Knowledge and Skills Needed by Speech-Language Pathologists Serving Persons With Mental Retardation/Developmental Disabilities

I. Definitions, Basic Foundations, and Diagnostic Issues

This domain addresses basic knowledge of MR/DD, how diagnoses are determined, and their implications in the lives of persons with MR/DD.

1. Knowledge of:

   1. definitions of mental retardation, developmental disability, and developmental delay and issues related to identification;

   2. historical foundations of service provision for persons with MR/DD;

   3. causes and theories of developmental and intellectual disabilities and implications for prevention;

   4. medical aspects of developmental and intellectual disabilities and their implications for learning;

   5. medications and associated side-effects that may affect communication, hearing, and feeding and swallowing behaviors;

   6. psychological, psychiatric, social/emotional, and motor characteristics of persons with MR/DD;

   7. issues, assurances, and due process rights related to assessment, eligibility, and placement within a continuum of services;

   8. family systems and the role of families in serving persons with MR/DD;

   9. potential impact of differences in values, languages, and customs that can exist among the home, school, work, and community;

   10. factors that influence overrepresentation of culturally and linguistically diverse individuals as persons with MR/DD; and

   11. impact of multiple disabilities on behavior, development, and learning.

2. Skills in:

   1. demonstrating commitment to developing the highest educational and quality-of-life potential for persons with MR/DD;

   2. demonstrating sensitivity for the culture, language, religion, gender, disability, socioeconomic status, and sexual orientation of persons with MR/DD and their families;

   3. effective communication with families, caregivers, school personnel, and other professionals; and

   4. practicing within one's skill limit and obtaining assistance as needed.

Return to Top

II. Assessment

This domain addresses the goal of assessing the functional communication, social interaction, cognitive, and adaptive strengths, challenges, and opportunities for persons with MR/DD.

1. Knowledge of:

   1. laws and policies regarding referral and placement procedures;

   2. implications of the World Health Organization (WHO) classification framework for assessment of persons with MR/DD (WHO, 2001; see ASHA, 2005-a, 2005-b);

   3. appropriate selection and use of assessment instruments, including recognition of monolingual tests standardized on native speakers versus tests standardized on bilingual speakers;

   4. limitations in using assessment instruments with persons with MR/DD;

   5. the family's role in the assessment of communication, social interaction, cognition, and adaptive function;

   6. the role of the interdisciplinary or transdisciplinary team in the assessment of persons with MR/DD;

   7. bilingual language development and American English dialects;

   8. appropriate tests and measurements for first and second language proficiency;

   9. the language of the community of a person with MR/DD;

   10. environments affecting communication, social interaction, cognitive, and adaptive function opportunities;

   11. strategies for functional communication assessment of challenging behavior;

   12. ecological and dynamic assessment models in different contexts;

   13. AAC techniques to assess full potential; and

   14. strategies for collecting performance data to analyze progress and modify intervention.

2. Skills in:

   1. participating on an interdisciplinary or transdisciplinary assessment team;

   2. selecting, adapting, and using formal and informal assessment tools with persons with MR/DD;

   3. selecting, adapting, and using assessment strategies to accommodate the abilities and needs of persons with MR/DD;

   4. observing and evaluating communication, social interaction, cognition, and adaptive function within a variety of environmental contexts;

   5. interpreting assessment information gathered from both formal and informal measures;

   6. identifying a profile of strengths and challenges for children, youth, and adults with MR/DD;

   7. identifying appropriate tests and measurements for first and second language proficiency;

   8. using interpreters/translators or multicultural liaisons for second language users;

   9. documenting family and community language use and opportunities for experiencing each language or dialect;

   10. documenting language competence in each language or dialect (e.g., the level of fluency in each);

   11. documenting oral language learning opportunities for each language in the community, school, and home as opportunities for incidental language learning;

   12. implementing functional communication assessment for challenging behavior;

   13. selecting, adapting, and implementing techniques involving AAC;

   14. monitoring changes in communication skills;

   15. assessing communication supports at the program level; and

   16. measuring staff, parent, teacher, and community sensitivity and consistency.

