State Board of Examiners for Speech-Language Pathology and Audiology
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Board Position

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Licensees are encouraged to review the following Board position statements relating to:

• SPEECH-LANGUAGE PATHOLOGY:
• Work Load and Caseload Size in the Public Schools
• Services to Dysphagic Patients by Speech-Language Pathologists
• Laryngeal Videoendoscopy/Stroboscopy
• Utilization and Employment of Speech-Language Pathology Supportive Personnel with Underserved Populations
• Supervising Licensed Interns in Speech-Language Pathology
• AUDIOLOGY/FITTING AND DISPENSING OF HEARING INSTRUMENTS:
• Regarding the Need for an Amplification Device Candidacy Determination Audiological Evaluation
• Hearing Aid Fitting for Adults
• Newborn Hearing Screening
• Vestibular and Balance Rehabilitation
• Supervising Licensed Interns in Audiology
• Licensure of Au.D. Student Externs
• ASSISTANT IN SPEECH-LANGUAGE PATHOLOGY OR AUDIOLOGY:
• Supervising Licensed Assistants in Speech-Language Pathology and Audiology
• LICENSE/REGISTRATION RENEWAL, INCLUDING CONTINUING EDUCATION
  • Continuing Education Credit for Coursework and the American Medical Association (AMA)

POSITION STATEMENT RELATING TO WORK LOAD AND CASELOAD SIZE IN THE PUBLIC SCHOOLS

PURPOSE:

The purpose of this document is to ensure the public of professional conduct by speech language pathologists by providing guidance relating to workload in determining an appropriate caseload size in the public schools.

REFERENCES:

The Act: Texas Occupations Code (TOC), Chapter 401

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 - §741.45 relating to Code of Ethics; Duties and Responsibilities of License Holders

Variables that affect quality of services and caseload include the following:

• the severity of the communication disorder
• the effect of the disorder on the individual's ability to function in educational, employment, and home/social settings
• the special needs of the student/client
• the number of locations in which services are provided
• the need for providing services to students receiving homebound services
• the need for providing services to students in private school
• the travel time between locations
• the effect of variable schedules to include year round and multi-track schools and
• the workload requirements of the caseload.

Speech language pathologists are required to perform duties other than direct services that are essential to the appropriate management of each student/client. These duties may include, but are not limited to the following:

• conducting speech-hearing-language screenings
• carrying out comprehensive diagnostic evaluations
• writing reports
• participating as a member of multi-disciplinary teams and conferences
• developing Individual Education Plan (IEP)'s goals and objectives and/or treatment plans
• developing service plans for qualifying students who attend private school per school district’s in-service requirements
• participating in on-going teacher and parent conferences and family education support
• providing in-service training
• developing and teaching the use of low tech augmentative and assistive communication systems
• learning, programming and utilizing high tech augmentative and assistive communication systems
• receiving training, learning and utilizing computerized management systems
• completing ongoing paperwork requirements for students receiving School Health and Administrative Services (SHARS)
• participating in continuing professional education
• participating in annual review conferences and staffings
• coordinating assistive technology support services
• participating in the pre-referral and referral process (Note: In the public school setting, the speech-language pathologist participates in the pre-referral process as a consultant to general education.)
• planning instructional/therapeutic changes
• supervising support personnel, speech-language pathology interns, and speech-language pathology assistants (Note: An intern may pursue the American Speech-Language-Hearing Association Clinical Fellowship (ASHA CF) simultaneously.)

Since services must be provided by a licensed speech-language pathologist and certain types of services and students/clients are more time-intensive than others, it is necessary to consider realistically how the amount of time available in each day/week/month can be divided across all services to students/clients. The caseload must reflect a balance between how many hours are available in a day for services to the student/client and how many hours are needed to complete paperwork, staffing, and other required activities. It is also imperative to consider that the roles and responsibilities of speech-language pathologists have a major impact on caseload size, by reducing the amount of time available for direct and indirect services to students/clients. In order to provide this balance, it is recommended that the caseload/workload needs are weighted in order to determine a manageable caseload size. Depending upon the associated workload, when the above factors are less, a maximum caseload limit of 50 is recommended taking into account the variables that affect quality of services.

Click here to print "Position Statement Relating to Work Load and Caseload Size In the Public Schools", (Adobe Acrobat, 44 KB)

POSITION STATEMENT RELATING TO SERVICES FOR DYSPHAGIC PATIENTS BY SPEECH-LANGUAGE PATHOLOGISTS

PURPOSE: This purpose of this statement is to notify licensees and consumers that a licensee shall adhere to the national standard of practice in order to protect the public.

REFERENCES:

The Act: Texas Occupations Code, Chapter 401, §401.001

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 - §741.41 relating to the Code of Ethics; Duties, and Responsibilities of Supervisors

The Board recommends that speech-language pathologists and interns in speech-language pathology utilize the American Speech-Language-Hearing Association's statements relating to Knowledge and Skills Needed by Speech-Language Pathologists Providing Services to Dysphagic Patients/Clients, Dysphagia, and Instrumental Diagnostic Procedures for Swallowing.  

You may contact the American Speech-Language-Hearing Association to obtain this document.

