educational programs would have to be changed to reflect the new entry level for the profession of audiology. We are now in a transition to the doctorate. Beginning in 2012, only doctoral graduates can obtain the CCC-A. The reason the Standards Council initiated a 75 hour requirement in 2007 is because students will require four to five years to complete most entry-level professional doctoral programs. So if the programs are going to meet the certification requirements for 2012, they must have their programs up and running by 2007. In essence, nothing really has changed in terms of accreditation as ASHA-CAA remains the recognized accrediting body for graduate entry level programs whether they are master's or doctoral level. The only difference is that in the future, only doctoral level professional programs will be accredited instead of either doctoral or master's programs which is now the standard. The professional entry-level is transitioning to the doctoral degree. ASHA continues to be the accrediting body for the audiology programs. I might add that ASHA already accredits some entry level doctoral degree programs as current accreditation requires a graduate degree and some institutions already have professional doctoral programs in place. There is an area where ASHA does not have jurisdiction, and that is the post-master's or non-entry level doctoral programs. Post master's distance-ed programs are not entry-level, and so there is no accreditation body for those programs. However, ASHA is very concerned that such programs are of high quality as I am sure are all audiologists. I know this is a little confusing, but I hope this clarifies the status of accreditation of educational programs.

AO/Beck: So then, just to clarify this, the doctorate will become the entry-level degree and ASHA is the accrediting body for entry-level educational programs in audiology. However, if the Au.D. program is a post-master's program in audiology for previously licensed professionals, then ASHA has no accreditation authority over such distance-ed programs.

Bernthal: Yes, that's an accurate summary statement. Nothing really changes relative to accreditation, ASHA (via CAA) will continue accreditation of entry-level audiology programs just as they do now. The big difference is that certification will be at the doctoral level and that requires that all accredited programs must meet new standards for audiology accreditation.

AO/Beck: So currently, none of the distance-ed programs are ASHA accredited?

Bernthal: Only entry-level programs are accredited. I am not aware of any entry level distance-ed programs. There is no accrediting body for programs offering post-master's Au.D. programs as they are not entry level. However, ASHA is the accrediting agency for all entry-level graduate programs including Au.D. programs.

AO/Beck: What can you tell me abut the CCC-A situation with regards to the amount of people seeking and maintaining the CCC-A, and the status of the CCC-A in general?

Bernthal: For a few years, there were a small number of people who dropped ASHA membership but kept their CCC-A. That trend has reversed and in 2000 we saw a change in this trend as more individuals were keeping both their membership and their CCC-A and we had a reduction in the number of individuals who maintain certification only without membership. So the trend appears positive. I might mention that as we transition the profession to the doctoral entry level, maintaining the CCC-A certification will assist the profession to move to a doctoral level. The certification program will help to achieve doctoral level entry. For instance, if you don't have a state licensure, which requires a doctorate as the minimal entry level, licensure at the master's level is likely to continue even though academic programs will not be eligible for accreditation from ASHA. This is an important issue because most states model their licensure laws after the ASHA standards for certification, and several states have a pass-through provision for individuals who hold the CCC-A. In addition, CCC-A is required for reimbursement by some third party payers. If the CCC were removed, there is no assurance of what the standards for reimbursement would be. The CCC-A program will help transition the profession to the doctoral level. Without ASHA certification guidelines, there is very little in place to mandate a transition to doctoral level entry. Even with the CCC-A, it will take at least a decade or two for states to require a doctoral level entry for audiology.

AO/Beck: What about the number of ASHA approved audiology programs?

Bernthal: There are approximately 110 accredited audiology programs at the present and a current list of accredited programs can be found on the ASHA professional website (professional.asha.org) under student affairs and then go to academic programs. On this site you will note there are already ten Au.D. accredited programs with seven more who have accepted students for Fall 2001. As the standards become more rigorous and the costs of running the programs for equipment, personnel, faculty etc. increase, fewer programs will be able to meet the new accreditation standards. We anticipate a continued erosion of master's level entry programs until 2007 as less well funded programs, or those without the authority to grant doctoral degrees, will be unable to meet accreditation standards or the new certification standards. A second problem that is causing some institutions to drop their audiology programs is the lack of available individuals with Ph.Ds interested in academic positions.

AO/Beck: Please tell me about the upcoming ASHA meeting. I understand there will be two distinct meetings in New Orleans?

Bernthal: Yes, that's correct. Fred Bess Ph.D., is chair of the audiology program and suggested this format. The idea is to have all of the audiology programs in one place and have a separate audiology convention at the annual ASHA event called-- The Audiology Convention at ASHA. I think it's a good idea. Fred reports that the call for papers was very positive, which would suggest a good reception to the idea. The advantage of two separate conventions at the same location and time is that we can still celebrate together at events such as the awards ceremony. Similarly, in the big picture, even though we have separate professions, both groups benefit form the combined strength in membership, dollars, educational oversight, clinical protocols, research production, and political power provided by the two professions.

AO/Beck: Dr. Bernthal, I know you can't tell me about or report on 'closed-door' meetings, and that's fine. However, can you tell me whether or not you can envision areas of common growth and exploration between AAA and ASHA?

Bernthal: Absolutely. We have worked together in the past on some issues and a good example is the algorithm project. There are other areas where we collaborated. Both organizations are working for the profession of audiology and our clients. Many audiologists belong to both groups. It makes little sense for each organization to be duplicating effort and protocols. I'd like to see a stronger bond between the two organizations, and I think the potential is present for that to occur.

AO/Beck: Dr. Bernthal, I want to thank you for your time. I think you've addressed many issues that are of concern to all audiologists and I hope we can get some time to revisit some of these issues, perhaps towards the end of your presidency?

Bernthal: Sure, Doug that would be great. I'll look forward to catching up with you after the convention.