In this issue we continue exploring audiology training routes across the world and our next destination is India. This article is provided by Lalsa Shilpa Perepa, a Clinical Audiologist who started her audiology career in India.
Audiology and speech language pathology (ASLP) courses in India are offered by various colleges and institutes that are affiliated with different universities or function as a university. ASLP is an allied healthcare profession governed by the Rehabilitation Council of India (RCI), which is the regulating body for professions related to rehabilitation. All professionals practising in India, as well as colleges and institutes, are required to obtain RCI registration and adhere to the requirements, for clinical and professional practices.
The ASLP programme is delivered as a bachelor’s (undergraduate) course, which is mandatory to become an ASLP in India. It is a four-year course, three of which are dedicated to classroom curriculum along with practical and clinical training. The eligibility requirements for bachelor’s is senior secondary education in physics, chemistry, maths/biology and English. Students should be between 17 and 25 years for admission to bachelor’s course.
“Clinical training of ASLPs begins from the first year of bachelor’s where they are exposed to and observe different clientele under the guidance of clinical supervisors.”
The first-year coursework includes introductory topics in audiology and speech language pathology, anatomy and physiology, electronics and acoustics, psychology and linguistics. Second year content incorporates in-depth knowledge of each aspect of ASLP with courses like childhood communication disorders, voice and laryngectomy, articulation and phonological disorders, diagnostic audiology, educational audiology, amplification and assistive devices, otorhinolaryngology, community-oriented professional practices in ASLP, statistics and research methodology. In third year, courses related to fluency and its disorders, neuro-motor speech disorders, adult neuro-communication disorders, rehabilitative audiology, noise and hearing conservation and paediatric audiology are offered.
At the end of each year, a clinical practicum is submitted: this includes familiarisation with test materials, lab work for instrumentation usage, simulation practices, acoustic analysis of voice and speech samples, material development, diagnostics, therapeutics, preparation of ear-moulds and electroacoustic measurements.
Clinical training of ASLPs begins from the first year of bachelor’s where they are exposed to and observe different clientele under the guidance of clinical supervisors. Institutes have their own clinics, while colleges have clinics in hospital setups where students are posted in departments, such as, paediatrics, neonatal units, plastic surgery, ENT, psychology and neurology. All clinical postings are provided on a rotational basis to give holistic exposure to a variety of clinical cases. From the second year, students can independently take up cases and their work is monitored by clinical supervisors, professors and the head of the department. Clinical hours are recorded for assessment, intervention, case discussion and observation.
The number of clinical hours usually varies for each college and institute and each student in third year presents a clinical case in the form a seminar. Internship takes place the fourth year of training: students are posted in hospitals, special schools, military hospitals, industrial set-ups, community service centres, private clinics and district disability rehabilitation centres. Students graduating from government institutes are required to work in rural areas for three months: this provides extensive exposure to the most typical cases that prepares students to deal with any kind of case.
Many students start clinical practice after completing a bachelor’s degree and many pursue a master’s degree. Students intending to pursue a master’s degree are required to take separate entrance examinations for each college and institute. Currently Audiology and speech language pathology courses are offered jointly during a master’s degrees, except in two institutes; the All India Institute of Speech and Hearing and the Dr Chandrashekhar Institute of Speech and Hearing. RCI is in the process of implementing a single degree master’s programme in other institutes and colleges from 2018.
The master’s degree is research-based and coursework is focused on research. The programme deals with several of the bachelors’ programme topics in greater detail, along with other topics such as auditory physiology, psychophysics of audition, speech perception, electrophysiology and vestibular assessment and rehabilitation. At the end of master’s, students are required to submit a dissertation/thesis in their desired area of ASLP, as well as present a critical evaluation of a research article of their choice. Clinical training continues during the master’s programme. Throughout the ALSP programme, students are encouraged to present research and scientific papers, attend conferences, seminars, workshops and publish papers and articles.
“All clinical postings are provided on a rotational basis to give holistic exposure of a variety of clinical cases.”
After completing the master’s degree, very few graduates pursue PhD and post-doctoral fellowships. Most of the students work as professionals in salaried positions and are employed to work in a variety of settings such as healthcare (including hospitals, clinics, nursing homes, medical rehabilitation centres and mental health facilities), regular and special schools, early intervention programmes/ multi- disciplinary rehabilitation centres, industrial settings, hearing aid and cochlear implant manufacturers, manufacturers of devices/prosthesis for individuals with communication and swallowing disorders, universities/colleges and their clinics, professional associations, state and central government agencies and institutions, research centres, and private practice settings. Most professionals with PhD and post-doctoral degrees opt to work at educational institutions.
Indian Speech and Hearing Association (ISHA) is a professional organisation whose members include both students and professionals who are dedicated to scientific study of the processes involved in speech-language and hearing. ISHA provides a platform for members to collaborate, enhance and develop research ideas and facilities through seminars, workshops, annual conferences, continuing education, webinars and published journals. It is committed to maintaining the highest standard of education and research. ISHA is also involved in creating awareness of communication disorders through camps, brochures and other public information materials and outreach programmes.
India, being a multicultural society, offers unique opportunities for training, education and clinical practice for audiologists and speech-language pathologists but also poses many challenges. Hundreds of languages and as many cultures, varied religions, the unique caste system, the urban-rural divide, and issues relating to literacy and economic emancipation, among others, not only offer opportunities but also present hurdles for educational, research and clinical work in the area of speech and hearing in India. Due to these challenges, students graduate with the ability and experience to apply their knowledge and skills to deal with a vast variety of people, customise their approach to the needs of the local people and are able to work successfully all over the world.
My heartfelt gratitude to Dr Dinesh Ayyala for his continuous support, motivation, encouragement and effort from the start to this day. I am really thankful to him for helping me complete this article and for his constant guidance throughout.
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