In my first blog, I went over some terms related to speech assistants, gave a little background info about why there are different types of assistants, and hopefully got you set off on the right foot. This time, I’ll go a bit more in depth about what assistants can do and supervision requirements.
What I want to point out that SLPs have assistants for a variety of reasons. Assistants may be there to help prepare materials, escort kids to and from the speech room, translate, file paperwork, and/or actually provide therapy. You may start out asking your assistant to do certain tasks and then change as you go. First off, it’s absolutely essential that you know what your assistant can and cannot do in your state. So…
What is within the scope of practice for Speech Language Pathology Assistants versus Speech Aides?
This depends on each state and/or what type of assistant you’re working with – SLPA or Speech Aide. Go back to my first blog for an explanation of the different types of assistants. You need to know which type you have and then go to your state’s Speech Language Pathology regulations website for the details or go to the ASHA website and find the link from there. I’ll go over a couple of states that I have worked in that greatly differ in their regulations:
If you want to work with students as a Speech Language Pathology Assistant in the state of Oregon, go to school first!
OAR 335-095-0060 lists what’s under the scope of practice for SLPAs*.
- SLPAs CAN do speech and language screenings, provide direct treatment, document progress, take data, interpret a second language during assessments, prepare materials, assist with other clerical duties, schedule activities, perform checks and maintenance of equipment, and participate with the speech-language pathologist in research projects and in-service training.
- SLPAs CANNOT do swallowing screenings or assessments, administer diagnostic tests or evaluations, interpret test results, participate in parent conferences or meetings without the supervising SLP in presence, write, develop, or modify a student’s treatment plan in any way, sign any formal documents (e.g. treatment plans, IEPs, IFSPs, determination of eligibility statements or reports, etc.), select or discharge students for services, and more…
OAR 335-095-0065 lists what’s under the scope of practice for EAs* (Education Assistants – aka Speech Aides)
- EAs CAN perform non-instructional activities and clerical duties, but
- EAs CANNOT directly provide therapy, do speech and language screenings, document progress, or take data.
*Please go to the actual website for the whole list.
Washington, like many other states, doesn’t require assistants in schools to have previous education in, or knowledge about, speech and language sciences. Their regulations can be quite different.
Information about becoming a Speech Language Pathology Assistant in Washington can be found here and here. I provided two links because the ASHA link (second one) has an important detail – “Support personnel are not regulated in Washington schools”.
This means that, while in the state of Washington you certainly can become a Speech Language Pathology Assistant, you don’t need to be an SLPA to work in the schools. You can apply for a ‘Speech Assistant/Aide’ job without any previous education or experience. If you want to work as an assistant in a clinical or medical setting, then go get those classes done! I’m focusing on schools for this blog.
While support personnel (for our purposes, Speech Assistants/Aides) in schools aren’t regulated in the state of Washington, which means there’s a lot of flexibility about their duties, it’s probably best practice to at least follow the state guidelines written for actual SLPAs (WAC 246-828-112):
- Speech Assistant/Aides CAN perform the following tasks under direct or indirect supervision at the discretion of the supervising SLP: provide direct therapy, hearing screenings (not interpret results), document student performance (such as data, charts, graphs, progress notes, and treatment notes), implement treatment plans and protocols developed by the SLP, perform clerical duties, check and maintain equipment, sign treatment notes, progress notes, and other paperwork as directed by the speech-language pathologist and/or state regulations (i.e., Medicaid). They may only perform procedures or tasks delegated by the SLP.
- Speech Assistant/Aides CANNOT perform tasks that require diagnosis, evaluation, or clinical interpretation, screening and/or diagnose feeding and swallowing disorders, develop or modify treatment plans, implement therapy outside of the treatment plan, select or discharge students for services, or refer students for additional services. Assistants that are not SLPAs may not bill Medicaid for services.
If you open up the Oregon and Washington pages side-by-side, you’ll see that Oregon’s list of duties and regulations is much longer than Washington’s. I imagine each state will look quite different. So please look at your state’s requirements. Don’t rely on my information alone, especially if you’re not providing services in Oregon or Washington.
Another important consideration is how much time you’ll be required to supervise your assistant. You can’t just hand them a list of students and goals and check in with them when progress notes or IEPs are due. Go back to the list of duties – you, as the SLP, write the treatment plans. That doesn’t necessarily mean that you have to prepare daily lesson plans. It does mean that your assistant needs to know what goals will be targeted with each student, for how long, and perhaps some direction about how to work on those goals. This really will depend on how experienced and how comfortable your assistant is with providing speech therapy, working with each student, on each type of goal, and how comfortable you are with letting them choose activities and carving out the path you’ve set before them.
Again, requirements vary by state. Since Washington doesn’t regulate assistants in schools, what are the supervision requirements? I sure hope people are following best practice and actually supervising assistants they work with! Meanwhile, Oregon has it all laid out there for us… 🙂
OAR 335-095-0050 – Requirements for Supervising Licensed Speech-Language Pathology Assistants
The gist is that the amount and type of supervision requirements are based on the skills and experience of the SLPA (remember that you have to be an SLPA in Oregon to work with students). I don’t want to go over every detail because you can go to the actual website and read it there, but the percentage of time supervised varies from 20% to 30%. Most of that time should be direct supervision versus indirect. Another important thing for those working in states like Oregon: Supervision of SLPAs must be documented. You have to prove it.
WAC 246-828-112 – Speech-language pathology assistants—Minimum standards of practice
The gist here is that there aren’t as many rules in Washington, and nothing stating the percent of supervision needed (that I found). A summary of what WAC states is that the SLPA must be supervised by the SLP while performing these procedures or tasks: A) direct supervision when participating during parent conferences, case conferences, or interdisciplinary team meetings with the SLP present, or when assisting the SLP during evaluations and assessments, and B) direct or indirect supervision at the discretion of the supervising SLP for all those other tasks I listed above for SLPA duties in the state of Washington.
Whether you’re working in a state like Oregon or a state like Washington, you need to know the regulations when it comes to working with a speech assistant or aide. I live in Oregon, but most of my work is with students in Washington. When I’m working with assistants in Washington, I don’t just follow their rules, I actually go by even stricter rules and follow Oregon’s regulations. That way I know I’m doing more than the minimum. I highly recommend you do the same!
Stay tuned for future blog posts about working with Speech Assistants. Later this month, I’ll be sitting down with other SLPs to get their input and advice about working with assistants, so it’s not just my opinion you’re reading 😉