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Position Descriptions
Clinical Education
Department of Communication Sciences and Disorders
Saint Louis University
Prepared by Travis T. Threats, Ph.D., Chair
Clinical Education Principles
This document sets forth the goals and aspirations of the clinical education provided to students
in the Department. The Scope of Practice for Speech-Language Pathology (ASHA, 2007) states
in its preamble the following:
“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.”
Later in this document are the two following quotes:
“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 and health . . .
The ICF framework is useful in describing the breadth of the role of the speech-language
pathologist in the prevention, assessment, and habilitation/rehabilitation, enhancement,
and scientific investigation of communication and swallowing. . . Speech-language
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.” (ASHA, 2007)
The Scope of Practice thus clearly delineates that evidence based practice, cultural and linguistic
diversity, and the use of the International Classification of Functioning, Disability and Health
(ICF) are principles and philosophical underpinnings of the field. That is, these principles apply
across all populations and all settings for all speech-language pathologists.
ICF, Evidenced-Based Practice and Diversity
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In the 2004 Scope of Practice for Audiology, it states:
“The practice of audiology includes both the prevention of and assessment of auditory,
vestibular, and related impairments as well as the habilitation/rehabilitation and
maintenance of persons with these impairments. The overall goal of the provision of
audiology services should be to optimize and enhance the ability of an individual to hear,
as well as to communicate in his/her everyday or natural environment. In addition,
audiologists provide comprehensive services to individuals with normal hearing who
interact with persons with a hearing impairment. The overall goal of audiologic services
is to improve the quality of life for all of these individuals.
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 and health. The ICF
framework is useful in describing the role of audiologists in the prevention, assessment,
and habilitation/rehabilitation of auditory, vestibular, and other related impairments and
restrictions or limitations of functioning” (p. 2).”
Concerning evidence based practice, the 2004 Scope of Practice in Audiology states the
following as part of the professional roles and responsibilities of audiologists:
“Measurement of functional outcomes, consumer satisfaction, efficacy, effectiveness, and
efficiency of practices and programs to maintain and improve the quality of audiologic
services;
Design and conduct of basic and applied audiologic research to increase the knowledge
base, to develop new methods and programs, and to determine the efficacy, effectiveness,
and efficiency of assessment and treatment paradigms; disseminate research findings to
other professionals and to the public;”
Concerning diversity, this document states:
Audiologists serve diverse populations. The patient/client population includes persons of
different race, age, gender, religion, national origin, and sexual orientation. Audiologists'
caseloads include individuals from diverse ethnic, cultural, or linguistic backgrounds, and
persons with disabilities. Although audiologists are prohibited from discriminating in the
provision of professional services based on these factors, in some cases such factors may
be relevant to the development of an appropriate treatment plan. These factors may be
considered in treatment plans only when firmly grounded in scientific and professional
knowledge.
Thus, for both the professions of audiology and speech-language pathology, evidence based
practice, the value of cultural diversity and non-discrimination, and the use of the ICF as the
framework for practice are three principal tenets.
ICF, Evidenced-Based Practice and Diversity
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References
Cardinal ASHA documents
American Speech-Language-Hearing Association. (1985). Clinical Management of
Communicatively Handicapped Minority Language Populations [Position Statement].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2010). Code of Ethics [Ethics].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2004). Evidence-Based Practice in
Communication Disorders: An Introduction [Technical Report]. 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
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.
American Speech-Language-Hearing Association. (2004). Preferred Practice Patterns
for the Profession of Speech-Language Pathology [Preferred Practice Patterns].
Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2005). Cultural Competence [Issues
in Ethics]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2007). Scope of Practice in SpeechLanguage Pathology [Scope of Practice]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2008). Clinical Supervision in SpeechLanguage Pathology [Technical Report]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2008). Knowledge and Skills Needed
by Speech-Language Pathologists Providing Clinical Supervision [Knowledge and
Skills].Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2010). Supervision of Student
Clinicians [Issues in Ethics]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (1988). Prevention of Communication
Disorders [Position Statement]. Available from www.asha.org/policy.
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Evidence based practice articles/books
Cherney, L, Patterson, J., Ramyer, A., Frymark, T., & Schooling, T. (2008). EvidenceBased Systematic Review: Effects of Intensity of Treatment and Constraint-Induced
Language Therapy for Individuals with Stroke-Induced Aphasia. Journal of Speech,
Language, and Hearing Research, 51, 1282-1299.
Dollaghan, C. (2004). Evidence-based practice in communication disorders: What do we know
and when do we know it? Journal of Communication Disorders, 37(5), 391–400.