Internet site: http://www.asha.org

Phone: (800) 498-2071

E-mail: actioncenter@asha.org

Click here to print "Position Statement Relating to Services to Dysphagic Patients by Speech-Language Pathologists", (Adobe Acrobat, 31 KB)

POSITION STATEMENT RELATING TO LARYNGEAL VIDEOENDOSCOPY/STROBOSCOPY

PURPOSE:

The purpose of this statement is to notify licensees and consumers that a licensee shall adhere to the national standard of practice in order to protect the public.

REFERENCES:

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 - §741.41 relating to the Code of Ethics; Duties, and Responsibilities of Supervisors

The Board accepts the joint statement regarding the Role of Otolaryngologists and Speech-Language Pathologists in the Performance and Interpretation of Strobovideolaryngoscopy developed by the American Academy of Otolaryngology Voice and Swallow Committee and the Special Interest Division on Voice and Voice Disorders of the American Speech-Language-Hearing Association (ASHA). Licensees should refer to the ASHA Training Guidelines for Laryngeal Videoendoscopy/Stroboscopy to determine competency.

You may contact the American Speech-Language-Hearing Association to obtain this document.

Internet site: http://www.asha.org

Phone: (800) 498-2071

E-mail: actioncenter@asha.org

Click here to print "Position Statement Relating to Laryngeal Videoendoscopy/Stroboscopy", (Adobe Acrobat, 31 KB)

POSITION STATEMENT RELATING TO UTILIZATION AND EMPLOYMENT OF SPEECH- LANGUAGE PATHOLOGY SUPPORTIVE PERSONNEL WITH UNDERSERVED POPULATIONS

PURPOSE:

The purpose of this document should act as a “Best Practices” benchmark through which licensees may evaluate and improve their current practice relating to underserved populations.

REFERENCES:

The Act: Texas Occupations Code (TOC), Chapter 401, §401.302

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 - §741.41 relating to the Code of Ethics; Duties, and Responsibilities of Supervisors

The Board recommends that speech-language pathologists and interns in speech-language pathology utilize the “Utilization and Employment of Speech-Language Pathology Supportive Personnel with Underserved Populations” developed by the American Speech-Language-Hearing Association (ASHA) Committee on Supportive Personnel.

You may contact the American Speech-Language-Hearing Association to obtain this document.

Internet site: http://www.asha.org

Phone: (800) 498-2071

E-mail: actioncenter@asha.org

Click here to print "Position Statement Relating to Utilization and Employment of speech-Language Pathology Supportive Personnel With Underserved Populations", (Adobe Acrobat, 31 KB)

POSITION STATEMENT FOR SUPERVISING LICENSED INTERNS IN SPEECH-LANGUAGE PATHOLOGY

PURPOSE:

The purpose of this document is to provide guidance related to the supervision of speech-language pathology interns. The Act and the Board Rules permit speech-language pathology interns to deliver speech-language services under the supervision of a licensed speech-language pathologist. The supervising speech-language pathologist shall be responsible for all client services performed by the speech-language pathology intern, and must determine that the speech-language pathology intern is qualified to perform those services. A licensed speech-language pathology intern shall only practice under supervision of the licensed speech-language pathologist(s) who have completed the Intern Plan and Agreement of Supervision Form and received approval from the Board office.

REFERENCES:

The Act: Texas Occupations Code, Chapter 401, §401.311

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 relating to the Code of Ethics; Duties and Responsibilities of License Holders

Subchapter E, §741.62 relating to Requirements for an Intern in Speech-Language Pathology License

(NOTE: Failure to follow the requirements of the Act and Board Rules shall result in disciplinary action being proposed by the Board against both the supervising speech-language pathologist and the speech-language pathology intern.)

RESPECTIVE DUTIES OF THE SPEECH-LANGUAGE PATHOLOGIST AND INTERN:

Under the supervision of a licensed speech-language pathologist, the licensed speech-language pathology intern is authorized to: conduct evaluations; interpret test results; determine case selection; design treatment programs; collect data and document performance; maintain clinical records; provide written or oral reports (e.g., progress notes, diagnostic reports) regarding patient/client status; make referrals, and participate in interdisciplinary team meetings (e.g., Admission Review Dismissal (ARD)’s, Individual Family Services Plan (IFSP) conferences, discharge staffings) for all patients/clients being served. The licensed speech-language pathology intern shall abide by the decisions made by the licensed speech-language pathologist supervisor relating to the speech-language pathology intern's scope of practice. In the event the supervising speech-language pathologist requests that the speech-language pathology intern violate Board Rules, the Texas Occupations Code, or any other law, the speech-language pathology intern shall refuse to do so and immediately notify the Board office and any other appropriate authority.

The licensed speech-language pathologist is responsible for verifying that the Board office has approved the Intern Plan and Agreement of Supervision, and that the speech-language pathology intern holds a current, valid license before allowing him/her to practice. (Note: The speech-language pathology intern may simultaneously pursue the American Speech-Language-Hearing Association (ASHA) Clinical Fellowship, but approval from ASHA to begin the Clinical Fellowship is not a license to practice.)

