August 2, 2011 Features

Addressing the Shortage of School-Based SLPs: An Innovative Approach in Texas

Faced with a shortage of school-based speech-language pathologists, the Texas Education Agency (TEA) worked with Texas Woman's University (TWU) to create a statewide distance-learning program that blends innovative and traditional delivery systems. As a result, a master's degree in speech-language pathology is available on a large-scale format in all regions of the state—and Texas has more than 500 new SLPs.

Cindy Gill, EdD, CCC-SLPSince 1998, the program, nicknamed TETN after its original communication system, has allowed students to attend classes close to their homes and remain employed while completing their education. Although not an online program, TETN includes features that help students overcome traditional barriers to attending graduate school. Today, more than 100 students—in addition to the TWU on-campus group—enter this innovative speech-language pathology graduate program every two years.

The program was created in response to the education agency's request for TWU's help in relieving the shortage of public school SLPs. Faculty at TWU piloted a small distance program that included flying professors weekly to western regions of Texas. The plan evolved into a large-scale program that now is transmitted from the TWU campus via videoconferencing to 20 educational service centers throughout the state.

Overcoming Barriers

Addressing the school-based SLP shortage in Texas called for a radical shift in speech-language pathology graduate education to overcome a number of challenges:Ginger White, MS, CCC-SLP

  • Academic programs could not increase their enrollment because of the intensive level of clinical supervision required for students. Each university supervisor can monitor only a small number of students, each of whom must acquire a minimum of 400 practicum hours in a combination of university clinic and externship placements. Texas universities have the capacity to graduate an average of 16 master's students each year.
  • Potential students who are employed in any field may need to keep working while they are in graduate school.
  • The distance between a student's home and a university with a speech-language pathology program may be prohibitive (in Texas, some students are more than a five-hour drive from any speech-language pathology master's program).

Specific Responsibilities

To help overcome these challenges, TWU chose to supplement its campus-based traditional program with a master's degree program that would be accessible to qualified applicants in all regions of Texas and that would provide the required supervision levels. The program entails participation by TWU, the TEA and the state's public school system; each accepts specific responsibilities to make the program work. Laura Green, PhD, CCC-SLP

TWU directs the program and takes responsibility for all academic work and the clinical practicum. The school districts allow release time for their employees (usually speech-language pathology assistants) who are participating in the program, so that participants can attend a week of classes on the TWU campus and leave work early for subsequent twice-weekly classes. Schools also provide a certified SLP to supervise the graduate student for six hours a week and allow those supervisors release time to attend TWU supervisor training.

Not all of the graduate students work in the schools; for those who do not, school districts provide supervisors and allow the students to complete supervised practica in the schools for six hours a week. TEA provides TWU with funding to administer the program and assist with travel, and the agency also provides a state coordinator to work with the 20 education service centers (ESCs) where the graduate students attend classes.

Distance Education

Allan Bird, PhD, CCC-SLPTechnological advances enable individuals in remote regions of Texas to access university coursework. The program initially used videoconferencing technology, which transmitted classes to central locations. Students gathered twice a week at the 20 ESCs for real-time instruction, and instructors presented in many formats available in traditional classrooms—lectures, questions for students, and shared diagrams and video clips. The ESCs provide classroom space, classroom coordinators, videoconferencing equipment, and a technology specialist to troubleshoot technical problems. The ESCs functioned as an extension of the physical campus of TWU by providing the space and equipment in districts throughout the state. Students paid a nominal fee (about $80 a month) to cover the cost of the classroom and technology. More recently, students' attendance at the ESC was reduced to one night a week; the second night of classes is transmitted to students' home computers via a live interactive software platform.

To supplement the instructor's reach to each of the 20 regional receiving sites, an ASHA-certified, Texas-licensed SLP (hired by each ESC in accordance with the TWU agreement) serves as the class coordinator. The class coordinator attends each class and completes many non-instructional tasks, such as connecting equipment, scoring objective quizzes, overseeing the administration of exams, mailing assignments and projects to the professor, maintaining classroom decorum, and taking attendance.

Other communication components allow for daily communication with the students and interactive discussions and for posting and transmitting assignments, grades, PowerPoint presentations, and other documents.

Clinical Practicum

Cindy Teach

Addressing the Shortage of School-Based SLPs: An Innovative Approach in Texas.

Supervisor Training

Quality practicum experiences for all students has been critical to program success. The program allows in-field supervisors to use content experts to provide hands-on practicum instruction, a concept used in occupational and physical therapy. TWU maintains control of the practicum through supervisor training, routine visits to practicum sites, close control of paperwork, rigid practicum requirements, and a contractual sponsorship agreement (see sidebar). All the school-based supervisors are required to attend a minimum of eight hours of initial supervisor training and bimonthly trainings throughout the year. Supervisors earn CEUs for their participation in these mandatory trainings. Training topics—similar to on-campus supervisor trainings—cover a review of ASHA requirements/suggestions for supervision of graduate students (including Position Statement on Clinical Supervision; Knowledge and Skills Needed by SLPs Providing Clinical Supervision; and Tips for First-Time Supervisors of Graduate Student Clinicians). The sessions also include training in departmental requirements, forms, paperwork, and supervisor skill development; a review of the continuum of supervision as outlined by Jean Anderson (1988) and skill-enhancement topics, such as successful conferencing, conflict management, competency development, formative and summative assessment, and evidence-based practice.