Dollaghan, C. (2007). The Handbook for Evidence-Based Practice in Communication
Disorders. Baltimore, MD: Paul Brooks Publishing Co.
Reilly, S., Douglas, J., & Oates, J. (2004). Evidence based practice in speech pathology.
London: Whurr Publishers
Sackett, D., Rosenberg, W, Gray, J, Haynes, R, & Richardson, W. (1996). Evidence based
medicine: what it is and what it isn’t. British Medical Journal, 312, 71-72.
Robey, R., Apel, K., Dollaghan, C., Elmo,W., Hall, N., Helfer, T., et al. (2004). A report of the
joint committee of evidence based practice. Rockville, MD: ASHA. Available at:
http://www.asha.org/members/slp/topics/ebp/.
Improving the Reporting Quality of Nonrandomized Evaluations of Behavioral and Public
Health Interventions: The TREND Statement
http://www.cdc.gov/trendstatement/docs/AJPH_Mar2004_Trendstatement.pdf
ICF articles
Brown, J. & Hasselkus, A. (2008). Professional associations’ role in advancing the ICF in
speech-language pathology. International Journal of Speech-Language Pathology,
10(1,2), 78-82.
Cruice, M. (2008). The contribution and impact of the International Classification of
Functioning, Disability and Health on quality of life in communication disorders.
International Journal of Speech-Language Pathology, 10(1,2), 38-49.
Doyle, P. & Skarakis-Doyle, E. (2008). The ICF as a framework for interdisciplinary
doctoral education in rehabilitation: Implications for speech-language pathology.
International Journal of Speech-Language Pathology, 10(1,2), 83-91.
Dykstra, Hakel, M., & Adams, S. (2007). Application of the ICF in reduced speech
intelligibility in dysarthria. Seminars in Speech and Language, 28 (4), 301-311.
Eadie, T. (2007). Application of the ICF in communication after total laryngectomy.
Seminars in Speech and Language, 28 (4), 291-300.
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Hancock, H. (2003) Rehabilitation for enhanced life participation: A living well program.
Speech Pathology Online at http://www.speechpathology.com/
Hickson, L. & Scarinci, N. (2007). Older adults with acquired impairment: Applying the ICF in
rehabilitation. Seminars in Speech and Language, 28 (4), 283-290.
Howe, T. (2008). The ICF Contextual Factors related to speech-language pathology.
International Journal of Speech-Language Pathology, 10(1,2), 27-37.
Hopper, T. (2007). The ICF and dementia. Seminars in Speech and Language, 28 (4),
273-282.
Larkins, B. (2007). Application of the ICF in cognitive communication disorders
following traumatic brain injuries. Seminars in Speech and Language, 28 (4),
334-342.
Ma E., Yiu, E., Verdolini, K. & Abbott, (2007). Application of the ICF in voice
disorders. Seminars in Speech and Language, 28 (4), 343-350.
McCormack, J. & Worrall (2008). The ICF Body Functions and Structures related to
speech-language pathology. International Journal of Speech-Language Pathology,
10(1,2), 9-17.
McLeod, S. & McCormack (2007). Application of the ICF and the ICF-Children and
Youth in children with speech impairment. Seminars in Speech and Language, 28
(4), 254-264.
Mulhorn, K. & Threats, T. (2008). Speech, hearing, and communication across five
national disability surveys: Results of a DISTAB study using the ICF to compare
prevalence patterns. International Journal of Speech-Language Pathology,
10 (1,2), 61-71.
McLeod, S. & Threats, T. (2008). Application of the ICF-CY to children with
communication disabilities. International Journal of Speech-Language
Pathology, 10(1,2), 92-109.
O’Halloran, R. & Larkins, B. (2008). The ICF Activities and Participation related to
speech-language pathology. International Journal of Speech-Language
Pathology, 10(1,2), 18-26.
Simeonsson, R. ICF for children and youth (ICF-CY): moving beyond classification of
the child. Presentation given by the Interagency Committee on Disability Research State
-of-the-Art Conference: New Federal Applications of the ICF, Arlington, VA, 2007
Simmons-Mackie, N. & Kagan, A. (2007). Application of the ICF in aphasia. Seminars
in Speech and Language, 28 (4), 244-253.
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Smiley, D., Threats, T., Mowry, R., & Peterson, D. (2005). The International Classification of
Functioning, Disability and Health (ICF): Implications for Deafness Rehabilitation
Education, Rehabilitation Education, 19 (2-3), 139-158.
Stucki G, Grimby G. (2007). Organizing human functioning and rehabilitation research into
distinct scientific fields. 1. Developing a comprehensive structure from the cell to society.
