Clinical Methods and Practicum in Speech-Language

Pathology

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 FIFTH EDITION

Clinical Methods
and Practicum in
Speech-Language
Pathology

M. N. Hegde, Ph. D.
Deborah Davis, M.A.

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Clinical Methods and © 2010, 2005 Delmar Cengage Learning
Practicum in Speech-Language
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 CO NTENTS

Preface to the Fifth Edition ix

About the Authors xi

Part I: Clinical Practicum

Chapter 1: Clinical Practicum in Speech-Language Pathology 3

Clinical Practicum: An Overview 4

General Preclinic Requirements 5
ASHA Guidelines on Practicum 18
Clinical Practicum as a Learning Experience 29

Chapter 2: Organization of Clinical Practicum 31

On-Campus Clinical Practicum 33

Off-Campus Clinical Practicum Sites 35
Clinical Internships 60
General Administrative Procedures 61
Clinical Supplies, Materials, and Equipment 63

Chapter 3: The Conduct of the Student Clinician 67

General Professional Behavior 67

ASHA Code of Ethics 69
Other Codes and Regulations 84

Chapter 4: The Clinical Supervisor and the Student Clinician 95

The Role of the Clinical Supervisor 95
Off-Campus Clinical Supervision 104
Responsibilities of the Student Clinician 106

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vi Contents

Chapter 5: Working with Clients 113

Scheduling Clients 114

Assessment of Clients 121
Reassessment of Clients 128
Establishing a Working Relationship with Client and Family 129
Report Writing 133
Record-Keeping Procedures 149
Working with Other Professionals 151
Establishing Collaborative Relationships with
Other Professionals 160

Chapter 6: Multicultural Issues in Clinical Practicum 165

Student Clinicians with Multicultural Backgrounds 166

ASHA Position Statements 167
Multicultural Assessment Issues 172
Treatment Issues 183
Working with an Interpreter 186

Part II: Clinical Methods in Speech-Language Pathology

Chapter 7: Target Behaviors across Disorders 193

Selection of Target Behaviors 194

Approaches to Target Behavior Selection 195
Guidelines on Selecting Target Behaviors 196
Potential Target Behaviors across Disorders 197
Articulation and Phonological Disorders 198
Language Disorders 206
Literacy Skills 213
Voice Disorders 216
Disorders of Fluency 220
Neurogenic Communicative Disorders in Adults 223
Neurogenic Communicative Disorders in Children 232
Target Behaviors for Persons with Hearing Impairment 234
Target Behaviors for Persons with Limited Oral Skills 235
Target Behaviors for Clients with Swallowing Disorders 239

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 Contents vii

Chapter 8: Treatment in Speech-Language Pathology:

Concepts and Methods 243

Basic Methods of Treatment 244

How to Evoke Communicative Behaviors 245
Creating New Responses 263
Increasing the Frequency of Responses 270
Strengthening and Sustaining Target Behaviors 277
Sequence of Treatment 280

Chapter 9: Controlling Undesirable Behaviors 291

Behaviors to Be Reduced 292

Assessment of the Maintaining Causes of Undesirable Behaviors 293
General Strategies for Decreasing Undesirable Behaviors 295
Direct Strategy for Decreasing Behaviors 296
Indirect Strategy for Decreasing Behaviors 305
General Guidelines for Reducing Undesirable Behaviors 308
Aversive Nature of Response-Reduction Procedures 312

Chapter 10: Maintenance of Target Behaviors 313

Maintenance of Target Behaviors in Natural Settings 314

Maintenance Procedures 314
Developing Home Treatment Programs 326
Follow-up Assessments 328

References 331

Appendices

A Glossary of Educational Abbreviations and Acronyms 339

B Glossary of Medical Abbreviations and Symbols 343
C Sample Recording Form 347
D Code of Ethics of the American Speech-Language-Hearing
Association 349
E Sample Clinical Interview 355
F Examples of Dysfluency Types and Calculation of Dysfluency Rates 361
G Obtaining and Analyzing Conversational Speech Samples 365
H Sample Probe Recording Sheet 369

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viii Contents

I Sample Treatment Plan 371

J Sample Lesson Plan 375
K Sample Diagnostic Report 377
L Discrete Trial Treatment Procedure and Recording Form 381
M Daily Progress Notes 385
N Sample Progress Report 389
O Sample Final Summary 393
P Sample Referral Letters 397

