This is a quantitative study using descriptive statistics on principals’ perceptions of the role of speech pathologists in elementary schools. The project will involve interviews with principals from traditional public schools. The researcher will transcribe the interviews and use descriptive statistics to look for common strands in the principals’ perceptions. The study will be organized around a description of the speech pathologist’s role, personal attributes needed for the job of the principal and the speech language pathologist, and support given to principals by the special education department.
Background
A study by Sanger, Hux, and Griess in 1995 examined educators’ opinions of speech language pathology services in schools. Since that time, changes have occurred in the field of speech language pathology which warrants further research in the area of educators’ opinions of speech-language pathology services in schools.
Recent legislation and research support a more inclusionary collaborative model of service delivery. Revisions of the Individuals with Disabilities Education Act (IDEA) in 1997 and 2004 changed the way many school-based speech language pathologists provided services (ASLHA, 1997). Speech language pathologists are being pressured, if not mandated, to provide services more inclusively to students with disabilities (Faber & Klein, 1999). Federal law has always required the provision of services in the least restrictive environment, but changes in the IDEA Act have reinforced the notion that the general classroom is the least restrictive environment for most students (Ehren, 2000). For speech-language pathologists this meant changing the way they provided services, resulting in less pull-out therapy and more classroom-based interventions.
The Principal’s Role in Special Education and Service Delivery
As the educational leader of a school, principals have been given many responsibilities by school districts, state agencies, and the federal government. One of the biggest responsibilities given to principals involves compliance with all the various state and federal laws (Cunningham & Cordeiro, 2005). More specifically, school principals have been charged with ensuring that appropriate and legally defensible special education and related services are provided to students with disabilities and that each of these students’ potential is realized (Adelman & Taylor, 2006).
At the state and federal level, school principals have been encouraged and mandated to ensure that students with disabilities in their buildings receive instruction in the least restrictive environment and make progress in the general education curriculum. In order to give principals the necessary skills and training to follow these laws, state and local agencies have provided training. Through their role as the representative at individualized educational planning meetings, principals have the ultimate responsibility to ensure that students with disabilities, including students with speech or language impairments, make progress in the general education curriculum, learn next to their nondisabled peers to the maximum extent appropriate, and receive education from teachers through the use of a variety of supports and strategies.
Speech Language Services in the Public School Setting
Under IDEA (2008), a speech or language impairment was considered to be a communication disorder (e.g., speech sound, language, or voice impairment and stuttering) that adversely affected the student’s educational performance. The provision of speech language pathology services to students with communication impairments has had a long history in education. Dating as far back as 1900, American public school students received segregated services from teachers in an attempt to address speech and language impairments (Osgood, 2005).
By 1948, one of the earliest national attempts was made to include students with speech or language impairments in the regular education setting and also provide these students with partial day or pull-out speech language services (Osgood, 2005). Through the creation of The Education for All Handicapped Children Act of 1975, certified speech language pathologists (SLPs) were hired by school districts, county boards of mental retardation and developmental disabilities, and educational service centers to work directly and indirectly (e.g., consultation, counseling, and guidance to teachers and parents) with students who had speech or language impairments (Ehren, 2000; Huefner, 2000).
School districts have been mandated by state and federal law to provide services in the least restrictive environment and encouraged by policies from national professional associations to take part in the inclusion movement, move away from pull-out only segregated programs, and integrate speech language pathology services into the regular education setting (Beck & Dennis, 1997; Elksnin & Capilouto, 1994; McGinty & Justice, 2006; Zionts, 2005). As educational teams seek to determine the most appropriate service delivery model at IEP team meetings, research has pointed in the direction of integrated classroom-based speech language pathology services as an effective and legally defensible service delivery model for many students who required services to address a speech or language impairment (American Speech-Language Hearing Association [ASHA], 2005a, 2005b, 2006b; Bellini, Peters, Benner, & Hopf, 2007; Ellis, Schlaudecker, & Regimbal, 1995; McGinty & Justice, 2006; Throneburg, Calvert, Sturm, Paramboukas, & Paul, 2000; Wilcox, Kouri, & Caswell, 1991).
