A Guide to the ASHA Clinical Fellowship Experience

About the Clinical Fellowship (CF) 

The speech-language pathology CF is the transition between being a student enrolled in a communication sciences and disorders (CSD) program and being an independent provider of speech-language pathology clinical services. The CF is a mentored professional experience after the completion of academic course work and clinical practicum.

The purpose of the CF is to integrate and apply the knowledge from academic education and clinical training, evaluate strengths and identify limitations, develop and refine clinical skills consistent with the Scope of Practice in Speech-Language Pathology, and advance the Clinical Fellow from needing constant supervision to being an independent practitioner.

Duration of the CF Experience

The ASHA CF experience is a minimum of 1,260 hours and a minimum of 36 weeks of full-time experience or its part-time equivalent. The majority of applicants will complete this experience in one location with one mentor in a full-time setting. Part-time experiences will require additional weeks to reach the minimum required 1,260 hours. 

The CF experience is divided into three equal segments, and each segment represents one third of the total experience.

Full-time CF experience is considered 35 hours per week for 36 weeks, for a total of 1,260 hours. Working more than 35 hours per week will not shorten the length of the CF experience; however, working fewer than 35 hours per week will extend the number of weeks required to reach 1,260 hours. Part-time experiences must be a minimum of 5 hours per week in order to be counted toward the total 1,260 hours.

Travel, lunch, vacations/holidays, leaves of absence, and other forms of paid or unpaid time off cannot be counted in your number of hours worked per week.

Eighty percent of the Clinical Fellow’s work week must be spent in direct clinical contact related to the management of disorders that fit within the ASHA Scope of Practice in Speech-Language Pathology. Examples of direct clinical contact include the following:

  • Screening, Response to Intervention (RtI), and/or observations of the client/patient
  • Assessment/diagnostic evaluations
  • Treatment
  • Writing of reports, notes; billing
  • Family/client consultation
  • Family/client counseling
  • Individualized Education Program (IEP) meetings, Individualized Family Service Plan (IFSP) meetings, rounds, or other meetings related to the management of a client/patient’s diagnosis and treatment plan

Twenty percent of the work week may be spent doing other activities such as attending in-services or providing trainings and presentations. 

As a Clinical Fellow, you are required to complete your CF experience within 4 years (48 months) or less from the date your CF began.

Clinical Fellow

Qualifications

The ASHA CF experience may be started only after all academic coursework and supervised clinical practicum have been completed, as outlined in the ASHA SLP Certification Standards, including all prerequisite coursework (Standard IV-A), core coursework (Standard IV-C), and supervised clinical practicum (Standard V). Professional experiences prior to the completion of all academic coursework and practicum may not be used or applied toward your CF experience. 

Responsibilities

Before beginning the CF, and periodically throughout the CF experience, it is important that the Clinical Fellow ensures that their CF mentor(s) meet the required qualifications. Mentoring SLPs must hold a current ASHA Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP). It is the Clinical Fellow's responsibility to verify their CF mentor's status to ensure their mentor's certification remains current throughout the duration of the CF experience; periodic verification is a good practice to follow, such as (1) before the CF experience begins, and then (2) mid-April and mid-September.

Beginning January 1, 2020, mentors also must have at least 9 months of full-time experience; and have completed at least 2 hours of professional development in the area of supervision. Your CF mentor’s status can be checked online:

ASHA Certification Online Verification Portal 

As a Clinical Fellow, you must:

  • Contact your state regulatory agency/licensing board for licensure requirements. Some states grant CFs temporary or provisional licensure.
  • Ensure that the setting will provide you with the opportunity to provide the full range of services to evaluate, habilitate, or rehabilitate individuals with speech and language disabilities.
  • Confirm that at least 80% of your time will be spent on activities directly related to the care and management of individuals with speech and language disorders.
  • Verify your role within your company/employer. In some instances, Clinical Fellows are considered interns, and in others they are considered to be full staff members. Check company and state policies and procedures regarding billing practices and how to sign off on documentation.
  • Verify that the setting provides the full range of services and opportunities to have each skill as outlined in the CFSI appropriately supervised. All skills must be rated during each segment (or part-segment) for the segment to count toward your CF.
  • Verify that your CF mentors will each be providing the minimum supervisory activities (a minimum of 6 hours of direct supervision and 6 hours of indirect supervision per segment). You may use this template for tracking supervisory activities [PDF].
  • If alternative methods of supervision/telesupervision are required, you and your CF mentor must submit a written request to the Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC)—and have the request approved—prior to starting the CF experience. (See 2020 Standard VII-B for instructions.)
  • Confirm that each setting will be able to provide you with a minimum of 5 hours per week.
  • If you change settings, supervisors, or the number of hours you work per week (e.g., full-time to part-time, part-time to full-time, multiple part-time positions, etc.), please complete a separate Clinical Fellowship Report and Rating Form [PDF] for each change.

