Speech-Language Pathology Assistants (SLPAs)
SPEECH-LANGUAGE PATHOLOGYASSISTANTS (SLPAS):GUIDELINES, TRENDS AND RESOURCESSandra Nettleton, Ph.D., CCC-SLPUniversity of New MexicoNMSHA President-Elect
DISCLOSURESSANDRA NETTLETONI have no relevant financial ornonfinancial relationship(s) withinthe products or services described,reviewed, evaluated or comparedin this presentation.
PRESENTATION HANDOUTAND CEUSThis power point presentation is available on a linkbelow the video.CEUs: Watch full content of training video. Click link to take test for Assessment of Learning (belowvideo). Take test unlimited number of times. Once completed, a certificate will be emailed to you. Complete course feedback (following test). NMSHA will submit credit information to ASHA for CEUcredit(s).
RESOURCES AND REFERENCES ASHA Speech-Language Pathology AssistantScope of Practice. 2013 ASHA Frequently Asked Questions: SpeechLanguage Pathology Assistants. 2013 ASHA Speech-Language PathologyAssistants: Overview, Key Issues, Resources,References. 2013 ASHA Issues in Ethics: Speech-LanguagePathology Assistants. 2014 Speech-Language Assistants (SLPAs):Current Trends. Presentation by Jennifer A.Ostergren and Sara Aguilar. California. Technical Training Programs for SLPAs. ASHA
RESOURCES AND REFERENCESOstergren, J. & Aguilar, S. (2012). A Survey ofSpeech-language Pathology Assistants inCalifornia: Current Trends in Demographics,Employment, Supervision and Training.Contemporary Issues in CommunicationScience and Disorders, 39, 121-136.Ostergren, J. and Aguilar, S. (2015). SpeechLanguage Pathology Assistant SupervisorSurvey. Contemporary Issues inCommunication Science and Disorders, 42,226-245.
WHO ARE SLPAS?(ASHA, 2013, FREQUENTLY ASKED QUESTIONS)“Speech-Language Pathology Assistants aresupport personnel who, following academiccoursework, fieldwork, and on-the-job training,perform tasks prescribed, directed, andsupervised by ASHA-certified speech-languagepathologists.” (ASHA, 2013).States will use different terminology to refer toassistants in Speech-Language Pathologyincluding aides, assistants, andparaprofessionals.
THE DIFFERENCE BETWEEN SLPAPPRENTICES AND SLP ASSISTANTSApprentices Currently licensed in New Mexico. Temporary License with supervisionfrom a licensed SLP. Must have a BA degree in SLP or 30hours of course credit incommunication disorders Must be enrolled in a Master’sProgram in SLP or will enter aprogram within 2 years of initiallicensure Must have Grade Point Average of3.0 or above.Assistants Currently NOT licensed in NM,although state licensing board isproposing an SLPA license to theNM Legislature. Are currently hired as licensedschool-based paraprofessionals. Permanent license with supervisionby a licensed SLP. May have a BA in CommunicationDisorders plus 100 hours of clinicexperience or an SLPA AssociateDegree.
USE OF SLPAS(ASHA, 2013 EXECUTIVE SUMMARY)“Some tasks, procedures, or activities used totreat individuals with communication andrelated disorders can be performedsuccessfully by individuals other than SLPs ifthe persons conducting the activity areproperly trained and supervised by ASHAcertified and/or licensed SLPs.”
USE OF SLPAS“The utilization of evidence andethical and professionaljudgment should be at the heartof the selection, management,training, supervision, and use ofsupport personnel.”
SLPA: PRACTICE SETTINGS(ASHA, 2013)Under the specified guidance and supervision of anASHA-certified SLP, SLPAs may provide services in awide variety of settings, which may include: public, private, and charter elementary andsecondary schools; early intervention settings, preschools, and day caresettings; hospitals (in- and outpatient); residential health care settings (e.g., long-term careand skilled nursing facilities); nonresidential health care settings (e.g., home healthagencies, adult day care settings, clinics); private practice settings; university/college clinics.