Statement of the Problem
Since the days of the one-room schoolhouse, the public school in the United States has been at the heart of the community. The school, conventionally a center for formal learning, has increasingly become a focal point of efforts to improve and rebuild communities. By building stronger communities (and families), the hope is that students will be less at risk of academic failure and social problems. Many school reformers believe that the logical place to address the needs of at-risk children is at the place where so many of society’s problems intersect--the public school (Fusarelli, 2008).
Historically, a variety of specialized private and public agencies have emerged to provide assistance to those in high-risk circumstances. Often these agencies worked in a virtual vacuum, not knowing what services other agencies were or were not providing. This resulted in three major problems: underuse of the resources available, cracks in the system through which children and families could fall, and a duplication of similar services by multiple agencies (Johnson, 2003).
Interagency collaborative programs arose to address the issue of fragmented and detached services. The desire for a coordinated approach to solve the multifaceted problems of today’s youth has led to efforts to restructure service provision; the formation of school-linked services has become a well-accepted part of school reform efforts (Fusarelli, 2008).
However, advocates for coordinated services are increasingly facing tough questions about the effectiveness of coordinated programs, and about fears that these programs may distract educators’ attention from their primary mission: effective academic instruction. Empirical data on the effects, both short and long-term, of these programs is inconclusive (Cibulka & Kritek, 1996; Crowson & Boyd, 1993; Haertel & Wang, 1997; Honig, Kahne, & McLaughlin, 1999; Kahne & Bailey, 1999; Warren, 2005).
If there is any consensus among most educational researchers and policy makers, it is this simple fact: schools in the United States, particularly in urban areas, are in crisis. Students are failing at astounding rates and students’ social needs are not being met. But what role, if any, should the school play in trying to solve this crisis? Harold Howe, the former U.S. Commissioner of Education, suggests: “schools cannot do it alone. It is either naïve or irresponsible to ignore the connection between children’s performances in school and their experiences with malnutrition, homelessness, lack of medical care, inadequate housing, racial and cultural discrimination and other burdens” (as cited in Merseth et al., 1999, p. 7). Howe (and others) believe that schools should have a role in solving students’ nonacademic problems but they proclaim, schools cannot do it alone. While it may be true that schools cannot do it alone, some question, “Should schools be doing it at all?”(Merseth et al., 1999, p. 8).
Educators continue to disagree over the role and purpose of school-linked coordinated services. However, research suggests that strong leadership helps district employees accept the expanded role of the school and its staff that results from districts’ efforts to establish school-social service agency collaborations (Johnson, 2001). It may not be the mission of a school to meet the nonacademic needs of children, but if certain prerequisites from learning are not met, it is the students and their academic performance that suffer. Research indicates that there is an underlying conflict between the push for higher student academic achievement and the need to meet the nonacademic needs of students (Johnson, 2001).
Some educators complain about what they perceive as added duties because of the collaborative services efforts. These complaints range from mild statements of disapproval to outright hostility. Some of the resistance stems from the fact that educators are increasingly experiencing role overload caused by the enormous pressure they are under to increase student test scores and meet the mandates of NCLB (Fusarelli, 2008).
The way they coordinated services efforts are introduced and the leadership skills of administrators seem to play a role in district employees’ acceptance or rejection of the reform as part of the school’s mission (Johnson, 2001). The manner in which leaders introduce an initiative to coordinate social services for students can have an impact on the eventual acceptance or rejection of the reform.
Teachers and speech-language pathologists need to have a clear understanding of what their roles are and what agencies and programs are involved in the coordinated services effort. If coordinated services efforts are viewed by teachers as one more thing added to their workload, then they are less likely to embrace such initiatives (Fusarelli, 2008).
