CFCC - 2Certification Matters: The CFCC's Official Newsletter

Issue 2, March 2016

Letter From Dan C. Halling, CFCC Chair

Welcome to Certification Matters, the newsletter from the Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC). In this edition, I would like to highlight our 2015 accomplishments and then address our plans for 2016.

A Look Back at 2015

In 2015, the CFCC awarded certification to more than 9,400 audiologists and speech-language pathologists—this is a record number of newly certified professionals and represents an increase of more than 1,000 new certificate holders from 2014. One of the Council's goals in the current Strategic Plan is to ensure that ASHA certification continues to be the preferred credential by audiologists and speech-language pathologists. This increase in the number of new certificate holders is evidence that the Certificate of Clinical Competence (CCC) continues to be relevant and of value to today's professionals.

As most already know, Clinical Specialty Certification, which formerly was known as Clinical Specialty Recognition, now falls under the purview of the CFCC. Board specialty certification is now available in child language and language disorders, fluency and fluency disorders, intraoperative monitoring, and swallowing and swallowing disorders. Practice analyses are underway. New specialty certification areas are in various stages of development, or are under consideration, in autism, gerontology, voice and voice disorders, and vestibular disorders.

The CFCC created the File Review and International Committee to evaluate applications and to more clearly define the processes for certifying international applicants. The committee has developed a checklist of required documents, which should provide the benefit of making the entire process more transparent, standardizing the review process, and also reducing the review time for these applications.

The Council revised the "Inactive" status policy for certificate holders who have a medical circumstance or are primary caregivers for someone with a medical circumstance that prevents the certificate holder from working in the professions. Certificate holders can have their status changed to Inactive but, to do so, must submit a signed affidavit confirming that they will not provide or supervise the provision of clinical services while their certification is Inactive. Inactive status now cannot be held for more than 4 years. Individuals holding the Certificate of Clinical Competence in Audiology (CCC-A [Inactive]) or Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP [Inactive]) who wish to return to practice may be able to regain Active status by following the policy now in effect.

A Look Ahead to 2016

As of March 1, 2016, the Council has made two changes to the implementation language of the SLP standards. The first change was to clarify the deadline for submitting completed Clinical Fellowship documentation. The second change allows applicants for certification to use alternative clinical education (ACE) to fulfill up to 75 of the 375 direct client/patient contact hours. Refer to the SLP certification standards on the ASHA website. The Council is also proposing changes to the SLP standards that will be available for widespread peer review from March 28 to May 15, 2016. The exact implementation language and proposed changes are found below in Lynn Flahive's report from the SLP Committee.

The Council is planning to propose changes to the audiology standards this year, which will most likely include significant revisions to the standards as well as updates to the Knowledge and Skills statements as a result of the practice analysis. Any proposed changes in standards will be sent out for widespread peer review.

It looks to be a busy year in certification! Remember, you can always reach out to ASHA's Certification staff at [email protected] with any problems, questions, or concerns related to certification. We are also looking for dedicated, experienced, and passionate professionals to become involved in ASHA certification by serving on the CFCC. I ask that you consider responding to the CFCC call for nominations—the deadline to apply is June 1, 2016.

Audiology Update

by Diane Sabo, Vice Chair

The Audiology Committee of CFCC is hard at work continuing with last year's endeavors to update the standards. We have two new audiologists on the committee, so we have been reviewing and aligning ourselves for the year's work. In addition, the practice analysis has been completed and compiled for us. This new information on audiology practice was needed for us to complete the update for the Knowledge and Skills area of the audiology standards. The Audiology Committee decided to do regular bi-monthly teleconferences in order to prepare a draft of the proposed standards by mid-year, and then make the draft available to you, our stakeholders, for peer review later in 2016.

SLP Update

by Lynn Flahive, Vice Chair

The SLP Committee has been working on making changes to both SLP certification standards and implementation language, and, at the February 2016 meeting, the Council approved the proposed language below to be sent out for widespread peer review. The SLP Certification Standards Peer Review Survey will be open from March 28 to May 15, 2016. Please be sure to make your opinion heard!

SLP Certification Standards Changes

In order to meet growing concerns over the quality of student supervision and accountability of Clinical Fellow mentorship, the proposed updates, as listed below in bold, will require certified speech-language pathologists (SLPs) to be actively certified for a minimum of 9 months prior to supervising student clinicians or mentoring clinical fellows. Additionally, supervisors and mentors will be required to take continuing education hours in supervision.

Standard V-E

Supervision must be provided by individuals who hold the Certificate of Clinical Competence in the appropriate profession and who, at a minimum, have the equivalent of 9 months' full-time clinical experience after the awarding of ASHA certification. Every three (3) years, supervisors will be required to have two (2) hours of continuing education in supervision. Experience and supervision training/professional development must be earned prior to supervising students or mentoring Clinical Fellows.

Standard VII-B: Clinical Fellowship Mentorship

Mentorship must be provided by individuals who hold the Certificate of Clinical Competence in Speech-Language Pathology and who, at a minimum, have the equivalent of 9 months' full-time clinical experience after the awarding of ASHA certification. Every three (3) years, mentors will be required to have two (2) hours of continuing education in supervision. Experience and supervision training/professional development must be earned prior to supervising students or mentoring Clinical Fellows.

