CE Intersections

June 2019

Intersections is the quarterly e-newsletter distributed to ASHA Approved Continuing Education Providers to connect and exchange ideas in order to better accomplish their continuing education activities.

In this issue:

Connect

Becoming Other-Wise

In recognition of the 50th anniversary of the ASHA Office of Multicultural Affairs, and to advance ASHA's Strategic Objective to increase members' cultural competence, the next three issues of Intersections will reprise the 2018 CE Provider Workshop presentation by ASHA's Chief Staff Officer for Multicultural Affairs, Vicki Deal-Williams, "Becoming Other-Wise." CE Providers are uniquely positioned to help address the knowledge gap that exists on the part of audiologists and speech-language pathologists (SLPs) related to the influence of culture and language on service delivery. The provision of educational programming that addresses aspects of diversity in clinical service delivery can help ASHA members to intervene in and manage clinical interactions across cultures successfully. Part I of this three-part series introduces the need for members to increase their cultural competence—and the role of CE Provider personnel in facilitating that knowledge and skill by becoming "other-wise."

The Need

One of the primary functions of the Office of Multicultural Affairs (OMA) is to provide technical assistance to ASHA members. OMA staff have typically fielded questions from audiologists and SLPs seeking assistance on how to provide services when they do not speak the same language as their client/patient/student. SLPs are often seeking information on how to use English to treat a child who does not use English very well, if at all, whereas audiologists are often looking for a word list recorded in another language that they can use to determine a client/patient/student's speech reception threshold.

Now, however, we're seeing a new version of technical assistance questions. Parents and caregivers are contacting OMA staff because they're not convinced that a disorder attributed to their preschooler is accurate when it is based on the child's inability to use masculine and feminine pronouns and the child is being raised in a single-gender household with limited external socialization. Clinicians are reaching out to us with concerns because their supervisor is suggesting they use a cell phone translation app to conduct an evaluation of an older adult with limited English proficiency. Other clinicians are contacting us because their school system has mandated the use of standardized test scores, or has eliminated the use of standardized tests altogether for certain populations, and they aren't sure how to complete their assessment.

Clinical competence is defined very differently today; being clinically competent means that audiologists and SLPs have to be culturally competent. They have to be able to account for culture and language routinely and respond appropriately in situations like these—because these situations are now the norm. Clinicians do not have to know everything about every culture or group, or know every language, but they should know to actively inquire about potential implications, seek resources or additional information, and manage the impact that culture and/or language has in the clinical context in which they are operating. They have to know where to find that information and those resources and how to apply them in their clinical decision making. In addition, service providers have to account for legal and regulatory mandates as well as ethical implications—along with misinformed colleagues, supervisors, and/or educators.

The Role of CE Provider Personnel

The training provided in our academic programs to prepare professionals for making these kinds of clinical decisions is evolving slowly, and faculty members may not have some of this information—or, they may not have the breadth of diversity of cases for students to practice and gain applicable experience. The result? A large number of audiologists and SLPs seeking answers to the questions about the cases they're currently encountering in clinical practice. Professionals need a different body of knowledge, but, more important, they need to think differently than they were trained to think. To get clinicians to think differently, CE Providers also have to think differently and build the requirement for thinking differently into their educational offerings. You have to be "Other-Wise"—that is, you need an increased level of knowledge about "Others" and have to build that focus into your planning and programming. You must be allocentric in your approach—that is, your interest and attention must be actively and intentionally centered on your learners and those they serve.

To become Other-Wise, you have to make your attendees/learners the central focus of your planning. Of course, that's what you know you should do and ASHA CE standards require that you do needs assessments to determine what your learners need to know. But, how much do your really know about your learners? In becoming Other-Wise, you may need to rethink your needs assessment process and approach. Think about the kinds of assumptions you may have made about your learners. Ideally, you would devote time to finding out not just what they need to know, but also who they are; how they acquired the information they have (adults don't come to educational programs as empty vessels); how they learn best; and when, where and how they might use what they learn. You also need to consider who might be missing from among your learners (that missing person may be the one who most needs the information you're providing) and what might be contributing to their absence.

In a best-case scenario, you would work on getting information about your Others prior to planning your program, so you can build your offerings to accommodate them. The more you know about them, the more likely you'll be to keep them engaged and effectively enable them to learn and use what you offer—and, in the end, isn't that your mission, after all?

(Part II of this series will appear in the September issue of Intersections and will delve into assessing and expanding CE provider personnel cultural competence.)

