Using Speech-Language Pathology Assistants

What may speech-language pathology assistants do?

According to ASHA's 1995 Guidelines for the Training, Credentialing, Use, and Supervision of Speech-Language Pathology Assistants, which apply across all practice settings, a speech-language pathology assistant may conduct the following tasks under the supervision of a speech-language pathologist:

• Conduct speech-language screenings.

• Follow documented treatment plans or protocols.

• Document patient/client progress.

• Assist during assessment.

• Assist with informal documentation, prepare materials, and perform other clerical duties.

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

• Perform checks and maintenance of equipment.

• Participate in research projects, in-service training, and public
  relations programs.

State laws vary and may differ from ASHA guidelines.  Check specific state regulations to determine the tasks permitted by assistance in a particular state.

What is outside the speech-language pathology assistant's scope of responsibilities?

According to ASHA's 1995 guidelines for the Training, Credentialing, Use and Supervision of Speech-Language Pathology Assistants, a speech-language pathology assistant may not perform the following tasks:

• May not perform standardized or nonstandardized diagnostic tests, formal or informal evaluations, or interpret tests.

• May not participate in parent conferences, case conferences, or any interdisciplinary team without the supervising speech-language
  pathologist present.

• May not provide patient/client or family counseling.

• May not write, develop, or modify a patient/client's individualized
  treatment plan.

• May not assist with patients/clients without following the individualized treatment plan or without access to supervision.

• May not sign any formal documents.

• May not select patient/clients for service.

• May not discharge patients/clients from service

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

• May not make referrals.

• May not communicate with the patient/client, family, or others regarding any aspect of the patient/client status or service without the specific consent of the supervising speech-language pathologist.

• May not represent himself or herself as a speech-language pathologist.

State laws vary and may differ from ASHA guidelines.  Check specific state regulations to determine which tasks are outside the scope of responsibilities for assistants in a particular state.

What is the average salary for speech-language pathology assistants?

At this time, ASHA collects salary data only on ASHA-certified speech-language pathologists and audiologists.  Occupational and physical therapy data show that assistants in those fields make about 60% to 75% of professional level salaries.  Except for physician employees and contractors, Medicare reimburses on a cost basis.  Although no formula for payment of speech-language pathology assistants is established in Medicare policy manuals, it is assumed that the cost would be lower than that of fully qualified speech-language pathologists.  For contractors subject to salary equivalency per hour limits (late 1997 or early 1998), the payment for occupational therapy, physical therapy and speech-language pathology assistants will be 75% of the full salary equivalency rate.  The intermediary can determine the amount of supervision required.   State regulations can supersede Medicare provisions regarding coverage.

How will this program affect the culturally and linguistically diverse professional population?

ASHA places a high emphasis on attracting individuals from culturally and linguistically diverse backgrounds into the speech-language pathology/audiology professions.  In related professions that use assistants, the proportions of minorities to non-minorities at both the assistant and the professional levels are similar.

Who is responsible for services provided by a speech-language pathology assistant?

The fully qualified, ASHA-certified speech-language pathologist is responsible for the services provided by assistants.   In states that regulate speech-language pathology assistants, speech-language pathologists who hold full, unrestricted licenses assume these responsibilities for persons working under their direction.

Will caseloads expand due to the use of assistants?

AS has always been the case, caseload size of speech-language pathologists may or may not increase depending on client needs and the nature of the services provided.   If speech-language pathology assistants are used appropriately, and if pathologists' caseloads may decrease to permit sufficient time to supervise staff working under their direction.  Speech-language pathology assistants do not carry their own caseloads.  Assistants help to provide services as directed for the caseloads of speech-language pathologists.