In addition to the changes in the Standards as listed above, the CFCC voted to require a minimum of one (1) hour of continuing education in ethics, in order to hold paramount the safety and ethical treatment of our consumers. Although this change occurs in the implementation language of Standard VIII, the CFCC felt that it was necessary to be included in peer review because it adds a new requirement for certification maintenance.

Standard VIII: Maintenance of Certification

Certificate holders must demonstrate continued professional development for maintenance of the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP).

Implementation: Individuals who hold the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) must accumulate 30 certification maintenance hours (CMH) of professional development during every 3-year maintenance interval. The 30 CMHs must include a minimum of 1 continuing education unit/certificate maintenance hour in ethics. Intervals are continuous and begin January 1 of the year following award of initial certification or reinstatement of certification. A random audit of compliance will be conducted.

SLP Implementation Language Changes

The SLP Committee has addressed the issue of alternative clinical education (ACE) in the revision of implementation language. The purpose of the revisions to the implementation language of Standards V-B and V-C, written below in bold, is to expand the definition of supervised clinical experiences to include alternative clinical education. This will allow applicants for certification to obtain up to 20% (i.e., 75 hours) of direct contact hours through ACE methods.

Standard V-B

Implementation: The applicant must have acquired the skills referred to in this standard applicable across the nine major areas listed in Standard IV-C. Skills may be developed and demonstrated by direct client/patient contact in clinical experiences, academic course work, labs, simulations, examinations, and completion of independent projects.

The applicant must have obtained a sufficient variety of supervised clinical experiences in different work settings and with different populations so that he or she can demonstrate skills across the ASHA Scope of Practice in Speech-Language Pathology. Supervised clinical experience is defined as clinical services (i.e., assessment/diagnosis/evaluation, screening, treatment, report writing, family/client consultation, and/or counseling) related to the management of populations that fit within the ASHA Scope of Practice in Speech-Language Pathology.

These experiences should allow students to:

  • interpret, integrate, and synthesize core concepts and knowledge;
  • demonstrate appropriate professional and clinical skills; and
  • incorporate critical thinking and decision-making skills while engaged in identification, evaluation, diagnosis, planning, implementation, and/or intervention.

Alternative clinical experiences may include the use of standardized patients and simulation technologies (e.g., standardized patients, virtual patients, digitized mannequins, immersive reality, task trainers, computer-based interactive).

Supervisors of clinical experiences must hold a current ASHA Certificate of Clinical Competence in the appropriate area of practice during the time of supervision. The supervised activities must be within the ASHA Scope of Practice in Speech-Language Pathology to count toward certification.

Standard V-C

Implementation: Guided observation hours generally precede direct contact with clients/patients. The observation and direct client/patient contact hours must be within the ASHA Scope of Practice in Speech-Language Pathology and must be under the supervision of a qualified professional who holds current ASHA certification in the appropriate practice area. Such supervision may occur simultaneously with the student's observation or afterwards through review and approval of written reports or summaries submitted by the student. Students may use video recordings of client services for observation purposes.

Applicants should be assigned practicum only after they have acquired sufficient knowledge bases to qualify for such experience. Only direct contact with the client or the client's family in assessment, intervention, and/or counseling can be counted toward practicum. Up to 20% (i.e., 75 hours) of direct contact hours may be obtained through alternative clinical education (ACE) methods. Only the time spent in active engagement with the ACE may be counted. ACE may include the use of standardized patients and simulation technologies (e.g., standardized patients, virtual patients, digitized mannequins, immersive reality, task trainers, computer-based interactive). Debriefing activities may not be included. 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 at a time in order to count the practicum hours. 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 student A works with the client for 30 minutes and student B works with the client for the next 45 minutes, each student receives credit for only the time he/she actually provided services—that is, 30 minutes for student A and 45 minutes for student B. The applicant must maintain documentation of time spent in supervised practicum, verified by the program in accordance with Standards III and IV.

A revision to Standard VII's implementation language now requires Clinical Fellows to report the completion of their Clinical Fellowship Year within 90 days of the 48-month timeframe, or their applications will be closed.

Standard VII: Speech-Language Pathology Clinical Fellowship

Implementation: The Clinical Fellowship may be initiated only after completion of all academic course work and clinical experiences required to meet the knowledge and skills delineated in Standards IV and V. The CF experience must be initiated within 24 months of the date the application is received. Once the CF has been initiated, it must be completed within 48 months. For applicants completing multiple CFs, all CF experiences related to the application must be completed within 48 months of the date the first CF was initiated. Applications will be closed for a CF/CFs that is/are not completed within the 48-month timeframe or that is/are not reported to ASHA within 90 days after the 48-month timeframe. The Clinical Fellow will be required to reapply for certification and must meet the Standards in effect at the time of re-application. CF experiences older than 5 years at the time of application will not be accepted.