School administrators need to take the time to build a groundswell of support for the initiative. They must sell their plan to the public and at the same time gain the acceptance of educators. The way the initiative is introduced is important. However, strong leadership appears to be associated with district employees accepting the expanded role of the school in school-linked coordinated services efforts. Even with strong leadership, change is difficult to achieve. It is very difficult to change beliefs about the role of the school in society (Fusarelli, 2008).
The politics involved with the collaboration of school and community resources affects the working relationship between school administrators and their staff. Increased responsibilities and misunderstanding the staff’s roles will increase misunderstanding, thus impacting student achievement. That’s why it is important for principals’ perceptions to be articulated positively so that each member of the staff knows his/her role at the school.
Purpose of the Study
The purpose of this study is to survey the opinions of principals concerning the role of speech-language pathologists (SLP’s) in elementary schools. No study to date has investigated the perceptions of principals on the role of SLP’s. Although principals’ perceptions and attitudes have been blamed for the excessive use of the pull-out of students in speech-language only programs in the public school setting, this belief has not been substantiated by research (Krenik, 2008)
Definition of Terms
The Individuals with Disabilities Education Act was signed into law on November 29, 1975. President Ford signed Public Law 94-142 while at the same time he recognized the challenges of implementation that it presented. He stated, “Unfortunately, the bill contains more than the federal government can deliver, and its good intentions could be thwarted by the many unwise provisions it contains” (Sack, 1999, p. 5). Today, the federal funding of the laws stands at eight percent, far below the promised forty percent by the federal government (Chinni, 1996). The bill mandates that each student identified as disabled receive an individual education program, or IEP, that is determined by the parent, a school principal, and the student’s teacher and case manager, and the student if he/she is over the age of 14. The current special education legislation identifies eleven areas of special needs students, including learning disabled, behaviorally and emotionally disabled multi-handicapped emotionally and mentally disabled, and so on.
By far the largest area is Learning Disabled, or LD. Over half of the students in special education fall under this classification. The law defines LD as “a disorder in which one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder may manifest itself in imperfect ability to listen, think, speak, read, write, spell or do mathematical calculations.” The legislation further states that those students who show a severe discrepancy between their achievements in one or more subject areas and their intelligence, usually measured by an IQ test, are classified as LD. These students receive extra support in a variety of ways, from increased test time, to audiotapes, to extra help within the classroom.
Other areas of identification include BED or behaviorally and emotionally disabled, OHI or other health impaired which includes diagnoses such as ADHD as well as hearing impaired, and other medical handicaps. Categories also include AU or autistic, MU or multiple handicaps, EMD which is educably mentally handicapped or students with IQ’s of less than 60, VI or vision impaired or legally blind students, and MR or mental retardation. Many of these disabilities require specialized training and knowledge on the part of the teacher in order to understand how best to develop and implement an individual education program for the student. Categories of special education teachers’ licenses vary based on the needs of the students. There is certification for each of the areas listed above, as well as CCR or IRR, which stands for Cross-Categorical Resource, or Interrelated Resource, a license that allows a teacher to work with all students who are identified.
The speech-language pathologist (SLP) plays a variety of roles depending on the learning/support needs of the students, especially those with IEPs, the classroom context, and the needs of the classroom staff. Teachers and SLPs have some skill sets that are different from each other and others that overlap but which might be used differently by each professional. The classroom teacher has expertise in curriculum, classroom management, and group instruction while the SLP has knowledge about individual language and communication development, language/communication disabilities, and individualized intervention strategies. It is the marriage of the two sets of complimentary professional skills that can add power to an integrated services model.
Because of the increased resources allotted to special program students, a division has grown between general and special educators (Sack, 1999). The division, along with excessive paperwork to document the modifications, the fear of litigation, and the amount of effort required to produce results with special education students, encourages many special educators to leave the field. Over the last 5 years, North Carolina has averaged an overall teacher turnover rate of 12.94% and over 20% in special education (NCDPI website). These numbers are not disaggregated for the difference in turnover rate of an emergency licensed or alternative licensed special educator versus a traditionally licensed special educator.
