Do You Know Who is Providing Your Child’s Speech Language Therapy?

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If your child receives speech language therapy, you need to pay attention to how the service provider is described in the IEP. If the IEP includes acronyms, you need to ask questions so you know what they mean. Why?

If your child’s IEP says speech therapy services will be provided by a Speech Language Pathologist (SLP), this is legally correct and legitimate.

If your child’s IEP says speech language services will be provided by “SLP/Staff,” your child may receive speech therapy from an untrained, unlicensed individual.

Some administrators encourage IEP teams to write “Special Education Staff,” “SPED staff, or “SLP/Staff” as the speech therapy provider on the child’s IEP. The term “Staff” may refer to anyone on the staff who is willing to do speech therapy — including untrained substitutes, aides and paraprofessionals.

Substitutes, aides and paraprofessionals usually have high school diplomas. They are not licensed by your state Department of Education, nor are they certified by The American Speech-Language-Hearing Association (ASHA). ASHA is the professional, scientific, and credentialing association for audiologists, speech-language pathologists, and speech, language, and hearing scientists.

Substitutes may sign off on the IEP paperwork as “Speech Therapy Substitutes.” This suggests that they are legitimate, certified Speech Therapists when they are not.

Schools are using this back door approach to get around hiring trained, certified Speech Language Pathologists.

Yes, there is a shortage of certified Speech Language Pathologists who are willing to work in schools. There are also shortages of other service providers including Occupational Therapists and Physical Therapists. There are many reasons for these shortages including lower pay, high caseloads, and poor working conditions.

If your child receives speech language therapy, make sure the IEP states that these services will be provided by a Speech Language Pathologist (SLP).

Know Your State Requirements

States have different regulations and requirements for speech-language support personnel. State laws may differ from ASHA’s guidelines and requirements.

Check your state regulations for education and licensing requirements for SLPs and SLPAs.

ASHA State-by-State Licensure Requirement, Support Personnel Requirements, individual State information, and State Contacts.

To see where your state stands on support personnel licensure trends, please view the ASHS trends charts which are updated annually – Support Personnel in School Settings (PDF).

Get up to speed on your state regulations.

Read more.

ASHA Speech Language Pathology Assistants Overview and Key Issues

Wrightslaw webpage: Do You Know Who is Providing Your Child’s Speech Language Therapy?

Do You Know Who is Providing Your Child’s Speech Language Therapy? Blog Discussion Part 2

I was outraged when i met my son’s speech therapist during an iep meeting to find that the speech therapist has a heavy accent and working with my son who has autism! I find this highly inapropriate. When i made my concerns clear to the school district, they wrote me a letter and said that I shouldnt discriminate against her because of her accent, that she is a highly qualified therapist! To me, this is like an oxy moron! Now what should I do???

You are right to be careful about the wording used in the IEP, but in many states, an SLPA license has been enacted and they pass a test to demonstrate professional capabilities. SLPA’s must have at least a Bachelor’s degrees and are allowed to provide speech therapy under the supervision of a licensed Speech Pathologist. In fact, many universities are offering Bachelor’s degree programs designed to cater to the needs of Speech and Language Assistants and certifications are available upon completion. I suggest you verify your information before deciding that 4 year degrees only qualify a person to “file paperwork and make copies”.

I want to make a slight correction in the above article. I am a licensed Speech Language Pathology Assistant. I attended school for years to get my degree and be able to apply for a state license as a Speech Language Pathology Assistant. I also had to complete hundreds of hours of clinical fieldwork under the direct supervision of a Speech Language Pathologist. SLPAs are licensed and can provide therapy to clients, patients, and students. Of course we do have a supervising SLP that would do the assessments, come up with the therapy plan, go to the IEP, etc, but the SLPA can implement therapy, collect, data and take notes. The SLPA can be alone as long as the SLP is available for contact via phone. An Aide is different. An aide would get paid less and would not ever be able to be alone with a client, patient, or student. They would be ones who could file papers and do various clerical work, help gather materials, etc, but can not provide therapy.