Glossary 401
Index 411

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 PREFACE

This text was written for students in speech-language pathology who are about to
begin their clinical practicum. The text was also written for supervisors of clinical
practicum who need a systematic body of information on the various structural,
methodological, and ethical aspects of clinical practicum and its supervision. Our
goal was to offer a single and comprehensive source of information that will help
establish clear expectations for both student clinicians and clinical supervisors. By
dividing the book into two major parts, we have covered both the structural and
conceptual aspects of clinical practicum and the basic clinical methods of client
management. We emphasize that the clinical practicum is a learning experience
and that it involves clearly defined expectations, governed by ethical principles of
clinical services, and requiring effective and efficient methods of treatment.
Students who read this book prior to starting their clinical practicum will be
better prepared to meet the exciting and yet often challenging task of providing
ethical and effective services to children and adults with various forms of commu-
nicative disorders. Student clinicians will gain an understanding of the structure of
various clinical practicum sites; principles of ethical practices; conduct, behavior,
and competencies expected of them; justifiable expectations of their clinical
supervisors; and the many fundamental principles of assessment and intervention
across a variety of disorders. Clinical supervisors, too, may find the book helpful in
understanding their own roles and responsibilities better so that they can create a
productive and exciting clinical practicum experience for student clinicians.
We have received excellent comments from instructors and reviewers for the
earlier editions. Many positive and constructive comments have reinforced our
belief that the book offers a single source of comprehensive information on clini-
cal practicum and supervision. Such comments also have helped us in this
revision.
For the fifth edition, we have updated: ASHA requirements or guidelines for
certification and clinical practicum in speech-language pathology; the methods by
which university departments are expected to track a student’s progress in the pro-
gram; clinical practicum sites, related agencies, and professional expectations; the
use of Response to Intervention; and assessment of individuals with English as a sec-
ond language. The clinical methods section of this edition includes new informa-
tion on treatment targets for clients with swallowing disorders. We have added
additional information on assessment and treatment of emergent literacy skills in
preschool children. We have further revised or expanded the existing information

ix

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x Preface

on target behaviors and treatment strategies for voice disorders (including

functional aphonia), childhood apraxia of speech, augmentative and alternative
communication, traumatic brain injury, right hemisphere syndrome, dementia,
stuttering, and other disorders of communication. The text includes several boxed
sections that refer students to specific guidelines. Finally, a comprehensive appen-
dix provides resources and examples for students’ reference.
As in the previous editions, our motivation to revise and expand this book
came from the students and their devotion to excel and help their clients, the cli-
ents and their amazing resilience and dedication to hard work, and the profession-
alism and expertise of paid and volunteer staff with whom we work. All have
enriched our lives and taught us much about the practice of speech-language
pathology.
We would like to thank the anonymous reviewers whose comments and sug-
gestions have immensely helped us improve this revision.We are thankful to Sherry
Dickinson, the Senior Acquisitions Editor, and Laura Wood, the Product Manager,
at Delmar Cengage Learning for their sustained, courteous, and competent support
in planning and completing this revision.

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 A BO UT THE AUTHO RS

M. N. (Giri) Hegde, Ph. D., is Professor of Communication Sciences and Disor-

ders at California State University, Fresno. He holds a master’s degree in experi-
mental psychology from the University of Mysore, India, a post master’s diploma
in medical (clinical) psychology from Bangalore University, India, and a doctoral
degree in speech-language pathology from Southern Illinois University at
Carbondale.
Dr. Hegde is a specialist in fluency disorders, language disorders, research
methods, and treatment procedures in communicative disorders. He has made
numerous presentations to national and international audiences on various basic
and applied topics in communicative disorders and experimental and applied
behavior analysis. With his deep and wide scholarship, Dr. Hegde has authored
several highly regarded and widely used scientific and professional books,
including Treatment Procedures in Communicative Disorders, Clinical Research in
Communicative Disorders, Introduction to Communicative Disorders, A Coursebook on
Aphasia and Other Neurogenic Language Disorders, A Coursebook on Scientific and
Professional Writing in Speech-Language Pathology, Hegde’s PocketGuide to Commu-
nication Disorders, Hegde’s PocketGuide to Treatment in Speech-Language Pathology,
and Hegde’s PocketGuide to Assessment in Speech-Language Pathology. He has served
on the editorial boards of scientific and professional journals and continues to
serve as an editorial consultant to Journal of Fluency Disorders, the American Jour-
nal of Speech-Language Pathology, and the Journal of Speech-Language Pathology—
Applied Behavior Analysis.
Dr. Hegde is a recipient of various honors, including the Outstanding Profes-
sor Award from California State University, Fresno, CSU Fresno Provost’s Recog-
nition for Outstanding Scholarship and Publication, Distinguished Alumnus Award
from the Southern Illinois University Department of Communication Sciences
and Disorders, and Outstanding Professional Achievement Award from District 5
of California Speech-Language-Hearing Association. Dr. Hegde is a Fellow of the
American Speech-Language-Hearing Association.
A speech-language pathologist for over twenty years, Deborah Davis, M.A., is a
special education Program Manager with the Fresno County Office of Education.
She oversees special education services for infants and preschoolers as well as ser-
vices for children with autism and communication disabilities. Prior to accepting
Program Manager responsibilities, Ms. Davis was Director of the Speech and Hear-
ing Clinic at California State University, Fresno, where she supervised on- and