Significance of the Study
The increase in special programs students, the over-identification of minority students within special programs, the higher turnover rate for teachers of minority students and special programs teachers, as well as the definition of principal support of special programs teachers are all areas of concern to all school districts. No current study has looked specifically at the types of principal support that an emergency, lateral-entry, alternative licensed teacher (all interchangeable terms in North Carolina) needs versus a traditionally licensed special programs teacher. Given the current shortage of special programs teachers as well as speech pathologists, administrators are often forced to hire alternative or emergency licensed teachers and need to know the types of support that these teachers need to be given, understanding that they have not completed a traditional certification program. By understanding their needs, the principal can develop programs that best meet the needs and in turn reduce turnover in an area of high teacher turnover.
Research Questions
The following research questions will be examined in the study:
1. Why are speech-language pathologists leaving the public school setting?
2. What types of support do the speech-language pathologists seek from administrators?
3. What can school systems do to recruit and retain speech-language pathologists?
Brief Overview
Today’s speech-language pathologists (SLPs) play many roles as they attempt to support the development of speech, language, communication, and literacy skills of America’s children. Their roles often include screening, assessing, advocating, and programming/designing augmentative communication equipment in addition to providing direct intervention with students and indirect roles of consulting, coaching, collaborating, and training educators and families. In some districts, SLPs also function as case managers, team leaders, and supervisors of SLP assistants. In order to accommodate all of the roles necessary to provide the best services to children, SLPs are encouraged by the American Speech Language and Hearing Association to adopt a workload model approach to school services.
The increase in expanded roles is a response to the more complicated needs of U.S. children (the growing number of students with autism spectrum disorder, for example), more available information about a variety of language/communication based challenges and interventions, greater reliance on evidence based practices, and school district responses to legislation such as IDEA and No Child Left Behind. Educators and parents are becoming more aware of the expanded roles of the speech-language pathologist. In order to educate about the SLP’s expanding roles, schools need to recognize the benefits for students or children from the additional roles and to encourage support for these practices within the local school districts.
As a result of expanded roles for SLPs, many are leaving the school setting. The shortage has occurred because there has been a large increase in the number of students identified as special programs students. The increase in the number of students identified has led to a need for more special educators and speech-language pathologists. Special educators leave the classroom at a faster rate than their regular education peers. The large number of teachers leaving the profession and the small number entering can be attributed to a number of factors, including low pay, little guidance or help with mentoring, ill-prepared teachers (those on emergency permits), the challenge of working with diverse student populations, increasing demands with regard to accountability, and poor administrative support (Archer, 1998; Bradley, 1999; Sack, 1999, 2000). Corss and Billingley (1999) have completed numerous studies regarding special program teacher turnover and the importance of principal support, publishing the text Cultivating and Keeping Committed Special Education Teachers. Their research has not noted the differences in support needed for lateral entry or alternative licensed special education teachers versus traditionally licensed special education teachers. This study will investigate principals’ perceptions of speech-language pathologists by interviewing principals who are having difficulty keeping their SLPs in their educational settings.
Chapter Summary
Although speech pathologists’ roles in the educational environment continue to increase, they are still responsible to provide the best services to students. With the increase of the number of students identified as special programs students, building principals are given the responsibility to provide an appropriate education. These standards continue to place a high demand on professionals with regard to accountability.
CHAPTER TWO
The critical shortage of speech-language pathologists in the public school setting has caused some school administrators’ perceptions of the responsibility of the speech pathologist to become confused with his/her actual role. Since the school administrator must be familiar with the day- to- day operation of the school, difficulties arise when students with speech disabilities require additional services under the category of special education. Most principals do not attend IEP (Individualized Educational Plan) meetings to discuss whether or not a student is eligible for speech services, but leave this responsibility to the school’s special education team.
