Q&A: Speech-Language Pathology vs Audiology, Part 1

In part one of this podcast, we talk with Dr. Lindsay Bondurant, director of the Pennsylvania Ear Institute and associate professor for Salus University's Osborne College of Audiology and with Robert Serianni, chair, program director and associate professor for the Speech-Language Pathology program. They talk with us about the audiology and speech-language pathology professions, how to know which one to choose, and how they work together in the healthcare field. 

Q: Can you each describe what your profession does? 

Lindsay Bondurant:

An audiologist is a specialist in hearing and balance, so we specialize in pretty much everything related to the auditory system for all ages. I work with children and adults who have hearing loss. We fit hearing aids, we work with cochlear implants for people who are deaf, we do balance evaluations, balance rehabilitation, anything related to the ears. That's what an audiologist is doing.

Bob Serianni:

Speech-language pathologists assess, diagnose, treat, and counsel a variety of communication and swallowing disorders. Much like audiology, we work across the lifespan from the very young to the very old concentrating on things like speech, language, voice, fluency, and swallowing impairments.

Q: What are the differences and similarities of audiologists and SLPs when it comes to their education?

Lindsay Bondurant:

I think the similarities in terms of education primarily are that both fields require a graduate degree in order to become licensed and to practice as an audiologist or a speech-language pathologist. Many of us have similar undergraduate backgrounds in both speech and audiology or communication sciences and disorders, although people do come into the field from other backgrounds. But I think many audiologists and SLPs have very similar undergraduate backgrounds.

One of the big differences in terms of the graduate education is that currently audiology requires a doctoral-level entry. So, audiologists have a clinical doctorate, while speech-language pathologists undergo a master's degree.

Bob Serianni:

Although speech-language pathology has a post-graduate doctoral option, in order to practice, speech pathologists are required to obtain a master's degree in the United States. I think one of the similarities that overlaps both professions is the high degree of clinical education our students are exposed to as part of their graduate and professional training, in a sense, infusing what we teach them in the classroom right into their fieldwork opportunities. I think both of us follow a similar track that we first expose our students in an internship or an on-campus experience before we move them into the community or in their externship experiences.

Speech pathologists still complete a clinical fellowship, which is a basically nine months to a year of mentorship post-graduation where they're in practice. But they're practicing in conjunction with another speech pathologist who has achieved their certificate of clinical competence, which allows them to transition between graduate education and full practitioner in the field, whereas I believe audiology infuses that into its doctoral-level training where they're completing that as part of their fourth-year rotations.

Lindsay Bondurant:

Exactly. It’s still quite similar in the sense that for an audiology student, that's occurring prior to graduation but it is nine to 12 months of full-time clinical work under the supervision of a licensed audiologist and that has to be good before somebody can get licensed as an audiologist. Just like for a speech-language pathologist, that clinical fellowship year has to be completed before they can get licensed as a speech-language pathologist.

People who are seeking our services should know that anybody who is licensed to practice in either one of these fields has had, as Bob said, extensive training in both the classroom and the clinical setting and has worked for at least a year under the supervision of somebody who is already licensed and credentialed in that field.

Q: How would you help an undergrad student who might be a communication sciences and disorder major that is deciding whether to pursue an AuD versus SLP?

Bob Serianni:

I would say to our undergraduate CSD majors, as well as those in other majors who might be interested in either one of our career paths, really should do a lot of fact-finding as part of their undergraduate programs. We both have prerequisite courses that are required to get into our respective programs. However, they're cursory, they're the minimal requirements. So, doing things like picking up a minor in American Sign Language or gerontology or early education might be ways for them to explore different aspects of the field of communication sciences and disorders, and then help them sort of divide out what area is of most interest to them.

I think the other way is to do observations. Now they can either be simulated observations where you're watching videos of care of individuals that have speech and language deficits or hearing impairments. And what are you drawn to? What are you interested in? I find that students usually have a personal story when we meet them, that say they had a relative who had a stroke and was under the care of a speech pathologist and that really interested them, or they had a friend in the neighborhood who wore hearing aids, and they were always so intrigued by how well the technology worked or didn't work and how could they access communication.

I think self-exploration is really important because once you get into graduate school, we want you to know this is the career path. Back when I was trained, there were speech pathologists who were audiologists and audiologists who were speech pathologists because they had similar training paths and similar credentialing. As the fields became better defined as care expanded, it became more and more difficult to be able to manage both types of licensure requirements and educational requirements. So that happens less and less and, quite frankly, there's so much in the individual scopes of practice I don't know how you manage both scopes of practice efficiently.

My story was like many others. I had family experiences with speech pathologists. I was a talker and became really interested in sort of the study of communication. I took audiology classes as well as speech pathology classes and through time and observations, it was the SLP program that really spoke to me and haven't looked back.

Lindsay Bondurant:

Like many audiologists, I started out as an undergraduate, communication sciences and disorders major, planning to go into speech-language pathology because I think a lot of people have had exposure to speech-language pathologists and the field and they're a little more familiar with it. As I went through my undergraduate program, I started to connect a little bit more with the audiology side of things. I had never even heard of audiology until I took my first audiology class as an undergrad and my very first audiology class, I thought, “I do not like this. This is not what I want to do. I don't know why anybody would do this.” But then the next one, I was like this is actually really more interesting than I thought because a lot of audiology appeals to people who like to solve puzzles and so you grab this piece of information, and you slot it into the picture, and you get this piece of information. You slot it into the picture and you start to build out that puzzle and understand a little better what direction things are going and what pieces make the most sense as you're proceeding.

That was kind of my first literally called Introduction to Audiology Class. And then my next class in sequence was Aural Rehabilitation where you really learn about the human side of audiology, which is connecting with patients and helping them hear better to connect with other people and be able to navigate their lives in a way that is very meaningful.

It really spoke to me. I really felt like the intellectual puzzle solver part of the way my mind works with the sort of people person, warm and fuzzy. I love to see people really improving their quality of life. For whatever reason, audiology just connected those pieces a little bit more fully for me and so I decided to go in that direction. As much as I really enjoy working with my speech-language pathology colleagues, I have never thought once that that was the direction I should have gone. I've always felt like audiology was the right fit for me and I've really, really enjoyed it.

I spent many years working in undergraduate, CSD, communication sciences and disorders programs and I've talked to many students who are at that juncture of, “I think I really like audiology but it's not something I ever considered. How do I know if I should make this leap because it is a big decision to make?” A lot of students are having that thought process in their senior year of college, which is a scary time to change career paths.

I completely agree with Bob that doing observations and talking to other professionals, and even watching videos of kind of day in the life of an audiologist and speech-language pathologist, and imagining whether those are activities that you can see yourself doing on a day-to-day basis and being happy with it, that's really helpful.

As somebody who chose audiology, when I thought about whether or not I was well-suited to do the work that a speech pathologist did, I just didn't feel like that was the right fit for me. The speech pathologists, and certainly Bob can correct me if I'm wrong, but I think oftentimes speech pathologists are working with their clients very often over a shorter amount of time so they really get to know their clients very well. And then in many situations, they kind of get them to a point that they can do those things independently and they're sort of discharged from the therapy.

In audiology, hearing loss doesn't go away. We provide management. We provide intervention. We help people communicate that way, but they will need an audiologist's services usually for the rest of their lives and so we don't see our patients as often as a speech pathologist does, but we see them for a much longer period of time. That was something that really appealed to me, like I can watch my patients grow and change and I get to know their families for years and years and years. It has been a joy in my career to see my patients grow from babies to teenagers and see families grow and change and kind of go on that journey with them.