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Speech-Language Pathology Assistants Guidance for West Virginia Schools and Districts Office of Special Programs West Virginia Department of Education December 2013

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Page 1: Speech-Language Pathology Assistantssupervising speech-language pathologist. • Make referrals for additional services. • Communicate with the student, family, or others regarding

Speech-Language Pathology Assistants

Guidance for West Virginia Schools and Districts

Office of Special ProgramsWest Virginia Department of Education

December 2013

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West Virginia Board of education

2013-2014

Gayle C. Manchin, PresidentMichael I. Green, Vice PresidentRobert W. Dunlevy, Secretary

Thomas W. Campbell, MemberTina H. Combs, Member

Lloyd G. Jackson II, MemberL. Wade Linger Jr., MemberWilliam M. White, Member

Paul L. Hill, Ex OfficioChancellor

West Virginia Higher Education Policy Commission

James L. Skidmore, Ex OfficioChancellor

West Virginia Council for Community and Technical College Education

James B. Phares, Ex OfficioState Superintendent of Schools

West Virginia Department of Education

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Guidance for West Virginia Schools and Districts i

SPEECH-LANGUAGEPATHOLOGY ASSISTANTS

Guidance for West Virginia Schools and Districts

West Virginia Department of EducationDivision of Teaching and LearningOffice of Special Programs

Pat HombergExecutive Director

December 2013

Notes:This guidance document is available at http://wvde.state.wv.us/osp/speechassistants.html and replaces the WVDE Guidelines for the Use of Speech Assistants, 2004.

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ii Speech-Language Pathology Assistants

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Guidance for West Virginia Schools and Districts iii

ForewordThe requirements for the issuance of an authorization for speech-language pathology assistants are defined in West Virginia Board of Education Policy 5202: Minimum Requirements for the Licensure of Professional/ Paraprofessional Personnel and Advanced Salary which was approved by the West Virginal Board of Education in July 2003. The intent of this policy is to address the shortage of certified speech- language pathologists in West Virginia and to better serve students with communication disorders by ensuring that personnel providing services are supervised and executing only those tasks within their scope of responsibilities and training.

The purpose of this document is to provide guidance to local school districts regarding the use of speech-language pathology assistants in public schools and includes information outlining the roles and responsibilities of the speech-language pathology assistant and the supervising speech-language pathologist. Support personnel can provide an effective way of increasing the frequency and intensity of services for students who receive speech/language services. The West Virginia Department of Education believes that quality and access to services must be maintained for all students.

James B. Phares, Ed. DState Superintendent of Schools

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iv Speech-Language Pathology Assistants

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Guidance for West Virginia Schools and Districts v

Table of ContentsIntroduction ...............................................................................................................................................................1

Assurances ..................................................................................................................................................................2

Requirements for Issuance of Temporary Authorization of Speech-Language Pathology Assistant (SLPA) ...................................................3 Roles and Responsibilities of the Speech-Language Pathology Assistant ..........................................................4 Activities Outside the Scope of Responsibilities of the Speech-Language Pathology Assistant .....................5

Supervision Requirements for Speech-Language Pathology Assistants ............................................................6 Program Implementation .........................................................................................................................................8

Appendix ....................................................................................................................................................................9A. County Supervision Plan – SLPA ...............................................................................................................9 B. WVDE Verification Report: SLPA ..........................................................................................................11C. SLPA Session Documentation ..................................................................................................................12D. SLPA Self-Evaluation of Intervention Session ........................................................................................13E. SLPA Supervision: Direct Observation Form ........................................................................................14F. Supervision Log: Direct/Indirect ............................................................................................................15G. Summary: SLPA Observation Log Direct/Indirect ...............................................................................16H. Supervising SLP Evaluation Form ...........................................................................................................17I. Form 38 Temporary Authorization for SLPAs .......................................................................................18J. SLPA: Questions and Answers.................................................................................................................20K. Contact Information ..................................................................................................................................22

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vi Speech-Language Pathology Assistants

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Guidance for West Virginia Schools and Districts 1

Introduction

The requirements for the issuance of an authorization for speech-language pathology assistants are defined in West Virginia Board of Education Policy 5202, “Minimum Requirements for the Licensure of Professional/Paraprofessional Personnel and Advanced Salary.” Policy 5202 became effective on June 18, 2003. The following guidelines were developed to assist personnel in the appropriate use of speech-language pathology assistants in the West Virginia public schools.

The shortage of certified speech-language pathologists (SLP) in the public schools is a critical issue for school districts throughout the country. The US Department of Education has reported that an additional 14.3% SLPs are needed nationwide to provide adequate services to students in school settings. In West Virginia, the Annual Report on the Supply/Demand of Educational Personnel indicates that school districts consistently have difficulty recruiting personnel to employ in these positions.

The role of the SLP has expanded dramatically in the past few years as a result of changes in the service delivery system, increasing numbers of children who need communication and related services, rising costs of providing services and technological and scientific advances. The exclusive use of a service model with a certified speech-language pathologist may not be an option in many settings, especially those in rural and remote areas where certified personnel are difficult to recruit and employ.

The Individuals with Disabilities Education Act (IDEA) ensures a free appropriate public education for students with disabilities. IDEA has embodied the concept of teams of professionals, often from different disciplines, working together to meet the needs of children and youth with disabilities and their families in all phases of the special education process. Teams make decisions regarding identification, assessment, Individualized Education Program (IEP) development, placement and service delivery for students with disabilities. The team concept has expanded to include the use of support personnel in the provision of services to students with disabilities.