The History of Speech Pathology
Many who have studied the history of speech language pathology in the U.S. have placed its origins in the founding of the professional organization around 1925 (e.g., Malone, 1999; Paden, 1970). This abrupt rendering of our beginning as the day that Edward Lee Travis called a meeting at his house in Iowa City, Iowa, about forming a new organization leaves unanswered the question of what happened prior to that day. What prompted those at the meeting to want to separate themselves from their mother organization, the American Speech Society? Where did they get their ideas, their expertise, and their sense of professional identity? What other options besides separating from their parent organization were available to them?
Answers to these questions requires several trips back in time to much earlier periods when the intellectual seeds that influenced the thinking of the men and women at Travis’s meeting were planted. We will follow the historical paths to the beginning of the 19th century.
There were at least three trends in the 19th century that led to the need for the first speech-language pathology professionals. Each exerted a separate identifiable influence on the evolution of the field. As with other trends, these worked together to form a common pathway that was to eventually lead to the formation of the profession in 1925. The first pathway, the elocution movement, was a broad movement in America where elocutionists set up practices to work with orators, politicians, singers, preachers, actors, and non-specialists who wanted to improve their speaking, orating, or singing. Some elocutionists, such as Andrew Comstock and Alexander Graham Bell, also offered lessons for individuals with speech, language, or hearing problems.
Also operating early in the 19th century was a dramatic shifting from a religious and philosophical view of causality to a scientific one. Charles Darwin published his influential book on the origin of different species, Paul Broca and Carl Wernicke’s studies of the brain were having their impact, and the first academic psychology programs were becoming established in Europe and the United States. All these influences created a scientific revolution, one that strongly influenced the participants at that historic meeting that led to the founding of the American Speech and Hearing Association (ASHA) in 1925.
In 19th century America there was no such thing as “allied health professionals”. Indeed, the professions making up this group such as occupational therapists, physical therapists, and speech-language pathologists were not yet founded. Services when they were provided in these areas were administered by self-styled practitioners—those who had an interest, talent, or personal experience with a type of therapy. Among these pre-professionals was a group of practicing specialists who drew their expertise from having cured their own speech problems or from their felt talents in teaching or orating. These pre-professionals increased in number in the mid and late 19th century as a result of other reforms that were taking place in the United States. The group members began to work together contributing to a general rise of professionalism that was happening throughout the United States early in the twentieth century.
In the twentieth century, it was the wounded soldiers from the First and Second World Wars that brought about significant advances in the way that rehabilitative medicine is carried out. Not only was speech pathology born, but other fields such as physical therapy, occupational therapy, and physical medicine and rehabilitation arose to help those who had fought overseas return to as normal a life as was possible. The first physical therapists were called “reconstruction aides” and treated patients in military rehabilitation centers and hospitals. The vast majority of these professionals were women, with an academic background in physical education. Because of the polio epidemic, physical therapy took off as a career; what drove occupational therapy was the vast number of crippling injuries with which the American “doughboys” returned from the fields of Europe.
Parallel to these fields of rehabilitation, the Academy of Speech Correction was founded in 1925, which started the history of the field of speech language pathology. As soldiers returned in greater numbers of wounded from the Second World War, the need for continued and increased availability of rehabilitation was made obvious. This recognition “led to the institution of speech, language and hearing services in military hospitals during the war, and after, in veterans' administration medical centers” (Minifie, 1994, p. 5). Once the war wound down, those professionals who had delivered speech pathology services to wounded soldiers began looking for ways to continue their career by delivering them to the public at large.
With the rolls of the wounded in need of speech pathology services dwindling in the years following the Second World War, the trained pathologists began looking for other clienteles. At this point, those children who had spent their whole childhoods suffering ridicule and bullying because of their speech delays now had a cadre of pathologists waiting to help them. Ballew (1993) defined the burgeoning profession as an organization of nationally certified professionals with training to give language and speech therapy to those who are impaired in the area of communication. Miller and Groher (1993) describe the growth of the profession in this way: “during the 1970's and 80's, the clinical setting of speech-language pathologists began to evolve from what was once almost exclusively a public school and an ambulatory care population, to a practice in acute and chronic care medical institutions” (p. 180).
