Preparing to Effectively Supervise the SLP-Assistant

1. Preparing to Effectively Supervise the SLP-Assistant TSHA Annual Convention San Antonio, Texas February 22, 2008 Rosario R. Brusniak

2. Preparation Are you ready to supervise? • What are the state guidelines for SLP-Assistant supervision? • Supervisors must have 3 years of professional experience • Supervisors cannot supervise more than 4 SLP-Interns and/or SLP-Assistants • See §741.44 and §741.64 of Board rules

3. Preparation Remember that SLP-Assistants DO NOT have their own caseloads SLP-Assistants provide therapy for the caseload of their supervising SLP(s) SLP-Assistants are tied to the caseload of their SLP supervisor(s) SLP-Assistants may have more than one supervisor, but each completes a SRS – Supervisory Responsibility Statement

4. Preparation SRS need not be submitted annually if the SLP-Assistant and SLP supervisor remain the same, however, if the SLP-Assistant or SLP supervisor change, then the board must be notified in writing SRS must be approved by the board prior to supervision taking place The board can fax acceptance or denial of the SRS to a designated FAX phone number

5. Preparation Review Code of Ethics and Duties and responsibilities of all license holders Up to date information on both SLP-Assistants and SLP supervisors can be found on the SBESPA website and looking for Live-On Line Search Verification Documentation of SLP-Assistant direct and indirect supervision must be kept

6. Knowledge and Skills ASHA 2002 – Knowledge and Skills for Supervisors of Speech-Language Pathology Assistants 17 knowledge and skills have been identified: • Select and assign appropriate patients • Determine the nature of supervision for SLP-Assistant • Maintain an effective relationship with SLP-Assistant • Direct SLP-Assistant in following screening protocols

7. Knowledge and Skills 5. Demonstrate and participate with SLP-Assistant in the clinical process 6. Direct SLP-Assistant in addressing the specific treatment plans developed by SLP 7. Direct SLP-Assistant in maintaining clinical records 8. Interact with SLP-Assistant in planning and executing supervisory conferences 9. Provide feedback to SLP-Assistant 10. Assist SLP Assistant in developing skills of verbal reporting to SLP

8. Knowledge and Skills 11. Assist SLP-Assistant in selecting, preparing treatment materials/environment 12. Share information re: ethical, legal, regulatory and reimbursement issues 13. Model and facilitate professional conduct 14. Direct SLP-Assistant in implementation of research procedures, in-service training 15. Train SLP-Assistant to check and maintain clinical equipment 16. Assist SLP-Assistant in using appropriate language when interacting with clients/patients

9. Preparation Be sure SRS has been approved and that you have confirmation (fax; written from the board) Be sure if there is a Clinical Deficiency Plan to complete it as soon as possible with the required 100% supervision Note dates of license renewal for all SLP-Assistants as well as your own license Monitor Continuing Education Units (CEUs)

10. Preparation In the school setting – meet with the respective school administrators and special education staff to outline specific information regarding duties, limitations of the SLP-Assistant license – set up a procedure to contact you regarding initial referrals, re-evaluations and ARD/IEP meetings (leave business card) -- meet with school personnel to inquire about specific programs used for documentation, etc.

11. Setting up the Supervision Plan Does the SLP-Assistant have the necessary prerequisite computer skills and knowledge to collect and document data Sit down with SLP-Assistant and investigate clinical skills they bring to the job; training they would need to work with particular types of disorders, working with adults vs. working with children; behavioral and attention problems, etc.

12. Setting up the Supervision Plan Nine Areas of Knowledge for all graduate students: • Articulation • Fluency • Voice and Resonance • Receptive and Expressive Language • Hearing • Swallowing • Cognitive Aspects of Communication • Social Aspects of Communication • Communication Modalities

13. Setting up the Supervision Plan Review current caseload/projected caseload Determine which cases to be seen by SLP-Assistant – frequency, therapy time and include associated information Review goals and objectives for all clients All initial contact for all clients is made by SLP supervisor (can include diagnostic) Prepare a weekly schedule for the SLP-Assistant

14. Setting up the Supervision Plan Alternate direct therapy observations during the week to make sure that you observe the SLP-Assistant with all clients Remember all clients be notified that services will be provided by SLP-Assistant Plan weekly to meet for supervisory conferences (can be via e-mail; phone calls, weekly group conferences and individual conferences)

15. Setting up the Supervision Plan Maintain a reasonable therapy caseload – be guided by what is reasonable, ethical. -- be guided by information available regarding current workloads se: ASHA’s resource guide – A Workload Analysis Approach for Establishing Speech-Language Caseload Standards -- remember that the care and treatment of each client is ultimately your responsibility