AGENCIES AND SUPERVISORS MUST ASSURECOMPLIANCE WITH THE FOLLOWING:1) SLPAs need to identify themselves as an SLP Assistant (not a licensedSLP). Name badge with qualifications. Written qualifications provided to other professionals, clients andfamilies. Qualifications verbally expressed as introduced to professional, clientsand families.2) SLPAs must exhibit compliance with HIPAA and FERPA regulations,reimbursement requirements, and responsibilities of the SLPA.
SLPA SCOPE OF PRACTICE:SERVICE DELIVERY(ASHA SLPA SCOPE OF PRACTICE, 2013)“Provided that the training, supervision and planning are appropriate,tasks in the following areas of focus may be delegated to an SLPA (this isnot a complete list): Assist the SLP during assessment of students, patients and clientsexclusive of administration and/or interpretation. Follow documented treatment plans and protocols developed by theSLP.” Document student, patient and client performance (e.g. tallying datafor SLP use, preparing charts and graphs) and report this information tothe SLP. Program and provide instruction in the use of AAC devices
USING THE SLPA AS ANINTERPRETERSLPAs who have the skills in a second language mayserve as interpreters when needed.Additional training is required and ASHA provides thefollowing resources: Knowledge and Skills Needed by Speech-language Pathologists and Audiologists toProvide Culturally and Linguistically Appropriate Services (ASHA, 2004). ASHA Practice Portal: Cultural Competence. Tips for Working with an Interpreter (ASHA).
SLPA SCOPE OF PRACTICE:ADMINISTRATIVE SUPPORT(ASHA SLPA SCOPE OF PRACTICE, 2013) Assist with preparation of materials andscheduling activities, as directed by theSLP. Perform checks and maintenance ofequipment. Assist with departmental operations(recordkeeping, safety/maintenance ofsupplies and equipment).
SLPA SCOPE OF PRACTICE:PREVENTION/ADVOCACY(ASHA SLPA SCOPE OF PRACTICE, 2013) Present primary preventioninformation to individuals and groupsknown to be at risk forcommunication disorders. Advocate for individuals and familiesthrough community awareness andeducation.
SLPA SCOPE OF PRACTICE:PREVENTION/ADVOCACY(ASHA SLPA SCOPE OF PRACTICE, 2013) Advocate at the local, state andnational levels for improved publicpolicies. Participate actively in professionalorganizations such as NMSHA andASHA.
OUTSIDE THE SCOPE OF AN SLPA(ASHA SLPA SCOPE OF PRACTICE, 2013)The SLPA should NOT engage in the following: Represent himself or herself as an SLP. Perform standardized or non-standardized diagnostic tests,formal or informal evaluations, or swallowingscreenings/checklists. Perform procedures that require a high level of clinical andtechnical skills (e.g., vocal tract imaging and oral pharyngealswallowing treatment). Provide interpretative information to the student/patient/client,family, or others regarding the patient/client status or service.
OUTSIDE THE SCOPE OF AN SLPA(ASHA SLPA SCOPE OF PRACTICE, 2013)The SLPA should NOT engage in the following: Participate in formal parent conferences, caseconferences, or any interdisciplinary team without thepresence of the supervising SLP or other designated SLP. Write, develop or modify a student’s, patients, or client’streatment plan in any way. Sign any formal documents (e.g., treatment plans,reimbursement forms, or reports) The SLPA should sign or initial informal treatment notes forreview and co-sign with the SLP.
OUTSIDE THE SCOPE OF AN SLPA(ASHA SLPA SCOPE OF PRACTICE, 2013)The SLPA should NOT engage in the following: Assist with student, patients, or clients without followingthe individualized treatment plan prepared by thecertified SLP and/or without access to supervision. Select students, patients or clients for service. Discharge a student, patient or client from services. Make referrals for additional service. Develop or determine the swallowing strategies orprecautions for patients, family or staff.
OUTSIDE THE SCOPE OF AN SLPA(ASHA SLPA SCOPE OF PRACTICE, 2013)The SLPA should NOT engage in the following: Disclose clinical or confidential information either orally orin writing to anyone other than the supervising SLP (theSLPA must comply with current HIPAA and FERPAguidelines) unless mandated by law. Treat medically fragile students/patients/clientsindependently. Design or select augmentative and alternativecommunication systems or devices.Note: State laws vary and may differ from ASHAs guidelines andrequirements for tasks outside of the SLPA Scope of Practice.
