Personnel Issues in Early Intervention Part C: A Discussion With Service Provider Associations

1. Personnel Issues in Early Intervention Part C: A Discussion With Service Provider Associations OSEP National Early Childhood Conference December 8, 2008 Diane R. Paul, PhD, CCC-SLP Director, Clinical Issues in Speech-Language Pathology

2. What strategies is your association using to address personnel shortages in early intervention? National Coalition on Personnel Shortages in Special Education and Related Services: www.specialedpros.comMission Sustain a discussion among all stakeholders on the need for and value of special education, related services, and early intervention Identify, disseminate, and support implementation of national, state, and local strategies to remedy personnel shortages and persistent vacancies for the benefit of all children and youth

3. What strategies is your association using to address personnel shortages in early intervention? …… Coalition Activities Collect data on personnel shortages across professions Establish Web site on careers in various professions Can link to professions on Web site Can get certification and job information Provide centralized location for resources about professions and shortages Offer outreach to school administrator and policy maker groups Work with states to help implement good data systems and recruitment and retention of qualified providers

4. What strategies is your association using to address personnel shortages in early intervention? …… Coalition Activities… Advocate for specific legislation Support loan forgiveness Support related groups to establish Department within ED that addresses related professionals and specialized instructional support personnel Start recruitment in middle and high schools Provide telepractice in rural areas

5. ASHA Web Page on Personnel Shortages Examples of successful recruitment/retention strategies in state and local districts http://www.asha.org/about/recruitment/schools Financial incentives Salary supplements or other compensation Relocation expenses/higher pay/sign on bonus Workload management ideas Use of a caseload/workload model to increase student services Establishing district-wide eligibility/dismissal criteria that incorporate the workload model Clerical, technical, or other support Success stories: Receiving additional equipment, resources, payment for fees, and professional development Model collaborative university and school district partnerships Model university distance learning and incentive programs Career recruitment materials What strategies is your association using to address personnel shortages in early intervention? ……

6. Complexity of Personnel Shortage Issue Attracting people to professions early Personnel preparation program capacity Choice to work in school setting when there are a choice of settings Retention What strategies is your association using to address personnel shortages in early intervention? ……

7. Causes for Personnel Shortages Small personnel preparation programs Intensity of clinical education Programs are expensive People have choice of settings Increased demand for services because of federal mandates Population has grown—demand for services at both ends of spectrum Babies surviving with more complex medical needs Children with medical problems being seen in schools Desire for better quality of life Women have more career choices Low pay Efforts not focused on retention and valuing employees What strategies is your association using to address personnel shortages in early intervention? ……

8. Impact of Shortage on Early Intervention Services Pressure to use transdisciplinary model when there may not be adequate training Limited one-on-one services Reduced frequency or intensity of service Concern about quality of services and lower standards States have flexibility to have bachelor level personnel Staying in services longer than necessary Less focus on prevention Imposition of early childhood credentials that may not be needed Waste of tax payers’ money if services are inadequate or inappropriate What strategies is your association using to address personnel shortages in early intervention? ……

9. Describe your position statements/standards on training personnel to work in early intervention. Speech-Language Pathology Early Intervention Policy Documents Roles and Responsibilities of Speech-Language Pathologists in Early Intervention: Position Statement Roles and Responsibilities of Speech-Language Pathologists in Early Intervention: Technical Report Roles and Responsibilities of Speech-Language Pathologists in Early Intervention: Guidelines Core Knowledge and Skills in Early Intervention Speech-Language Pathology Practice Roles of Speech-Language Pathologists in the Neonatal Intensive Care Unit: Position Statement Roles and Responsibilities of Speech-Language Pathologists in the Neonatal Intensive Care Unit: Technical Report Roles and Responsibilities of Speech-Language Pathologists in the Neonatal Intensive Care Unit: Guidelines Knowledge and Skills Needed by Speech-Language Pathologists Providing Services to Infants and Families in the NICU Environment

10. Guiding Principles Services are family centered and culturally and linguistically responsive. Services are developmentally supportive and promote children's participation in their natural environments. Services are comprehensive, coordinated, and team based. Services are based on the highest quality evidence that is available. Describe your position statements/standards on training personnel to work in early intervention…..