The CF must have been completed under the mentorship of an individual who held the ASHA Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) throughout the duration of the fellowship. It is the Clinical Fellow's responsibility to identify a mentoring speech-language pathologist (SLP) who holds an active Certificate of Clinical Competence in Speech-Language Pathology. Should the certification status of the mentoring SLP change during the CF experience, the Clinical Fellow will be awarded credit only for that portion of time during which the mentoring SLP held certification. It, therefore, is incumbent on the CF to verify the mentoring SLP's status periodically throughout the Clinical Fellowship experience. A family member or individual related in any way to the Clinical Fellow may not serve as a mentoring SLP.

SLP Practice Analysis Scheduled

The CFCC and CAA are conducting a joint practice analysis study of speech-language pathology in 2016. Results are projected to be available in early 2017. Subject matter experts will participate in a face-to-face meeting at the ASHA National Office at the end of April. It is anticipated that the practice analysis survey will be open in September—please watch for information about a survey in which you will be able to help steer the future of the SLP profession. This new information may lead to further changes in the SLP standards!

International Initiative

by Nancy Alarcon

Two CFCC committees—the File Review Committee and the International Committee—have merged to increase work efficiency on the Council. This new committee, known as the File Review and International Committee, comprises audiology and SLP colleagues and focuses on (a) clarifying and streamlining the application process, (b) enhancing information resources for international applicants, and (c) reviewing applications that require more thorough examination to determine compliance with certification standards. International applicants represent those who have been educated outside the United States and then apply for ASHA certification. In addition, there may be applications received from individuals who have graduated from CAA-accredited programs in the United States that require more careful examination. In an upcoming newsletter, we will discuss applications from individuals educated in CAA-accredited programs (these applications may require further review before being granted certification).

This issue highlights the Mutual Recognition Agreement (MRA) and how it relates to specific groups of international applicants from the MRA's signatory associations:

  • Speech-Language and Audiology Canada (SAC)
  • Royal College of Speech Therapists in the United Kingdom (RCSLT)
  • Irish Association of Speech and Language Therapists (IASLT)
  • New Zealand Speech-Language Therapists' Association (NZSTA)
  • Speech Pathology Association of Australia Limited (SPA)

The MRA is not a "reciprocal" agreement, where the associations agree to accept all of the standards of the other signatory associations without additional work or documentation. Rather, the MRA is one of "substantial equivalence," where it may be necessary for certificate holders from a signatory association to complete additional standards before achieving certification by another of the signatory associations.

ASHA entered into its first MRA in 1997, when an agreement was signed between ASHA and the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA), now referred to as Speech-Language and Audiology Canada (SAC). This agreement went into effect on January 1, 1998, and was for recognition in both speech-language pathology and audiology. The audiology agreement with CASLPA expired in 2009 due to changes in ASHA's audiology certification standards. The SLP recognition remains in place today.

Applicants applying for ASHA certification through the MRA must submit:

  • a completed certification application form with applicable fees;
  • a letter of good standing from the current signatory association, attesting that the applicant holds current certification or full membership in that association;
  • a signed declaration of disclosure regarding convictions for criminal offenses, any profession misconduct, incompetence or incapacity as related to the profession, and any pending charges from a disciplinary board; and
  • signed statement of consent to allow all disciplinary boards to share information.

For more information regarding the MRA program, including application instructions, frequently asked questions, and MRA history, please visit ASHA's MRA webpage.

Future newsletters will contain information on current objectives regarding course interpretation and examination of English proficiency across related professional organizations. While recognizing the association's respect for cultural diversity across the professions and the broad range of international degree programs, the File Review and International Committee is working with Certification staff to ensure the preservation of audiology and speech-language pathology certification standards throughout the application process. Certification Information for International Applicants on the ASHA website provides additional international application information.

Growing Interest in Specialty Certification

by Linda Mackay

Currently, there are four established Clinical Specialty Certification boards in the areas of fluency and fluency disorders, child language and language disorders, swallowing and swallowing disorders, and intraoperative monitoring. As of December 31, 2015, the numbers of Board Certified Specialists in the various areas are as follows:

  • Fluency and Fluency Disorders: 155
  • Child Language and Language Disorders: 77
  • Swallowing and Swallowing Disorders: 285
  • Intraoperative Monitoring: 25

The CCSC has been working with all four current specialty boards to complete a practice analysis in each area. To date, three of the four boards have completed the analysis, and the intraoperative monitoring practice analysis has been scheduled for 2016.

The CCSC continues to foster and market additional areas of specialty certification. The Stage II application for the autism spectrum disorder petitioning group has been submitted and is in the process of review. Several other specialty areas have come forward to seek information for possible pursuit of Stage I applications. Grant funding was awarded to a petitioning group to aid in completion of their Stage 1 application. Grants still exist to support the groups through every stage of the application process for specialty certification.

Specialty certification will help pave the way in defining the future of our professions and facilitate recognition by others of the many areas of expertise that exist within the professions of audiology and speech-language pathology.

Certification Disclosure Appeals Policy

Policies and procedures related to certification disclosure have been updated and have gone into effect for all applications received by ASHA on or after March 15, 2016.

Previous Issue of Certification Matters

Issue 1, December 2015

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