2007 Student Ethics Essay Award - 2nd Place 

Principle of Ethics II

"Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence." This principle is one part of ASHA's code of ethics. In order for clinicians to adhere to this principle, they must account for the clients' individuality during assessments and when designing therapy in order to provide the highest level of care possible. Although a wide variety of cultures exist within the borders of our country, most standardized tests and therapies are based on the mainstream, Anglo-American culture. The highest level of professional competence can only be achieved once a clinician treats each client as a unique individual, and uses assessments and therapeutic techniques accordingly.

When initially assessing a client, clinicians must consider the evaluation procedures being used and the groups that the norms are based on. Although standardized tests can provide valuable information, results may not always be valid or representative. A client who is not part of the normative group that standards were based on cannot be compared to those norms. Culture, socioeconomic status and second language learning are three important aspects to consider when clinicians interpret the results of standardized tests. When tests are not available given the clients' background, the clinician must use a number of resources to conclude what the client needs to work on and how. Learning about the client's culture, community and history are crucial parts of this decision making process. The opinions of other professionals, journal articles, and the client's family and teachers (when applicable) can help create an accurate picture of the client and guide the clinician in formulating goals.

When a client is young, parental expectations are extremely important when developing a therapy program (e.g. traditionally, mothers in the Navajo culture do not believe in speaking to their children until children begin developing speech). When working with older clients, their family's expectations as well as their own should be at the forefront of therapy and goal formulation. Usually, clinicians work with clients for short periods of time every week. If the client (or their family) have doubts about the therapy's goals and effectiveness, therapy will most likely be ineffective. The goal of therapy is to modify or improve aspects of the client's communication or literacy skills. If the client and/or their family believe goals and therapy are not viable or worthwhile, the carryover of skills out of the therapeutic setting will be limited or will not occur. If this is the cause of ineffective therapy, the clinician has not maintained the highest level of professional competence. It is the clinician's responsibility to ensure that the client (and their family) understands and respects the rationale and goals for therapy. To help the client progress, clinicians must work with their clients and their families to determine what appropriate goals and effective therapy are. This will inevitably change for each individual client, and clinicians must work hard to learn about and understand each individual. Within the speech and language profession, this knowledge is required in order to provide the "highest level of their professional competence".

Nobody knows everything. Even if a clinician takes the client's culture, background, community, history, family and expectations into account, therapy may not be entirely effective. It is extremely rare (if not impossible) to find a therapy that is effective for every individual with a certain difficulty or disorder. The clinician must continuously evaluate therapeutic techniques in order to ensure that the client is making adequate progress. Flexibility on the clinician's part will inevitably play a role in attaining the highest level of performance with all clients. To attain and maintain this level in speech and language pathology, continuous evaluation and modifications are required on the part of the clinician. Trust is put into professional clinicians to provide appropriate therapy and work towards appropriate goals. The only way to ensure this is to regularly evaluate sessions and the progression of the client. Although this is a time consuming process, it is a vital part of being a professional in the field of speech and language pathology and maintaining the "highest level of professional competence."

I entered the field of speech and language pathology in order to help individuals with communication disorders. In my current graduate program I am learning about different populations in order to give me the background to effectively treat individuals. Speech and language pathologists have an opportunity to provide therapy for individuals, not generalized populations, and this is an incredible responsibility. Being from a cultural background that differs from the Anglo-American mainstream has always affected my life. I am aware of the many cultures that exist within this country and the importance of understanding those cultures before decisions involving an individual and/or family are made. Many challenges lie ahead. Until standardized tests are developed based on the many different populations we work with, the duty of providing appropriate assessment lies with the clinician. Only this can help develop proper goals and the highest level of therapy for all individuals. Ongoing assessment of therapy is also the responsibility of the clinician. Capturing individual clients and helping them progress to the fullest extent possible requires a consistently high level of professional competence.

In the field of speech and language pathology, working with individuals means continually having new challenges and being in a position where learning more is a necessity. The Principle of Ethics II of ASHA's code of Ethics ensures that speech and language pathologists continue to rise to all of these challenges and provide the best assessment and therapy possible to a wide range of individuals who are struggling with communication. Clients are not the only ones benefiting from these ongoing challenges that speech and language pathologists face. Clinicians themselves develop by expanding their knowledge base and progressing professionally in this ever-changing field. This principle within the code of ethics represents the lifetime of learning, which is an undeniable part of speech and language pathology.