SLPA Intern Midterm
What are SLPA's?
*support personnel *assist licensed SLPs in the clinical management of their caseloads across various settings *have more experience and training than SLP aids
Key Components of Supervision
Defining/communicating tasks that are within your scope of responsibilities as an SLPA Counseling/coaching for improved performance Providing job-related instruction, including planning and organizing of delegated work Evaluating your performance Providing formative feedback Providing consequences for poor performance Arranging the environment to support positive performance
What else can happen if assistants are used?
If speech-language pathology assistants are used appropriately, and if they are adequately supervised, ASHA-certified speech-language pathologists' caseloads may decrease to permit sufficient time to supervise staff working under their direction; however, workload may increase as the speech-language pathologist assumes responsibilities for training and supervising assistants. Speech-language pathology assistants do not carry their own caseloads. Assistants help to provide services as directed for the caseloads of speech-language pathologists.
Principle of Ethics IV
Individuals' statements shall contain no misrepresentations, and will exhibit good professional judgment No discrimination in relationships with colleagues Notify the ASHA board of ethics if reason to believe someone has violated the Code
SLPA: Duties Outside of your job description
MAY NOT: Participate in any type of case conference without an SLP present Develop treatment plans Select clients for services Discharge clients from services Participate in parent conferences, team meetings without the presence of the supervising SLP Disclose confidential information to any other personnel other than your supervisor unless required to do so by law Represent yourself as a Speech-Language Pathologist (name badge with Speech-Language Pathology Assistant
SLPA: Duties Outside of your job description
MAY NOT: Perform or interpret standardized assessments Screen/evaluate/diagnose patients or clients with feeding or swallowing disorders Sign documents in lieu of the supervising SLP—including treatment plans, reports, or reimbursement forms Make referrals for additional services Provide counseling or advice to a client or caregivers beyond the scope of the client's treatment Discharge clients from services Write & sign reports
Principle of Ethics IV
Maintain harmonious inter- and intra-professional relationships Prohibit anyone under supervision from engaging in any practice in violation of Code Do not engage in dishonesty, fraud, deceit, or misrepresentation, unlawful harassment or power abuse or any form of conduct that adversely reflects on the professions
Can speech-language pathologists receive reimbursement for speech-language pathology assistant services?
Medicare policy currently does not recognize speech-language pathology assistants, regardless of the level of supervision, and does not reimburse for speech-language pathology assistant services. Private insurers may cover licensed or registered speech-language pathology assistants. One must query each payer to verify coverage. Private insurers may or may not provide a different rate of reimbursement for services provided by a speech-language pathologist as opposed to a speech-language pathology assistant.
During training:
Minimum amount of direct supervision - 50% of the time you are in direct contact with clients/patients
Can SLPAs replace SLP's?
No SLP's have master degrees State regulations: SLPAs cannot be hired without a licensed SLP as their supervisor
Principle of Ethics IV
No unlawful harassment or sexual activities with clients, students, or research participants over whom they exercise authority. Reference/Cite sources Credit will be assigned only to those who have contributed to a publication, presentation or product
Does the minimum of 100 clock hours of fieldwork include observation hours?
No. ASHA guidelines recommend a minimum of 100 clock hours of fieldwork that includes direct and indirect client contact activities covering all of the job responsibilities of a speech-language pathology assistant, but no observation hours. ASHA recommends that observation hours be undertaken before starting the 100 fieldwork hours. It is up to the training program to set the appropriate number of observation hours.
Consumer Protection: Licensure requirements
Regulation of training, experience, education, and required supervision by the licensed SLP
What credentials are available for SLPAs?
State licensure with either a 2-year (AA) or 4 - year degree in Speech Pathology plus field experience
Who is responsible for services provided by a speech-language pathology assistant?
The fully qualified, ASHA-certified supervising speech-language pathologist is responsible for the services provided by assistants. In states that regulate speech-language pathology assistants, speech-language pathologists who hold full, unrestricted licenses assume these responsibilities for persons working under their direction.
Individuals shall honor their responsibilities to the professions and their relationships with colleagues, students, and members of other professions and disciplines.
True
J.Individuals shall not guarantee the results of any treatment or procedure, directly or by implication; however, they may make a reasonable statement of prognosis.
True
R. Individuals shall not discontinue service to those they are serving without providing reasonable notice.
True
The amount of supervision can be adjusted if the supervising SLP determines the SLPA has met appropriate competencies and skill levels with a variety of communication and related disorders. Minimum ongoing supervision must always include documentation of direct supervision provided by the SLP to each student, patient, or client at least every 60 calendar days.