Communication with supervisors continues throughout the year. An electronic mailing list of supervisors facilitates the continual flow of information. Supervisors also participate in an informal course via the classroom-hosting platform, where practicum documents and discussion boards support interactive discussions between clinical faculty and on-site supervisors. Finally, to ensure supervisors' access to the academic and practicum information given their students, they are invited to attend academic classes and view the course materials. Several supervisors elect to attend some classes, usually those focusing on a specific area in which they needed to update their knowledge (e.g. dysphagia or childhood apraxia of speech). Most supervisors supervise only one graduate student. Districts are required to provide a different supervisor for the graduate student's third and fourth semesters of school practicum. Supervisors complete an evaluation at the end of each training session and their comments have been uniformly positive. They report that the supervisory experience was very positive and also was a learning experience.

TWU faculty make onsite visits to review the students' progress, portfolios, logs, lesson plans, and data collection, and to address any supervisor concerns. TWU faculty make additional site visits to any student having difficulty applying academic information to practicum clients.

Traci Tawney

Student Traci Tawney attends class from her home computer.

The Two-Hat Challenge

Although employment in the schools is not a requirement of the program, many students become licensed assistants after their first semester of graduate work, which means they wear two hats—graduate student and licensed assistant. Graduate students employed in the schools as licensed assistants are trained in the distinction between the two roles, as are their supervisors. The roles, rules, and responsibilities for each position are vastly different and are determined by different governing bodies. This information is discussed at the initial program meeting, the clinical process course (taken prior to beginning practicum) and supervisor training sessions. To ensure that roles are clearly delineated, TWU requires an approved schedule for all clients seen by graduate students. That is, the supervisor determines the appropriate cases for the student and establishes a schedule showing the practicum cases. This schedule is submitted to TWU for approval and adjustment by the practicum director before any intervention begins. The schedule also documents that the student is functioning as a graduate student for purposes of university-based liability insurance. The remainder of the graduate student's week, if he/she functions as a licensed assistant, is not under university jurisdiction.

Educational Sponsorship Agreement

In large part, the program's success relies on the written clarification of stakeholder responsibilities, including the sponsorship agreement between TWU and the school district. This agreement, which enumerates the school district's contributions (e.g., providing supervisors and giving them release time), is signed by a district administrator after meeting with TWU. Although students do seek out a school district willing to serve as a sponsor, they do not contact potential supervisors. The district later identifies potential supervisors, who are then trained and approved by TWU.

Practicum Sequence

Students enroll in a clinical practicum for six semesters. They work in their sponsoring school districts each fall and spring semester. In summer semesters, they are placed at externships in hospitals, long-term care facilities, and specialty camps. During each semester, approved disorder types for clinical practica are carefully outlined by the university faculty. To date, more than 500 facilities in Texas have contracted to serve as externship sites for TWU students.

Student Considerations

Student-Teacher Interactions

The academic coursework and practicum requirements for the TETN graduate students are the same as those for on-campus students, but program designers feared that student-faculty relationships would be difficult to replicate across the miles and took several steps to enhance those opportunities. First, most classes use synchronous (real-time) interactive lectures, supplemented by some asynchronous (delayed) learning activities. This format allows for student-faculty discussions and spontaneous direct interactions similar to a typical campus program. Secondly, to increase instructor access, many of the instructors (who are the same faculty who teach the on-campus classes) travel to receiving sites to deliver their class lectures. TEA and TWU fund additional TWU faculty as needed. Additionally, students have 30 minutes at the end of each class period to visit with the professors via the videoconferencing system, and they use e-mail, phone calls, and office hours, to conduct personal exchanges. In the fifth cycle of the program, students were given additional access to professors by way of real-time visual/auditory computer connections for requested review or discussion sessions outside of class time.

In the fourth cycle of the program, Campus Kick-Off week—an opportunity for more campus-like interaction—was added. Students spend a week living in campus dorms and attending 30 hours of class. In the evenings, students engage in teambuilding activities. Those employed by a school district are released for the week.

School District Commitment

To help the graduate students become or remain employed, the participating schools districts agree to sponsor a student in return for future employment in the school. In a written agreement, schools consent to certain conditions for the graduate students, such as allowing them to leave work early two days a week to attend class, releasing them for the Campus Kick-off week, and providing a variety of supervisors in the spring and fall semesters.