I am currently in disagreement with my school district. My son has been diagnosed with severe apraxia of speech since the age of 2 and was in early intervention since the age of 1. Now he is 3 and just started special education preschool. I do not agree with the related services the school offered. He is receiving PT 1x a week for 30 min in a group setting, OT 2x a week for 30 mins also in a group, and speech 4x a week (3 in group and 1 individual). I only received more than normal 2x a week of speech, bc I came to that IEP meeting prepared and did my homework! I hired an advocate to help me fight for my son’s needs! He also has other diagnoses but dealing with speech, my son needs an SLP which the school has none. They are called speech language specialist. When my son was in EI, he was receiving speech 3x a week ind. for an hour.

This article is a bit misleading for parents and can possibly set them up for failure. IDEA allows trained and certified assistants to provide speech therapy. The last sentence in this article presumes all kids will be guided only by a SLP. In 90% of schools, this simply will not happen. Instead, demand that your school provides the name and credentials of any assistant working under the SLP and check your state laws regarding “related services” to verify that certified assistants are allowed. IDEA allows the states to decide if SLPs can use certified assistants. Get geared up and then go after the school if they are providing inadequate services. If they are, demand that only the SLP provide the speech therapy until they can hire real assistants.

At our last district, there was a big distinction made about Speech therapy vs Language therapy. Apparently our child’s teacher was allowed to provide services if it stated Language Therapy and the if the goals did not involve voice, articulation or fluency. If a child is non-verbal and using PECS, it is very important to double check to see exactly what type of therapy is listed in your IEP. (We won compensatory because though it stated Language, the goals included articulation for emerging speech).

We play it safe now and make sure it’s listed as individual or group, length of time, place of services and that services will be provided by an SLP.

Speech-language pathology assistants are licensed in the state of Texas and are required to not only maintain their license, but also be supervised by either an ASHA certified SLP or state licensed SLP. They typically hold Bachelors degrees in speech or they have had intensive training prior to obtaining their licenses. In Texas, the supervisor is responsible for the caseload. There are stringent guidelines in this state according to ASHA standards. The use of assistants varies from state-to-state. I am an ASHA certified SLP and have supervised many assistants. I am continually impressed with their work and am very aware of the students on their caseloads because they are MY responsibility. Please make sure the information you are giving is accurate.

Thank you to all of the Speech Language Pathologists that posted accurate information about our credentials (Bachelor Level SLPs). I can speak about FL… You need to get a license to practice as a Bachelor Degree level Speech Language Pathologist and within 2 years of employment we need to be enrolled in a Masters Degree program in order to continue our employment in the schools. Once one gets the Masters Degree you start your Clinical Fellowship Year (just like the Physicians year of residency) and get the clinical hours and other requirements needed to comply with the certificate of clinical competency (CCC). If you go to a clinic you will be most likely seen by a P.A. which stands for Phisician’s Assistant, not a Ph.D. This professional has a Bachelors Degree in P.A. and is qualified to see patients, just like a SLPA (SLP Bachelors).

I graduated in 2008 with a BS in Communication Disorders. In school, I completed 30 hours of clinical observation and assisted with therapy. My education included hours of course work in audiology and communication disorders.

I can be hired as an SLPA….and I CAN provide therapy. I DO have to be supervised by an SLP.

Get your facts straight. You are giving parents incorrect information and making my job harder. You make it sound as though SLPAs are glorified secretaries.

My 13 year old son is diagnosed PDD-nos and ADHD. He makes up for so much b/c of his intellectual ability. However, he is made fun of and has a difficult time with his peers. We began last year w/ an IEP in place and a TSS. Great Beginning. By Dec. things started to turn. Another student w/ special needs began annoying and saying inappropriate things to our son. My son became aggressive towards this child. Nothing was done. I asked for mediation w/ the parents. Nothing was done. My son finally threatened this child. The child’s parents threatened to call the police. I contacted an educational Atty. We feel a private educate is in order. We also feel that his resource room Language Arts does not match his intellectual ability. They want to do the same for Middle School. Do we have a case? Tired of the wrong label. Pat

What about aac? My child uses a dynavox V-had to pull teeth to get support. Went to due process-sought reimbursement-lost, but won compensatory speech services. The slp didn’t provide the consults because she wasn’t comfy with the device and she didn’t get along with the aac consultant!
Now we have to return to the district. Esy going horribly. The slp they committed to knowing what to do- wrote me a letter saying she is no aac expert- the district thinks 1 training is complying with aac support.

