EASTERN MICHIGAN UNIVERSITY
Department of Special Education
Speech and Hearing Clinic
Clinician's Handbook
SPSI 528 and 538
Clinical Practice in Speech-Language
Pathology
Effective May 2015
Table of Contents
SPSI 528 & 538
Clinician’s Handbook
BACKGROUND INFORMATION…………………………………………………….1
POLICIES………………………………………………………………………………..2
Coursework and Grade Requirements…………………………………………….2
Professional Demeanor…………………………………………………………....3
Clinic Schedules and Caseloads…………………………………………………...4
Files………………………………………………………………………………..4
Forms……………………………………………………………………...5
Clinic Office Protocol……………………………………………………………..6
Log Entries………………………………………………………………..6
Signing Out Files………………………………………………………….6
Filing Information…………………………………………………………7
Universal Precautions, Health and Accident……………………………………...8
Work Practice Controls…………………………………………………………....9
Hearing Evaluations……………………………………………………………...10
Agency Liaison…………………………………………………………………..10
Family-Centered Evaluation and Treatment……………………………………..11
Informal Verbal Feedback……………………………………………..11
Family Conferences……………………………………………………...12
Homework……………………………………………………………….12
Observation of Therapy………………………………………………………….13
CLINICAL PERFORMANCE………………………………………………………..14
Clinic I, SPSI 528………………………………………………………………..14
Clinic II, SPSI 538……………………………………………………………….15
General Requirements…………………………………………………………...16
Attendance……………………………………………………………………….16
Communication…………………………………………………………………..17
Documentation…………………………………………………………………...17
At the End of Each Semester…………………………………………………….21
ASHA Logs …………………………………………………………..................22
THERAPY/MATERIALS……………………………………………………………..23
Availability………………………………………………………………………23
Procedures for Use……………………………………………………………….23
Maintenance of Therapy Rooms and Work Areas……………………………….24
Observation Rooms………………………………………………………………25
Bulletin Boards…………………………………………………………………..25
FEES…………………………………………………………………………………….26
APPENDICES
A ASHA Code of Ethics
Confidentiality
Scope of Practice in Speech-Language Pathology
B HIPAA Behavior
Confidentiality Agreement
C ASHA Clock Hours
D Hearing Evaluation and Monitoring for Clinic Clients
E Clinical Policies and Protocols
Referral Policy
Admission Policy
Continuation/Discharge/Follow up Policy
Emergency Plan
Medical Emergency
Supervision Plan
Confidentiality
Clinical Readiness Test
Remediation Plan and Form
Notification of Failure at Midterm and Form
Withdrawal Policy
Materials Room Policy
FORMS
F Client Status Review and Plan of Assessment
G SOAP Note Checklist
Reporting Guidelines
Diagnostic SOAP sample
Treatment SOAP sample
H Lesson Plan
Group Lesson Plan
I
Self-Evaluation Guidelines
Self-Evaluation Checklist
I
Clinician Self-Reflection
J
Calipso Clinical Performance Scale Review
K Self-Evaluation of Videotaped Session
L Observation of Clinical Session
M Group Observation Form
N Treatment Plan-Narrative
O Summary of Goals
P Calipso Clinical Performance Scale
Grading Scale
Q Treatment Outcome
R Outline for Clinician/Client/Family Conferences
Scoring Rubric for Clinician/Client/Family Conferences
SPSI 528 and 538, Clinician’s Handbook-May 2015
EASTERN MICHIGAN UNIVERSITY
DEPARTMENT OF SPECIAL EDUCATION
SPEECH AND HEARING CLINIC
BACKGROUND INFORMATION
The Speech and Hearing Clinic at Eastern Michigan University is an integral part of the
training program for students majoring in the area of Speech - Language Pathology.
The graduate program is accredited by the Council on Academic Accreditation (CAA)
of the American Speech-Language-Hearing Association (ASHA). The professional
services offered by the Clinic are accredited by the Council for Professional Services
Accreditation (CPSA) of the American Speech-Language-Hearing Association (ASHA).
The clinicians supplying diagnostic and therapy services are all students who are
successfully completing courses in the evaluation and remediation of speech and
language disorders. The goals of the program are two-fold:
1) to provide supervised practical experience for students-in-training, and
2) To provide expert speech, language and hearing diagnostic and therapeutic
services to the community.
The mission of the Speech and Hearing Clinic is to create an exemplary educational
environment to facilitate the acquisition of knowledge and skills and to encourage the
intellectual curiosity and creativity of its students. Students will be prepared as
professionals who deliver habilitative/rehabilitative services to persons with
communicative impairments.
The Speech and Hearing Clinic strives to provide quality services to clients from the
University and community with:
 A caring and considerate attitude to foster a sense of worth in clients and
families
 Ethical and open communication with clients, families, the community and
each other
 Respect for the dignity of the individual.
University faculty and staff participate in all evaluations as part of a student-faculty
team. University staff also supervises all therapy, both by approving therapy plans prior
to use and by observing students implementing the approved plans. Any question
regarding either an evaluation or therapy technique should be directed to the Clinical
Educator. All audiological services are provided by a certified audiologist. The Clinic
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offers a full range of diagnostic and therapeutic services as required for students-intraining.
POLICIES
Coursework and Grade Requirements
All graduate SLI majors are required to complete a minimum of two full semesters in
clinical practice by enrolling in SPSI 528 and 538. Students will submit evidence that
they have completed the 25 clock hours of supervised observation of individuals with
communication disorders prior to beginning their clinical practicum. Students must also
meet the following continuation criteria of the SLI program.
A. Maintenance of a cumulative major GPA of 3.0 or better (SPSI and SPHI courses).
B. Receive a grade of B- or better in any major academic graduate course and a B or
better in a clinical practicum course (i.e., SPSI 528 and 538). Courses in which a lower
grade is achieved (i.e., less than a B- in an academic course or less than a B in SPSI 528
or 538) must be repeated. ONLY ONE FAILED COURSE MAY BE REPEATED
including undergraduate deficiency courses, graduate academic courses or graduate
practica. [This means that a student may receive below a B- in an academic course and
retake it OR receive below a B in a clinic course and retake it.] Once a student has failed
a second course (or for the second time as in a retake), he or she may not continue in the
program. Failure in any course will prevent a student from enrolling in clinical
practicum courses: SPSI 528, 538, 687, 688, or 698. The failed course must be repeated
at the next opportunity.
During the semester in which a course is repeated a student may enroll in only two
additional courses within the program in consultation with the academic advisor.
Students may not exceed specified number of hours before passing clinic. For purposes
of financial aid, the student is responsible for choosing electives outside of the program
to complete the required academic load required by financial aid. Note that 8 credit
hours (for fall and/or winter) are considered full time for graduate students; however,
students should check their financial aid package as the requirements may vary
depending upon the source.
C. Complete any Incompletes (I) within one year of issuance of the I. Note that a grade
of Incomplete is given in a course when a student has completed at least fifty percent of
the course requirements with a grade of B or better.
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D. Demonstration of behaviors that indicate reasonable aptitude, maturity, stability,
skill and understanding as judged necessary for predicted success as a SpeechLanguage Pathologist. Such qualitative judgments will be made by the SLI Faculty and
staff.
E. Students on academic probation WILL NOT be allowed to enroll in major courses
until the probation is lifted and their overall GPA is 3.00.
Professional Demeanor
Students are expected to conduct themselves in a professional manner in accordance
with the ASHA Code of Ethics, the Confidentiality statement and Scope of Practice
(See Appendix A) at all times in the clinic. Demonstration of unprofessional conduct
will result in a meeting with you, the Clinical Educators, and your advisor to discuss
your behavior and develop a remediation plan. Failure to improve your behavior will
result in dismissal from clinic and/or the SLI program. The following guidelines are
suggested:
1. The language used in the clinic should not include inappropriate slang, profanity or
inappropriate topics of conversation. The clinic is a professional place of business.
Loud boisterous behavior is not acceptable.
2. Discussion of clients should occur in the Case Analysis Room or Clinical Educator or
faculty offices ONLY. Avoid discussion of clients in the waiting areas, the front office,
therapy rooms, observation rooms and hallways. Clients should not be discussed outside
of the clinic in any public places. Remember that all therapy rooms have remote
observation, so your behavior and conversation can be monitored at any time.
3. You will be expected to dress in a manner appropriate for a professional clinic,
“business casual”. While a range of styles is acceptable, dress that is appropriate for
class and campus may not be appropriate for the clinic. Remember that your dress
provides the first impression your clients, families and other professionals have of you.
Clinical Educators reserve the right to determine appropriate clinical dress. Coats or
boots are not to be worn or carried into the therapy room. Please hang your coats in
rooms 135C-15 or 135C-19. Since many people have allergies, perfume or aftershave
should be lightly applied or avoided.
4. Clinical Educators will be addressed in the clinic by Ms., Mr. or Dr. and their last
name. You may decide what form of address you would prefer to be called by your
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clients and families. Assume that adult clients and adult family members of clients are
addressed as Mr. or Ms. unless they inform you otherwise.
5. At NO time should a clinician eat, drink, or chew gum in the observation rooms,
waiting room or therapy rooms. The Porter Building has been designated a "smoke-free
environment" by the University.
6. Students should not accept gifts or other forms of remuneration or compensation from
clients or their families.
7. All Clinicians are expected to wear nametags identifying them as student clinicians
while in the clinic. Your nametag should be worn on your shirt collar or pocket so that
it is near your face, NOT on your pants or skirt. Nametags will be issued free of charge
at the beginning of each semester. Replacement tags will cost $1.00.
Clinic Schedules and Caseloads
Clinicians should expect to be assigned to two to four hours per week of actual contact
therapy. In order to schedule based on students’ needs and clients’ preferences,
clinicians are expected to clear time in one of the options listed below:
1. Mondays and Wednesdays from 8:30 to 5:00
2. Tuesdays and Thursdays from 8:30 to 5:00
3. Mondays through Thursdays 8:30 to 11:30
4. Mondays through Thursdays 1:00 to 5:00
Clinicians should also schedule every Wednesday from 5:30-6:35 p.m. for the Clinic
meeting. If you are not free for this meeting you will be reassigned to clinic in a
subsequent semester. When additional meetings are requested by individual Clinical
Educators students are expected to respond promptly to the request. Clinicians are also
encouraged to initiate conferences with their Clinical Educators.
Files
Files are maintained for each client. All reports and client files are confidential. See
Appendix A and B for ASHA’s Code of Ethics, their Confidentiality policy and HIPAA
Behavior. Only students officially assigned to a clinic client may check out files from
the Clinic office. All files are to be read in the student room and returned to the Clinic
office by 4:30 p.m. Monday through Thursday or 4 p.m. on Fridays.
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NO FILE OR PORTION THEREOF MAY BE REMOVED FROM THE CLINIC
EXCEPT TO DISCUSS THE CLIENT WITH A CLINICAL EDUCATOR OR
FACULTY MEMBER IN HER/HIS OFFICE.
YOU MAY NEVER, UNDER ANY CIRCUMSTANCES, XEROX ANYTHING IN
YOUR CLIENT'S FILE.
One copy of the Treatment Plan and Treatment Outcome will be provided at the end of
the semester. SOAP notes will not be provided. Immediate family members (guardians,
spouses, and parents) must FILL IN AND SIGN A RELEASE FORM to receive
records. It is the responsibility of the clinician to check the file at the beginning of the
semester to make sure that all forms are accurate, complete and have not expired.
Forms (The first three must be signed before services are provided)
Because the majority of services are provided by students who will be observed by
program staff and other students, the client or the person legally responsible for a client
MUST read and sign an Authorization Form (green) acknowledging acceptance of
student-provided services and audio and video observation of all services.
The Consent for Release of Confidential Information form (blue) must also be
completed (by the student clinician, if necessary) and signed by the client or the person
legally responsible for the client.
If a client has Medicare, the Advanced Beneficiary Notice of Noncoverage (ABN) form
must be signed and dated by the client or the person legally responsible for the client,
acknowledging that the fee for services will not be billed to Medicare and accepting
responsibility for the fee for services provided at the clinic.
A general Client Consent to Release Confidential/Protected Health Information (white)
form may be completed and signed by the client or the person legally responsible for the
client, to allow communication between the clinician and family members or other
professionals involved with the client.
A red Emergency Information form is completed in consultation with the client or
family members and contains emergency contact information, allergies to food,
medicine, etc., medications (time and dosage), medical history and specific protocols, as
needed, for seizure disorders, fall risks, dysphagia risks, etc. (See Appendix EMedical Emergency Policy). This form must be reviewed, updated as needed and
initialed/dated by the client or family member each semester.
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A Continuation and Discharge Criteria form (hot pink) must be completed when a
client has been on the caseload for two years (6 semesters) or when a client is
discharged.
Clinic Office Protocol
The Clinic office is a place of business. When entering the office, please check out your
client file and chart in it elsewhere; i.e.: student workroom. Do not have conversations
in the main office with your colleagues, the Clinic Secretary, or the office assistants.
CABINET NUMBERS 12 AND 13 ARE THE ONLY CABINETS IN THE MAIN
CLINIC OFFICE THAT MAY BE USED BY CLINICIANS.
Log Entries
Log entries must be made in INK each and every time phone or email contact is made
with your client, when items are added or removed from the file, and if any action is
taken in conjunction with your client. Never use liquid paper or correction tape to
correct errors. Draw a line through errors and write the correct information.
New Log Sheets: When the log is full, put the file in the secretary’s work box. Remove
your outguide and place an OFFICE OUTGUIDE (located on the side of file cabinet at
office door) in the pendaflex.
Signing Out Files
AN ‘OUT’ CARD MUST BE USED EVERY TIME A CLIENT FILE IS REMOVED
FROM ITS PENDAFLEX FOLDER. (“OUT” cards are stored in the student work
room area.) To sign out a file, write your name, the client’s initials, and the date and
place the card in the pendaflex folder. Never remove the pendaflex folder from the file
drawer. Be sure to work with your files in the student work room, not in the Clinic
office. To return the file, place the file back in the pendaflex folder with the most
current file in front, remove the “OUT” card and return the “OUT” card to the student
work room. FILES MUST BE RETURNED BY 4:30 PM, MONDAY THROUGH
THURSDAYS AND BY 4:00 PM ON FRIDAYS.
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Filing Information
ALL FORMS LOCATED ON THE LEFT SIDE OF THE CLIENT FILE ARE TO
BE FILED THERE BY THE CLINICAL EDUCATOR OR THE CLINIC
SECRETARY ONLY. These include the contact logs (yellow), the Consent for
Release form (blue), the Client Consent to Release Confidential/Protected Health
Information (white), the Authorization Form (green) and the white Advanced
Beneficiary Notice of Noncoverage (ABN). Emergency Information forms (red) are
always filed on TOP of the contact log on the left side of the client file.
SOAP notes, test protocols, Treatment Plans, Treatment Outcomes, etc. are filed on the
right side of the client file by the student clinician. All information should show a
natural chronology; i.e.: case history on the bottom, medical reports next, etc. Please be
sure that materials on the right side do not cover the file tab or the folder crease (to
protect them from damage when the file is closed). REMOVE ALL STAPLES AND
PAPER CLIPS BEFORE FILING MATERIALS.
Place any papers to be shredded in the “Please Shred” box on top of cabinet #12.
DO NOT USE THE PAPER SHREDDER. Room 135D-4 is to be used by the Clinic
Office staff only with the exception of the water cooler. The photocopier in the student
workroom is the only photocopier that may be used by the clinicians.
Universal Precautions, Health and Accident
The following procedures or conditions occur in the Clinic and may involve exposure
to pathogens contained in body fluids or blood. Personal Protective Equipment (PPE)
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procedures are to be used to avoid exposure to these pathogens.
Procedure/
Condition
Oral Mech. Exam 3
Personal Protective Equipment Needed
NSG*
X
Oral-motor exercises3
X
Otoscopy with drainage
X
Earmold modification
X
Ear impressions
X
Vomiting 2
X
Toileting 2
X
SG*
UG*
FS*
PC*
OTHER
**
**
Equipment Cleaning
X
Spill Cleanup
X
X
Saliva Management
X
Feeding evaluation1
X
X
Videofluoroscopy1
X
X
Dysphagia Evaluation1
X
X
Cleaning Treatment Rooms
X
X
**
# Procedures vary depending on the setting and population served. Health care settings with clients/patients
diagnosed with TB, Hepatitis, HIV, Meningitis, etc. will have specific procedures utilized by all staff.
* Code to abbreviations *:
NSG: Nonsterile Gloves
SG: Sterile Gloves
UG: Utility Gloves
FS: Face Shield
PC: Protective Clothing
** Optional
1- Procedure not performed in the EMU Clinic.
2- Housekeeping is to be notified IMMEDIATELY when a clean up is needed, the room shall be closed until
clean up is completed.
3- All oral motor supplies are placed in a paper bag and disposed of in the waste basket in the Clinicians’
Workroom after use.
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SPSI 528 and 538, Clinician’s Handbook-May 2015
Universal precautions are used in the EMU Speech and Hearing Clinic to eliminate
contact with body fluids, secretions and blood. The following fluids are to be treated as
if they are known to contain Hepatitis, Human Immunodeficiency Virus (HIV) or other
pathogens:
 Saliva
 Blood
It is not expected that clinicians will come into contact with other fluids such as semen,
vaginal secretions, cerebrospinal fluid, pericardial fluid, etc. in the Clinic; however, all
fluids are to be treated as if they are infectious.
Work Practice Controls
To minimize exposure to pathogens all Clinic personnel will do the following:
 Wash hands* prior to wearing gloves and as soon as possible after removing gloves.
 Wash hands* prior to each session and after each session.
 Clean all surfaces exposed to fluids with disinfectant spray.
 Equipment and therapy materials that become contaminated shall be cleaned
immediately with disinfectants.
 Clinicians with open lesions or weeping dermatitis on his/her hands will wear gloves
during treatment sessions and when handling all clinical materials. If the lesions
cannot be covered the clinician will not conduct treatment.
 Clinicians with a fever or severe illness will cancel sessions to prevent infection of
clients.
* Hands and wrists shall be thoroughly lathered and scrubbed for at least 15 seconds. Care
must be taken to clean between fingers and under fingernails. Dry hands and wrists
completely with a clean towel.
Every clinician must submit a copy of a negative TB test. All tests are valid for three
years; however, a test may not expire during the middle of the term.
Appropriate clinical procedures must be observed at all times to protect both client and
clinicians. This means that disposable gloves are to be worn during all oral peripheral
examinations, at all times with clients who demonstrate self-destructive behaviors, and
with all clients known to be carrying communicable viruses. When gloves are needed,
the clinician must also take a paper bag into the therapy room and place the used gloves
in the bag. The bag shall be disposed of in the trash bin in the Student Workroom. At
NO TIME shall the bags be placed in the wastebaskets in the therapy rooms. When a
client drools on tables or therapy materials or places materials in the mouth the
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materials should be disinfected with disinfectant spray. Alcohol wipes, disinfectant
spray, tongue blades, paper bags and gloves are located on the sink cabinet outside of
the audiology test booth.
You should make every effort to insure that your client is safe while under your care.
Review your client’s file to determine if there is a red Medical Alert Notice with special
procedures of which you should be aware (see Appendix E-Medical Emergency Plan). If
you have a child who mouths toys, be sure that toys with small pieces are NOT used in
therapy. If you have a child who runs and jumps, be careful to prevent falls and bruises.
Geriatric clients may need your assistance as they open clinic doors or navigate clinic
hallways. All accidents or injuries to either clients or clinicians must be reported to
your Clinical Educator immediately and logged in the client file.
Hearing Evaluations (see Appendix D)
Hearing evaluations will be scheduled during normal therapy hours so clinicians can
accompany their clients to the evaluation. At the beginning of each semester clinicians
are expected to review recommendations and then consult with the audiologist, as
appropriate, to schedule hearing evaluations for their clients and to write audiological
reports.
Agency Liaison
Most of the children enrolled in the Clinic are involved in some type of school program.
Therefore, IEPC meetings are usually scheduled once each year by the school district.
If a Clinical Educator has been invited to attend the IEPC, the assigned clinician is
encouraged to accompany the Clinical Educator. If the child is receiving speech and
language services in a school program, the student clinician should contact the school
speech-language pathologist to coordinate therapy goals and procedures.
Adult clients may be involved in educational and/or rehabilitation programs in addition
to the services received in the Clinic. The clinician should initiate and maintain
communication with other professionals involved with the client.
When it is necessary to contact another agency, either in person or by phone, the
Clinical Educator must be consulted prior to the contact. All agency contacts must be
logged in the client's file.
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SPSI 528 and 538, Clinician’s Handbook-May 2015
Family-Centered Evaluation and Treatment
While the primary goal of the Speech and Hearing Clinic is to provide high quality
clinical practicum experiences for students in the SLI program, the Clinic also seeks to
provide treatment that is family-centered. All services will be provided with the
following values:
1. The client is embedded in a family system that is a constant more powerful
than the episodic contact maintained by the Clinic staff.
2. The family provides the context for further growth and development of
communication.
3. Each family is different and has a right to determine their individualized
priorities and goals.
4. Services will be provided to foster a family's independence, competence and
worth.
5. Goals will be developed in collaboration with families based on their perceived
needs and priorities.
6. A family's right to define their membership and relations will be respected by
clinic staff. Thus the family will determine who will represent them in the treatment of a
family member.
7. The University affirms the participatory rights of all individuals, regardless of
gender, race, color, religion, and creed, national or ethnic origin. The University also
complies with the Americans with Disabilities Act.
Informal Verbal Feedback
It is suggested that a clinician leave the therapy room five minutes before the session is
over so there is time to give some general statement of the client's progress to the
appropriate family member or guardian. Complaints concerning the client's general
behavior should never be made, nor should it be suggested that disciplinary action be
taken outside of the Clinic for misbehavior during therapy. A serious problem should
immediately be reported to your Clinical Educator who will recommend appropriate
steps. Any discussion with a family member that includes more than a general
statement of client progress or homework assignment should NOT take place in the
waiting room. Such discussions should be planned in advance and conducted in an
office or empty therapy room.
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Informal, positive, contacts can often be the single most helpful strategy because:
A parent who cannot read can benefit from brief informal contacts.
Informal verbal feedback can often allow a shy or confused or angry parent to
become receptive to professional advice and feel free to ask questions in "lay" terms.
A reminder of what the child can do may provide clues to more realistic expectations
for the over-protective or rejecting parent.
Guidelines for approaching parents:
Be brief--one or two positive examples are enough. Never complain about the child's
behavior--management is YOUR problem.
Be specific--don't say "John did well today," say "John said his whole name today."
Be genuine in your enthusiasm but don't make predictions or overwhelm the parent.
Explain why each achievement is important.
If the child is present, don't compete with him/her for the parent's attention or ask
him/her to "perform" to prove your success. If homework is to be assigned, allocate
time during a treatment session to explain to the family member or parent how it is to be
carried out. See below for further details.
