SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY AS A HIGHER EDUCATION OPTION: EXPLORATORY STUDY

(1) Speech Language Pathology Departament of Faculdade de Odontologia de Bauru da Universidade de São Paulo), Bauru, SP, Brasil. (2) Speech Language Pathology Departament of Faculdade de Odontologia de Bauru da Universidade de São Paulo, Bauru, SP, Brasil. (3) Speech Language Pathology Departament of Faculdade de Odontologia de Bauru da Universidade de São Paulo, Bauru, SP, Brasil. (4) Speech Language Pathology Departament of Faculdade de Odontologia de Bauru da Universidade de São Paulo, Bauru, SP, Brasil.


INTRODUCTION
One of the most significant moments on the education of an individual is the end of high school, choice of this career and whether there is information they would have liked to receive before applying to college.Invitations to take part on this study were sent to every SLP-Audiology department on behalf of their respective undergraduate studies coordinators, who were kindly requested to forward them to all students and alumni.Information regarding the study was then attached to the invitations, along with an online address through which an Informed Consent Form and a participation questionnaire were made available.

METHODS
Each participant was required to sign a copy of the Informed Consent Form and, after that, to anonymously fill in an online 10 item questionnaire (2 open, 3 semi-open and 5 closed questions) on the following aspects of the profession of SLP-Audiology: (a) career options within university and (b) the degree and sources of information participants had on the profession prior to applying to college (Figure 1).The questionnaire, developed by the authors of this study, was available at kwiksurveys.com,an online free platform.
Data obtained was processed by means of descriptive statistics.
plan and a minimum curriculum, USP was the first university in Brazil to offer the degree of Bachelor in SLP-Audiology.At last, in 1981, regulations to this career were given by Law 6569 2,3 .
In Brazil there are currently 104 SLP-Audiology undergraduate courses recognized by the Ministry of Education.These are spread across the whole national territory except in the states of Tocantins, Acre and Roraima 4 .
Choosing a profession means defining one's "life project and way of achieving autonomy, personal recognition and participation in society through work".This induces youths to think about a broader range of aspects of life, like the employability of their future careers.This choice is part of a process of one's personal growth and reflection as well as the one's knowledge on careers and of a professional activity that inserts in the social context 5 .
Different factors act on individuals' careerchoosing process, covering both personal and social dimensions, involving influences from family and peers, education, work possibilities and other external factors related to social, political, economical and cultural issues.All these factors continually act upon an individual, influencing and being influenced by the human vocational journey 5,6 .
People often make career choices with very little knowledge on aspects inherent to the profession, as far as responsibilities, difficulties and duties are concerned.The development of decision-making skills in children is not a cause of systematic concern by parents and educators.Children who lack exposure to situations where such skills are needed, especially during adolescence, are more likely to experience feelings of immaturity and insecurity later in their professional lives, often having their capacity to formulate consistent career projects impaired 7,8 .
That being said, this study aimed to identify the factors that led SLP-Audiology students to the   2 shows whether individuals had the career of SLP-Audiology as their main choice when applying to college, that being the case for 119 participants (59.2%).Although 2 participants had preferences for other careers, two them did not answer the question regarding approval in the college entry exam.
Table 3 shows whether individuals had the career of SLP-Audiology as their only choice when applying to college.Out of the 201 participants, only 54 (26.8%) applied exclusively for this career.The remaining 147 participants also applied for other careers (degree/majors) at college.

RESULTS
This study counted with 201 individuals (144 undergraduates regularly enrolled in the year of 2011 and 57 alumni from the campus of Bauru) out of the 437 eligible candidates (380 undergraduates and 57 alumni), which corresponds to response rates of 37% (144 out of 380) and 100% (57 out of 57), respectively.Participants were aged between 17 and 39 years (20.62 years, in average).Table 1 show the distribution of undergraduate participants in terms of their year (1 st to 4 th ) at university.Regarding information participants would have liked to receive before choosing the career of SLP-Audiology (Table 4), out of 123 respondents only 23 (17%) were satisfied with the information received.The majority of people (n=103, 77%) reported they were willing to receive further information on the career, specially with respect to the employment of SLP-Audiologists.Some participants found it necessary to have knowledge on the core curriculum (n=7, 5.5%) and on the minimum wages allowed by law (n=2, 1.5%).
Multiple answers were allowed on questions concerning the factors that led participants to the choice of SLP-Audiology (Figure 2) and the main sources of information available on this career (Figure 3).
Out of the 191 individuals who answered the question on their current degree of knowledge about this career, 112 (58.6%) claimed that the perception they had on the matter prior to applying to college does not correspond to reality.