If he has a device doesn’t he get a provider that knows what she is doing? He had an aac group with another child at the private placement- I want one at the district too! If he was deaf- he’d have a deaf group-My distr is the largest in state-no other aac user. He is diagnosed with DD (Down’s) and severe apraxia of speech.

I would like to know how parents can verify the certification of a speech therapist in a school district? Is it only by asking the therapist / school district itself or is there a website where I could type in the name of the therapist to check her credentials?

I would also like to know if there are any rights for parents when a school district has switched speech therapists three times in one year and then highers a 20 year veteran school teacher (with some apparent speech experience…so I am told) who will probably retire some time soon? I know it is often difficult to higher for this position, but come on…this affects my son who has great needs in this area. With staff revolving so frequently and this is only his first year in the program, What rights do I have to help my son? He has autism and speech is key in his therapy.

We are new to the special ed programs. Our 5 year old son has Down Syndrome and recently had open heart surgery. He will be going to “kindergarten” in August. He had been receiving services at a special preschool–not as much as we had requested–we were pretty much ignored. They did quit “speech group” as we didn’t feel he was learning anything and was in the group for up to 45 min. at a time at 3-4 years of age. We wanted them to increase his time of 2×20 min./week. We were told we would have to wait until school starts and discuss it with the SLP at the new school. He was denied services over the Summer. Any ideas on how to increase his time with out causing a problem? Thank you for any ideas/help. (P.S. I also work for the district–this will be my second year.)

I earned my BA in speech and hearing science from The Ohio State University. Unfortuanetly, the field of Communication Sciences and Disorders is a highly competitive field and not all students are immediately admitted to a masters program. This was the case for me and becoming an assistant is my best way to continue on to graduate school. I think assistants are a great asset and can help with the SLPs caseload. If you look on ASHA’s website, there are regulations for assitants.
I think this a great way for potential SLPs to gain real world experience before entering graduate school.

Just to add information to Robbie. In some states for 2-4 years after you graduate with your BS/BA you are considered an SLP as long as you are attempting to enroll in a Master’s program. In AZ after this time period you are considered a speech language technician but still perform the same duties if you have the SLT certification. I worked as an SLPA for 6 years before entering grad school and on several occasion had to train the new “SLP” or correct their mistakes so that the IEPs are in complience. When I was cleaning up the mess was I less qualified? To make a correction to the article SLPAs/SLPPs ARE QUALIFIED to provide direct therapy in the school system.

A lot of people need to get their information straight before they pass it on to parents. In many states direct therapy can be provided by an SLPA/SLPP under the supervision of an SLP. SLPA’s and SLPP’s must have a BS/BA in speech pathology or communication disorders to be employed. At most universities ungraduate students participate in clinicals and actually provide therapy as a part of their program. So in fact when they graduate they are knowledgeable and can provide direct therapy. In most cases an SLPA has more experience and is a better therapist than a Master level clinician. Its sad that COTAs and PTAs have less education and get more respect from their superiors than SLPAs. I don’t understand why a person can’t work in the educational field with a BS/BA and not be looked at as unqualified or underqualified.

In New York State, speech teachers must be supervised by licensed speech therapists. This occurred about 6 years ago when Medicaid decided that speech teachers were not qualified to be giving speech therapy. So New York schools now have speech therapists whose jobs are to monitor the speech teachers and sit in on their lessons as well as sign the reports. Does anyone know if Medicaid rules state how much contact time with a student is a session-for instance if a student has three times a week for 30 minutes. If the session lasts for 20 minutes is that considered a session??

Speech therapy can be provided by SLP assistants. SLP assistants are supervised by Certified SLPs. They can do more than make copies and do paperwork. In fact, if they have more than 5 years experience they may even write I.E.P.s and be the voting member of the ARD committee. Or at least, that’s what we do in Texas.

