December 26, 2006 Features

The Professions Around the World

New Web-Based Directory Goes Global

Many speech-language pathologists and audiologists have interests that extend beyond their national borders. Some seek international connections for information exchange, discussion, and a sense of belonging to a large professional community. Some hope to visit, study, volunteer, or work abroad. Others are motivated by wanderlust, or the urge to "make a difference," or by concerns about disparities in health care, educational opportunities, and social challenges faced by persons with communicative disorders in various places around the world. Many others wish to participate in international activities without leaving their home country—perhaps collecting books and supplies for professionals in a developing country, or simply reading about communication disorder services in professional journals. The recent quadrilateral agreement among the United States, Canada, England, and Australia both reflects and is likely to spur interest in international issues (Boswell, 2004).

To judge by letters to international Web sites and frustrations voiced at professional meetings, far more clinicians seek international connections than obtain them. Often, professionals cite lack of readily accessible, reliable information as the single biggest stumbling block to obtaining international experiences. Those who would like an international experience sometimes feel they must "re-invent the wheel" to obtain one. As Caroline Bowen wrote in her Web site in response to a query asking how to obtain an international experience, "I get a lot of inquiries about this sort of thing, but as far as I know there is no central office that adventurous, globetrotting SLPs can turn to for advice."

Fortunately, a person who wants to develop a more international perspective on communication disorders need not re-invent the wheel. Great stores of information and advice already exist. The difficulty is that the information is spread across numerous places, including a multitude of Internet sites, books, articles, and discussion forums. An important step toward developing an international perspective was to pull this wealth of information together.

The information that follows is based on the International Directory of Communication Disorders (IDCD), a free Internet resource (www.comdisinternational.com). The IDCD is a contribution to the attempt to facilitate international communication among persons in the professions. It required two years to complete and involved the efforts of many students and colleagues—including an advisory board that began as eight colleagues meeting in the author's hotel room at the 2003 ASHA Convention and grew to include a diverse group of 27 clinicians, academics, and students from many places around the world. Tracking down information for the IDCD felt like detective work—following leads, interviewing in person and via e-mail, contacting colleagues of colleagues, visiting programs, collecting stories. Many more leads ended in dead-ends than in somewhere fruitful. Sometimes, though, patient labor was rewarded with a huge cache of information, or a single hard-to-find address, or a great, fascinating story from a colleague in a distant country.

Six insights emerged from the effort to develop the IDCD:

1. The impact of a communication disorder varies depending on where a person lives.

The amount of attention a country gives to communication disorders depends on its history, cultural views on language and disability, economics, and availability of services (Kotby, 2006; McLeod & Bleile, 2007). As a result, someone with a fluency disorder may lead a normal and productive life in one country, while in another may spend life shut away in the family home (St. Louis & Andrade, 2004). In many countries a developmental language disorder is considered a treatable problem; in others, it may prohibit an education. In some countries a person with a severe hearing impairment may elect to enter the Deaf community or receive a cochlear implant, while in others a severe hearing impairment effectively denies or limits access to education, health services, and community (Jewett, 2003).

Challenges encountered by a person with a communication disorder may be aggravated in countries with more limited health and education resources. In an impoverished country, not all children may be permitted to attend school. As the World Bank's Millennium Project (World Bank Group, 2005) emphasizes, child mortality rates are tied to poverty, lack of education, and limited access to health care. To illustrate, in the West African country of Mali, the mortality rate in poor, rural families is twice as high as that in wealthy urban families. Worldwide, 100 million primary-aged school children remain out of school, almost 60% of them girls. A disability that limits a person's educational and vocational opportunities, including those in communication, contributes to poverty and, consequently, to higher childhood mortality. In recognition of the impact of education and disability on childhood mortality, the Millennium Project's five-point agenda includes improving human development services by rapidly increasing the supply of skilled workers in health and education (World Bank Group, 2005).

