Donna D. Merritt, Ph.D., CCC SERC Mary Jo Chretien, M.S., CCC Thompson Public Schools

1. Supporting Students’ Communication Needs in CT Schools with SLP Assistants and Aides (SLPAs)A Self- Guided Tutorial Donna D. Merritt, Ph.D., CCC SERC Mary Jo Chretien, M.S., CCC Thompson Public Schools

2. PD Description Speech-Language Pathology Assistants or Aides (SLPAs) can supplement the delivery of speech and language services in schools and have a positive impact on students’ communication skills. This professional development will describe the scope of tasks and activities appropriate for SLPA implementation, as well as the types and frequency of supervision required. It will also address the benefits and restrictions of using SLPAs by determining the viability of their use and analyzing cost effectiveness.

3. Learner Objectives Participants completing this professional development will: • improve student learning for children with communication disabilities by clarifying the range of activities appropriate for SLPA implementation and the level of supervision required to perform them; and • examine the need for SLPAs and the viability of their use.

4. Application of Learning A brief quiz is included at the conclusion of this tutorial to assess application of learning. Questions are framed as TRUE or FALSE. The quiz can be downloaded as a Word document and an answer key is provided for self-evaluation.

5. Tutorial Topics • Evolution of School-Based SLPs • Qualifications and Credentials of SLPs • Legal Guidance • Reasons for Using SLPAs • Levels of SLPAs, Prerequisites and Roles • SLP Supervision • Cost Effectiveness

6. Evolution of School-Based Speech-Language Pathologists (SLPs) • Expanded knowledge, research base and scope of professional practice • Change from traditional roles in schools

7. Students with more significant needs are included in schools and often require the expertise of an SLP

8. SLPs have a role in determining language difference from language disorder in Connecticut’s English Language Learners

9. SLPs have additional roles within the general education continuum of support

10. Unique Qualifications of SLPs • Master’s Degree in Speech-Language Pathology (often 60 credits) • Supervised Practicum • Coursework • Child and Adolescent Development • Neurology • Communication Disorders • Language Difference vs. Disorder • The Speech and Language Basis of Literacy • Communication, Social Interaction and Behavior

11. Professional SLP Credentials • Required • Connecticut State Department of Education Certification (061) • Department of Public Health Licensure • Recommended • American Speech-Language-Hearing Association (ASHA) • Connecticut Speech-Language Hearing Association (CSHA)

12. SLP Shortage • Connecticut shortage area • Consistent with national trend • CT universities graduating more SLPs • Financial incentive to choose school-based practice varies • LEAs exploring different models of service delivery

13. Assisting SLPs • Some tasks and activities related to providing supports and services for students with communication needs can be performed by support personnel with supervision

14. Connecticut Law • Speech-Language Pathology Assistants/Aides may assist SLPs to complete tasks that are: • Designed by the SLP; and are • Routine; • Involve implementing plans developed by the SLP (i.e., IEPs); • Include collecting or charting data; and could entail • Supporting maintenance of AAC and AT devices

15. CSDE Guidance “… Under the Connecticut SLP licensure statute and regulations and codes of ethics of national and state professional associations, the SLP has legal authority and ethical responsibility for overseeing the design, implementation and supervision of … speech and language services” (Guidelines for Speech and Language Programs, CSDE, 2008).

16. Reasons for Using SLPAs • To augment the delivery of speech and language services – a shared work load • To serve the needs of students and families from diverse cultures and linguistic backgrounds • To direct the expertise of SLPs where it is most needed

17. Level 1: SLP Aide • Education • High School diploma • GED or equivalent • Training • “Home grown” • Typically “on-the-job” • Supported by relevant college or vocational coursework Directed and supervised experience by a DPH licensed and CSDE certified SLP

18. Level I SLPA Roles • Provide clerical support • Assemble bulletin boards • Search for materials (e.g., finding pictures on the Internet) • Prepare instructional materials • Work with individual students or small groups to extend practice of specific skills as assigned, directed, and supervised by an SLP • Maintain assistive devices (e.g., FM units)

19. Level I SLPA Roles (cont.) • Assist in broad-based screenings (e.g. kindergarten) • Support family education programs • Record, chart and graph student data • Assist in communication with families and students learning English • Support computer-assisted learning activities

20. Level 2: SLP Assistants • Education • Associate Degree in Speech-Language Pathology, or • Post secondary equivalent course work and equivalent training and experience • Professional Development • Relevant activities and workshops; • Selected post-secondary courses • Directed and supervised experience by a DPH licensed and CSDE certified SLP

21. SLPA Roles – Level II • Assist in speech-language and hearing screenings (without interpretation) • Assist in an array of non-instructional activities (e.g., clerical support, equipment maintenance) • Assist in an array of indirect instructional activities (e.g., construction of materials)