Journal of Rehabilitation Medicine, 39, 293–298.
Stucki G, Reinhardt J, Grimby G (2007): Organizing human functioning and rehabilitation
research into distinct scientific fields. Conceptual descriptions and domains for research.
Journal of Rehabilitation Medicine, 39: 299–307.
Threats, T. (2007). Use of the ICF in dysphagia management. Seminars in Speech and
Language, 28 (4), 323-333.
Threats, T. (2008). Use of the ICF for clinical practice in speech-language pathology.
International Journal of Speech-Language Pathology, 10(1,2), 50-60.
Yaruss, J.S. (2007). Application of the ICF in fluency disorders. Seminars in Speech and
Language, 28 (4), 312-322.
Westby, C. (2007). Application of the ICF in children with language impairments.
Seminars in Speech and Language, 28 (4), 265-272.
Worrall, L. & Hickson, L. (2008). Use of the ICF in speech-language pathology research:
Towards a research agenda. International Journal of Speech-Language
Pathology, 10(1,2), 72-77.
World Health Organization. (2001). International Classification of Functioning, Disability, and
Health. Geneva, Switzerland: Author.
World Health Organization. (2007). International Classification of Functioning, Disability, and
Health for Children and Youth. Geneva, Switzerland: Author.
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Multicultural/Diversity articles
Threats, T. (2010). The complexity of social/cultural dimensions in communication disorders.
Folia Phoniatrica et Logopaedica, 62 (4), 158-165.
Battle, D. (2000) Becoming a culturally competent clinician. Perspectives in Communication
Disorders and Sciences Culturally Linguistic Diverse Populations. 6, 19–22.
Anderson N (1992). Understanding cultural diversity. American Journal of Speech Language
Pathology, 1, 11-12
.
Porter, R., Samovar L, (1976). Communicating interculturally; in Samovar LA, Porter
RE (eds): Intercultural Communication. A Reader: Belmont, Wadsworth.
Heatwole, C. (2006) Culture: a geographical perspective. Received at
http://www.emsc.nysed.gov/ciai/socst/grade3/geograph.html.
Threats T (2005). Culturally sensitive care in the health care setting. Perspectives in
Communication Sciences and Disorders Culturally, Linguistically, Diverse
Populations; 12: 3–5.
Vogel E, Awh E. (2008). How to exploit diversity for scientific gain: using individual
differences to constrain cognitive theory. Current Directions in Psychology, 17, 171-176.
Servant Leadership articles
Barbuto, J. & Wheeler, D. (2006).Scale Development and Construct Clarification of
Servant Leadership. Group & Organization Management, 31(3), 300-326.
Russell, R. (2001).The role of values in servant leadership. Leadership & Organization
Development Journal, 22(2), 76-83.
Sendjaya, S. & Sarros, J. (2002). Servant Leadership: Its Origin, Development, and
Application in Organizations. Journal of Leadership and Organizational
Studies, 9 (2), 57-64.
Spears, L. (2004). Practicing Servant-Leadership. Leader to Leader. 34, 7-11.
Stone, G., Russell, R., Patterson, K. (2004).Transformational versus servant
leadership: a difference in leader focus. The Leadership & Organization
Development Journal, 25 (4), 349-361
The Greenleaf Center for Servant Leadership
http://www.greenleaf.org/
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Ethics articles/books
Body, R., & McAllister, L. (ed.) (2009). Ethics in Speech and Language Therapy. West
Sussex, UK: John Wiley & Sons.
Peterson, D. & Threats, T. (2005). Ethical and Clinical Implications of the International
Classification of Functioning, Disability and Health (ICF). Rehabilitation
Education, 19 (2-3), 129-138.
Threats, T. (2010). The ICF and speech-language pathology: Aspiring to a fuller
realization of ethical and moral issues. International Journal of Speech-Language
Pathology, 12(2), 87–93.
ASHA website of Ethics-Related Articles
http://www.asha.org/practice/ethics/ethics-articles.htm
Supervision of student clinicians: Modeling ethical practice for future
http://www.asha.org/practice/ethics/supv_of_student.htm
Chabon, S., Denton, D., Lansing, C., Scudder, R., & Shinn, R. (2007) Ethics Education. ASHA:
Rockville Pike, MD.
Irwin, D., Pannbacker, M., Powell, T.,Vekovius, G. (2007).Ethics for Speech-Language
Pathologists and Audiologists: An Illustrative Casebook. Thomson- Delmar Learning:
Clifton Park, NY.
Horner, J. (2003). Morality, ethics, and law: Introductory concepts. Seminars in Speech
and Language, 24, 263–274.
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