23. ASHA Curriculum Process Mystery Resolved

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?”

Kids stuff for school.

Kids stuff for school.

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.

Schism Confirmed

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)

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