Background Information and Standards and Implementation for the Certificate of Clinical Competence in Speech Language Pathology
(Updated 7/1/05)
Background Information
The Council on Professional Standards in Speech-Language Pathology and Audiology (Standards Council) of the American Speech-Language-Hearing Association (ASHA), which was sunset in December 2000, was responsible for developing the standards for clinical certification and for monitoring those standards. That is, the Standards Council developed new standards in response to changes in the scope of practice, to protect consumers and to promote quality services. In January 2001 the Council For Clinical Certification (CFCC) was established and assumed both the standard-setting and implementation functions. After finalization of the standards, the CFCC began the development of the implementation language, which clarifies or interprets the standards.
The Standards Council had developed an action plan to identify the "…academic, clinical, and other experiences required for attaining the critical knowledge and skills necessary for entry-level, independent practice of speech- language pathology." As a part of that plan, ASHA commissioned the Educational Testing Service to conduct a skills validation study for the profession of speech-language pathology, and the Standards Council examined information from the following: the skills validation study; practice-specific literature (e.g., scope of practice statements, position papers, preferred practice patterns, and publications of related professional organizations); national examination results; information obtained from focus group discussions of the future of speech- language pathology (Practice Setting Panel, ASHA Leadership Conference, Multicultural Issues Board, and the Board of Division Coordinators); a review of external factors (e.g., demographic factors, changes in health care and public education service delivery systems, reimbursement changes in health care and public education service delivery systems, reimbursement regulations, state regulations, and legal issues); consumer groups; and widespread peer review from the ASHA membership, the ASHA leadership, state licensure boards, academic programs, related professional organizations, and consumer groups.
Following a review of the data noted above, the Standards Council published proposed standards for widespread peer review in 1999. The proposed standards were modified on the basis of the peer review comments and adopted by the Standards Council in October 2000, to be implemented in 2005.
Overview of Standards
Although previous certification standards emphasized process measures of academic and clinical knowledge, the 2005 standards combine process and outcome measures of academic and clinical knowledge and skills. Process standards specify the experiences, such as course work or practicum hours; outcome standards require demonstration of specific knowledge and skills. The 2005 standards utilize a combination of formative and summative assessments for the purpose of improving and measuring student learning.
Salient features of the standards for entry- level practice include the following requirements:
A. A minimum of 75 semester credit hours culminating in a master’s, doctoral, or other recognized post-baccalaureate degree. The graduate education in speech-language pathology must be initiated and completed in a program accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) of the American Speech-Language-Hearing Association.
B. Skills in oral and written communication and demonstrated knowledge of ethical standards, research principles, and current professional and regulatory issues.
C. Practicum experiences that encompass the breadth of the current scope of practice with both adults and children (with no specific clock-hour requirements for given disorders or settings) resulting in a minimum of 400 clock hours of supervised practicum, of which at least 375 hours must be in direct client/patient contact and 25 in clinical observation.
D. A 36-week speech- language pathology clinical fellowship that establishes a collaboration between the clinical fellow and a mentor.
E. A maintenance of certification requirement (Standard VII) that went into effect on January 1, 2005.
Standards and Implementation for the Certificate of Clinical Competence in Speech-Language Pathology
Effective January 1, 2005
Applicants for Initial Certification Under the 1993 Standards
Individuals must apply for initial certification on or before December 31, 2005, in order to be evaluated under the 1993 standards.
Applicants for Initial Certification Under the 2005 Standards
Individuals may apply for initial certification on or after January 1, 2005, in order to be evaluated under the 2005 standards. Individuals applying for initial certification after January 1, 2006, will be evaluated under the 2005 standards.
Applicants for Reinstatement Under the 1993 Standards
Individuals must apply for reinstatement on or before December 31, 2005, in order to be evaluated under the 1993 Certification Standards. The reinstatement policy under the 1993 Certification Standards is as follows:
- If lapsed less than 5 years: Submit a reinstatement application form and the appropriate fee.
- If lapsed more than 5 years: Submit an application for certification with the appropriate fee and either (a) obtain a passing score on the Praxis Series examination within the 3 years preceding application or (b) meet the 1993 certification standards.