11. Roles of Speech-Language Pathologists in Early Intervention Implemented in collaboration with families, caregivers, and other professionals Implemented in accord with the four guiding principles Prevention Screening, evaluation, and assessment Planning, implementing, and monitoring intervention Consultation with and education for team members, including families and other professionals Service coordination Transition planning Advocacy Awareness and advancement of the knowledge base Describe your position statements/standards on training personnel to work in early intervention…..

12. Audiology Early Intervention Policy Documents Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs Roles, Knowledge, and Skills: Audiologists Providing Clinical Services to Infants and Young Children Birth to 5 Years of Age Guidelines for the Audiologic Assessment of Children From Birth to 5 Years of Age Guidelines for Audiologists Providing Informational and Adjustment Counseling to Families of Infants and Young Children With Hearing Loss Birth to 5 Years of Age Fact Sheet Natural Environments for Infants and Toddlers Who Are Deaf or Hard of Hearing and Their Families Early Hearing Detection and Intervention (EHDI) Program Check List Access Audiology on EHDI (Vol. 6, No. 6, November/December 2007) Describe your position statements/standards on training personnel to work in early intervention…..

13. Highlights from 2007 Joint Committee on Infant Hearing Position Statement The goal of early hearing detection and intervention (EHDI) is to maximize linguistic competence and literacy development for children who are deaf or hard of hearing. Early intervention services for infants with confirmed hearing loss should be provided by professionals with expertise in hearing loss, including educators of the deaf, speech-language pathologists , and audiologists. Intervention programs should recognize and build on strengths, informed choices, traditions, and cultural beliefs of the families Describe your position statements/standards on training personnel to work in early intervention…..

14. Highlights from ASHA Audiology Policies Children with confirmed hearing loss and their families have the right to prompt access to quality intervention services. Successful early intervention programs (a) are family centered, (b) provide families with unbiased information on all options regarding approaches to communication, (c) monitor development at 6-month intervals using norm-referenced instruments, (d) include individuals who are deaf or hard of hearing, (e) provide services in a natural environment in the home or in the center, (f) offer high-quality service regardless of where the family lives, (g) obtain informed consent, (h) are sensitive to cultural and language differences and provide accommodations as needed, and (i) conduct annual surveys of parent satisfaction. Describe your position statements/standards on training personnel to work in early intervention…..

15. Standards for Accreditation of Graduate Education Programs in Audiology and Speech-Language Pathology (Effective January 1,2008) Instruction in foundations of audiology must include opportunities for students to acquire knowledge in speech and language characteristics across the life span associated with hearing impairment The program [audiology and speech-language pathology] must describe how it ensures that each student is exposed to a variety of populations across the life span and from culturally and linguistically diverse populations The program [speech-language pathology] must provide opportunities for students to acquire and demonstrate knowledge in principles and methods of prevention, assessment, and intervention for people with communication and swallowing disorders across the life span Describe your position statements/standards on training personnel to work in early intervention…..

16. 2007 Standards and Implementation Procedures for the Certificate of Clinical Competence in Audiology Foundations of Practice The applicant must have knowledge of: Normal processes of speech and language production and perception over the life span Prevention and Identification The applicant must be competent in the prevention and identification of auditory and vestibular disorders. At a minimum, applicants must have the knowledge and skills necessary to: Prevent the onset and development of communication disorders Describe your position statements/standards on training personnel to work in early intervention…..

17. 2005 Standards and Implementation Procedures for the Certificate of Clinical Competence in Speech-Language Pathology Supervised practicum must include experience with client/patient populations across the life span and from culturally/linguistically diverse backgrounds. Practicum must include experience with client/patient populations with various types and severities of communication and/or related disorders, differences, and disabilities Develop setting-appropriate intervention plans with measurable and achievable goals that meet client’/patients’ needs. Collaborate with clients/patients and relevant others in the planning process. Describe your position statements/standards on training personnel to work in early intervention…..