2. Titles, education levels, and responsibilities of professionals vary widely among nations.

Clinicians in the U.S. professions of speech-language pathology and audiology have different names elsewhere—including speech and language therapists, logopedics, speech-language pathologists, speech pathologists, phonoatricans, phonoaudiologists, audiologists, and audiometricists. Differences go beyond name. A bachelor's degree is required to practice in many countries; associate and master's degree requirements are less common. Importantly, because university systems differ, a bachelor's degree in one country may not be equivalent to the same degree in another. Responsibilities of professionals also differ: some countries blend speech-language pathology and audiology services, while in others the professions more closely resemble a branch of special education.

3. The professions of speech-language pathology and audiology are new or non-existent in many countries.

Poverty may preclude a nation's ability to train professionals (Ndigirwa, 2006). In less-affluent countries, communication services may not exist or may be provided by family members, volunteers, or members of another discipline, including nursing, psychology, or education. In Turkey, for example, the profession of speech-language pathology is newly established. As a result, 97% of speech-language pathology services are still performed by persons in other disciplines, including audiologists [Topbas S., & Özdemir, S. (2001)]. Formal education for such persons about communication disorders may be nonexistent or consist of a single course or seminar.

4. At least 55 nations or territories have national professional associations focusing on communication disorders.

Approximately one-quarter of the world's nations have national professional associations focusing on communication disorders (see Table 1). In countries in which the professions are well-developed, an increasingly typical pattern is to have two national associations, one focusing on speech-language pathology and the other on audiology. Some countries have more than two. For example, Germany has at least five national associations, and Argentina and Brazil each have four. Table 1 lists the largest national association in each country (in English when reliable translations are available); a maximum of two are listed for countries in which each of the professions has a national association.

National professional organizations are well- established in Europe, throughout the Americas, and in parts of the Middle East and Asia-Pacific. In sub- Saharan Africa, national associations are found in South Africa and Nigeria. As of this writing, the newest national association is in Turkey. National associations in some countries comprise many thousands of members, while others consist of a few pioneers. Information on numbers of persons within these associations is not always available.

5. At least 24 international professional associations and groups focus primarily on communication disorders.

These organizations differ enormously from one another in perspective and scope (see Table 2). For example, the International Affairs Association and Communication Therapy International share broad perspectives, with the former focusing on the entire world and the latter on supporting SLPs in countries with no or limited services for persons with communication impairments. The International Hearing Society, Humanitarian Audiology, the International Society of Audiology, and the International Association of Logopedics and Phonoatrics have missions nearly as broad—they have the entire world and either audiology or speech-language pathology within their purviews. Associations such as the International Stuttering Association, the International Society for Augmentative and Alternative Communication, and International Clinical Phonetics and Linguistics Association focus on a narrower range of disability. Still other types of associations concentrate on communication disorders as they occur in a specific world region, including the Asia Pacific Society for the Study of Speech, Language and Hearing and the Indo-International Society of Communication and Hearing Sciences.

6. At least 51 nations and territories have post-secondary school programs that educate students in either speech-language pathology or audiology.

Addresses for education programs in these countries are best accessed through national and international associations (see Table 3). This list overlaps extensively with, but is not identical to, the list of countries and territories with national associations. Student education programs are found primarily in Europe, the Americas, Asia-Pacific, and parts of Asia and the Middle East. A single sub-Saharan African country—South Africa—has student education programs. The newest student education programs (as of this 2006 writing) are in Kuwait and Bangladesh. In total, at least 672 student education programs exist worldwide. In countries and territories with student education programs, the number of programs available to a student varies tremendously. To illustrate, two large populous countries—the United States and Brazil—have approximately 300 and 100 student education programs, respectively. However, an even larger and more populous country, China, has one such program—the University of Hong Kong Speech and Hearing Services.

The International Perspective

In countries with more limited resources, a disability that restricts a person's educational and vocational opportunities contributes to poverty and, consequently, to higher childhood mortality. Education programs for students and national associations help protect the public through advocacy and education, and by establishing and maintaining standards of care. International associations facilitate interactions among groups with similar professional interests.

A person seeking an international perspective on communication disorders may be surprised to learn how much international work already is taking place. A quarter of the world's countries and territories have professionals who provide communication services to their citizens—a vast increase in service provision and a shining accomplishment for professions that existed in only a handful of countries 50 years ago.