xi

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xii About the Authors

off-campus practicum. Ms. Davis has worked extensively as an itinerant speech-

language pathologist in the public schools and as a teacher in a classroom for chil-
dren with communicative disorders. She also worked with the geriatric populations
in skilled nursing facilities and home health. Ms. Davis received her bachelor’s and
master’s degrees from California State University, Fresno, and is a Fellow of the
California Speech-Language-Hearing Association.

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 PA R T
I

Clinical Practicum

W hen you have completed a certain course in communicative

disorders, your advisor may tell you that you are ready for
clinical practicum. This means that you have acquired some basic
knowledge about communication and its disorders. Yet, you may not
know much about the practicum itself. Therefore, in Part I of the
text, we have described the organization of clinical practicum, various
rules and regulations you must follow, the relationship with your clin-
ical supervisor, and some basic principles of working with clients.
Read this part of the text carefully to understand what practicum is
and how to prepare yourself for it.
In Part II of the text, we have described the basic clinical methods
of treating clients with communicative disorders. We have given an
overview of commonly used treatment techniques with an emphasis
on working with families of your clients to achieve maintenance of
treatment gains.

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Copyright 2009 Cengage Learning, Inc. All Rights Reserved.
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 CHAPTER
1
Clinical Practicum in
Speech-Language Pathology

Chapter Outline

• Clinical Practicum: An Overview

• General Preclinic Requirements
• ASHA Guidelines on Practicum
• Clinical Practicum as a Learning Experience

Speech-language pathology is a profession with scientific and academic bases. To

be a speech-language pathologist, you need to gain both academic and scientific
knowledge through coursework and practical experience in working with clients
who have communicative disorders. Therefore, speech-language pathology degree
programs at colleges and universities include two types of training.
The first type of training is offered through academic coursework. You
learn about speech, language, communication, and communicative disorders by
taking various academic courses. Some academic courses are a prerequisite to
beginning clinical practicum and others may be taken in conjunction with clinical
practicum. The academic portion of the training program provides you with an
empirical as well as theoretical basis from which you can expand your knowledge
and carefully analyze the validity of new ideas and trends in the assessment and
treatment of communicative disorders. Your academic training also provides the
foundation for clinical practicum.
The second type of training is offered through clinical practicum. Clinical
practicum gives you the opportunity to apply and practice what you have learned

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4 Clinical Practicum

in academic courses, under the guidance of your clinical mentor (supervisor). You
will have diverse clinical experiences and may use these opportunities to help you
determine an area, or areas (e.g., medical, pediatric, adult, etc.), in which you are
most interested in pursuing more advanced study and employment. The combina-
tion of academic coursework and practicum provides you with well-rounded
training in speech-language pathology and prepares you to pursue a variety of ca-
reer options.
Occasionally, students try to rate the importance of academic classes versus
practicum assignments. However, there is no comparison because each is equally
important. Without a strong academic background, you would not know how to
assess and treat people with communicative disorders. Without practicum, you
would not learn the skills you must have to be a successful speech-language pa-
thologist. Therefore, from the beginning, avoid making judgments in favor of one
or the other and apply yourself fully and equally to your academic courses and
practicum assignments.
Although reference may be made to academic coursework, this text empha-
sizes clinical practicum. If you have any questions regarding specific academic re-
quirements, contact your advisor. Questions regarding clinical practicum
requirements should be referred to your advisor, clinical supervisor, or clinic
director.