PROVIDING ADEQUATE SUPERVISION:

To allow time for appropriate training and supervision, it may be necessary to reduce the number of clients directly served by the licensed speech-language pathologist in relation to the number of speech-language pathology interns being supervised. Variables that affect the maximum number of individuals who can be supervised appropriately by the licensed speech-language pathologist may include but are not limited to:

a. the number of hours per week the speech-language pathologist and speech-language pathology intern(s) are employed;

b. the number of other individuals (e.g., speech-language pathology assistants) being supervised;

c. time required of the supervising speech-language pathologist in direct service provision;

d. the experience level of the speech-language pathologist supervisor and speech-language pathology intern(s);

e. the time limits imposed by supervision requirements;

f. the number of locations in which services are provided and travel time between locations;

g. other roles and responsibilities assigned to the speech-language pathologist (e.g., attending staff meetings and fulfilling other campus/district/agency assignments).

The supervising speech-language pathologist should be the only professional to decide how many, if any, speech-language pathology interns he/she can supervise and still ensure that all services are provided in compliance with Board Rules and the Texas Occupations Code, Chapter 401.

AMOUNT OF SUPERVISION REQUIRED:

The supervising speech-language pathologist must provide no fewer than 36 clock hours of supervisory activities over the course of the internship. Supervision must be divided equally among the three segments (1/3 length of the internship), including 6 hours of on-site observation of direct client contact at the speech-language pathology intern’s work site and 6 hours of other monitoring activities during each segment. Other monitoring activities may include, but are not limited to: telephone conferences with the speech-language pathology intern, evaluating the speech-language pathology intern’s records and correspondence, reviewing videotapes of the speech-language pathology intern’s therapy, and discussing the speech-language pathology intern’s performance with his/her professional colleagues.

CHANGES IN SUPERVISOR, EMPLOYER, OR NUMBER OF HOURS EMPLOYED:

If the speech-language pathology intern changes his or her speech-language pathologist supervisor or adds additional supervisors, a current speech-language pathology Intern Plan and Agreement of Supervision Form must be submitted by the new speech-language pathologist supervisor and approved by the Board office before the speech-language pathology intern may resume practice. The past speech-language pathologist supervisor and the speech-language pathology intern must complete a Report of Completed Internship Form and submit it to the Board office upon completion of that portion of the internship. The Board office shall evaluate the form and inform the speech-language pathology intern of the results.

If the speech-language pathology intern changes employers, but the speech-language pathologist supervisor and the number of hours employed per week remain the same, the speech-language pathologist supervisor must submit a signed statement giving the name, address and phone number of the new location. A Report of Completed Internship Form must be submitted for the experience at the previous location.

If the number of hours worked per week changes but the speech-language pathologist supervisor and the location remain the same, the speech-language pathology supervisor must submit a signed statement giving the date the change occurred and the number of hours per week the speech-language pathology intern is now working. A Report of Completed Internship Form must be submitted for the past experience. Be sure the form clearly indicates the number of hours worked per week.

DESIGNATE PRIMARY SUPERVISOR:

If more than one speech-language pathologist supervisor supervises the speech-language pathology intern, each speech-language pathologist supervisor must complete the Intern Plan and Agreement of Supervision Form and be approved by the Board office before supervising. The primary speech-language pathologist supervisor must be designated. At the end of the internship, the designated primary speech-language pathologist supervisor must complete the Report of Completed Internship Form. Additional speech-language pathologist supervisors may either submit the form or write a letter to the Board, naming the primary speech-language pathologist supervisor and concurring with the primary supervisor’s report.

DOCUMENTATION REQUIRED:

The supervising speech-language pathologist must provide feedback to the speech-language pathology intern throughout the internship, and shall conduct at least one formal evaluation of the speech-language pathology intern’s progress in each segment of the internship. Both the speech-language pathology intern and speech-language pathologist supervisor must maintain documentation of the speech-language pathologist supervisor’s observation and evaluation records for three (3) years, or until the speech-language pathology license is granted. These records must be provided to the Board upon request.

ISSUANCE OF INTERN LICENSE AND RENEWAL:

The speech-language pathology intern license is issued for one full year to allow sufficient time for most individuals to complete the internship and apply for full licensure or the temporary certificate of registration.

If the internship is not completed by the expiration date of the license, the speech-language pathologist supervisor should verify that the speech-language pathology intern renewed the license. (Ten continuing education hours are required to renew the speech-language pathology intern’s license, in addition to other required forms and the fee. A Renewal Form is mailed 45 days prior to the expiration date of the speech-language pathology intern’s license and will include complete instructions.)

INTERNSHIP COMPLETED:

Once the internship has been completed, the speech-language pathology intern must submit a current Application Form, fee, and other required documentation to the Board office to apply for full licensure or the temporary certificate of registration. The speech-language pathologist supervisor shall complete the Report of Completed Internship Form. It is the decision of the speech-language pathologist supervisor to determine whether the internship is acceptable. Refer to Board Rules, §741.112(a) for documentation to submit to the Board office.

