May 29, 2007 Features

Looking Back and to the Future of Professional Education in Speech-Language Pathology

Second in a series on topics addressed at the Speech-Language Pathology Education Summit

Over the past 80 years, ASHA has developed a program of standards for membership, and subsequently, entry-level clinical (or personnel) certification as well as academic accreditation. The more than 100 participants in the Speech-Language Pathology Education Summit (see the April 17 issue of The ASHA Leader) discussed the history of ASHA certification in the context of emerging trends—in particular, whether the entry level-doctorate should be in the future of speech-language pathology.

Summit participants focused on the purpose of personnel certification programs and reviewed milestones in ASHA's certification program in pondering future directions. Personnel certification programs, such as the one developed by ASHA, are designed to match the knowledge, skills, and attributes of the clinician to job requirements; validate that the clinician has the knowledge, skills, and attributes to fulfill the job responsibilities; permit entry to the profession for qualified professionals; and protect the public from unqualified professionals.

Personnel Certification

Personnel certification has positive outcomes for certificate-holders, employers, and patients/clients. For professionals, it helps secure and retain jobs, increases mobility and portability of certification, promotes professional self-esteem, and improves the credibility of the occupation. For employers it helps match personnel to employer needs, streamlines education/job preparation systems, and offers assistance in employment decision-making. For consumers it provides increased protection and a fair and transparent way to identify qualified providers.

In order to meet these outcomes, a personnel certification program must exhibit certain essential characteristics. The program must develop quality systems that balance the needs of both the employer and the professionals who are employed. The program must match evolving employer needs with competencies demonstrated by the credential. The program also must promote legal compliance and controls against improper use of the credential, fraud, and corruption. Finally, the program must promote, not impede, access to jobs (see sidebar online for key components of personnel certification programs).

ASHA Certification

By the end of the Association's first 25 years of existence, it was clear to ASHA leadership (the Executive Council) that certification was an important requirement for employment, and that specialization in speech-language and hearing disorders needed to be recognized. At the time, there was a major controversy regarding separate requirements for speech-language pathology and audiology certification, which later was resolved (see sidebar online for key components of ASHA's personnel certification programs).

ASHA developed the beginning of a certification program as we know it in 1952, and the result was twice as many applications that single year than in the first 10 years of the Association's history. This influx created a backlog of several hundred applications that took three years to process, but proved that a bottleneck in Association's progress had been circumvented. With the creation of the certification program, the emergence of new questions, new interpretations, and new standards have continued as the standards have evolved. (For more information on the evolution of the program, see sidebar online.)

The ASHA voluntary certification program has accounted for major changes in practice standards for the professions and has served as a model for state licensure bills. In audiology a professional doctorate (AuD) is the entry-level degree, and licensure for audiologists exists in all states. In speech-language pathology, the master's degree is the entry level, as it has been for about three decades; however, unlike many other health care and rehabilitation professions, such as occupational therapy, physical therapy, optometry, and pharmacy, speech-language pathology is not moving to a doctoral-level entry degree in the foreseeable future.

A universal doctoral-level entry to both professions would require a change in certification standards as well as in curriculum requirements within academic programs. While there have been proposals to create a doctoral-level entry to speech-language pathology, only a limited number of professional preparation programs have ever been developed. Alternatives to the doctoral degree as the entry-level degree for the discipline include creating two levels of certification, one for SLPs in health care and another for SLPs in education. Another alternative is to create an add-on or board certification for the health care arena.

A National Discussion

The summit marked the beginning of a national discussion on the historic, current, and emerging contexts, challenges, and opportunities as we prepare the future SLP. Through a series of Web chats, you can address the same questions raised at the conference.

ASHA invites you to join colleagues around the nation to discuss issues related to this article in an online chat moderated by Nancy Creaghead, a facilitator at the SLP Summit, on June 13 from 8-10 p.m. EDT. 

Clarification: Beginning in 2012, entry into the profession of audiology will require a clinical doctoral degree (e.g., AuD, PhD, ScD) to achieve ASHA certification. State licensure boards may require a doctoral degree prior to that date. The Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) does not require accredited academic programs to restrict the degree offered to the AuD designator. 