Minimum wages "I would like to know that the profession of SLP-Audiology does not minimum wages"
which might be due to the reduced demand for this career 13 .At first, the low demand for this career is associated to its relative performance on the market (employability), since this is a factor that directly affects career choices by college applicants.A study has shown a positive and significant effect on the importance of a profession's average wage when an individual chooses their career 14 .However, a decrease on the demand for SPL-Audiology undergraduate courses is also observed in other countries such as the United States in spite of their expanding labour market.There, a research made with 1090 college students has shown that only 1% opted for a career on the fields of Speech Science and Speech Disorders 15 .
Another factor that might contribute to the low demand for this profession is social status.Of 13 higher level professions (social worker, biologist, dentist, nurse, engineer, pharmacist, physical therapist, speech therapist, physician, psychologist, sociologist and chemical) staggered by undergraduates and graduate of the University of São Paulo, SLP-Audiology occupied the 7 th or 8 th positions in accordance with the scaling method used.The professions of Medicine, Dentistry and Engineering, in this order, were evaluated as the most prestigious 16   .
In fact, along with the retirement of current professionals, the low demand on the career has been the cause of insufficiency of Audiology professionals 15 .This deficiency is a global phenomenon -an analysis made with 62 countries has shown that 86% of them do not have enough professionals to meet their own needs 17 .
This scenario is quite worrying considering that, at the same time, a combination of trends will result on a higher demand for SLP-Audiologists on the following decades: advances in medicine will entail higher life expectancy rates and therefore bring significant demographic changes such as population aging, meaning that the number of people with neurological and hearing disorders will tend to increase with time.These advances are also responsible for increases on the survival rate of preterm babies, trauma victims and stroke survivors, individuals who will most likely need treatment by an SLP-Audiologist.Furthermore, policies on early identification of disorders (e.g.hearing newborn screening) and on the inclusion of people with special needs on education will increase the demand for professionals trained on these areas 18 .
In Brazil, the Federal SLP-Audiology Council has indicated the existence of a gradual yet non-uniform growth of this profession, with increases on job offers Regarding the spread of information regarding the profession, out of the 191 participants who chose to answer this question, 182 (95.8%) reported they promote the career of SLP-Audiology to family and friends and 160 (83.8%) reported they spread information on the career to college applicants.