Clinical Practicum: An Overview

Clinical practicum is an exciting component of your educational experience.You
will have opportunities to work with a variety of professionals and clients, apply
much of what you have learned in your academic courses, and expand on your
knowledge of communication and its disorders.Your clinical practicum is a super-
vised experience in which you learn professional skills of assessing and treating
people with communicative disorders. In some assignments you learn to work in-
dependently, and in other assignments you learn to work as a member of a team.
Your clinical practicum experiences are designed to prepare you for your future
role as a professional speech-language pathologist. Enrollment in clinical practicum
is a required part of the curriculum in programs accredited by the American
Speech-Language-Hearing Association (ASHA). Clinical practicum provides
you with the necessary opportunities to apply and expand the information learned
in academic courses. Your enthusiasm, dedication, and hard work are impor-
tant variables that influence the degree to which you will benefit from your clini-
cal assignments.
Students generally enroll in clinical practicum during their senior year as under-
graduates or during their first semester as graduate students. Certain universities allow
students to participate in clinical practicum earlier in the training program. In some
cases, this early experience may be limited to observing graduate students providing
clinical services and assisting with a client or two toward the end of the semester. For
example, you may be assigned to observe a student clinician for a semester prior to

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 Clinical Practicum in Speech-Language Pathology 5

being assigned your own clients. You will be involved gradually in the treatment pro-
cess. You may be required to assist in charting responses, developing stimulus materi-
als, and eventually working with a client for one or two sessions as the primary
clinician.Your training program structures your activities to maximize your learning as
well as your academic and clinical success.
As much as a university clinic’s caseload allows, a beginning student clinician
is assigned clients with less complex disorders. In most universities, student clini-
cians are assigned clients based on the academic courses they have completed. For
example, during your first semester of graduate work, you may enroll in a course
in articulation and be assigned clients with articulation disorders only. As you
complete coursework on other disorders of communication, you may be assigned
clients with those types of disorders.
Other universities take a more gestalt view of clinical experience and provide
a student clinician with a variety of clients each term, based on the student’s level
of expertise and previous educational experience and the supervisor’s expertise.
For example, as a first-semester graduate student, you may take a seminar in articu-
lation, a seminar in language, and a seminar in research methods. However, in your
clinical practicum, you may be assigned a client with a fluency disorder based on
your undergraduate class in fluency and the expertise of your clinical supervisor.
You will participate in clinical practicum assignments at the university clinic
and various off-campus clinical sites. Many universities require student clinicians
to complete a certain minimum number of clinical hours before they are assigned
to off-campus practicum sites. Your clinical practicum may include hospital, school,
or various other clinical sites.
As you progress through your clinical and academic programs, you are given
more responsibility in planning, evaluating, and treating clients. As a beginning
student clinician, you will not be expected to have all the answers; your clinical
supervisor will help you find those answers. Although you will be supervised
throughout your clinical practicum, as you gain clinical experience, you will be
expected to perform more independently in most of your clinical responsibilities.
Eventually, you will be expected to conduct most of your clinical duties with min-
imal supervisory input.

General Preclinic Requirements

In addition to a solid academic foundation, good writing skills are necessary for suc-
cess in clinical practicum. Equally important is your ability to talk to people from all
walks of life and of all ages. Finally, there are less tangible, personal characteristics
without which you cannot successfully complete your clinical practicum; for exam-
ple, you must be conscientious and reliable. You should be able to organize your
schedule and allocate sufficient time to your clinical responsibilities. Your flexibility
and nonjudgmental disposition will influence your clinical success. Although you
may begin the term with a specific clinical assignment, your clinic assignment may
be altered mid-term due to a client schedule change, supervisor change, or other

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6 Clinical Practicum

uncontrollable variables. You should accept and adapt quickly to such changes. In
addition, you may be assigned a client whom you dislike—perhaps you do not ap-
prove of the client’s demeanor or lifestyle. Nonetheless, be flexible and find a way
to work effectively with this person. You are always expected to be committed to
providing the best quality of client care possible. You are not expected to enter
clinical practicum with all the necessary skills, but you should be able to learn from
your clinical experiences and the interactions with your supervisor.