When a district supports a student in the program, the district commits some of a certified SLP's time for supervision. If the graduate student is employed as an assistant, the district also sacrifices some of that employee's time for class attendance (if the graduate student is employed as an assistant). The returns appear to be worth the investment. The six weekly practicum hours result in excellent intervention for those on the school caseload (as reported in supervisor evaluations), as the graduate student prepares lesson plans and carefully designs and executes each session under the direction of the supervisor. In return, the graduate student is expected to work for the sponsoring school district for an agreed-upon number of years. (The commitment, usually two to four years, is determined by the district.)

Evaluation

The Texas Education Agency retained outside evaluation agencies to evaluate the program during and after each cycle. In addition, TWU regularly collects evaluative data (regarding academic and clinical preparation) from graduates and their employers and supervisors. Responses help TWU to improve the program; however, in all past qualitative evaluative measures, the program rankings were uniformly high. In addition, TWU students' pass rate for the speech-language pathology PRAXIS Examination is consistently greater than 96%, well above the 84% national average passing rate (ASHA, 2009).

To determine how the two TWU venues—TETN and on-campus—compare, retrospective demographic and success-related data were gathered on 126 on-campus (OC) students (admitted annually over a five-year period) and 126 distance-learning (DL) students admitted to the third TETN cycle. The groups were compared on pre-entrance factors (GREs, GPAs, and written goals), demographic factors (gender, race, and age) for admitted students, and post-entrance factors (attendance, grades, PRAXIS scores, (withdrawals, and job placements) for those who graduated. There were no appreciable differences between the two groups on either the pre-entrance factors or most post-entrance factors. The only significant difference identified was higher racial diversity in the TETN program (39% minority) than in the on-campus program (8% minority).

Expanding Access

The shortage of SLPs in Texas schools is a problem not likely to be solved in the near future. However, the urgent need for highly qualified SLPs compels us to explore non-traditional solutions, including the delivery of educational programs via distance-learning venues. The TETN program is one example of a successful non-traditional program that has produced more than 500 highly qualified SLPs who are committed to the schools of Texas in 13 years (100 every four years at the beginning of the program; 100 every two years today). Essential elements in the success of the program are the interagency cooperation, hands-on university involvement and direction, support from Texas school districts, and extremely dedicated students and supervisors. With continued technological advances, faculty dedication and flexibility, and school district contributions, perhaps many more qualified potential SLPs will have access to a master's program in the future.

Cindy Gill, EdD, CCC-SLP, has served as the director of Texas Woman's University's TETN master's program since 2002. She teaches neurology and school-age language disorders classes in the on-campus and TETN venues, and is former vice president of the Texas Speech-Language-Hearing Association. Contact her at cgill@mail.twu.edu.

Ginger White, MS, CCC-SLP, has served as the director of practicum for the Texas Woman's University TETN- master's program for the past16 years.

Laura Green, PhD, CCC-SLP, teaches in the program and directs the TETN students' research, which has been presented 23 times at state conventions.

Allan Bird, PhD, CCC-SLP, was one of the founders of the TETN program and has recently retired from the TWU faculty.

cite as: Gill, C. , White, G. , Green, L.  & Bird, A. (2011, August 02). Addressing the Shortage of School-Based SLPs: An Innovative Approach in Texas. The ASHA Leader.

References

American Speech-Language-Hearing Association. (2008). Clinical Supervision in Speech-Language Pathology [Position Statement]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2008). Knowledge and Skills Needed by Speech-Language Pathologists Providing Clinical Supervision [Knowledge and Skills]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2008).Tips for First-Time Supervisors of Graduate Student Clinicians. www.asha.org/slp/supervisortips.htm.

American Speech-Language-Hearing Association. National Summary Report: Descriptive Statistics of PRAXIS Examination Scores for the Speech- Language Pathology Specialty Test for Test Administration Years 1997–1998 through 2007–2008, retrieved from www.asha.org/uploadedFiles/certification/praxis/PraxisScoresSLP.pdf#search="Praxis", Dec. 9, 2009



Sample Items from the Education Sponsorship Agreement

The Educational Entity agrees to:

  • Provide practicum site(s) for the TWU graduate student 6 hours per week.
  • Ensure that the graduate student's practicum placements allow him/her to acquire the practicum experiences required by ASHA. This includes experience in preschool, school-age, and secondary populations and with eight disorder types (for evaluation and treatment) as mandated by ASHA.
  • Provide an ASHA-certified speech-language pathologist to supervise the graduate student for six hours of practicum/week (four to five semesters).
  • Adjust the ASHA-certified SLP supervisor's workload to allow time for supervision.
  • Allow practicum supervisor's release time to attend a full-day initial supervisor training at the Education Service Center (ESC) or the local district via TETN connection (requires 10-day advance written request to the ESC).
  • Allow practicum supervisors release time to attend mandatory supervisor trainings.
  • Allow student to leave district campus to be in class by 4:30 on Tuesdays and Thursdays.
  • Release the student from the district to attend a week of classes on the TWU Denton campus.
  • Provide a change in practicum supervisors the second year of practicum.


  

Advertise With UsAdvertisement