Physical therapists, occupational therapists and special education teachers frequently use support personnel to assist in the implementation of a student’s IEP. IDEA allows paraprofessionals and assistants who are appropriately trained and supervised according to state law, regulations or written policies to assist in providing special education and related services to children with disabilities. Support personnel can provide an effective means of increasing the frequency and intensity of services for students who receive speech/language services. At the same time, quality and access to services must be maintained for all students. While there is a growing awareness of the potential of support personnel, there is equal concern for ensuring that these individuals are effectively trained and have appropriate responsibilities.

Speech-language patholgoy assistants (SLPA) are individuals who may provide services to students with communication disorders under the guidance and direction of a certified SLP. They may assist the supervising SLP with record keeping, generalization of learned skills to multiple settings, implementation of assistive technology devices/services, services for diverse and under served populations and other responsibilities. The purpose of this document is to provide guidelines for the use of speech-language pathology assistants in the West Virginia public schools.

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2 Speech-Language Pathology Assistants

As stipulated in federal and state regulations concerning the special education process, parents must be involved in decisions and informed about the level of the service provider (i.e. certified SLP or assistant). The use of support personnel may be an appropriate option in school districts when a position has been posted and no fully certified SLP has applied for the position as documented by the district superintendent. This documentation must be submitted to the West Virginia Department of Education, Office of Personnel Preparation by the district superintendent.

The foundation for successfully using this service delivery model includes:

• Administrative understanding that will support the appropriate use of speech-language pathology assistants in speech-language pathology providing services to students with communication disorders.

• Administrative understanding of the benefits and restrictions of using support personnel.

• Availability of certified SLPs with an understanding of the use of support personnel and the appropriate training to supervise support personnel.

• Appropriate target populations for service by support personnel as determined by the supervising SLP.

• Availability of qualified people to work as support personnel.

• Sufficient information available to other personnel (i.e., teachers and administrators) so they are aware of the role of support personnel when they are used.

• Provision of sufficient time and resources to adequately train and supervise support personnel.

It must be stressed that the use of speech-langague pathology assistants does not preclude the active recruitment and hiring of speech-language pathologists in the workplace.

Assurances

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Guidance for West Virginia Schools and Districts 3

Initial Authorization

The applicant must:

A. Hold a minimum of a bachelor’s degree in speech pathology or communication disorders from an accredited institution;

B. Be employed by a local West Virginia board of education;C. Receive the recommendation of the district superintendent verifying that the applicant is the most

qualified candidate for the position and that no fully certified speech-language pathologist has applied for the available position; and

D. Complete Form 38 (Temporary Authorization) and Form 38A (Temporary Authorization for Speech Assistant) and submit to the West Virginia Department of Education, Office of Professional Preparation. (See Appendix I)

Renewal of Authorization

An authorization is valid for one school year and expires on June 30th of each year. In order to renew the authorization, the applicant must complete professional development activities and receive the recommendation of the district superintendent verifying that no fully certified speech-language pathologist has applied for the available position. Professional development activities may include the following:• 3-semester hour course in an area related to the field of communication disorders• 3-semester hour course that is required for the completion of a masters degree in communication

disorders• Attendance at state or national conferences in communication disorders• Professional Development activities designated by the WVDE, Office of Special Programs or provided

by the LEA.

Verification of professional development activities must be provided to the WVDE, Office of Special Programs prior to renewal. (See Verification Report Form in Appendix B)

Requirements for Issuance of a Temporary Authorization for Speech-Language Pathology Assistant

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4 Speech-Language Pathology Assistants

Speech-language pathology assistants may conduct specific components of a speech and language delivery program as specified in an IEP under the direction and guidance of a certified SLP. Tasks executed by speech-language pathology assistants must be within their scope of responsibilities and include only those tasks they have the expertise and training to perform.

The following tasks may be designated to a speech-language pathology assistant:

• Conduct speech-language screenings (without interpretation) following specified screening protocols selected by the supervising speech-language pathologist.

• Provide direct therapy to identified students.

• Follow goals and objectives identified on the IEP and plans developed by the supervising speech-language pathologist.

• Document student progress toward meeting established goals and objectives as stated in the IEP and report this information to the supervising SLP.

• Assist the SLP during assessment of students, as directed.

• Assist with informal documentation (e.g., tallying notes for the SLP to use), prepare materials and assist with other clerical duties as assigned by the SLP.

• Schedule activities, prepare charts, records, graphs or otherwise display data.

• Perform checks and maintenance of equipment.

• Participate with the SLP in research projects, staff development and public relations programs, as deemed appropriate by the SLP.

• Assist in the implementation of assistive technology devices and services as deemed appropriate by the SLP.

Roles and Responsiblities of the Speech-Language Pathology Assistant

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Guidance for West Virginia Schools and Districts 5

The speech-language pathology assistant may NOT:

• Perform standardized or non-standardized diagnostic tests, formal or informal evaluations or interpret test results.

• Participate in parent conferences or any team meeting not designated by the supervising SLP.

• Write, develop or modify a student’s IEP.

• Assist with student’s therapy without following the IEP prepared by the speech-language pathologist or without access to supervision.

• Sign any formal documents without approval of the supervising SLP.

• Select students for services.

• Dismiss a student from services.

• Disclose confidential information either orally or in writing to anyone not specifically designated by the supervising speech-language pathologist.

• Make referrals for additional services.

• Communicate with the student, family, or others regarding any aspect of the student’s status or service without the specific consent of the supervising speech-language pathologist.

• Represent himself or herself as a speech-language pathologist.

