Celebrating 100 years of School Speech-Language Pathology: 1910-2010
Welcome journalists, government specialists, researchers, ASHA administrators!
John M. Panagos, Editor
Celebrating 100 years of School Speech-Language Pathology: 1910-2010
Welcome journalists, government specialists, researchers, ASHA administrators!
John M. Panagos, Editor
“Suspensions hit minorities, special-ed students hardest” is the headline for an article authored by Linda Shaw
Seattle Times education reporter.
No surprise here: “A new analysis of discipline data in nine Washington school districts shows that black and Native American students, as well as those in special education, are suspended and expelled at higher rates than the average student.” The U. S. Department of Education is looking into this.
What is important is that the problem is beyond special education personnel and policies. School cultures seek to exclude struggling children from educational opportunity and minority children are more likely to struggle.
The ASHA Board of Directors has the authority to straighten out the curriculum mess. It can facilitate creation of thoughtful proposals for change at the academic centers.
“4.1.2. The Board of Directors is the single governing body of the Association and shall actively promote the objectives of the Association, operating in accordance with and administering and implementing the programs and policies established by these Bylaws and by the Board of Directors. Members of the Board of Directors are elected to serve by and are accountable to the members of the Association.” (Bylaws)
The ASHA Board of Directors has the authority to reorganize The Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) for modern curriculum development and change at the academic centers.
“4.9.1. The Board of Directors may establish and dissolve standing committees, boards, councils, ad hoc committees, working groups, and other entities necessary to conduct the Association’s business, and designate and change their charges and determine their size, member qualifications, and terms.
The ASHA President has the authority to see that the Board of Directors advances curriculum change at the academic centers.
“The President serves as the chair of the Board of Directors. The President ensures that the Board of Directors fulfills its responsibilities for the governance of the Association. – See more at: http://www.asha.org/About/governance/BOD/President/#sthash.QvA16wdX.dpuf”
The ASHA Board of Directors has the authority to direct the professional staff to facilitate curriculum change at the academic centers.
“7.2.1. The Chief Executive Officer shall be appointed by the Board of Directors and shall serve at the pleasure of the Board. The Chief Executive Officer serves as the chief administrative officer of the Association. The Chief Executive Officer monitors work assigned to the National Office staff and provides periodic reports to the Board of Directors.”
The ASHA Board of Directors has the authority to reorganize the Speech-Language Pathology Advisory Council so members actively participate in curriculum change at the academic centers.
“5.1. An Audiology Advisory Council and a Speech-Language Pathology Advisory Council shall be established to identify and discuss issues of concern to members and provide advice to the Board of Directors.”
For now we have some resolution of the mystery of how ASHA processes curriculum topics for steady improvement of graduate education. We posed the question:
“How are school curriculum trends identified, studied, described as course topics, and approved for implementation at the 300 or so national academic centers?”
The answer, simply, is VERY BADLY!
Curriculum trends and topics are processed across different ASHA components with clear and disappointing results. Members offer hundreds of imaginative and appropriate ideas for improving the knowledge-base for clinical practice but to little effect. Much of the content appropriate for inclusion in graduate education is siphoned off into frenzied continuing education programming advertised as “hot topics.”
Certainly, school slps are all but ignored.
Filtering Curriculum Input
For the sake of comparison-making, we estimate that 60% or more of the input goes into continuing education. Some 25% of the input goes into articles and reports but with no long-term effect because once placed in the archives they are ignored. Some 10% is listed as “preferred practice patterns” but this material is not kept up to date. Some 5% is listed in the Scope of Practice document serving as the input to The Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA). The overall effect of filtering is the proverbial black hole. There is almost no way the membership can influence lasting curriculum development for graduate education.
The one exception is inexplicable, the push through in-house deliberations for swallowing and clinical collaboration in the medical setting. It appears the motivation is income-based rather than theory-based.
Lapse of Administration
It is up to the Board of Directors to make sure new content is offered in academic programs but that step is slighted. The Board of Directors has the authority and a chief executive office plus staff to carry out the implementation of trending curriculum content. There is a large and well-paid administrative staff, ample funding and a new office building for planning and on-site meetings. Many of the Board members have academic backgrounds in curriculum management but their interests are in continuing education and their special interests. Throughout the ASHA hierarchy, school slps are almost invisible.
