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Supporting CT Schools with SLP Assistants and Aides (SLPAs)
- 1. Supporting Students’ Communication Needs in CT Schools with SLP Assistants and Aides (SLPAs)A Self- Guided Tutorial Donna D. Merritt, Ph.D., CCC SERC Mary Jo Chretien, M.S., CCC Thompson Public Schools
- 2. PD Description Speech-Language Pathology Assistants or Aides (SLPAs) can supplement the delivery of speech and language services in schools and have a positive impact on students’ communication skills. This professional development will describe the scope of tasks and activities appropriate for SLPA implementation, as well as the types and frequency of supervision required. It will also address the benefits and restrictions of using SLPAs by determining the viability of their use and analyzing cost effectiveness. 2
- 3. Learner Objectives Participants completing this professional development will: improve student learning for children with communication disabilities by clarifying the range of activities appropriate for SLPA implementation and the level of supervision required to perform them; and examine the need for SLPAs and the viability of their use. 3
- 4. Application of Learning A brief quiz is included at the conclusion of this tutorial to assess application of learning. Questions are framed as TRUE or FALSE. The quiz can be downloaded as a Word document and an answer key is provided for self-evaluation. 4
- 5. Tutorial Topics Evolution of School-Based SLPs Qualifications and Credentials of SLPs Legal Guidance Reasons for Using SLPAs Levels of SLPAs, Prerequisites and Roles SLP Supervision Cost Effectiveness 5
- 6. Evolution of School-Based Speech-Language Pathologists (SLPs) Expanded knowledge, research base and scope of professional practice Change from traditional roles in schools 6
- 7. Students with more significant needs are included in schools and often require the expertise of an SLP 7
- 8. SLPs have a role in determining language difference from language disorder in Connecticut’s English Language Learners 8
- 9. SLPs have additional roles within the general education continuum of support 9
- 11. Neurology
- 13. Language Difference vs. Disorder
- 14. The Speech and Language Basis of Literacy
- 15. Communication, Social Interaction and Behavior10
- 18. Connecticut Speech-Language Hearing Association (CSHA)11
- 19. SLP Shortage Connecticut shortage area Consistent with national trend CT universities graduating more SLPs Financial incentive to choose school-based practice varies LEAs exploring different models of service delivery 12
- 20. Assisting SLPs Some tasks and activities related to providing supports and services for students with communication needs can be performed by support personnel with supervision 13
- 22. Routine;
- 23. Involve implementing plans developed by the SLP (i.e., IEPs);
- 24. Include collecting or charting data; and could entail
- 25. Supporting maintenance of AAC and AT devices14
- 26. CSDE Guidance “… Under the Connecticut SLP licensure statute and regulations and codes of ethics of national and state professional associations, the SLP has legal authority and ethical responsibility for overseeing the design, implementation and supervision of … speech and language services” (Guidelines for Speech and Language Programs, CSDE, 2008). 15
- 27. Reasons for Using SLPAs To augment the delivery of speech and language services – a shared work load To serve the needs of students and families from diverse cultures and linguistic backgrounds To direct the expertise of SLPs where it is most needed 16
- 31. Supported by relevant college or vocational coursework Directed and supervised experience by a DPH licensed and CSDE certified SLP 17
- 32. Level I SLPA Roles Provide clerical support Assemble bulletin boards Search for materials (e.g., finding pictures on the Internet) Prepare instructional materials Work with individual students or small groups to extend practice of specific skills as assigned, directed, and supervised by an SLP Maintain assistive devices (e.g., FM units) 18
- 33. Level I SLPA Roles (cont.) Assist in broad-based screenings (e.g. kindergarten) Support family education programs Record, chart and graph student data Assist in communication with families and students learning English Support computer-assisted learning activities 19
- 36. Selected post-secondary coursesDirected and supervised experience by a DPH licensed and CSDE certified SLP 20
- 37. SLPA Roles – Level II Assist in speech-language and hearing screenings (without interpretation) Assist in an array of non-instructional activities (e.g., clerical support, equipment maintenance) Assist in an array of indirect instructional activities (e.g., construction of materials) 21
- 38. SLPA Roles – Level II (cont.) Maintain assistive devices (e.g., AAC/AT) Instruct students in the use and maintenance of assistive devices Administer and score objective speech-language screening instruments Assist the SLP during speech and language assessments 22
- 39. SLPA Roles – Level II (cont.) Work with individuals and small groups as assigned, directed and supervised by an SLP Follow lesson plans Document student performance (i.e., progress monitoring) by collecting and tallying data and recording it on charts and graphs 23