If the speech-language pathology intern has not passed the Praxis Exam, by the end of the Clinical Fellowship Year (CFY) the speech-language pathology intern must apply for a Temporary Certificate of Registration (§741.65) which allows him/her to practice for eight (8) weeks after the next Praxis Exam. However, after that timeframe if the speech-language pathology intern has not passed the exam, the speech-language pathology intern will need to apply for an speech-language pathology assistant license and submit a new Supervisory Responsibility Statement (SRS) and abide by the rules and regulation of a speech-language pathology assistant.

As long as the speech-language pathology intern’s license remains valid, the speech-language pathology intern may practice under supervision while awaiting full licensure or the temporary certificate of registration. The supervising speech-language pathologist must mail or fax a signed letter to the Board office, stating that he/she will continue to supervise the speech-language pathology intern from the “Ending Date of Internship” as shown on the Report of Completed Internship Form until the speech-language pathology intern receives the full license or temporary certificate of registration. However, if the speech-language pathology intern changes supervisors, the new speech-language pathologist supervisor shall first submit the speech-language pathology intern plan and agreement of supervision form and receive Board approval before the speech-language pathology intern may resume practice.

NOTE: Please understand that holding the ASHA Certificate of Clinical Competency (CCC) is not a license to practice in Texas.

We can be contacted by regular mail at:

State Board of Examiners for Speech-Language Pathology and Audiology
1100 West 49 th Street
Austin , Texas 78756-3183

Or by e-mail at: Speech@dshs.state.tx.us

Or by phone at: (512) 834-6627

Or by fax at: (512) 834-6677, Attention: SPEECH

Click here to print "Position Statement for Supervising Licensed Interns in Speech-Language Pathology", (Adobe Acrobat, 44 KB)

POSITION STATEMENT REGARDING THE NEED FOR AN AMPLIFICATION DEVICE CANDIDACY DETERMINATION AUDIOLOGICAL EVALUATION:

PURPOSE:

The purpose of the "candidacy determination" audiological evaluation is to assess the functional status of the auditory system and to ensure that a hearing instrument(s) and/or other amplification device(s) are an appropriate treatment strategy.

REFERENCES:

The Act: Texas Occupations Code (TOC), Chapter 401

Board Rules: 22 Texas Administrative Code, Chapter 741

The Board recommends that, before fitting and dispensing a hearing instrument(s) or other amplification device(s), an audiologist shall first conduct a comprehensive audiological evaluation for the purpose of determining candidacy. The audiological evaluation must include any and all procedures necessary for the determination of:

(a) a thorough history of hearing loss;

(b) auditory sensitivity (audiometric thresholds);

(c) speech recognition capabilities;

(d) the type, degree, and configuration of hearing loss;

(e) the need for referral to a physician;

(f) the need for referral to other professionals and agencies; and

(g) candidacy for hearing instrument(s) and other amplification devices.

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POSITION STATEMENT RELATING TO HEARING AID FITTING FOR ADULTS

PURPOSE:

The purpose of this document is to provide “best practices” benchmark through which licensees may evaluate and improve their current hearing aid fitting procedures.

REFERENCES:

The Act: Texas Occupations Code (TOC), Chapter 401, §401.403

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 relating to the Code of Ethics; Duties and Responsibilities of License Holders

The Board recommends that audiologists and interns in audiology utilize the “Guidelines for Hearing Aid Fitting for Adults” developed by the American Speech-Language-Hearing Association Ad Hoc Committee on Hearing Aid Selection and Fitting. The Guidelines contain components of a comprehensive process of assessment, treatment planning, selection, verification, orientation, and validation components to insure that the hearing impaired consumer has received the best evaluation and treatment possible.

You may contact the American Speech-Language-Hearing Association to obtain this document.

Internet site: http://www.asha.org

Phone: (800) 498-2071

E-mail: actioncenter@asha.org

Click here to print "Position Statement Relating to Hearing Aid Fitting for Adults", (Adobe Acrobat, 31 KB)

POSITION STATEMENT RELATING TO NEWBORN HEARING SCREENING

PURPOSE:

The purpose of this document is to provide a "best practices" benchmark through which licensees may model their role in infant screening programs.

REFERENCES:

The Act: Texas Occupations Code (TOC), Chapter 401, §401.403

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter C, §741.33 relating to Newborn Hearing Screening

The Board endorses the American Academy of Audiology (AAA) position statement, "Statement on the Role of the Audiologist in the Newborn Hearing Screening Program" as printed in Volume 12, Number 3, May/June 2000 Audiology Today, and the Joint Committee on Infant Screening (JCIH) 2000 Position Statement, "Principles and Guidelines for Early Hearing Detection and Intervention Program" as printed in the American Journal of Audiology, Volume 9, 9-29, June 2000.

You may contact the American Academy of Audiology to obtain the document.

Internet site: http://www.audiology.org

Phone: (800) AAA-2336

You may contact the American Speech-Language-Hearing Association to obtain the document.

Internet site: http://www.asha.org

Phone: (800) 498-2071

E-mail: actioncenter@asha.org

Click here to print "Position Statement Relating to Newborn Hearing Screening", (Adobe Acrobat, 31 KB)

POSITION STATEMENT RELATING TO VESTIBULAR AND BALANCE REHABILITATION

PURPOSE:

The purpose of this document is to define the competency licensees must hold to participate in vestibular and balance rehabilitation. Proof of competency should be maintained by the licensee and available to the Board, upon request.