DISCUSSION
As far as the number of participants in the study goes, it should be highlighted that even though researches made by online means have their advantages (low costs, fast data collecting, possibility of reaching specific populations, convenience and easiness on asking and answering questions), there are also disadvantages, such as the low response rates to online questionnaires 9 .This explains the 37% response rates for undergraduate students found on this study, which may be seen as reasonable.The fact that 85% of the students were from Bauru campus (Table 1) can be attributed to increased opportunities for publicity and more interest for participation in research since the study has been conducted on this site.
SLP-Audiology was the main career option for 119 (59%) of the total number of participants (Table 2), in accordance to another research that found that 54% of students enrolled in SLP-Audiology undergraduate courses in public universities from the State of Sao Paulo had this as their main option when applying to college 10 .
Off all 82 participants who did not have SLP-Audiology as their main career option, 80 answered the question about being accepted at the career of their preference (Table 2).Also, 43.7% (n=35) of participants opted to major in SLP-Audiology over their alleged main career option (any undergraduate program other than SLP-Audiology) even though they were accepted by both programs.The main reasons for that were the localization of campi and the reputation of the university.It has been shown on other researches that the location (distance from home/work) and tradition/reputation of an institution of higher education are among the most popular factors that lead individuals to the choice of their careers/ majors 11,12 .
It is also observed from Table 2 that the number of SLP-Audiology majors who have this career as their main choice tends to decrease throughout the years.The design used in this study does not allow identifying the reasons for this finding; nevertheless, this should still be brought into attention.A survey made by the Regional SLP-Audiology Council (2 nd region) in the state of Sao Paulo has shown a decrease in the number of professionals, The reputation of the University of Sao Paulo also contributed to the choice of profession by participants.Another study conducted in private universities has shown that the institution's image (respectability, social status) is a major attractor to students.Such reputation is often build through excellence on services provided 22 .
With respect to the influence of parents and relatives observed on the present study, an analysis of the literature available on the field has revealed that the influence of parents on their children's career choice continuously occur in the interactions within the family unity.This influence involves not only objective and practical actions (e.g.financial support, dialog and other initiatives for vocational exploration) but also subjective ones which are often not clear nor conscious -e.g.support, approval/ disapproval on the students' choices, outcomes expectations, plans and dreams that parents make for their children, among others.All these variable may enable or limit their children vocational development and their process of choosing a career 6 .
On the item "others" participants indicated items such as "lowest financial investment" (since it is a public university) and "existence of student aid/ support programs" at the University of Sao Paulo (e.g. the provision of food and housing for students in need of financial support).
Relatives, friends and booklets on career possibilities were the main source of information about the SLP-Audiology career for college applicants (Figure 3).It has also been verified by another study that family and friends were the main information source for undergraduates on their respective courses 5 .SLP-Audiologists from the State of Minas Gerais have also reported their first contact with the profession had occurred through booklets on careers options and also through individuals with speech/hearing disorders 20 .
Another relevant fact is that 58.6% of participants indicated their insufficiency of knowledge on SLP-Audiology as of when applying to college, in accordance to other researches that have shown that 40% of SLP-Audiology undergraduates had little knowledge on the career 10 and that 68% of college students were unaware of the profession of audiology 15 .
on the field.Recent advances, such as mandatory hearing screenings on newborns, the recognition of new fields of specialization and changes in the of therapy sessions authorized by the National Regulatory Agency for Private Health Insurance and Plans also promise to boost important areas 19 .
On this study, it was verified that 54 students (26.9%) applied exclusively for the career of SLP-Audiology whereas 73.1% of participants also applied for other courses, not necessarily on the field of health.Such is a common phenomena as it has also been show by another study where SPL-Audiology undergraduates also applied for other careers on the areas of Biology and Humanities 10 .A research with 391 undergraduates from different degrees/majors has shown that 52% of the participants applied for multiple careers 7 .Another research with 655 college freshmen from 23 different major fields of study has pointed out that 47.1% of individuals applied exclusively for one major whereas the remaining 28.1% and 24.8% of people applied, respectively, for two or more degrees/majors not all necessarily on the same area 12 .
The interest on the profession of SPL-Audiology was reported to be the main motivating factor leading to this career choice by 42% of participants.Interviews made with SLP-Audiologists indicated that the career's rehabilitating character was a determinant factor to the choice of their careers 20 .Questionnaires answered by college students in the USA also indicated that in 58% of cases careers were chosen with basis on their interest on or passion for the area 15 .
It should be highlighted on Figure 2, however, that for most participants (58%) the choice for the career of SPL-Audiology was made due to other reasons.Data from the FUVEST, the Foundation in charge of organizing the entry exam at University of Sao Paulo, has shown that from the years of 2009 to 2011 the candidate-to-vacancy ratio for the career of SLP-Audiology (considering all campi, Sao Paulo, Bauru and Ribeirao Preto) varied from 4.2 to 8.45:1.This upper limit of 8.45 decreases to 5.01 when taken into consideration only applicants who have finished high school.For comparison purposes, the average candidate to vacancy ratio to all careers on the field of "Biological Sciences" on the last three years has been around 14 to 15:1 21 .individuals consider themselves to be, the more they reaffirm their decisions -the converse is also valid 8 .
In other areas, heads of private higher education institutions have employed certain marketing techniques in order to increase the exposure of career options to students in earlier stages of their education.In the USA, professionals associations and universities have targeted students The present study has also demonstrated that the majority of participants (77%) would have liked to receive more information, when applying to college, on the different fields where SLP-Audiologists are employed.The amount of information one has on a given profession influences their decisionmaking process on the matter.The better informed history, fields of specialization, current job offer in the market, perspectives for the career, professional profiles, characteristics of the different undergraduate courses offered by USP and their core curriculum among others.
Another factor that contributes to the spread of information on the profession is the action of other undergraduate students.According to the present study, 95.8% of participants promote their career to family and friends.This percentage falls to 83.8% concerning promotion to college applicants.
This fact reinforces the need of greater investments in strategies that bring current and future college students together, answering possible questions that may arise with respect to the career and its fields of employment.This interaction adds to the promotion of the profession and arousal of interest on the same by applicants on SLP-Audiology.