Academic Requirements
Preclinic academic requirements are completed both at the undergraduate and
graduate levels. At the undergraduate level, one of your first courses may be an
introduction to communication sciences and disorders. Then you will probably
take courses on phonetics; anatomy and physiology of speech, swallowing, and
hearing mechanisms; speech science (perception and production of speech); and
those courses related to normal acquisition of speech and language. Some clinical
courses, especially those related to disorders of articulation, language, voice, fluency,
and hearing, also may be taken at the undergraduate level.
Graduate courses provide you with more advanced information on all as-
pects of communication sciences and disorders and on assessment and treatment of
various disorders. These courses are more research based than the undergraduate
courses. Graduate courses build on the information offered at the undergraduate
level and emphasize specialized information. For example, besides taking advanced
courses in articulation and language, you also take courses in fluency, adult lan-
guage disorders, craniofacial anomalies, augmentative communication, dysphagia
(swallowing disorders), and motor speech disorders. At the graduate and postgrad-
uate levels, an increasing number of universities offer courses in administration and
supervision, including the supervision of speech-language pathology assistants
(SLPAs), a trend reflecting ASHA’s position on the use of qualified assistants.
Although course requirements and sequences vary from university to university,
students are expected to have completed, as a minimum, introductory courses in
normal and abnormal speech and language development and courses in speech
and hearing science before beginning clinical practicum. You should discuss the
specific requirements with your advisor well in advance of the time you plan to
begin your clinical practicum.

General Writing Requirements

Accurately documenting and precisely reporting clinical information in writing are nec-
essary skills in the practice of speech-language pathology. The approval for patient
treatment by insurance companies; a doctor’s decision to provide medical inter-
vention; monetary reimbursement for your services; and your determination of the
need for initiating, continuing, or discontinuing services are just a few of the areas
that may be influenced by your documentation and reports. Therefore, part of
your clinical practicum will include learning different reporting formats.

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 Clinical Practicum in Speech-Language Pathology 7

Student clinicians are required to write numerous clinical reports, treatment

programs, lesson plans, and progress notes. You will discover that different clinical
settings have varying writing requirements. Regardless of the specific requirements,
you will be expected to have good basic writing skills at each of your assignments.
In many instances, your reports may be read by other people, including clients’
family members, physicians, teachers, and other speech-language pathologists. It is
important that you develop your writing skills before enrolling in clinical practi-
cum. Unless you have had a course on professional writing in communicative dis-
orders, you are not expected to know the specific formats for reports and some of
the technical terms before clinical enrollment, but you should be able to write
clearly and concisely. You should be able to organize your thoughts coherently and
write grammatically correct sentences. Your writing should be free from spelling
errors and be clear and simple enough to be understood by the intended audience.
With these skills, you should be able to adapt your writing to the different formats
and styles expected at various sites.
Before you are awarded your graduate degree, you will be required to demon-
strate professional writing skills sufficient for entry-level practice in speech-
language pathology. If you are concerned about your general writing skills and
your program does not offer a course on professional writing, discuss the problem
with your advisor as early in your program as possible.Your advisor can assist you
in overcoming your writing problems.You may need to take a writing course, or
you may need additional practice in writing.You may practice professional writing
skills in a book that is designed for self-teaching. One such book is by Hegde
(2010), which gives exemplars of scientific and professional writing along with op-
portunities to practice writing skills. Take these and other steps that will prepare
you for meeting clinical writing requirements.

Oral Communication Skills

Effective oral communication skills are essential to the practice of speech-language
pathology. As a student clinician, you will communicate with many clients with varied
educational, socioeconomic, and cultural backgrounds. You also will interact with many
professionals. For example, you may discuss your clients’ evaluation, treatment, and
progress with physical therapists, physicians, nurses, teachers, audiologists, psychol-
ogists, and other speech-language pathologists.
Regardless of the client, professional, or family member you communicate
with, you must speak so that that individual will understand you.With some clients
you will need to use simple, brief language; with other clients you may use techni-
cal terms, advanced vocabulary, and you can present complex concepts. At times,
to establish a shared basis of understanding, you may need to use some professional
jargon along with an understandable definition. With certain individuals you may
introduce the term apraxia and explain exactly what you are referring to when you
use that term. With other individuals you may introduce the term apraxia and pro-
vide the common definition followed by an analogy that will assist them in under-
standing it. At another time you may refer to an “SST” (student study team)

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8 Clinical Practicum

meeting and explain the meaning of that initialism. You should develop the flexi-
bility to speak at whatever level the communicative situation requires. In all in-
stances, you should clearly and concisely articulate information. You should learn to
communicate in the way that maximizes comprehension for the listener.You will
develop your communication competence as part of your graduate training; how-
ever, it is helpful to begin with a certain skill level. Your department or one of the
other departments in your university may offer a counseling course that teaches
specific interpersonal communication skills. Consider taking such a course and
discuss this with your academic advisor.