The professions are largely absent in three-quarters of the world's countries and territories, many of which are also the most impoverished. In such countries, communication services may not exist or may be provided by volunteers or members of another discipline, including nursing, psychology, or education.

Fortunately, a professional seeking a more international perspective on communication disorders has many resources upon which to draw. Whether the motivation is simple curiosity, armchair traveling, fundraising, or the desire to study, volunteer, or work abroad, great stores of information and resources already exist. The challenge is to learn where these resources are and how to tap into them.

Kenneth M. Bleile, is a professor in the Department of Communicative Disorders at the University of Northern Iowa. He is the author of several publications, including The Late Eight and Manual of Articulation and Phonological Disorders. Contact him at ken.bleile@uni.edu.

Lauren Ireland, recently graduated from the University of Northern Iowa with a master's degree in speech- language pathology. She has worked as an SLP in Chile, Peru, Honduras, and Nicaragua.

Tricia Kiel, recently graduated from the University of Northern Iowa with a master's degree in speech-language pathology. She has strong interests in international issues affecting persons with communication disorders.

cite as: Bleile, K. M. , Ireland, L.  & Kiel, T. (2006, December 26). The Professions Around the World : New Web-Based Directory Goes Global. The ASHA Leader.

By the Numbers

Countries with national associations: At least 55

Country with the newest national association: Turkey

Number of international professional associations and groups: At least 24

Newest international association: Asia Pacific Society for the Study of Speech, Language and Hearing

Number of countries with student education programs: At least 51

Region with fewest student education programs: Sub-Saharan Africa

Countries developing student education programs: Iceland and Singapore

Number of student education programs worldwide: Approximately 672

Country with the newest student program: Bangladesh



Resource

The International Directory of Communications Disorders (ICDC) can be found at www.comdisinternational.com. This free Internet resource for SLPs and audiologists includes comprehensive listings of:

  • National speech-language-hearing and audiology associations in countries and territories throughout the world, with descriptions and addresses
  • International organizations for professionals who care for persons with communication disorders
  • Countries and territories with student education programs
  • Agencies that offer study, volunteer, or work abroad opportunities

The site also includes health and travel guides and first-person accounts of international experiences.



References

Boswell, S. (2004, Oct. 19). International agreement brings mutual recognition of certification. The ASHA Leader, pp. 1, 22

Bowen, C. (2004). http://www.speech-language-therapy.com/index.php?option=com_content&view=article&id=20&Itemid=122.

Jewett, J. (2003, May 23). A labor of love in Bosnia. The ASHA Leader, 11 (7), 20-21, 27.

Kotby, M. N. (2006, May 23). Egypt: Four decades of voice research. The ASHA Leader, 11(7), 30-32.

McLeod, S. & Bleile, K. (2007). Speech acquisition: A framework. In McLeod (Ed.)., The International Perspective on Speech Acquisition. New York: Thomson Delmar.

Ndigirwa, P. (2006). A View from Tanzania. The International Directory of Communication Disorders.

St. Louis, K. O., & Andrade, C. R., F. de (2004). Public attitudes toward stuttering and other human attributes in Brazil. In A. Packman, A. Meltzer, & H. F. M. Peters (Eds.). Proceedings of the 4th World Congress on Fluency Disorders (pp. 488-495). Nijmegen: The Netherlands: Nijmegen University Press.

Topbas, S., & Özdemir, S. (2001). An emerging profession in Turkey: Speech and language therapy. Abstract Proceedings of International Special Education Congress, 2001 Jul 24-27; Antalya, Turkey.

World Bank Group (2005). www.worldbank.org



Countries with National Associations

Argentina
Asociacion Argentina de Logopedia
www.asalfa.org

Asociacion Argentina de logopedia Foniatria y Audiologia (ASALFA)
www.afafonoaudiologica.com.ar

Australia
Speech Pathology Australia
www.speechpathologyaustralia.org.au

Audiological Society of Australia (ASA)
www.audiology.asn.au/

Austria
Bundesverband Diplomierte Logopädinnen Österreich
http://www.logopaedieaustria.at/de/welcome.htm