- 40. SLPA Roles – Level II (cont.) Maintain an intervention log as determined by the supervising SLP (co-signed by SLP) Support staff professional development Participate in meetings WITH the supervising SLP and others (e.g., PPT) Assist with family service (e.g., gathering information; sharing resources) 24
- 41. An SLPA May Not … Represent herself or himself as an SLP Administer standardized or non-standardized diagnostic tests or assessments Interpret assessments Screen or diagnose communication concerns 25
- 42. An SLPA May Not … Demonstrate feeding or swallowing techniques or procedures Use a checklist or tabulate results of feeding and swallowing evaluations Participate in parent conferences, case conferences, PPT meetings, or any interdisciplinary team meetings without the presence of an SLP 26
- 43. An SLPA May Not … Communicate with the student’s family or others about the child’s individual status or service without the consent of the supervising SLP Write, develop or modify an IEP or an IFSP in any way Provide speech and language intervention without access to supervision by an SLP Sign formal documents 27
- 44. An SLPA May Not … Select students for intervention Discharge students from services Make referrals for additional services Counsel or consult with the student, family or others regarding the student’s progress, service or needs Disclose educational or confidential information in oral or written form 28
- 47. Two or more years of practice in a school setting
- 49. Supervision of no more than 3 SLPAs29
- 51. The first consecutive 10 hours of student contact following initial hiring should be directly supervised (i.e., minimum of 2 school days)
- 52. After 90 days supervision is required for no less than 20% of student contact time 30
- 54. In view (i.e., face-to-face) observation
- 55. While the service is being performed by the SLPAThe SLP must also share the intervention by maintaining direct contact with students at least once every two weeks. This is in addition to SLPA supervision time. 31
- 57. Record review and data analysis
- 58. Review of audio or video-taped sessions
- 59. Telephone conferencingThe supervising SLP must be able to be reached by personal contact, phone or pager at all times 32
- 60. Documenting Services and Supervision Establish supervision protocols and procedures Communicate with families Maintain intervention logs Read and co-sign documentation 33
- 61. SLPA Supervision Strategies 34
- 63. Analyze data
- 64. Write IEPs
- 65. Attend PPTs
- 67. Maintain direct contact with parents and students
- 68. Write reports35
- 71. Literacy
- 72. Behavior
- 77. Application of Learning 39
- 78. Resources ASHA (1996). Guidelines for the training, credentialing, use, and supervision of speech-language pathology assistants. Asha, 38 (Suppl. 16, 21-34). CSDE (1999). A guide for the training, use and supervision of speech-language pathology aides and assistants in Connecticut. Moore, S.M. & Pearson, L. (2003). Competencies and strategies for speech-language pathology assistants. Née: Delmar. Tanner, D. C. (1997). Handbook for the speech-language pathology assistant. CA: Academic Communication Associates. 40
- 79. Contact Information Donna D. Merritt, Ph.D., CCC Speech-Language Pathologist and Consultant SERC merritt@ctserc.org Mary Jo Chretien, M.S., CCC Speech-Language Pathologist Thompson Public Schools mchretien@thompsonpublicschools.org 41
Hinweis der Redaktion
- This self-guided tutorial has been developed for administrators and school-based speech-language pathologists (SLPs) interested in clarifying the roles of speech-language pathology assistants (SLPAs) in their schools. The content of this professional development is based on A Guide for the Training, Use and Supervision of Speech-Language Pathology Aides and Assistants in Connecticut (1999), which can be downloaded from CSDE’s Web site orSERC’s Web site. The guidelines are modeled after guidelines from the American Speech-Language-Hearing Association (ASHA) for using SLPAs. Of note is that the guidelines were written to provide clarification regarding the appropriate use and supervision of SLP aides and assistants in a variety of settings, including schools, hospitals, rehabilitation facilities, and clinics. As such, they are broad in their focus.This tutorial is not designed to increase skill development in SLPAs or to directly support the supervision of SLPAs by SLPs. Some SLPAs may find it useful, though, in clarifying their role.
- Supporting Students’ Communication Needs in CT Schools with SLP Assistants and Aides (SLPAs)Individuals completing this professional development can use the professional development (PD) event description in this slide and the learner objectives in the next slide to apply for CEUs from their Local Education Agency (LEA). It is anticipated that the tutorial can be completed in 1 hour (.1 CEUs). However, additional CEUs may be awarded at the discretion of the school district to participants who engage in some or all of the application of learning activities included in the tutorial.
