He has a conviction that a division for the allied health professions, physical therapy being one of them, was of priority importance in his area of the country.

Recently a letter addressed to the association president, Miss Mary Elizabeth Cole, was received from the president of the council of physical therapy school directors which I would like to read into the record.

As president of the council of physical therapy school directors I wish to express the council's interest in H. R. 13196, Allied Health Professional Personnel. Training Act of 1966, which is under consideration by the Committee on Interstate and Foreign Commerce. The schools of physical therapy currently graduate over 900 students per year.

With your present faculties and educational facilities the maximum of final year students which could be accommodated without lowering the quality of instruction is less than 1,100. In order to meet the health needs of our expanding population we must educate increasing numbers of professional physical therapists. To do this expansion of physical therapy educational faculties is essential, H.R. 13196 would provide financial assistance for this needed expansion of physical therapy education programs. We urge support then of these provisions of the bill. The increasing cost of tuition is a factor which markedly influences enrollment. Although there is some scholarship assistance available for students enrolled in course work of the final 1 or 2 years of a physical therapy educational program, assistance is not generally available to students during the first 1 or 2 years of a 4-year undergraduate physical therapy curriculum.

In light of the existing legislation which makes provision for forgiveness of loans to nurses, teachers, physicians, dentists, optometrists, podriatists and others it is difficult to understand why this bill to increase the opportunities for training of allied health personnel does not make provision for cancellation of loans made to students in allied health professions.

We urge that consideration be given to amendment of H. R. 13196 to include such provisions.

Sincerely,

GRACE PHILLIPS.

Health power manpower needs are great. Distribution and utilization of skilled personnel and available facilities and institutions are important and immediate factors to be considered for expansion and strengthening. It is imperative that the program envisioned in this proposal be coordinated closely with existing Government programs which are doing a fine job of leadership in our field.

I refer particularly to the Vocational Rehabilitation Administration, I might say the Children's Bureau and the Public Health Service. All of these have had long supported not only teachers but supervisors and researchers as well.

The American Physical Therapy Association supports H.R. 13196 wholeheartedly and earnestly hopes the initial amendments or clarification will improve student loan programs for physical therapy students as are provided for other disciplines identified with the health profession.

The importance of cooperation and coordination between governmental and professional organizations such as ours are welcomed to prevent duplication of effort when there is so much to be done in meeting the health needs of people.

Thank you very much.

The CHAIRMAN. Thank you, Miss Blair. The essence of your testimony is that you are in favor of the bill?

Miss BLAIR. I am.

The CHAIRMAN. You do favor some amendments?

Miss BLAIR. We think that there might be clarification. In the regulations that might come out if the bill is passed or some of them might come out in clarification in expediting the bill.

The point that I raise particularly has been brought to our attention particularly from the Council of Physical Therapy Directors; of course they are the group who are primarily interested and are attached to our educational institutions.

The question of providing for forgiveness for clarification of loans, they believe was of great importance to be considered.

The CHAIRMAN. Mr. Moss?

Mr. Moss. I have no questions, Mr. Chairman.
The CHAIRMAN. Mr. Younger?

Mr. YOUNGER. No questions.

The CHAIRMAN. Mr. Murphy?

Mr. MURPHY. No questions, Mr. Chairman.
The CHAIRMAN. Thank you.

Miss BLAIR. I think all the members of the committee who were here this morning are all from States that do have approved programs of physical therapy attached to their universities. It is good to see them here.

The CHAIRMAN. Thank you.

Is Dr. Parley Newman, associate secretary of the American Speech & Hearing Association, Washington, D.C., here?

Will you come forward, sir, and take the stand and give us the benefit of your views.

Dr. NEWMAN. Thank you, Mr. Chairman, it is a pleasure to be here to represent the American Speech & Hearing Association. On my left is Dr. William Castle, my colleague in the national office of the association. He is the associate secretary for research and scientific affairs in the association.

The CHAIRMAN. You may proceed.

STATEMENT OF DR. PARLEY NEWMAN, ASSOCIATE SECRETARY, AMERICAN SPEECH & HEARING ASSOCIATION

Dr. NEWMAN. Mr. Chairman, the bill entitled "The Allied Health Professions Personnel Training Act"-H.R. 13196 now under consideration, names only a few of the existing allied health professions. I represent one of the unmentioned professions-speech pathology and audiology.

