By Angela Loavenbruck, Ed.D.
The Crabby Audiologist is going to begin this week’s entry with a little mystery and then review a little history. Here’s a number that makes me very very crabby: $6,000,000. And another number that makes me even crabbier: $40,000,000. These two numbers are the answers to two questions that I will discuss more fully in future columns.
Before the numbers can be placed in a suitable context, however, we have to go back to the beginning in order to understand how we’ve arrived at the spot we find ourselves in as audiologists and how we are going to move forward. Back to the Beginning so we can get Back to the Future.
In the Beginning…
The beginnings of the audiology profession are very much intertwined with the beginnings of the speech-language pathology profession. In 1925, a group of academics interested in the scientific aspects of communication disorders decided to form a separate organization independent of the National Association of Teachers of Speech (NATS). NATS was an organization of individuals who worked in the areas of rhetoric, debate and theater.
The new organization – The American Academy of Speech Correction – was formed to promote scientific work in the area of speech correction. The organization changed its name several more times before becoming the American Speech and Hearing Association in 1947 and finally the American Speech-Language-Hearing Association in 1978. In its early years, the association was interested primarily in stuttering. It gradually broadened its scope to other speech and voice disorders and to the need to train “Speech Correctionists” for the public schools and to include these service providers in the membership.
Early requirements for membership included clinical work in speech correction, an MD, PhD, DDS or Master’s degree in speech correction, and publication of original research. By 1935, education in the physiology of speech disorders was required, and by 1938, a BA degree in speech correction was required along with clinical practice and at least a year of employment.
By the late 1940s, the Executive Council of the American Academy of Speech Correction recognized that specialization in speech versus hearing disorders had to be recognized and the name of the organization was changed to the American Speech and Hearing Association.
By 1952, the new organization had developed two levels of certification for speech and hearing and established that certification was an important requirement for employment. The Basic Certificate required 30 semester hours of education, 275 hours of practicum and a year of sponsored professional employment.
In 1954, the requirements for SLP and audiology certification were separated. The Advanced Certificate required 60 semester hours, 400 hours of clinical practicum, 4 years of sponsored employment and passing a written and oral exam. These requirements remained in place until 1965. At that time, a single level of certification for Hearing and for Speech (Certificate of Clinical Competence) was established. Those holding the Advanced Certificate were granted the CCC while all other applicants were required to have a Master’s degree.
New Requirements Stir Debate
The change from a BA to an MA requirement was controversial, with many prominent members arguing that the move was ill-considered and dangerous to the profession. The ASHA Certificate of Clinical Competence was important in the early development of curriculum and professional practice standards and in defining the scope of practice for both speech pathology and audiology.
State licensure momentum began to build in 1965 in the realization that our scope of practice needed legal protection. In 1969, Florida became the first state to establish licensure requirements for speech pathologists and audiologists. Today, all states require licensure.
ASHA initially strongly opposed licensure laws, but eventually began to support licensure by writing model laws that included the CCC as a mechanism for ensuring that entry-level standards had been met.
Note that ASHA did not lobby for standards to be met, but rather for their proprietary certificate to represent the standards. While many initial laws listed the CCC as a requirement, most have been changed to say “or the equivalent” and/or to include ABA (AAA’s certificate). Also note that many states have combined audiology, speech pathology and hearing aid dispenser boards; a few have combined audiology/hearing aid dispenser boards; and a number of states require audiologists to apply for both audiology and hearing aid dispenser licenses.
This brief historical review has taken us to 1969, and the best is yet to come. But we can already see that our beginnings as part of an association of speech correctionists has laid groundwork from which we have yet to extricate ourselves. How has our early history set up roadblocks for our future as a more autonomous profession? I entered the profession in 1965 – one semester too late to be grandfathered into the CCC’s.
I was fortunate to participate in some exciting audiology history from the early 70’s to the present, so the history lesson will continue next time with more personal experiences. Oh, and don’t forget the mystery numbers – $40,000,000 and $6,000,000.
*Title image courtesy MVRmusic