REFERENCES:

The Act: Texas Occupations Code (TOC), Chapter 401, §401.001

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 relating to Code of Ethics

The Board adopts as best practices the American Speech-Language-Hearing Association (ASHA) position statement and guidelines, “The Role of Audiologists in Vestibular and Balance Rehabilitation”.

You may contact the American Speech-Language-Hearing Association to obtain this document.

Internet site: http://www.asha.org

Phone: (800) 498-2071

E-mail: actioncenter@asha.org

Click here to print "Position Statement Relating to Vestibular and Balance Rehabilitation", (Adobe Acrobat, 31 KB)

POSITION STATEMENT FOR SUPERVISING LICENSED INTERNS IN AUDIOLOGY

PURPOSE:

The purpose of this document is to provide guidance related to the supervision of audiology interns. The Act and the Board Rules permit audiology interns to deliver audiological services under the supervision of a licensed audiologist. The supervising audiologist shall be responsible for all client services performed by the intern, and must determine that the intern is qualified to perform those services. A licensed intern shall only practice under supervision of the licensed audiologist(s) who completed the Intern Plan and Agreement of Supervision Form and received approval from the Board office.

REFERENCES:

The Act: Texas Occupations Code, Chapter 401, §401.311

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 Professional Responsibilities of License Holders

Subchapter E, §741.82 relating to Requirements for an Intern in Audiologist License

Subchapter H, Fitting and Dispensing of Hearing Instruments

(NOTE: Failure to follow the requirements of the Act and Board Rules shall result in disciplinary action imposed by the Board against both the supervising audiologist and the intern.)

RESPECTIVE DUTIES OF THE AUDIOLOGIST AND INTERN:

Under the supervision of a licensed audiologist, the licensed audiology intern is authorized to: conduct evaluations; interpret test results; determine case selection; design treatment programs; collect data and document performance; maintain clinical records; provide written or oral reports (e.g., progress notes, diagnostic reports) regarding patient/client status; make referrals, and participate in interdisciplinary team meetings (e.g., ARD’s, IFSP conferences, discharge staffings) and fit and dispense hearing aids for all patients/clients being served. The licensed intern shall abide by the decisions made by the supervisor relating to the intern's scope of practice. In the event the supervisor requests that the intern violate Board Rules, the Texas Occupations Code, or any other law, the intern shall refuse to do so and immediately notify the Board office and any other appropriate authority.

The licensed audiologist is responsible for verifying that the Board office has approved the Intern Plan and Agreement of Supervision, and that the intern holds a current, valid license before allowing him/her to practice. (Note: The intern may simultaneously pursue the American Speech-Language-Hearing Association Clinical Fellowship, but approval from ASHA to begin the Clinical Fellowship is not a license to practice.)

PROVIDING ADEQUATE SUPERVISION:

To allow time for appropriate training and supervision, it may be necessary to reduce the number of patients/clients directly served by the licensed audiologist in relation to the number of interns being supervised. Variables that affect the maximum number of individuals who can be supervised appropriately by the licensed audiologist may include but are not limited to:

a. the number of hours per week the audiologist and intern(s) are employed;

b. the number of other individuals (e.g., audiology assistants, graduate externs) being supervised;

c. time required of the supervising audiologist in direct service provision;

d. the experience level of the supervisor and intern(s);

e. the time limits imposed by supervision requirements;

f. the number of locations in which services are provided and travel time between locations;

g. other roles and responsibilities assigned to the audiologist (e.g., attending staff meetings and fulfilling other campus and district assignments).

The audiologist should be the only professional to decide how many, if any, audiology interns he/she can supervise and still ensure that all services are provided in compliance with Board Rules and the Texas Occupations Code, Chapter 401.

AMOUNT OF SUPERVISION REQUIRED:

The supervising audiologist must provide no fewer than 36 clock hours of supervisory activities over the course of the internship. Supervision must be divided equally among the three segments (1/3 length of the internship), including 6 hours of on-site observation of direct client contact at the intern’s work site and 6 hours of other monitoring activities during each segment. Other monitoring activities may include, but are not limited to: telephone conferences with the intern, evaluating the intern’s records and correspondence, reviewing videotapes of the intern’s evaluations and/or hearing aid fittings, and discussing the intern’s performance with his/her professional colleagues.

CHANGES IN SUPERVISOR, EMPLOYER, OR NUMBER OF HOURS EMPLOYED:

If the intern changes his or her supervisor or adds additional supervisors, a current Intern Plan and Agreement of Supervision Form must be submitted by the new supervisor and approved by the Board office before the intern may resume practice. The past supervisor and the intern must complete a Report of Completed Internship Form and submit it to the Board office upon completion of that portion of the internship. The Board office shall evaluate the form and inform the intern of the results.

If the intern changes employers, but the supervisor and the number of hours employed per week remain the same, the supervisor must submit a signed statement giving the name, address and phone number of the new location. A Report of Completed Internship Form must be submitted for the experience at the previous location.