Return to Top

III. Collaborative Consultation and Teaming

This domain addresses the goal of working as a member of an interdisciplinary or transdisciplinary team to assess communication, social interaction, cognitive abilities, adaptive function, and environmental needs of persons with MR/DD.

1. Knowledge of:

   1. advantages and disadvantages of various models of teaming in addressing the needs of persons with MR/DD;

   2. strategies for consultation and collaboration;

   3. the role of persons with MR/DD, their families, SLPs, school personnel, and community providers (e.g., occupational therapists, physical therapists, vocational rehabilitation counselors, physicians, personal care attendants) in goal setting and program planning;

   4. the values, beliefs, and concerns of families of persons with MR/DD affecting communication, social interaction, cognition, and adaptive function;

   5. effective speaking and listening strategies that promote communication and collaboration with persons with MR/DD, their families, SLPs, and school and community providers; and

   6. services and supports that can address the communication, social interaction, and learning needs of persons with MR/DD.

2. Skills in:

   1. collaborating with families and other service providers in the assessment, goal setting, and intervention planning;

   2. group problem solving to develop, implement, and evaluate program plans;

   3. maintaining effective team collaboration, demonstrating cultural understanding, mutual respect, and positive regard for the individual with MR/DD, families, school personnel, and community providers;

   4. communicating with families, school personnel, and community providers about the communication and social interaction characteristics and needs of persons with MR/DD;

   5. modeling and coaching families, school personnel, and community providers in the use of instructional strategies and accommodations affecting the communication and social interaction of persons with MR/DD;

   6. planning, participating, and conducting collaborative meetings with persons with MR/DD and their families; and

   7. creating options to optimize communication among family and team members representing diverse ethnocultural groups.

Return to Top

IV. Program Planning

This domain addresses the goal of developing meaningful learning environments and outcomes for communication, social interaction, cognition, and adaptive function for persons with MR/DD.

• B. Knowledge of:

  1. the role of assessment in program planning and evaluation;

  2. evidence-based interventions to support program development for persons with MR/DD;

  3. approaches to creating positive learning environments that facilitate communication, social interaction, cognition, and adaptive function;

  4. social skills needed for home, school, vocational, and community environments to ensure the success of persons with MR/DD;

  5. methods for creating learning environments that demonstrate an appreciation for cultural and individual differences;

  6. the role of augmentative communication strategies for supporting communication;

  7. the role of general educators, paraprofessionals, job coaches, residential support staff, and families in program planning;

  8. planning and selection of related services for persons with MR/DD as part of IFSP/IEP/IPP processes; and

  9. the role of transition in program planning across the life span.

• B. Skills in:

  1. structuring the environment to provide optimal communication and social interaction opportunities;

  2. planning instruction for fostering communication and social interaction in a variety of environments with multiple communication partners;

  3. identifying and prioritizing curricular areas that can be used to support communication, social interaction, cognition, and adaptive function;

  4. integrating communication, social interaction, cognition, and adaptive function goals within the academic curriculum, community living, and work settings;

  5. developing and implementing a comprehensive instructional plan in collaboration with the individual with MR/DD, families, school personnel, and community service providers;

  6. incorporating and implementing augmentative communication into educational and community-based programs;

  7. developing methods for evaluating instruction and monitoring progress;

  8. using performance data and information from the individual with MR/DD, families, school personnel, and community providers to make appropriate adjustments in goal setting;

  9. designing learning environments that encourage initiation of communication and active participation in individual and group educational, vocational, and community activities;

  10. implementing strategies for emergent literacy and reading instruction;

  11. establishing criteria for language or dialect choice(s) when English is not the first language;

  12. establishing classroom intervention opportunities within bilingual or language transition programs; and

  13. developing community opportunities for extended language and dialect use, ensuring community access as part of intervention goal setting.

Return to Top

V. Instructional Strategies and Adapting Learning Environments

This domain addresses the goal of implementing effective instruction and developing meaningful learning environments that produce functional outcomes for communication, social interaction, cognition, and adaptive function for persons with MR/DD.