In the Shadows
The meager curriculum input represented in the Scope of Practice document disappears into the standoffish, formalistic environment of The Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA). Wrapped in the cloak of “high standards” plus references to accrediting agencies, the input referred for consideration is reduced to almost zero. Whole areas of content are reduced to lists of curriculum strands many of which representing 75 years of classic material. Current changes are rendered in a few words and phrases. Emphasis is placed on procedure rather than the content. Though the stated CAC mission promotes forward thinking and creativity, actualization for curriculum advances is nil. Efficient management of procedures is the goal. Though half the paying ASHA membership works in schools, only one school SLP is on the Council.
The schism between ASHA divisions, set up by the founders in 1930, is affirmed by CAA policy: “The CAA was established by ASHA and is authorized to function autonomously in setting and implementing standards and awarding accreditation.” The founders wanted control over accreditation and their disciples set up the structures to sustain their de facto policy. Other than historical precedent, and self acclamation, one does not find published justification for CAA. Mistakes made years ago do not constitute a rationale for today’s CAA.
The Board of Directors, with full authority to re-organize committees and councils, has failed to enforce the aims of the profession, which is a modern and up-to-date professional curriculum. For the BOD to influence CAA, the two must “collaborate” in some grand gesture of cooperation. This attitude short-circuits the rights of members, who expect the ASHA BOD to represent them in advancing the curriculum in the academic programs. The CAA insulates itself from the paying membership as much as possible. School slps pay a lot of the costs of accreditation.
The Collaboration Test
As a method of investigation, we have tracked the topic of collaboration across the divisions. While public relations and continuing education are moving forward according to early planning for Interprofessional education and practice (ASHA Leader, Vol 18, 2013), collaboration is an insignificant CAA standard. The disconnect is clear and odd. There are BOD members on the CAA, working to approve the 2014 revised standards. The CEO attends both BOD and CAA meetings. It is the classic problem of the right hand not knowing what the left hand is doing. While top officials push collaboration for continuing education credit, thereby gradually changing school practice for everyone, collaborations will remain a minor skill-development standard for graduate students. Pickering and Embry (p. 46) in the special edition say: “It is not enough to extol the virtues of interprofessional care. Graduate programs are being asked to teach students how to work with other professionals into training.” The CAA has neither the inclination nor the capacity to implement a standard for full-blown collaborative training. As usual, the topic will be puffed up for continuing education programming and sold to school slps who can afford to travel to receive instruction.
“Since ASHA published its seminal collaboration model in 1990, clinicians are now middle-age and older SLPs have retired. School office leadership has turned over, another executive director is in place, and countless presidents and directors have come and gone. And still no action on bringing collaboration into graduate programs of America’s academic programs.” (Prior post)
3. Accreditation Component
The Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) of the American Speech-Language-Hearing Association establishes and revises the professional curriculum for undergraduate and graduate education at accredited U. S. colleges and universities. The curriculum contains “a core set of knowledge and skills” for “independent professional practice.” (Bylaws) Members “…promote the acquisition of new knowledge and skills for those within the discipline.” “Collaborating with all stakeholders for continuous quality improvement…” is an aim. The Council schedules meetings. “CAA has authority to determine how its members and committees are selected…” in its relationship with ASHA. “The CAA was established by ASHA and is authorized to function autonomously in setting and implementing standards and awarding accreditation.” Membership surveys have been conducted.
Along with member suggestions, the Scope of Practice Document is the input to the curriculum process. The output of the CAA curriculum process are lists of “standards.”
The Council is composed of 26 members. There are 11 college faculty members; 5 clinical practitioners; one public member. There are four Ex Officios and BOD Liasons and five National Office Staff. There are several key members.
CAA Vice-Chair for Speech-Language Pathology
CAA Vice-Chair for Audiology
Ex Officios and BOD Liasons
ASHA Director of Accreditation
ASHA Vice President for Academic Affairs in Audiology (Board of Directors Liaison)
ASHA Vice President for Academic Affairs in Speech-Language Pathology
(Board of Directors Liaison)
ASHA Executive Director
National Office Staff
ASHA Associate Director for Accreditation Services
ASHA Accreditation Program Coordinator
ASHA Associate Director of Accreditation for Policy and Education ASHA Associate Director of Accreditation for Research and Quality Management
ASHA Manager of Accreditation Systems
2. Administrative Component
With accreditation activities, affiliations, fiduciary obligations, legal requirements and commitment to public disclosure, there must be accountability system to keep ASHA curriculum standards current. Yes, the Board of Directors, according to the bylaws, is responsible. It must ensure new knowledge and clinical applications are represented in modern college programs.