Activities Outside the Scope of Responsibilities of a Speech-Language Pathology Assistant

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6 Speech-Language Pathology Assistants

It is the responsibility of the supervising SLP and special education director to collaboratively design and implement a supervision system that maintains the highest possible standard of quality. The amount and type of supervision required should be based on the skills and experience of the SLPA, the needs of individuals served, the service setting, the tasks assigned and other factors. More intense supervision for example, would be required in such instances as the orientation of a new SLPA, initiation of a new program, equipment or tasks; or a change in the student status (e.g., medical complications). Functional assessment of the speech-language pathology assistant’s skills with assigned tasks should be an on-going, integral element of supervision.

COMPLETE THE SUPERVISION PLAN AND SUBMIT TO THE WVDE, OFFICE OF SPECIAL PROGRAMS (See Appendix A)

The speech-language pathology assistant must be supervised by a SLP who holds a Master’s degree and is certified through the West Virginia Department of Education, who has an active interest and wants to use support personnel, and who has practiced speech-language pathology for at least 2 years following certification. As the supervisory responsibilities of the SLP increase, the caseload and other responsibilities of the SLP must decrease. The supervisory responsibilities should be mutually agreed on by the supervising SLP and special education director.

Responsibilities: Supervising Speech-Language Pathologist

The supervising SLP must provide at least the minimum specified level of supervision to ensure quality of care to all students served. The amount of supervision may vary and must depend on the complexity of the case and the experience of the assistant. Documentation of training and supervision of the SLPA must be maintained. Responsibilities include the following:

• Inform families about the level (professional vs. support personnel), frequency and duration of services as well as supervision.

• Represent the speech-language pathology team in all collaborative, professional, IEP, interagency meetings, correspondence and reports. This would not preclude the speech-language pathology assistant from attending meetings along with the SLP as a team member or drafting correspondence and reports for editing, approval and signature by the SLP.

• Make all clinical decisions, including determining student selection for inclusion/exclusion in the caseload, and dismissing students from therapy.

• Communicate with students and family members about diagnosis, prognosis and IEP.

• Conduct diagnostic evaluations, assessments or appraisals, and interpret obtained data in reports.

• Review each IEP with the speech-language pathology assistant.

• Delegate specific tasks to the speech-language pathology assistant.

• Participate in the development of the IEP or make modifications prior to or during implementation as appropriate.

• Discuss the case with or refer the student to other professionals.

Supervision Requirements for Speech-Language Pathology Assistants

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Guidance for West Virginia Schools and Districts 7

• Review and sign all informal progress notes prepared by the speech-language pathology assistant.

• Coordinate ongoing training to the speech-language pathology assistant on the job.

• Provide and document appropriate supervision of the speech-language pathology assistant.

• Ensure that the SLPA only performs tasks within their scope of responsibility.

• Provide information regarding the performance appraisal of the SLPA.

Supervision Requirements

• The minimum amount of supervision suggested is at least 30% weekly during the first 90 workdays. (20% direct)

• Direct means on-site, in-view observation and guidance.

• Indirect supervision may include demonstration, record review, review and evaluation of audio or videotaped sessions, Skype and/or supervisory conference that may be conducted by telephone.

• The supervisor should review weekly data collected by the SLPA.

• Supervision should provide information about the quality of the speech-language pathology assistant’s performance of assigned tasks and should verity that therapy is limited to tasks specified within the SLPA’s scope of responsibilities.

• Information obtained during direct supervision may include data relative to (a) agreement between the SLPA and supervisor on recording of target behavior, (b) accurate implementation of screening and treatment procedures (c) accuracy in recording data and (d) ability to interact effectively with the student.

• Additional supervision, beyond the minimum 30% required in the first 90 workdays, may be necessary depending on the skills of the speech-language pathology assistant.

• After the 90-day work period, the amount of supervision may be adjusted depending on the competency of the SLPA, the needs of the individual served, and the nature of the assigned tasks. The minimum recommended is 20% supervision, with no less than 10% being direct supervision.

• If for any reason (i.e., maternity leave, illness change of jobs) the supervisor is no longer available to provide the level of supervision stipulated, the speech-language pathology assistant may not perform tasks until an appropriately certified speech-language pathologist has been designated as the speech-language pathology assistant’s supervisor.

• Although more than one speech-language pathologist may provide supervision to a SLPA, at no time may a speech-language pathologist supervise more than three (3) speech-language pathology assistants.

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8 Speech-Language Pathology Assistants

• The speech-language pathology assistant will be assigned a caseload based on their level of expertise, experience, and supervision requirements.

• The caseload of the certified speech-language pathologist working with the SLPA should be adjusted to provide adequate time for supervision.

• Services provided by a SLPA are NOT an allowable expenditure for Medicaid reimbursement.

• County school districts using speech-language pathology assistants must provide information to the Office of Special Programs regarding implementation of this program and verification of professional development activities.

SLPA Program FormsCounty Supervision Plan Completed by special

education director, SLPA and supervising SLP

Submitted to OSP whenSLPA is hired.

WVDE Verification Report: Speech Language Pathology Assistant

Document speech therapy services delivered and the supervision of the SLPA

Submitted to OSP prior to June 15

SLPA Session Documentation Document goals,materials, activities, evaluation and comments about sessions with students

For use by LEA to document program – no submission requirements.

SLPA Self-Evaluation of Intervention Session

Evaluate clinicalperformance during direct therapy sessions with students.

Documentation – nosubmission required.

SLPA Supervision DirectObservation Form

Record direct observation suggestions and follow-up

Documentation – no submission required.

Supervision Log:Direct/Indirect

Record direct and indirect supervision

Documentation – nosubmission required.

