ACQ Vol 12 No 3 2010

SLHT educational programs which are offered at tertiary level institutions across the country, including 17 four-year colleges and 10 graduate schools. Of JAS members, 30.5 % hold diploma or associate degrees, 60.1 % bachelors, 8.1% masters, and 1.4% doctoral degrees. The curriculum to be completed before taking the national examination includes linguistic and phonetic sciences, cognitive behavioural sciences, medical sciences, clinical medicine, social welfare and education, speech pathology and audiology (diagnostics, intervention, clinical practicum). For more detailed information about the curriculum, please refer to the JAS website at http://www.jaslht.or.jp/enlglish/e_education. html

insurance, there are more needs related to ageing such as dementia, dysphasia, and presbycusis, than are currently being met. Recent achievements of JAS JAS was established in 2000 as a voluntary organisation but one of its mid-term goals was incorporation. On 13 September 2009, JAS held an extraordinary general meeting to become incorporated, which is a necessary step towards the establishment of a public-service corporation in the future. Incorporation of the association is a prerequisite to catch up with other related professional organisations with longer histories and larger memberships (for example, the Japanese Physical Therapy Association established in 1966 has 59,586 members (JPTA, 2010b)) so as to receive greater social recognition and to conduct more effective promotion of activities that benefit not only persons with disabilities but the general public as well. Since its establishment, JAS has endeavoured to have our service fees raised in medical settings and to establish a staffing requirement for SLHTs to be included in rehabilitation facilities. SLHTs fees under the medical insurance system are now comparable to those for PTs and OTs. Rehabilitation facilities are ranked by the number of professional staff including SLHTs because the Ministry of Health, Labour and Welfare considers the number of professional staff to be an indication of the quality of service. For example, as of April 2010, hospitals and clinics which have at least one full-time doctor and more than three full-time SLHTs can charge 2,450 yen per 1 unit of therapy (20 minutes) whereas facilities with more than one full-time doctor and one full-time SLHT can charge only 1,000 yen per unit. Under the long- term care insurance system, SLHTs are also recognised for their services in day programs and home-visit rehabilitation. JAS also puts a lot of energy into activities for professional development of its members. It holds an annual congress (11th Japanese Congress of Speech-Language-Hearing, a two-day conference, in June 2010 was held in Saitama Prefecture), and offers seminars for the basic and specialised stages of continuing education programs. Seminar topics to be covered in the next year or so include developmental disorders, dementia, and home-visit rehabilitation. There are also advanced programs run by JAS leading to the specialty recognition in two areas: dysphagia and aphasia/higher cognitive disorders. Advanced programs in other areas such as speech and language delay, voice and speech disorders, hearing disorders, will be added in the near future. JAS also publishes a professional journal, Japanese Journal of Speech, Language, and Hearing Research (in Japanese with English abstracts) three times a year. Challenges and needs of the profession Our scope of practice is expanding to non-medical settings. New opportunities for SLHTs have been developing in areas such as follow-up evaluation and intervention after (almost universal) newborn hearing screening, early detection and intervention of developmental disorders with and without intellectual impairment, evaluation and intervention in special needs education, early detection and prevention of dementia. To meet the changing needs of Japanese society,

Current size and scope of practice According to the member statistics of JAS as of March 2009, 74% of the members work in medical settings, 9% in welfare, and 8% in nursing homes and facilities for the elderly. Within a hospital, SLHTs usually work in departments related to the rehabilitation of neurogenic disabilities. Only 2% of JAS members work in schools, probably because the teacher’s licence, which is required to work in schools, is obtained through a separate training system under the Ministry of Education, Culture, Sports, Science and Technology. Other members work for companies such as manufacturers/dispensers of hearing aids, research institutes, or educational programs for SLHTs. Although our SLHT licence allows us to work with both adults and children, the nature of the workplace greatly influences the types of clients each SLHT sees in practice; some JAS members work with all ages and virtually all types of disorders, but others work with subgroups of clients. In terms of clinical areas, most JAS members work with adult language and cognition (74%), closely followed by feeding/ swallowing (73%) and speech and voice (65%). Relatively fewer JAS members work with child language and cognition (29%) and fewer still with hearing (14%). Paediatric speech and language services are largely for preschool children, and school-aged children are, regrettably, underserved. Also, since there are relatively few SLHTs in facilities for the elderly who are receiving services based on long-term care

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ACQ Volume 12, Number 3 2010

ACQ uiring knowledge in speech, language and hearing