School Based Speech-Language Pathologists—One Title, Multiple Roles

Did you know that of the 204,000 ASHA members and affiliates, 175,025 are speech-language pathologists (SLPs) and 51.4% of those SLPs work in schools (ASHA Membership and Affiliation Counts, Year-End 2018 [PDF])? School-based SLPs work across ages and settings—preschool, elementary, and secondary schools, special day/residential schools, or a combination—serving students with a variety of disorders. ASHA's Roles and Responsibilities of Speech-Language Pathologists in Schools Professional Issues Statement notes that SLPs work to ensure educational relevance, provide unique contributions to curriculum, highlight the importance of spoken language and literacy skills, and provide culturally competent services.

Beyond the statistics, school-based SLPs have to deal with many logistics. They must abide by federal, state, and district mandates that drive assessment and intervention services. At the highest level, the Individuals with Disabilities Education Act (IDEA) federal law requires that states identify children with disabilities through Child Find. More than 6.5 million children in our schools receive special education via IDEA, which preserves a free appropriate public education for children with disabilities, including students with communication disorders. In fact, children with communication disorders are the second largest group of students receiving special education services. Children and youth (ages 3–21) receive special education and related services under IDEA Part B, whereas infants and toddlers with disabilities (ages birth–2) receive early intervention services under IDEA Part C. At the district level, they may use specific eligibility and dismissal criteria and data collection methods.

In their clinical practice, SLPs must pursue evidence-based research and practices to serve the communication needs of their students—who have a wide range of abilities. Respondents to the 2018 Schools Survey [PDF] indicated that the top four areas of intervention were as follows:

  1. Language disorders: semantics, morphology, syntax (91%)
  2. Autism spectrum disorder (90%) 
  3. Speech sound disorders (90%)
  4. Language disorders: pragmatics/social communication (85%)

SLPs across the country also noted in the survey that median caseload sizes range from 30 (New York) to 76 (Indiana), with an overall median caseload of 48 students.

School-based SLPs deal with a multitude of factors that contribute to overall workload—such as providing direct and indirect speech-language services (including seeing students individually and in small groups), tracking data from intervention sessions, and completing evaluation reports—in and out of the general education setting. They also must complete necessary paperwork and documentation, attend meetings, consult with staff and colleagues, and complete duties integral to the school community, such as helping with bus logistics and lunch duty. Today, the issue of workload may be ever more relevant as members continue to report caseload sizes that either have remained the same or have increased. New mandates and reporting requirements include the need to attend more student-centered meetings and participate in multi-tiered system of supports (MTSS) and behavioral teams. 

So, what new skills and knowledge might your participants need related to school-based practice? Consider data from the 2018 Schools Survey [PDF] indicating that four of the greatest challenges faced by SLPs are

  • having large amounts of paperwork;
  • having high workload/caseload size;
  • having limited time for collaboration; and
  • incorporating optimal service delivery models.

Check with your participants to learn what their top issues are in schools. Gather information about state and local regulations that may impact SLPs. Are school administrators asking them to serve on MTSS teams, with no background or training? Are participants being asked to treat reading and writing disorders when, in fact, they do not feel adequately trained to do so?

We urge you to explore these issues and others highlighted in the following ASHA resources:

Exchange

Changes to Audiology and Speech-Language Pathology Standards That Could Apply to CE Course Development and ASHA CE Registration

As of 1/1/2020, Clinical supervisors and Clinical Fellowship mentors will have to have a minimum of nine months practice experience post-certification before serving as a supervisor plus two hours of professional development in the area of supervision post-certification. (These 2 hours of training could have occurred in the past as long as that training took place after their certification. If participants want to mentor/supervise after January 1, 2020, then they need to have this training documented. Want to check your record? Go to my account, under account information click on the 2020 Requirements for Clinical Instructions, Supervisors, and Clinical Fellowship Mentors.)

Beginning with the 2020–2022 certification maintenance interval, certificate holders will have to earn one of their 30 required certification maintenance hours (CMHs) in Ethics.

Be sure to register your courses for supervision topics under subject code 7080 and ethics topics under subject code 7070. These codes will help ASHA Certification identify your course as meeting the content requirement for these topics. When a conference contains an ethics or supervision session, consider registering the session separate from the conference. This will ensure that the ethics/supervision hours are indicated on the learner's ASHA CE transcript.