Summary: SLPAObservation Log - Direct/Indirect

Document number of sessions provided and percentage of sessions supervised

Documentation – nosubmission required.

Supervising SLPEvaluation Form

Evaluate supervisorand his/her clinical interactions with SLPA.

Documentation – nosubmission required.

Program Implementation

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Guidance for West Virginia Schools and Districts 9

1. The county supervision plan should be developed according to the following guidelines as described in the guidance document:• It is the responsibility of the supervising SLP and special education director to collaboratively design

and implement a supervision system that maintains the highest possible standard of quality.• The amount and type of supervision required should be based on the skills and experience of the

speech-language pathology assistant, the needs of individuals served, the service setting, the tasks assigned and other factors.

• More intense supervision would be required in such instances as the orientation of a new SLPA, initiation of a new program, equipment or tasks; or a change in the student status.

• Functional assessment of the SLPA’s skills with assigned tasks should be an on-going, integral element of supervision.

2. Caseload assignments must reflect the skills and expertise of the speech-language pathology assistant. The caseload of the supervising SLP must be adjusted to provide adequate time for supervision.

3. A training module for the SLPA and the supervising SLP is available online on the Office of Special Programs’ website and should be completed when the SLPA is employed.

4. Complete the attached form and return toKathy Knighton, WVDEOffice of Special ProgramsBuilding 6, Room 304Charleston, WV 25305 or fax (304)558-3741

Appendix A: County Supervision Plan Speech-Language Pathology Assistant (SLPA)

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10 Speech-Language Pathology Assistants

SUPERVISION PLAN: SPEECH-LANGUAGE PATHOLOGY ASSISTANTS2013-2014

Date: County:

Special Education Director:

Speech-Language Pathology Assistant:

Supervising Speech-Lanuage Pathologist:

I. Describe the educational background and experience of the SLPA.

II. ROLES/RESPONSIBILITIES: List the responsibilities assigned to the SLPA.

III. SUPERVISION REQUIREMENTS: Describe the supervision plan developed by the supervising SLP, special education director and SLPA.

IV. COMPLETION OF TRAINING MODULE:

SLPA/Date Completed:

Supervising SLP/Date Completed:

V. CASELOAD ASSIGNMENTS: (Indicate #of students on assigned caseloads.)

SLPA:

Supervising SLP:

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Guidance for West Virginia Schools and Districts 11

Date: County:

Speech-Language Pathology Assistant:

Supervising SLP:

Special Education Director:

Number in Caseload: Number of Sessions Provided:

Number of Sessions Supervised:

Percentage of Sessions:Direct Supervision Indirect Supervision

PROFESSIONAL DEVELOPMENT COMPLETED BY SPEECH-LANGUAGE PATHOLOGY ASSISTANT

TITLE DATE

Comments

SUPERVISION VERIFIED BY:Supervising SLP Date

SLPA Date

Special Education Director Date

Complete and return to: Kathy Knighton ([email protected]) WVDE, Office of Special Programs (Prior to June 1, 2014)

Appendix B - WVDE Verification Report Speech Language Pathology Assistant (2013-2014)

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12 Speech-Language Pathology Assistants

Student Name: SLPA:

Supervising SLP: County/School: IEP Goal #1Date(s):

Materials/Equipment Activity Evaluation Comments

IEP Goal #2Date(s):

Materials/Equipment Activity Evaluation Comments

IEP Goal #3Date(s):

Materials/Equipment Activity Evaluation Comments

Appendix CSLPA Session Documentation

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Guidance for West Virginia Schools and Districts 13

School:Date: Time of Session:

Disagree Agree

1. I maintained an appropriate relationship with the student throughout the session. 1 2 3 4

2. I was self-confident in this session. 1 2 3 4

3. I considered the student’s needs in selecting my materials and interacting with this student. 1 2 3 4

4. I considered the student’s cultural/linguistic needs in selecting my materials and interacting with this student. 1 2 3 4

5. I used language appropriate for the student’s age and education. 1 2 3 4

6. I was courteous and respectful with this student. 1 2 3 4

7. I was punctual for the session. 1 2 3 4

8. I was prepared for the session. 1 2 3 4

9. I was dressed appropriately for this session. 1 2 3 4

10. I used time efficiently during this session. 1 2 3 4

11. I completed the assigned tasks during this session. 1 2 3 4

12. I accurately determined correct vs. incorrect responses. 1 2 3 4

13. I provided appropriate feedback to the student. 1 2 3 4

14. The work area was appropriate for this student. 1 2 3 4

15. I was aware of my professional boundaries during this session. 1 2 3 4

16. I documented the results of the session appropriately. 1 2 3 4

17. I shared the results with my supervisor. 1 2 3 4

Comments:

SLPA Signature: (Adapted from ASHA)

Appendix D - SLPA Self-Evaluation of Intervention Session: Educational Setting

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14 Speech-Language Pathology Assistants

Speech-Language Pathology Assistant:

Supervising SLP:

County/School:

Date of Session observed:

Student Observed:

Description of behavior/skill(s) needing improvement:

Recommendation for improvement (specify time frame):

Follow-up Date:

Were recommendations followed & proficiency achieved in this skill area? YES NOWithin the expected time frame? YES NO

Comments:

Appendix ESLPA Supervision: Direct Obseration Form

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Guidance for West Virginia Schools and Districts 15

Appendix FSupervision Log: Direct/Indirect

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16 Speech-Language Pathology Assistants

SLPA:

Supervising SLP:

County/School:

Direct Supervision is on-site, in-view observation and guidandce.Indirect Supervision may include deomnstrations, record review, review and evaluation of audio or videotaped sessions, Skype and/or telephone conferences.