Be willing to listen--the parent knows the child best and may begin the
communication you need for success.
Family Conferences
All conferences with family members must be approved by your Clinical Educator prior
to the contact. Formal conferences or meetings to discuss progress, diagnosis,
educational or treatment plans or prognosis should be scheduled with your Clinical
Educator. Use your own discretion when answering a family's or client's questions.
Answer the question if you think you have the knowledge and expertise to answer it
appropriately and accurately. If you have any doubts, tell the family you'd like to speak
to your Clinical Educator before you answer. The last week of therapy each semester
will be used to conduct family conferences with family members and appropriate clients
(see Appendix R). Consult your Clinical Educator regarding scheduling one of your
sessions during the last week with you, your Clinical Educator and the appropriate
members of the family.
Homework
You should assign homework to address each semester goal. Refer to the Clinician
Directed Hierarchy Chart given in class. This is to be done only with your Clinical
Educator's approval.
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If homework is assigned make sure you discuss the following with
the client and/or family:
1. the exact procedures to be employed by them, the responses they will accept
and the type of reinforcement to be used.
2. the suggested maximum length of the activity which should be well within the
ability of the client.
3. the number of times per week the client is expected to practice.
4. when correction should and should not take place.
Observation of Therapy
Adult family members may observe therapy sessions as often as they wish to facilitate
an understanding of the procedures being used. Such observation will also help in
understanding the purpose of homework assignments. CHILDREN ARE NOT
ALLOWED IN OBSERVATION ROOMS.
Students will be observed regularly by their Clinical Educator through one-way mirrors
in the observation areas or through video observation. ASHA requires that at least 25%
of all client contact be directly observed by your Clinical Educator. After each
observation, a written summary with suggestions, questions or feedback may be placed
in the student's mailbox. After reading the summary a student who has questions should
immediately seek an appointment with the Clinical Educator. If your Clinical Educator
has asked you a question, you are expected to respond on the reverse side of the sheet or
in person. The written summary should be returned to your Clinical Educator after your
review.
Absences: As student clinicians are required to complete a specific number of clinical
hours, it is essential that absences be kept to a minimum. Should a client not be able to
attend a session, the Clinic should be contacted (487-4410). Excessive absences for
whatever reason will result in termination of therapy for the remainder of the term. The
clinic maintains a waiting list of clients who need therapy who will be scheduled in that
slot.
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CLINICAL PERFORMANCE
The following section is intended as a guide to understanding the performance levels
expected of clinicians as they move through the practicum experience. Appendix P of
this Handbook contains the Calipso Clinical Performance Scale and the grading scale.
This evaluation procedure will be used at midterm and at the conclusion of each
semester (by both the student clinician and the Clinical Educator) to evaluate student
clinicians' performance, and to determine, in part, the final grade for clinical practicum.
Clinic I, SPSI 528, and Clinic II, SPSI 538, will be evaluated on a scale of 1 to 5 on this
instrument.
Clinicians are also evaluated on the following:
a. compliance with policies and procedures listed in the Handbook
b. CE’s observation of therapy sessions (may be accompanied by a narrative
evaluation/remarks by your CE, see Handbook)
c. paperwork submitted by you for each client
d. interaction with supervisors, peers, and families
e. presentation of your client in clinic meeting
f. participation in clinic meeting;
g. unannounced quizzes over the assigned readings which may be given over the
course of the semester.
Clinic I-SPSI 528
By the end of the semester, clinicians will be expected to:
1. Answer any question concerning developmental norms in the
following areas:
a. cognition
b. language
c. motor
d. socio-emotional.
2. Explain how each client deviates from any or all norms.
3. Establish semester goals appropriate to each client.
4. Demonstrate behavior management techniques appropriate to the
client's age and impairment that will:
a. facilitate the achievement of therapeutic goals
b. develop and maintain positive client attitudes toward the
therapeutic process.
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5. Communicate effectively through:
a. professional writing
1. Treatment Plan preparation
2. Treatment Outcome preparation
3. SOAP notes
4. Letters and other correspondence
5. Logging phone calls, contacts and correspondence in client's
folder.
6. Complete all paperwork and correspondence in a timely manner.
NOTE: If weekly paperwork or paperwork revisions are incomplete,
unacceptable or late more than three times during a semester (with any client), a
failing grade of B- or lower will be assigned by the supervising CE. A meeting will
then be held with the CE, Academic Advisor and student to formulate a
Remediation Plan for Poor Clinical Performance (see Remediation Plan protocol).
7. Communicate concisely and grammatically in all interactions with the client
and family.
8. Professionally present themselves during:
a. personal and telephone communication with
families of clients to explain home assignments
b. personal and telephone communication with involved agencies or other
professionals to coordinate programming
c. communication with families and clients at the final
conference scheduled the last week of clinic.
Clinic II-SPSI 538
By the end of the semester, clinicians will be expected to:
l. Answer any question concerning the possible etiology, prognosis or techniques
appropriate to the disorder exhibited by individual clients.
2. Organize short-term objectives that effectively progress to achieve long term
goals.
3. Organize individual therapeutic sessions that utilize appropriate procedures
and materials and thus ensure adequate therapeutic progress.
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SPSI 528 and 538, Clinician’s Handbook-May 2015
4. Communicate effectively in oral and written communication:
a. Treatment Plan preparation
b. Treatment Outcome preparation
c. SOAP notes
d. Letters and other correspondence
e. Logging phone calls, contacts and correspondence in
the client's folder.
5. Complete all paperwork and correspondence in a timely manner.
NOTE: If weekly paperwork or paperwork revisions are incomplete, unacceptable
or late more than three times during a semester (with any client), a failing grade of
B- or lower will be assigned by the supervising CE. A meeting will then be held
with the CE, Academic Advisor and student to formulate a Remediation Plan for
Poor Clinical Performance (see Remediation Plan protocol).
6. Communicate concisely and grammatically in all interactions with the client
and family.
7. Present information at an IEPC or similar program planning meeting.
General Requirements
All clinicians are responsible for the information transmitted in both lectures and
readings from all classes taken prior to a clinical assignment and from Clinic Meetings.
In addition, Clinical Educators will require outside reading pertinent to individual
clients.
Attendance
Therapy sessions should always begin promptly and continue through the prescribed
time for that client, unless other specific arrangements have been approved by your
Clinical Educator. You are expected to be in the clinic at least 30 minutes prior to your
session. Therapy sessions should be held in the rooms assigned unless permission to
hold sessions elsewhere has been granted. Any clinician who is unable to keep his/her
appointment and/or to attend the Clinic Meeting must call the Clinic at least two
hours prior to his/her scheduled therapy or Clinic Meeting. Failure to do so will
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SPSI 528 and 538, Clinician’s Handbook-May 2015
result in an unexcused absence. Clinician absence should only be due to illness or other
extreme circumstance. Absence due to illness for 2 or more days will require a written
physician's excuse. Late arrival to Clinic Meetings (over 10 minutes) will constitute
being tardy. Three (3) tardies will be counted as one (1) unexcused absence. Three
(3) unexcused absences will lead to client reassignment, your dismissal from
clinical practicum and a failing grade for the semester. If a student accrues over
three excused absences, this will lead to client reassignment and a failing grade.
Individual arrangements between clinicians and families may be made if your client is
scheduled for 8:30. These arrangements MUST be cleared with your Clinical Educator
FIRST. Otherwise, only the Clinic secretary, on the Clinical Educator's advice, may
cancel a client. Any clinician, whose client has canceled or has been canceled by the
Clinical Educator, is still expected to be in the Clinic at his/her appointed hour. The
clinician should observe therapy at these times and submit a written report of the
observation to their Clinical Educator (Appendix L).
Communication
Mailboxes are available in the student work area. Each clinician should look for his/her
name at the beginning of the semester. To facilitate communication with the Clinical
Educator, clinicians are expected to respond promptly to Clinical Educator questions or
requests for a meeting or other information.
Clinicians will not distribute letters or reports regarding their client without the approval
of the Clinical Educator and the signed release by an authorized party. Any
communication which has been approved must be typed on EMU letterhead and a copy
placed in the client file. A clinician's personal telephone number should not be given to
clients or families of clients. Phone calls or communication with clients or families is
not acceptable outside of the clinic unless your Clinical Educator has approved that
communication. ALL communication, written or verbal, with outside agencies and
individuals should be authorized by the client or family FIRST. These communications
should be logged in ink on the log sheet in the client's folder.
Documentation
Appropriate and professional documentation is required by law and many national
accrediting agencies. The following documentation is required in this clinic. There are
to be NO STAPLES in any document that will be filed. USE ONLY CLIENT
INITIALS ON PAPERWORK, TEST PROTOCOLS, ETC. FULL, LEGAL
CLIENT NAMES ARE WRITTEN ONLY ON THE COMPLETED
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SPSI 528 and 538, Clinician’s Handbook-May 2015
TREATMENT PLAN AND TREATMENT OUTCOME WHEN IT IS
PRINTED ON STUDENT REPORT PAPER.
WEEKLY PAPERWORK for Monday/Wednesday clients is due, at the latest by 4:00
p.m. Wednesday. WEEKLY PAPERWORK for Tuesday/Thursday clients is due at
the latest by 4 p.m. Thursday. If you have a 3:00 or 4:00 p.m. client on Wednesday,
paperwork is due Thursday by noon. If you have a 3:00 or 4:00 p.m. client on
Thursday, paperwork is due Friday by noon. If you have extenuating circumstances
which prevent you from meeting these deadlines, see the appropriate Clinical Educator.
1. Client Log Sheet- The client log sheet is a yellow sheet located on the left-hand
side of each folder. Every telephone call, document mailed or received, or clinic
paperwork filed is logged on this sheet. Each time a SOAP note is filed or removed for
typing it is also recorded on the log sheet. Be sure to date and initial each entry on the
sheet. Entries should be made in ink. Errors are to have a line drawn through them with
the corrected information written next to the error.
2. Client Status Review and Plan of Assessment- During the first week, after you
have completed a Chart Review and the Client Information Sheet, you are expected to
meet with your Clinical Educator to discuss your client’s status and plans for
assessment. You will then submit a detailed list of areas and skills that you plan to
assess in the Plan of Assessment column on the Client Status Review form. Include
informal and formal tests/subtests that will be used to evaluate your client. (See
Appendix F).
All evaluation data should be written on the POA in the appropriate section. The POA
can then be used to write the Treatment Plan.
3. SOAP Note- A daily annotation of therapy must be maintained in each client
file in the SOAP note format (See Appendix G). SOAP notes must be submitted to your
Clinical Educator with your weekly lesson plans. These reports may be hand-written
with the client’s initials, clinician and Clinical Educator's names, date of session and the
title SOAP Note at the top of each sheet. Attach data sheets, protocols, prior drafts, etc.
After approval by your Clinical Educator these notes should be filed immediately in
each client’s file-in chronological order. It is the clinician’s responsibility to file all
SOAP notes and to log the filing on the log sheet in the client's folder. All SOAP notes
should be typed and placed in the folder by the midterm conference and by the final
conference of each semester.
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SPSI 528 and 538, Clinician’s Handbook-May 2015
See Appendix G for Guidelines for Describing the Severity of Disorders and the format
to report the ASHA QCL Scale and the ALA.
4. Self-Evaluations- Each clinician is expected to complete the Clinician Self
Evaluation Check Sheet and write a narrative of his/her therapy with each client each
week. This is then submitted with SOAP notes and lesson plans. Self evaluation
reports should deal strictly with the success or failure of a particular lesson, i.e. the
clinician’s performance. They should NOT be descriptive in nature, but instead should
attempt to answer the questions: "why", "when", and "how". It is perhaps most
important to analyze when a particular session was successful or unsuccessful. The
knowledge learned from such analysis should allow additional sessions to be equally
successful (See Appendix I and K). The Clinician Self-Reflection form is only to be
used after midterm.
5. Clinical Performance Scale (CPS) Review- Beginning the 2nd week of clinic,
each clinician is expected to complete this review alternating with the Self Evaluation
check Sheet. The narrative should pertain to the CPS review. Submit with your weekly
paperwork (See Appendix J).
6. Lesson Plans- See Appendix H for format. The format will also be sent to you
electronically. Lesson plans are to be written for each week after assessment is
completed for each client until such time as your Clinical Educator indicates otherwise.
At least 10 minutes before each session the corrected and/or revised copy of your
lesson plan is to be placed in your Clinical Educator’s mailbox, NOT IN A FOLDER.
Your Clinical Educator will use the lesson plan as your therapy session is observed.
7. Graphs and Treatment Hierarchies-When your Treatment Plan is approved,
you will be expected to prepare one graph per goal including baselines (see Appendix
R) and write treatment hierarchies or teaching steps appropriate for each semester goal.
Include possible homework assignments for each level of the hierarchy. These are due
48 hours after your Treatment Plan has been signed by your Clinical Educator.
8. Goal Cards- If the Treatment Hierarchies are approved by your Clinical
Educator and if your therapy sessions are progressing satisfactorily your Clinical
Educator may approve the use of Goal Cards, an abbreviated planning format. All
lesson plans or goal cards for the following week are due following the WEEKLY
PAPERWORK deadlines stated above. Lesson plans will be reviewed/corrected by
your Clinical Educator and returned to you. Check your Clinical Educator’s out-basket
Monday morning for your lesson plan.
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SPSI 528 and 538, Clinician’s Handbook-May 2015
9. Observation Reports- See Appendix L and M for formats of observation
reports. These are to be completed in detail for any required observation and placed in
your Clinical Educator's IN box for checking.
10. Treatment Plans- Treatment Plans for each client must be submitted to the
Clinical Educator 48 hours after four (4) sessions for Clinic I students and 48 hours
after three (3) sessions for Clinic II students (see Clinical Educator for form and ICD10 codes). A template that illustrates how to report the details of evaluation
information for an adult with aphasia is located in the “Forms” pendaflex in the student
work area.
All information reported in the evaluation SOAP Notes and therefore written on the
POA, must be included in this report.
All drafts should be submitted to your Clinical Educator typed double-spaced. Submit
all previous drafts, test protocols and all applicable data sheets with the first draft and all
revisions. If the Treatment Plan has not been approved by Friday of midterm week (see
Syllabus for date), the student will be informed that a failing grade of B- or lower has
been assigned at midterm. A letter will be sent to your advisor and the instructor of
record informing them of your grade, strengths, weaknesses and plan of action (See
Notification of Failure at Midterm Protocol).
When the Clinical Educator approves the T.P., the student clinician inserts all
identifying information including the client’s full legal name and the client’s name or
applicable pronoun throughout the report.
Two final copies of the T.P. will be printed on "Student Report" paper and should be
single-spaced. These are to be signed by the clinician and given to your Clinical
Educator for their signature. After the Clinical Educator signs, one copy is filed in the
client’s file and the other given to the client and family, when the Summary of Goals is
reviewed, for a child client.
11. Results of Evaluation-If you have an adult client, you are expected to submit
an organized, typed list of evaluation results that can be understood by your client. You
will use this to review assessment results within 1 to 2 sessions after your evaluation is
completed.
12. Summary of Goals- After Treatment Plans have been approved, you will
complete 2 copies of the Summary of Goals on plain, white paper. See Appendix O for
the format. This is a one-page summary which states the goals for your client for the
semester.
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SPSI 528 and 538, Clinician’s Handbook-May 2015
Sign both copies, turn in to your Clinical Educator to sign with your completed T.P.,
then review with the client or family and obtain their signature. The review should
include baselines for each goal and a brief description of procedures to be used to
achieve each goal. DO NOT BEGIN TO REVIEW THE SoG WITHOUT YOUR
CLINICAL EDUCATOR. One copy is given to the family; the other copy is filed in the
client's file on top of the T.P.
13. Treatment Outcomes- After Treatment Plans have been approved; clinicians
may begin writing the Treatment Outcome (see Appendix Q), a summary of your
treatment for each client for a given semester. All drafts should be submitted to your
Clinical Educator typed double-spaced. Please submit previous drafts with each
revision. Final copies will be printed on paper labeled "Student Report" and should be
single-spaced. The original and one copy of the typed final report must be submitted,
approved and signed by your Clinical Educator prior to your Final Conference.
14. Clinician/Client Family Conference- see Appendix R for format. Each
semester goal is to be graphed on a single piece of paper, i.e.: 4 goals=4 graphs. They
can be hand-drawn or computer generated. DO NOT BEGIN THE FAMILY
CONFERENCE WITHOUT YOUR CLINICAL EDUCATOR.
When you are requested to revise any of the above documentation, the revision is due in
your Clinical Educator’s mailbox within 48 hours of the time you receive the request
for revision.
Due to confidentiality laws, it is not appropriate for a clinician to maintain a copy
of any client paperwork for personal files. All drafts and copies are to be given to
your Clinical Educator to be shredded. Delete all client documents from work
room computers before you leave each day.
At the End of Each Semester
1. If clients are returning the next semester, have them complete a preference sheet so
we can schedule them in the time slots they prefer. Be certain they give 2 day and 2
time preferences. If they are not returning, complete a preference sheet with
that written on it.
2. If YOU are returning the next semester, we need a schedule telling us when you are
available. Please give us times in ONE of the following options:
 Mondays through Thursdays from 8:30 to 11:30
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SPSI 528 and 538, Clinician’s Handbook-May 2015
 Mondays through Thursdays from 1:00 to 5:00
 Mondays and Wednesdays from 8:30 to 5:00
 Tuesdays and Thursdays from 8:30 to 5:00
3. Reserve time for Clinic meetings on Wednesdays from 5:30 to 6:35 p.m.
Attendance is mandatory.
4. Final conferences with your Clinical Educators will be scheduled the week of final
exams. Please sign up for times outside their doors.
 You must have Treatment Outcomes approved and signed and all SOAPS
typed and filed PRIOR to the conference.
 Bring your clients’ files, two (2) ASHA log sheets and the Generic
Abilities form to the conference.
 Clinical Educators will announce due date for your Clinical Performance
Scale self-evaluation.
5. Clean out your mailbox, materials shelf and locker if you are completing SPSI 538.
6. Remove all items from the refrigerator.
7. Return books and materials borrowed from Clinical Educators.
8. Return all clinic materials by the date posted by Materials Librarian.
9. Delete all client related documents on your computer, memory stick, etc and empty
the Trash Bin on your computer.
ASHA Logs
Two ASHA (semester) logs will be completed at your final evaluation conference with
your clinical educator. She will review your hours and appropriate placement on the
logs.
You will enter the ASHA Log hours on Calipso and send it to the appropriate CE for
approval within one week of the close of the semester. This proof of supervised
practicum will be necessary for ASHA application. Appendix C lists the clinical
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SPSI 528 and 538, Clinician’s Handbook-May 2015
practicum clock hour requirements for ASHA certification. The program will make
every effort to see that you obtain the necessary experiences to meet the clinical
practicum clock hour requirements. It is YOUR responsibility to monitor your
progress, however, and to notify your advisor if you are short of hours in particular
categories.
Calipso Supervisor Evaluation Form
Complete this form within one week after the end of the semester.
THERAPY / MATERIALS
Availability
Each student is encouraged to prepare and use personal materials for therapy. However,
the Clinic maintains a large supply of various types of therapy materials for student use.
These materials have a dual purpose. First, they should be considered by the clinician as
samples of items which may be effective with various types of clients. Second, they
should be evaluated by the clinician for overall effectiveness with an eye toward future
professional purchase on a limited budget. You will be expected to vary the materials
you use weekly. Exceptions to this must be approved by your Clinical Educator.
Procedures for Use
All materials are requested by completing a materials request form. Request forms
should be completed in full and placed in the materials librarian's IN box according to
dates/times posted each semester. The materials librarian will place requested materials
on the shelf labeled with the clinician's name in the materials room. After use, all
materials are to be returned to the shelf. Tests are also to be returned to the clinician’s
shelf in the materials room. The Clinic is not responsible for personal therapy materials
you may store on your shelf. Please place your personal materials in a small container
on your shelf with your name clearly marked on the container. Therapy materials not
belonging to the clinic which are left on the materials room floor or not in clinician's
container for a period of one week will be offered to other clinicians.
Students are never to be in the Speech and Hearing Storage Room without permission or
to take or return any materials to that room. Should a clinician wish to survey the
materials which are available, he/she may make an appointment with his/her Clinical
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SPSI 528 and 538, Clinician’s Handbook-May 2015
Educator. Whenever such items as the Webber Articulation cards are requested, they
must be kept together as a unit. Should a clinician desire to use only a portion of a kit or
card file, for instance, the entire kit or file must be taken into the therapy room and
the entire kit returned to the student room. At no time should any parts of kits be
observed anywhere except in close proximity to their container. No clinician should
ever borrow materials placed in the student room at the request of another clinician.
Materials are ONLY to be used by the clinician requesting them. Clinicians found
violating these rules will receive a check on the material's log. Two checks shall mean
the termination of the privilege of using Clinic materials. Students who have been
denied the use of Clinic materials may petition for reinstatement of the privilege at the
end of one month.
Materials should not be checked out over-night. However, should you need to study a
manual or test prior to using a specific material; it may be checked out by signing the
enclosed card and receiving permission from the appropriate Clinical Educator or
instructor.
At least two weeks each term will be designated "No Materials Week". This means that
the only therapy aids available to the clinician are those already in each room (mirror,
dry-erase board, etc.) and any materials a clinician may choose to purchase or make.
Any clinician who believes that a clinic material is essential to the treatment of his/her
client will be given the opportunity to defend that position by his/her Clinical Educator.
Maintenance of Therapy Rooms and Work Areas
All students are expected to help maintain the therapy rooms. This means that
furniture is expected to be returned to its proper place, dry-erase boards are to be
erased, and all waste paper is to be picked up from the floor. If you complete an activity
or project that litters the floor, you are expected to vacuum after your session. A handheld vacuum is available in the materials room. At no time should a clinician leave
equipment or materials in the therapy room or clinic hallways after a therapy session is
concluded. Clients should be involved in the therapy room cleanup.
Clinicians with 4 p.m. clients are expected to clean the table(s) with antibacterial
spray after their session is completed. Periodically, students may be requested to help
clean rooms, which mean washing boards, tables and mirrors and decorating bulletin
boards. The student work areas are provided for the benefit of all Speech - Language
Impaired majors. They are intended as work and study rooms.
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SPSI 528 and 538, Clinician’s Handbook-May 2015
Meetings and conferences may be held in the Case Analysis Room or other conference
rooms in the Clinical Suite. Students enrolled in SPSI 528, 538 and 568 have priority for
use of the work areas. The Eastern Michigan University Chapter of the National
Student Speech-Language-Hearing Association has purchased a refrigerator for storage
of snacks for clinic clients and oral-motor supplies. Snacks or supplies must be labeled
with client's name and date that they were put in refrigerator.
There are lockers available in the Case Analysis Room. See your Clinical Educator if
you wish to use a locker for the semester.