Applicants for Reinstatement Under the 2005 Standards
Individuals who apply for reinstatement on or after January 1, 2006, cannot be evaluated under the 1993 Certification Standards and must meet the 2005 Certification Standards. The reinstatement policy under the 2005 Certification Standards is as follows:
- If lapsed less than 5 years: Submit a reinstatement application form, the reinstatement fee, and evidence of professional development hours based on the number of years lapsed (i.e., 1 year = 10 hours; 2 years = 20 hours; 3-5 years = 30 hours).
- If lapsed more than 5 years: Submit a new application for certification with the appropriate fee, obtain a passing score on the Praxis Series examination within 5 years of application for reinstatement, complete a modified clinical fellowship (12-weeks duration), and accumulate 30 contact hours of professional development for the 3 years prior to the application for reinstatement.
STANDARD I: DEGREE
Effective January 1, 2005, the applicant for certification must have a master’s or doctoral or other recognized post-baccalaureate degree. A minimum of 75 semester credit hours must be completed in a course of study addressing the knowledge and skills pertinent to the field of speech-language pathology.
Implementation:
Verification of the graduate degree is required of the applicant before the certificate is awarded. Degree verification is accomplished by submitting (a) an application signed by the director of the graduate program indicating the degree date, and (b) an official transcript showing that the degree has been awarded. Individuals educated in foreign countries must submit official transcripts and evaluations of their degrees and courses to verify equivalency.
All graduate course work and graduate clinical practicum required in the professional area for which the Certificate is sought must have been initiated and completed at an institution whose program was accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) of the American Speech-Language-Hearing Association in the area for which the Certificate is sought.
Automatic Approval. If the graduate program of study is initiated and completed in a CAA-accredited program and if the program director or official designee verifies that all knowledge and skills requirements have been met, approval of the application is automatic provided that the application for the Certificate of Clinical Competence is received by the National Office no more than 3 years after the degree is awarded.
Evaluation Required. The following categories of applicants must submit a completed application for certification that includes the Knowledge and Skills Acquisition (KASA) summary form for evaluation by the Council For Clinical Certification (CFCC):
(a) those who apply more than 3 years after the completion of the graduate degree from a CAA-accredited program
(b) those who were graduate students and were continuously enrolled in a CAA-program that had its accreditation withdrawn during the applicant's enrollment
(c) those who satisfactorily completed graduate course work, clinical practicum, and knowledge and skills requirements in the area for which certification is sought in a program that held candidacy status for accreditation
(d) those who satisfactorily completed graduate course work, clinical practicum, and knowledge and skills requirements in speech-language pathology at a CAA-accredited program but (1) received a graduate degree from a program not accredited by CAA, (2) received a graduate degree in a related area, or (3) received a graduate degree from a non-U.S. institution of higher education.
The graduate program director must verify satisfactory completion of both undergraduate and graduate academic course work, clinical practicum, and knowledge and skills requirements.
STANDARD II: INSTITUTION OF HIGHER EDUCATION
The graduate degree must be granted by a regionally accredited institution of higher education.
Implementation:
The institution of higher education must be accredited by one of the following: Commission on Higher Education, Middle States Association of Colleges and Schools; Commission on Institutions of Higher Education, New England Association of Schools and Colleges; Commission on Institutions of Higher Education, North Central Association of Colleges and Schools; Commission on Colleges, Northwest Association of Schools and Colleges; Commission on Colleges, Southern Association of Colleges and Schools; or Accrediting Commission for Senior Colleges and Universities, Western Association of Schools and Colleges.
Individuals educated in foreign countries must submit documentation that course work was completed in an institution of higher education that is regionally accredited or recognized by the appropriate regulatory authority for that country. In addition, applicants educated in foreign countries must meet each of the Standards that follow.
STANDARD III: PROGRAM OF STUDY—KNOWLEDGE OUTCOMES
The applicant for certification must complete a program of study (a minimum of 75 semester credit hours overall, including at least 36 at the graduate level) that includes academic course work sufficient in depth and breadth to achieve the specified knowledge outcomes.
Implementation:
The program of study must address the knowledge and skills pertinent to the field of speech-language pathology. The applicant must maintain documentation of course work at both undergraduate and graduate levels demonstrating that the requirements in this standard have been met. The minimum 75 semester credit hours may include credit earned for course work, clinical practicum, research, and/or thesis/dissertation. Verification is accomplished by submitting an official transcript showing that the minimum credit hours have been competed.