Personal Characteristics
In addition to academic preparation and good written and oral communication
skills, there are some personal characteristics that are required for successful clinical
work. Responsible behavior is probably one of the most important characteristics.
Student clinicians are expected to act responsibly in all areas of clinical in-
volvement, including preparation for treatment sessions, meeting with clients,
report writing, and interactions with office staff and clinical supervisors. You will
have deadlines for various clinical assignments, including scheduling of clients,
completion of various reporting forms needed by clinic administrative staff , and
submission of diagnostic reports, treatment plans, and lesson plans. Regardless of
other academic or personal commitments, you must be well-prepared for all your
diagnostic and treatment sessions.
As a graduate student, you will have many obligations and it will be important
for you to organize your time. Typically, this means you must establish priorities
and prepare in advance. You may have an examination scheduled and a new
client to evaluate on the same day a major paper is due. Obviously, to accomplish
all these well, you must allow for sufficient preparation time.
Student clinicians work with many people, and your ability to maintain
your professional boundaries while empathizing with your clients and
their families is essential. You must not become overly involved in your clients’
personal lives or allow them to become overly involved in your personal life.
However, you must combine your technical knowledge with care and regard to
your clients’ living situations and their personal concerns. For example, it probably
would not be useful to expect clients living alone in private care facilities to be
able to find people with whom to practice a speech assignment. However, know-
ing this, you might talk with cooperative nursing assistants and ask them to help
your clients practice their speech. Many external and internal factors influence cli-
ents’ progress. It will be important for you to know and understand the interac-
tions among your clients’ disabilities, living situations, and support systems and
how they affect your clients’ speech therapy.
Student clinicians should learn to work independently within their level of
experience. For example, as a beginning clinician, you are expected to rely on your
supervisor for assistance more than experienced clinicians do; however, you still
must be prepared to research material independently and, with your supervisor’s

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 Clinical Practicum in Speech-Language Pathology 9

help, evaluate the efficacy of your clinical sessions, determine areas of needed
change, and implement appropriate modifications that your supervisor suggests to
you. You will be expected to demonstrate systematic progress toward working inde-
pendently. See Chapter 4 for more on student clinician responsibilities.

Knowledge of the Profession and Related Agencies

In addition to your university’s requirements, several agencies and professional organi-
zations affect your training and career as a speech-language pathologist. As you pre-
pare to enroll in clinical practicum, you should have at least a basic knowledge of the
various accrediting and licensing agencies and regulations related to the profession of
speech-language pathology. Two agencies affect your training and professional career
the most: the ASHA and, if your state has a licensure law, the Board of Examiners for
Audiology and Speech-Language Pathology (or other licensing agency in your state).

The American Speech-Language-Hearing Association (ASHA)

The ASHA is the national professional organization representing speech-language

pathologists and audiologists. Students and student clinicians in departments of
communication sciences and disorders or speech-language pathology will repeat-
edly hear references to ASHA and its various activities, guidelines, and require-
ments that affect the profession. Student clinicians will constantly be told of
ASHA’s requirements on how to complete their clinical practicum. Also, students
will be expected to become members of ASHA’s student organization, the
National Student Speech-Language-Hearing Association (NSSLHA).
As you probably know, ASHA is a scientific and professional organization with a
long history of contributions to communication sciences and disorders. This na-
tional organization is the major force that shapes our scientific and professional
discipline. The organization acts as an advocate for individuals with communica-
tive disorders and the professionals who provide services to these individuals and
has nine goals (American Speech-Language-Hearing Association, 2008a).

The Goals of the American

Speech-Language-Hearing Association

1. Encourage basic scientific study of the processes of individual human

communication with special reference to speech, language, and hearing
and related disorders;
2. Promote high standards and ethics for the academic and clinical prepa-
ration of individuals entering the discipline of human communication
sciences and disorders;
(continues)

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10 Clinical Practicum

3. Promote the acquisition of new knowledge and skills for those within
the discipline;
4. Promote investigation, prevention, and the diagnosis and treatment of
disorders of human communication and related disorders;
5. Foster improvement of clinical services and intervention procedures
concerning such disorders;
6. Stimulate exchange of information among persons and organizations,
and disseminate such information;
7. Inform the public about communication sciences and disorders, related
disorders, and the professionals who provide services;
8. Advocate on behalf of persons with communication and related dis-
orders; and
9. Promote the individual and collective professional interests of the
members of the Association.
Source: Bylaws of the American Speech-Language-Hearing Association by the American
Speech-Language-Hearing Association, 1997–2008, Rockville, MD: Author.