It is of the utmost importance that the rooms be maintained in a sanitary manner. FOOD
AND DRINK ARE ALLOWED ONLY IN THE CASE ANALYSIS ROOM IN THE
CLINICAL SUITE unless you are providing snacks or using food and drink for
oral motor treatment during therapy. Students are requested to take lunches to the Case
Analysis Room or the Student Lounge on the second floor of the Porter Building.
Observation Rooms
The observation rooms are available to SLI majors from selected classes, families of
clients and student clinicians. Other persons wishing to observe must consult the
appropriate Clinical Educator. Conversation among students is prohibited in the
observation rooms. Please enter and leave the rooms quietly and close the door behind
you. If the door is open clients may see through the observation room and into the
hallway. Everything you hear or see in therapy is CONFIDENTIAL and not to be
discussed outside of the clinic.
Bulletin Boards
The bulletin boards in the hall outside the clinic classroom and in the main hallway
outside of the entrance to the Clinical Suite are the main information centers of the SLI
Area. All schedules, notices, messages, and announcements related to the academic
program are regularly posted on these bulletin boards. Clinic cancellations are posted
on the bulletin board of the Clinic office. Other clinic notices and job openings are
posted on the board in the clinicians' work areas. It is essential that each clinician check
every day for any pertinent announcements.
FEES
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SPSI 528 and 538, Clinician’s Handbook-May 2015
As the Clinic is an integral part of a University training program, only nominal fees are
assessed. All therapy fees are based on treatment for a semester and all diagnostic fees
are based on a total evaluation (speech, language and hearing.) All audiology fees are
based on the specific service rendered. The Speech and Hearing Clinic does not accept
insurance.
The following are current Clinic fees:
Speech and Language
Initial Evaluation
Speech, language or hearing therapy - all types
Two individual sessions a week per semester
One group session a week per semester
Audiology
Basic Hearing Evaluation
Hearing Screening
Tympanometry
Hearing Aid Evaluation/Orientation
Hearing Aid Analysis
Earmold Impression (each ear)
$60.00
125.00
30.00
70.00
20.00
10.00
80.00
30.00
75.00
The following persons are not charged for services: EMU faculty, children of EMU
faculty, EMU staff, the children of EMU staff, EMU students, and the children of EMU
students.
26
Code of Ethics
Reference this material as: American Speech-Language-Hearing Association. (2010). Code of Ethics [Ethics].
Available from www.asha.org/policy.
Index terms: ethics
doi:10.1044/policy.ET2010-00309
© Copyright 2010 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.
Code of Ethics
Preamble
Ethics
The preservation of the highest standards of integrity and ethical principles is vital
to the responsible discharge of obligations by speech-language pathologists,
audiologists, and speech, language, and hearing scientists. This Code of Ethics sets
forth the fundamental principles and rules considered essential to this purpose.
Every individual who is (a) a member of the American Speech-Language-Hearing
Association, whether certified or not, (b) a nonmember holding the Certificate of
Clinical Competence from the Association, (c) an applicant for membership or
certification, or (d) a Clinical Fellow seeking to fulfill standards for certification
shall abide by this Code of Ethics.
Any violation of the spirit and purpose of this Code shall be considered unethical.
Failure to specify any particular responsibility or practice in this Code of Ethics
shall not be construed as denial of the existence of such responsibilities or practices.
The fundamentals of ethical conduct are described by Principles of Ethics and by
Rules of Ethics as they relate to the responsibility to persons served, the public,
speech-language pathologists, audiologists, and speech, language, and hearing
scientists, and to the conduct of research and scholarly activities.
Principles of Ethics, aspirational and inspirational in nature, form the underlying
moral basis for the Code of Ethics. Individuals shall observe these principles as
affirmative obligations under all conditions of professional activity.
Rules of Ethics are specific statements of minimally acceptable professional
conduct or of prohibitions and are applicable to all individuals.
Principle of Ethics I
Individuals shall honor their responsibility to hold paramount the welfare of
persons they serve professionally or who are participants in research and scholarly
activities, and they shall treat animals involved in research in a humane manner.
Rules of Ethics
A. Individuals shall provide all services competently.
B. Individuals shall use every resource, including referral when appropriate, to
ensure that high-quality service is provided.
C. Individuals shall not discriminate in the delivery of professional services or
the conduct of research and scholarly activities on the basis of race or ethnicity,
gender, gender identity/gender expression, age, religion, national origin,
sexual orientation, or disability.
D. Individuals shall not misrepresent the credentials of assistants, technicians,
support personnel, students, Clinical Fellows, or any others under their
supervision, and they shall inform those they serve professionally of the name
and professional credentials of persons providing services.
E. Individuals who hold the Certificate of Clinical Competence shall not delegate
tasks that require the unique skills, knowledge, and judgment that are within
the scope of their profession to assistants, technicians, support personnel, or
any nonprofessionals over whom they have supervisory responsibility.
1
Code of Ethics
Ethics
F. Individuals who hold the Certificate of Clinical Competence may delegate
tasks related to provision of clinical services to assistants, technicians, support
personnel, or any other persons only if those services are appropriately
supervised, realizing that the responsibility for client welfare remains with the
certified individual.
G. Individuals who hold the Certificate of Clinical Competence may delegate
tasks related to provision of clinical services that require the unique skills,
knowledge, and judgment that are within the scope of practice of their
profession to students only if those services are appropriately supervised. The
responsibility for client welfare remains with the certified individual.
H. Individuals shall fully inform the persons they serve of the nature and possible
effects of services rendered and products dispensed, and they shall inform
participants in research about the possible effects of their participation in
research conducted.
I. Individuals shall evaluate the effectiveness of services rendered and of
products dispensed, and they shall provide services or dispense products only
when benefit can reasonably be expected.
J. Individuals shall not guarantee the results of any treatment or procedure,
directly or by implication; however, they may make a reasonable statement of
prognosis.
K. Individuals shall not provide clinical services solely by correspondence.
L. Individuals may practice by telecommunication (e.g., telehealth/e-health),
where not prohibited by law.
M. Individuals shall adequately maintain and appropriately secure records of
professional services rendered, research and scholarly activities conducted,
and products dispensed, and they shall allow access to these records only when
authorized or when required by law.
N. Individuals shall not reveal, without authorization, any professional or
personal information about identified persons served professionally or
identified participants involved in research and scholarly activities unless
doing so is necessary to protect the welfare of the person or of the community
or is otherwise required by law.
O. Individuals shall not charge for services not rendered, nor shall they
misrepresent services rendered, products dispensed, or research and scholarly
activities conducted.
P. Individuals shall enroll and include persons as participants in research or
teaching demonstrations only if their participation is voluntary, without
coercion, and with their informed consent.
Q. Individuals whose professional services are adversely affected by substance
abuse or other health-related conditions shall seek professional assistance and,
where appropriate, withdraw from the affected areas of practice.
R. Individuals shall not discontinue service to those they are serving without
providing reasonable notice.
Principle of Ethics II
Individuals shall honor their responsibility to achieve and maintain the highest
level of professional competence and performance.
2
Code of Ethics
Ethics
Rules of Ethics
A. Individuals shall engage in the provision of clinical services only when they
hold the appropriate Certificate of Clinical Competence or when they are in
the certification process and are supervised by an individual who holds the
appropriate Certificate of Clinical Competence.
B. Individuals shall engage in only those aspects of the professions that are within
the scope of their professional practice and competence, considering their level
of education, training, and experience.
C. Individuals shall engage in lifelong learning to maintain and enhance
professional competence and performance.
D. Individuals shall not require or permit their professional staff to provide
services or conduct research activities that exceed the staff member's
competence, level of education, training, and experience.
E. Individuals shall ensure that all equipment used to provide services or to
conduct research and scholarly activities is in proper working order and is
properly calibrated.
Principle of Ethics
III
Individuals shall honor their responsibility to the public by promoting public
understanding of the professions, by supporting the development of services
designed to fulfill the unmet needs of the public, and by providing accurate
information in all communications involving any aspect of the professions,
including the dissemination of research findings and scholarly activities, and the
promotion, marketing, and advertising of products and services.
Rules of Ethics
A. Individuals shall not misrepresent their credentials, competence, education,
training, experience, or scholarly or research contributions.
B. Individuals shall not participate in professional activities that constitute a
conflict of interest.
C. Individuals shall refer those served professionally solely on the basis of the
interest of those being referred and not on any personal interest, financial or
otherwise.
D. Individuals shall not misrepresent research, diagnostic information, services
rendered, results of services rendered, products dispensed, or the effects of
products dispensed.
E. Individuals shall not defraud or engage in any scheme to defraud in connection
with obtaining payment, reimbursement, or grants for services rendered,
research conducted, or products dispensed.
F. Individuals' statements to the public shall provide accurate information about
the nature and management of communication disorders, about the
professions, about professional services, about products for sale, and about
research and scholarly activities.
G. Individuals' statements to the public when advertising, announcing, and
marketing their professional services; reporting research results; and
promoting products shall adhere to professional standards and shall not contain
misrepresentations.
Principle of Ethics IV
Individuals shall honor their responsibilities to the professions and their
relationships with colleagues, students, and members of other professions and
disciplines.
3
Code of Ethics
Rules of Ethics
Ethics
A. Individuals shall uphold the dignity and autonomy of the professions, maintain
harmonious interprofessional and intraprofessional relationships, and accept
the professions' self-imposed standards.
B. Individuals shall prohibit anyone under their supervision from engaging in any
practice that violates the Code of Ethics.
C. Individuals shall not engage in dishonesty, fraud, deceit, or misrepresentation.
D. Individuals shall not engage in any form of unlawful harassment, including
sexual harassment or power abuse.
E. Individuals shall not engage in any other form of conduct that adversely reflects
on the professions or on the individual's fitness to serve persons professionally.
F. Individuals shall not engage in sexual activities with clients, students, or
research participants over whom they exercise professional authority or power.
G. Individuals shall assign credit only to those who have contributed to a
publication, presentation, or product. Credit shall be assigned in proportion to
the contribution and only with the contributor's consent.
H. Individuals shall reference the source when using other persons' ideas,
research, presentations, or products in written, oral, or any other media
presentation or summary.
I. Individuals' statements to colleagues about professional services, research
results, and products shall adhere to prevailing professional standards and shall
contain no misrepresentations.
J. Individuals shall not provide professional services without exercising
independent professional judgment, regardless of referral source or
prescription.
K. Individuals shall not discriminate in their relationships with colleagues,
students, and members of other professions and disciplines on the basis of race
or ethnicity, gender, gender identity/gender expression, age, religion, national
origin, sexual orientation, or disability.
L. Individuals shall not file or encourage others to file complaints that disregard
or ignore facts that would disprove the allegation, nor should the Code of Ethics
be used for personal reprisal, as a means of addressing personal animosity, or
as a vehicle for retaliation.
M. Individuals who have reason to believe that the Code of Ethics has been
violated shall inform the Board of Ethics.
N. Individuals shall comply fully with the policies of the Board of Ethics in its
consideration and adjudication of complaints of violations of the Code of
Ethics.
4
Confidentiality
Board of Ethics
Reference this material as: American Speech-Language-Hearing Association. (2004). Confidentiality [Issues
in Ethics]. Available from www.asha.org/policy.
Index terms: confidentiality, ethics
DOI: 10.1044/policy.ET2004-00168
© Copyright 2004 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.
Confidentiality Issues in Ethics Confidentiality Issues in Ethics
About This
Document
Issues in Ethics
Statements:
Definition
Introduction
Background
2001; revised 2003
****
From time to time, the Board of Ethics determines that members and certificate
holders can benefit from additional analysis and instruction concerning a specific
issue of ethical conduct. Issues in Ethics statements are intended to heighten
sensitivity and increase awareness. They are illustrative of the Code of Ethics and
intended to promote thoughtful consideration of ethical issues. They may assist
members and certificate holders in engaging in self-guided ethical decisionmaking. These statements do not absolutely prohibit or require specified activity.
The facts and circumstances surrounding a matter of concern will determine
whether the activity is ethical. This Issues in Ethics statement was revised to update
references to the Code of Ethics as revised in 2003.
This Issues in Ethics statement is presented for the guidance of ASHA members
and certificate holders in matters relating to confidentiality.
ASHA members and certificate holders are employed in a variety of work settings
and are faced daily with issues of confidentiality of client/student/patient
information. Some examples include records management, information exchanged
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in the course of the client-clinician relationship, disclosure, release of information,
access to records, exchange of records between professionals. The following
information is provided in an attempt to heighten sensitivity, increase awareness,
and enhance judgments in situations dealing with confidentiality of information.
ASHA members and certificate holders are also faced with issues of confidentiality
in their relationships with colleagues and information they obtain as they serve in
roles such as site visitors, consultants, supervisors, or reviewers.
Confidentiality of client/student/patient information is specifically addressed by
the ASHA Code of Ethics through Principle of Ethics I, Rules K and L.
K. Individuals shall adequately maintain and appropriately secure records of
professional services rendered, research and scholarly activities conducted, and
products dispensed and shall allow access to these records only when authorized
or when required by law.
L. Individuals shall not reveal, without authorization, any professional or personal
information about identified persons served professionally or identified
participants involved in research and scholarly activities unless required by law
to do so, or unless doing so is necessary to protect the welfare of the person or of
the community or otherwise required by law.
The ASHA Code of Ethics, through Principle of Ethics IV, Rules B, F, I, and J,
addresses confidentiality in relationships with colleagues.
Confidentiality Issues in Ethics Confidentiality Issues in Ethics
Confidentiality ofClient/Student/
Patient Information
B. Individuals shall not engage in dishonesty, fraud, deceit, misrepresentation,
sexual harassment, or any other form of conduct that adversely reflects on the
professions or on the individual's fitness to serve persons professionally.
F. Individuals' statements to colleagues about professional services, research
results, and products shall adhere to prevailing professional standards and shall
contain no misrepresentations.
I. Individuals who have reason to believe that the Code of Ethics has been violated
shall inform the Board of Ethics.
J. Individuals shall comply fully with policies of the Board of Ethics in its
consideration and adjudication of complaints of violation of the Code of Ethics.
Discussion
Confidentiality of privileged information stems from codes of ethics, federal law,
and state law. If one works in an educational setting (such as a college or school)
there are relevant laws that specify the management of school records including
access to information and release of information. If one works in a health care
setting (such as a hospital, nursing facility, or rehabilitation setting) there are
relevant laws for the management of medical records. If one works in a private
practice setting confidentiality of client/student/patient information must be
protected. Speech-language pathologists and audiologists, regardless of setting,
are responsible for obtaining and adhering to laws and guidance policies for records
management in that setting.
Records management guidance will typically cover
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• record storage;
• ownership of records;
• access of clients and their legal guardians to records;
• record retention and statutes of limitation;
• transfer of information;
• requests for information by someone other than the client/student or the
client's/student's legal guardian; and
• use of client/student records for research.
Guidance
1. Speech-language pathologists and audiologists must be aware of who owns the
records. In a medical setting, the hospital owns the record. In a private practice the
individual who is legally responsible for the practice owns the records. In a school
setting, the school district owns the record. For example, a school district maintains
one “official” record on each student. Speech-language pathology or audiology
reports are the property of the school district and may not be released to anyone
without appropriate, signed releases of information. A report prepared by a speechlanguage pathologist or audiologist in the course of employment in a particular
setting is not “owned” by the speech-language pathologist or audiologist.
Confidentiality Issues in Ethics Confidentiality Issues in Ethics
Confidentiality inRelationships WithColleagues
2. Persons other than the client/student may request information about the client's
communication problem. Requests might come from an off-site clinic supervisor,
Clinical Fellowship supervisor, a professional who supervises student teachers,
reporters, insurance companies, and government agencies. Again, information
cannot be disclosed without signed releases.
3. It is important to be aware of what information is required and what information
is appropriate to be included in the client's legal record and to exercise professional
judgment in making notations in the client's/student's record.
4. Data and the personal identities of individual participants in clinical activities
and research must be kept confidential. Some reasonable precautions to protect
and respect the confidentiality of participants include
• dissemination of clinical service and research findings without disclosure of
personal identifying information, if possible;
• secure storage and limited access to clinical and research records by authorized
personnel only;
• removal, disguise, or coding of personal identifying information; and
• written, informed consent from participants, parent, or guardian to disseminate
findings observable from photographic/video images or audio voice
recordings in which personal identifying information may be disclosed to
others.
Summary
It is incumbent on the speech-language pathologist or audiologist to be
knowledgeable about federal and state laws, professional codes of ethics to which
they must adhere (in addition to the ASHA Code of Ethics), and work-site specific
procedures regarding the handling of patient information.
Discussion
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Speech-language pathologists and audiologists function in a variety of roles and
activities that allow access to information of a personal and confidential nature.
For example, speech-language pathologists may be reviewers of manuscripts/
publications authored by others or of grant, fellowship, or scholarship applications;
site visitors; consultants; supervisors; administrators; or participants in groups
dealing with confidential and personal information.
Individuals reporting or responding to alleged violations of codes of ethics or
professional codes of conduct are also dealing with a confidential matter and acting
in a confidential relationship with the adjudicating body.
Adjudicating bodies typically follow rules of confidentiality (some dictated by law
and regulation, some dictated by the organization's internal governance policies
and procedures) regarding disclosure of decisions.
Guidance
1. In the multiple roles and activities in which speech-language pathologists and
audiologists are engaged, confidentiality of proprietary and personal information
obtained in conjunction with the activity/role is paramount.
Confidentiality Issues in Ethics Confidentiality Issues in Ethics
2. With regard to reporting/responding to alleged violations of codes of conduct,
respect for the confidentiality of the matter is the responsibility of all individuals
involved. It would be prudent to consider all aspects of a matter confidential until
a final decision is rendered.
3. With respect to disclosure of decisions by adjudicating bodies, individuals need
to inform themselves of pertinent laws and organizational policies regarding
disclosure of information.
Summary
It is incumbent on speech-language pathologists or audiologists to honor their
responsibilities to the profession and their relationships with colleagues in matters
of confidentiality of proprietary and personal information.
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Scope of Practice in Speech-Language
Pathology
Ad Hoc Committee on the Scope of Practice in Speech-Language Pathology
Reference this material as: American Speech-Language-Hearing Association. (2007). Scope of Practice in
Speech-Language Pathology [Scope of Practice]. Available from www.asha.org/policy.
Index terms: scope of practice
DOI: 10.1044/policy.SP2007-00283
© Copyright 2007 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.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
About This
Document
Introduction
Statement of Purpose
This scope of practice document is an official policy of the American SpeechLanguageHearing Association (ASHA) defining the breadth of practice within
the profession of speech-language pathology. This document was developed by
the ASHA Ad Hoc Committee on the Scope of Practice in Speech-Language
Pathology. Committee members were Kenn Apel (chair), Theresa E. Bartolotta,
Adam A. Brickell, Lynne E. Hewitt, Ann W. Kummer, Luis F. Riquelme, Jennifer
B. Watson, Carole Zangari, Brian B. Shulman (vice president for professional
practices in speech-language pathology), Lemmietta McNeilly (ex officio), and
Diane R. Paul (consultant). This document was approved by the ASHA Legislative
Council on September 4, 2007 (LC 09-07).
****
The Scope of Practice in Speech-Language Pathology includes a statement of
purpose, a framework for research and clinical practice, qualifications of the
speech-language pathologist, professional roles and activities, and practice
settings. The speech-language pathologist is the professional who engages in
clinical services, prevention, advocacy, education, administration, and research in
the areas of communication and swallowing across the life span from infancy
through geriatrics. Given the diversity of the client population, ASHA policy
requires that these activities are conducted in a manner that takes into consideration
the impact of culture and linguistic exposure/acquisition and uses the best available
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evidence for practice to ensure optimal outcomes for persons with communication
and/or swallowing disorders or differences.
As part of the review process for updating the Scope of Practice in SpeechLanguage Pathology, the committee made changes to the previous scope of
practice document that reflected recent advances in knowledge, understanding, and
research in the discipline. These changes included acknowledging roles and
responsibilities that were not mentioned in previous iterations of the Scope of
Practice (e.g., funding issues, marketing of services, focus on emergency
responsiveness, communication wellness). The revised document also was framed
squarely on two guiding principles: evidence-based practice and cultural and
linguistic diversity.
The purpose of this document is to define the Scope of Practice in SpeechLanguage Pathology to
1. delineate areas of professional practice for speech-language pathologists;
2. inform others (e.g., health care providers, educators, other professionals,
consumers, payers, regulators, members of the general public) about
professional services offered by speech-language pathologists as qualified
providers;
3. support speech-language pathologists in the provision of high-quality,
evidence-based services to individuals with concerns about communication or
swallowing;
4. support speech-language pathologists in the conduct of research;
5. provide guidance for educational preparation and professional development of
speech-language pathologists.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Figure 1. Conceptual Framework of ASHA Practice Documents
This document describes the breadth of professional practice offered within the
profession of speech-language pathology. Levels of education, experience, skill,
and proficiency with respect to the roles and activities identified within this scope
of practice document vary among individual providers. A speech-language
pathologist typically does not practice in all areas of the field. As the ASHA Code
of Ethics specifies, individuals may practice only in areas in which they are
competent (i.e., individuals' scope of competency), based on their education,
training, and experience.
In addition to this scope of practice document, other ASHA documents provide
more specific guidance for practice areas. Figure 1 illustrates the relationship
between the ASHA Code of Ethics, the Scope of Practice, and specific practice
documents. As shown, the ASHA Code of Ethics sets forth the fundamental
principles and rules considered essential to the preservation of the highest
standards of integrity and ethical conduct in the practice of speech-language
pathology.
Speech-language pathology is a dynamic and continuously developing profession.
As such, listing specific areas within this Scope of Practice does not exclude
emerging areas of practice. Further, speech-language pathologists may provide
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additional professional services (e.g., interdisciplinary work in a health care
setting, collaborative service delivery in schools, transdisciplinary practice in early
intervention settings) that are necessary for the well-being of the individual(s) they
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Framework for
Research and
Clinical Practice
are serving but are not addressed in this Scope of Practice. In such instances, it is
both ethically and legally incumbent upon professionals to determine whether they
have the knowledge and skills necessary to perform such services.
This scope of practice document does not supersede existing state licensure laws
or affect the interpretation or implementation of such laws. It may serve, however,
as a model for the development or modification of licensure laws.
The overall objective of speech-language pathology services is to optimize
individuals' ability to communicate and swallow, thereby improving quality of life.
As the population profile of the United States continues to become increasingly
diverse (U.S. Census Bureau, 2005), speech-language pathologists have a
responsibility to be knowledgeable about the impact of these changes on clinical
services and research needs. Speech-language pathologists are committed to the
provision of culturally and linguistically appropriate services and to the
consideration of diversity in scientific investigations of human communication and
swallowing. For example, one aspect of providing culturally and linguistically
appropriate services is to determine whether communication difficulties
experienced by English language learners are the result of a communication
disorder in the native language or a consequence of learning a new language.