Oesterreichische Gesellschaft für Logopädie
www.hno.at

Belgium
Union Professionnelle des Logopèdes Francophones (UPLF)
www.uplf.be

Vlaamse Verening voor Logopedisten
www.vvl.be

Brazil
Conselho Regional de Fonoaudiologia
www.cefac.br

The Regional Council of Speech-language Pathology (São Paulo)
www.fonosp.org.br

Canada
Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA)
www.caslpa.ca

Canadian Academy of Audiology
www.canadianaudiology.ca

Chile
Colegio de Fonoaudiólogos de Chile
E-mail: colfono@colfono.tie.cl

China
The Hong Kong Association of Speech Therapists (HKAST)
www.speechtherapy.org.hk

Columbia
Asociación Colombiana de Fonoaudiología y Terapia del Lenguaje (ACFTL)
www.asofono.org/

Costa Rica
Asociación Costarricense de Terapeutas del Lenguaje (ACOTEL)
E-mail:  marce_mv@yahoo.com

Cuba
Asociacion de Linguistas de Cuba
No Web site

Cyprus
Cyprus SLT-SLP Association
www2.cytanet.com.cy/speechtherapy  

Czech Republic
The Association of Clinical Logopedics
No Web site

Denmark
Danish Speech-Language-Hearing Association (ALF)
Audiologopaedisk Forening 
www.alf.dk

Egypt
Egyptian Society of Phoniatrics and Logopedics
E-mail: nkotby@attmail.com

Estonia
Estonian Logopedists Union
No Web site

Finland
Suomen Puheterapeuttiliitto
www.puheterapeuttiliitto.fi

France
Federation Nationale des Orthophonistes
www.orthophonistes.fr

Union Nationale pour le Développement de la Recherche et de l'Évaluation en Orthophonie
www.unadreo.org  

Germany
Deutscher Bundesverband für Logopädie e.V.
www.dbl-ev.de

Deutsche Gesellschaft fur Phoniatrie und Padaudiologie e.V.
Abt fur Audiologie und Phoniatrie
www.dgpp.de/

Greece
Panhellenios Syllogos Logopedikon
www.logopedists.gr

Hungary
Ungarishe Gesellschaft fur Phonetik, Phoniatrie und Logopadie
(Ungarishe Society for Phonetics, Phoniatrie und Logopadie)
No Web site

Iceland
The Icelandic Association of Speech Therapists and Speech-language Pathologists
No Web site

India
Indian Speech and Hearing Association
http://ishaindia.org.in/

Indonesia
Indonesian Speech Therapist Association
E-mail: munas_ikatwi@mail.com

Ireland
Royal College of Speech and Language Therapists
www.rcslt.org/

I.A.S.L.T. (Irish Association for Speech and Language Therapists)
E-mail: info@iaslt.com

Israel
Israeli Speech, Hearing and Language Association (ISHLA)
http://www.ishla.org.il/

Italy
Federazione Logopedisti Italiani (FLI)
www.fli.it

Japan
Japanese Association of Speech Language-Hearing Therapists (JAS)
www.jaslht.gr.jp/

Japan Audiological Society
www.audiology-japan.jp

Luxembourg
Association Luxembourgeoise des Orthophonistes
www.alo.lu

Malaysia
Malaysian Association of Speech-Language and Hearing (MASH)
www.mash.org.my/

Malta
The Association of Speech Therapists
No Web site

Mexico
Sociedad Mexicana de Audiologia y Foniatria
No Web site

The Netherlands
Nederlandse Verening voor Logopedie en Foniatria (NVLF)
www.nvlf.nl

New Zealand
New Zealand Speech-Language Therapists Association (NZSTA)
www.nzsta-speech.org.nz

New Zealand Audiological Society (NZAS)
www.audiology.org.nz/

Nigeria
Nigerian Speech and Hearing Association
No Web site

Norway
The Norwegian Association of Speech and Language Therapists
www.norsk-logopedlag.no

The Norwegian Association of Audiologists
No Web site

Panama
Colegio Nacional de Fonoaudiólogos de Panamá   
E-mail: thelmaderocha@hotmail.com

Philippines
Philippine Association of Speech Pathologists
E-mail: pasp_secretariat@yahoo.com