John Bernthal, is professor and chair of the Department of Special Education and Communication Disorders and director in the Barkley Memorial Center at the University of Nebraska-Lincoln. He is an ASHA past president and presenter at the SLP Summit. Contact him at jbernthal1@unl.edu.

cite as: Bernthal, J. (2007, May 29). Looking Back and to the Future of Professional Education in Speech-Language Pathology. The ASHA Leader.

Key Components of Personal Certification Programs

A Personal certification program:

  • Defines the occupation or profession
  • Determines the knowledge, skills and attributes necessary to enter the profession or occupation
  • Delineates how people will demonstrate that they have the knowledge, skills and attributes (competencies),
  • Ensures that there is a transparent, fair process to make decisions about individual candidates,
  • Surveils candidates to determine conformance to a code of ethics


Key Components of ASHA Certification

The following outlines the components of the ASHA program, which are similar to those of most professional certification programs. 

Outlines educational requirements:

  • Course work
  • Practical experiences (clinical practicum)
  • Degree required
  • Characteristics (accreditation) of the program where education is offered
  • Recognition of prior learning

Outlines the required work experience (clinical fellow, internship):

  • Type of experience
  • Length of experience
  • Extent of supervision
  • Supervisor recommendation
  • Rating scales
  • Portfolios

Determine the competency of the applicants through assessments such as:

  • Written examination
  • Structured observation and rating
  • Simulations/case studies
  • Oral interviews 


History of ASHA Membership and Certification Requirements

Membership Requirements (1926)

  • Clinical work in speech correction OR administrative duties associated with supervision
  • MD, PhD, DDS, or a master's degree with work in speech correction or some closely allied field
  • Publication of original research
  • Professional reputation; no blatant commercialization or guaranteeing "cures"
  • Member of National Association of Teachers of Speech

Membership Requirements (1930)

The West Committee created two classes of members:

  • Fellows—same as original membership requirements without mandatory publication requirement; but another outstanding achievement
  • Associates—Bachelor's degree with "high grade, independent, practical experience in an accredited working situation"

Membership Requirements (1935)

  • In 1935, membership in National Association of Teachers of Speech no longer required
  • Education in physiology of speech and its disorders
  • 10 fellows had to review and approve each associate applicant
  • Review reduced to two in 1936 (53 new individuals)

Membership Requirements (1938)

  • Period of employment reduced from three to one year but BA had to be in speech correction with clinical practice.

Membership Requirements (1942)

Associates

  • BA with 18 semester credit hours in speech correction; 12 hours in allied fields; 200 clock hours of supervised clinical training and one year clinical employment
  • Several years later the Associates category was changed to Clinical Members

Professional Members

  • Meet requirement for Associates plus master's degree; 24 semester credit hours speech correction courses and additional three years of clinical experience

Fellows

  • Meet requirements for Professional Members and must have made "significant and worthy contributions in the field" as demonstrated by publications

Highlights

  • Clinical membership/associate status was intended as an interim stop for those preparing for the profession—approval was needed by two Fellows for Professional Members and Fellows, and one Fellow for Associates
  • Fellows and Professional Members were considered professionally competent
  • Clinical Members could be speech correctionists with supervision (apprentices)
  • Fellow status did not indicate more training; rather it was a professional distinction
  • These membership categories were not revised in a major way for a decade

Membership and Recognition of Two Professions (Late 1940s)

  • It was clear to the Executive Council (EC) that specialization in speech-language and hearing disorders had to be recognized
  • EC also recognized there were research scientists in speech or hearing that needed to be in the Association but could not meet correct membership qualifications

Membership and Certification (1952)

  • Membership separated from certification of clinical competence
  • Any person with a Bachelor's degree could be a member
  • Associates were continued with no voting right. These members primarily consisted of subscribers to Association publication
  • Beginning of Certification Program as we know it
    • Clinical certification rather than a membership requirement became a service to members
    • Two levels and two different certificates at each level:
      1. Basic Speech or Basic Hearing—30 semester credit hours, 275 hours of clinical Practicum and one year of "sponsored Professional experience"
      2. Advanced Speech or Advanced Hearing—60 semester credit hours, 400 hours of clinical practicum and 4 years of sponsored Professional experience
    • Written and oral exam for Advanced Hearing
  • The result of not processing new applications during the establishment of the two different certificates and the separation of membership from certification was a backlog of several hundred applications and three years to process all of the applications.
  • 15 months after the plan was instituted 600 new applications were filed.
  • When reorganization had begun, the entire membership was 787