- There are many forces at work, both nationally and within Connecticut, that currently impact the field of speech-language pathology. The scope of practice of school speech-language pathology and the roles of school SLPs have evolved during the last fifteen years in response to influences such as: research in communication disorders and the ways in which they manifest as learning disabilities, autism, ADHD/executive functioning, and emotional disturbance; affecting academic progress and social-emotional development of students from early childhood into young adulthood; explicit and reciprocal connections between oral language and literacy; a shift toward providing inclusive practices for students with disabilities; and federal and state legal mandates, policies and initiatives.The traditional role of the “speech therapist” who worked primarily with children with articulation errors is a thing of the past. Today, school-based SLPs work primarily with students with language-based concerns that affect their ability to learn to read, write, comprehend, express themselves and interact with others. The work of SLPs is tied directly to the outcomes of the Common Core of State Standards and are critical for successful transition to adulthood.
- Of the total number of K-12 students with disabilities in Connecticut, approximately 20% are identified as Speech-Language Impaired under IDEA. Members of a child’s Planning and Placement Team (PPT) can also determine that the student requires speech and language intervention as a related service, but CSDE does not collect data on the number of students who receive this support. Within the past ten years an explosion of technologies (e.g., augmentative, alternative communication [AAC]/assistive technology [AT]) have become available to support students’ communication. Children who are not able to communicate through typical means now have opportunities to become active participants in school when appropriate speech and language interventions are designed and implemented. Schools are also faced with changes in the population of children needing communication services. More students are on the autism spectrum and require assistance with social communication. Similarly, as infant survival rates have increased, children with significant communication needs due to serious health conditions are requiring speech and language services in public schools (e.g., students requiring feeding and swallowing intervention) .
- Between 2003-04 and 2007-08 English Language Learners (ELLS) in Connecticut increased by 15.5%; in 2008-09 one in 20 Connecticut students was an ELL and this population of students represent 161 languages (The Condition of Education in Connecticut, CSDE). From 2003 to 2008 the percentage of ELLs identified as special education increased by two-thirds, with Speech-Language Impaired being the second highest disability category (CSDE, 2009).
- In addition to meeting the communication needs of students with speech and language disabilities under IDEA, SLPs also have a general education role in schools within SRBI, assisting team members in preventing communication problems and providing early intervening services as needed, particularly in the early elementary grades and specifically in the development of oral language and literacy.
- An entry level position for a school SLP requires a Master’s Degree in Communication Disorders. This degree can require completion of up to 60 academic credits plus 325 “clock” hours of supervised practicum, making the education of an SLP comparable to a 6th year teaching certificate.
- SLPs must be certified by CSDE and licensed by the Department of Public Health (DPH) to be employed in schools. DPH licensure is non-negotiable and allows SLPs to make lateral moves from school-based practice into other work settings. Membership and participation in ASHA and the Connecticut Speech-Language-Hearing Association (CSHA) are recommended, but not required for SLPs. ASHA certification yields a Certificate of Clinical Competence (CCC), which is comparable to a National Credential in teaching. ASHA and CSHA offer advanced level discipline-specific professional development.
- Currently 2363 professionals are licensed by the Department of Public Health as speech and language pathologists (DPH, 2009). Of that number 1638 (69%) hold active 061 CSDE certificates, with 12% certified at the initial level, 29% at the provisional level, and 59% at the professional level (CSDE, 2010). LEAs reported 1042 Full Time Equivalent (FTE) school-based SLPs in 2009-10, an increase of 2.1% from 2008-09; 186 SLPs received their first SDE certification in 2009-10 (CSDE, Data Bulletin, April, 2010). Despite the recent increase in FTE SLPs, Connecticut faces a critical shortage of school-based SLPs, with 118 available positions noted in 2009-10 and 26 vacancies reported by LEAs due to lack of qualified candidates, resulting in a shortage rank of 1 for the field of speech and language pathology (Fall Hiring Survey, CSDE Data Bulletin, April, 2010). Connecticut’s situation is consistent with national data and indicative of a decade long trend (ASHA, 2000-2010 Schools Survey Report). To counteract this trend both the University of Connecticut and Southern Connecticut State University are graduating more students with Master’s Degrees in Communication Disorders in the past few years than they did a decade ago. Not all CT LEAs offer graduating or experienced SLPs financial compensation at a “step” comparable to their level of education (i.e., Master’s Degree + 30 credits) when hiring. SLPs graduating from SCSU and UConn report that this is a critical non-negotiable in their decision to choose school-based practice over another work setting and their decision about which school district to work in. Some LEAs are exploring different models of service delivery to address the SLP shortage, including using SLP Assistants.
