American Speech-Language-Hearing Association

Position Statement

Roles and Responsibilities of Speech-Language Pathologists in Service Delivery for Persons With Mental Retardation/Developmental Disabilities

Ad Hoc Committee to Review/Revise Current Practice and Policy Documents Related to Mental Retardation/Developmental Disabilities


About this Document

This position statement is an official statement of the American Speech-Language-Hearing Association (ASHA). It was developed by ASHA's Ad Hoc Committee to Review/Revise Current Practice and Policy Documents Related to Mental Retardation/Developmental Disabilities. Members of the Committee included Howard Goldstein (chair), Kevin Cole, Philip S. Dale, Jon F. Miller, Patricia A. Prelock, Krista M. Wilkinson, and Diane R. Paul (ex officio). Celia Hooper, ASHA vice president for professional practices in speech-language pathology (2003–2005), served as the monitoring officer. The ASHA Scope of Practice (ASHA, 2001b) states that the practice of speech-language pathology includes providing services for persons with mental retardation/developmental disabilities with communication needs. The ASHA Preferred Practice Patterns (ASHA, 2004) are statements that define universally applicable characteristics of practice. It is required that individuals who practice independently in this area hold the Certificate of Clinical Competence in Speech-Language Pathology and abide by the ASHA Code of Ethics (ASHA, 2003), including Principle of Ethics II, Rule B, which states “Individuals shall engage in only those aspects of the profession that are within their competence, considering their level of education, training, and experience.” This document was approved by the Speech-Language Pathology/Speech-Language Science Assembly of ASHA's Legislative Council (SLP/SLS 1-2005) on April 2, 2005.



Position Statement

It is the position of the American Speech-Language-Hearing Association (ASHA) that speech-language pathologists (SLPs) play a critical role in enhancing the communication development of persons with mental retardation/developmental disabilities (MR/DD) [1] throughout the life span. Like all people, persons with MR/DD have a basic right to influence their life circumstances and opportunities through communication. In general, individuals of all ages with MR/DD are eligible for SLP services when enhancement of communication skills is needed to function effectively in their everyday lives, regardless of age or cognitive level relative to communication abilities. Adequate communication skills enable persons with MR/DD to achieve their social, educational, recreational, and vocational goals.

SLPs work with teams of parents, other caregivers, and professionals to coordinate services that are family-centered, culturally appropriate, comprehensive, and compassionate, and that produce functional outcomes. SLPs ensure that decisions about team members, service delivery models and settings, and how services are delivered are based on the individual needs and preferences of persons with MR/DD and their families. Because of their expertise in facilitating communication development and use, SLPs play an important role in enhancing the life opportunities of people with MR/DD.

SLPs do not withhold services based on predetermined criteria that preclude consideration of individual needs, preferences, and priorities for communication. Unfortunately, there are commonly used “eligibility” criteria that ignore individual needs (National Joint Committee for the Communication of Persons with Severe Disabilities, 2003a, 2003b). SLPs avoid applying a priori criteria, such as (a) discrepancies between cognitive and communication functioning, (b) chronological age, (c) diagnosis, (d) absence of cognitive or other skills purported to be prerequisites, (e) failure to benefit from previous communication services and supports, and (f) restrictive interpretations of educational, vocational, and/or medical necessity. The lack of appropriately trained personnel or a lack of adequate funds or other resources does not justify denial of services.

SLPs provide communication assessment and intervention services and supports that honor and adapt to differences in families, cultures, languages, and resources. Persons with MR/DD and their families, guardians, and caregivers are integral to the assessment process and are pivotal decision makers in determining specific goals and objectives and how clinical services shall be provided. Thus, team members and SLPs adapt their service delivery to changes in the strengths, needs, preferences, and priorities for communication in persons with MR/DD and their changing life circumstances.

SLPs select assessment and intervention goals that have a meaningful impact on social, behavioral, emotional, academic, and vocational functioning within a variety of settings (residential, school, community, and work settings). In doing so, they embrace a broad view of speech and language that encompasses an array of communication modalities (e.g., spoken language, gestures, signs, augmentative and alternative communication [AAC] systems, listening and comprehension, reading, and writing). SLPs and other service providers design environments and provide opportunities to enable and optimize clients' unique receptive and expressive modes of communicating, whether conventional or nonconventional. SLPs are aware of the potential communication function of challenging behavior and of effective strategies for replacing such behavior with more appropriate forms of communication.