Student Sessions Supervised(List students/or group by initials only) During First 90 Workdays After First 90 Workdays

Number of Number ofsessions provided sessions providedsessions supervised sessions supervised

Percentage of Percentage ofsessions w/ direct supervision sessions w/ direct supervisionsessions w/ indirect supervision sessions w/ indirect supervision

Number of Number ofsessions provided sessions providedsessions supervised sessions supervised

Percentage of Percentage ofsessions w/ direct supervision sessions w/ direct supervisionsessions w/ indirect supervision sessions w/ indirect supervision

Number of Number ofsessions provided sessions providedsessions supervised sessions supervised

Percentage of Percentage ofsessions w/ direct supervision sessions w/ direct supervisionsessions w/ indirect supervision sessions w/ indirect supervision

Number of Number ofsessions provided sessions providedsessions supervised sessions supervised

Percentage of Percentage ofsessions w/ direct supervision sessions w/ direct supervisionsessions w/ indirect supervision sessions w/ indirect supervision

Verified by:

Supervising SLP Date

SLPA Date

Appendix GSummary: SLPA Observation Log - Direct/Indirect

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Guidance for West Virginia Schools and Districts 17

Supervisor’s Name Completed: January June

Instructions: to insure the quality of supervision provided to you as an SLPA please respond to the following items.INITIAL ITEMS

My Supervisor:RESPONSE

(check the appropriate response)1. provided me a copy of the Speech-Language Pathology Assistant: Guidance

for WV Schools & Districts. Yes No

2. explained my duties as an SLPA. Yes NoPlease rate each subsequent item according the rating scale that follows.

1 = Yes; 2 = No; 3 = Sometimes; NA = Not Applicable INITIAL ITEMS

My Supervisor:RESPONSE

(circle the appropriate response)1. explained to me the type of documentation that is necessary to use for each

therapy session. 1 2 3 NA

2. provided me with frequent, constructive verbal and/or feedback about my performance 1 2 3 NA

3. used a variety of ways of providing feedback to me about my performance e.g. verbal, written, rating scale, videotape of the session, suggested self-evaluation, etc.

1 2 3 NA

4. followed the suggestions in the Speech-Language Pathology Assistant: Guidance for WV Schools & Districts regarding supervision (i.e. minimum of 30% weekly; 20% direct supervision during the first 90 days of employment and minimum of 10% after the 90 day period) .

1 2 3 NA

5. followed the suggestions in the Speech-Language Pathology Assistant: Guidance for WV Schools & Districts regarding indirect supervision (i.e. maximum of 10% indirect supervision during the first 90 days of employment and a maximum of 10% after the 90 day period).

1 2 3 NA

6. supervised me more frequently & gave me specific suggestions if I requested it or needed it. 1 2 3 NA

7. was always accessible in person, telephone or pager during the time I worked with students. 1 2 3 NA

8. showed appropriate courtesy & respect for me. 1 2 3 NA9. answered questions about clinical matters satisfactorily. 1 2 3 NA10. was knowledgeable about students, their communication disorders and the

therapy process in general. 1 2 3 NA

11. communicated effectively with me. 1 2 3 NA12. explained clinical procedures effectively. 1 2 3 NA13. encouraged me to participate in continuing education activities. 1 2 3 NA14. showed effective supervisory skills. 1 2 3 NA

Comments: (Please include meaningful comments regarding strengths and suggestions for improvement in the space below.)

SLPA: Date:

Appendix HSupervising SLP Evaluation Form

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18 Speech-Language Pathology Assistants

Appendix I - FORM 38“Temporary Authorization for Speech Assistant”

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leva

rd E

ast

Char

lest

on, W

V 25

305

304-

558-

7010

4/3

0/12

Dat

e Re

ceiv

ed b

y Co

unty

Boa

rd o

f Ed

ucat

ion:

_

____

____

____

____

__ __

____

____

____

Dat

e Re

ceiv

ed b

y In

stitu

tion

of H

ighe

r Ed

ucat

ion:

___

____

____

____

__

Col

lege

/Uni

vers

ity

Deg

ree

Dat

e

List

the

inst

itutio

ns f

rom

whi

ch a

deg

ree

has

been

ear

ned

Do

you

curr

ently

hol

d a

Lice

nse

to

wor

k in

the

pub

lic s

choo

ls o

f an

-ot

her

stat

e?

Y

es

N

o

If y

ou a

nsw

er y

es t

o an

y qu

esti

on

belo

w,

SUB

MIT

a n

arra

tive

wit

h yo

ur

appl

icat

ion

. Th

e na

rrat

ive

shou

ld in

clud

e da

tes,

loca

tions

, sc

hool

sy

stem

s, a

nd a

ll/an

y ot

her

info

rmat

ion

that

ex

plai

ns

the

circ

umst

ance

(s)

in

deta

il.

1) H

ave

you

ever

had

adv

erse

act

ion

take

n ag

ains

t an

y ap

plic

atio

n,

cert

ifica

te,

or

licen

se

in

any

stat

e?

Adve

rse

actio

n in

clud

es

but

is

not

limite

d to

th

e fo

llow

ing:

le

tter

of

w

arni

ng,

repr

iman

d,

deni

al,

susp

en-

sion

, re

voca

tion,

vol

unta

ry s

urre

nder

or

can

cella

tion.

2)

Hav

e yo

u ev

er

been

di

scip

lined

, re

pri

ma

nd

ed

, su

spe

nd

ed

, o

r

di

scha

rged

fr

om

any

empl

oym

ent

beca

use

of a

llega

tions

of

mis

cond

uct?