I am a nurse who has been taking care of a child on ventilator support, j-g tube and is in a wc. He is medically fragile but does attend school 3 hrs a day 5 days a week. He is receiving minimal education no interaction or plan with teachers, no homework. He get 45minutes with a parapro during instruction for the day. His speech consists of a speech asst sitting next to him in science class. We have alot of down time were we are doing nothing and must go to special ed at the end of the day for 30 minutes where the child is put on a computer by the special ed teacher and she sits at her desk on hers. Someone decided he couldn’t learn and is their for socialization. Now they want to extend his hours to accomodate a child with behaviors who came last month. The same thing happened last year and he got so ill we lasted about 2 weeks. HELP

Unfortunately, it really doesn’t matter what ASHA standards are unless your State Dept. of Ed. incorporated them into it’s certification requirements. What I found out, and the problem here in Arizona is that IDEA allows the SDE to create the certification requirements for related service providers, and they do not have to correspond with ASHA requirements. So now my son with an ASD, has an SLP, with nothing more than a BA, and it is completely within the law in this State.
I urge everyone to check the certification requirements of your SDE regarding SLP’s, and then check what certification your childs SLP has, you may be in for a shock. This is not to say you cannot get an ASHA certified SLP with their CCC’s on your child’s IEP, you just have to go about it a different way.
Pam, Pete: I could sure use some help/advice/counsel.

My son’s IEP meeting was on Mar. 10, 09.
On the Speech and language section, it is said that speech and language for my son would be provided by Speech-Language pathologist and/or Speech language Pathologist Assisstant, under the supervision of the Speech language Pathologist.

I politely raised my broken English voice and humbly said that I needed our district and team members to reconsider this offer because of my concern regarding the qualification.
The program supervisor ‘s face became red but I tried to save his face by saying that I learn that some parents in the Viet community and I was very sincere when brought up this issue.
I didn’t sign the IEP.
The supervisor program was trying to be fair to me and said he would revise it. He friendly tapped me on the shoulder and asked: “Who did your learn that from?”
I smiled.

In California, we do have licensed Speech-Language Pathology Assistants (SLP-As) who are qualified to work with students for direct therapy services in the public schools and clinical settings. They do have a supervising SLP. They are a wonderful asset to the field. They have BA or BS degress in Communicative Distorders or Speech Pathology, and most are working towards their Master’s Degree. SLPs often have high caseloads in the school setting, and would not be able to effectively do their jobs without the professional assistance of a SLP-A.

I am curious about provision by an SLP clinician. What are the regulations on “interns” and students in training. It is done across the board with psychologists, SLP, OT and Teachers. However I can’t seem to find any regulations. I wonder also if then the direct related service may need to be documented as consult in the IEP?

I find it interesting that this article will use ASHA as a source of information when it suits the assertions of the article. However, research should be more thorough in the area of SLP assistants (SLPAs). According to the ASHA guidelines in their Guidelines for the Training, Use, and Supervision of Speech-Language Pathology Assistants it states “Provided that the training, supervision, and planning are appropriate …, the following tasks may be delegated to a speech-language pathology assistant: (c) follow documented treatment plans or protocols developed by the supervising speech-language pathologist”. ASHA clearly rejects the assertion that SLPAs are inappropriate to provide direct intervention. How often a one on one Assistant (less trained than an SLPA) is requested for a child yet parents resist service provision by SLPAs.

John, thanks for the clarification. That sounds exactly like what is happening. My question then is, if she hasn’t gotten this certification yet, is she a licensed speech-language pathologist like this article says she needs to be? I thought it was really odd that they tried to sneak the change from “speech language pathologist” to “speech language clinician” past us, which makes me wonder if they were doing something wrong and trying to cover it up.

Hello again. I was re-reading my response and I just wanted to let everyone know that I think that this is a topic of great importance that should be clear and understandable and it is, unfortunately, muddy and confusing. I also don’t like the character limit…so I apologize if I seemed short in my last reply, I had to count characters.
As to JN’s statement, the person providing the service is probably in their CFY (Clinical Fellowship Year), the post-Master’s training we all must receive before we can get our CCC (Certificate of Clinical Competence). Please go ahead and ask your child’s clinician if this is so and how often their CFY supervisor visits…also have them explain their particular CFY experience, they should be happy to tell you about it…All CCC-SLP’s since the 70’s must have a CFY period.