Additionally, an important characteristic of the practice of speech-language
pathology is that, to the extent possible, clinical decisions are based on best
available evidence. ASHA has defined evidence-based practice in speechlanguage pathology as an approach in which current, high-quality research
evidence is integrated with practitioner expertise and the individual's preferences
and values into the process of clinical decision making (ASHA, 2005). A highquality basic, applied, and efficacy research base in communication sciences and
disorders and related fields of study is essential to providing evidence-based
clinical practice and quality clinical services. The research base can be enhanced
by increased interaction and communication with researchers across the United
States and from other countries. As our global society is becoming more connected,
integrated, and interdependent, speech-language pathologists have access to an
abundant array of resources, information technology, and diverse perspectives and
influence (e.g., Lombardo, 1997). Increased national and international interchange
of professional knowledge, information, and education in communication sciences
and disorders can be a means to strengthen research collaboration and improve
clinical services.
The World Health Organization (WHO) has developed a multipurpose health
classification system known as the International Classification of Functioning,
Disability and Health (ICF; WHO, 2001). The purpose of this classification system
is to provide a standard language and framework for the description of functioning
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and health. The ICF framework is useful in describing the breadth of the role of
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Qualifications
the speech-language pathologist in the prevention, assessment, and habilitation/
rehabilitation, enhancement, and scientific investigation of communication and
swallowing. It consists of two components:
• Health Conditions
• Body Functions and Structures: These involve the anatomy and physiology
of the human body. Relevant examples in speech-language pathology
include craniofacial anomaly, vocal fold paralysis, cerebral palsy,
stuttering, and language impairment.
• Activity and Participation: Activity refers to the execution of a task or
action. Participation is the involvement in a life situation. Relevant
examples in speech-language pathology include difficulties with
swallowing safely for independent feeding, participating actively in class,
understanding a medical prescription, and accessing the general education
curriculum.
• Contextual Factors
• Environmental Factors: These make up the physical, social, and attitudinal
environments in which people live and conduct their lives. Relevant
examples in speech-language pathology include the role of the
communication partner in augmentative and alternative communication,
the influence of classroom acoustics on communication, and the impact of
institutional dining environments on individuals' ability to safely maintain
nutrition and hydration.
• Personal Factors: These are the internal influences on an individual's
functioning and disability and are not part of the health condition. These
factors may include, but are not limited to, age, gender, ethnicity,
educational level, social background, and profession. Relevant examples
in speech-language pathology might include a person's background or
culture that influences his or her reaction to a communication or
swallowing disorder.
The framework in speech-language pathology encompasses these health
conditions and contextual factors. The health condition component of the ICF can
be expressed on a continuum of functioning. On one end of the continuum is intact
functioning. At the opposite end of the continuum is completely compromised
functioning. The contextual factors interact with each other and with the health
conditions and may serve as facilitators or barriers to functioning. Speechlanguage pathologists may influence contextual factors through education and
advocacy efforts at local, state, and national levels. Relevant examples in speechlanguage pathology include a user of an augmentative communication device
needing classroom support services for academic success, or the effects of
premorbid literacy level on rehabilitation in an adult post brain injury. Speechlanguage pathologists work to improve quality of life by reducing impairments of
body functions and structures, activity limitations, participation restrictions, and
barriers created by contextual factors.
Speech-language pathologists, as defined by ASHA, hold the ASHA Certificate
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of Clinical Competence in Speech-Language Pathology (CCC-SLP), which
requires a master's, doctoral, or other recognized postbaccalaureate degree. ASHAcertified speech-language pathologists complete a supervised postgraduate
professional experience and pass a national examination as described in the ASHA
certification standards. Demonstration of continued professional development is
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Professional Roles
and Activities
mandated for the maintenance of the CCC-SLP. Where applicable, speechlanguage pathologists hold other required credentials (e.g., state licensure, teaching
certification).
This document defines the scope of practice for the field of speech-language
pathology. Each practitioner must evaluate his or her own experiences with
preservice education, clinical practice, mentorship and supervision, and continuing
professional development. As a whole, these experiences define the scope of
competence for each individual. Speech-language pathologists may engage in only
those aspects of the profession that are within their scope of competence.
As primary care providers for communication and swallowing disorders, speechlanguage pathologists are autonomous professionals; that is, their services are not
prescribed or supervised by another professional. However, individuals frequently
benefit from services that include speech-language pathologist collaborations with
other professionals.
Speech-language pathologists serve individuals, families, and groups from diverse
linguistic and cultural backgrounds. Services are provided based on applying the
best available research evidence, using expert clinical judgments, and considering
clients' individual preferences and values. Speech-language pathologists address
typical and atypical communication and swallowing in the following areas:
• speech sound production
• articulation
• apraxia of speech
• dysarthria
• ataxia
• dyskinesia
• resonance
• hypernasality
• hyponasality
• cul-de-sac resonance
• mixed resonance
• voice
• phonation quality
• pitch
• loudness
• respiration
• fluency
• stuttering
• cluttering
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• language (comprehension and expression)
• phonology
• morphology
• syntax
• semantics
• pragmatics (language use, social aspects of communication)
• literacy (reading, writing, spelling)
• prelinguistic communication (e.g., joint attention, intentionality,
communicative signaling)
• paralinguistic communication
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Clinical Services
• cognition
• attention
• memory
• sequencing
• problem solving
• executive functioning
• feeding and swallowing
• oral, pharyngeal, laryngeal, esophageal
• orofacial myology (including tongue thrust)
• oral-motor functions
Potential etiologies of communication and swallowing disorders include
• neonatal problems (e.g., prematurity, low birth weight, substance exposure);
• developmental disabilities (e.g., specific language impairment, autism
spectrum disorder, dyslexia, learning disabilities, attention deficit disorder);
• auditory problems (e.g., hearing loss or deafness);
• oral anomalies (e.g., cleft lip/palate, dental malocclusion, macroglossia, oralmotor dysfunction);
• respiratory compromise (e.g., bronchopulmonary dysplasia, chronic
obstructive pulmonary disease);
• pharyngeal anomalies (e.g., upper airway obstruction, velopharyngeal
insufficiency/incompetence);
• laryngeal anomalies (e.g., vocal fold pathology, tracheal stenosis,
tracheostomy);
• neurological disease/dysfunction (e.g., traumatic brain injury, cerebral palsy,
cerebral vascular accident, dementia, Parkinson's disease, amyotrophic lateral
sclerosis);
• psychiatric disorder (e.g., psychosis, schizophrenia);
• genetic disorders (e.g., Down syndrome, fragile X syndrome, Rett syndrome,
velocardiofacial syndrome).
The professional roles and activities in speech-language pathology include clinical/
educational services (diagnosis, assessment, planning, and treatment), prevention
and advocacy, and education, administration, and research.
Speech-language pathologists provide clinical services that include the following:
• prevention and pre-referral
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• screening
• assessment/evaluation
• consultation
• diagnosis
• treatment, intervention, management
• counseling
• collaboration
• documentation
• referral
Examples of these clinical services include
1. using data to guide clinical decision making and determine the effectiveness
of services;
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
2. making service delivery decisions (e.g., admission/eligibility, frequency,
duration, location, discharge/dismissal) across the lifespan;
3. determining appropriate context(s) for service delivery (e.g., home, school,
telepractice, community);
4. documenting provision of services in accordance with accepted procedures
appropriate for the practice setting;
5. collaborating with other professionals (e.g., identifying neonates and infants
at risk for hearing loss, participating in palliative care teams, planning lessons
with educators, serving on student assistance teams);
6. screening individuals for hearing loss or middle ear pathology using
conventional pure-tone air conduction methods (including otoscopic
inspection), otoacoustic emissions screening, and/or screening tympanometry;
7. providing intervention and support services for children and adults diagnosed
with speech and language disorders;
8. providing intervention and support services for children and adults diagnosed
with auditory processing disorders;
9. using instrumentation (e.g., videofluoroscopy, electromyography,
nasendoscopy, stroboscopy, endoscopy, nasometry, computer technology) to
observe, collect data, and measure parameters of communication and
swallowing or other upper aerodigestive functions;
10. counseling individuals, families, coworkers, educators, and other persons in
the community regarding acceptance, adaptation, and decision making about
communication and swallowing;
11. facilitating the process of obtaining funding for equipment and services related
to difficulties with communication and swallowing;
12. serving as case managers, service delivery coordinators, and members of
collaborative teams (e.g., individualized family service plan and
individualized education program teams, transition planning teams);
13. providing referrals and information to other professionals, agencies, and/or
consumer organizations;
14. developing, selecting, and prescribing multimodal augmentative and
alternative communication systems, including unaided strategies (e.g., manual
signs, gestures) and aided strategies (e.g., speech-generating devices, manual
communication boards, picture schedules);
15. providing services to individuals with hearing loss and their families/
caregivers (e.g., auditory training for children with cochlear implants and
hearing aids; speechreading; speech and language intervention secondary to
hearing loss; visual inspection and listening checks of amplification devices
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for the purpose of troubleshooting, including verification of appropriate
battery voltage);
16. addressing behaviors (e.g., perseverative or disruptive actions) and
environments (e.g., classroom seating, positioning for swallowing safety or
attention, communication opportunities) that affect communication and
swallowing;
17. selecting, fitting, and establishing effective use of prosthetic/adaptive devices
for communication and swallowing (e.g., tracheoesophageal prostheses,
speaking valves, electrolarynges; this service does not include the selection or
fitting of sensory devices used by individuals with hearing loss or other
auditory perceptual deficits, which falls within the scope of practice of
audiologists; ASHA, 2004);
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Prevention and
Advocacy
Education,
Administration, and
Research
Practice Settings
18. providing services to modify or enhance communication performance (e.g.,
accent modification, transgender voice, care and improvement of the
professional voice, personal/professional communication effectiveness).
Speech-language pathologists engage in prevention and advocacy activities related
to human communication and swallowing. Example activities include
1. improving communication wellness by promoting healthy lifestyle practices
that can help prevent communication and swallowing disorders (e.g., cessation
of smoking, wearing helmets when bike riding);
2. presenting primary prevention information to individuals and groups known
to be at risk for communication disorders and other appropriate groups;
3. providing early identification and early intervention services for
communication disorders;
4. advocating for individuals and families through community awareness, health
literacy, education, and training programs to promote and facilitate access to
full participation in communication, including the elimination of societal,
cultural, and linguistic barriers;
5. advising regulatory and legislative agencies on emergency responsiveness to
individuals who have communication and swallowing disorders or difficulties;
6. promoting and marketing professional services;
7. advocating at the local, state, and national levels for improved administrative
and governmental policies affecting access to services for communication and
swallowing;
8. advocating at the local, state, and national levels for funding for research;
9. recruiting potential speech-language pathologists into the profession;
10. participating actively in professional organizations to contribute to best
practices in the profession.
Speech-language pathologists also serve as educators, administrators, and
researchers. Example activities for these roles include
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1. educating the public regarding communication and swallowing;
2. educating and providing in-service training to families, caregivers, and other
professionals;
3. educating, supervising, and mentoring current and future speech-language
pathologists;
4. educating, supervising, and managing speech-language pathology assistants
and other support personnel;
5. fostering public awareness of communication and swallowing disorders and
their treatment;
6. serving as expert witnesses;
7. administering and managing clinical and academic programs;
8. developing policies, operational procedures, and professional standards;
9. conducting basic and applied/translational research related to communication
sciences and disorders, and swallowing.
Speech-language pathologists provide services in a wide variety of settings, which
may include but are not exclusive to
1. public and private schools;
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
References
Resources
2. early intervention settings, preschools, and day care centers;
3. health care settings (e.g., hospitals, medical rehabilitation facilities, long-term
care facilities, home health agencies, clinics, neonatal intensive care units,
behavioral/mental health facilities);
4. private practice settings;
5. universities and university clinics;
6. individuals' homes and community residences;
7. supported and competitive employment settings;
8. community, state, and federal agencies and institutions;
9. correctional institutions;
10. research facilities;
11. corporate and industrial settings.
American Speech-Language-Hearing Association. (2004). Scope of practice in audiology.
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Evidence-based practice in
communication disorders [Position statement]. Available from www.asha.org/policy.
Lombardo, T. (1997, Spring). The impact of information technology: Learning, living, and
loving in the future. The Labyrinth: Sharing Information on Learning Technologies. 5
(2). Available from www.mcli.dist.maricopa.edu/LF/Spr97/spr97L8.html.
U.S. Census Bureau. (2005). Population profile of the United States: Dynamic version. Race
and Hispanic origin in 2005. Available from www.census.gov.
World Health Organization. (2001). International classification of functioning, disability
and health. Geneva, Switzerland: Author.
ASHA Cardinal Documents
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American Speech-Language-Hearing Association. (2003). Code of ethics (Revised).
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Preferred practice patterns for
the profession of speech-language pathology. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Standards for the certificate of
clinical competence in speech-language pathology. Available from www.asha.org/
about/membership-certification/handbooks/slp/slp_standards.htm.
General Service Delivery Issues
Admission/Discharge Criteria
American Speech-Language-Hearing Association. (2004). Admission/discharge criteria in
speech-language pathology [Guidelines]. Available from www.asha.org/policy.
Autonomy
American Speech-Language-Hearing Association. (1986). Autonomy of speech-language
pathology and audiology [Relevant paper]. Available from www.asha.org/policy.
Culturally and Linguistically Appropriate Services
American Speech-Language-Hearing Association. (2002). American English dialects
[Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Knowledge and skills needed by
speech-language pathologists and audiologists to provide culturally and linguistically
appropriate services [Knowledge and skills]. Available from www.asha.org/policy.
Definitions and Terminology
American Speech-Language-Hearing Association. (1982). Language [Relevant paper].
Available from www.asha.org/policy.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
American Speech-Language-Hearing Association. (1986). Private practice [Definition].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1993). Definition of communication
disorders and variations [Definition]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1998). Terminology pertaining to
fluency and fluency disorders [Guidelines]. Available from www.asha.org/policy.
Evidence-Based Practice
American Speech-Language-Hearing Association. (2004). Evidence-based practice in
communication disorders: An introduction [Technical report]. Available from
www.asha.org/policy.
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American Speech-Language-Hearing Association. (2005). Evidence-based practice in
communication disorders: An introduction [Position statement]. Available from
www.asha.org/policy.
Private Practice
American Speech-Language-Hearing Association. (1990). Considerations for establishing
a private practice in audiology and/or speech-language pathology [Technical report].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1991). Private practice [Technical
report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1994). Professional liability and risk
management for the audiology and speech-language pathology professions [Technical
report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2002). Drawing cases for private
practice from primary place of employment [Issues in ethics]. Available from
www.asha.org/policy.
Professional Service Programs
American Speech-Language-Hearing Association. (2005). Quality indicators for
professional service programs in audiology and speech-language pathology [Quality
indicators]. Available from www.asha.org/policy.
Speech-Language Pathology Assistants
American Speech-Language-Hearing Association. (2001). Knowledge and skills for
supervisors of speech-language pathology assistants [Knowledge and skills]. Available
from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Guidelines for the training, use,
and supervision of speech-language pathology assistants [Guidelines]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Support personnel [Issues in
ethics]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Training, use, and supervision
of support personnel in speech-language pathology [Position statement]. Available from
www.asha.org/policy.
Supervision
American Speech-Language-Hearing Association. (1985). Clinical supervision in speechlanguage pathology and audiology [Position statement]. Available from www.asha.org/
policy.
American Speech-Language-Hearing Association. (2004). Clinical fellowship supervisor's
responsibilities [Issues in ethics]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Supervision of student
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clinicians [Issues in ethics]. Available from www.asha.org/policy.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Clinical Services and Populations
Apraxia of Speech
American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech
[Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech
[Technical report]. Available from www.asha.org/policy.
Auditory Processing
American Speech-Language-Hearing Association. (1995). Central auditory processing:
Current status of research and implications for clinical practice [Technical report].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). (Central) auditory processing
disorders [Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). (Central) auditory processing
disorders—the role of the audiologist [Position statement]. Available from
www.asha.org/policy.
Augmentative and Alternative Communication (AAC)
American Speech-Language-Hearing Association. (1998). Maximizing the provision of
appropriate technology services and devices for students in schools [Technical report].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2001). Augmentative and alternative
communication: Knowledge and skills for service delivery [Knowledge and skills].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of
speech-language pathologists with respect to augmentative and alternative
communication [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of
speech-language pathologists with respect to augmentative and alternative
communication [Technical report]. Available from www.asha.org/policy.
Aural Rehabilitation
American Speech-Language-Hearing Association. (2001). Knowledge and skills required
for the practice of audiologic/aural rehabilitation [Knowledge and skills]. Available
from www.asha.org/policy.
Autism Spectrum Disorders
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American Speech-Language-Hearing Association. (2006). Guidelines for speech-language
pathologists in diagnosis, assessment, and treatment of autism spectrum disorders
across the life span [Guidelines]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2006). Knowledge and skills needed by
speech-language pathologists for diagnosis, assessment, and treatment of autism
spectrum disorders across the life span [Knowledge and skills]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2006). Principles for speech-language
pathologists in diagnosis, assessment, and treatment of autism spectrum disorders
across the life span [Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2006). Roles and responsibilities of
speech-language pathologists in diagnosis, assessment, and treatment of autism
spectrum disorders across the life span [Position statement]. Available from
www.asha.org/policy.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Filipek, P. A., Accardo, P. J., Ashwal, S., Baranek, G. T., Cook, E. H., Dawson, G., et al.
(2000). Practice parameter: Screening and diagnosis of autism—report of the Quality
Standards Subcommittee of the American Academy of Neurology and the Child
Neurology Society Neurology, 55, 468–479
Cognitive Aspects of Communication
American Speech-Language-Hearing Association. (1990). Interdisciplinary approaches to
brain damage [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1995). Guidelines for the structure and
function of an interdisciplinary team for persons with brain injury [Guidelines].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2003). Evaluating and treating
communication and cognitive disorders: Approaches to referral and collaboration for
speech-language pathology and clinical neuropsychology [Technical report]. Available
from www.asha.org/policy.
American Speech-Language-Hearing Association. (2003). Rehabilitation of children and
adults with cognitive-communication disorders after brain injury [Technical report].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Knowledge and skills needed by
speech-language pathologists providing services to individuals with cognitivecommunication disorders [Knowledge and skills]. Available from www.asha.org/
policy.
American Speech-Language-Hearing Association. (2005). Roles of speech-language
pathologists in the identification, diagnosis, and treatment of individuals with cognitivecommunication disorders: Position statement. Available from www.asha.org/policy.
Deaf and Hard of Hearing
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American Speech-Language-Hearing Association. (2004). Roles of speech-language
pathologists and teachers of children who are deaf and hard of hearing in the
development of communicative and linguistic competence [Guidelines]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Roles of speech-language
pathologists and teachers of children who are deaf and hard of hearing in the
development of communicative and linguistic competence [Position statement].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Roles of speech-language
pathologists and teachers of children who are deaf and hard of hearing in the
development of communicative and linguistic competence [Technical report]. Available
from www.asha.org/policy.
Dementia
American Speech-Language-Hearing Association. (2005). The roles of speech-language
pathologists working with dementia-based communication disorders [Position
statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). The roles of speech-language
pathologists working with dementia-based communication disorders [Technical report].
Available from www.asha.org/policy.
Early Intervention
American Speech-Language-Hearing Association. Roles and responsibilities of speechlanguage pathologists in early intervention (in preparation). [Position statement,
Technical report, Guidelines, and Knowledge and skills].
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
National Joint Committee on Learning Disabilities (2006). Learning disabilities and young
children: Identification and intervention Available from www.ldonline.org/article/
11511?theme=print.
Fluency
American Speech-Language-Hearing Association. (1995). Guidelines for practice in
stuttering treatment [Guidelines]. Available from www.asha.org/policy.
Hearing Screening
American Speech-Language-Hearing Association. (1997). Guidelines for audiologic
screening [Guidelines]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Clinical practice by certificate
holders in the profession in which they are not certified [Issues in ethics]. Available from
www.asha.org/policy.
Language and Literacy
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American Speech-Language-Hearing Association. (1981). Language learning disorders
[Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association and the National Association of School
Psychologists (1987). Identification of children and youths with language learning
disorders [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2000). Roles and responsibilities of
speech-language pathologists with respect to reading and writing in children and
adolescents [Guidelines]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2000). Roles and responsibilities of
speech-language pathologists with respect to reading and writing in children and
adolescents [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2000). Roles and responsibilities of
speech-language pathologists with respect to reading and writing in children and
adolescents [Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2002). Knowledge and skills needed by
speech-language pathologists with respect to reading and writing in children and
adolescents [Knowledge and skills]. Available from www.asha.org/policy.
Mental Retardation/Developmental Disabilities
American Speech-Language-Hearing Association. (2005). Knowledge and skills needed by
speech-language pathologists serving persons with mental retardation/developmental
disabilities [Knowledge and skills]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Principles for speech-language
pathologists serving persons with mental retardation/developmental disabilities
[Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Roles and responsibilities of
speech-language pathologists serving persons withmental retardation/developmental
disabilities [Guidelines]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Roles and responsibilities of
speech-language pathologists serving persons withmental retardation/developmental
disabilities [Position statement]. Available from www.asha.org/policy.
Orofacial Myofunctional Disorders
American Speech-Language-Hearing Association. (1989). Labial-lingual posturing
function [Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1991). The role of the speech-language
pathologist in assessment and management of oral myofunctional disorders [Position
statement]. Available from www.asha.org/policy.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
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American Speech-Language-Hearing Association. (1993). Orofacial myofunctional
disorders [Knowledge and skills]. Available from www.asha.org/policy.
Prevention
American Speech-Language-Hearing Association. (1987). Prevention of communication
disorders [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1987). Prevention of communication
disorders tutorial [Relevant paper]. Available from www.asha.org/policy.
Severe Disabilities
National Joint Committee for the Communication Needs of Persons With Severe
Disabilities. (1991). Guidelines for meeting the communication needs of persons with
severe disabilities. Available from www.asha.org/NJC/njcguidelines.
National Joint Committee for the Communication Needs of Persons With Severe
Disabilities (2002). Access to communication services and supports: Concerns
regarding the application of restrictive “eligibility” policies [Technical report].
Available from www.asha.org/policy.
National Joint Committee for the Communication Needs of Persons With Severe
Disabilities (2003). Access to communication services and supports: Concerns
regarding the application of restrictive “eligibility” policies [Position statement].
Available from www.asha.org/policy.
Social Aspects of Communication
American Speech-Language-Hearing Association. (1991). Guidelines for speech-language
pathologists serving persons with language, socio-communicative and/or cognitivecommunicative impairments [Guidelines]. Available from www.asha.org/policy.