If the number of hours worked per week changes but the supervisor and the location remain the same, the supervisor must submit a signed statement giving the date the change occurred and the number of hours per week the intern is now working. A Report of Completed Internship Form must be submitted for the past experience. Be sure the form clearly indicates the number of hours worked per week.

DESIGNATE PRIMARY SUPERVISOR:

If more than one supervisor supervises the intern, each supervisor must complete the Intern Plan and Agreement of Supervision Form and be approved by the Board office before supervising. The primary supervisor must be designated. At the end of the internship, the designated primary supervisor must complete the Report of Completed Internship Form. Additional supervisors may either submit the form or write a letter to the Board, naming the primary supervisor and concurring with the primary supervisor’s report.

DOCUMENTATION REQUIRED:

The supervising audiologist must provide feedback to the intern throughout the internship, and shall conduct at least one formal evaluation of the intern’s progress in each segment of the internship. Both the intern and supervisor must maintain documentation of the supervisor’s observation and evaluation records for three years or until the audiology license is granted. These records must be provided to the Board upon request.

ISSUANCE OF INTERN LICENSE AND RENEWAL:

The intern license is issued for one full year to allow sufficient time for most individuals to complete the internship and apply for full licensure or the temporary certificate of registration.

If the internship is not completed by the expiration date of the license, the supervisor should verify that the intern renewed the license. (Ten continuing education hours are required to renew the intern’s license, in addition to other required forms and the fee. A Renewal Form is mailed 45 days prior to the expiration date of the intern license and will include complete instructions.)

INTERNSHIP COMPLETED:

Once the internship has been completed, the intern must submit a current Application Form, fee, and other required documentation to the Board office to apply for full licensure or the temporary certificate of registration. The supervisor shall complete the Report of Completed Internship Form. It is the decision of the supervisor to determine whether the internship is acceptable. Refer to Board Rules, §741.112(a) for documentation to submit to the Board office.

As long as the intern license remains valid, the intern may practice under supervision while awaiting full licensure or the temporary certificate of registration. The supervising audiologist must mail or fax a signed letter to the Board office, stating that he or she will continue to supervise the intern from the “Ending Date of Internship” as shown on the Report of Completed Internship Form until the intern receives the full license or temporary certificate of registration.

NOTE: Please understand that holding the ASHA CCC is not a license to practice.

We can be contacted at:

State Board of Examiners for Speech-Language Pathology and Audiology
1100 West 49 th Street
Austin , Texas 78756-3183

Or by emailed at: Speech@dshs.state.tx.us

Or by phone at: (512) 834-6627

Or by faxed at: (512) 834-6677, Attention: SPEECH

Click here to print "Position Statement for Supervising Licensed Interns in Audiology ", (Adobe Acrobat, 41 KB)

LICENSURE OF AU.D. STUDENT EXTERNS

PURPOSE:

The purpose of this document is to define the recommended best practices for licensure for Au.D. student externs in the state of Texas.

REFERENCES:

The Act: Occupations Code (TOC), Chapter 401

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter F, 741.82 Relating to requirements for an Intern in Audiology License.

The Board has agreed that it strongly recommends that all Au.D. student externs obtain an Intern Audiology License prior to beginning their clinical experience in Texas. The Board will promulgate a new rule requiring Au.D. student externs obtain such a license in the very near future.

Students may apply under the Rules section 741.82(f) until such time as the rules are amended to reflect the change in academic degree requirements.

Click here to print "Position Statement Relating to Licensure of Au.D. Student Externs ", (Adobe Acrobat, 30 KB)

POSITION STATEMENT FOR SUPERVISING LICENSED ASSISTANTS IN SPEECH-LANGUAGE PATHOLOGY

PURPOSE:

The purpose of this document is to provide guidance related to the use of speech-language pathology assistants in the delivery of speech-language services.

The Act and the Board Rules allow speech-language pathology assistants to assist in the delivery of speech-language services and to augment program and treatment activities under the supervision of a licensed speech-language pathologist. Although the speech-language pathologist may delegate specific tasks to the assistant, the legal and ethical responsibility for all services remains with the supervising speech-language pathologist at all times. Speech-language pathology assistants cannot be assigned to or be responsible for their own caseloads. The purpose of the speech-language pathology assistant is not to increase caseload size, but to manage existing caseloads under the direct responsibility of the licensed speech-language pathologist supervisor.

REFERENCES:

The Act: Texas Occupations Code (TOC), Chapter 401, §401.312

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter D, §741.41 relating to the Professional Responsibilities of License Holders

Subchapter D, §741.43 relating to Recordkeeping and Billing

Subchapter D, §741.44 relating to Requirements, Duties, and Responsibilities of Supervisors

Subchapter E, §741.64 relating to Requirements for an Assistant in Speech-Language Pathology License

(NOTE: Failure to follow the requirements of the Act and Board Rules shall result in disciplinary action being proposed by the Board against both the supervising speech-language pathologist and the assistant.)