True
Individuals shall honor their responsibility to the public by promoting public understanding of the professions, by supporting the development of services designed to fulfill the unmet needs of the public, and by providing accurate information in all communications involving any aspect of the professions, including the dissemination of research findings and scholarly activities, and the promotion, marketing, and advertising of products and services. Code of Ethics 3
True Do not misrepresent credentials, competence, education, training, experience, or scholarly research contributions Do not participate in any professional activities that constitute a conflict of interest Do not defraud (receive payment) Information provided to the public about CSD must be accurate
Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence and performance. Code of Ethics 2
True Engage in aspects of the professions that are within their scope of practice, considering education and training Engage in lifelong learning (SLPA CEUs) Do not require or permit professional staff to provide services or conduct research activities that exceed their level of competence, education, training, and experience Ensure that all equipment is in working order
SLPA: Scope of Practice Roles & Responsibilities
Under direction & supervision of a licensed speech pathologist, SLPAs assist with the clinical management of individuals with communication disorders.
When speech-language pathology assistant students are engaged in patient/client contact, does ASHA recommend that they receive direct supervision or indirect supervision for the specified minimum of 50% of the time?
When students are engaged in patient/client contact, ASHA recommends that the speech-language pathology assistant student be supervised a minimum of 50% of the time. The patient/client contact refers to direct supervision of the speech-language pathology assistant student, which is defined as on-site, in-view observation and guidance.
When speech-language pathology assistant students are placed in fieldwork settings, can they be supervised by more than one speech-language pathologist?
Yes. ASHA recommends that each speech-language pathologist supervising the student complete a technical proficiency or skills competency checklist [PDF] (or whatever specific format your institution uses for fieldwork assessments) for that particular student.
These SLPs indicated that support personnel assist primarily in the following five ways:
1) assist with clerical duties (56%), 2) follow treatment plans or protocols developed by the SLP (48%), 3) assist with informal documentation as directed by the SLP (48%), 4) document client performance (45%), and 5) collect data for monitoring quality improvement (40%).
How much supervision is recommended?
A total of at least 30% supervision, including at least 20% direct and 10% indirect supervision, is required weekly. Direct supervision of student, patient, and client care should be no less than 20% of the actual student, patient, and client contact time weekly for each SLPA. 1 hour direct supervision each week; documentation of direct supervision provided to each patient at least every 60 workdays; 100% supervision for medically fragile clients Supervision days and time of day (morning/afternoon) may be alternated to ensure that all students, patients, and clients receive some direct contact with the SLP at least once every 2 weeks.
Will caseloads expand when assistants are used?
As has always been the case, caseload size of ASHA-certified speech-language pathologists may or may not increase depending on client needs and the nature of the services provided.
Duties include:
Assist licensed SLP with speech & hearing screenings WITHOUT interpretation Assist with clinical assessments WITHOUT interpretation (taking data or setting up) Follow documented treatment plan developed by the licensed SLP Document client performance/progress Assist with informal documentation as directed by licensed SLP
SLPA & Scope of Practice: Roles & Responsibilities
Assist with non-clinical (clerical) duties such as scheduling/preparing materials for desired activities Act as an interpreter for non-English speaking clients and/or caregivers when competent to do so Perform checks/maintenance on equipment Support licensed SLP in research projects, in-service training, & public relation programs Assist with departmental operations (therapy notebook/manual) Exhibit compliance with regulations, reimbursement requirements, and SLPA job responsibilities
After the first 90 workdays
The amount of supervision can be adjusted if the supervising SLP determines the SLPA has met appropriate competencies and skill levels with a variety of communication and related disorders. Minimum ongoing supervision must always include documentation of direct supervision provided by the SLP to each student, patient, or client at least every 60 calendar days.
100% direct supervision of SLPAs for medically fragile students, patients, or clients is required.
True
Ethics 1: Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or who are participants in research and scholarly activities, and they shall treat animals involved in research in a humane manner.
f.Individuals who hold the Certificate of Clinical Competence may delegate tasks related to provision of clinical services to assistants, technicians, support personnel, or any other persons only if those services are appropriately supervised, realizing that the responsibility for client welfare remains with the certified individual.
Supervision feedback should provide
information about the quality of the SLPA's performance of assigned tasks and should verify that clinical activity is limited to tasks specified in the SLPA's ASHA-approved responsibilities. Information obtained during direct supervision may include, but is not limited to, data relative to (a) agreement (reliability) between the assistant and the supervisor on correct/incorrect recording of target behavior, (b) accuracy in implementation of assigned treatment procedures, (c) accuracy in recording data, and (d) ability to interact effectively with the patient, client, or student during presentation and application of assigned therapeutic procedures or activities.