Tips for Selecting a CF Mentor

  • Meet with the individual to determine his or her previous supervisory experience.
  • Discuss what the CF experience means to the mentor and about his or her experiences as a Clinical Fellow.
  • Determine that they have experience working with the populations that most interest you and that you will have an opportunity to work with these clients.
  • Find out how many other Clinical Fellows they may be mentoring and the impact this will have on the time they have available to meet with you.
  • If possible, talk with other professionals who have been mentored by this individual. Ask how their experience was, how accessible the mentoring SLP was, and how quickly the required paperwork was completed.
  • Discuss how the supervisory activities will be completed and, if possible, outline a plan and stick with it. 

CF Mentor

Qualifications

In order to be eligible to mentor a Clinical Fellow, all CF mentors must meet the following requirements:

  • Hold a current CCC-SLP throughout the entire CF experience.
  • The CF mentor and Clinical Fellow cannot be related in any way.
  • For all applicants who apply under the 2020 standards and begin their CF after January 1, 2020, their CF mentors must also
    • have 9 months of full-time experience (or its part-time equivalent) working as a speech-language pathologist after being awarded the CCC-SLP; and 
    • have completed 2 hours of professional development in the area of supervision at least once in your career after being awarded the CCC-SLP.  

Responsibilities

  • The CF mentor helps improve the clinical effectiveness of the Clinical Fellow through meaningful mentoring and feedback, and assists the Clinical Fellow in developing independent clinical skills.  
  • The CF mentor must be ASHA certified during the entire CF experience in order for the Clinical Fellow to use those hours to apply for ASHA certification. 
  • Each CF mentor and Clinical Fellow is strongly encouraged to read ASHA's Issues in Ethics statement, Responsibilities of Individuals Who Mentor Clinical Fellows in Speech-Language Pathology.
  • The CF mentor must complete all records and feedback/ratings within a timely manner.

Observations

Following an extensive CF Revalidation Study, the CFCC confirmed that in order to provide an accurate rating of a Clinical Fellow's independence with each skill on the CFSI, a minimum of 6 hours of direct and 6 hours indirect observation must be completed during each segment (or part-segment) that you serve as their CF mentor.

During each segment of the CF experience, each CF mentor must provide a minimum of 6 hours of direct observation and 6 hours of indirect observation, which typically include reviewing diagnostic reports/treatment records/plans of treatment, monitoring the Clinical Fellow's participation in case conferences or professional meetings, and/or evaluating the Clinical Fellow's work by consulting with colleagues or clients and their families. The CF mentor and the Clinical Fellow must coordinate the observation schedule to ensure that all skills are observed and evaluated during each segment of the CF experience. It is expected that the observations are spread over the duration of the CF experience, with no more than 6 total observation hours completed in 1 day. You may use this template for tracking supervisory activities [PDF].

For the purposes of ASHA certification, Clinical Fellows may work in more than one location and they may have more than one CF mentor. If the Clinical Fellow has more than one CF mentor, the following guidelines must be met. The examples below are the most common scenarios. If your experience does not fit one of the following scenarios, or if you need clarification, please reach out to the ASHA Certification Unit at certification@asha.org for guidance.

One CF Mentor, One Location
The CF mentor must complete a minimum of 6 hours of direct and 6 hours of indirect supervision per segment.

One CF Mentor, Two or More Locations  
(e.g., two skilled nursing facility (SNF) locations within the same company/employer, two schools within the same district, etc.)
The CF mentor must complete a minimum of 6 hours of direct and 6 hours of indirect supervision per segment.

One CF Mentor, Two or More Settings
(e.g., a full-time school position and a part-time/as needed (PRN) position in a SNF)
The CF mentor must complete a minimum of 6 hours of direct and 6 hours of indirect supervision per segment and per setting  A minimum of 6 hours of direct and 6 hours of indirect supervision per setting is required so that the CF mentor can accurately determine the Clinical Fellow's independence in each setting.

Two or More CF Mentors, One Location
One CF mentor will act as the "primary" CF mentor and will collaborate with the second CF mentor; together they will determine ratings. The CF mentors will determine how best to split or schedule observations to ensure that the minimum of 6 hours of direct and 6 hours of indirect supervision are completed during each segment. Only the "primary" mentor will complete the CF Report & Rating forms.

Two or More CF Mentors, Two or More Locations
(e.g., two SNF locations within the same company/employer, two schools within the same district, etc.).
One CF mentor will act as the primary CF mentor and must collaborate with the second CF mentor; together they will determine ratings. The CF mentors will determine how best to split or schedule observations to ensure that the minimum of 6 hours of direct and 6 hours of indirect supervision is completed during each segment. Only the "primary" mentor will complete the CF Report & Rating forms. 