RESPECTIVE DUTIES OF THE SPEECH-LANGUAGE PATHOLOGIST AND ASSISTANT:

The speech-language pathology assistant may not practice until the Board has received and approved a Supervisory Responsibility Statement (SRS) which has been completed and signed by both the licensed speech-language pathologist supervisor and the speech-language pathology assistant. In addition, only licensed speech-language pathologists who have practiced for at least three (3) years may serve as supervisors. Written requests for exemptions to this three year professional requirement for speech-language pathologist supervisors must be submitted to the Board for consideration and approval

Provided that the training, supervision, documentation, and planning are appropriate, the following tasks may be delegated to a speech-language pathology assistant: implementing treatment programs designed by the supervising speech-language pathologist; providing carry-over activities; collecting data and documenting performance; maintaining clinical records; preparing clinical materials; and administering routine tests, but not interpreting test results or determining severity of the communication disorder. The licensed speech-language pathology assistant shall abide by the decisions made by the supervising speech-language pathologist relating to the assistant's scope of practice. In the event the speech-language pathologist supervisor requests that the speech-language pathology assistant violate Board Rules, the Texas Occupations Code, or any other law, the speech-language pathology assistant shall refuse to do so and immediately notify the Board office and any other appropriate authority.

The licensed speech-language pathologist must conduct evaluations, interpret test results, determine case selection, design treatment programs, provide written or oral reports (e.g., progress notes, diagnostic reports) regarding patient/client status, make referrals, and participate in interdisciplinary team meetings (e.g., Annual Review Dismissal (ARD)’s, Individualized Family Services Plan (IFSP) conferences, and discharge staffings) for all patients/clients being served in the entire caseload. Under the new rule changes enacted March, 2006, under §741.64(i), the speech-language pathology assistant may represent special education and speech pathology at ARD meetings with specific stipulations in place including: the speech-language pathology assistant must have at least three (3) years experience as a speech-language pathology assistant in the schools; the speech-language pathology assistant may attend, with written approval of the supervising speech-language pathologist, the annual ARD meeting of a student for which he/she provides therapy services; the supervisor must attend if the purpose of the ARD meeting is to initiate special education speech-language services, to develop the student’s initial Individual Educational Plan (IEP) or if the meeting is convened to discuss dismissal from speech language services; the speech-language pathology assistant shall present IEP goals and objectives that have been developed by the supervising speech-language pathologist and reviewed by the parent; and the speech-language pathology assistant shall discontinue the ARD meeting and contact the supervising speech-language pathologist when questions or changes arise regarding the IEP document. Additional requirements for supervising speech-language pathologists are listed in §741.64(j).

PROVIDING ADEQUATE SUPERVISION:

To ensure quality service, the supervising speech-language pathologist must be provided adequate time for all aspects of managing the caseload. Because of the time required for training and supervising speech-language pathology assistants, it will be necessary to reduce the number of patients/clients directly served by the licensed speech-language pathologist in relation to the number of assistants being supervised. Variables that affect the maximum number of individuals (4) who can be supervised appropriately by the licensed speech-language pathologist, may include, but are not limited to:

a. the number of hours per week the speech-language pathologist and speech-language assistant(s) are employed;

b. specific tasks assigned to speech-language pathology assistants (e.g., number, severity, and types of cases for whom they are implementing treatment plans);

c. time required of the supervising speech-language pathologist in direct service provision;

d. the experience level of the speech-language pathologist supervisor and speech-language assistant(s);

e. the time limits imposed by supervision requirements (minimum two hours per week);

f. the number of locations in which services are provided and travel time between locations; and

g. other roles and responsibilities assigned to the supervising speech-language pathologist (e.g., supervising interns, attending staff meetings, and fulfilling other campus/district/agency assignments).

The supervising speech-language pathologist should be the only professional to decide how many, if any, speech-language pathology assistants he/she can supervise and still ensure that all services are provided in compliance with Board Rules and the Texas Occupations Code, Chapter 401. If services are not provided in accordance with these rules, and a complaint is filed, the supervising speech-language pathologist may be subject to disciplinary action.

In the event the supervising speech-language pathologist ceases supervision of the speech-language pathology assistant, the speech-language pathologist supervisor must notify the Board in writing of this change and the speech-language pathology assistant must stop practicing immediately. The supervising speech-language pathologist shall be responsible for the practice of the speech-language pathology assistant until the supervisor notifies the Board of this change.

AMOUNT OF SUPERVISION REQUIRED:

The supervising speech-language pathologist must supervise the speech-language pathology assistant two hours per week, whether the speech-language pathology assistant works full or part-time. At least one-half of the minimum supervision requirements (i.e., one hour per week) must be met through face-to-face observation, at the location where the speech-language pathology assistant is employed; the other half can be accomplished through audio/videotaping, telephone communication, e-mail, or other means of reporting.

DOCUMENTATION REQUIRED:

The supervising speech-language pathologist must maintain documentation of regularly scheduled observation and evaluation of the speech-language pathology assistant’s performance. These records of supervision, and a job description for the speech-language pathology assistant, must be provided to the Board upon request.