Direct supervision means
on-site, in-view observation and guidance while a clinical activity is performed by the assistant. This can include the supervising SLP viewing and communicating with the SLPA via telecommunication technology as the SLPA provides clinical services, because this allows the SLP to provide ongoing immediate feedback. Direct supervision does not include reviewing a taped session at a later time.
Administrative Support
•Assist with clerical duties, such as preparing materials and scheduling activities, as directed by the SLP. •Perform checks and maintenance of equipment. •Assist with departmental operations (scheduling, recordkeeping, safety/maintenance of supplies and equipment).
What else can SLPA's perform?
•Follow documented treatment plans or protocols developed by the supervising SLP. •Provide guidance and treatment via telepractice to students, patients, and clients who are selected by the supervising SLP as appropriate for this service delivery model. •Document student, patient, and client performance (e.g., tallying data for the SLP to use; preparing charts, records, and graphs) and report this information to the supervising SLP. •Program and provide instruction in the use of augmentative and alternative communication devices. •Demonstrate or share information with patients, families, and staff regarding feeding strategies developed and directed by the SLP. •Serve as interpreter for patients/clients/students and families who do not speak English. •Provide services under SLP supervision in another language for individuals who do not speak English and English-language learners.
Prevention and Advocacy
•Present primary prevention information to individuals and groups known to be at risk for communication disorders and other appropriate groups; promote early identification and early intervention activities. •Advocate for individuals and families through community awareness, health literacy, education, and training programs to promote and facilitate access to full participation in communication, including the elimination of societal, cultural, and linguistic barriers. •Provide information to emergency response agencies for individuals who have communication and/or swallowing disorders. •Advocate at the local, state, and national levels for improved public policies affecting access to services and research funding. •Support the supervising SLP in research projects, in-service training, public relations programs, and marketing programs. •Participate actively in professional organizations.
What may speech-language pathology assistants do?
•Self-identify as SLPAs to families, students, patients, clients, staff, and others. This may be done verbally, in writing, and/or with titles on name badges. •Exhibit compliance with The Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA) regulations, reimbursement requirements, and SLPAs' responsibilities. •Assist the SLP with speech, language, and hearing screenings without clinical interpretation. •Assist the SLP during assessment of students, patients, and clients exclusive of administration and/or interpretation. •Assist the SLP with bilingual translation during screening and assessment activities exclusive of interpretation; refer to Knowledge and Skills Needed by Speech-Language Pathologists and Audiologists to Provide Culturally and Linguistically Appropriate Services
What is outside of speech-language pathology assistants' scope of responsibilities? part 2
•assist with students, patients, or clients without following the individualized treatment plan prepared by the certified SLP and/or without access to supervision; •sign any formal documents (e.g., treatment plans, reimbursement forms, or reports; the SLPA should sign or initial informal treatment notes for review and co-sign with the supervising SLP as requested); •select students, patients, or clients for service; •discharge a student, patient, or client from services; •make referrals for additional service; •disclose clinical or confidential information either orally or in writing to anyone other than the supervising SLP (the SLPA must comply with current HIPPA and FERPA guidelines) unless mandated by law; •develop or determine the swallowing strategies or precautions for patients, family, or staff; •treat medically fragile students/patients/clients independently; •design or select augmentative and alternative communication systems or devices.
Who can supervise speech-language pathology assistants?
•current ASHA certification and/or state licensure, •completion of at least 2 years of practice following ASHA certification, •completion of an academic course or at least 10 hours of continuing education credits in the area of supervision, completed prior to or concurrent with the first SLPA supervision experience.
What is outside of speech-language pathology assistants' scope of responsibilities?
•represent himself or herself as an SLP; •perform standardized or non-standardized diagnostic tests, formal or informal evaluations, or swallowing screenings/checklists; •perform procedures that require a high level of clinical acumen and technical skill (e.g., vocal tract prosthesis shaping or fitting, vocal tract imaging, and oral pharyngeal swallow therapy with bolus material); •tabulate or interpret results and observations of feeding and swallowing evaluations performed by SLPs; •participate in formal parent conferences, case conferences, or any interdisciplinary team without the presence of the supervising SLP or other designated SLP; •provide interpretative information to the student/patient/client, family, or others regarding the patient/client status or service; •write, develop, or modify a student's, patient's, or client's treatment plan in any way;