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by Michelle Ferketic
An ASHA-sponsored global survey of professionals in communication sciences and disorders (CSD) reveals that most countries have a written scope of practice and a formal mechanism for certifying and/or licensing CSD professionals. Most also have or are developing lists of knowledge bases and clinical skills.
The survey was sent to nearly 300 ASHA international affiliates, ASHA members or colleagues with expertise and interest in international issues related to CSD, and individuals overseas who had expressed an interest in participating in this project. The idea for the project developed at the 2006 ASHA Convention.
The survey addressed topics such as educational standards/requirements for students; service delivery to persons in remote/rural areas; the use of telepractice; and cultural, linguistic, and political influences on service delivery.
This global outreach and data-gathering is part of ASHA's Strategic Plan, which strives for mutual recognition by health and education organizations of each nation's certification standards, and for enhanced interchange of knowledge and education related to international collaboration on CSD issues.
The survey's response rate was 25%, and responding nations included Australia, Belgium, Brazil, Canada, Croatia, Cyprus, Denmark, Germany, Greece, Hong Kong, Iceland, Israel, Jamaica, the Netherlands, New Zealand, Norway, Saudi Arabia, South Africa, Switzerland, Turkey, the United Kingdom, and the United States.
The majority of respondents:
- Identified themselves as speech-language pathologists, followed by audiologists and orthophonists
- Work in a college/university, followed by nonresidential health care facility (e.g., clinic, private practice)
- Are educated and/or trained directly in a CSD profession
Service Delivery
The majority of clinical speech-language pathology services, including swallowing treatment and evaluation and/or treatment of central processing disorders, are provided by SLPs/logopedists/communication clinicians. However, 28% of respondents identified occupational therapists as responsible for providing swallowing treatment. Also, 64% of respondents identified audiologists as responsible for providing evaluation and/or treatment of central processing disorders, compared with 74% of SLPs.
Survey respondents indicated that audiologists are the primary providers of audiology/hearing testing services (95%) and audiologic/aural rehabilitation (AR) (86%). However, hearing aid fitters/audioprosthesists also were identified as providing audiology/hearing testing services (35%) and AR (50%).
Audiologists are reported as responsible for providing services related to balance disorders by 53% of respondents, balance training services by 33%;,and intraoperative/neurophysiological monitoring by 30%. Physiotherapists/physical therapists were identified by 30% of respondents as providing balance training services. Physicians were identified by 21% of respondents as responsible for intraoperative/neurophysiological monitoring.
Services related to learning disabilities showed the greatest provider variability. Although 79% of respondents identified SLPs/therapists/logopedists as responsible for the diagnosis and management of learning disabilities, 71% of respondents identified special education teachers and 66% identified school psychologists as responsible for these services.
The survey asked if knowledge bases and clinical skills statements (e.g., clinical competencies) had been developed. Of the 59 respondents, 44.1% indicated yes and 17% indicated that they were in process; 20% indicated these statements had not been developed, and 19% didn't know.
Almost half of respondents (43%) indicated that telepractice was not being used to deliver service; 36% indicated that telepractice was being used; and 21% didn't know.
Training
Both bachelor's and master's degrees were identified as the entry-level degrees, with 63% (n = 35) indicating a bachelor's and 59% (n = 33) indicating a master's. Similarly, 57% of respondents indicated that both a bachelor's and master's degrees were required for clinical preparation.
The survey findings must be interpreted with discretion because of limited sampling and response rate. More research is needed to increase ASHA's understanding of global CSD issues. An International Issues Board (IIB) has been established to continue ASHA's international initiatives.
Michelle Ferketic, director, special interest divisions and international liaison programs, can be reached at mferketic@asha.org. The IIB assisted with the development of survey questions, and ASHA's Survey and Information Unit assisted with fielding and analysis.
The Special Interest Divisions and International Liaison Programs unit wishes to express special thanks to the IIB for its help with the development of the survey questions, and to the ASHA Survey and Information unit for assistance with fielding and analysis.
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