SUMMARY: MAJOR POINTS

• Speech-language pathology assistants do not have their own caseloads; they assist the licensed speech-language pathologist in managing an existing caseload by implementing documented treatment plans. (Also see Board Position Statement, “Position Statement for Caseload Size in the Schools”. Board Position Statements and Frequently Asked Questions available on the Board's webpage at: www.dshs.state.tx.us/speech )

• Speech-language pathology assistants may administer routine tests (if the supervising speech-language pathologist has determined that the speech-language pathology assistant has the training, experience, and competence), but they may not interpret test results, determine severity of the communication disorder, or make case selection decisions. The supervising licensed speech-language pathologist is responsible for ensuring that test administration follows the publisher’s instructions (e.g., the examiner must have a graduate degree).

• The supervising speech-language pathologist shall make all initial contact with each patient/client served by the speech-language pathology assistant (contact with the patient/client may include evaluation).
   
• Speech-language pathology assistants may not attend any interdisciplinary team meetings (e.g., ARD’s, IFSP conferences, discharge staffings) without the physical presence of the supervising speech-language pathologist except as specified in the section regarding representation of special education and speech pathology at ARD meetings [see §741.64(i) and §741.64 (j)]. Speech-Language Pathology Assistants who attend ARD meetings with their speech-language pathologist supervisor may sign the IEP as “in attendance” but shall not check the “agree/disagree” column.

• Speech-language pathology assistants must be supervised two hours per week, regardless of the number of hours they are employed. At least one hour of supervision per week must be face-to-face, in the location where the speech-language pathology assistant works. The licensed speech-language pathologist must maintain supervision and performance records that may be requested by the Board.

• Speech-language pathology assistants should not use “SLP-A” as an indicator of their credentials. They may use “Assistant SLP” or “SLP Assistant” if they need to shorten the title.

• Before allowing a speech-language pathology assistant to practice, the speech-language pathologist must verify the speech-language pathology assistant holds a valid license, the speech-language pathologist has been approved to supervise the speech-language pathology assistant and the Board has received and approved a completed and signed Supervisory Responsibility Statement (SRS).

While speech-language pathology assistants provide carry-over activities and prepare clinical materials, these tasks may also be performed by other personnel. For example, a classroom aide might provide models for language targets during class activities, prepare picture cards for a communication system, or program a communication device. These activities are not considered “speech-language therapy” and do not count toward the speech-language services specified in a student’s IEP.

We can be contacted by regular mail at:

State Board of Examiners for Speech-Language Pathology and Audiology
1100 West 49 th Street
Austin , Texas 78756-3183

Or by e-mail at: Speech@dshs.state.tx.us

Or by phone at: (512) 834-6627

Or by fax at: (512) 834-6677, Attention: SPEECH

Click here to print "Position Statement for Supervising Licensed Assistants in Speech-Language Pathology", (Adobe Acrobat, 53 KB)

POSITION STATEMENT RELATING TO CONTINUING EDUCATION CREDIT FOR COURSEWORK AND THE AMERICAN MEDICAL ASSOCIATION (AMA)

PURPOSE:

To establish parameters for acceptance of academic coursework or events approved by the American Medical Association (AMA) for continuing education credit.

REFERENCES:

The Act: Texas Occupations Code (TOC), Chapter 402, §401.355

Board Rules: 22 Texas Administrative Code, Chapter 741

Subchapter L, §741.162 relating to Requirements for Continuing Professional Education

University or college course work or events approved by the AMA in an area of study related to basic communication processes, speech-language pathology, or audiology shall be considered for continuing education credit. Licensees shall submit a description of the course or continuing education activity, an official transcript demonstrating a grade of “C” or better for academic coursework, along with a description of:

• how the activity furthers the licensee's knowledge of speech-language pathology or audiology; or

• how the activity enhances the licensee's service delivery.

The Board advises licensees to obtain prior approval of these types of activities for continuing education credit.

It is the policy of this Board that the chair shall appoint a Board member to review university or college coursework and events approved by the AMA in content areas ancillary to speech-language pathology and audiology. Review of these courses shall be determined on a case-by-case basis resulting in assignment of full, partial, or no credit for the continuing education hours required for license renewal. Coursework in categories other than those listed below shall be subject to Board ratification.

The following guidelines shall be utilized in reviewing the activities described above:

Full credit shall be assigned to:

• academic coursework in the areas of speech pathology and audiology leading to an advanced academic degree in the professional licensure area;

• academic coursework in the areas of speech pathology and audiology that are taught by the licensee, for the fist time;

• AMA category 1 credit courses pertaining to disorder or practice areas related to the areas of speech pathology and audiology.

Partial credit may be assigned to:

• academic coursework in areas ancillary to speech pathology and audiology in which a project was completed that directly relates to the licensee’s area of practice;

• academic coursework in areas ancillary to speech pathology and audiology in which there is evidence of how the subject area enhanced or altered the licensee’s service delivery.

No credit shall be assigned to:

• academic coursework for general computing or software applications;

• academic coursework for foreign language;

• academic coursework for general management or supervisory practices;

• academic coursework for general psychological assessment or behavior management.

Click here to print "Position Statement Relating to Continuing Education Credit for Coursework and the America Medical Association (AMA)", (Adobe Acrobat, 41 KB)

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Last Updated March 28, 2007