Swallowing
American Speech-Language-Hearing Association. (1992). Instrumental diagnostic
procedures for swallowing [Guidelines]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1992). Instrumental diagnostic
procedures for swallowing [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2000). Clinical indicators for
instrumental assessment of dysphagia [Guidelines]. Available from www.asha.org/
policy.
American Speech-Language-Hearing Association. (2001). Knowledge and skills needed by
speech-language pathologists providing services to individuals with swallowing and/or
feeding disorders [Knowledge and skills]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2001). Knowledge and skills for
speech-language pathologists performing endoscopic assessment of swallowing
functions [Knowledge and skills]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2001). Roles of speech-language
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pathologists in swallowing and feeding disorders [Position statement]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2001). Roles of speech-language
pathologists in swallowing and feeding disorders [Technical report]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Guidelines for speech-language
pathologists performing videofluoroscopic swallowing studies. [Guidelines]. Available
from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Knowledge and skills needed by
speech-language pathologists performing videofluoroscopic swallowing studies
Available from www.asha.org/policy.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
American Speech-Language-Hearing Association. (2004). Role of the speech-language
pathologist in the performance and interpretation of endoscopic evaluation of
swallowing [Guidelines]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Role of the speech-language
pathologist in the performance and interpretation of endoscopic evaluation of
swallowing [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Role of the speech-language
pathologist in the performance and interpretation of endoscopic evaluation of
swallowing [Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Speech-language pathologists
training and supervising other professionals in the delivery of services to individuals
with swallowing and feeding disorders [Technical report]. Available from
www.asha.org/policy.
Voice and Resonance
American Speech-Language-Hearing Association. (1993). Oral and oropharyngeal
prostheses [Guidelines]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1993). Oral and oropharyngeal
prostheses [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1993). Use of voice prostheses in
tracheotomized persons with or without ventilatory dependence [Guidelines]. Available
from www.asha.org/policy.
American Speech-Language-Hearing Association. (1993). Use of voice prostheses in
tracheotomized persons with or without ventilatory dependence [Position statement].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1998). The roles of otolaryngologists
and speech-language pathologists in the performance and interpretation of
strobovideolaryngoscopy [Relevant paper]. Available from www.asha.org/policy.
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American Speech-Language-Hearing Association. (2004). Evaluation and treatment for
tracheoesophageal puncture and prosthesis [Technical report]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Knowledge and skills for
speech-language pathologists with respect to evaluation and treatment for
tracheoesophageal puncture and prosthesis [Knowledge and skills]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of
speech-language pathologists with respect to evaluation and treatment for
tracheoesophageal puncture and prosthesis [Position statement]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Vocal tract visualization and
imaging [Position statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Vocal tract visualization and
imaging [Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). The role of the speech-language
pathologist, the teacher of singing, and the speaking voice trainer in voice habilitation
[Technical report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). The use of voice therapy in the
treatment of dysphonia [Technical report]. Available from www.asha.org/policy.
Health Care Services
Business Practices in Health Care Settings
American Speech-Language-Hearing Association. (2002). Knowledge and skills in business
practices needed by speech-language pathologists in health care settings [Knowledge
and skills]. Available from www.asha.org/policy.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
American Speech-Language-Hearing Association. (2004). Knowledge and skills in business
practices for speech-language pathologists who are managers and leaders in health
care organizations [Knowledge and skills]. Available from www.asha.org/policy.
Multiskilling
American Speech-Language-Hearing Association. (1996). Multiskilled personnel [Position
statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1996). Multiskilled personnel
[Technical report]. Available from www.asha.org/policy.
Neonatal Intensive Care Unit
American Speech-Language-Hearing Association. (2004). Knowledge and skills needed by
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speech-language pathologists providing services to infants and families in the NICU
environment [Knowledge and skills]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of
speech-language pathologists in the neonatal intensive care unit [Guidelines]. Available
from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of
speech-language pathologists in the neonatal intensive care unit [Position statement].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of
speech-language pathologists in the neonatal intensive care unit [Technical report].
Available from www.asha.org/policy.
Sedation and Anesthetics
American Speech-Language-Hearing Association. (1992). Sedation and topical anesthetics
in audiology and speech-language pathology [Technical report]. Available from
www.asha.org/policy.
Telepractice
American Speech-Language-Hearing Association. (2004). Speech-language pathologists
providing clinical services via telepractice [Position statement]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Speech-language pathologists
providing clinical services via telepractice [Technical report]. Available from
www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Knowledge and skills needed by
speech-language pathologists providing clinical services via telepractice [Technical
report]. Available from www.asha.org/policy.
School Services
Collaboration
American Speech-Language-Hearing Association. (1991). A model for collaborative
service delivery for students with language-learning disorders in the public schools
[Relevant paper]. Available from www.asha.org/policy.
Evaluation
American Speech-Language-Hearing Association. (1987). Considerations for developing
and selecting standardized assessment and intervention materials [Technical report].
Available from www.asha.org/policy.
Scope of Practice in Speech-Language Pathology Scope of Practice Scope of Practice in Speech-Language Pathology
Scope of Practice
Facilities
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American Speech-Language-Hearing Association. (2003). Appropriate school facilities for
students with speech-language-hearing disorders [Technical report]. Available from
www.asha.org/policy.
Inclusive Practices
American Speech-Language-Hearing Association. (1996). Inclusive practices for children
and youths with communication disorders [Position statement]. Available from
www.asha.org/policy.
Roles and Responsibilities for School-Based Practitioners
American Speech-Language-Hearing Association. (1999). Guidelines for the roles and
responsibilities of the school-based speech-language pathologist [Guidelines].
Available from www.asha.org/policy.
“Under the Direction of” Rule
American Speech-Language-Hearing Association. (2004). Medicaid guidance for speechlanguage pathology services: Addressing the “under the direction of” rule [Position
statement]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Medicaid guidance for speechlanguage pathology services: Addressing the “under the direction of” rule [Technical
report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Medicaid guidance for speechlanguage pathology services: Addressing the “under the direction of” rule [Guidelines].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Medicaid guidance for speechlanguage pathology services: Addressing the “under the direction of” rule [Knowledge
and skills]. Available from www.asha.org/policy.
Workload
American Speech-Language-Hearing Association. (2002). Workload analysis approach for
establishing speech-language caseload standards in the schools [Guidelines]. Available
from www.asha.org/policy.
American Speech-Language-Hearing Association. (2002). Workload analysis approach for
establishing speech-language caseload standards in the schools [Position statement].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2002). Workload analysis approach for
establishing speech-language caseload standards in the schools [Technical report].
Available from www.asha.org/policy.
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APPENDIX B
HIPAA Behavior
Speech & Hearing Clinic
Eastern Michigan University

Your Behavior:
1. Protect PHI at all costs.
2. Access, use, or provide only the minimum necessary information to complete the task.
3. Cover, turn over, or lock up PHI that is not in immediate use.
4. Report accidental or willful disclosures of PHI to your supervisor.
5. Do not discuss clients outside of clinic, including hallways and classrooms.
6. Always dispose of PHI according to guidelines.
7. When discussing PHI, lower your voice and/or move to more private setting.
8. Protect PHI on computers.
9. If in doubt, ask your supervisor.
10. Students may never remove files from the clinic.
11. Files are signed out according to Diagnostic and Clinical Manual procedures.
12. Any papers provided to clinician from clients must be filed and logged immediately.
13. Use initials or first name only on drafts of reports and paperwork.

The privacy regulations penalties include:
 Civil penalties of $100 per person for each violation, with a $25,000 limit per
calendar year.
 Criminal penalties up to $250,000 and 10 years in jail.

EMU policies include disciplinary action up to and including permanent discharge from the
program.
APPENDIX B
Eastern Michigan University
Speech & Hearing Clinic
135 Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Confidentiality Agreement
All EMU Speech & Hearing Clinic client information whether contained in a client’s Clinic record, or in any
other medium, including audio, videotapes, or any computer system is strictly confidential. Disclosing, accessing,
or permitting access to confidential client information without proper authorization is a violation of EMU Speech
& Hearing Clinic policy, state laws and Federal laws, including the Health Insurance Portability and
Accountability Act of 1996 (HIPAA), and unauthorized disclosures may result in disciplinary action. In addition,
disclosing, accessing, or permitting access to confidential Protected Health Information (PHI) without proper
authorization may also subject the violator to civil and/or criminal penalties for violation of state laws and
HIPAA. Billing and financial management information is also to be held in strict confidence and is not to be
disclosed without written authorization by the client.
I certify that as a practicum student, staff, volunteer, or faculty member of the EMU Speech & Hearing Clinic, I
understand the statements above and am aware of the confidential nature of the client’s PHI. I understand and
agree that in the performance of my duties at the EMU Speech & Hearing Clinic, I am obligated to respect client
privacy and to protect client PHI from unauthorized use and/or disclosure. This includes only accessing client’s
PHI on a need to know basis related to treatment, payment, and health care operations, or training. I understand
that when the audio or videotapes for a client are in my possession, I assume total responsibility for the
confidential retention and viewing of these tapes. I understand that the unauthorized use and/or disclosure of
information from the client’s record, audio or videotapes, or from any computer system may result in disciplinary
action up to and including dismissal, in accord with the policy outlined in the EMU Speech & Hearing Clinic
Policy and Procedures Manual, and may further subject me to civil and criminal penalties under HIPAA.
I acknowledge that I may have access to confidential client information. By signing this statement, I agree to
follow the guidelines below, and as further detailed in the EMU Speech & Hearing Clinic Policy and Procedures
Manual.
The identity of clients, or information that would reveal the identity of clients, cannot be revealed without the
specific permission of the client. The only exceptions to this are cases in which the client may be dangerous to
themselves or others and in cases of child abuse. In such situations, there may be legal requirements that
responsible agencies be informed. There are also certain legal proceedings in which case notes and other records
can be ordered to be released by the courts. Clinicians must familiarize themselves with, and adhere to,
confidentiality procedures of the Clinic and the laws of the State. Case material discussed in class must be
prepared in such a way that client confidentiality is maintained.
___________________________
Name (print)
_______________________________
Position in Clinic
_______________________________________
Signature
______________________
Date
APPENDIX C
CLINICAL CLOCK HOUR REQUIREMENTS FOR ASHA
CERTIFICATION
Taken from the Membership and Certification Handbook of the American-SpeechLanguage-Hearing Association-effective January 1, 2005.
Standard III-C: The applicant must demonstrate knowledge of the nature of speech,
language, hearing, and communication disorders and differences and swallowing
disorders, including the etiologies, characteristics, anatomical/physiological,
acoustic, psychological, developmental, and linguistic and cultural correlates.
Specific knowledge must be demonstrated in the following area:









Articulation
Fluency
Voice and resonance, including respiration and phonation
Receptive and expressive language (phonology, morphology, syntax
semantics, and pragmatics) in speaking listening, reading, writing, and
manual modalities.
Hearing, including the impact on speech and language
Swallowing (oral, pharyngeal, and related functions, including oral function
for feeding; orofacial myofunction)
Cognitive aspects of communication (attention, memory, sequencing,
problem-solving, executive functioning)
Social aspects of communication (including challenging behavior, ineffective
social skills, lack of communication opportunities)
Communication modalities ( including oral, manual, augmentative, and
alternative communication techniques and assistive technologies)
APPENDIX C
Standard IV-C: The applicant for certification in speech-language
pathology must complete a minimum of 400 clock hours of supervised
clinical experience in the practice of speech-language pathology.
Twenty-five hours must be spent in clinical observation, and 375 hours
must be spent in direct client/patient contact.
Standard IV-D: At least 325 of the 400 clock hours must be completed
while the applicant is engaged in graduate study in a program
accredited in speech-language pathology by the Council on Academic
Accreditation in Audiology and Speech-Language Pathology.
Standard IV-F: Supervised practicum must include experience with
client/patient populations across the life span and from
culturally/linguistically diverse backgrounds. Practicum must include
experience with client/patient populations with various types and
severities of communication and /or related disorders, differences, and
disabilities.
Implementation:
The applicant must demonstrate direct client/patient clinical experiences in both
diagnosis and treatment with both children and adults from the range of disorders and
differences named in Standard III-C.
APENDIX D
SECTION III. HEARING EVALUATION AND MONITORING FOR CLINIC CLIENTS
A.
Annual monitoring of hearing
Each client should have his/her hearing checked on an annual basis for monitoring
purposes. (Note: Due to ongoing hearing and/or middle ear problems, some clients may
require more frequent assessment). Upon assignment of clinic clients, each student
clinician should review the client’s audiological history and notify Dr. Lee, preferably in
writing, if his/her clients are due for a hearing evaluation. This should be done prior to
your first meeting with your client.
The student clinician is expected to do the following:
 Review client cases - especially the audiological history.
 Make a 15-minute consultation appointment to see Dr. Lee (arrange this at the front
desk or with Dr. Lee). Please see Dr. Lee if you want to make an appointment with
her during her office hours (Porter 108; phone 487-7120 ext 2653).
 At this meeting, bring the client’s current chart, and previous records that discuss
his/her audiological data or history in regards to hearing. At this meeting, two
additional meetings will be scheduled.
o A hearing evaluation appointment will be scheduled for the client.
o A 30-minutes “final-draft” appointment will be scheduled with the clinician
to review the final draft of the audiological report (1-2 weeks after the
hearing evaluation appointment)
 Inform client and/or parent/care provider of the test date and reason for the test.
 Accompany the client to the audiology appointment.
 Assist the audiologist in the assessment process. A student who has taken a course
in Audiology will be asked to administer the test (with supervision), screening
hours may be obtained if the student perform the test.
 Submit a draft of the audiological report (hard copy) within 48 hours in Dr. Lee’s
Clinic mailbox.
The audiologist will be responsible for the following:
 Determining the type and extent of testing necessary.
 Ensure all testing and report findings/recommendations were discussed with the
clinician, client and/or his/her family/care providers in writing and/or verbally.
 Posting written report in file and notes in log.
 Providing the student clinician with explanation or description of any audiological
related information pertinent to the client and his/her communicative needs.
B. Ongoing consultation
In the event that a client has a hearing loss, and/or ongoing middle ear problems, the
audiologist will provide ongoing consultation and/or frequency follow-up assessments
upon request. Please see the audiologist if your client has such needs and a plan for
involvement can be determined in conjunction with the assigned supervisor.
APENDIX D
SECTION IV. AUDIOLOGICAL REPORT
Purpose of the evaluation, audiometric findings, and recommendations should be
included in the report. The draft will be reviewed by the Dr. Lee, and returned to
clinician’s mailbox. During the final draft meeting, the clinician should see Dr. Lee with
current client’s file, and final draft (2nd draft) of the audiological report – in electronic
format.
Typically, reports are in the following format:
1. Background
a. Audiological history
b. any information in regards to hearing
c. purpose of assessment
2. Results
a. Otoscopy
b. Immittance
c. Pure-tone findings
d. Speech audiometry (if appropriate)
e. Aided findings (if appropriate)
3. Recommendations
The SOAP note should include all frequencies tested and dB levels of pass/fail in the “O”
statement. Rate the hearing loss or WNL in the “A” statement.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject:
Referral Procedures
Date: 09/12/00
Revised: 12-2-11
1.0
POLICY
Referrals will be accepted from all outside agencies and families. All clinic clients
who are in need of additional services will be referred to the appropriate agency
or individual.
2.0
PURPOSE
This policy will insure that referrals are accepted and that all clinic staff makes
referrals as appropriate.
3.0 RESPONSIBILITY
The Clinic office staff, Speech-Language Pathology staff and Audiologist.
4.0 PROCEDURES
4.1 Referrals from outside sources:
4.1.1 Referrals will be accepted from all outside agencies and families.
4.1.2. When the referral is from a family member or designated
representative of the family, the clinic intake from will be completed to provide
information for mailing the application materials.
4.1.3. When the referral is from an agency or individual involved with the
family, information regarding services offered by the Clinic will be provided. The
referral source will be instructed to have the family call the clinic to provide initial
intake information.
APPENDIX E
4.1.4. Office staff may answer any inquiries regarding office intake and
application procedures and fees. Other questions regarding professional
services, nature and treatment of various disorders or referrals to other
agencies/individuals will be referred to certified professional clinical staff.
4.1.5. See Office Procedures manual for intake procedures completed by
office staff.
4.2 Referrals to outside sources:
4.2.1 A list of school system special education directors and Intermediate
School Districts will be kept in the Clinic office for contacts to local public schools.
4.2.2 A list of physicians will be kept in the Clinic office for referral to
medical professionals.
4.2.3 A list of other speech-language pathologists, psychologists, physical
therapists, occupational therapists and other allied professionals will be
maintained in the Clinic Coordinator’s Office.
4.3 Referrals will be made when:
4.3.1 Client or family requests a referral for additional services.
4.3.2 Clinic staff wishes to refer a client or family for additional services.
4.3.3 Client or family requests speech, language or hearing services
elsewhere.
4.3.4 Clinic staff wishes to refer client or family for speech, language or
hearing services elsewhere.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject: Admission Criteria
Date: 09/12/99
1.0 POLICY
Uniform procedures will be used to determine who will be admitted for therapy
when an opening occurs in the caseload of the Speech and Hearing Clinic.
2.0 PURPOSE
The purpose of this policy is to notify all interested parties of the criteria used for
admission for speech, language and hearing therapy at the Speech and Hearing
Clinic.
3.0 RESPONSIBILITY
The Clinic Speech-Language Pathology and Audiology staff.
4.0 PROCEDURES
4.1 When an opening occurs in the caseload, clinic staff will review all files in
“Pending Enrollment”.
4.2 The current caseload will be analyzed to determine which types of disorders
and clients are needed to provide variety and diversity for students in clinical
practicum.
4.3 Clients who add to the variety and diversity of the caseload will be selected
from the Pending Enrollment group.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject: Subject: Continuation, Discharge and Follow-up
Date: 12/19/03
1.0 POLICY
Uniform procedures will be used to determine when clients should continue in treatment or be
discharged and what follow-up will be necessary.
2.0 PURPOSE
The purpose of this policy is to inform Clinic staff and student clinicians of the continuation and
discharge policies and procedures in use in the Speech and Hearing Clinic.
3.0 RESPONSIBILITY
The Clinic Speech-Language Pathology staff, Audiologist and the office staff.
4.0 PROCEDURES
4.1
At the end of each semester the progress of each client as reflected in the Treatment
Outcome will be reviewed to determine whether treatment should be continued or terminated.
4.2
If the client’s treatment is to continue beyond two calendar years, the clinician will
complete the “Continuation and Discharge Criteria for Speech, Language and Hearing Therapy
Clients” form. Treatment may continue if all the following conditions are met:
 Ongoing measurable progress in treatment continues to be significant.
 There is good to excellent prognosis for further improvement with continued treatment.
 The client is willing to continue in treatment.
APPENDIX E

The family, where applicable, is supportive of and invested in the therapeutic process.
4.3
If the client’s treatment is to be terminated the clinician will complete the “Continuation
and Discharge Criteria for Speech, Language and Hearing Therapy Clients” form. One of the
eight discharge options will be selected:
 The disorder is now within normal limits or consistent with premorbid status or client has
attained the desired level of enhanced communication skills.
 Long-term speech and language goals and objectives have been met.
 Skills no longer adversely affect the client’s educational, social, emotional, vocational
performance or health status.
 Unwilling to participate in treatment; treatment attendance has been inconsistent or poor
and efforts to address these factors have not been successful.
 The client has made minimal or no measurable progress over a period of two or more
semesters. During this time, program modifications and varied approaches have been
attempted unsuccessfully. A second opinion may be obtained. Prognosis is fair or lower.
Reevaluation should be considered at a later date to determine whether status has
changed or new treatment options have become available.
 Parent/guardian or age of majority client requests that speech-language service be
discontinued. And/or requests continuation of services with another provider.
 Unable to tolerate treatment due to a serious medical, psychological, or other condition.
 Demonstrates behavior that interferes with improvement or participation in treatment
(noncompliance, malingering, etc.), providing that efforts to address the interfering
behavior have been documented and unsuccessful.
4.4
Appropriate follow-up will be determined and documented on the “Continuation and
Discharge Criteria for Speech, Language and Hearing Therapy Clients” form.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Clinical Policy
Subject:
Emergency Plan
Date: 09/12/99
Revised: 12-2-11, 1-5-14
1.0
POLICY
All staff and students in the Speech and Hearing Clinic will know and will follow established
procedures in the event of environmental emergencies.
2.0
PURPOSE
This policy is established to provide clear guidelines for staff and students to follow in the event of
an environmental emergency.
3.0
RESPONSIBILITY
The Clinic Speech-Language Pathology staff, Audiologist, students and the office staff.
4.0 PROCEDURES IN THE EVENT OF A FIRE
4.1 In the event of a fire, pulling the nearest fire alarm switch will activate the fire alarm.
4.2 The office staff will call Campus Security at 911 to report the fire.
4.3 All individuals in the clinic will be directed to follow the exit signs to the nearest exit from the
Porter Building and across the street.
4.4 The audiology booth will be checked to insure that clients and staff in the booth are notified of
the alarm.
4.5 Campus security or the Fire Department will authorize reentry.
5.0 PROCEDURES IN THE EVENT OF A SEVERE WEATHER WARNING
5.1 Storm sirens will be activated when the National Weather Service issues a tornado or severe
storm warning for the Ann Arbor-Ypsilanti area.
5.2 All occupants in the Clinical Suites are to move to rooms on the West and North walls of the
Porter Building, rooms 135 C-2, 135 C-4, 135 C-6, 135 C-12, 135 C-15, 135 C-17, 135 C-18, 135
C-19, 135 F-11, 135 F-12.
5.3 Occupants will remain in these areas until the all clear signal is issued.
6.0 PROCEDURES IN THE EVENT OF A SNOW EMERGENCY
6.1 Sessions in the Speech & Hearing Clinic will not be held when Ypsilanti Community Schools
are closed for a weather emergency (snow or extreme cold temperatures). Clients are to check
online or on TV re: school closures, as no phone calls will be made to them.
6.2 Clinic staff will be expected at work.
6.3 All classes and Clinic meetings will be held as scheduled.
6.4 Classes will not be held and the Clinic office will be closed if the University Administration
closes the University.
7.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject: Medical Emergency Plan
1.0
Date: 09/12/99
Revised: 12/2/03
POLICY
All staff and students in the Speech and Hearing Clinic will know and will follow
established procedures in the event of a medical emergency.
2.0
PURPOSE
This policy is established to provide clear guidelines for staff and students to
follow in the event of a medical emergency.
3.0
RESPONSIBILITY
The Clinic Speech-Language Pathology staff, Audiologist, students and the office
staff.
4.0 PROCEDURES
4.1The clinical educator and student clinician will review each of their client files
to determine if there is a red medical alert sheet and to review and update, as
necessary, the appropriate procedure specified on the form in case of an
emergency.
4.2 All clinical educators will be apprised of the nature of the medical alert and
the procedures to be followed in the event of a medical emergency.