Even as the role of the speech pathologist has grown beyond the military and the public school system, though, that role in the schools has changed as students’ needs have shifted. One example is the need for a speech language pathologist to help a patient develop the ability to swallow effectively in normal situations (Lubinski, 2003). It is also true that the speech language pathologist on a particular campus will need to build a stronger relationship with a student's pediatrician than may have been necessary in the past. As one speech pathologist put it, “My day is probably not at all what you might think. I rarely address 'speech' disorders anymore because my focus is so predominantly on swallowing. Yes, that's right, swallowing. Eighty percent to ninety percent of my caseload involves swallowing disorders, otherwise known as dysphagia” (Kosteva, Schaller, Brian, & Strayer, 2005). Swallowing, of course, is not the only area in which pathologists have had to develop more expertise. In the public school system, they see everything ranging from neoplasms and vascular infections to traumatic neurological impairments, generating flaws in cognition and speech – as well as in swallowing. As the number of disorders grows, it will be vital for the speech language pathologist to be able to provide a comprehensive diagnosis and recommendation for treatment within a short amount of time.
In 1980, 17 family practice residents in Columbus, Ohio, took a survey. The purpose of this survey was to evaluate their comprehension of aphasia, as well as the particular function of the speech language pathologist in evaluating and treating aphasia. The results of the survey were interesting, especially given the residents' existing medical knowledge. The test showed that, while the residents did know something about the sorts of patients that speech language pathologists treat, the residents did not know a lot of things. For example, almost 50 percent of the residents did not know the proper procedures for referring a patient for services. A particular interesting result from the study was the preconception among residents that speech language pathologists only need a high school diploma, or maybe a college degree; the truth is that speech language pathologists often have to have a master's degree to work to their full potential. Indeed, the likelihood of a resident to refer a patient to a speech language pathologist often has to do with affective factors, such as knowing the pathologist, referrals from others, or other sources, rather than by assessing a patient's actual needs and making a decision based on those findings (McCauslin, et al., 1980).
In 1985, a study was administered to doctors, teachers, and nurses about their opinions of speech therapy. Quite a few of the professionals believed that speech language pathology was a discipline practiced only with children – and predominantly within the public school system. The study showed that professionals in the medical field were less likely to know that speech pathologists help patients as they recover from stroke to recover their communicative abilities (Lesser & Hassip, 1986).
A 2000 study took stock of the knowledge and attitudes that primary care physicians and nurse practitioners had toward speech dysfluency in preschool children (Lees, Star, Baird, & Birse, 2000). This study also included a Likert-type questionnaire, and over three quarters of the professionals asked to take the survey agreed to complete it. It turned out that the professionals who had received more training on speech dysfluencies after completing their medical education were more likely to refer students to a speech language pathologist. It seems, then, that the more training of professionals outside the field of speech language pathology, the more sensitive they are toward the people they serve, and the more likely they are to believe that speech language pathology works.
In 1995, a survey of educators (general and special education teachers, school psychologists, and elementary professionals) asked about their particular attitudes about the performance and role of speech language pathologists in the schools. While only 43 percent of the potential respondents returned a survey, those who did respond had a positive attitude toward speech language pathology services, although they showed a lack of uniformity when it came to identifying the specific student groups who should receive speech language pathology services. The precise role of the pathologist appeared to create some confusion as well (Sanger, Hux, & Griess, 1995).