Certification (1952-1965)

  • Basic and Advanced levels of certification-requirements for speech-language pathology and audiology remained until 1965.
  • In 1965, a single level of certification for Hearing and for Speech (Certification of Clinical Competence) was established.
  • Members with Advanced Certification were granted CCC in either Speech or Hearing.
  • New applicants for CCC required the master's degree

Grandfather Period (1965-1970)

  • Option for non-certified pre-1965 members and holders of Basic Certification
    • 4 years of acceptable Report of Sponsored Professional Experience prior to 1/1/70
    • or achieving a passing score on the Special 1969 exam

Standards and Structure (1965-1973)

  • Master's degree or equivalent required
  • 60 semester credit hours
  • 275 hours of clinical practicum
  • Supervised clinical fellowship
  • June 30, 1970—CFY supervisors were required to be certified
  • Passing score required on National Examination in Speech Pathology and/or Audiology (NESPA)
  • Coursework required in 1965
    • 60 semester credit hours
    • 18 semester credit hours in Foundation/Development areas
    • 24 semester credit hours in major area; no specific language or aural rehabilitation course required
    • 6 semester credit hours in minor area
    • maximum of 6 semester credit hours of practicum
  • Practicum in 1965
    • 275 clock hours of practicum
      • 200 clock hours in major area
      • 25 in minor area ("significant amount in audiological evaluation and rehabilitation")
      • 30 hours in assessment
      • 25 clock hours each in articulation, voice, and fluency and 75 clock hours in language
      • Jan. 1, 1970—all supervisors had to have ASHA certification

Certification Standards (1973)

  • No specific supervision for clinical practicum hours or CFY
  • Had an appeals body

Certification Changes (1980)

  • Practicum supervisory requirements specified
  • ASHA Membership Requirement dropped
  • Master's degree or equivalent specified

Certification Standards (1993)

  • Graduate degree required
  • CF required 36 weeks full-time employment or part-time equivalent had to be initiated within 7 years following completion of course work/practicum and had to include periodic formal evaluation from supervisor
  • 75 semester credit hours
  • 27 semester credit hours in basic science, 6 semester credit hours in biological or physical science and math, 6 semester credit hours behavioral/social science, 15 semester credit hours in basic human communication
  • 36 semester credit hours professional course work; 30 at graduate level; 21 in major professional area
  • Speech/Language 6 semester credit hours in speech, 6 semester credit hours in language, 3 semester credit hours Audiology assessment, 3 semester credit hours auditory rehabilitation
  • 375 clock hours of clinical practice; 250 at graduate level in major area
  • 25 clock hours of observation prior to initiation of practicum
  • 50 clock hours in 3 different clinical settings
  • 20 clock hours each evaluation of speech disorder with children; evaluation of speech disorder with children, evaluation of language disorders with adults
  • Treatment with all of the about groups
  • 35 clock hours in minor area
  • Nov. 28, 1998—minor area practicum reduced to 20 clock hours and deletion of distribution
  • July 1, 2004—modification of Clinical Fellowship for individuals in doctoral programs-allows for as few as 5 hours per week

Current Standards (2005)

  • No specific course work; 75 total semester credit hours; 36 semester credit credit hours at post-BA level
  • 400 clock hours of supervised clinical experience; 375 clock hours direct clinic contact
  • 325 clock hours at graduate level; minimum 25% supervision
  • Passed Exam
  • Clinical Fellowship; mentored by individual holding CCC-SLP
  • At least 36 weeks at 35 hours per week
  • Verified by employer
  • Continued professional development
  • Graduated from CAA-accredited program
  • Tracking system for outcomes (KASA) 


Looking Back at Program Accreditation

  • In 1965 there were 4 accredited programs; now 249
  • 1964—Council for High Education Accreditation (and its predecessors) recognized program accreditation
  • 1967—U.S. Dept. of Education recognized program accreditation 


  

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