4.3 In the event of a medical emergency with a clinic client, the student clinician
is to notify the clinical educator immediately.
APPENDIX E
The clinical educator will determine whether emergency services should be
requested.
4.4 In the event of a medical emergency with a student clinician or clinic staff, a
clinical educator will be contacted to determine if emergency services should be
requested.
4.5 Emergency services will be contacted by calling 911 and providing the
following information:
4.5.1 the location of the emergency- The Clinical Suite on the first floor of
the Porter College of Education Building, Suite 135
4.5.2 the kind of assistance needed- police or ambulance
4.6 If emergency services are called, a clinic staff member will proceed to the first
floor entrance of the Porter Building to help direct emergency personnel to the
Clinic.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject: Supervision Plan for Student Clinicians
Date: January 6, 2000
Revised: 4-25-03, 12-17-04
4-17-08, 12-2-11
1.0 POLICY
The professional staff and faculty of the Speech and Hearing Clinic will provide
systematic and appropriate supervision to students engaged in clinical practicum.
2.0 PURPOSE
The purpose of this plan is to describe the quality, kind and amount of clinical
supervision that will be provided to student clinicians engaging in clinical practice in
the Speech and Hearing Clinic.
3.0 APPLICABILITY
This plan applies to all students enrolled in SPSI 528, 538 and any other students
completing clinical practicum experiences in the Speech and Hearing Clinic.
4.0 RESPONSIBILITY
Professional staff and faculty in the Speech and Hearing Clinic
5.0 PROCEDURES FOR STUDENT CLINICIANS ENROLLED IN SPSI 528 AND
SPSI 538
5.01 Students shall not assess or treat clients without having their lesson
plans approved by the appropriate Clinical Educator. If lesson plans are not
turned in when due or if they are unacceptable and they are not revised or the
student does not meet with the appropriate Clinical Educator at least one day
APPENDIX E
before the session, the session will be cancelled. The clinician is then
responsible to do an observation of any client and complete the observation
form.
5.02 Students will be required to see the appropriate Clinical Educator if there
are questions about a lesson plan prior to initiating a therapy session with the
plan.
5.03 Clinical Educators will provide students with written and oral feedback
regarding their observations of therapy sessions.
5.04 Clinical Educators will complete an Observation Checklist or the
Observation Notes when observing a session. The written feedback will be
submitted to the student clinician. After review of the written feedback the
student will respond to questions or comments in person or in writing and sign
and return the form to the Clinical Educator.
5.05 Students will write SOAP notes after each therapy session and submit
them to the appropriate Clinical Educator. Data sheets used to record client
performance on treatment goals will also be submitted. Any revisions
requested by the Clinical Educator are due back within 48 hours with all prior
drafts attached.
5.06 Students complete the Self-evaluation checklist and submit it to the
appropriate Clinical Educator each week in order to evaluate themselves
regarding their clinical practice. The self-evaluation is reviewed by the Clinical
Educator and returned to the student.
5.07 Treatment Plans describing client status and the goals established by the
student clinician will be submitted to the appropriate Clinical Educator at the
beginning of each semester by the due date listed in the syllabus. Plans will
be filed in the client’s file upon approval by the appropriate Clinical Educator.
5.08 Two formal evaluation conferences, one at mid-term and one at the
conclusion of the semester, will be held by each Clinical Educator with
students under her supervision. The Clinical Performance Scale will be
completed by the student as a self-evaluation and compared to the Scale
competed by the Clinical Educator. A grade will be assigned to provide
quantitative feedback to the student regarding her/his progress.
5.09 A Treatment Outcome describing client progress toward treatment goals
will be completed by students and submitted to the appropriate Clinical
Educator by the due date listed in the syllabus. Outcomes will be filed in the
client’s file upon approval by the appropriate Clinical Educator.
APPENDIX E
5.10 In the event of Clinical Educator absences for sick, annual, or
administrative leave, or other absences, there will be an ASHA certified
Clinical Educator in the Speech and Hearing Clinic when therapy is in session.
6.0 PROCEDURES FOR STUDENT CLINICIANS ENROLLED IN SPSI 568
6.1 Students will meet with the supervising faculty member or Clinical
Educator prior to the diagnostic session to present their file review, plan and
outline for the session.
6.2 Students will not begin a diagnostic session until the supervisor has
arrived.
6.3 Students will meet with the supervisor at the conclusion of the diagnostic
to discuss results and recommendations, and determine the content of the
conference with the family.
6.4 Only one diagnostic session will be assigned to each supervisor at one
time to allow for 100 percent observation. At a minimum, the supervisor will
observe at least 50 percent of the session.
6.5 At the conclusion of each diagnostic the supervisor will complete the
Diagnostic Evaluation Scale and will conduct a conference with the student to
provide feedback regarding the student’s performance.
6.6 The student submits a written report of the diagnostic to the supervisor
within 48 hours of the diagnostic.
6.7 Upon approval of the report the supervisor completes the section of the
Diagnostic Evaluation Scale pertaining to the report and discusses it with the
student.
6.8 The supervisor assists the student(s) in completing an ASHA clock hour
log for the diagnostic session and signs it.
6.9 The Diagnostic Evaluation Scale is submitted to the course instructor for
purposes of assigning a course grade at the end of the semester.
7.0 DATE TO BE REVIEWED
This plan will be reviewed annually by the clinical educators in the Speech and
Hearing Clinic.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject:
Confidentiality
Date: 3-26-07
Revised: 12-19-07, 4-17-08, 12-2-11
1.0 POLICY
All staff and students in the Speech & Hearing Clinic will know and follow established
procedures regarding confidentiality of clients and clinical records. These are stated
throughout the Clinician’s Handbook and in Appendix A in (ASHA Code of Ethics and
Confidentiality statement) and Appendix B (HIPAA Behavior).
2.0 PURPOSE
This policy is established to provide clear guidelines for staff and students to follow
regarding the protection of client’s privacy.
3.0 RESPONSIBILITY
The Clinic Speech-Language Pathology staff, Audiologist, students and office staff.
4.0 PROCEDURES
4.1. All SPSI 528 and 538 clinicians will sign a Confidentiality Agreement at the
first Clinic Orientation meeting after reading Appendix B. This signed Agreement will be
kept in each clinician’s file in the Speech & Hearing Clinic.
4.2. Files are maintained for each client and are confidential. All files are stored
in a locked filing cabinet in the Clinic office.
4.3. Only students officially assigned to a clinic client, i.e.: enrolled in SPSI 543Clinical Methods in Speech-Language Pathology; SPSI 568-Diagnostic Methods; and
APPENDIX E
SPSI 528 and 538-Clinical Practice in Speech-Language Pathology I and II may check
out files from the Clinic office.
4.4. To check out a file, fill in an orange checkout card, located in the wire basket
in the student work area, with the date, your name and client’s initials. Place the
checkout card in the pendaflex in place of the file.
4.5. All files are to be read in the student work areas within the clinic and
returned promptly. Do not leave a file unattended. All files must be returned to the
client’s pendaflex by 4:30 p.m. Monday through Thursday and by 4:00 p.m. on Fridays.
The orange checkout card must then be put back in the wire basket in the student work
area. Be certain to return the file to the appropriate pendaflex and maintain the
chronological order (File 1 in back, most recent in front).
4.6. No file or portion thereof may be removed from the Clinic except to discuss
the client with a faculty member in her/his office. You must receive one of the clinical
educators’ permission to do this.
4.7. You may never, under any circumstances, take a client file out of the
building.
4.8. You may never, under any circumstances, Xerox anything in your client’s
file. Any client document must be given to your supervisor to be shredded. Any client
document typed on the student work room computers must be deleted immediately.
Client documents on personal computers must be deleted after the final draft is printed.
4.9. If you receive a document from another setting (hospital, school system,
etc.) you must log and file it immediately.
4.10. You are to use only the client’s initials on SOAP notes; these will then be
filed with initials only.
4.11. Treatment Plan and Treatment Outcome report drafts are to be written with
client initials only and without the file number. The client’s full name and file number will
be added only when the report is approved by your supervisor to be printed on Student
Report paper.
4.12. All videotapes or DVDs of clients’ sessions are confidential and are the
property of EMU’s Speech & Hearing Clinic. They may not be viewed by anyone other
than the clinician and must be returned to the Clinical Educator within 48 hours.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject: CLINICAL READINESS TEST
Date: 12/02/04
Revised: 8/4/05, 11/7/05,9/5/06,
12/13/06, 4/17/08, 12-2-11
1.0 POLICY
Uniform procedures will be used to determine who will be allowed to register for SPSI
528 and SPSI 538.
2.0 PURPOSE
The purpose of this policy is to notify all interested parties of the prerequisites for SPSI 528Clinical Practicum I and SPSI 538-Clinical Practicum II.
3.0 RESPONSIBILITY
The Speech-Language Impaired Faculty advisors and Clinical Educators (CE).
4.0 PROCEDURES
4.1 When a graduate student is advised to register for SPSI 528 or 538, the advisor
will write the student’s name, ID # and telephone # on a list in the Speech & Hearing Clinic
coordinator’s office and give the student the Clinical Readiness Test (CRT) Study Guide.
4.2 The student must take and pass the CRT prior to the semester they plan to
register for clinic. Scheduled dates will be posted on the bulletin board outside the Clinical
Suite. The CRT is given on the 2nd Monday in February and March for the Spring/Summer
semester; June and July for the Fall semester; and in October and November for the Winter
semester.
4.3 The CRT can only be taken twice. If it is not passed, the student will not be given
permission to register for SPSI 528 or 538. A student is not guaranteed placement in 528 or
538 for the following semester. Thus, it is recommended that it be taken at the first
opportunity.
APPENDIX E
4.4 When the CRT is passed with a score of 85% or better, the appropriate Instructor
of Record will give written permission to register to the Department of Special Education
secretary to input. The student will be given a Clinical Practicum schedule to complete and
return to the clinic coordinator.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
EFFECTIVE IMMEDIATELY
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Protocol
Subject: Remediation Plan for Poor Clinical Performance
Date: 12/17/04
Revised: 12/19/07,
4/17/08, 12/5/11
1.0 POLICY
Uniform procedures will be followed to assist clinicians who are performing poorly in
SPSI 528 or 538 prior to midterm.
2.0 EXPECTED OUTCOME
Completion of a Remediation Plan will allow the clinician and Clinical Educator(s) to
identify problems and develop an Action Plan with dates of completion and expected
performance ratings to facilitate an improvement in clinical skills.
3.0 RESPONSIBILITY
The Clinic Speech-Language Pathology staff.
4.0 PROCEDURES
4.1 The clinician, the Clinical Educator(s), the faculty advisor, the Instructor of Record
and any other faculty member that the clinician chooses (the SLI Support Team) will
meet to complete a Remediation Plan containing identification of strengths and
weaknesses in clinical skills and an Action Plan with dates of completion and proposed
performance ratings.
4.2 The form will be copied and given to the clinician, the Instructor of Record and the
clinician’s faculty advisor. The Clinical Educator will retain the original.
APPENDIX E
4.3 The clinician will have responsibility in meeting with the Clinical Educator(s) on an
on-going basis throughout the semester to discuss progress toward or accomplishment
of each item on the plan of action as well as the performance rating(s) numerical values
assigned by the Clinical Educator(s).
4.4 The SLI Support Team may ask to meet with the clinician periodically to discuss the
remediation plan and the clinician’s progress on the plan of action.
4.5 Failure to maintain the Remediation Plan related to completion dates and
performance ratings could result in a failing grade in SPSI 528 or 538.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
REMEDIATION PLAN FOR POOR CLINICAL PERFORMANCE
DATE:
TO: ______
, CCC-SLP, Instructor of Record and Dr. _________________________, Advisor
FROM: ___________________________________________ , SPSI 528/538 Clinician
Clinician Strengths:
Clinician Weaknesses:
Plan of Action/Person Responsible/Due Date/Proposed Performance Rating
________________________________
Clinician
___________
Date
Completion Date/Actual Performance Rating
__________________________________
Clinical Educator
________
Date
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Protocol
Subject: Notification of Failure at Midterm
Date: 12/06/04
Revised: 8/04/05,
12/19/07, 4/17/08,
12/8/11
1.0 POLICY
Uniform procedures will be followed to assist clinicians in SPSI 528 or 538 who
have received a failing grade at midterm.
2.0 EXPECTED OUTCOMES
Notification will allow the clinician to collaborate with the Clinical Educator, the
Instructor of Record and the academic advisor in identification of strengths and
weaknesses, as well as, to develop an action plan with proposed performance
ratings and dates of completion.
3.0 RESPONSIBILITY
The Clinic Speech-Language Pathology staff.
4.0 PROCEDURES
4.1 If the Treatment Plan has not been approved, signed and filed by the date
listed in the syllabus, or if the clinician displays performance-based concerns the
Notification of Failure at Midterm form will be completed by the clinician and the
appropriate Clinical Educator(s).
4.2 The clinician and Clinical Educator(s) will collaborate in identifying strengths
and weaknesses and developing a plan of action which the clinician will follow.
APPENDIX E
Each item on the plan of action will be given a proposed performance rating
based on the Clinical Performance Scale and a date for completion.
4.3 The form will be copied and given to the clinician, the Instructor of Record
and the clinician’s faculty advisor. The Clinical Educator will retain the original.
4.4 The clinician will have responsibility in meeting with the Clinical Educator(s)
on an on-going basis throughout the semester to discuss progress toward or
accomplishment of each item on the plan of action as well as the performance
rating(s) numerical values assigned by the Clinical Educator(s).
4.5 The clinician, if willing, may also be referred to the SLI Support Team which
will include the Clinical Educator, the faculty advisor, the Instructor of Record and
the clinician.
4.6 Failure to maintain the Remediation Plan related to completion dates and
performance ratings could result in a failing grade in SPSI 528 or 538.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
Notification of Failure at Midterm
DATE:
TO: ___
, CCC-SLP, Instructor of Record and Dr. _________________________, Advisor
RE: __________________________ Midterm grade in SPSI 528/538
A midterm grade of _____ was assigned.
Clinician Strengths:
Clinician Weaknesses:
Plan of Action/Person Responsible/Due Date/Proposed Performance Rating
_________________________________
__________________________________ _________
Completion Date/Actual Performance Rating
APPENDIX E
Clinician
Clinical Educator
Date
Referral to Support Team □ Accepted □ Denied
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject: Withdrawal Policy
Date: 10/09/08
1.0 POLICY
All professional staff and student clinicians in the Speech & Hearing Clinic
will know and follow uniform procedures regarding withdrawal from Clinical
Practicum, SPSI 528 or SPSI 538. Withdrawal from clinical practicum due to
poor performance will trigger a review by the SLI faculty. A student enrolled in
SPSI 528 or 538 may withdraw only once from any and all Clinical Practica
courses due to poor performance.
2.0 PURPOSE
This policy is established to provide clear guidelines to enable professional
staff and student clinicians to uphold:
The Speech & Hearing Clinic Mission Statementto provide quality services to clients from the University and community
with a caring and considerate attitude to foster a sense of worth in clients and
families, ethical and open communication with clients, families, the community
and each other, with respect for the dignity of the individual.
The SLI Program Mission StatementTo provide a full complement of exceptional clinical and academic
experiences for students.
-These experiences prepare students to provide clinical services that
improve the life quality of those with communication disorders and those with
whom they interact in a diverse and democratic society.
APPENDIX E
and the ASHA Code of EthicsPrinciple I-Individuals shall honor their responsibility to hold paramount the
welfare of persons they serve professionally or participants in research and
scholarly activities and shall treat animals involved in research in a humane
manner.
This policy is established to provide a structured, individualized experience with
intensive instructional and supervisory input, for student clinicians who are
experiencing difficulty acquiring and/or demonstrating satisfactory clinical skills.
3.0 RESPONSIBILITY
The Speech-Language Pathology Clinical Educators and Faculty
4.0 PROCEDURES
1. When a student withdraws from SPSI 528 or 538 for the first time, s/he
will be asked to sign a form indicating that s/he is aware of this policy.
2. The original copy of this form will be retained by the Clinical Educator.
A copy will be placed in the student’s file. If the student desires to re-enroll in
clinical practicum, the student must request a faculty review, in writing to her/his
advisor, during the semester s/he has withdrawn.
3. Discussion will take place by all Faculty and Clinical Educators
regarding the student’s academic performance to date and the strengths and
weaknesses noted in Clinical practicum.
After the faculty review, a meeting with the student, her/his academic
advisor, the Instructor of Record and the Clinical Educator(s) will be required.
4. At this meeting, the student and faculty will write a Remediation Plan
with Strengths, Weaknesses and Plan of Action including Due Dates and
Proposed Performance Rating Scores, using the scoring on the Clinical
Performance Scale. The student’s self-evaluation using the Generic Abilities
Assessment will be reviewed along with the faculty’s assessment.
5. The student will be responsible for scheduling and meeting weekly with
the Clinical Educator and/or other faculty member to review the Plan of Action
APPENDIX E
6. The Clinical Educator and/or faculty member will assess the items on
the Plan of Action and schedule a follow-up meeting with the student, her/his
academic advisor and the Instructor of Record.
7. If the student does not achieve the proposed performance rating
scores assigned on the Remediation Plan, s/he will be counseled by the Clinical
Educator and/or faculty advisor regarding the most appropriate educational plan.
No student who has failed to successfully complete an agreed upon Remediation
Plan will be allowed to continue with their graduate education in the SpeechLanguage Pathology program.
8. Following successful completion of the Remediation Plan, the student
must enroll and successfully complete her/his clinical practicum prior to enrolling
in further academic coursework.
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by the SLI Faculty.
APPENDIX E
EASTERN MICHIGAN UNIVERSITY
Speech and Hearing Clinic
Suite 135, Porter Building
Ypsilanti, MI 48197
(734) 487-4410
Clinical Policy
Subject:
Clinic Materials
Date: April 10, 2012
1.0 POLICY
Uniform procedures will be followed to ensure that materials signed out of the Speech &
Hearing Clinic Materials Room by students, faculty or staff are returned and in good
condition, i.e.: with all parts intact and not torn or written on.
2.0 PURPOSE
The purpose of this policy is to inform clinical staff, faculty and students of the
procedures to be followed prior to signing out materials and the consequences if
materials are not returned in good condition.
3.0 RESPONSIBILITY
The Speech and Hearing Clinic Clinical Educators, clerical staff, Audiologist, and the
SLI faculty members.
4.0 PROCEDURES
1. Faculty members are responsible for reviewing the checkout procedure, on page 19
of the online Clinician’s Handbook, with their students prior to the students checking out
the material. The office staff is not responsible for explaining procedures to students.
2. Before students sign out materials, they must sign and date the attached form
accepting liability and return it to their instructor prior to requesting materials. The
faculty member will bring the completed forms to the clinic secretary to be filed in the
materials room.
APPENDIX E
3. If a SLI faculty member requires students to check out materials for a course,
the faculty member must send a class list with student names / E #s and
Faculty name Course #/Name Semester/Year at the top
to the clinic secretary (globbesta@emich.edu) at least one week prior to the
assignment date.
4. The clinic secretary will give the class list to the Materials Librarian. The materials
will be placed on the shelves on the right wall of the materials room.
5. If a SLI faculty member wishes to request material(s) for use in the classroom, he or
she must email the clinic secretary with a list of titles and the date(s) needed at least
one week prior to the date needed and return the attached, signed form. The secretary
will forward the list to the Materials Librarian who will then place the materials on the
shelves on the right wall of the materials room.
6. When the student or faculty member receives the material, they are responsible for
checking them to be certain that all the parts are intact and not damaged or torn. If
there is something missing or damaged, the materials librarian or a clinical educator
must be notified immediately, to note or repair damage and/or to replace the missing
item.
7. If the material(s) signed out to a student are not returned or are returned with a part
or parts missing or are returned damaged, the student will receive a grade of
Incomplete (I) in the applicable course until the material is replaced.
8. If the material(s) signed out to a faculty member are not returned or are
returned with a part or parts missing or are returned damaged, the faculty
member will replace the material(s).
5.0 DATE TO BE REVIEWED
This policy will be reviewed annually by all Clinic Staff.
APPENDIX E
Speech and Hearing Clinic
Eastern Michigan University
STUDENT FORM FOR CLINIC MATERIALS
I,
agree to return materials that have been
(print name)
signed out to me when they are due and to return them in good condition; i.e.: with all
parts intact and not torn, written on or otherwise damaged.
If I do not return them in good condition, I will receive an incomplete (I) in the applicable
course until the material is replaced.
Signature
Date
E#
--------------------------------------------------------------------------------------------------------------------Speech and Hearing Clinic
Eastern Michigan University
STUDENT FORM FOR CLINIC MATERIALS
I,
agree to return materials that have been
(print name)
signed out to me when they are due and to return them in good condition; i.e.: with all
parts intact and not torn, written on or otherwise damaged.
If I do not return them in good condition, I will receive an incomplete (I) in the applicable
course until the material is replaced.
Signature
Date
________________
APPENDIX E
E#
Speech and Hearing Clinic
Eastern Michigan University
FACULTY FORM FOR CLINIC MATERIALS
I agree to return materials that have been signed out to me when they are due and to
return them in good condition, i.e.: with all parts intact and not torn or written on or
otherwise damaged.
If I do not return them or do not return them in good condition, I will pay to replace them.
_______
Faculty Signature
Date
APPENDIX F
CLIENT STATUS REVIEW and PLAN OF ASSESSMENT
Prior Semester
Assessments
Life Participation
Receptive Language
auditory comp
reading comp
Results of Treatment
Recommendations of
prior Semester
Plan of Assessment
APPENDIX F
Expressive Language
verbal
written
gestures
Motor Speech/Oral
Mechanism
Articulation/Phonology
APPENDIX F
Voice/Fluency
Hearing
Behavior
Cognition (If
applicable)
APPENDIX G
SOAP NOTE CHECKLIST
General Guidelines
Throughout the entire SOAP note:
 Complete sentences are not necessary
 Use abbrev as much as possible
 “Short and Sweet” is the key for the note
 Can use charts especially for articulation results
 Don’t be hesitant to look back at other notes for examples
 Don’t worry if you get notes back to revise. Writing these notes is an art that has
to be learned via trial and error.
 No bold face should be used on the note
 Tests are initially spelled out for the first reference but initials are used thereafter
for every soap note of the semester.
 Your performance charting reminders are necessary for interpreting your results
for the soap notes if standard scores, developmental norms, or criterion references
are not available.
 Don’t have to mention the clients name throughout the note. That information is a
given since the note is about their performance only.
 Bullet points are an effective way to record results and it makes the information
easier to scan to find specific info.
S=Subjective
 Short and sweet.
 Information you need to include-client feels, late or on time-if late how many
minutes
 This section includes any information that you obtained via mom or other
professionals working with your client. Can directly quote parents if needed. This
is the information that you obtain outside the therapy room. Includes information
also obtained on the phone.