ASHA works in various ways to help maintain high standards of clinical com-
petence of speech-language pathologists and audiologists. Two governing bodies
interact to identify and respond to priorities of the profession. The Board of Direc-
tors is comprised of 16 elected officers and the Executive Director of the Associa-
tion. The Advisory Council (AC) consists of an Audiology Advisory Council and a
Speech-Language Pathology Advisory Council. Each AC has 53 members includ-
ing one elected member from every state, the District of Columbia, and other
areas. Two members of the NSSLHA also are elected to serve on the AC. (Ameri-
can Speech-Language-Hearing Association, 2008a.) ASHA sponsors conferences
and workshops to encourage continuing professional education. It collects and dis-
seminates data related to research, clinical service delivery, education, and career
opportunities. It has a policy on the scope of practice for speech-language pathol-
ogists and audiologists and has established accreditation and certification proce-
dures that outline minimal standards of education and clinical service delivery.
These standards are outlined in the form of academic and clinical preparation
guidelines and include required compliance with the ASHA Code of Ethics. These
standards are designed to protect consumers and the professionals who serve them.

ASHA Accreditation

University training programs that meet ASHA standards may receive accreditation
from it. ASHA’s Council on Academic Accreditation in Audiology and
Speech-Language Pathology (CAA) accredits academic programs.

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 Clinical Practicum in Speech-Language Pathology 11

A university must request accreditation of its program. When it does this, the
university may seek accreditation for its speech-language pathology program or
audiology program, or both. ASHA will then send a team of trained professionals
to evaluate the programs seeking accreditation. ASHA accredits only programs
offering advanced degrees.
The evaluation team looks at the quality and number of faculty teaching the
courses, the curriculum offered by the department, physical facilities and instruc-
tional equipment and laboratories, the library and other resources of the university,
the administrative support, and such other factors that affect the education of future
speech-language pathologists and audiologists.
The professionals evaluating clinical services offered by a department look at the
qualifications and certification status of clinical supervisors, financial resources and
management, adequacy of clinical facilities and equipment, and all other factors that
affect the quality of clinical services offered to the public. The teams may schedule
meetings to discuss the training program with current students as well as graduates of
the program. After the site visit, the team submits a report to the ASHA board. Based
on the report, a final decision on whether to accredit the program is made.
The CAA requirements directly influence you and your training program.
First, if you are attending a program accredited by ASHA, you are assured that the
department has met ASHA’s standards. Second, you must have initiated and satis-
factorily completed all of your graduate academic coursework and clinical practi-
cum (in the area in which certification is sought) at a CAA-accredited program to
be eligible for the Certificate of Clinical Competence.

ASHA Certification

ASHA certifies both audiologists and speech-language pathologists. The Certificate

of Clinical Competence is more commonly referred to as the CCC (pronounced
“sees”). The Council for Clinical Certification (CFCC) sets the standards for
and awards the CCC to speech-language pathologists and audiologists who have
successfully met ASHA’s academic, clinical, and ethical standards (Lubinsky, 2003).
Earning the CCC indicates that individuals have met a certain level of professional
competence. Under ASHA’s guidelines, individuals with their CCCs may supervise
student clinicians, support personnel, and professionals who do not hold certification.
When you complete a program of study and clinical experience approved by ASHA
you may receive this certification. This certificate may be in audiology or speech-
language pathology. Effective January 1, 2005, ASHA evaluates CCC applicants based
on outcome standards that were designed to ensure that applicants have demonstrated
specific academic knowledge and clinical skills.
To be eligible for certification in speech-language pathology, you must satisfy
the following standards:

1. Earn a graduate degree. You must have earned a master’s (MA or

MS) or doctoral (SLPD or PhD) degree in the area in which you are ap-
plying for certification at an accredited institution of higher education.
As you know, your graduate coursework and practicum must be initi-

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May not be copied, scanned, or duplicated, in whole or in part.