Standard III-A: The applicant must demonstrate knowledge of the principles of biological sciences, physical sciences, mathematics, and the social/behavioral sciences.
Implementation:
The applicant must have transcript credit (which could include course work, advanced placement, CLEP, or examination of equivalency) for each of the following areas: biological sciences, physical sciences, social/behavioral sciences, and mathematics. Appropriate course work may include human anatomy and physiology, neuroanatomy and neurophysiology, genetics, physics, inorganic and organic chemistry, psychology, sociology, anthropology, and non-remedial mathematics. The intent of this standard is to require students to have a broad liberal arts and science background. Courses in biological and physical sciences specifically related to communication sciences and disorders (CSD) may not be applied for certification purposes in this category. In addition to transcript credit, applicants may be required by their graduate program to provide further evidence of meeting this requirement.
Standard III-B: The applicant must demonstrate knowledge of basic human communication and swallowing processes, including their biological, neurological, acoustic, psychological, developmental, and linguistic and cultural bases.
Implementation:
This standard emphasizes the basic human communication processes. The applicant must demonstrate the ability to integrate information pertaining to normal and abnormal human development across the life span, including basic communication processes and the impact of cultural and linguistic diversity on communication. Similar knowledge must also be obtained in swallowing processes and new emerging areas of practice. Program documentation may include transcript credit and information obtained by the applicant through clinical experiences, independent studies, and research projects.
Standard III-C: The applicant must demonstrate knowledge of the nature of speech, language, hearing, and communication disorders and differences and swallowing disorders, including the etiologies, characteristics, anatomical/physiological, acoustic, psychological, developmental, and linguistic and cultural correlates. Specific knowledge must be demonstrated in the following areas:
- articulation
- fluency
- voice and resonance, including respiration and phonation
- receptive and expressive language (phonology, morphology, syntax, semantics, and pragmatics) in speaking, listening, reading, writing, and manual modalities
- hearing, including the impact on speech and language
- swallowing (oral, pharyngeal, esophageal, and related functions, including oral function for feeding; orofacial myofunction)
- cognitive aspects of communication (attention, memory, sequencing, problem-solving, executive functioning)
- social aspects of communication (including challenging behavior, ineffective social skills, lack of communication opportunities)
- communication modalities (including oral, manual, augmentative, and alternative communication techniques and assistive technologies)
Implementation:
The applicant must demonstrate the ability to integrate information delineated in this standard. Program documentation may include transcript credit and information obtained by the applicant through clinical experiences, independent studies, and research projects. It is expected that course work addressing the professional knowledge specified in Standard III-C will occur primarily at the graduate level. The knowledge gained from the graduate program should include an effective balance between traditional parameters of communication (articulation/phonology, voice, fluency, language, and hearing) and additional recognized and emerging areas of practice (e.g., swallowing, upper aerodigestive functions).
Standard III-D: The applicant must possess knowledge of the principles and methods of prevention, assessment, and intervention for people with communication and swallowing disorders, including consideration of anatomical/physiological, psychological, developmental, and linguistic and cultural correlates of the disorders.
Implementation:
The applicant must demonstrate the ability to integrate information about prevention, assessment, and intervention over the range of differences and disorders specified in Standard III-C above. Program documentation may include transcript credit and information obtained by the applicant through clinical experiences, independent studies, and research projects.
Standard III-E: The applicant must demonstrate knowledge of standards of ethical conduct.
Implementation:
The applicant must demonstrate knowledge of, appreciation for, and ability to interpret the ASHA Code of Ethics. Program documentation may reflect course work, workshop participation, instructional module, clinical experiences, and independent projects.
Standard III-F: The applicant must demonstrate knowledge of processes used in research and the integration of research principles into evidence-based clinical practice.
Implementation:
The applicant must demonstrate comprehension of the principles of basic and applied research and research design. In addition the applicant should know how to access sources of research information and have experience relating research to clinical practice. Program documentation could include information obtained through class projects, clinical experiences, independent studies, and research projects.
Standard III-G: The applicant must demonstrate knowledge of contemporary professional issues.
Implementation:
The applicant must demonstrate knowledge of professional issues that affect speech-language pathology as a profession. Issues typically include professional practice, academic program accreditation standards, ASHA practice policies and guidelines, and reimbursement procedures. Documentation could include information obtained through clinical experiences, workshops, and independent studies.