1. ASHA Board of Directors is broadly responsible for the ASHA curriculum for school practice. The Scope of Practice Document represents the output of public relations component. It is directly supervised and endorsed by the Board of Directors.
2. ASHA President is generally responsible for curriculum: “President, who shall serve as Chair of the Board of Directors and coordinate the functions of the Board of Directors.” (Bylaws)
3. Vice President for Speech-Language Practice: “…servicing as the Board liaison and facilitating Association activities designed to promote and enhance professional practices and service delivery in speech-language pathology.”
4. Vice President for Standards and Ethics in Speech-Language Pathology: “Initiating appropriate actions to ensure high-quality, culturally competent service delivery by speech-language pathologists.”
5. Vice President for Academic Affairs in Speech-Language Pathology: “Initiating appropriate recommendations for actions to advance undergraduate and graduate education in speech-language pathology;”
6. Chief Executive Officer: “The Chief Executive Officer shall supervise and have general charge of all operating functions and activities of the Association and shall be charged with carrying out the policies, programs, orders, and resolutions of the Board of Directors.”
We return to the question posed in an earlier post:
How are school curriculum trends identified, studied, described as course topics, and approved for implementation at the 300 or so national academic centers?
Our analysis settles on how an ASHA bifurcation makes curriculum processing almost impossible.
We begin to conceptualize curriculum inefficiency by considering curriculum processing — inputs, throughputs and outputs. Collaboration continues to be our source of evidence. Throughput is “the amount of material or items passing through a system or process.” (Google)
Three overlapping components under the supervision of the ASHA Board of Directors are coordinated to change curriculum in academic programs for graduate student.
Public Relations Component
1. The curriculum process starts with the identification of topics flooding in to ASHA headquarters via conference reports, advocates, blogs, journal articles, position papers, personal contacts, heath care trends, internet sources, letters to the editor and Facebook. The Vice President for Speech-Language Practice is responsible for evaluating the input: “Identifying issues and forecasting needs and trends; Initiating and directing recommendations to enhance professional and clinical practice in speech-language pathology services…” (2014)
2. The input serves the public relations functions of ASHA. Positive images of the profession are created, both for the non-profit organization in Washington, D.C., and the large and diverse ASHA membership. Members wish to see their professional curriculum positively presented. The ASHA Leader publication and the ASHA website are key public relations organs. To “…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.” http://www.asha.org/policy/SP2007-00283/ The public relations component supports income generation for products, services and charitable contributions.
3. Curriculum input serves to justify and support ASHA continuing education programs. Where graduate SLPs lack new knowledge for emerging practice, they must up-date skills through ASHA programs. ASHA encourages excitement for learning and professional pride. Members are obliged to maintain their credentials by taking yearly continuing education courses. Continuing education can cover professional knowledge not covered in graduate school. New topics are called “hot topics.”
ASHA maintains a well-developed Continuing Education Board in support: “The CEB develops the policies and procedures of the ASHA Continuing Education (CE) program. It comprises nine volunteer ASHA members and two monitoring vice presidents from the ASHA Board of Directors who serve as liaisons. The ASHA CE staff at the National Office implement the policies and procedures developed by the CEB. Seventeen ASHA CE staff directly support the CEB’s work.”
4. For topics having apparent weight, ASHA decision-makers facilitate analysis using a variety of techniques. Expert panels are assembled to sort out details. Invited articles organize and document content. Convention presentations foster broader discussions of emerging issues. Approved workshops provide instruction on clinical applications. Feature articles share success stories. Expert reports are published on the ASHA website. Quasi-policy statements are written to advocate for best-practice application.
5. Selected skill areas are designated “preferred practice patterns.” http://www.asha.org/policy/PP2004-00191/ Included is the Scope of Practice Document which serves as the input to the Accreditation process.
“We continue to explore how ASHA’s “curriculum process” works or is supposed to work to keep school practice up-to-date.”
A series of 18 posts bring the problem into focus. To explore the “process” the curriculum topic of collaboration has been employed in the manner of case study testing.