CONCLUSION
Interest in the profession was the motivating factor for the choice of the career of SLP-Audiology for 42% of participants.For most of them (58%), however, such choice was motivated by other factors such as the reputation of the university and the low candidates to vacancy ratio for this course.Throughout the years, there has been a decrease on the number of SLP-Audiology freshman who had this career as their main option, suggesting a possible decrease on the number of applicants for this career.
More information on the career of SLP-Audiology should be available to college applicants, especially concerning the different fields of employment of this profession.
with awareness campaigns on the profession of audiology 23 .
People who choose their careers with little knowledge and distorted, idealized or stereotyped visions on the field are more likely to experience feelings of disappointment and regret regarding their degree/major choice at university, sometimes leading students to drop out of college or switch degrees/majors 24 .
In that sense, the Dean of Culture and Extension of the University of Sao Paulo has created the initiative "USP and careers" with the intent of providing students with subsides to enable them to make conscious career choices, with the help of their relatives and teachers.This program encompasses the publishing of a catalog, a visit calendar for high-school students and preparatory courses for vestibular (an exam that grants access to university based on the candidates' grades and on their career choices) and the organization of career fairs.In career fairs, students are brought into contact with all undergraduate courses offered by the university and can clarify their ideas with respect not only to professions and their employability but also to the college application process 25 .
Internet has been widely used mainly for its free/ public character and easiness on quickly obtaining and providing up-to-date information 26 .With that in mind, the Health Channel from "IPTV USP" has created the series of informative videos "Health Professions" which allowed the promotion of 14 health-related undergraduate courses offered by USP.
DESCRITORES: Escolha da Profissão; Educação Superior; Fonoaudiologia This exploratory, descriptive, cross-sectional study was conducted at the Department of SLP-Audiology, College of Dentistry, University of Sao Paulo (USP), under the approval of the Research Ethics Committee of this institution (protocol reference number 048/2009).Participated voluntarily in this research students regularly enrolled in the first to fourth years of SLP-Audiology undergraduate courses at University of São Paulo in the campi of Bauru (classes of 40 students), Ribeirao Preto (classes of 30) and Sao Paulo (classes of 25), as well as alumni from Bauru campus, from the classes of 2007 to 2010 (convenient sample).

Figure 1 -
Figure 1-Questionnaire -SLP-Audiology as a higher education option

Figure 2 -Figure 3 -
Figure 2 -Factors that led to the choice of SLP-Audiology undergraduate courses at the University of Sao Paulo

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Considering the different careers available when applying to college, how would classify the course of SLP-Audiology in terms of your personal preferences?□main (1 st ) option □ secondary (2 nd ) option □ tertiary (3 rd ) option

Table 3 -Other careers to which candidates applied prior to entering college (number of answers = 212) Table 4 -Information that participants would have liked to receive when applying to college Category Comment Fields
of employment "I didn't have a clue that SLP-audiologists can work in so many areas, I thought we only took care of people with speech/hearing disorders" "I didn't know SLP-audiologists could work in hospitals, schools and private businesses."Theprofession of SLP-Audiology must be widespread to outsiders think it only concerns stuttering."