There are inherent similarities in the work of audiologists and speech-language pathologists (SLPs). Best practice in client-centered care focuses on bringing our disciplines together in the service of our mutual populations. This article outlines the broad areas where our professions intersect and how we share in developing optimal outcomes for the people we serve.
The Field of Speech-Language Pathology
An SLP is an expert in communication and cares for patients across the lifespan, from newborns to geriatrics. SLPs address speech-sound production, language, literacy, social communication, cognitive-communication, feeding, and swallowing. We provide education, collaboration, counseling, prevention and wellness, screening, assessment, diagnosis, and treatment while using advanced modalities, technology, and instrumentation (American Speech-Language-Hearing Association, 2016).
We work with individuals who have delays or disorders that sometimes have comorbidities, one of which may be hearing loss. The SLP works in various settings, including hospitals, educational settings, outpatient care, skilled nursing facilities, physician offices, and private clinics. Some examples of the type of populations we serve are babies with a cleft palate who have feeding problems, children or adults with a wide range of mild to severe disabilities, individuals with traumatic brain injuries or dementia, and students with a cochlear implant.
An SLP’s education starts with obtaining a master’s degree in communication sciences and disorders. After a student has completed a master’s degree program, including 400 hours of clinical experience, they must (1) complete a 36-week clinical fellowship, (2) apply for the Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association (ASHA), and (3) obtain a state professional license (Hudson et al, 2021). Some states required a provisional license during the clinical fellowship.
SLPs are also required to complete 30 hours of continuing education within three-year certification intervals. To enhance learning and skills further, an SLP can join a special interest group through ASHA to gain knowledge and skills in specialized practice areas. Four of the 18 special interest groups include Audiology and Public Health, Hearing and Hearing Disorders in Childhood, Aural Rehabilitation and Its Instrumentation, and Hearing and Hearing Disorders: Research and Diagnostics.
The International Classification of Functioning (ICF) model has shifted our focus to treating the whole person, concentrating on their quality of life rather than just their diagnoses (World Health Organization, 2015). The most recent release of the ASHA scope of practice in speech-language pathology emphasizes the ICF model, which embraces the environment, personal factors, activity and participation, and body functions in caring for people with an impairment.
Some ways that an audiologist and an SLP may work together collaboratively using a team approach, making both jobs easier, are prevention and wellness, counseling, screening, assessment, and treatment. Using the ICF model while being cognizant of professional roles and knowing the scope of practice, responsibilities, and ethical duty is important (Ukstins et al, 2017).
A Culture of Interprofessional Collaboration
In education settings, SLPs work in general education and special education programs and collaborate on teams with other educators, professionals, and other school faculty developing individualized education plans (IEPs) for students and individual family service plans (Murphy, 2018), providing best evidence-based practices and outcomes for students. School-based SLPs and audiologists have experienced expanding caseloads requiring an expansive skill set.
Using a team approach, audiologists and SLPs may provide in-service training to educators, provide consultation for the impact of hearing loss on students’ lives, provide aural rehabilitation, and teach students listening skills (Richburg et al, 2011).
Auditory processing disorder is a common diagnosis involving the expertise of audiologists and SLPs. Auditory processing and language processing are closely linked and establishing differential diagnoses is imperative in developing a functional treatment plan. Audiologists and SLPs have unique skills that complement and strengthen each other, while jointly improving the quality of education for students who have auditory disorders and are d/Deaf or hard of hearing.
Collaboration among professionals in medical settings is often a part of the care for patients with neurogenic communication disorders. Hearing loss is unidentified and undertreated in patients with neurogenic communication disorders (Davis et al, 2019). Therefore, patients with dementia or dysphagia (swallowing disorder) who have hearing loss are best served by both an audiologist and an SLP to determine the best treatments resulting in the optimal hearing outcomes. Serving patients with dementia and aphasia (acquired language disorder) as a team effort is necessary, not just preferred, in working with this population.
Another area of collaboration is the prevention of noise-induced hearing loss. The World Health Organization estimates that at least 1.1 billion teenagers and young adults are at risk (World Health Organization, 2015). Given this large population, it is essential to advocate for hearing-loss prevention, thus preventing the incidence of new disorders and promoting education concerning the insidious dangers of excessive noise, the safer use of personal devices, and the use of hearing-protection devices in recreational settings (Cheng et al, 2019).
Research has shown that, when treating a person with a cochlear implant (CI), the patient’s needs are best met by an interprofessional team using a holistic approach and creative brainstorming, with professional respect for each other’s knowledge skill set (Van Hyfte et al, 2020). An example of this could be an SLP noticing a child who has a CI withdrawing from group activities in the classroom. The SLP then notifies the audiologist and secures an FM system for the student. Another example is an audiologist who teaches an SLP about CI management, device troubleshooting, and advising daily listening checks.
We have a shared vested interest in the hearing health of the people we serve and joint education efforts between the disciplines are an area for continued collaboration.
Both audiologists and SLPs must be competent in an ever-expanding range of practice areas and skills. These include, for example, cochlear implants, auditory neuropathy, auditory processing disorder for the audiologist and augmentative communication, pediatric dysphagia, and traumatic brain injury for the SLP (Richburg et al, 2011). As mentioned, our fields encompass a broader scope of practice, more now than ever before. We serve culturally diverse populations and we must have an expanded knowledge of advanced technologies and techniques, with service delivery that now includes telepractice/teletherapy.
Both professions have unique perspectives and skills, yet complement and augment each other (Murphy, 2018). An SLP’s role is interprofessional in nature. The benefits of collaboration include more professional satisfaction, the broadening of professional skills, comprehensive service provision, time and cost efficiency, and joint decision-making with various professionals working toward the shared goal of optimal patient outcomes (Ukstins et al, 2017).
Together, we can highlight our unique skill sets while using a team approach, supporting our different and varying populations with hearing and communication disorders, and increasing the quality of life for all we serve.