Poland
Polish Logopaedic Society
www.logopedia.umcs.lublin.pl

Phoniatric Section of the Polish ENT Society
E-mail: aobrebowski@am.poznan.pl

Portugal
Associação Portuguesa Terapeutas da Fala
www.aptf.org

Puerto Rico
Organización Puertorriqueña de Patología del Habla, Lenguaje y Audiología (OPPHLA)
E-mail: calimarmoral@centenniapr.net

Russia
Association of Phoniatricians and Speech Therapists
E-mail: ivanchenkolon@rambler.ru

Saudi Arabia
Saudi speech Pathology and Audiology Association
No Web site

Singapore
Speech Language Hearing Association, Singapore (SHAS)
www.shas.org.sg/

South Africa
South African Speech Language Hearing Association (SASLHA)
www.saslha.co.za

South Korea
Korean Academy of Speech-Language Pathology & Audiology
www.kasla.or.kr/

Spain
Asociación de Diplomados Universitarios en Logopedia
www.adul-logopedia.org

Association Espanola de Logopedia Foniatria y Audiologia (AELFA)
www.aelfa.org/

Sweden
The Swedish Association of Logopedists (SLOF)
http://www.dik.se/logoped

Swedish Association of Phoniatrics and Logopedics (SFFL)
No Web site

Switzerland
Conference des Associations Professionnelles Suisses des Logopedistes - C/APSL
Schlössli 62
CH- 2512 Tüscherz-Alfermée
Switzerland
www.logopaedie.ch

Schweizerische Arbeitsgemeinschaft  fürLogopädie (SAL)
www.salogopaedie.ch

Taiwan
The Speech-Language-Hearing Association of the Republic of China
www.slh.org.tw/

Thailand
Thai Speech and Hearing Association
E-mail: krisna44@hotmail.com

Turkey
Association of Speech and Language Pathologists (DKBUD)
www.dkbud.org

Association of Audiology, Speech and Voice Pathologists
No Web site

United Kingdom
Royal College of Speech and Language Therapists (RCSLT)
www.rcslt.org/

British Academy of Audiology
www.baaudiology.org/

United States of America
American Speech-Language-Hearing Association (ASHA)
www.asha.org/

American Academy of Audiology (AAA)
www.audiology.org

Uruguay
Asociación de Fonoaudiología del Uruguay (A.deF.U.) 
E-mail: adefu@adinet.com.uy

Venezuela
Asociación Fonoaudiólogos Venezuela
No Web site 



International Associations

Afasic 
http://www.afasic.org.uk/

Asia Pacific Society for the Study of Speech, Language and Hearing  
www.shrs.uq.edu.au/asiapacific

Council of Academic Programs in Communication Sciences and Disorders 
www.capcsd.org/

Caroline Bowen's Website
http://www.speech-language-therapy.com

Comité Permanent de Liaison des Orthophonistes / Logopedes de l'Union Européenne (CPLOL)
www.cplol.org/default_.htm

Communication Therapy International (CTI)
No Web site

DGSS (Deutsche Gesellschaft f. Phoniatrie u. Pädaudiologie e.V.)
www.dgss-ev.org

Disability Resource Directory
www.disability-resource.com

Humanitarian Audiology
http://www.isa-audiology.org/human.html

Indo-International Society of Communication and Hearing Sciences
www.iischs.com

The International Association of Logopedics and Phonatrics (IALP)
http://www.ialp.info/

International Association of Orofacial Myology (IAOM)
www.iaom.com/

International Clinical Phonetics and Linguistics Association (ICPLA)
http://www.ucs.louisiana.edu/~mjb0372/ICPLA.html

International Fluency Association (IFA)
www.theifa.org

International Hearing Society (IHS)
www.ihsinfo.org

International Society of Audiology (ISA)
www.isa-audiology.org

International Society for Augmentative and Alternative Communication (ISAAC)
http://www.isaac-online.org/en/about/index.html

International Stuttering Association (ISA)
http://www.stutterisa.org/

PanAmerican Society of Audiology
www.pasaudi.org

The Overseas Association of Communication Sciences (OSACS)
E-mail: Susan.Abbott@Lnd.amedd.army.mil

