ASHA Philosophy of Curriculum Turned Upside Down. 3

Curriculum Redesign

According to Dr. Spahr, a new SLP “product” should be graduated.  Cost-containment should be a factor.  SLPs should follow practices suitable for immediate application and revenue generation.

Here are the keys to reform of the traditional curriculum:

1. The curriculum in the academic centers should be designed for “competency-based” practice. Knowledge and skill should be adapted to the cases assigned.The number of courses taken is not that important. SLPs should not strive to be experts in narrow areas like language.

2. The curriculum focus should be on “knowledge, skills and attributes.” The approach decategorizes the traditional knowledge base in favor of “strands” of information (my term). Traditional course titles are less important. The “knowledge-skill paradigm” (my term) should be essential  to coursework and clinical application.

3. The curriculum should be designed to graduate “multiskilled, multifunctional, [and] cross-trained” SLPs.”  Cross-training allows employers to place SLPs in any service delivery configuration.  SLPs should work outside of their therapy rooms doing articulation therapy.

4. The curriculum should be designed to support broad scopes of practice. SLPs should be ready to take on all disabilities as assigned in a flexible and adaptive manner.

Translated into accreditation and certification standards, the new curriculum forced academic programs out of old patterns dating back to 1930.  It gave ASHA great leverage to control academic programs.  It also gave more control to marketplace pressures facing ASHA politically in 1994. The “New Agenda” weakened the strong case made over the years for full academic status of speech-language pathology in the United States.  As in other countries, speech-language pathology — speech therapy — can be viewed as a service program placed in medicine for example.  ASHA has similarly weakened the clinical doctorate, making it a non-research  degree.  It’s all about marketing and sales.

Which Model?

When I look over the Spahr proposal for curriculum modification I am aware of my own background.  It is academic and my instructional framework is to conduct research to support best practice.  An academic framework for curriculum looks something like this:

Academic: Courses are summaries of knowledge and experience known to be effective via textbooks and research articles. Courses achieving long-term status remain in the course inventory and must be justified to curriculum committees. Courses lacking best practice status and scientific backing are gradually dropped from the course inventory. New courses must be tested for science value. The use of best-practice courses along with scientific study create valid and reliable practice standards. Clinical supervisors work with professors to apply course principles. Efforts are made to achieve precise nomenclature, again under review and approval. Valid courses are carefully placed in the scope of practice. SLPs are encouraged to use methods meeting best practice standards, and to avoid methods regarded as unscientific.  The scope of practice governs the range of clinical conditions treated by SLPs.

On the other hand, Dr. Spahr advocated what I would call a business view of curriculum development, defined this way:

Business:  Courses are products to be marketed for revenue advantages. Courses marketed for continuing education are exciting. Building the brand requires a variety of products responding to customer demands. The more acceptable courses placed in the scope of practice, the better. Variety satisfies a range of employers and customers.  Shredded courses reduced to knowledge-skill strands let SLPs service more disabilities and clients in different settings. Strands are desirable to place in collaborative programs making SLP services more useful to employers. Fixed service boundaries make it difficult to squeeze SLPs into different service categories. Where curriculum selections are unpopular, they are placed on the bottom shelf, e.g. articulation. Where they are popular, they can be marketed effectively, e.g. autism.  SLPs are encouraged to use methods desired by employers, and to show less favor for courses not meeting employer desires. ASHA should view SLP graduates as “products” to be marketed to potential employers.

Marshalla, P. (2007). Letters. A travesty! The ASHA Leader, Aug. 24.

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