3) H

ave

you

ever

res

igne

d, e

nter

ed

into

a s

ettle

men

t ag

reem

ent,

or

oth-

erw

ise

left

em

ploy

men

t as

a r

esul

t of

al

lege

d m

isco

nduc

t?

4) I

s an

y ac

tion

now

pen

ding

aga

inst

yo

u fo

r al

lege

d m

isco

nduc

t in

an

y sc

hool

dis

tric

t, c

ourt

, or

bef

ore

any

educ

ator

lice

nsin

g ag

ency

?

5)

Hav

e yo

u ev

er

been

ar

rest

ed,

char

ged

with

, co

nvic

ted

of,

or

are

curr

ently

und

er i

ndic

tmen

t fo

r a

fel-

ony?

*

6)

Hav

e yo

u ev

er

been

ar

rest

ed,

char

ged

with

or

conv

icte

d of

a

mis

-de

mea

nor?

(Fo

r th

e pu

rpos

e of

thi

s ap

plic

atio

n,

min

or

traf

fic

viol

atio

ns

shou

ld n

ot b

e re

port

ed)

Char

ges

or

conv

ictio

ns

for

driv

ing

whi

le

into

xi-

cate

d (D

WI)

or

dr

ivin

g un

der

the

influ

ence

of

al

coho

l or

ot

her

drug

s (D

UI)

mus

t be

rep

orte

d. *

* Fo

r a

YES

resp

onse

to

item

s 5

& 6

, th

e fo

llow

-in

g m

ust

be i

nclu

ded

for

all

char

ges,

inc

ludi

ng

thos

e th

at h

ave

been

dis

mis

sed

or e

xpun

ged:

1)

Judg

men

t O

rder

; O

R 2

) Fi

nal O

rder

; O

R 3

) M

ag-

istr

ate

Cour

t D

ocum

enta

tion;

AN

D 4

) al

l ot

her

rele

vant

cou

rt d

ocum

enta

tion.

YES

NO

I ce

rtify

tha

t I

have

rev

iew

ed a

nd c

an a

ttes

t to

the

acc

urac

y an

d tr

uthf

ulne

ss o

f th

e in

form

atio

n pr

ovid

ed in

thi

s ap

plic

atio

n.

Whe

n ne

cess

ary,

I h

ave

incl

uded

doc

umen

tatio

n ve

rifyi

ng t

his

info

rmat

ion.

I h

ave

revi

ewed

the

dis

clos

ure

of b

ackg

roun

d in

form

atio

n, a

nd,

to t

he b

est

of m

y kn

owle

dge,

the

ap

plic

ant i

s of

goo

d m

oral

cha

ract

er a

nd is

phy

sica

lly, m

enta

lly, a

nd e

mot

iona

lly q

ualif

ied

to p

erfo

rm th

e du

ties

of a

tea

cher

. I

reco

mm

end

that

s/h

e be

gr

ante

d ce

rtifi

catio

n.

____

____

____

____

____

____

____

____

____

__

____

___

____

____

____

____

____

____

____

_ __

____

____

____

____

____

____

____

__

Sign

atur

e of

Sup

erin

tend

ent

Coun

ty

D

ate

I sw

ear

or a

ffirm

und

er t

he p

enal

ty o

f fa

lse

swea

ring

that

all

info

rmat

ion

prov

ided

in o

r w

ith t

his

appl

icat

ion

is t

rue,

cor

rect

, an

d co

mpl

ete

to t

he b

est

of m

y kn

owle

dge.

I

unde

rsta

nd t

hat

any

fals

e st

atem

ents

, m

isre

pres

enta

tions

, or

om

issi

ons

of f

act

in o

r w

ith t

his

appl

icat

ion

are

grou

nds

for

deni

al,

susp

ensi

on,

or r

evoc

atio

n of

the

lice

nse(

s)

that

I a

m s

eeki

ng o

r cu

rren

tly h

old.

____

____

____

____

____

____

____

____

____

____

___

__

__

____

____

____

____

____

___

Sign

atur

e of

App

lican

t

Dat

e

Par

t 2-

Dis

clos

ure

of

Bac

kgro

un

d In

form

atio

n

P

art

1 -A

pplic

ant

Info

rmat

ion

____

____

____

____

_

___

____

____

____

___

_

____

____

____

____

____

____

____

_

____

____

____

____

____

_ So

cial

Sec

urity

Num

ber

Birt

h D

ate

(MM

-DD

-YYY

Y)

Gen

der

(M o

r F)

U

S Ci

tizen

( Y

ES o

r N

O)

Ser

ved

in U

S Ar

med

For

ces

( YE

S or

NO

)

____

____

____

____

____

____

____

____

____

__

____

____

____

____

____

____

____

___

__ _

____

____

____

____

____

____

____

____

____

___

Last

Nam

e

Firs

t N

ame

M

I Pr

evio

us L

ast

Nam

e (M

aide

n)(I

f yo

ur n

ame

has

chan

ged

sinc

e yo

ur la

st a

pplic

atio

n, p

roof

of

nam

e ch

ange

mu

st b

e at

tach

ed e

.g. p

hoto

copy

of

mar

riage

cer

tific

ate,

etc

.)

