Joint Statement on the American Speech-Language-Hearing Association Draft of the Revised Scope of Practice in Speech-Language Pathology
The American Academy of Audiology (AAA) and the Academy of Dispensing Audiologists (ADA) jointly express significant concern regarding the document entitled Revised Scope of Practice in Speech-Language Pathology. The American Academy of Audiology represents nearly 7000 audiologists, the Academy of Dispensing Audiology 1300 audiologists, many of whom are also members of ASHA. We view this statement as a clear attempt to expand the scope of practice of the speech language pathologist into the domain of the audiologist. In view of the fact that audiology and speech-language pathology are separate professions, distinct boundaries exist between the two, and must be maintained. This draft, as written, is unacceptable.
Professional scope of practice implies activities in which the professional engages as part of his or her professional domain. Many of the statements made in this document refer to activities that the speech-language pathologist may perform in the role of a technician, supervised by an audiologist, and as such, do not constitute professional scope of practice.
This statement notes (page 8) that '...(speech-language pathologists') services need not be prescribed or supervised by individuals in other professions'. The statement goes on (page 9) to identify as a portion of the speech-language pathologist's scope of practice 'Screening hearing across the lifespan....through the use of dedicated physiologic and acoustic screening technologies (e.g., ABR, OAE...)...'. The Joint Committee on Infant Hearing Year 2000 Position Statement clearly identifies that the role of the speech-language pathologist in such screening is equivalent to the role played by nurses, technicians and 'others who are trained by the audiologist'. The JCIH statement stipulates that an individual performing screening who is not an audiologist must use only automated ABR or OAE, in which the decision regarding pass or fail is made by the equipment, not the individual. As such, this type of screening is performed not as a part of the scope of practice, but as any technician or indeed trained volunteer under the supervision of an audiologist. In this role, the speech-language pathologist is not acting as a professional, and as such, does not constitute scope of professional practice.
The ASHA requirements for audiology credit hours require that a speech-language pathologist attain 6 credit hours, 3 of which are in basic audiometry. To suggest that 3 credit hours in aural (auditory) rehabilitation is sufficient to provide competency in the administration and interpretation of physiologic tests such as ABR, OAE, and acoustic immittance, not to mention attaining competency in auditory rehabilitation for children and adults, is incredible. Certainly, by training, experience and professional practice, the suggestion that the speech language pathologist is qualified to independently perform ABR, OAE and aural acoustic immittance on a patient of any age, let alone a newborn or young infant, is absurd and dangerous.
Item 2 page 9 requires the same footnote as that appended to item 6 on the same page. Otherwise, the dispensing of hearing aids and assistive (listening) devices would fall under this statement.
Any reference to manual inspection of amplification devices, as shown in Item 3 page 9, should be eliminated, as the speech-language pathologist does not have the training nor the experience to offer any advice regarding amplification devices.
Finally, auditory rehabilitation is central to the practice of audiology and the professional scope of practice of the audiologist. While speech-language pathologists play an important role, along with the audiologist and deaf educator, in the rehabilitation of hearing impaired children, the knowledge base of the speech-language pathologist in providing rehabilitation services to the hearing impaired adult is significantly limited. Auditory rehabilitation activities for adult patients center around hearing aids and assistive listening devices, areas in which the training of the speech language pathologist is minimal. The statement in this draft document that speech-language pathologists provide any and all auditory rehabilitation activities on an equal footing with the audiologist is unacceptable.
This draft statement appears to be a deliberate foray into the scope of practice of the audiologist, and an expansion of the role of the speech pathologist at the expense of the audiologist. It is unacceptable to the American Academy of Audiology and to the Academy of Dispensing Audiology.
Robert G. Glaser, Ph.D.
President
American Academy of Audiology
James M. McDonald, Sc.D.
President
Academy of Dispensing Audiologists