Standard III-H: The applicant must demonstrate knowledge about certification, specialty recognition, licensure, and other relevant professional credentials.
Implementation:
The applicant must demonstrate knowledge of state and federal regulations and policies related to the practice of speech-language pathology and credentials for professional practice. Documentation could include course modules and instructional workshops.
STANDARD IV: PROGRAM OF STUDY—SKILLS OUTCOMES
Standard IV-A: The applicant must complete a curriculum of academic and clinical education that follows an appropriate sequence of learning sufficient to achieve the skills outcomes in Standard IV-G.
Implementation:
The applicant’s program of study should follow a systematic knowledge- and skill-building sequence in which basic course work and practicum precede, insofar as possible, more advanced course work and practicum.
Standard IV-B: The applicant must possess skill in oral and written or other forms of communication sufficient for entry into professional practice.
Implementation:
The applicant must demonstrate communication skills sufficient to achieve effective clinical and professional interaction with clients/patients and relevant others. For oral communication, the applicant must demonstrate speech and language skills in English, which, at a minimum, are consistent with ASHA’s most current position statement on students and professionals who speak English with accents and nonstandard dialects. For written communication, the applicant must be able to write and comprehend technical reports, diagnostic and treatment reports, treatment plans, and professional correspondence.
Individuals educated in foreign countries must meet the criteria required by the International Commission of Healthcare Professions (ICHP) in order to meet this standard.
Standard IV-C: The applicant for certification in speech-language pathology must complete a minimum of 400 clock hours of supervised clinical experience in the practice of speech-language pathology. Twenty-five hours must be spent in clinical observation, and 375 hours must be spent in direct client/patient contact.
Implementation:
Observation hours generally precede direct contact with clients/patients. However, completion of all 25 observation hours is not a prerequisite to begin direct client/patient contact. For certification purposes, the observation and direct client/patient contact hours must be within the scope of practice of speech-language pathology.
For certification purposes, observation experiences must be under the direction of a qualified clinical supervisor who holds current ASHA certification in the appropriate practice area. Such direction may occur simultaneously with the student’s observation or may be through review and approval of written reports or summaries submitted by the student. Students may use videotapes of the provision of client services for observation purposes. The applicant must maintain documentation of time spent in supervised observation, verified by the program in accordance with Standards III and IV.
Applicants should be assigned practicum only after they have acquired a sufficient knowledge base to qualify for such experience. Only direct contact with the client or the client’s family in assessment, management, and/or counseling can be counted toward practicum. Although several students may observe a clinical session at one time, clinical practicum hours should be assigned only to the student who provides direct services to the client or client’s family. Typically, only one student should be working with a given client. In rare circumstances, it is possible for several students working as a team to receive credit for the same session depending on the specific responsibilities each student is assigned. For example, in a diagnostic session, if one student evaluates the client and another interviews the parents, both students may receive credit for the time each spent in providing the service. However, if one student works with the client for 30 minutes and another student works with the client for the next 45 minutes, each student receives credit for the time he/she actually provided services— that is, 30 and 45 minutes, not 75 minutes. The applicant must maintain documentation of time spent in supervised practicum, verified by the program in accordance with Standards III and IV.
Standard IV-D: At least 325 of the 400 clock hours must be completed while the applicant is engaged in graduate study in a program accredited in speech-language pathology by the Council on Academic Accreditation in Audiology and Speech-Language Pathology.
Implementation:
A minimum of 325 clock hours of clinical practicum must be completed at the graduate level. The remaining required hours may have been completed at the undergraduate level, at the discretion of the graduate program.
Standard IV-E: Supervision must be provided by individuals who hold the Certificate of Clinical Competence in the appropriate area of practice. The amount of supervision must be appropriate to the student’s level of knowledge, experience, and competence. Supervision must be sufficient to ensure the welfare of the client/patient.
Implementation:
Direct supervision must be in real time and must never be less than 25% of the student’s total contact with each client/patient and must take place periodically throughout the practicum. These are minimum requirements that should be adjusted upward if the student’s level of knowledge, experience, and competence warrants. A supervisor must be available to consult as appropriate for the client’s/patient’s disorder with a student providing clinical services as part of the student’s clinical education. Supervision of clinical practicum must include direct observation, guidance, and feedback to permit the student to monitor, evaluate, and improve performance and to develop clinical competence.
|