Speech pathologists are primarily interested in disorders in the production of spoken language, while audiologists are primarily interested in disorders in the reception and perception of spoken language and other acoustic stimuli. Together these professionals serve to help identify persons who have such disorders; to help determine the etiology, the history, and the severity of specific communication disorders through interviews and special tests, and to aid persons with such disorders of communication through speech, hearing, and language habilitation and rehabilitation procedures, counseling, or referrals for medical or other professional attention.

Our profession, like most allied health professions, is highly supportive of the basic purposes of the Training Act under deliberation.

THE NEED FOR MORE SPEECH PATHOLOGISTS AND AUDIOLOGISTS

We are in complete support of the intent of legislation for enlarging the supply of allied health professionals and for improving training facilities. We have long been aware of a sizable gap between supply and demand for speech pathologists and audiologists. In 1960, it was estimated, conservatively, that at least 20,000 speech pathologists and audiologists were needed to provide services for the demands of over 8 million persons with significant speech and hearing handicaps. At that time also, it was estimated that there were approximately 6,000 such specialists available. In the last 5 years the number of qualified specialists has nearly doubled, but the demand for such services has also enlarged due primarily to the rapid growth of the population, but the present supply still falls short of the need expressed in 1960.

NEED FOR OUR EDUCATION AND TRAINING PROGRAMS

Helping as they can to fill the gap between supply and demand, there are, by our latest count, some 240 education and training programs in speech pathology and audiology located in our nation's colleges and universities. Eighty of these provide only preprofessional undergraduate training, and of the 160 which offer professional graduate training, 43 train to the Ph. D. level, and the remainder offer the master's degree.

To provide the professional services needed, at least 2,000 speech pathologists and audiologists should be receiving graduate degrees or their equivalent annually. Presently, a little over 1,100 are doing so.

The American Speech & Hearing Association wishes to express the opinion that proposal H.R. 13196, if enacted in its present form, will not prove of maximum benefit to education and training programs in speech pathology and audiology, because it does not provide for support of programs of training lying outside the purview of medical administration.

The vast majority of the education and training programs in speech pathology are not in institutions which are medically affiliated. Not more than 10 exist within a medical administrative unit. Thus, under the bill as presently constituted, the education and training programs in speech pathology and audiology stand to gain only very limited support from H.R. 13169.

We would strongly urge that provision be made for the support of the profession of speech pathology and audiology, the majority of whose education and training programs are not under medical administration.

If I may depart from the prepared text for a moment I would like to point out that the activities of this profession may be placed under the broad heading of "Behavior." Our scientists would be most appropriately regarded as behavioral scientists and our practitioners would be most appropriately regarded as behavioral specialists in the disorders of human communication. Thus, the nonmedical setting of most of our education and training programs in colleges and universities is consistent with the nature of our research and service.

This statement does not imply that those few programs located in medical settings are inappropriately administered. It has reference only to the general nature of the profession. We readily acknowledge

the need for cooperation with medicine and other professions such as psychology and education.

Actually, the Department of Health, Education, and Welfare has been generous in its support of speech pathology and audiology in the past several years in the areas of training and research. To more fully meet the need for trained specialists in speech pathology and audiology, additional support of existing programs would be all that is required. For example, for fiscal year 1967, the Vocational Rehabilitation Administration requested a total of $3,267,000 to support 61 teaching grants and 678 traineeships in speech pathology and audiology. The dollar figure for fiscal year 1967 is the same as it was for fiscal year 1966.. Relatively few of the education and training programs in speech. pathology and audiology would be eligible for support from H.R. 13169 in its present form. We thus urge that whatever new legislation is produced by Congress for supporting training in the allied health professions that it be so written to bring maximal assistance to the education and training programs of all such professions, not just those that have a close medical affiliation.

There already exist within the Department of Health, Education, and Welfare a number of grants programs for advancing professional training in allied health professions, including ours.

We recommend that Congress need not create new grants programs. to administer H.R. 13169, but that it can be efficiently administered through the existing agencies of the Department of Health, Education, and Welfare such as the Vocational Rehabilitation Administration, the Children's Bureau, the Office of Education, the National Institutes of Health, and the neurological and sensory diseases service program of the Public Health Service.

