FAST FACTSCourse: Bachelor of Audiology And Speech-Language Pathology (BASLP) Duration: 3 years of classroom study + 1 year internship (mandatory)Eligibility: 10 + 2 (Physics, Chemistry and Biology/ Math/ Comp Science/Statistics/Electronics/ Psychology) Best colleges: AIISH (Mysore); AYJNIHH (Delhi, Mumbai, Secunderabad, Kolkata); Dr. S R Chandrashekar (Bangalore); KMC (Mangalore); MCOAHS (Manipal); Topiwala National Medical College (Nair Hospital,Mumbai); AIIMS (Delhi)Class 11 student Shashank would feel perennially humiliated. “People would say I sound like a female. Customer-care people would address me as madame on the phone and even girls would tease me,” he shares. This sorry state of affairs prompted Shashank to seek professional help through Speech Language Therapist Sanjay Kumar, who runs his own practice in Bangalore. Shashank was diagnosed with puberphonia, a common problem in teenage boys and young men, which causes them to speak in a high-pitched tone, often making them the object of ridicule. A series of voice therapy sessions helped Shashank completely transform his voice tone. His confidence also improved. The pillars of communication While improving speech capability is one aspect, another is hearing. Say, a patient undergoes a surgery, which impairs his hearing ability, the shock and impact of this loss is hard to fathom for the patient and his or her family. An Audiologist and Speech-Language Pathologist (ASLP) would step in to assess the extent of the damage, then charter a plan of action to help the patient adapt to his new capabilities. "The eventual focus is to help people of all ages and walks of life improve their communication skills," shares young speech language therapist Gayathri Khandhije who works at an 'early intervention centre' for young children with hearing and speech-related issues.^
Scope of work ASLP professionals focus on three areas: audiology that’s related to hearing; speech that relates to voice functions; and language, which relates to one’s ability to pick up language skills. These professionals are equipped to diagnose or assess the problem through a battery of tests, following which therapy is administered through voice exercises and extensive counselling. ASLP professionals also test and recommend relevant electronic products such as hearings aids and cochlear implants, to enhance amplification of sound. This is a highly collaborative field and professionals work with doctors, psychologists, occupational therapists, educators, amongst others. Diverse disorders Hearing and speech-language problems arise due to many reasons. Some are the result of stroke and cancer. Others are affected by hearing impairments, learning disabilities, developmental delays, autism, cerebral palsy and cleft palate. Some people have speech-related problems like stammering/ stuttering, puberphonia, functional aphonia (absence of voice) and leukoplakia (when a lesion develops on tongue due to chronic smoking) and misarticulation. Even a simple task like swallowing proves difficult for some. The BASLP programme Sanjay and Gayathri both pursued specialised programmes that trained them for the profession - a three-year BSc in Hearing & Speech at AIIMS, Delhi and a Bachelor of Audiology & Speech Language Pathology (BASLP) at Manipal College of Allied Health Sciences, respectively. “The BSc at AIIMS (now discontinued) offered exactly the same curriculum and training as a BASLP,” states Sanjay. Essentially, the BSc is an older version of BASLP, which has an additional element – one-year mandatory internship in the fourth year.
Recognition of the course The BASLP course is prescribed by the Rehabilitation Council of India (RCI). Set up in 1986, one of RCI’s main objectives is to standardise training courses in the area of rehabilitation. A BASLP degree makes one eligible to practise in the field. However, registering with RCI is mandatory before one starts practice. Today, RCI recognises 54 institutes in India, which offer UG, PG and Diploma programmes.
Eligibility for UG-level You must have completed 10+2 with Physics, Chemistry, compulsory, while the third subject can be one of the following: Computer Science, Statistics, Electronics, Psychology. Alternatively, one can gain lateral entry into the second year of BASLP with a Diploma in Hearing-Language-Speech (DHLS) and two years of work experience. A two-year DHLS qualifies one to practice as a “speech and hearing technician” under the guidance of a fully-trained graduate or postgraduate.
The selection process Each institute conducts its own entrance. Multi-campus institute Ali Yavar Jung National Institute for the Hearing Handicapped (AYJIHH), holds a single exam for all centres. The All India Institute of Speech & Hearing, established in 1965, the oldest institute in the country conducts an all-India entrance, which is based on Class 11 and 12 syllabus in one of the three subjects – Physics, Math, Chemistry and Biology.Medical college advantage Choosing an institute affiliated to a hospital has its advantages, states Dr Venkataraja Aithal U, Prof & HOD- Dept of Speech and Hearing at Manipal University’s College of Allied Health Sciences. “For instance, laryngectomy cases get referred to us, where the larynx, which is responsible for voice functions is removed in case of laryngeal cancer,” explains Prof. Aithal. Some medical colleges like SRM Medical College Hospital & Research Centre, realising the lacunae of trained professionals in this domain, took initiative and launched a BASLP course in 2007.
Research institutes AIISH, considered a mecca by professionals in this domain, is a good place for students to learn because the institute provides services to the public. "Many referrals of cases come from neighbouring and outstation hospitals," shares Gayathri. But competition is high due to the brand equity of the institute as well as low fee. Hence, those who cannot do a UG course here, come for a Master's, in which one must choose one specialisations – Speech-Language or Audiology, unlike earlier when one could do both. AYJNIHH, which has four campuses today, is also a pioneer in this domain.
Employment options ASLP professionals work closely with ENT, neurology, psychiatric, paediatrics, surgery and oncology departments in hospitals, where cases involving hearing and speech-language related problems crop up. Specialised centres or clinics dedicated to voice or rehabilitation for children, also have options. ASLP professionals can also work in special schools and early intervention centres. Overseas, regular schools also have ASLP professionals on call and this trend has caught up in some upper crust schools in India, as students tend to have speech-related problems. You can be a consultant or like Sanjay Kumar, set up your own practice. “It needs investment and contacts, which is tough for freshers,” advises Sanjay, who feels that the field needs more opportunities to open up. Pay scales vary across the board and nothing is standardised. A good hospital is likely to employ a fresher for Rs 35,000 to Rs. 45,000 with postgraduate qualification.
Working in industry Another lucrative option for professionals is industry, that is, companies that manufacture and market amplification devices such as hearing aids. Today, there are at least eight to 10 prominent names in the field in India, and ASLP professionals play a crucial role in offering feedback to companies about the consumer experience, to help make products more relevant.
Getting tech-savvy Back in the 1970s and 80s, the diagnostic process must have been a traumatic process for both adults and children. But today clinical audiologists use sophisticated equipment for the purpose of diagnostic audiometry, hearing aid calibration, ear mould lab, play therapy, stroboscopy and computer aided speech analysis. Hence, being up-to-date with the latest technologies is a must. ASLP’s play an important role in cochlear implants i.e, when an electronic device is surgically implanted inside the skull in profoundly deaf or severely hard of hearing people. Anupriya, Clinical Audiologist with Starkey Hearing Technologies, who has extensive experience in this area shares that eligibility for this procedure is stringent. ASLP professionals assess the patient to establish candidacy. “During surgery we make sure the implant is in place, followed by post-surgical rehabilitation to help the patient adapt to the new hearing conditions,” she shares.
Counselling angle Speech and hearing disorders often tend to be associated with societal stigma. Anupriya has counselled many a parent who have just discovered that their child is deaf. “Many remain in denial mode and resort to rituals to try and change the fate of the child,” she shares. Hence, clinical psychology is an important component, which helps professionals gauge the psychological aspect of every case. Gayathri who works with autistic children, says that it’s a lot of hard work and one needs patience and perseverance. “But in the end, it’s very emotionally satisfying,” she rounds up.
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