1. Knowledge of:

   1. instructional strategies responsive to the characteristics, needs, and interests of persons with MR/DD;

   2. instructional strategies that respond to cultural, linguistic, and gender differences;

   3. expectations for communication, social interaction, cognition, and adaptive function in a variety of placements and community settings;

   4. strategies to facilitate maintenance and generalization of skills across learning environments;

   5. strategies used to enhance self-awareness, self-management, self-reliance, and self-esteem;

   6. learning environments, supports, and instructional strategies used to facilitate integration, participation, and independence in various settings;

   7. assistive technologies and AAC systems appropriate for persons with MR/DD; and

   8. independent functional life skills relevant to the community, personal living, sexuality, and employment of persons with MR/DD.

2. Skills in:

   1. selecting, adapting, and using appropriate instructional strategies and materials;

   2. facilitating maintenance and generalization of skills across learning environments;

   3. teaching persons with MR/DD to use self-assessment and problem solving strategies to enhance self-awareness, self-management, self-reliance, and selfesteem;

   4. identifying supports and instructional strategies to facilitate integration and participation within various settings;

   5. teaching communication skills that promote successful transitions;

   6. designing and adapting learning environments to encourage active participation and increased independence in individual and group activities;

   7. using performance data and information from all stakeholders to make or suggest modifications in learning environments;

   8. using the least intrusive behavior management strategy consistent with the needs of the individual with MR/DD;

   9. programming, using, and maintaining assistive technologies, such as AAC, and instructing others on the use of these systems;

   10. designing accommodations to facilitate meaningful participation in the general curriculum;

   11. developing and implementing comprehensive, longitudinal individualized programs in collaboration with team members;

   12. developing and selecting instructional content, resources, and communication strategies that respond to cultural, linguistic, and gender differences;

   13. making responsive adjustments to goal selection and instruction based on continuous observations; and

   14. planning age- and ability-appropriate communication instruction for independent functional life skills relevant to the community, personal living, sexuality, and employment.

Return to Top

VI. Transition and Advocacy

This domain addresses the need to collaborate in the planning and implementation of lifelong programming for persons with MR/DD and to advocate for access to services across settings.

1. Knowledge of:

   1. current laws and policies and affecting services for persons with MR/DD;

   2. the process of developing and adopting new policies, laws, and regulations;

   3. services, networks, and organizations for persons with MR/DD;

   4. transitions critical to independence for persons with MR/DD; and

   5. communication, social interaction, cognition, and adaptive function needs to ensure successful educational, employment, residential, recreation, and leisure opportunities.

2. Skills in:

   1. collaborating with families and community providers to plan transition from school to work to achieve community participation;

   2. advocating for services for persons with MR/DD, including recreation and leisure;

   3. preparing persons with MR/DD for educational, work, and community transitions;

   4. supporting communication, social interaction, cognitive and adaptive function needs in educational, employment, recreational, and residential settings;

   5. selecting, scheduling, coordinating, and evaluating services; and

   6. contributing to the development of policy, legislation, and regulations that will enhance services for persons with MR/DD.

Return to Top

VI. Professional Development and Evidence-Based Practice.

This domain addresses the preparation and continuing development of professionals in service to persons with MR/DD, including the ability to evaluate research, conduct or participate in research, and apply research to practice.

1. Knowledge of:

   1. methods for remaining current in evidence-based practices relevant to persons with MR/DD,

   2. one's own personal and cultural assumptions that affect service provision for persons with MR/DD,

   3. professional organizations and publications (print and electronic) relevant to the field of MR/DD, and

   4. principles and guidelines for evaluating, selecting, and contributing to evidence-based practice methods.

2. Skills in:

   1. integrating new knowledge to adjust teaching practices to achieve the greatest impact for persons with MR/DD,

   2. applying research in MR/DD to practice,

   3. applying the principles of evidence-based practice in intervention, and

   4. developing and evaluating new methods, materials, and other technologies to improve assessment and intervention practices for persons with MR/DD.