2007 Student Ethics Essay Award - 3rd Place

The Ethic of Competence

By Elissa M. Larkin
Arizona State University
Tempe, Arizona
NSSLHA Chapter Advisor: Catherine Bacon

The field of speech-language pathology revolves around the pursuit of the highest quality evidence. This is what we base our practices on, how we support our decisions. It is the foundation of everything we undertake in the name of meeting the diverse needs of our clients. This larger goal to which our professional community subscribes trickles down to each individual speech-language pathologist (SLP) in three important ways. First, we must acknowledge the personal responsibility embedded in this professional value: our practices should be informed by the most current, well-constructed evidence available. Second, we are part of a field that is in a constant state of evolution. We too, as clinicians and academics, must be willing to change as the parameters of our professional scope continue to be altered and informed by new and improved sources of information. Finally, we must honor the trust placed in us by every individual we encounter in the professional setting. Clients seek our help as compassionate specialists. We must do our best to honor that impression by gathering all pertinent information shared by the client, and incorporating it into treatment approaches based equally upon lessons learned from clinical experiences as well as critical appraisals of current relevant literature.

The nature of the field of speech-language pathology demands that we continually subject our knowledge base to an exacting process of revision. As accredited SLPs, we must keep up. Evidence-based practice has become the gold standard for how we judge the quality of the services we provide. If we have these lofty goals for the ways in which we want the field to change and grow, we must be ready to accept the challenges inherent in that process. We must be motivated to become lifelong learners: SLPs who work to strike the delicate balance between our ever-expanding foundation of experiential knowledge and the implications of high quality evidence produced by our scholarly leaders. SLPs have to make time to consult our professional and medical-based journals. The themes addressed by investigators in our field grow more diverse each year, making our profession both a challenge and a joy. It will never grow stale or routine. On any given day, an SLP may see a wide variety of clients. We see parents who are desperate to know why their child still isn't speaking. We see a stroke survivor whose family knows she understands what's going on and has things to say, but they just can't understand her gestures and speech attempts. We see a neck cancer survivor who is extremely motivated to drink a chocolate milkshake again. Each client presents an SLP with a unique set of needs and at the same time, research continues to offer new avenues by which we may approach communication and swallowing disorders.

Just as our profession changes, so must our practices. Many experienced clinicians warn that it is too easy to grow comfortable in routines that seem to yield generally positive results. It is imperative that SLPs remain vigilant and that they collect accurate, meaningful data on the effects of the treatments they implement. If a particular treatment is not as effective for a certain population, this shortcoming must be acknowledged. Concurrent review of relevant literature could reveal more efficacious methods, and SLPs must guard against the tendency to grow complacent or overly confident in familiar treatment approaches. After all, at the heart of our vocation is a role that calls us to ask each client to change the way they do things. We have not earned the right to pose this question and guide our clients' responses to it unless we too are willing to change to improve our professional performance.

Finally, we are resources. Clients seek our help because we have credentials that certify us as experts in the areas of communication, swallowing and upper aerodigestive behaviors and disorders. These functions are crucial elements of the human experience. As such, if we are considered powerful societal resources to whom people with life-altering circumstances can turn, we must do our best to sharpen our mastery of the many tools available to help these individuals. A person with a life-threatening disease seeks the help of a physician with the assumption that the physician will be prepared to offer the best possible advice. So too must we as SLPs prepare ourselves to be fine-tuned resources for our clients. We must collect our own data with each client we treat, evaluating both the client's progress as well as our own professional growth in treatment provision. Outside the therapy room, we are bound to push ourselves to seek and evaluate relevant evidence and to integrate it into multifaceted, flexible treatment approaches. In addition, we should also remember not only to track our data as clients progress through treatment, but also to share the meaningful patterns we find in practical revelations of treatment efficacy with our colleagues. We are all members of a professional community and we are bound by that membership to contribute to the collective knowledge base, establishing norms on large samples gathered over time and across experiences.

According to the ASHA "Code of Ethics," SLPs are expected to "honor their relationships with colleagues, students, and members of allied professions." Truly, when we are certified as SLPs, we are tied to a communal code of ethics that contains guidelines such as the one in question. We must challenge ourselves to grow in pace with the scope of our chosen field. And we must work together to pursue ever-improving solutions to the diverse obstacles that threaten our clients' quality of life. Through our membership in this professional community, we commit to letting these ethics guide our practices. If we truly embrace the implications of these ethics, however, we will not only implement what we learn; we will come to embody the progress and positive changes held up as the perpetual aims of the American Speech-Language-Hearing Association.