WHAT ARE THE ADVANTAGES TO THESLP IN USING AN SLPA IN PRACTICE? Results of surveys and report indicate that the SLP may increase thefrequency and intensity of services to patients or clients on his/hercaseload/workload with assistance by an SLPA. SLP may focus more on professional-level tasks and achieve moreefficient/effective use of time and resources. ASHA 2000 Schools Survey: 47.3% of respondents reported that use of SLPAlead to more time for service; 23% said that use of SLPAs led to moreplanning time and consultation with teachers. ASHA 2009 Membership Survey: 36% of SLPs had more time to work withcomplex clients; 33% reported less clerical duties; 29% indicated a highercaseload or workload with SLPAs.
WILL SLPAS BE USED TO REPLACE SLPS?(ASHA, SLPA FREQUENTLY ASKED QUESTIONS) NO. SLPAs support clinical servicesprovided by SLPS. SLPAs do not carry their owncaseloads. ASHA and most states limit thenumber of SLPAs an SLP cansupervisor as well as their scope ofservice.
REIMBURSEMENT FORSLPA SERVICES(SLPA FREQUENTLY ASKED QUESTIONS, ASHA 2013) MEDICARE. Services of SLPAs are NOT recognized by Medicare. Servicesprovide by SLPAs will be considered unskilled services and defined as notreasonable and necessary if they are billed as therapy services withinMedicare. PRIVATE INSURANCE: may not cover licensed or registered SLPAs. NewMexico does not reimburse SLPAs for services. MEDICAID reimbursement of SLPAs varies from state to state. Contact the“National Association of Medicaid Directors” to determine coverage in eachstate. New Mexico does not reimburse SLPAs for services.
EDUCATIONAL AND TRAININGREQUIREMENTS FOR SLPAS(SLPA EDUCATIONAL AND TRAINING REQUIREMENTS, ASHA 2013) Educational requirements and preparation for SLPAs varyconsiderably from state to state and by practice setting. ASHA does not accredit or approve SLPA education ortraining programs. 27 programs are currently reported including Arizona StateUniversity, Northern Arizona University, University of Colorado,University of Northern Colorado, and University of Houston. Currently, there are no SLPA training programs in the state ofNew Mexico.
ASHA SUGGESTED MINIMALQUALIFICATIONS (ASHA 2013)DegreeRequirement An Associate’sdegree in an SLPAprogram; or A Bachelor’sdegree in aspeech-languagepathology orcommunicationdisorders programClinicalExperienceSuccessfulcompletion of aminimum of 100 hoursof supervised fieldexperience or itsclinical experienceequivalent.(At least 1 hour of direct supervisionweekly and as much indirectsupervision as needed.)ObservationExperienceInclude direct onsite or videoobservation of anASHA certified SLP.
SUGGESTED GENERAL EDUCATIONCOURSES (ASHA, 2013) Oral and written communication, includinggrammar and usage, composition andbusiness writing. Mathematics including businessmathematics, accounting, algebra. Technology: computer literacy, wordprocessing, web-based applications, digitalaudio and video files. Social and natural sciences: psychology,sociology, anatomy and physiology.
SUGGESTED TECHNICAL COURSES(ASHA, 2013) Overview of normal processes ofcommunication, including normal speech,language and hearing development Overview of communication disorders,including introduction/survey to communicationdisorders in both speech and language. Overview of anatomy and physiology of thespeech and hearing mechanism. Instruction in assistant-level service deliverypractices (e.g. technical procedures for SLPAsand ethics in SLP).
INSTRUCTION IN WORKPLACEBEHAVIORS (ASHA, 2013) Relating verbally and nonverbally to clientcaregivers in a professional manner. Accepting and implementing supervisorfeedback. Maintaining confidentiality and security ofclient information. Following health and safety precautions. Communicating effectively in oral andwritten formats that are consistent withfederal and state regulations.
CULTURAL AND LINGUISTIC FACTORSIN COMMUNICATION(ASHA, 2013) Language and Culture Interpersonal Communication Sign language or other manuallycoded systems Bilingualism Multicultural Issues
ADDITIONAL CURRICULUM ANDEXPERIENCESShould include: Training in therapy techniques and strategies suchas treatment plans, data collection. Training in specific populations (e.g., autism,cerebral palsy). Documentation ( SOAP notes, data collection). Once employed, training on tasks and populationsspecific to their work employment.