Talking Point
http://www.talkingpoint.org.uk/

Union of the European Phoniatrics
http://www.uni-leipzig.de/~uep/

World Federation of the Deaf
http://www.hearinglossweb.com/res/hlorg/wfd.htm



Nations and Territories with Student Education Programs

Algeria Japan
Argentina Jordan
Australia Kuwait
Austria Latvia
Bangladesh Malaysia
Belgium Mexico
Brazil Netherlands
Canada New Zealand
Chile Norway
China Peru
Columbia Philippines
Costa Rica Portugal
Cuba Puerto Rico
Denmark Russia
Dominican Republic Singapore*
Egypt Slovak Republic
Finland South Africa
France South Korea
Germany Spain
Greece Sri Lanka
Iceland* Sweden
India Taiwan
Indonesia Thailand
Iran United Kingdom
Ireland Turkey
Israel Uruguay
Italy  

* Development of a program is under discussion



A Quick Tour Around the World

If you want a quick Internet tour of the professions of communication disorders around the world, the following opinionated list may provide a good place to start.

American Academy of Audiology (AAA)
www.audiology.org
An excellent website with good information about audiology from an international perspective.

American Speech-Language-Hearing Association
www.asha.org/
Website of the world's largest national association of communication disorders; the site has excellent resources both on the professions in the United States and on international topics.

Asia Pacific Society for the Study of Speech, Language and Hearing
www.shrs.uq.edu.au/asiapacific
The newest international association focusing on communication disorders; its focus is the Asia Pacific Rim, a vast region containing equally vast disparities in health care and education. 

Conselho Regional de Fonoaudiologia (Regional Council of Phonoaudiology)
www.cefac.br
A very complete website focusing on Brazil, the country with the world's second largest number of student education programs in communication disorders.  Most of the website is in Portugeuse, though sectcions are also in English.

Caroline Bowen's Website
http://www.speech-language-therapy.com/  
A wonderful international website; the listserv is the best place on the Internet to discuss phonological disorders from an international perspective.

Centers for Disease Control and Prevention
http://www.cdc.gov/travel/
If you plan to travel internationally, especially in areas where health risks exist, this is the site to visit.

Comité Permanent de Liaison des Orthophonistes / Logopedes de l'Union Européenne (CPLOL) (Speech and Language Therapy in European countries)
www.cplol.org/default_.htm
This is the best Internet resource for information on the professions in Europe.

Humanitarian Audiology
http://www.isa-audiology.org/human.html
A website for audiologists, mostly American based, dedicated to improving the care of hearing disorders worldwide.

Indo-International Society of Communication and Hearing Sciences
www.iischs.com
A great site filled with useful information about the professions in India.  A new feature of the site is an electronic journal.

The International Association of Logopedics and Phoniatrics (IALP)
http://www.ialp.info/
This is the website of the oldest international association focusing on communication disorders. 

Malaysian Association of Speech-Language and Hearing (MASH)
www.mash.org.my/
This is a great website to find out what's going on in Malaysia, a country with an extremely dedicated community of speech-language pathologists and audiologists.

New Zealand Speech-Language Therapists Association (NZSTA)
www.nzsta-speech.org.nz
This is a well-organized, user friendly site that offers an excellent perspective on the professions in New Zealand.

Speech Language Hearing Association, Singapore (SHAS)
www.shas.org.sg/
Singapore has a small professional association, but makes up for smallness of numbers with extra energy and intelligence.  The website is an excellent place to learn more about the professions in an exciting part of the world. 

South African Speech Language Hearing Association (SASLHA)
www.saslha.co.za
This is the website of the best established professional association in sub-Saharan Africa.  Increasingly, South Africa is where African students go for training in communication disorders.  If the field of communication disorders has a hub in sub-Saharan Africa, it lies in South Africa.

United States Central Intelligence Agency
https://www.cia.gov/cia/publications/factbook/index.html
This website contains brief, very useful profiles of individual countries.

World Health Organization
www.who.int/en
Website of the premiere international health care organization; the site is not always easy to navigate, but the information it contains is worth the time and effort. 



  

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