- SLPs are guided in their school practice by two sets of regulations: CT State Department of Education certification and Department of Public Health law. In general school-based SLPs provide services to children and families that are within a scope of practice. In contrast SLPAs have a scope of work.SLP licensing requirements are delineated in Chapter 399 of the Connecticut General Statutes (CGS), Paragraph 8 in Section 20-413. CGS permit the use of “supervised support personnel to assist licensed speech pathologists with tasks that are (A) designed by the speech pathologist being assisted, (B) routine, and (C) related to maintenance of assistive and prosthetic devices, recording and charting or implementation of evaluation or intervention plans.”It is unclear how many individuals are designated as SLPAs in Connecticut schools. Their levels of education, additional training, and experience are also unknown.
- Under DPH law and ASHA’s code of ethics, school-based SLPs must have responsibility to assess the communication needs of students, diagnose communication disorders, determine the presence of a disability, and, if special education is required, craft goals and objectives, determine what supplemental supports may be indicated (e.g., AAC/AT), and design intervention(s). Teachers may not supervise SLP Assistants/Aides.The legal and ethical responsibility of the work of the SLPA resides with the SLP. Any activities completed by an SLPA that are beyond the purview of CT’s Guidelines (e.g., writing IEP goals) can potentially compromise the status of the SLP’s license as well as place the SLPA in situations that do not meet the requirments of the law and for which their training has not prepared them. As such, it is important that school districts follow the Guidelines in their entirety, eliminating this risk for their SLPs.
- CT’s Guidelines establish two levels for SLPAs that are differentiated by education and roles in which they can serve students and families.Possible Preservice Education and Training Models for a Level 1 SLPA (Aide) can include:a). a secondary vocational training program for support personnel in speech-language pathology; orb). a1 year post secondary certificate program for support personnel in speech-language pathology; orc). employer sponsored preservice workshops for support personnel in speech-language pathology; and relevant coursework from a post secondary program approved by the qualifying entity.Currently, CT does not have established programs that would fulfill the preservice requirements of either option (a) or (b). As such, Level 1 SLPAs are usually “home grown.”
- Level I SLPAs have a limited scope of responsibilities in schools.
- Manchester Community College has an established Associates Degree Disability Specialist Program that has a Speech-Language Pathology Assistant option. Graduates from this program have completed specialty courses in communication development, disorders, intervention, and early language and literacy. A supervised public school internship is also required.Some individuals with Bachelor’s Degrees in Communication Disorders apply for SLPA positions if they are unable to attend graduate school or choose not to. These individuals usually have a good base of understanding of typical speech and language development and have had survey courses in various types of communication disorders. They also may have had experience working with children, but they typically have had no supervised clinical speech-language pathology experience. As such, they also need to learn how to perform in their role, which requires demonstration and supervision from an SLP.
- Regardless of whether the SLPA is Level I or II, there are specific roles that are beyond their purview. Engaging in any of these activities may compromise the SLP’s license and/or create a due process risk for the LEA.
- SLPAs are encouraged to write and sign intervention notes, but these must be co-signed by the supervising SLP.
- SLP supervising competencies are delineated on pages 6 and 7 in CT’s Guidelines.ASHA recommends completion of at least one course or CEU in supervision to supervise SLPAs.
- Slides 30, 31 and 32 present the minimal supervision required by CT’s Guidelines, which must be maintained to provide quality speech and language services and to avoid due process. Additional supervision may be needed depending on the skills of the SLPA and the needs of the students, which may fluctuate during the school year.
- As the overarching construct of using SLPAs involves sharing the workload, the supervising SLP must have an appropriate amount of time in a school to provide the mandated level of direct supervision and maintain direct contact with students. This will require a carefully crafted schedule with some flexibility as some students are seen in the morning and some in the afternoon and their schedule (and that of their teacher’s) should not be disrupted to accommodate a supervised observation or a session with the SLP.
- During each week data on every student served by the SLPA should be reviewed by the supervising SLP. Additional direct and indirect supervision may be needed depending upon the skills of the SLPA and the needs of the student. Supervision should be planned and executed on a case-by-case basis.