ASSOCIATES IN ASHAASHA has established an associate affiliationprogram for support personnel initiated toimprove the use of support personnel inspeech-language pathology and audiology.Source: Robinson, Jr., T (2010 August).Associates in ASHA: A New Initiative. ASHALeader.
ASHA ASSOCIATE ELIGIBILITY Associates must meet the state licensing, certification, or registrationrequirements as an assistant (if applicable). Associates must agree to adhere to ASHA policies pertaining to supportpersonnel. There is an annual fee. If currently employed as an SLPA, the supervising SLP must attest to thecompetence of the SLPA. If not currently employed as SLPA, the college or university program directorattests to competence of SLPA.
ASSOCIATE BENEFITS Professional Development hours Networking opportunities with other Associates Access to on-line career center Affinity benefits such as insurance, credit card offers,car rental Liability insurance at a group rate
SLPA SUPERVISOR QUALIFICATIONS(ASHA SCOPE OF PRACTICE, 2013) Current ASHA certification and/or statelicensure. Completion of at least 2 years ofpractice following CF Year. Completion of an academic course orat least 10 hours of continuingeducation credits in the area ofsupervision.
RECOMMENDED AMOUNT OFSUPERVISION: FIRST 90 DAYS A total of at least 30% supervision weekly,including at least 20% direct and 10% indirectsupervision. During each week, data on every student,patient and client seen by the SLPA should bereviewed by the supervisor. Supervision days and time of day(morning/afternoon) may be alternated toensure that all students, patient and clientsreceive some direct contact with the SLP atleast once every 2 weeks.
RECOMMENDED AMOUNT OFSUPERVISION: AFTER FIRST 90 DAYS Amount of supervision can be adjusted if the supervising SLP determines thatthe SLPA has met appropriate skill levels with a variety of communicationand related disorders. Minimum ongoing supervision must include documentation of directsupervision provided by the SLP to each student, patient or client at leastevery 60 calendar days. At least one hour of direct supervision weekly. As much indirect supervision needed to assure maintenance of qualityservices. 100% supervision of medically fragile clients.
MAXIMIZE SUPERVISION ANDEFFECTIVENESS1) ASHA (2013) suggests no more than 2 full timeequivalent (FTE) SLPAs in any setting.2) Ensure good (not just minimal) contact withclients. Supervision days (and time of day)should be altered so that clients receive somedirect contact time with SLP at least onceevery 2 weeks.
CASELOAD-WORKLOADMANAGEMENT It takes time to adequately supervise anSLPA. Consider caseload-workloadformulas. Resource: ASHA (2002). A workload analysisapproach for establishing speechlanguage caseload standards in theschool position. Www. Asha.org/policy SLPAs do not carry their own caseloads;rather they help to provide services to theSLPs caseload as directed by the SLP.
ASHA CODE OF ETHICS: SLPASASHA (2013). ISSUES IN ETHICS: SLPAS It is imperative that the SLPs and SLPAs behave in a mannerthat is consistent with the ASHA Code of Ethics. The amount and type of supervision should meet the minimalrequirements and be increased based on the experienceand needs of the SLPA, student and clients, service setting,the tasks assigned and other factors. The SLP must ensure that roles and responsibilities are clearlydelineated and that task assignments are commensuratewith level of training. SLPAs must be appropriately identified to consumers,employers, colleagues and regulatory and fundingagencies.
ASHA PRINCIPALS AND RULES THATMOST APPLY TO SLPAS Principle of Ethics 1: Individuals shall honor their responsibility to hold paramountthe welfare of persons they serve professionally. Principle of Ethics 1, Rule D: Individuals shall not misrepresent the credentials ofassistants, technicians, support personnel, and students. Principles of Ethics 1, Rule E: SLPs shall not delegate tasks that require the uniqueskills, knowledge and judgment that are within their scope of practice toassistants . Principle of Ethics 1, Rule F: SLPS may delegate tasks related to provision ofclinical services to assistants only if those services are appropriately supervised
ASHA PRINCIPALS AND RULES THATMOST APPLY TO SLPAS Principle of Ethics II: Individuals shall honor their responsibility to achieve andmaintain the highest level of professional competence and performance. Principle of Ethics II, Rule D: Individuals shall not require or permit theirprofessional staff to provide services that exceed the staff member’scompetence. Principle of Ethics II, Rule E: Individuals shall ensure that all equipment used toprovide services is in proper working order and calibrated. Principle of Ethics IV: Individuals shall honor their responsibilities to the professionsand their relationships with colleagues, students and members. Principle of Ethics IV, Rule A: Individuals shall uphold the dignity and autonomyof the professions, maintain harmonious interprofessional and intraprofessionalrelationships .
