6. SLP Collaboration

The American Speech-Lanaguage-Hearing Association (ASHA) has published a survey study concerning “Role Ambiguity and Speech-Language Pathology” (The ASHA LEADER, December 15, 2009, pages 12-15) in which a number of issues are raised about SLP collaboration. A national sample of 4,708 members was used for the survey.
Sixty-five % were clinical service providers. Findings can be found online [http://www.asha.org/Publications/leader/2009/091215/RoleAmbiguity.htm]

The report documents the problems SLPs have participating in collaborative programs and offers eight general solutions.

A major concern was whether other specialists “encroached” on SLP practice. Half those surveyed said they had experienced it. Pinpointed were academic language therapists (89%), occupational therapists (65%), teachers (58%), nurses (55%) and reading specialists (50%). Encroachment centered around language/literacy (64%), autism (63%), learning disabilities (59%), early intervention (53%) and dysphagia/swallowing disorders (52%).

The SLPs thought other specialists did not know enough about SLP practice, and 71% thought ASHA should do something about encroachment, together with state associations (42%), state licensure boards (41%) and individual facilities (39%). Although ASHA recognized the challenges collaboration presents (time, money, information gaps, training, conflict), it took this position:

“It is ASHA’s position that SLPs do not “own” any aspect of their scope of practice, nor can they dictate what another profession can or cannot do. Clearly, speech-language pathology shares professional boundaries with related professions, and SLPs need to understand other team members’ expertise while articulating the value of their own unique knowledge and skills.”

Ellen Estomin (ASHA Leader, April 6, 2010) on behalf of the ASHA’s school-based SLPs said they agree with the part that says SLPs cannot dictate what other professionals do, or do not do, but they disagree with the part that says SLPs do not “own” aspects of scope of practice. Having an ethical code of conduct, extensive training, defined scope of practice and prescribed roles and responsibilities, SLPs should confidently communicate their strengths to the public.

It is clear the school-based SLPs are correct. ASHA properly certifies graduates in accredited institutions, and states add legal certification requirements. IDEA 2004 regulations and state statutes specify the legal foundations for SLP functions, functions in the past ASHA has lobbied for to Congress. School SLPs “own” articulation, whereas they do not “own” literacy:

“Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance” (Office of Special Education and Rehabilitation Services, Education: 34 Code of Federal Regulations, Section 300.8, Oct. 30, 2007).

It can be argued SLPs encroach on reading specialists when they assert rights to be accepted into literacy circles. Saying you have literacy expertise is not the same as Congress saying you have literacy expertise.

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