We urge that more funds be made available to these agencies to support their existing training grants programs, and that funds and authorization be made available to them to provide for construction of education and training facilities for all allied health professions regardless of type of administrative unit. Such an approach would increase the supply of allied health specialists in all fields in the most effective and economic manner.

Please accept our thanks for the opportunity to appear before you. The CHAIRMAN. Does your associate want to make a statement? Dr. NEWMAN. No, sir, he is here in case of questions.

Thank you.

The CHAIRMAN. He is your right arm?

Dr. NEWMAN. That is right.

Mr. MURPHY. Thank you, Mr. Chairman.

As far as Federal grants and Federal assistance is concerned under the mental retardation and other programs do we have assistance for audio and speech defects?

Dr. NEWMAN. It is not specifically stated but it is implied in the legislation.

Mr. MURPHY. Of the number of people you say need this assistance, the number of patients that there are, are they congenital speech and hearing defects or are they connected with, say, retardation or some other defect?

Dr. NEWMAN. Both. That is why I made reference to both medicine and psychology. As you understand, the act of speaking is determined by social and cultural factors. It also is dependent on a

sound organism. If either of these are impaired or inadequate, poor language or inadequate speech can develop.

Our people in their training have been exposed to the organic aspects of speech and hearing disturbances as well as to the psychological and social factors. Specifically our profession does have a contribution to make in the area of mental retardation.

Mr. MURPHY. Thank you, I have no other questions.
The CHAIRMAN. Mr. Younger.

Mr. YOUNGER. I have just one question, Doctor.
Most of this work is now done through the schools.

Dr. NEWMAN. I would judge that the majority of the service offered by our profession is done in the local school setting.

Mr. YOUNGER. Thank you.

The CHAIRMAN. Thank you for coming here and giving us the benefit of your views. It will be helpful in our consideration of the bill. Dr. NEWMAN. Thank you, Mr. Chairman.

The CHAIRMAN. Our next witness is Miss Martha Schnebly, director of occupational therapy, Institute of Physical Medicine & Rehabilitation, New York City. Miss Schnebly, you may proceed.

STATEMENT OF MISS MARTHA SCHNEBLY, DIRECTOR, OCCUPATIONAL THERAPY, INSTITUTE OF PHYSICAL MEDICINE &

REHABILITATION

Miss SCHNEBLY. Thank you, Mr. Chairman.

My statement is relatively brief. I request permission because of the late hour to just summarize the written statement and then add some additional comments.

The CHAIRMAN. You may do that. Your complete statement will be inserted in the record in its entirety.

Miss SCHNEBLY. Thank you.

(The document referred to follows:)

STATEMENT OF MISS MARTHA SCHNEBLY, O.T.R., DIRECTOR, OCCUPATIONAL THERAPY, INSTITUTE FOR PHYSICAL MEDICINE & REHABILITATION; INSTRUCTOR, OCCUPATIONAL THERAPY, NEW YORK UNIVERSITY; SPECIAL LECTURER, FACULTY OF MEDICINE, COLUMBIA UNIVERSITY, NEW YORK, N.Y.

Mr. Chairman and members of the committee, my purpose in appearing before you today is to respectfully request that the profession of occupational therapy be specifically named for inclusion in the proposed H. R. 13196, the Allied Health Professions Personnel Training Act of 1966 (to amend Public Law 88-129, Public Health Service Act of 1963). A study of the proposed act demonstrates that occupational therapy is included by inference and by intent but not by name, and your consideration is hereby invited to rectify this omission.

The occupational therapist, as a vital member of the rehabilitation team, treats physically and emotionally ill patients by means of purposeful activity. This form of treatment is planned to (1) decrease or eliminate disability resulting from illness or accident; (2) to increase or maintain independence in self-care; and (3) to promote total function to a maximum level leading, when feasible, to eventual return to the labor market.

The education of the occupational therapist is normally 42 years of college leading to a bachelor of science degree. Thirty-two colleges or universities in this country offer education for this profession. The National Commission on Accrediting recognizes the Council on Medical Education of the American Medical Association and the Accreditation Committee of the American Occupational Therapy Association as the two collaborative agencies responsible for the accreditation of these educational programs. Following graduation from an accredited school, the occupational therapist takes the national examination which, when successfully completed, leads to registration on a national basis.