 NO COMPLETE SENTENCES NEEDED!!
O=Objective
 This is for data (numbers) only.
 No interpretation of data is included in this section.
 This is the information that can be collected as an observer, meaning it is about
gathering the data.
 This section includes the scores of the test (standard, criterion, developmental) of
the tests and the mean ranges. Please include the mean ranges as follows:
 (Mean (M)=100, Standard Deviation (SD) +/-15)
APPENDIX G
 Then after you have written out the words the first time you can report it
this way: M=100, SD +/-100 for the reminder of the soaps for the
semester.
 Initially write out the standard score this way: Standard Score (SS) = 85
(whatever you child’s SS is). Then you can use SS throughout all soaps for
the semester.

NO COMPLETE SENTENCES NEEDED
A=Assessment
 This part of the note is analyzing the data/numbers from the O section.
 This is the part that we get paid for.
 Many times other professionals will only read this section of the note.
 This gives information based on what all the numbers mean/how do you
interpret your results.
 Includes severity ranges including WNL, mild, moderate and severe (these
descriptions can pertain to standard scores or informal assessment
percentages).
 Some tests include their own descriptive words ie., CAAP, TACL, Bracken
based on the SS. Need to check and see if your test has its own Descriptive
Words.
 If a test doesn’t have its own descriptive words use the descriptive words from
the CELF-4 which is included in this handout.
 Deviations from the mean are used in this section in addition to the descriptive
words. Example of how to write a summary statement.
 (Given SS) (Receptive, Expressive, Semantic etc) skills were within
one standard deviation below the mean indicating “borderline” skills.
 (without SS) Three to four year old receptive skills were WNL
 NO COMPLETE SENTENCES NEEDED
P=Plan
 Briefly list what you will be doing the next session. This should reflect changes
based on today’s S, O and A information.
 NO COMPLETE SENTNECES NEEDED
APPENDIX G
GUIDELINES FOR DESCRIBING THE SEVERITY OF DISORDERS
Taken from the Clinical Evaluation of Language Fundamentals-4 (CELF-4)
(Semel, Wiig, Secord 2003)
___________________________________________________________________
Core Language Score
and Index Scores
Classification
Relationship to Mean
115 and above
Above average
+ 1 SD and above
86 to 114
Average
Within + or -1 SD
78 to 85
Marginal/Borderline/Mild
Within -1 to -1.5 SD
71 to 77
Low range/Moderate
Within -1.5 to -2 SD
70 and below
Very low range/Severe
-2 SD and below
GUIDELINES FOR REPORTING ASHA QCL SCALE
O: Administered the “Quality of Communication Life Scale” (ASHA, 2004). Provided
assistance with ________________________ (or completed I ); completed in ____
minutes; mood today __________. Shown scale 1=low/no, 5=high/yes-overall mean
score-____, rated general quality of life ____. (Then list items from scale that received a
score of 3 or lower.)
A: WFL/Mild/Moderate/Severe impairment in quality of communication life skills.
(Based on % calculated re: overall score- i.e. mean score divided by 5).
APPENDIX G
GUIDELINES FOR REPORTING ASSESSMENT FOR LIVING WITH
APHASIA (ALA)
O: Began (or Administered –if completed in one session) Assessment for Living with
Aphasia (ALA). Chose responses shown a Rating Scale Card of 0 –“most negative
response ” to 4 – “most positive response” with .5 divisions.
Aphasia Domain
#/20 points
Talking
Understanding
Reading
Writing
Communication
# - average score
#
#
#
#
#
Participation Domain #/68 pts
#
# of places in a week - #
# of days in a week- #
# of people talk to- #
Environment Domain #/16 pts
#
# of strategies used- #
“
“ used by ___- #
Personal Domain
Wall Question
TOTAL
#/44 pt
#/4 pts
#
#
#/152
#
A: Perceived aphasia as ____________; talking most impaired, etc.
Participation in daily life was___________impacted by aphasia.
Perceived physical, social and attitudinal environment as mildly
impacting life with
aphasia.
Perceived autonomy, self-esteem and confidence as _____________ impacted by
aphasia.
Perceived _____________ disruption of life due to aphasia.
Overall impact of aphasia on life was ________.
APPENDIX G
DIAGNOSTIC SOAP NOTE
SAMPLE
S: POSSIBLE STATMENTS







Arrived on time and willingly went into the Tx room.
Cooperative and focused
Mom reported S.S. did not sleep well secondary to cold
Cancelled due to illness, family emergency, weather etc
20 minutes late
Mtg with classroom teacher scheduled for 1/23/12 at 2:00 at Bryant Elementary
Interviews that you conduct with the family or client are reported in the O
section of the SOAP. Direct quotes from the conversation with parents(s),
physicians(s), other SLP, OT, PT, Nursing, etc. can be included.
NOTICE
1.)
2.)
3.)
4.)
Client name not mentioned because this information is implied.
Specific information was given about the date and time of the school meeting.
Short phrases were used, omitting the “little words” (the, he, she etc.)
Past tense used in S, O and A
O: POSSIBLE STATEMENTS FOR FORMAL EVALUATION DOCUMENTATION

(Began, Continued or Completed) the Test of Language Development-I-3
(TOLD-I-3). Results of the subtests are as follows (Mean (M)=10, Standard
Deviation (SD)+/-3):
Sentence Combining (evaluates----------------------)-SS 6 =>1SD below M
Picture Vocabulary=(measures_____________)-SS 11 <1SD above the M
NOTICE
1.) The statement needs to begin with one of the words in parenthesis. This states the
progression of the test administration when given across more than one session.
2.) The test name was written out in its entirety since it was the first time the
assessment was documented. From that point on, the test abbreviation can be
used. This also applies to abbreviations for Standard Score and Mean. Be sure to
check the test manual for means and standard deviations for that particular test.
3.) The relationship to the M is stated with the SS and is part of the O section of the
SOAP.
4.) You may also want to include a brief description in parentheses as to what that
subtest evaluates in lay terms. You can refer to the test manual for this
information. This information can then be used in the Treatment Plan.
APPENDIX G
POSSIBLE STATEMENTS FOR INFORMAL EVALUATION
DOCUMENTATION
 Correctly read Dolch sight words at 1st, 2nd, and 3rd grade level 122/127 (96%)
o Level 1-39/40 (98%)
o Level 2-45/46 (98%)
o Level 3-38/41 (93%)

Informally assessed receptive language via guidelines from Shipley and McAfee
(2009):
o Pointed to objects 4 array when given function (cup, ball, brush, fork,
toothbrush, blocks, book, bowl ) 10/10
o Pointed to 7/13 (64%) colors when named (red, blue, green, not yellow or
black).
NOTICE
1.) When accuracy/trial percentage numbers are obvious (10/10) versus (7/13) the
percentage does not have to be documented on the SOAP.
2.) The source of the developmental guidelines is included. Be careful -some of
the sources in Shipley and McAfee are not from their research. Check the
author of the developmental sources carefully.
A: FORMAL EVALUATION DOCUMENTATION
The severity description in this section may be found in the test manual. If the manual has
descriptive words then you need to use those in your assessment section of the SOAP. If
the manual does not include descriptive words then you must use the CELF-4 descriptive
words outlined in your clinic handbook appendix.



Sentence Combining=below average
Picture Vocabulary=average
OR
Below Average
o Sentence Combining
o Malopropisms
Average
o Picture Vocabulary
o Word Ordering
o Grammatic Comprehension
INFORMAL EVALUATION DOCUMENTATION
(Use the Charting Reminder card for the informal section)
 Dolch Words at Levels 1-3;WNL
 Pointed to objects in 4 array when given function; WNL for 3-4 year old skill
 Identification of colors; moderate impairment; below 3-4 year old expectations
APPENDIX G
P:PLAN—What will you do in the next session based on what you saw in this session?
Brief statements i.e., Continue informal assessment of 4-5 y.o. receptive and expressive
language skills including 2-3 part commands, color recognition.
APPENDIX G
TREATMENT SOAP NOTE
SAMPLE
SOAP Note
Client: (Use initials)
Clinician:
Clinical Educator:
Date:
S: Arrived on time, brought his sight word flipbook from prior semester. Mother stated (initials)
is working on 2nd grade level books at school. Motivated and cooperative.
Notice:
1.) See information in Diagnostic SOAP sample.
O: Correctly produced initial (or I) /s/ monosyllabic word when shown a picture 8/13 (61%)
with no cue (obj: 70% with no cue).
Correctly highlighted characters and setting given a 50-75 word 2nd grade passage as
read aloud a story 30/31 (97%) with min verbal cuing (obj. 90% no cue).
(initials)
Note: If homework assigned for the 1st time, explain task(s).
Example:
Sent book home for practice after review with mother in session. Requested that she
1.) Listen to each production and mark √ =accurate or x=/th/ substitution.
2.) Not give verbal or nonverbal feedback re: accuracy
When homework assignment returned explain task(s) and the client’s
performance/accuracy.
Example:
Homework assignment returned-named I /s/ pictures @ home 4x since last session. Mother
reported accuracies of 6/10, 7/10, 8/10 and 8/10.
Notice;
1.) The statement in the O simply consists of your objective re-stated without the rationale.
2.) Remember to put the intended accuracy target in ( ), include cues, models, as appropriate.
3.) If there was not a specific accuracy and cue level targeted then simply say (no obj).
APPENDIX G
A: /s/ obj not met; mod imp; 10% decrease with increased cuing compared to last week.
Highlighting characters and setting obj not met due to cueing; mild imp; increased 10% from last
week.
Notice:
1.) The 3 components of a treatment A include (in this order):
-objective met/not met/surpassed;
-rating performance, i.e. mild, moderate, severe (remember informal evaluation and
treatment objectives use the rating ranges on the Charting Reminders). Be sure to weigh
amount of cueing needed with % accuracy achieved to choose the correct rating word.
-comparing performance to the last session or the last week’s performance; If this is the
first time you targeted this goal at the objective level state new objective.
2.) The A section of performance should follow the order of the objectives in the O
P: Continue /s/ monosyllabic words when shown a picture; increase verbal placement cues. Add
homework practice of tongue placement. Highlight characters and setting given a 75-100 word
passage at the 2nd grade level while following the text as the clinician reads.
Notice:
1.) This should be the planning of your next lesson. This is the most important part. If you
really think carefully regarding this section of the SOAP note your lesson plan for the next week
should be easy to write. Many times especially at the beginning of the semester this section is not
given the proper time and consideration. If the content in this section is analyzed and considered
then your lesson plan becomes easier.
When you begin re-evaluation sessions:
1st SOAP
“O” -Began re-evaluation.
(goal-
2nd SOAP
Continued…
3rd SOAP
Completed...
“
“
“
“
) vs. (obj) after tasks
“A” - report goal met/not met/surpassed
“P” -Cont. re-eval
Complete re-eval
Conduct Fam Conf.
APPENDIX H
Baseline
Semester Goal
or average of
Prior Sessions
Objective
Procedures for task and cueing
ATTACH THE FOLLOWING TO YOUR LESSON PLAN
1. DATA SHEET and STIMULI LIST
2. PRINTED KEY WORDS IF APPLICABLE
3. HOMEWORK & DATA SHEET IF APPLICABLE
Materials
Time #
of
Trials
Home
Work
APPENDIX H
GROUP LESSON PLAN
OBJECTIVE
To improve life
participation,
MODALITIES
A=auditory comp
R=reading comp
V=verbal
CB
W=writing
D=drawing
G=gesture
P=pt. to word
*=yes/no
PROCEDURES/ACTIVITIES/MATERIALS
ATTACH THE FOLLOWING TO YOUR LESSON PLAN
1. DATA SHEET
2. PRINTED KEY WORDS IF APPLICABLE
3. HOMEWORK & DATA SHEET IF APPICABLE
APPENDIX I
Self-Evaluation
The idea of a self-evaluation is for the clinician to examine himself/herself and his/her
role in the therapeutic process. It is NOT intended as a report on client progress. A good
introspective look at yourself and your place in the field of Speech - Language Pathology
is probably one of the most important assignments you will ever complete.
When you evaluate your clinical knowledge and skills, be certain to spend at least as
much time evaluating strengths as weaknesses. If you achieve success in a specific area,
your discussion should NOT deal with why it worked for this client, but rather how this
technique/procedure might be adapted to all therapeutic situations. Successes need to be
analyzed to help you generalize these strengths to the therapeutic process in its entirety.
The self-evaluation should always be written before you begin your next set of lesson
plans. The lesson plans should then reflect your new awareness.
APPENDIX I
The ability to evaluate your own clinical skills is a significant component in the development of your clinical
competence. In order for you to function independently you must be able to assess your own performance. On the
continuum of supervision, self supervision can be regarded as a final stage. Use the following form to assist you in the
self evaluation process. Do a self evaluation form weekly and always write a narrative on the reverse of the form. When
you are required to write self evaluations it helps you to clearly evaluate your therapy sessions. When you become
more astute with the self evaluation process your supervisor may permit you to use just the check list.
CLINICAN SELF EVALUATION CHECK SHEET
Clinician_________________________________
Client____________________________________
1. UNSATISFACTORY
2. WEAKNESS
3. SATISFACTORY
4. STRENGTH
5. COMPETENCE
Date___________________________
Supervisor_______________________
Needs direction in most areas and demonstrates inappropriate behaviors
Needs specific direction and demonstrated difficulty noted
Adequate skills; continued skill development needed
Above average skills demonstrated
Little or no improvement needed as demonstrated this semester
NOTE: SPSI 528 STUDENTS ARE RATED 1 THROUGH 4, SPSI 538 STUDENTS ARE RATED 1 THROUGH 5
1.
Did I effectively explain the objective of the task to my client?
5 4 3 2 1
2.
Did I clearly explain the desired response to my client?
5 4 3 2 1
3.
Did I give my client sufficient time to respond?
5 4 3 2 1
4.
Did I provide a model for the target behavior when necessary?
5 4 3 2 1
5.
Did I cue when appropriate?
5 4 3 2 1
6.
Did I accurately discriminate my client’s errors from the target behavior?
5 4 3 2 1
7.
Did I appropriately reinforce correct responses?
5 4 3 2 1
8.
Was my feedback consistent, concrete and concise?
5 4 3 2 1
9.
Did I encourage my client to self evaluate?
5 4 3 2 1
10. Did I get maximum responses from my client?
5 4 3 2 1
11. Were my materials and/or activities effective in eliciting the responses I wanted?
5 4 3 2 1
12. Was I able to maintain appropriate pace towards the completion of the session’s objectives?
5 4 3 2 1
13. Was I able to record data during the session?
5 4 3 2 1
14. Was my transition from activity to activity smooth?
5 4 3 2 1
15. Was the therapy room arranged in such a way to facilitate optimal therapy, (attention,
cooperation, and responding)?
16.
5 4 3 2 1
Was the therapy room arranged in such a way to facilitate optimal observation by Supervisor,
family members or others?
5 4 3 2 1
17. Did I use strategies for maintaining on task behavior (including controlling distracting stimuli)? 5 4 3 2 1
18. Did I convey and maintain limits when dealing with inappropriate behavior?
5 4 3 2 1
19. Was I able to be flexible and change planned procedures to meet my client’s needs?
5 4 3 2 1
20. Did I provide feedback to the client and/or family concerning the results of the session?
5 4 3 2 1
Clinician Self‐Reflection Client: Dates: Clinician: 1. What surprised you? 2. What was successful? 3. What was disappointing? 4. What was your role in any or all of the above? 5. What will you change? APPENDIX I Appendix J
CALIPSO Clinical Performance Scale Review
Review the specific items printed on the CALIPSO Clinical Performance Scale to assign yourself an
average score in each area that best describes your current performance. Then write a narrative about
your current strengths and weaknesses. You may refer to specific items from the CPS.
Complete every other week, beginning the 2nd week of clinic, instead of the Clinician Self Evaluation
Check Sheet.
Clinician___________________ Clinical Educator___________________ Date_______
5 Exceeds Performance Expectations. Adequately and effectively implements the clinical
skill/behavior. Demonstrates independent and creative problem solving.
4 Meets Performance Expectations. Displays minor technical problems which do not hinder
the therapeutic process. Minimum amount of direction from supervisor needed to perform
effectively.
3 Moderately Acceptable Performance. Inconsistently demonstrates clinical behavior/skill.
Exhibits awareness of the need to monitor and adjust and make changes. Modifications are
generally effective. Moderate amount of direction from supervisor needed to perform
effectively.
2 Needs Improvement in Performance. The clinical skill/behavior is beginning to emerge.
Efforts to modify may result in varying degrees of success. Maximum amount of direction
from supervisor needed to perform effectively.
1 Unacceptable performance. Specific direction from supervisor does not alter
unsatisfactory performance.
EVALUATION SKILLS_______
TREATMENT SKILLS________
PREPAREDNESS, INTERACTION AND PERSONAL QUALITIES________
APPENDIX K
SELF-EVALUATION OF VIDEOTAPED SESSION
__________________
Clinician
__________________
Client
________________
Supervisor
___________
Date
Please watch this tape, evaluate yourself and stop the tape at the end of the
session. (DO NOT rewind, so it can be easily taped on again). Then return to your
supervisor. This will take the place of your self evaluation this week.
As you review the video of your session, write about the following:
1. Describe the organization of your session-activities, materials, the room set-up
2. Describe the instructions you give before you being to work on each objective.
Does your client understand the instructions? How do you know? Do you give the
client enough time/too much time to respond?
3. Describe how you adapt your communication style to the client.
4. Describe how you maintain on-task behavior. Are your activities and material
motivating? Functional?
5. Is time used efficiently? How many responses does the client make during each
task?
6. Are the tasks appropriate for the client’s skill level? Describe teaching techniques
you’re using. Describe modeling and/or cueing.
7. ReinforcementAre the reinforcers motivating the client?
When and how are you reinforcing target behavior?
What is the frequency and do you modify it as necessary?
What do you do when the client is not successful or what do you do when the
client makes and error?
8. FeedbackWhen and how are you giving feedback? How does your client respond to your
feedback? Do you give a brief summery of performance after each activity? At
the end of the session?
9. After watching the video: What are your strengths/weaknesses? What skills do
you need to improve? How will you improve them?
APPENDIX L
Observation of Clinical Session
Name______________________________ Date________________
Client Name_______________________
Disorder____________
Clinician Name___________________ Number of times you have observed this client___________
1. What were the objectives of this session?
2.
How did the clinician explain the tasks? How was it effective? or ineffective?
3. What materials did the clinician employ? Did they stimulate responses and maintain
interest?
4. What methods, techniques, procedures did the clinician employ?
5. Does the clinician model/cue appropriately? Describe.
6. How many responses were elicited? Was this # sufficient? Why?
7. How does the clinician reinforce and give feedback?
8. How do you evaluate what the clinician did? Were the objectives accomplished?
9. What did you learn from observing this session?
APPENDIX M
Group Observation Form
Please use another piece of paper to give yourself enough room to respond to each item.
Facilitator_______________________________
Date_____________
1. Describe how the clinician adapts her communication style to the client(s).
2. Are the tasks appropriate for the clients’ skill levels?
Describe teaching techniques used.
Describe modeling and/or cueing.
3. When and how is feedback given?
How do the clients respond to feedback?
4. What does the clinician do verbally and nonverbally to ensure that all group members are
engaged?
5. How can you increase or decrease the level of the information that’s provided?
6. How can you apply what you observed today?
EASTERN MICHIGAN UNIVERSITY
Department of Special Education
Speech and Hearing Clinic
APPENDIX N
TREATMENT PLAN
Client:
File #:
Age: (year; months)
Gender:
ICD-10-CM: diagnosis #/term
Date of Report: (1st complete draft due date)
Clinician: ,B.S. or B.A. (as applicable)
Clinical Educator:
(Example words/statements are given in italics.)
Statement of Problem (includes diagnosis and severity level if applicable)
Begin this paragraph with: “client name, a ___year, ___month old male/female, is
being seen at the Eastern Michigan University Speech and Hearing Clinic for his/her # semester
of therapy”. Use the diagnosis stated in the IMPRESSION section of the prior TP (discuss with
supervisor). Include educational setting, IEP category and current services, if applicable. Include
information re: family, where the client resides, prior treatment and medical history, work
history, if applicable.
PRESENT LEVEL OF PERFORMANCE (present tense)
Receptive Language (present tense)
Begin this section with: Informal/formal assessment completed on date/s using the
name of test-write/underline complete name then give abbreviation in ( ), or assessment scale
or procedure-write author name and date of publication in( ) ), reveals that client’s name
receptive language abilities (or specific skill assessed) are developing at age level or use severity
rating words. If standard or scaled scores (SS) from standardized tests are presented, be sure to
state the mean score and standard deviation for the test, then interpret the score based on the
standard deviation from the mean score. Include specific examples of form, content, use you
have formally or informally documented.
For school-age children or adults-1st ¶ -Auditory comprehension
2nd ¶ -Reading comprehension. Rate overall performance in 1st sentence of ¶ . Then report
performance on individual tasks from WFL to severe or severe to WFL.
Expressive Language
See above.
A 50 to 100 utterance language sample should be used in addition to any formal or
informal assessment you complete. When reporting results of a language sample present the
following information (for children):
1. number of utterances in the sample
2. Mean Length of Utterance
3. TTR
4. description of semantics
5. description of grammar- morphemes and syntax
6. pragmatics-conversation initiation/maintenance,
turn-taking, etc.
For school age children or adults-1st ¶ -report in same order as Receptive Lang. section.
Rate overall impairment.
Describe spontaneous speech, conversation baseline
Naming, Repetition, Oral reading
2nd ¶ -Writing-hand preference,
mechanics, signature, words, sentences, functional material
Cognition-if applicable
Articulation/Phonology
You may begin this section with: Based on informal/formal assessment using the name
of test or assessment scale or procedure, client’s name articulation abilities are developing at
age level or use SS and rating words, for adults-describe abilities. Include a thorough analysis
of articulation errors (substitutions, omissions, distortions) or phonological rules you have
observed. Present in chart form. Include information, if applicable about speech rate and/or
intelligibility in single words versus connected speech.
For adults-include verbal praxis, intelligibility.
Oral Mechanism Examination/Observations
At a minimum descriptions of the following should be included in this section:
1. facial symmetry at rest
2. oral structure on visual examination (mandible, teeth, lips, tongue, hard palate, soft
palate/ velum)
3. oral function/movement (mandible, lips, tongue, soft palate/ velum)-include oral
apraxia, as necessary
4. diadochokinesis
Voice/Fluency
Always include a description of voice and fluency, even if these are normal.
Hearing Evaluation
See Audiological Report dated _____________.
Behavior Observation
All descriptions of behavior should be accompanied by concrete examples you have experienced
or observed. Avoid overly negative terms or subjective terms such as nice, well-mannered,
pretty, well-behaved, handsome. Describe attention, motivation, cooperation, and willingness to
accompany you to therapy.
