Monthly Archives: July 2013

4. More on The Mystery of the ASHA Curriculum Process Process

In 2009 an ASHA committee published the results of a survey of SLP views of service delivery overlap. Respondents expressed concern about the “…expanding scope of practice in the field.” They were asked to “…work in areas they deemed inappropriate given their training and comfort levels.” Some disapproved “…of SLPs’ involvement in specific areas of practice, including swallowing, literacy, and cognition.”

Role Ambiguity and Speech-Language Pathology, ASHA Leader, December 15, 2009, p. 12, Coordinating Committee of the Vice President for Speech-Language Pathology Practice, Brian Shulman, Vice President.

While ASHA received negative feedback from school members its public relations arm continued to push for new “responsibilities”: “In response to dramatic changes in school-based practice, ASHA has developed a new position statement and professional issues statement on the roles and responsibilities of speech-language pathologists in schools.”

The responsibilities included:

(a) reinforce SLP roles in schools; (b) serve all levels and client types; (c) ensure educational goals; (d) make contributions to school curriculum; (e) highlight language and literacy services; (f) conduct culturally relevant services (g) range of programmatic responsibilities (prevention, assessment, intervention,program design, data work, compliance); (h) collaborate; (i) leadership (advocacy, supervision, professional development, parent training, workload realignment, professional preparation, lifelong learning).

http://www.asha.org/Publications/leader/2010/100803/New-Schools-Document.htm

Comment

The curriculum process is unclear and paradoxical. New “responsibilities” are heaped on school personnel while long-standing concerns are ignored.

3. The Mystery of ASHA’s Curriculum Process

In the last post we found that for 23 years ASHA has heavily advocated collaboration for school SLPs but has not developed academic coursework to support the skills SLPs needs. We asked whether ASHA has a curriculum process? Is it set up to evolve new course offerings in a steady and systematic fashion?
We wonder whether collaboration is only an isolated example of equivocal response to changing curriculum demands.

Reading

Cynthia Sudduth Feeney in January of 2008 (ASHA Leader, 13, 4) wrote a letter to the editor (“SLPs or Reading Specialists?”) expressing concerns about school SLPs being pushed into providing reading intervention. She remarked that training for reading was not in her graduate program although she had nothing against reading instruction in principle.

The Feeney letter set off a flurry of important letters in the spring of 2008. On the whole, writers embraced reading intervention as a good idea within the framework of collaborative education but questioned having time for it, and whether it was legitimately within their scope of practice.

Christine MaGrath wrote a letter in March, with the title, “Literacy Instruction Requires Literacy Credentials.” Kenn Apel pointed out ASHA already had reading and writing in its scope of practice document. An Editor’s Note was added: “The ASHA position statement, Roles and Responsibilities of Speech-Language Pathologists With Respect To Reading and Writing in Children and Adolescents,” states that SLPs…play a critical and direct role in the development of literacy for children and adolescents with communication disorders…”

Iris Weiss agreed with Feeney and thought ASHA should survey opinions of school SLPs “in the trenches” because they are the ones who are to implement proposed changes. In June, Barbara Coonan, in “We Can’t Do It All,” said, ” I respect Dr. Apel, but his response to Ms. Feeney indicates that our field continues to be plagued by a gap between research and practice. One of Ms. Feeney’s points was that ASHA doesn’t address the reality of our workday.”

Comment

This is a second example of ASHA’s slow and confusing response to an identified need for pre-service curriculum change in the universities and colleges.

It has been slow because for at least 15 years expert groups within ASHA have recommended school SLP involvement in literacy but curriculum change has not happened.

It is confusing because ASHA continues to push school SLPs into literacy with little or no input from the real workers who must implement change (as Ira Weiss emphasized). On the basis of small numbers of experts brought to Washington, D. C., for panel work, new content is simply inserted in practice documents and labeled “responsibilities” on the basis of ASHA authority.