Two or More CF Mentors, Two or More Settings
(e.g., a position in a school and a position in a SNF)
Each CF mentor will complete the minimum of 6 hours of direct and 6 hours of indirect supervision per segment. A minimum of 6 hours of direct and 6 hours of indirect supervision per setting is required so that each of the two CF mentors can accurately determine the Clinical Fellow’s independence at their respective locations. Each mentor will complete separate CF Report & Rating forms.

Clinical Fellow Changes Settings/Employers Between Segments
In order for hours/experiences to be counted, the minimum of 6 hours of direct and 6 hours of indirect supervision per segment must be completed by each CF mentor.

Feedback Sessions

CF Experiences Beginning On or Before December 31, 2019
  • Feedback sessions are an integral part of the CF experience. The CF mentor must provide performance feedback to the Clinical Fellow at least once during each segment of the CF using the SLP Clinical Fellowship Skills Inventory (CFSI) form [PDF]. During feedback sessions, the CF mentor and Clinical Fellow should discuss strengths or weaknesses in the Clinical Fellow's ability to independently practice as a clinician. Through discussion and goal-setting, these sessions should be used to assist the Clinical Fellow in developing the required skills.
  • The Clinical Fellow must receive a score of "3" or better on core skills on the CFSI [PDF] during the final segment of the CF experience. 
  • Complete and submit the Clinical Fellowship Report and Rating Form [PDF] to the ASHA National Office no later than 4 weeks after the CF is completed. 
CF Experiences Beginning on or After January 1, 2020
  • The CF mentor must provide performance feedback to the Clinical Fellow at least once during each segment of the CF using the 2020 Clinical Fellowship Skills Inventory (CFSI) form [PDF]. 
  • The Clinical Fellow must receive a score of "2" or better on all skills on the 2020 CFSI [PDF] during the final segment of the CF experience. 
  • The Clinical Fellow will enter the experience on the online application. Mentors will verify the hours and enter the Clinical Fellow’s scores online. 

Negative Recommendations

If the CF mentor anticipates at any time during the CF that the Clinical Fellow will fail to meet requirements, the mentor must counsel the Clinical Fellow (both verbally and in writing) and maintain written records of all contacts and conferences over the ensuing months. If the CF experience is terminated at any time before completion of the CF, or if the CF mentor does not recommend approval, they must complete the online CF Mentor Verification page and provide justification for the negative recommendation. For applicants using the paper-based Clinical Fellowship Report and Rating Form [PDF], the CF mentor must indicate their negative recommendation in Section 7 and provide justification for the negative recommendation. CF experiences with negative recommendations will not be applied toward the total number of hours/weeks required to complete the CF. 

Within 30 days of making the negative recommendation, the CF mentor must submit to the CFCC: (a) a letter of explanation and supporting documentation, and (b) a signed Clinical Fellowship Report and Rating Form [PDF] completed for the portion of the CF they supervised. This information must be shared with the Clinical Fellow. Following a negative recommendation, the Clinical Fellow may complete an entirely new CF, a portion of the CF, and/or request an appeal by the CFCC.  

The CF mentor must complete the online CF Mentor Verification page when prompted to do so, and add justification for the negative recommendation. Within 30 days of making the negative recommendation, the CF mentor must also submit to the CFCC: (a) a letter of explanation, and (b) supporting documentation. 

Completion of the Clinical Fellowship

A complete CF experience must have

  1. a minimum of 1,260 hours of clinical experience working under the mentorship of a CCC-SLP;
  2. a minimum of 36 weeks (or its part-time equivalent) of clinical experience working under the mentorship of a CCC-SLP;
  3. a minimum of 6 hours of direct supervision and 6 hours of indirect supervision completed during each segment by each mentor;
  4. minimum ratings of 3 under the current CF experience, or ratings of 2 under the 2020 CF experience, in the final segment of the CF; and
  5. all hours/segments recommended by each CF mentor in order to count toward the CF experience.

Applicants who have begun their application for the CCC-SLP using the paper application must also use the paper-based CFSI [PDF] for documentation related to the CF experience. Applicants must also complete and return the Clinical Fellowship Report and Rating Form [PDF] within 90 days of completing the CF experience. All forms must be signed by both the Clinical Fellow and the CF mentor.

If an applicant has started the application process using the ASHA online application, they must login to their ASHA account and enter the CF experience details. Once that has been done, CF mentors will receive an e-mail requesting that they verify and complete the documentation on their CF mentor portals within their ASHA account. Verification must be completed within 90 days of the end of the CF experience. Completing this documentation online replaces the Clinical Fellowship Report and Rating Form [PDF].

In all cases, applicants should follow company and/or state policies and procedures regarding how long to keep this information in your records. 

Apply for ASHA Certification

Applicants do not have to wait until the conclusion of the CF experience to submit their application for certification, along with the Clinical Fellowship Report and Rating Form [PDF].

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