ACQ Vol 12 No 3 2010

44 / 56

146 ACQ Volume 12, Number 3 2010 ACQuiring knowledge in speech, language and hearing
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,
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
html
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