ASHA Philosophy of Curriculum Turned Upside Down. 4

Mixed Curriculum Approach

Our analysis posits two competing models for understanding curriculum organization and study.  They were brought into contrast by the 1994 meeting to advance a “New Agenda” for graduate education. The academic and business approaches are revealed when discrepant interpretations arise for curriculum decision-making.

Within ASHA, where professional public communications occurs, the two approaches are mixed freely.  Members cannot sort out issues because they do not have intellectual control of how conflicts of interest occur, and why they occur. History advances. Institutional memories fade. Members are left with an Irish stew of options on which to base policy directions. Members talk past one and another without knowing how history is selecting their words.  Members grow older, retire and die.

Example

In the 2000s, SLPs reported ASHA was not supporting Scope of Practice in schools. IDEA had brought more disabled children into schools and caseloads grew.  Other school specialists were “encroaching” on SLP assignments. ASHA took the business approach, leaving scope of practice wide open for employer convenience.  This view fits exactly into the 1994 Spahr playbook, point-for-point:

“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.”

ASHA’s school group countered, saying scope of practice is professionally defined and should be recognized as such.  Ellen Estomin (ASHA Leader, April 6, 2010) said they agree with the part that says SLPs cannot dictate what other professionals do, or do not do, but they disagreed with the part saying SLPs do not “own” their scope of practice. Having a code of ethics, extensive training, a defined curriculum and prescribed roles, SLPs should confidently communicate their strengths to the public and employers.

Scope of Practice Leverage

CEO Spahr advanced his “New Academic Agenda,” implementing it through ASHA committees. In 2001 the Ad Hoc Committee on Scope of Practice in Speech-Language Pathology with approval by ASHA Legislative Council carried out the Spahr theme of the business oriented approach to SLP practice and graduate education:

“Speech-language pathology is a dynamic and continuously developing profession; listing specific areas within this scope of practice does not exclude emerging areas of practice. Although not specifically identified in this document, in certain instances speech-language pathologists may be called on to perform services (e.g., “multiskilling” in a health care setting, collaborative service delivery in schools) for the well-being of the individual(s) they are serving. In such instances it is both ethically and legally incumbent upon professionals to determine that they have the knowledge and skills necessary to conduct such tasks.”

ASHA Administration Protected

So we see clearly the scope of practice forces maximum SLP adaptability and holds SLPs responsible for their decisions. But ASHA takes little responsibility while meeting the expectations of impatient employers. ASHA protects the non-profit legally when curriculum policies are discussed, such as cases of Portal clinical descriptions:

“Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting.” (2015)

In another version of the same disclaimer is attached to the guidelines on collaboration: “Disclaimer: The American Speech-Language-Hearing Association disclaims any liability to any party for the accuracy, completeness, or availability of these documents, or for any damages arising out of the use of the documents and any information they contain.”

Spahr Strategy

We notice that the business-legal approach advances in the dark, with no public ASHA debate, often with edits of old texts made without comment, or conflicting texts.  In the end school SLPs are pushed to the end point of practice behavior, even if they have not had the relevant course work and must pay for continuing education.  They cannot count on their professional organization to step up to the plate, to advocate for graduates placed in work settings where they have to be their own advocates.  It’s a shame!

Plus who has time to figure out in each and every case whether one’s qualifications can be defended, when scope of practice expands whimsically to the benefit of employers who advocate for their own preferences?  Talk about “hung out to dry.”

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