____

____

____

____

____

____

____

____

____

____

____

____

____

___

____

____

____

____

____

____

____

____

____

_ __

____

_ __

____

____

____

St

reet

Add

ress

City

St

ate

Z

ip C

ode

____

____

____

____

____

____

____

____

__ _

____

____

____

____

____

____

____

____

__ _

____

____

____

____

____

____

____

____

____

____

___

Prim

ary

Phon

e

S

econ

dary

Pho

ne

E-M

ail

Par

t 5

- Su

peri

nten

dent

Rec

omm

enda

tion

(R

equi

red

if e

mpl

oyed

in a

WV

Sch

ool S

yste

m)

Documentation Attached

Par

t 3—

App

lican

t Si

gnat

ure

Are

you

curr

ently

em

ploy

ed b

y a

Wes

t Vi

rgin

ia S

choo

l Sys

tem

?

Yes

No

If Y

ES, p

leas

e in

dica

te t

he

scho

ol s

yste

m:

Do

you

curr

ently

hol

d a

Lice

nse

to

wor

k in

the

pub

lic s

choo

ls o

f W

est

Virg

inia

?

Y

es

No

Firs

t-ti

me

appl

ican

ts a

re r

equ

ired

to

have

fin

gerp

rint

s pr

oces

sed

by L

-1 S

olut

ion

s (L

1enr

ollm

ent.

com

).

□ I

hav

e pr

evio

usly

rec

eive

d C

erti

fica

tion

in W

V a

nd u

nder

stan

d th

at I

do

not

nee

d to

re-

subm

it m

y fi

nge

rpri

nts

.

□I

hav

e n

ever

hel

d W

V C

erti

fica

tion

an

d ha

ve r

ecen

tly

subm

itte

d m

y fi

nge

rpri

nts

to

L1 S

olu

tion

s on

___

___/

____

__/_

____

____

(L

1 Tr

ansa

ctio

n #

____

____

____

____

____

____

)

A $2

5 no

n-re

fund

able

fee

req

uire

d pa

yabl

e to

WVD

E

for

each

app

licat

ion.

Appl

icat

ions

att

ache

d:

____

____

____

__

_

____

____

____

_ __

____

____

____

F

orm

#

For

m #

Fo

rm #

Supp

ortin

g do

cum

enta

tion

atta

ched

: (n

on-f

ee r

equi

red

Form

s, e

.g.

Form

s 4B

, 7, V

10, V

16)

____

____

____

__

_

____

____

____

_ __

____

____

____

For

m #

F

orm

#

Form

#

App

lican

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orm

atio

n Pa

ge

Par

t 4—

Fing

erpr

inti

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nfor

mat

ion

Page 27: Speech-Language Pathology Assistantssupervising speech-language pathologist. • Make referrals for additional services. • Communicate with the student, family, or others regarding

Guidance for West Virginia Schools and Districts 19

Des

igna

te if

thi

s re

ques

t is

for

an

Orig

inal

Tem

pora

ry A

utho

rizat

ion,

or

for

the

Rene

wal

of a

Tem

pora

ry A

utho

rizat

ion

in a

n en

dors

emen

t ar

ea p

revi

ousl

y gr

ante

d.

App

lican

t In

form

atio

n P

age

mus

t be

att

ache

d.

OR

IGIN

AL

REN

EWA

L

Dire

ctor

of In

stru

ctio

nal T

echn

olog

y D

irect

or o

f In

stru

ctio

nal T

echn

olog

y

Dire

ctor

of

the

Jobs

for

WV

Gra

duat

es

Dire

ctor

of

Scho

ol F

inan

ce

Dire

ctor

of

Child

Nut

ritio

n

Soci

al S

ecur

ity N

umbe

r: _

____

____

____

____

____

__

La

st N

ame:

___

____

____

____

____

____

____

__ F

irst

Nam

e: _

____

____

____

____

____

____

MI:

___

_

Form

38—

Tem

pora

ry A

utho

riza

tion

Empl

oyin

g C

ount

y

Sele

ct t

he

appr

opri

ate

endo

rsem

ent

area

to

be i

ssu

ed o

n t

he

Tem

pora

ry A

utho

riza

tion

and

ind

icat

e th

e sc

hoo

l ye

ar f

or w

hic

h t

he

Tem

pora

ry A

utho

riza

tion

is r

equ

este

d, in

the

spa

ce b

elow

. Th

e ap

prop

riat

e in

-ser

vice

tra

inin

gs/h

ours

an

d ot

her

requ

irem

ents

for

th

e en

dors

emen

t in

dica

ted

will

be

veri

fied

by

the

WV

DE

befo

re i

ssu

ance

of

each

Aut

hor

izat

ion.

Su

bmit

tra

nscr

ipts

an

d/or

all

docu

men

ts

requ

ired

for

the

sel

ecte

d en

dors

emen

t to

the

WV

DE

wit

h th

is a

pplic

atio

n.

Ref

er t

o W

V B

oard

of

Educ

atio

n Po

licy

5202

, §1

1.9,

fo

r th

e re

quir

emen

ts o

f the

sel

ecte

d en

dors

emen

t ar

ea.

REV2

0130

819

Ch

eck

Her

e

Indi

cate

Sch

ool Y

ear

Al

tern

ativ

e Ed

ucat

ion

O

ptio

n Pa

thw

ays

Fo

unda

tions

in E

ngin

eerin

g

H

ealth

Car

e Fu

ndam

enta

ls

H

uman

Ser

vice

s, D

evp

& R

elat

ions

hips

Ch

ief

Scho

ol B

usin

ess

Offic

ial

Cu

ltura

l Enr

ichm

ent

Ju

nior

RO

TC

Pr

oSta

rt R

esta

uran

t M

anag

emen

t

Re

adin

g fo

r G

rade

s Se

ven

and

Eigh

t

Sc

hool

Nur

se

Sc

hool

Nut

ritio

n D

irect

or

Sp

eech

Ass

ista

nt

Te

chno

logy

Int

egra

tion

Spec

ialis

t

Te

chno

logy

Sys

tem

Spe

cial

ist

O

ther

(Li

st)