SUPERVISION AND SLP ASSISTANTRESOURCES ASHA. Practical Tools and Forms for Supervising Speech-LanguagePathology Assistants. Ostergren, J. (2014). Speech-Language Pathology Assistants (SLPAs): Aresource manual. San Diego. CA. Plural Publishing. ASHA teleseminars and conferences on supervision as listed on theContinuing Education page. ASHA eWORKSHOP: Effectively Using SLP Assistants to Support Quality ServiceDelivery. McCready, V. (2007). Supervision of SLPAs: A Reciprocal Relationship. ASHALeader, May, Vol. 12, 10-13.
IN CONCLUSION As ASHA and states move forward in recognizing the use of supportpersonnel for the provision of speech-language pathology services moreresources, training and regulation is needed. I hope that this presentation has given you some preliminary and informativeguidelines and resources so that you can move forth in your employment ofSLPAs and/or make an educated decision about whether the employmentof SLPAs is the right decision for you and your agency. Thank you for your attention!!
Speech-language Pathology Assistants in California: Current Trends in Demographics, Employment, Supervision and Training. Contemporary Issues in Communication Science and Disorders, 39, 121-136. Ostergren, J. and Aguilar, S. (2015). Speech-Language Pathology Assistant Supervisor Survey. Contemporary Issues in Communication Science and Disorders .
Speech Language Pathology Assistants (SLPAs) are emerging professionals who, under the supervision of licensed Speech Language Pathologists (SLPs), provide treatment and screening services related to communication problems. SLPAs work in a multitude of settings, including schools, clinics, early intervention programs and rehabilitation .
Agape Speech Therapy utilizes an Speech Language Pathology Assistant (SLPA) to perform Speech therapy on patients. Additionally, a University Student-in-Training may accompany our Certified Speech Language Pathologists and SLPAs as part of their curricu
SPEECH-LANGUAGE PATHOLOGY LICENSING GUIDE LICENSURE REQUIREMENTS CHECKLIST (Listed below are the minimum requirements needed to obtain licensure in the Speech-Language Pathology field.) APPLICATION AND FEES Application for a Speech-Language Pathology License - Complete all fields, answer all questions and
Speech-Language Pathology Medical Review Guidelines 3 Introduction The purpose of the medical review guidelines for speech-language pathology is to serve as a resource for health plans to use in all facets of claims review and policy development. The guidelines provide an overview of the profession of speech-language pathology including
3. To provide clinical services in audiology and speech/language pathology. The information in this clinic handbook includes policies and procedures related to clinical education in speech-language pathology. Each student enrolled in the speech-language pathology program is responsible for the information contained herein.
Vista Pathology Laboratory – User’s Guide 1 Who We Are Reedy, Michael MD Pathology Nixon, Randal MD, PhD Pathology Neuropathology Loudermilk, Allison MD Pathology Hematopathology Wu, Bryan MD Pathology Breast Pathology Dermatopathology Pike, Robin MD Pathology Cy
Speech-Language Pathology Assistant (3003)- 130.00 Audiology Assistant (3004)- 130.00 Application for Speech-Language Pathology or Audiology Assistant Certification Board of Speech-Language Pathology & Audiology P.O. Box 6330 Tallahassee, FL 32314-6330 Fax: (850) 245-4161 Email: info@floridasspeechaudiology.gov Do Not Write in this Space
one or more long-term conditions. Men in Liverpool live 31 y. ears less and women 2.8 years less than the England average. LOW HIGH CANCER MORTALITY Liverpool has one of the highest cancer mortality rates in the country. You are 2.5 times more likely to die of cardiovascular disease if you live in Picton ward than if you live in Mossley Hill ward. 93,000 people in Liverpool are affected by .