IMPRESSIONS (present tense)
Summarize diagnosis and relative severity of current communication impairments. Present the
information in the same order as the report. Begin this statement with: client’s name presents
with a mild receptive and moderate expressive language delay....characterized by....
SEMESTER GOALS
(future tense)
The following goals have been established for client name this semester:
(List goals in the same order as the body of the Tx. Plan. Each goal must be stated behaviorally
and include the following components:)
1)
rationale/specific behavior to be changed
2)
performance or “do” statement
3)
condition
4)
criteria/ion
SPECIFIC PLACEMENT (future tense)
_____ will attend # individual and/or group (discuss with supervisor) therapy sessions per week.
EVALUATION
(future tense)
Progress toward goal one will be evaluated by:
1.
2.
Progress toward goal two will be evaluated by:
1.
2.
If using the same evaluation procedure(s) for all goals, just state it once. You may elect to
measure progress via test administration, a language sample or by averaging performance
over the last 3 sessions. Research reveals that if a skill is demonstrated over 3 sessions, the
skill is (probably) acquired. In some cases, a longer re-evaluation period is warranted.
_______________________
_________________________
Clinician’s Name, B.S. or B.A.
Clinical Educator’s Name, Degree
Graduate Clinician
Clinical Educator
1. All drafts must be type written, double-spaced.
2. Final drafts must be single spaced and on “student report” paper. Be certain that there
are at least 5 lines of typing on the last page.
3. Each revision submitted to supervisors must include all of your previous drafts.
4. Number each page after the first at the bottom center of each page.
5. Headings and subheadings should look EXACTLY like this sample.
APPENDIX O
EASTERN MICHIGAN UNIVERSITY
Department of Special Education
Speech and Hearing Clinic
SUMMARY OF GOALS
Client:
Clinician:
Age:
Semester:
SEMESTER GOALS
The following semester goals have been established with you or for your child (pick one):
1.
2.
3.
4.
5.
__________________________
Parent/Client (pick one)
_________________________
Clinician’s name, B.S. or B.A.
Graduate Clinician
__________________________
Supervisor’s name, degree
Clinical Educator
*This document should be no more than one page in length and printed on plain
paper.
*Goals should be single spaced, with double spacing between them.
*Signature line(s) should be as long as the typed name beneath.
CALIPSO – CLINICAL PERFORMANCE SCALE – SPSI 528 & 538
CLINICIAN________________________________________________ SEMESTER_________________ CLINICAL EDUCATOR____________________________________________ YEAR___________________ GRADING SCALE: 5
Exceeds Performance Expectations.
Adequately
and
effectively
implements
the
clinical
skill/behavior.
Demonstrates
independent
and
creative
problem
solving.
4
Meets Performance Expectations.
Displays
minor
technical
problems
which
do
not
hinder
the
therapeutic
process.
Minimum
amount
of
direction
from
supervisor
needed
to
perform
effectively.
3
Moderately Acceptable Performance.
Inconsistently
demonstrates
clinical
behavior/skill.
Exhibits
awareness
of
the
need
to
monitor
and
adjust
and
make
changes.
Modifications
are
generally
effective.
Moderate
amount
of
direction
from
supervisor
needed
to
perform
effectively.
2
Needs Improvement in Performance.
The
clinical
skill/behavior
is
beginning
to
emerge.
Efforts
to
modify
may
result
in
varying
degrees
of
success.
Maximum
amount
of
direction
from
supervisor
needed
to
perform
effectively.
1
Unacceptable Performance.
Specific
direction
from
supervisor
does
not
alter
unsatisfactory
performance.
EVALUATION SKILLS: Disorder(s)_________________________________________________________________ 1
2
3
4
5
6
7
Conducts
screening
and
prevention
procedures
(Std
III‐D,
Std
IV‐G,
1a)
5
4
3
2
1
Collects
case
history
information
and
integrates
information
from
clients/patients
and/or
5
4
3
2
1
relevant
others
(Std
IV‐G,
1b)
a
Writes
accurate
and
coherent
Statement
of
the
Problem
in
TP
Selects
appropriate
evaluation
instruments/procedures
(Std
IV‐G,
1c)
5
4
3
2
1
a
Writes
appropriate,
detailed
Plan
of
Assessment
for
initial
evaluation
sessions
b
Demonstrates
ability
to
explain
profile
of
client
strengths
and
weaknesses
to
supervisor
Average:
Administers
and
scores
diagnostic
tests
correctly
(Std
IV‐G,
1c)
5
4
3
2
1
a
Shows
evidence
of
thorough
review
of
evaluation
materials
when
administering
formal
or
informal
materials
to
clients
Adapts
evaluation
procedures
to
meet
client/patient
needs
(Std
IV‐G,
1d)
5
4
3
2
1
Possesses
knowledge
of
etiologies
and
characteristics
for
each
communication
and
5
4
3
2
1
swallowing
disorder
(Std
III‐C)
a
Demonstrates
appropriate
understanding
of
client’s
developmental/skill
level
in
speech,
language
and
cognitive
domains
Interprets,
integrates,
and
synthesizes
test
results,
history,
and
other
behavioral
5
4
3
2
1
observations
to
develop
diagnoses
(Std
IV‐G,
1e)
a
Interprets/writes
an
accurate
and
coherent
description
of
client’s
Current
Level
of
Functioning
in
speech,
language
and
hearing
in
TP
b
Interprets/writes
an
accurate
and
coherent
Behavior
Observation
in
TP
c
Develops
Evaluation
Procedures
that
are
measurable
and
relevant
in
TP
d
Interprets/writes
an
accurate
and
coherent
Clinical
Impressions
e
Interprets/writes
an
accurate
Prognostic
Statement
Average:
2 CALIPSO – CLINICAL PERFORMANCE SCALE 8
Makes
appropriate
recommendations
for
intervention
(Std
IV‐G,
1e)
a
Demonstrates
ability
to
select
relevant
goals
with
respect
to
disorder
areas
b
Demonstrates
ability
to
explain
rationale
for
goal
choices
c
Writes
appropriate
Semester
Goals
9
Completes
administrative
functions
and
documentation
necessary
to
support
evaluation
(Std
IV‐G,
1f)
a
Prepares
TP
in
a
timely
manner
c
Prepares
TX
outcome
in
a
timely
manner
c
Makes
and
submits
revisions
of
SOAPs,
LPs,
TP
and
TO
promptly
d
Follows
appropriate
office
procedures
for
filing,
logging,
phone
calls,
etc.
10
Refers
clients/patients
for
appropriate
services
(Std
IV‐G,
1g)
5
4
3
2
1
Average:
5
4
3
2
1
Average:
5
4
3
2
1
TREATMENT SKILLS: Disorder(s)__________________________________________________________________ 1
2
3
4
5
6
Develops
appropriate
treatment
plans
with
measurable
and
achievable
goals
5
4
3
2
Collaborates
with
clients/patients
and
relevant
others
in
the
planning
process
(Std
IV‐G,
2a)
a
Clearly
explains
results
of
evaluation
to
clients
and
families
b
Collaborates
with
clients
and
families
regarding
goals
c
Clearly
explains
semester
goals
and
procedures
to
be
used
to
achieve
those
goals
to
clients,
families
and
/or
other
professionals
Average:
Implements
treatment
plans
(Std
IV‐G,
2b)
5
4
3
2
a
Writes
lesson
plans
including
behavioral
objectives
and
procedures
which
will
efficiently
achieve
semester
goals
Selects
and
uses
appropriate
material/instrumentation
(Std
IV‐G,
2c)
5
4
3
2
a
Uses
materials
and
activities
appropriately
to
elicit
desired
behaviors
Sequences
tasks
to
meet
objectives
5
4
3
2
a
Organizes
and
sequences
activities
in
therapy
session
to
maximize
responses,
attention
and
cooperation
b
Establishes
time
frames
for
therapy
activities
appropriate
to
client’s
level
of
functioning
c
Writes
appropriate
hierarchies
for
each
semester
goal
d
Establishes
home
assignments
appropriate
to
the
client’s
level
of
functioning
and
the
family’s
ability
to
follow
through
Average:
Provides
appropriate
introduction/explanation
of
tasks
5
4
3
2
a
Uses
vocabulary
and
language
appropriate
to
client’s
level
of
comprehension
b
Clearly
explains
objective
and
desired
responses
at
client’s
level
of
comprehension
Average:
Measures
and
evaluates
clients’/patients’
performance
and
progress
(Std
IV‐G,
2d)
5
4
3
2
a
Maintains
accurate,
concise
SOAP
notes
b
Writes
an
accurate
and
coherent
Results
of
Therapy
in
TO
c
Writes
an
accurate
and
coherent
paragraph
on
Therapy
Techniques
in
TO
Average:
1
1
1
1
1
1
3 CALIPSO – CLINICAL PERFORMANCE SCALE 7
8
Uses
appropriate
models,
prompts
or
cues.
Allows
time
for
patient
response
a
Uses
appropriate
modeling
or
cueing
to
elicit
desired
response
b
Provides
appropriate
reinforcement
and
feedback
c
Provides
for
successful
experiences
to
exceed
failure
experiences
5
4
3
2
1
Average:
5
4
3
2
1
Modifies
treatment
plans,
strategies,
materials,
or
instrumentation
to
meet
individual
client/patient
needs
(Std
IV‐G,
2e)
a
Demonstrates
ability
to
select
materials
and
activities
appropriate
to
client’s
current
level
of
functioning
b
Planning,
implementation
and
adaption
of
treatment
sessions
are
client‐centered
Average:
9
Completes
administrative
functions
and
documentation
necessary
to
support
treatment
5
4
3
2
(Std
IV‐G,
2f)
a
Submits
hierarchies
within
48
hours
after
TP
is
signed
b
Makes
and
submits
revisions
of
LPs,
SOAPs,
TP,
and
TO
promptly
Average:
10
Identifies
and
refers
patients/clients
for
services
as
appropriate
(Std
IV‐G,
2g)
5
4
3
2
a
Writes
appropriate
and
specific
Recommendations
in
the
TO
1
1
\
PREPAREDNESS, INTERACTION AND PERSONAL QUALITIES: Disorder(s)__________________________________ 1
2
3
4
5
6
7
Possesses
foundation
for
basic
human
communication
and
swallowing
processes
(Std
III‐ 5
4
3
2
B)
Possesses
the
knowledge
to
integrate
research
principles
into
evidence‐based
clinical
5
4
3
2
practice
(Std
III‐F)
a
Shows
initiative
and
provides
evidence
of
outside
reading
related
to
client’s
disorder
b
Effectively
expresses
ideas
orally
and
in
writing
during
presentation
in
clinical
meeting
Average:
Possesses
the
knowledge
of
contemporary
professional
issues
and
advocacy
(Std
III‐G)
5
4
3
2
Communicates
effectively,
recognizing
the
needs,
values,
preferred
mode
of
5
4
3
2
communication,
and
cultural/linguistics
background
of
the
patient,
family,
caregiver,
and
relevant
others
(Std
IV‐G,
3a)
a
Demonstrates
ability
to
assimilate
client’s
or
supervisor’s
point
of
view
and
constructive
feedback
Establishes
rapport
and
shows
sensitivity
to
the
needs
of
the
patient
5
4
3
2
a
Clearly
defines
for
client
acceptable
behaviors
and
consequences
for
inappropriate
behavior
b
Maintains
control
of
therapy
situation
in
firm,
gentle
manner
c
Is
consistent
in
use
of
behavior
management
techniques
d
Reinforces
desired
behavior
with
appropriate
timing
and
reinforcer
e
Deals
appropriately
with
client’s
frustration,
grief,
anger,
etc
Average:
Uses
appropriate
rate,
pitch
and
volume
when
interacting
with
patients
or
others
5
4
3
2
a
Demonstrates
ability
to
communicate
in
an
articulate,
grammatical
fashion
Provides
counseling
and
supportive
guidance
regarding
communication
and
swallowing
5
4
3
2
disorders
to
patients,
family,
caregivers
and
relevant
others
(Std
IV‐G,
3c)
a
Consistently
delivers
concrete
and
constructive
informal
verbal
feedback
1
1
1
1
1
1
1
4 CALIPSO – CLINICAL PERFORMANCE SCALE 8
Collaborates
with
other
professionals
in
case
management
(Std
IV‐G,
3b)
a
Works
effectively
with
other
clinicians
when
client
is
involved
in
group
sessions
b
Actively
contributes
to
positive
group
functioning
c
Maintains
communication
with
other
professionals
working
with
the
client
5
4
3
2
1
Average:
5
4
3
2
1
9
Displays
effective
oral
communication
with
patient,
family,
or
other
professionals
(Std
IV‐B)
a
Clearly
explains
outcome
of
therapy
and
recommendations
to
family
at
end
of
semester
b
Maintains
open,
efficient
lines
of
communication
with
the
client’s
family
Average:
5
4
3
2
1
5
4
3
2
1
10
Displays
effective
written
communication
for
all
professional
correspondence
(Std
IV‐B)
a
Uses
correct
grammar,
spelling
and
punctuation
11
Adheres
to
the
ASHA
Code
of
Ethics
and
conducts
him/herself
in
a
professional,
ethical
manner
(Std
III‐E,
IV‐G,
3d)
12
Assumes
a
professional
level
of
responsibility
and
initiative
in
completing
all
5
4
3
2
requirements
a
Initiates
and
maintains
contact
with
supervisor
b
Demonstrates
insight
into
negative
consequences
of
own
behavior
and
does
not
blame
others
or
external
factors
for
failures
and
difficulties
c
Attends,
is
prepared
for,
and
participates
in,
clinic
meetings
d
Writes
self‐evaluations
that
reflect
careful
analysis
of
clinician
behavior
during
therapy
sessions
e
Seeks
own
solutions
for
problems
f
Summarizes
procedures
and
techniques
via
observation
when
client
is
absent
Average:
13
Demonstrates
openness
and
responsiveness
to
clinical
supervision
and
suggestions
5
4
3
2
a
Able
to
apply
suggestions
and
techniques
provided
by
supervisor
in
therapy
14
Personal
appearance
is
professional
and
appropriate
for
the
clinical
setting
5
4
3
2
a
Maintains
professional
appearance,
attitude,
and
behavior
at
all
times
15
Displays
organization
and
preparedness
for
all
clinical
sessions
5
4
3
2
1
1
1
1
MIDTERM GRADE
__________
CLINICIAN______________________________________
DATE_____________
CLINICAL
EDUCATOR_______________________________________________________
DATE_____________
Strengths/weaknesses:
Recommendations
for
improving
weakness:
FINAL GRADE
__________
CLINICIAN__________________________________________
DATE____________
CLINICAL
EDUCATOR_______________________________________________________
DATE_____________
Strengths/weaknesses:
Recommendations
for
improving
weakness:
CALIPSO Grading Scale 5 Exceeds Performance Expectations. Adequately and effectively implements the clinical skill/behavior. Demonstrates independent and creative problem solving. 4 Meets Performance Expectations. Displays minor technical problems which do not hinder the therapeutic process. Minimum amount of direction from supervisor needed to perform effectively. 3 Moderately Acceptable Performance. Inconsistently demonstrates clinical behavior/skill. Exhibits awareness of the need to monitor and adjust and make changes. Modifications are generally effective. Moderate amount of direction from supervisor needed to perform effectively. 2 Needs Improvement in Performance. The clinical skill/behavior is beginning to emerge. Efforts to modify may result in varying degrees of success. Maximum amount of direction from supervisor needed to perform effectively. 1 Unacceptable performance. Specific direction from supervisor does not alter unsatisfactory performance. 4.00-5.00
3.66-3.99
3.35-3.65
3.04-3.34
A
AB+
B
2.73-3.03
2.42-2.72
2.11-2.41
1.80-2.10
1.00-1.79
B- / Fail
↓
↓
↓
↓
APPENDIX Q
EASTERN MICHIGAN UNIVERSITY
Department of Special Education
Speech and Hearing Clinic
TREATMENT OUTCOME
Client:
File No.:
Age:(year; month)
Date of Report :( last date of clinic)
Time Period Covered: (1st-last date seen*)
Attendance: #/# sessions
*incl. Fam conf.
Clinician: B.S. or B.A. (if applicable)
Clinical Educator:
RESULTS OF THERAPY (present tense)
Write one result for each goal. Restate the goal in the result. Write the goals in the same order
as you wrote them in the Treatment Plan. For example, “The goal to improve articulation by
producing /k/ in the initial position of words with a model with 90%” was achieved/not
achieved/surpassed. “Sally produces /k/ in the......"
Re: ORLA, MIT, Phoneme ↔ Grapheme goals-Write “See attachment for targets.”
(OPTIONAL) If needed, give an overall general summary statement of progress emphasizing
the area(s) of achievement. This paragraph is useful when results of therapy (above) do not
accurately reflect progress in therapy. You may list dates absent or tardy and minutes missed if
you feel that this has affected progress. You may also report on tests administered after the
Treatment Plan was completed. Medical changes, events, procedures may also be reported here.
Your CE will help you decide if this paragraph is necessary.
THERAPY TECHNIQUES (past tense)
Write a paragraph about the techniques you used to teach the skills to your client. List the
techniques in a logical order in the first sentence. Explain the techniques as they relate to the
goals in the same order in the remainder of the paragraph. If you used a Life Participation
Approach to Aphasia and supplied the client with a wallet and/or visor card, “What is Aphasia”
packet, subscription to Stroke Connection magazine, etc., include that information here as well.
Write a second paragraph about the materials you used and the reinforcement
strategies/schedule. Describe their effectiveness.
CLINICAL IMPRESSIONS
Write a paragraph about home involvement. What types of assignments/suggestions were given
to clients/parents? Was home involvement successful? How did it affect change? (past tense)
APPENDIX Q
Write a paragraph about behavioral observations. Summarize any changes in behavior from the
beginning of the semester. Stress the positive. If detail on negative behavior is needed, do not
be punitive. Write a summary of incidents and describe behaviors. Be factual and concise.
(past tense)
The final paragraph of this section must include a statement of prognosis for further speech and
language development or improvement in skills. For example, “Based on the progress (or lack
of progress) obtained during this semester the prognosis for further speech and language
development or improvement in skills is (excellent, good, fair, guarded, poor). The prognostic
statement should also include other factors, such as health, age, attitude of client, family
involvement, services received elsewhere, etc. (present tense)
RECOMMENDATIONS (present tense)
Be specific about recommendations:
Should client continue to receive speech-language pathology services?
If so, should sessions be individual? group?
If not, provide rationale and procedures for follow-up.
If so, list goal areas for the next clinician and suggestions for further evaluation.
Give suggestions for maintenance and carryover to teachers, parents and/or clients.
Make referrals as needed to medical personnel and other professionals.
_________________________
Clinician’s Name, B.S. or B.A.
Graduate Clinician
________________________
Clinical Educator’s Name, Degree
Clinical Educator
All drafts must be typed, double-spaced
1. Final drafts must be single spaced and on “student report” paper
2. Each revision submitted to supervisors must include all your previous drafts
3. Number each page after the first at the bottom center of each page
4. Headings and subheadings should look EXACTLY like this sample.
APPENDIX R
Outline for Clinician/Client/Family Conferences
To construct Graphs- Review each treatment SOAP note and list dates/stimulus conditions/%/cueing per goal.
- Review the data to decide the clearest, easiest way to convey it on a graph. Use color coding
for cueing level, goal level, etc. to communicate information visually.
- Write semester goal at top of each graph.
- Be sure to incorporate SCT concepts into graph. Use color to communicate goal and cueing level.
- Perpendicular (Y) axis – usually % or frequency- Horizontal (X) axis – usually daily or weekly dates - TIME FORWARD →list every possible session
date.
a. Graph baseline phase/assessment
b. Graph daily/weekly objectives
c. Graph last 3 consecutive sessions-reevaluation
*May include a key to explain stimulus condition, modeling, cueing, etc.
I. Three objectives of a conference:
- to provide information
- to obtain information-This is where LISTENING comes in.
- to share information
II. Two way conference
-all involved feel comfortable-this starts with the clinician
-all involved are active participants
-LISTEN vs. talk
-give frequent opportunities for questions from client, family
- if you don’t know the answer, ask the CE
(Use the following bolded items as a guideline to write your Conference outline)
III.
Purpose:
- Welcome them
- State the purpose of the meeting which is to discuss/review goals, procedures, outcomes,
prognosis and recommendations.
IV.
Review treatment goals, procedures and progress in the following order:
- Place each graph in front of the client and family member(s).
- Review aloud each goal. State goal in lay language, if needed.
- Give them time to look at each graph.
- State whether goal was/not achieved or surpassed and current performance level, i.e.:
stimulus condition and accuracy level and write this at the top of the graph.
- Review progress toward each goal with the graph
- Describe how you evaluated progress
- Be careful to use positive language when discussing progress or other behaviors
APPENDIX R
V.
Prognosis
- State prognosis for further improvement or development in ______________.
- State factors contributing to this prognosis
VI.
Discuss further treatment and recommendations for next semester:
- Confirm if will be returning- i.e. Have you returned the Client Preference Sheet to the Clinic
Coordinator?
- Recommendations should be brief and clearly stated in behavioral terms
- Ask family/client for reaction to your recommendations, would they like to
make any changes to goals? Would they like to suggest any additional goals?
Do they have any other suggestions or comments?
-Suggestions regarding home assignments, carry-over activities. Homework packets should be
reviewed at the last treatment session instead of in the conference, secondary to time limitations.
-Referrals to outside professionals? Rationale.
Be sure that the client and/or family member(s) take the graphs home.
SAMPLE
SOAP Note
S: ____ attended Clinician/Client/Family Conference.
O: Discussed semester goals, procedures, outcomes, prognosis, recommendations and
homework.
Results of therapy: #/# goals achieved; #/# not achieved; #/# surpassed.
A: ___________ agreed with recommendations. (or “added...”)
P: State recommendations. i.e. Return in semester/year.
Scoring Rubric for Clinician/Client/Family Conferences
Welcome/Thank for attending
Explain purpose:
Discuss/review goals
Procedures
Outcomes
Prognosis
Recommendations
Graphs
Each graph provided for client and family members
Review aloud each goal
Give them time to look at graphs
State whether each goal was/not achieved or surpassed and current performance level and
Write at top of each graph
Review progress toward each goal with the graphs beginning with baseline
Describe how progress was evaluated
Procedure examples
Use of positive language
Check for clarity and understanding
Ask for client/family perception of change in functional skills
Prognosis
State prognosis and factors
Recommendations
Confirm if returning
Blue Preference sheet to clinic coordinator?
State recommendations
Family input for changes, suggestions for additional goals
Home assignments for the break
Referrals and rationale
Graphs go home
Nonverbal communication
Eye contact with and attention to client?
Professional demeanor and posture
Appropriate volume
Seating Arrangement
Placement of items to review
Family Member?