When courses are registered using these subject codes, CE Registry users who successfully complete the course, ask for ASHA continuing education units (CEUs) and use the ASHA CE Registry will automatically be placed in compliance for meeting the corresponding requirements. If courses are not registered using these subject codes, members will need to self-report and may need to provide course documentation for meeting the requirement if they are audited.

IPP/IPE Survey Fielded in February

Many thanks to all of you who responded to the February 2019 Interprofessional Education/Interprofessional Practice (IPE/IPP) Survey. This survey may have seemed familiar to some of you—ASHA first fielded it in 2015. The 2015 survey established a baseline as to the level of understanding of IPE/IPP and the degree to which ASHA Approved CE Providers were developing courses for interprofessional audiences (two or more professions) or courses that address interprofessional collaborative practice.

We are happy to see that the ratings from ASHA Continuing Education Administrators and ASHA Continuing Education Content Consultants of "moderate to major infusion of IPP into CE courses" increased 14%—from 52% in 2015 to 66% in 2019. IPE infusion increased 3%—from 59% in 2015 to 61% in 2019. ASHA CE is reviewing the resources that you requested to help your organizations further infuse IPE/IPP into CE course planning and delivery.

ASHA Continuing Education 2018 Data Report

The 2018 Data Report [PDF] from ASHA Continuing Education (CE) is now available. This high-level report provides information on the total number of courses registered with ASHA CE, the total number of course offerings held, and the total number of participant submissions that were eligible to earn ASHA CEUs in 2018. These numbers are examined further by a variety of other data, providing additional details about subject codes, course types, course levels, and relevant demographic information. The data report reflects information submitted by approximately 530 ASHA CE Providers for the 2018 year, with information included from 2017 and 2016 for comparison purposes.

Accomplish

Help for Attendees With Questions About ASHA CE and ASHA CEUs

Do you get questions from your course attendees about ASHA CEUs, the ASHA CE Registry, or ASHA Approved CE Provider status? If attendees ask these kinds of questions at your CE event, it is best to refer the person to the ASHA Continuing Education Frequently Asked Questions (FAQs) webpage. This resource provides detailed answers and links to resources about ASHA CEUs, ASHA CE Providers, and the ASHA CE Registry.

Short of directing attendees to the FAQs, here are some common questions your attendees may have, along with information to help answer:

What is the ASHA CE Registry? The ASHA CE Registry is the only service that tracks and awards ASHA CEUs. It is an optional service, and only those who pay the ASHA CE Registry fee for a calendar year earn ASHA CEUs in that calendar year.

What are ASHA CEUs? The ASHA Continuing Education Unit (CEU) is a nationally recognized standard unit of measurement for participation in a continuing education course.

What is an ASHA Approved CE Provider? An ASHA Approved CE Provider is an organization that meets rigorous standards before being approved by the ASHA CE Board to offer ASHA CEUs for their CE courses.

Who is eligible to earn ASHA CEUs? Individuals must meet at least one of the following conditions to be eligible to earn ASHA CEUs: 

  • ASHA Member (includes Life Member and International Affiliate)
  • ASHA Certificate of Clinical Competence (CCC) holder
  • Licensed by a state or provincial regulatory agency to practice speech-language pathology (SLP) or audiology
  • Credentialed by a state regulatory agency to practice audiology or speech-language pathology
  • Credentialed by a national regulatory agency to practice audiology or speech-language pathology
  • Engaged in a Clinical Fellowship, which is supervised by someone with the ASHA CCC designation
  • Currently enrolled in a master's or doctoral program in audiology or speech-language pathology

We know that attendees frequently ask providers if graduate students in speech-language pathology or audiology—or those in their Clinical Fellowship Year (CFY)—are eligible to earn ASHA CEUs. The answer is "yes": Both groups are eligible.

What are some of the benefits of earning ASHA CEUs and joining the ASHA CE Registry?

  • National Recognition—All state licensure boards accept ASHA CEUs toward license renewal.
  • Certification Maintenance—Once you accrue 3.0 ASHA CEUs in your interval and have "current" status, the Registry notifies ASHA Certification of your compliance.
  • ASHA CE TranscriptView your transcript online, or order an official ASHA CE Registry transcript. It is a secure, permanent record of courses you completed for ASHA CEUs.
  • Clinical Specialty Certification—Send your ASHA CE Registry transcript as documentation of advanced professional education when applying to become a Board-Certified Specialist (BCS).
  • Convenience—The ASHA CE Registry awards and tracks your ASHA CEUs and keeps CE records organized.
  • Award for Continuing Education (ACE)—Awarded to professionals who earn 7.0 ASHA CEUs (70 contact hours) within a 36-month period. ACE awardees can be eligible for a 10% discount on liability insurance!