Without the specifics of school practice, wide-ranging public debate and systematic curriculum follow-up, busy school professionals are left to ask, “Where is all of this coming from? Do they even know what we are doing out here?”

2. Does the American Speech-Language-Hearin g Association Have a Curriculum Process?

In our last post we raised questions about ASHA’s curriculum process. It is correct to say we are flummoxed by it.

Take the example of collaboration in schools. Collaboration is an old topic in the field. Sylvia Hanna and I as clinical supervisors at Ohio University in 1967 were part of an interdisciplinary team sent out on Saturdays into Appalachia to help with free diagnostic clinics. We organized our notes, had pictures taken and published an article in Rehabilitation Literature on the positive outcomes observed. It was selected as the featured article of the month. Since that experience many projects in collaborative programming have been carried out around the country. I have been a part of several collaborative programs on campus.

In 1975 Public Law 94-142 was enacted by congress. The courts upheld procedures obliging school speech pathologist to collaborate in the planning process for special education children. IDEA legislation later promoted response to intervention where for SLPs were asked to collaborate with general educators.

The ASHA Model

In a report received by the ASHA Executive Board in October of 1990, called “A Model for Collaborative Service Delivery for Students with Language-Learning Disorders in the Public Schools,” the idea of collaborative education in schools was thoroughly developed by the Committee on Language Learning Disorders. The report covered the topics of collaborative service delivery, collaborative teams, administration, planning programs, assessment, intervention, accountability and references (74 items). The report was authored by an expert ASHA panel of administrators, clinicians and academics. Research was described as a basis for collaborative practice. The report was highlighted in PubMed.gov in 1991: Collaboration…”holds great promise for providing services to maximize the functional potential of students with language-learning disorders.”

In 2002, Kathleen Whitmire, ASHA’s Director of School Services, promoted flexible SLP service delivery: “When developing the intervention plan, the team should take into consideration the full spectrum of service delivery options when deciding which options are appropriate for meeting the individual needs of the child. It may be appropriate to provide a mix of options, e.g., classroom-based, individual pull-out, and consultation, to help the child establish basic speech-language skills, examine attitudes and beliefs, and apply skills in various contexts.”

Continued Support

In 2009, in the ASHA Leader (December), President Sue Hale advocated for partnerships: “The opportunities for collaboration are limitless, and will help create more clinical outcomes and better science to enhance both professions.”

In the same edition, the Coordinating Committee of the Vice President of Speech-Language Pathology Practice report on page 12 on the collaborative role of speech-language pathology and changes on the horizon: “A key component of these changes has been the increased use of collaborative models for care that require speech-language pathologists to learn new skills related to team dynamics and conflict resolution.” Further: “A potential response to environmental changes in education and health care is to increase collaboration and teaming to enhance functional outcomes.”

In 2010 ASHA published its professional position statement on the “Role and Responsibilities of Speech-Language Pathologists in Schools.” The word “responsibility” signalled school SLPs now had a professional obligation to adopt the practices described. A section was devoted to collaboration where SLPs must work cooperatively with general education and special education. SLPs must also cooperate with university programs, communities, families and students. “Work within the larger context of education, such as with literacy, curriculum and RTI, require close collaboration with other educators.”

In the June, 2013 edition of The ASHA Leader, articles were presented on the status and potential of collaborative SLP practice. Instead of talking about collaboration Interprofessional education (IPE) is referenced. Aruna Hari Prasad, ASHA’s associate director of school services, writes on the value of collaboration in schools. Collaboration engenders a broader view of special education, more coordinated services, more creativity, more efficiency and easier parent involvement.

Comment

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.

If collaboration is such a good idea, why hasn’t ASHA acted on it? Is there no orderly process to address new curriculum topics?

“But do communication sciences and disorders graduates have the skills they need for successful collaboration with other professionals? The fact is that formal training in this area has lagged dramatically behind practice expectations” (Judith L. Page &  Donna S. Morris, ASHA Leader, May 15, 2012)