Form

38

and

Form

38A

, “Su

pple

men

t to

Form

38”

are

con

tain

ed in

one

doc

umen

t mus

t be

com

plet

ed a

nd su

bmitt

ed to

th

e W

VD

E, O

ffice

of

Pers

onne

l Pre

para

tion

avai

labl

e at

http

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vde.s

tate.

wv.u

s/cer

tifica

tion/

forms

/docu

ment

s/Fo

rm38

.pdf

Page 28: Speech-Language Pathology Assistantssupervising speech-language pathologist. • Make referrals for additional services. • Communicate with the student, family, or others regarding

20 Speech-Language Pathology Assistants

Appendix J - Speech-Language Pathology Assistants (SLPA): Questions and Answers

The requirements for the issuance of an authorization for speech-language pathology assistants are defined in West Virginia Board of Education Policy 5202, “Minimum Requirements for the Licensure of Professional/Paraprofessional Personnel and AdvancedSalary.” Policy 5202 becomes effective on June 18, 2003.

Is there a need for speech-language pathology assistants (SLPAs)?Yes. The intent of this policy is to address the shortage of certified speech-language pathologists in West Virginia and better serve students with communication disorders by ensuring that personnel providing services are supervised and executing those tasks only within their scope of responsibilities and training.

Who are speech-language pathology assistants?SLPAs are individuals who may provide services to students with communication disorders under the guidance and direction of a certified speech-language pathologist. School systems frequently use the services of certified occupational therapy assistants (COTAs) and physical therapy assistants (PTAs) to facilitate the provision of therapy to students with disabilities. The SLPA will serve a similar role in the provision of services to students with communication disorders. These individuals must be issued an authorization from the West Virginia Department of Education, Office of Professional Preparation, according to the rules outlined in Policy 5202.

What responsibilities are within the role of the speech-language pathology assistant?SLPAs may conduct specific components of a speech and language delivery program as specified in an Individualized Education Program (IEP) under the direction and guidance of a certified speech-language pathologist. Tasks executed by speech assistants must be within their scope of responsibilities and include only those tasks they have the expertise and training to perform. Responsibilities may include the following:• conducting speech-language screenings;• providing services to students according to the IEP;• documenting student progress toward his/her goals and objectives;• assisting with individual assessments;• performing checks and maintenance of equipment;• assisting in the implementation of assistive technology devices and services; and• other appropriate tasks as assigned.

Will speech-language pathology assistants be used to replace speech-language pathologists?

No. Assistants cannot replace qualified speech-language pathologists. Speech-language pathology assistants may only be used when a certified speech-language pathologist has not applied for the available position as documented by the county and verified by the county superintendent. The use of speech-language pathology assistants does not preclude the active recruitment of certified speech-language pathologists.

Page 29: Speech-Language Pathology Assistantssupervising speech-language pathologist. • Make referrals for additional services. • Communicate with the student, family, or others regarding

Guidance for West Virginia Schools and Districts 21

Who may supervise a speech-language pathology assistant?The speech-language pathology assistant must be under the direction and guidance of a fully certified speech-language pathologist who has practiced speech-language pathology at least 2 years following certification.

How much supervision is required?The amount and type of supervision required should be based on the skills and experience of the speech-language pathology assistant, the needs of the individuals served, the service setting, the tasks assigned and other factors. A supervision plan must outline procedures for direct and indirect supervision of the speech assistant including documentation requirements. Direct supervision means on-site, in-view observation and guidance during a therapy session. Indirect supervision may include demonstration, record review, review and evaluation of audio or videotaped sessions, or supervisory conferences conducted by e-mail or telephone.

What are the requirements for an authorization?The applicant must:A. hold a minimum of a bachelor’s degree in speech pathology or communication disorders from an

accredited institution;B. be employed by a local West Virginia Board of Education; andC. receive the recommendation of the district superintendent verifying that the applicant is the most

qualified candidate for the position and that no fully certified speech-language pathologist has applied for the available position.

How long will an authorization be in effect?An authorization is valid for one school year and expires on June 30th of each year.

How is an authorization renewed?In order to renew the authorization, the applicant must complete professional development activities and receive the recommendation of the district superintendent verifying that no fully certified speech-language pathologist has applied for the available position.

Will SLPAs be assigned a caseload?

Yes. The speech-language pathology assistant will be assigned a caseload based on their level of expertise, experience, and supervision requirements. The caseload of the certified speech-language pathologist working with the speech assistant should be adjusted to provide adequate time for supervision.

Will the use of SLPAs affect Medicaid billing for speech-language services?Yes. Services provided by a speech-language pathology assistant are not an allowable expenditure for Medicaid reimbursement.

Page 30: Speech-Language Pathology Assistantssupervising speech-language pathologist. • Make referrals for additional services. • Communicate with the student, family, or others regarding

22 Speech-Language Pathology Assistants

Appendix KContact Information

WEST VIRGINIA DEPARTMENT OF EDUCATION

Kathy Knighton, [email protected] of Special Programs

Scottie Ford, [email protected] Hudnall [email protected]

Office of Professional Preparation

Page 31: Speech-Language Pathology Assistantssupervising speech-language pathologist. • Make referrals for additional services. • Communicate with the student, family, or others regarding

Guidance for West Virginia Schools and Districts 23

Page 32: Speech-Language Pathology Assistantssupervising speech-language pathologist. • Make referrals for additional services. • Communicate with the student, family, or others regarding

James B. Phares, Ed.D.State Superintendent of Schools