The SLP also plays a critical role in identifying sensory challenges, in particular hearing loss. Because they are aware of the high prevalence of hearing impairments in persons with MR/DD and its impact on communication development and use, they are expected to screen auditory function routinely. Likewise, SLPs are called upon to assess and manage feeding and swallowing disorders in individuals with MR/DD (ASHA, 2001a, 2002).

SLPs promote early identification of developmental disabilities and implement services to maximize the potential of young children. They provide counseling and education to help families facilitate communication development. SLPs also collaborate with parents, teachers, caregivers, job coaches, peers, and others to promote communication development and use in individuals with MR/DD. To the greatest extent possible, services are provided within natural environments (e.g., homes, child care, educational, vocational, and community settings that include typical peers).

To maximize the development of persons with MR/DD through the life span and their ability to function successfully when included in natural environments, SLPs address communication skills that promote:

  • literacy and other academic skills;

  • access to regular curricula, extracurricular activities, and experiences with peers of the same age without disabilities;

  • participation in general education assessments and evaluations, with appropriate accommodations and alternative assessments as needed; and

  • successful future transitions to other environments (educational, residential, recreational, vocational).

Communication intervention focuses on the context of interactions with the variety of individuals that persons with MR/DD encounter in their natural environments. Thus, SLPs ensure that intervention environments provide ample interaction opportunities for communication involving (a) multiple functions and content, (b) multiple partners, and (c) multiple communication contexts (e.g., home, educational, recreational, vocational, and community settings). SLPs also help ensure that communication partners recognize and respond to communication attempts and build on the interests, initiations, and requests of persons with MR/DD.

A variety of intervention techniques have been shown to be effective in teaching communication skills. SLPs use evidence-based strategies for promoting communication skills and systematically evaluate the effectiveness of their practices. The key to effective intervention practices is arranging frequent opportunities for persons with MR/DD to transmit and receive information in the multitude of ways in which communication is woven into our lives. Effective intervention is driven largely by the quality of the contexts that set the occasion for communication learning and use, such as the number of opportunities for persons with MR/DD to practice receptive and expressive communication skills. SLPs are proficient in the use of a variety of teaching techniques, such as modeling, prompting/fading, and reinforcement procedures.

SLPs take seriously their role as advocates for persons with MR/DD. SLPs play an important role in promoting communication abilities that further the independence and self-advocacy of persons with MR/DD. SLPs help team members and others appreciate the impact of language for future learning and functioning, as part of involving them in intervention activities that facilitate communication and language skill development.

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References

American Speech-Language-Hearing Association. (2001a). Roles of speech-language pathologists in swallowing and feeding disorders: Technical report. ASHA 2002 Desk Reference, 3, 181–199.

American Speech-Language-Hearing Association. (2001b). Scope of practice in speech-language pathology. Rockville, MD: Author.

American Speech-Language-Hearing Association. (2002, April). Roles of speech-language pathologists in swallowing and feeding disorders: Position statement. ASHA Leader, 7(Suppl. 22), 73.

American Speech-Language-Hearing Association. (2003). Code of ethics. Rockville, MD: Author.

American Speech-Language-Hearing Association. (2004, November). Preferred practice patterns for the profession of speech-language pathology. Rockville, MD: Author.

American Speech-Language-Hearing Association. (2005). Principles for speech-language pathologists serving persons with mental retardation/developmental disabilities: Technical report. Rockville, MD: Author.

National Joint Committee for the Communication Needs of Persons with Severe Disabilities. (2003a). Position statement on access to communication services and supports: Concerns regarding the application of restrictive “eligibility” policies. ASHA Supplement, 23, 19–20.

National Joint Committee for the Communication Needs of Persons with Severe Disabilities. (2003b). Supporting documentation for the position statement on access to communication services and supports: Concerns regarding the application of restrictive.

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Notes

[1] For a discussion of definitions and terminology related to MR/DD, please refer to the accompanying document, Principles for Speech-Language Pathologists Serving Persons With Mental Retardation/Developmental Disabilities: Technical Report (ASHA, 2005).

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Index terms: service delivery models, mental retardation, developmental disorders, intellectual disabilities

Reference this material as: American Speech-Language-Hearing Association. (2005). Roles and responsibilities of speech-language pathologists in service delivery for persons with mental retardation/developmental disabilities [Position Statement]. Available from www.asha.org/policy.

© Copyright 2005 American Speech-Language-Hearing Association. All rights reserved.

Disclaimer: The American Speech-Language-Hearing Association disclaims any liability to any party for the accuracy, completeness, or availability of these documents, or for any damages arising out of the use of the documents and any information they contain.

doi:10.1044/policy.PS2005-00106

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