18. How do you work with IHEs to ensure that these standards are incorporated within the training programs? Resources and Support for Academic Programs in Communication Sciences and Disorders (CSD) 324 graduate programs (audiology, speech , language, and hearing science, speech-language pathology) Great variability in how programs infuse early intervention Set standards to accredit graduate programs in CSD Standards are broad-based and non-prescriptive No dedicated courses required Set standards to certify individuals in speech-language pathology and audiology Engage in regular review of practice skills through skills validation studies Create and disseminate policy documents Maintain online curriculum resources for faculty researchers Provide Web resources for PhD students Offer membership in Special Interest Divisions (some related to early intervention) Offer program for clinical specialty recognition in child language for practicing professionals Support efforts to increase number of speech-language pathologists and audiologists

19. How do you work with IHEs to ensure that these standards are incorporated within the training programs? … Strategies to Increase Personnel Preparation Program Capacity ASHA provides resources that might facilitate the process of academic program expansion Web resources for academic programs List of programs with personnel preparation grants, including those in early intervention FAQS about sources of funding Grant workshops Focus groups at ASHA convention in 2008 to determine academic program needs to expand programs Collaboration with Council for Academic Programs in CSD HES system to collect data in graduate education in CSD (e.g., specialty tracks in pediatric service delivery) Technical assistance

20. Challenges to Increasing Personnel Preparation Program Capacity Want healthy expansion that can be supported by all relevant stakeholders Need clinical education opportunities for all students Need sufficient faculty in time of PhD and faculty shortage Joint Committee between ASHA and the Council on Academic Programs in Communication Sciences and Disorders on PhD shortage Mentoring program for academic careers Resources and awards for students preparing for academic research careers. Showcase student research For more information, refer to academicaffairs@asha.org How do you work with IHEs to ensure that these standards are incorporated within the training programs? …

21. How do you disseminate information on your personnel policies? Need for more widespread outreach to a variety of audiences to enhance understanding and use of the principles, research, and information delineated in ASHA policy documents.

22. Dissemination Efforts Part of ASHA’s Strategic Pathway to Excellence Strategic Objective: Improve effectiveness across professions and settings Increase dissemination of ASHA policy documents Develop information from policy documents in a variety of formats for different target audiences (e.g., members, consumers, legislators, academics) Evaluate the importance of, satisfaction with, and use of different formats for ASHA practice policy documents. How do you disseminate information on your personnel policies? …..

23. Dissemination Options • Post on ASHA Web site • Create home page announcement • Send email blast to all members or members who identify themselves as working with young children • Write announcement in The ASHA Leader • Place notice in ASHA electronic newsletters • Share links to documents with other organizations

24. More Dissemination Options • Send press release with newsworthy information • Present at state association meetings, national conventions • Hold Webinar • Hold telephone seminar • Create logo for use with all articles and products related to early intervention

25. Dissemination Formats Develop briefs--summaries of key points of documents Write articles for The ASHA Leader Write articles for publication in interdisciplinary journals Write article for student newsletter Create FAQs for caregivers and professionals post on FAQ page on Web publish selected questions in The ASHA Leader

26. More Dissemination Formats Write a brochure for various audiences Prepare case studies for a Web-based professional development activity Publish the case studies in The ASHA Leader and provide links to the documents Write CEU questions for policy documents so that ASHA CEU credit can be available for members who read the documents Create a CD for printed materials Develop related podcasts for professional and consumer audiences Highlight success stories

27. And more… • Develop an implementation guide • Create a PowerPoint presentation • Conduct training for speakers using a trainer-to-trainer model • Conduct a “Meet the experts” interactive forum • Write a book related to documents • Create for-sale products such as clipboards with principles, posters, tote bag, T-shirt with EI logo • Include CD with documents

28. For More Information Diane Paul, PhD, CCC/SLP Director, Clinical Issues in Speech-Language Pathology American Speech-Language-Hearing Association dpaul@asha.org 301-296-5688

29. Questions