- Specific procedures for documenting SLPA services and supervision are not addressed in CT’s Guidelines, but are important for school districts to consider to ensure compliance with IDEA and avoid due process.LEAs are advised to establish a written supervision protocol/procedure that includes the work activities of the SLPA and the amount and type of supervision (direct vs. indirect) that will be provided. Procedures for maintaining personal contact with the supervising SLP are also advisable.It will be important for the student’s family to understand who is delivering the service to their child, when and how. SLPAs should attend PPTs with their supervising SLP to establish a relationship with the child’s parents or guardians. Intervention logs should be maintained for each contact the SLPA or SLP has with the student to ensure continuity of service and adequate supervision. SLPs should co-sign intervention logs when they are reviewed.
- A complete discussion of how to supervise an SLPA is beyond the scope of this tutorial, but a description of Strategies for Effective Supervision of SLPAs can be accessed by clicking here. If your district already has SLPAs in place the dialogue between SLPs and SLPAs can be enhanced within the supervision process by using a tool developed for this tutorial entitled SLP/SLPA Reciprocal Reflection. Ten statements for SLPs and SLPAs respectively have been developed to correlate with CT’s Guidelines. Each individual can reflect on the statements and then collaboratively compare their responses. Differences in perception can illuminate areas that require next steps to support training or need for resources. You can download the SLP/SLPA Reciprocal Reflection by clicking here.
- While on the surface it appears that it will require one day of overlapped time per week between a supervising SLP and SLPA to meet the minimum requirements of CT’s Guidelines, 30% supervision time, about 10 hours per week, is more reasonable. This time will need to be spread out over the course of the week to permit direct observation and supervision of regularly scheduled speech-language intervention sessions.Additionally, time needs to be allocated to accommodate SLP workload responsibilities associated with collaborative management of the communication needs of “shared” students, as some critical tasks cannot be done by an SLPA. Time needs to be accounted for in the supervising SLP’s schedule to attend to these responsibilities in a timely manner, while continuing to allow sufficient time for the SLP to also address the needs of those students who are not shared with the SLPA.Because of these realities schools may need to allocate as much as 40-50% of an SLP’s time to perform all of the duties required to adequately supervise an SLPA, ensuring that students and families are receiving quality services and the district is not vulnerable to due process complaints. This percentage is not a recommendation of CT’s Guidelines per se, but may be a reasonable staffing ratio for administrators to consider, particularly with new or inexperienced SLPAs.
- Some LEAs may anticipate that hiring SLPAs will be a cost saving decision. However, because SLPAs share a caseload with SLPs and because their roles have limitations and they require supervision, an SLPA is not a replacement for an SLP hour for hour.The decision to hire an SLPA will require strategic planning and investment in proper training and supervision. As finances are a consideration in this decision an Excel worksheet has been developed to assist LEAs in determining cost effectiveness. Click here to access this worksheet, which can be modified to adjust for employee salary ranges and benefits in your district.In this example it is assumed that the LEA has hired FTE certified and licensed SLPs with 10 years experience at a Master’s Degree plus 6th year step. Data for this example are derived from a Greater Hartford Area school district and include salary plus benefits. Full time SLP Assistant (i.e., Level II) salary is congruent with the national median of $35,000 plus benefits. The district needs 7.5 days of speech and language services per week. In scenario 1 the district hires an additional half-time SLP. In scenarios 2 and 3 the district hires a full-time SLPA and accounts for supervision at 30% (minimal overlap) and 50% (optimum overlap) respectively. A comparison of these scenarios yields realistic salary differences (approximately 10%). Alternative options can also be calculated to meet the district’s needs.
- In addition to determining the cost effectiveness of using SLPAs, school administrators are advised to garner the support of their SLPs before pursing this course of action. Some SLPs strongly favor the use of SLPAs and some reject this option. Few are neutral on the subject as it involves a significant change in practice.A tool entitled Are We Ready to Use SLPAs? has been designed for this tutorial to assist in facilitating the dialogue needed between SLPs and administrators in school districts prior to deciding to use SLPAs. The toolis a series of prompts. It can be useful for SLPs to self-examine their perspectives on the issue of using and supervising SLPAs and/or for administrators to explore an SLP’s leadership skills and readiness to be change agents. You may access this discussion guide by clicking here.
- Including SLPAs in school-based PD will help them to expand their repertoire of skills and work in a more collaborative, less fragmented way. Many PD topics would benefit their learning and CEUs should be granted to support their career advancement. Additional learning opportunities on speech and language topics specifically related to the children they serve are also advisable, such as those offered by the CSHA.
- You have reached the conclusion of this tutorial. You may download a True/False quiz to assess your knowledge of the essential ideas represented and check your understanding by clicking here for the answer key.Thank you for completing this professional development. Your feedback is welcome. Please see the final slides for resources and contact information.