16. Research in Supervision Supervisory effectiveness was found to be better when structured accountability (e.g. a written agreement/contract) is introduced into the supervisory conferences. Commitments ranged from: Type 1 – Clinical procedures – implementation and/or change of a therapy technique

17. Research in Supervision Type 2 – Clinical process administration – planning, data gathering, lesson plans Type 3 – Supervisory procedures regarding the conferences, focus of therapy, etc. Type 4 – Supervisory Process Administration, planning, analysis or evaluation phrase of the supervisory conference Type 5 Academic Information-Teaching Function – securing specific information

18. Research in Supervision McCreedy article “Supervision of SLP-Assistants as a Reciprocal Relationship” Stages of Supervision • Evaluation-Feedback Stage – beginning, where SLP has direct and active supervisory role • Transitional Stage – supervisee takes a more active role in problem solving

19. Research in Supervision • Self Supervision – SLP-Assistant is asked to evaluate clinical behaviors accurately Components of the Supervisory Process • Understanding the Supervisory Process and Planning • Observing/Monitoring • Reviewing and Analyzing • Learning/Integrating

20. Research in Supervision Active Listening and Conflict Management Active listening affects interpersonal communication. Hocker and Wilmot – typical responses to conflict are: • Avoiding a conflict or confrontation • Competing with the other person for control • Collaborating for mutual problem solving

21. Research in Supervision McCreedy article – Comparison of conflict tactics in the supervisory process Three different tactics: • Avoidance Tactics – uses semantic focus, topic avoidance, abstractness, simple denial • Competitive Tactics – uses hostile joking, hostile questioning, prescription, faulting, avoids responsibility • Collaborative Tactics – uses problem solving, empathy/support; accepting responsibility; disclosure

22. Other Supervisory Considerations Learning Styles • Modalities – visual; auditory, tactile-kinesthetic and multimodality • Thinking styles – concrete, abstract, random; analytical, global • Personalities – acts as a filter includes: directing; influencing, steady and conscientious

23. Other Supervisory Considerations • Expressions – Linguistic; Spatial; Mathematical/Logical; Body/Kinesthetic; Interpersonal; Mechanical; Musical; Natural • Personality types Keirsey’s Temperament Types (4) • Guardians – demand responsibility, duty • Idealists – support and encourage others

24. Other Supervisory Considerations • Artisans – troubleshoot, respond to crises and negotiate • Rationals – demand a high level of expertise and high standards of competency Dr. Gary Smalley and Dr. John Trent – base their personality types on animals: • Lion – is independent, strong willed, leader; wants you to be efficient, to the point

25. Other Supervisory Considerations • Otter – outgoing, responsive, warm compassionate, wants you to be stimulating and interesting • Golden Retriever – is calm, easy-going, dependable, quiet and wants you to be cooperative and pleasant • Beaver – is analytical, self-disciplined, organized wants you to be accurate and precise

26. Training Clinical Skills Provide supervision in a variety of ways – one on one; videotapes; small group session Periodically gather data to evaluate effectiveness Identify on a weekly basis clinical therapy needs of the SLP-Assistant Maintain the 1 hour direct/1 hour indirect supervision requirement

27. Training Clinical Skills • SLP supervisor cannot fill in for another SLP supervisor • Utilize formal SLP-Assistant evaluation Forms via ASHA, TSHA and handout • If new to the supervisory process locate a SLP supervisor Mentor who has experience with this process and meet with them on a routine basis

28. Training Clinical Skills Set up realistic collaborative goals for SLP-Assistant Contact graduate programs in Texas for additional resources regarding forms they may use in their graduate training programs Look on TSHA and ASHA website for CEUs in supervision

29. Representation at ARD/IEP mtgs SBESPA has specific guidelines on when a SLP-Assistant may represent speech pathology SLP-Assistant must: • Have written documentation of approval from the licensed board SLP supervisor • Have three years experience in the school setting as a SLP-Assistant

30. Representation at ARD/IEP mtgs • Have written approval of SLP for students seen by the SLP-Assistant but only reports progress and new goals/objectives already developed by the SLP supervisor • Discontinue the ARD/IEP meeting if questions or changes to the document arise • Use the correct title of SLP-Assistant or Speech Pathology Assistant on the paperwork

31. Representation at ARD/IEP mtgs The SLP Supervisor prior the ARD meeting must: • Notify parents of students that services will be provided by SLP-Assistant and that SLP-Assistant will represent speech pathology at meeting (important to develop a form/letter that can be used) • Develop the new IEP goals and objectives • Maintain undiminished responsibility