In Florida, we noticed our child’s IEP was changed to read “speech language clinician” instead of “speech language pahtologist.” The actual therapist does have a masters but is getting a ccc(?) certificiation. The school came back and said that having a masters makes you a speech language pathologist in Florida. Is that right or are they playing loose with the terminology?

As with most anything to do with Special Ed. and SLP services, it depends on the state in which you live. In NH, and many other states, there is a recognized SLPA (assistant) education program, however no credentialing/licensing for it yet. ASHA does have guidelines for SLPA, but they are not followed everywhere. As far as group vs. 1:1, the reasons for it should be explained to you by the SLP, there are reasons for each type of therapy (1:1 isn’t always necessary or beneficial, depending on the child’s needs). Also IFSP and IEP documentation require the setting of the therapy (group, individual, consult). If it’s not clear on the document, demand it. Jessica’s points as to educational/academic impact and need are spot on.
My main difficulty with the article is that seems that some research is lacking. Get the facts straight.

It should also be considered that the amount of service time given in a public school setting is based on what will make the child functional in the academic setting. Many speech pathologists would love to spend more time with the children; the fact of the matter is public school allows speech therapy to be provided to those that show a deficit in the area of speech/language that effects their academic performance. The main job of the slp is to assist the child in becoming successful/ functional within the realm of speech and language. I advise many parents to seek outside speech therapy if they are truly concerned about the speech/language development of the child. Speech/language can look very different outside of the academic setting.

Kristy, I could not remember that TX uses the term SLP assistants. I did say that certain staff could do certain activities & to check with the state SLP licensing agency. That agency works with ASHA in most states. So I do not see that I gave any incorrect information.

Speech and language pathology assistants are able to provide therapy services as delineated by the supervising speech and language therapist. You might want to check with ASHA before you give parents incorrect information.

It is important to study your state’s regulations on speech services. You may need to review the education agency’s rules & those of the speech pathology licensing board.
In TX when OSEP made us tighten up the qualifications of SLP’s, TX grandfathered all speech therapists with only a BA degree. They are allowed to do provision of speech services, but not speech assessments & reports. In some cases these individuals have more experience & knowledge than SLP’s. As mentioned some schools have gone to using paraprofessionals (i.e. aides) to provide some services.

As stated, it is important to monitor the language used & understand the qualifications of the person being used. As with any profession, some individuals have more experience & knowledge of certain conditions than others. So ask about experience also.

We had an SLP who was not ASHA certified and could not help my daughter who has Apraxia of Speech. She had never even heard of it. Our school Speech does not help at all and in one case the little girl started to stutter at the age of 5, since she started working with someone who has no apraxia experience.

To assist consumers in finding an speech-language pathologist or audiologist in their local area, the American-Speech-Language-Hearing Association (ASHA) has a free referral service entitled ProSearch. By going to ProSearch at http://www.asha.org/findpro/ consumers can type in their zip code or city and state and find an speech-language pathologist or audiologist who works close by. Consumers can also call ASHA’s toll-free number 1-800-638-Talk (8255).

Its the same over here in the UK.

What about a speech and language therapist? my son has a speech and language therapist he sees 2x a week for expressive and receptive language disorder. Do you think that is enough? He is also hearing impaired with high frequency sensorineuron hearing loss and wears hearling aids.

Is this true for all states. Only an SLP and not an SLP-Asst. can provide Speech Therapy Service in a Texas Public School??

My son receives ST. He receives 120min/week. I found that it was also important to know how the service will be provided. For example, group speech, 1-to1 speech. He was receiving mostly group speech until I requested that be changed.

Question: Is it important to have a Speech Pathologist institute the therapy vs a paraprofessional? I am confused. I understand that one has a Masters and the other a BS. But does it make a difference in the actual implementation of services if the Speech Pathologist is overseeing? My son receives his therapy from a paraprofessional.
Thanks.

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