For general information on the ASHA CE Registry and a comprehensive list of the many benefits of subscribing annually, please direct participants to the ASHA CE Registry homepage.

If you find that attendees are asking questions about something not addressed in the FAQs, or the other resources linked in this article, please let your Provider Manager or Accounts Manager know. They can help you with any other questions you may have!

Initial Cooperative Offering Fee Increase in 2021

ASHA Continuing Education (CE) will be increasing the fee for the first cooperative offering of a course from $325.00 to $400.00 starting on January 1, 2021. The fee for each subsequent cooperative offering of the same course will remain at $50.00. Therefore, if you were registering a course in February of 2021 with four cooperative offerings, the total fee for the combined cooperative offerings of that course would be $550.00 ($400.00 for the first offering, and $50.00 each for three subsequent offerings, equaling $150.00). The ASHA Continuing Education Fees listing has been updated with the 2021 fees column. Please contact your Provider Manager if you have any questions or need any additional information.

How to Improve your Provider Compliance and Productivity (PCAP) Report Rating

Top Ten Provider Compliance Issues in 2018

  1. ASHA CEU sentence
  2. Instructional personnel disclosure
  3. ASHA CEU calculation
  4. Inaccurate reporting
  5. Missed offering registration deadline
  6. Missed offering reporting deadline
  7. Course description
  8. Reporting end date does not match end date given in registration
  9. Promotional materials
  10. Course agenda/structure

Here are some resources to help you with the most common compliance issues:

1 & 3. ASHA CEU sentence and calculation: The ASHA CEU sentence and ASHA CEU calculation continue to be top compliance issues. There is no reason for this to be the case. ASHA CE provides a tool that you can use to figure out the correct ASHA CEU amount for your course, and you can submit that Excel spreadsheet [XLS] with your course registration form as your agenda. CEAs who use this form have seen a significant improvement in the number of compliance issues from 2017 to 2018.

2. Instructional personnel disclosure: Speakers must disclose both financial and nonfinancial relationships in the primary course promotion material prior to the event. Examples of disclosure statements are available on the website.

4. Inaccurate reporting: The Provider cannot use the process of correcting the roster to submit ASHA CEU Participant Forms in any of the following situations:

  • The Provider forgot to send in the form with the initial batch that accompanied the Course Offering Report Form.
  • A participant decided after the course offering that they wanted ASHA CEUs; ASHA CEUs cannot be awarded retroactively.
  • The 45-day post-course offering deadline has passed. 
  • The provider sent the incorrect ASHA CEU amount for an individual in the initial reporting.

5 & 6. Missing Deadlines: Here is a deadline chart [PDF] that will help you determine when registration and reporting forms are due. Remember: You do not count the start date of the course when counting the 15- or 30-day due date for course registration. Also, the 45-day due date for the reporting is the day it should physically arrive at the ASHA National Office.

9. Promotional materials: Your primary promotion piece must include the following: your customized ASHA CE Brand Block, an ASHA CEU sentence that correctly states the number of ASHA CEUs offered, course level and course content area, and speaker disclosures or a link to speaker disclosures that address both financial and nonfinancial relationships to the content of their presentations. Providers who have developed a template or format for their promotion pieces that adheres to these requirements are the most successful in compliance in this area. Once you have a template that works, don't change it.


Intersections is published by:
ASHA Continuing Education staff with the assistance of a volunteer advisory panel of ASHA Approved CE Providers: Lisa Milliken (Select Rehab), Wayne Secord (Red Rock Publications), Donna Spillman Kennedy (Selective Mutism Anxiety Research & Treatment Center), Cory Tompkins (Career Improvement & Advancement Opportunities), Melinda Wade (Cincinnati Children's Hospital) and Mark Witkind (Witkind Associates)

Managing Editors: Joan Oberlin, Jo Ann Linseisen

Continuing Education Board Members:
Valeria Matlock (chair), Sheila Bernstein, Kyle Epps, Shatonda Jones, Nan Liening, Tedd Masiongale, Miguel Montiel, Joanne Slater, Julie Verhoff, Arlene Carney (Board of Directors liaison), Barbara Jacobson (Board of Directors liaison), and Jo Ann Linseisen (ex officio)

ASHA Corporate Partners