Collaboration enjoys a long modern history in ASHA as an important curriculum trend for school SLPs but ASHA standards trivialize collaboration training. Failure to actualized substantive collaboration training for American graduate students raises questions about ASHA authority, structure and leadership. Clearly the bylaws indicate the Board of Directors is responsible for this poor showing.
A tentative first theory to explain ASHA’s faulty curriculum process, namely, a poorly understood division between accreditation and public relations components, is sketched. Current talk of collaboration has been assigned to the public relations side to stimulate interest in continuing education programming. It is not directed toward the elaborate and well-funded accreditation committee. In various meetings of accreditation officials, collaboration is a non-topic. New certificate standards are coming to us in September of 2014, with no indication collaboration training has been upgraded.
Therefore the Board of Directors systematically promulgates a mixed message about collaboration, that it is a “HOT TOPIC” but not enough so to bring to preservice education.
“A house divided against itself cannot stand.” 1859, Abraham Lincoln.
When one goes through ASHA posts, policies and public records there is the impression all committees and functions are all equal in their representational connection to the membership. But underlying “ASHA” are intentional authority disjunctions which disrupt the development of the educational foundations of school speech-language pathology — curriculum!
Consider the U. S. Federal Reserve to understand the problem
In grammar school we learned the U. S. government represents us democratically. “Write your congressman if you want change” But the federal reserve is a different animal (Wikiepedia):
“The Federal Reserve System…was designed to serve the interests of both the general public and private bankers. The Federal Reserve System has a “unique structure that is both public and private” and is described as “independent within the government” rather than “independent of government”.
….The authority of the Federal Reserve System is derived from statutes enacted by the U.S. Congress and the System is subject to congressional oversight. The members of the Board of Governors, including its chair and vice-chair, are chosen by the President and confirmed by the Senate.”
While on paper it appears the president and congress supervise the Federal Reserve, the Fed has its own expansive power which in real financial circumstances out controls the U. S. government and operates independently.
Amazon: “The Creature from Jekyll Island: A Second Look at the Federal Reserve by G. Edward Griffin (Sep 11, 2010).”
The Founder’s Legacy
In 1910, speech-language pathology was flourishing in American schools. Immigrant children were coming and they required speech correction. Training was received in the colleges of education — normal schools. In 1930, a small group of speech professors took control over speech pathology to enhance their status on college campuses. They did not especially like school clinicians but they saw the political and financial benefits of capturing on-campus training programs, effectively taking them away from education.
In the 1950s the burdens of training therapists mounted. Supervision demands and certification paperwork grew. The ASHA organization was moved from one university to another and the clerical work had to be shared. The founders wanted to retain control of the organization but wanted to shed the demands of the burgeoning national organization.
Off to Washington
The tight-knit group of professors and their students hired an executive director and moved ASHA to Washington, D.C. from Wayne State University in Detroit. Two aims evolved:
1. retain tight control over the core mission and authority.
2. organize a practical system for ASHA’s housekeeping.
The first strategy was to ensure control over credentialing — accreditation of institutions and certification of students. Education had already been pushed out of the picture. Now ASHA must be the sole provider of certified professions, establishing a training cartel. Training increased on campus and off campus revenues. The executive director through a small group of hand-picked doctoral-level men embracing the founder’s vision ran the show. The director was Kenneth O. Johnson (1958-1980), a disciplined administrator who pushed hard for control of accreditation.
Like the federal reserve, a “semi-autonomous body” was formed, The Council on Academic Accreditation (CAA).
The public side of ASHA became a successful non-profit organization widely respected as a non-profit. It became a polished public relations organ for ASHA and built a large continuing education system. CCC graduates were required to sign up for continuing education. As to collaboration, the deficiencies carried over from graduate education might be addressed through the continuing education channel.
Whereas the Executive Director played a strong role in providing administrative support for credentialing, the elected ASHA president became the figurehead for the non-profit organization with public relations affairs.
Hence the schism was formed with tacit understandings that CAA business was largely off-limits. The powerful position of the Board of Directors represented in the bylaws was diluted by the need to continue on with historical separations.
When the CAA announced “accreditation decisions” for academic programs, it did so in a manner suggesting ASHA is a separate distant entity:
“Below is a list of recent accreditation decisions made by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) of the American Speech-Language-Hearing Association (ASHA).”
In all aspects of public affairs, ASHA proper should be the face of the organization. It carries the authority to change CAA.