22. SLPA Roles – Level II (cont.) • Maintain assistive devices (e.g., AAC/AT) • Instruct students in the use and maintenance of assistive devices • Administer and score objective speech-language screening instruments • Assist the SLP during speech and language assessments

23. SLPA Roles – Level II (cont.) • Work with individuals and small groups as assigned, directed and supervised by an SLP • Follow lesson plans • Document student performance (i.e., progress monitoring) by collecting and tallying data and recording it on charts and graphs

24. SLPA Roles – Level II (cont.) • Maintain an intervention log as determined by the supervising SLP (co-signed by SLP) • Support staff professional development • Participate in meetings WITH the supervising SLP and others (e.g., PPT) • Assist with family service (e.g., gathering information; sharing resources)

25. An SLPA May Not … • Represent herself or himself as an SLP • Administer standardized or non-standardized diagnostic tests or assessments • Interpret assessments • Screen or diagnose communication concerns

26. An SLPA May Not … • Demonstrate feeding or swallowing techniques or procedures • Use a checklist or tabulate results of feeding and swallowing evaluations • Participate in parent conferences, case conferences, PPT meetings, or any interdisciplinary team meetings without the presence of an SLP

27. An SLPA May Not … • Communicate with the student’s family or others about the child’s individual status or service without the consent of the supervising SLP • Write, develop or modify an IEP or an IFSP in any way • Provide speech and language intervention without access to supervision by an SLP • Sign formal documents

28. An SLPA May Not … • Select students for intervention • Discharge students from services • Make referrals for additional services • Counsel or consult with the student, family or others regarding the student’s progress, service or needs • Disclose educational or confidential information in oral or written form

29. Supervision of SLPAs • SLP Supervisor • DPH license • CSDE certification (061) • Two or more years of practice in a school setting • Appropriate supervising competencies • Supervision of no more than 3 SLPAs

30. Supervision of SLPAs (cont.) • Minimal Supervision Requirements • At least 30% of SLPA student contact time is required to be supervised during the first 90 workdays (20% direct; 10% indirect) • The first consecutive 10 hours of student contact following initial hiring should be directly supervised (i.e., minimum of 2 school days) • After 90 days supervision is required for no less than 20% of student contact time

31. Supervision of SLPAs (cont.) • Direct Supervision and Student Contact • At least half of the SLPA supervision time (10%) must be direct • On-site • In view (i.e., face-to-face) observation • While the service is being performed by the SLPA • The SLP must also share the intervention by maintaining direct contact with students at least once every two weeks. This is in addition to SLPA supervision time.

32. Supervision of SLPAs (cont.) • Indirect Supervision Up to half of SLPA supervision time can be indirect (up to 10%) • Demonstration (requires face-to-face contact with SLPA) • Record review and data analysis • Review of audio or video-taped sessions • Telephone conferencing • The supervising SLP must be able to be reached by personal contact, phone or pager at all times

33. Documenting Services and Supervision • Establish supervision protocols and procedures • Communicate with families • Maintain intervention logs Read and co-sign documentation

34. SLPA Supervision Strategies

35. Realities of SLPA Supervision in Schools • Maintaining 20% minimum supervision requires more than 1 day of the SLP’s time per week • Because the student caseload is shared, the SLP needs additional time to: • Complete speech and language evaluations • Analyze data • Write IEPs • Attend PPTs • Create/evaluate lesson plans • Maintain direct contact with parents and students • Write reports

36. Financial Considerations District has one FTE SLP and needs 7.5 days per week of speech-language services = • Scenario 1 • District hires one full time SLP plus one ½ time SLP • Scenario 2 • District hires one full time SLP plus one full time SLPA (30% overlap) • Scenario 3 • District hires one full time SLP plus one full time SLPA (50% overlap)

37. Changing Practice

38. PD for SLPAs • General and Special Education Topics • Curriculum standards • Literacy • Behavior • Transition planning • Least Restrictive Environment/Inclusion • Autism Spectrum Disorders • Learning Disabilities

39. Application of Learning

40. Resources ASHA (1996). Guidelines for the training, credentialing, use, and supervision of speech-language pathology assistants. Asha, 38 (Suppl. 16, 21-34). CSDE (1999). A guide for the training, use and supervision of speech-language pathology aides and assistants in Connecticut. Moore, S.M. & Pearson, L. (2003). Competencies and strategies for speech-language pathology assistants. Née: Delmar. Tanner, D. C. (1997). Handbook for the speech-language pathology assistant. CA: Academic Communication Associates.

41. Contact Information Donna D. Merritt, Ph.D., CCC Speech-Language Pathologist and Consultant SERC merritt@ctserc.org Mary Jo Chretien, M.S., CCC Speech-Language Pathologist Thompson Public Schools mchretien@thompsonpublicschools.org