The Role of the Speech Pathologist
Speech-language pathology is the study of disorders that affect a person's speech, language, cognition, voice, swallowing (dysphagia), and the rehabilitative or corrective treatment of physical and/or cognitive deficits/disorders resulting in difficulty with communication and/or swallowing. Speech-language pathologists (SLPs) or Speech and Language Therapists (SLTs) address people's speech production, vocal production, swallowing difficulties and language needs through speech therapy in a variety of different contexts including schools, hospitals, and through private practice.
Communication includes speech (articulation, intonation, rate, intensity), language (phonology, morphology, syntax, semantics, pragmatics), both receptive and expressive language (including reading and writing), and non-verbal communication such as facial expression and gesture. Swallowing problems managed under speech therapy are problems in the oral, laryngeal, and/or pharyngeal stages of swallowing (not esophageal). Depending on the nature and severity of the disorder, common treatments may range from physical strengthening exercises, instructive or repetitive practice and drilling, to the use of audio-visual aids and introduction of strategies to facilitate functional communication. Speech therapy may also include sign language and the use of picture symbols (Diehl, 2003).
The practice of speech-language pathology involves:
Providing prevention, screening, consultation, assessment and diagnosis, treatment,
intervention, management, counseling, and follow-up services for disorders of:
speech (i.e., phonation, articulation, fluency, resonance, and voice including
aeromechanical components of respiration);
language (i.e., phonology, morphology, syntax, semantics, and pragmatic/social aspects of communication) including comprehension and expression in oral, written, graphic, and manual modalities; language processing; preliteracy and language-based literacy skills, including phonological awareness;
swallowing or other upper aerodigestive functions such as infant feeding and aeromechanical events (evaluation of esophageal function is for the purpose of referral to medical professionals);
cognitive aspects of communication (e.g., attention, memory, problem solving, executive functions).
sensory awareness related to communication, swallowing, or other upper aerodigestive functions.
Establishing augmentative and alternative communication (AAC) techniques and strategies including developing, selecting, and prescribing of such systems and devices (e.g., speech generating devices.)
Providing services to individuals with hearing loss and their families/caregivers (e.g., auditory training; speech reading; speech and language intervention secondary to hearing loss; visual inspection and listening checks of amplification devices for the purpose of troubleshooting, including verification of appropriate battery voltage).
Screening hearing of individuals who can participate in conventional pure-tone air conduction methods, as well as screening for middle ear pathology through screening tympanometry for the purpose of referral of individuals for further evaluation and management.
Using instrumentation (e.g., videofluoroscopy, EMG, nasendoscopy, stroboscopy, computer technology) to observe, collect data, and measure parameters of communication and swallowing, or other upper aerodigestive functions in accordance with the principles of evidence-based practice.
Selecting, fitting, and establishing effective use of prosthetic/adaptive devices for communication, swallowing, or other upper aerodigestive functions (e.g., tracheoesophageal prostheses, speaking valves, electrolarynges). This does not include sensory devices used by individuals with hearing loss or other auditory perceptual deficits.
Collaborating in the assessment of central auditory processing disorders and providing intervention where there is evidence of speech, language, and/or other cognitive communication disorders.
Educating and counseling individuals, families, co-workers, educators, and other persons in the community regarding acceptance, adaptation, and decision makes about communication, swallowing, or other upper aerodigestive concerns.
Advocating for individuals through community awareness, education, and training programs to promote and facilitate access to full participation in communication, including the elimination of societal barriers.
Collaborating with and providing referrals and information to audiologists, educators, and health professionals as individual needs dictate.
Addressing behaviors (e.g., perseverative or disruptive actions) and environments (e.g., seating, positioning for swallowing safety or attention, communication opportunities) that affect communication, swallowing, or other upper aerodigestive functions.
Providing services to modify or enhance communication performance (e.g., accent modification, transgendered voice, care and improvement of the professional voice, personal/ professional communication effectiveness).
Recognizing the need to provide and appropriately accommodate diagnostic and treatment services to individuals from diverse cultural backgrounds and adjust treatment and assessment services according.
Speech-language pathologists also develop an individualized educational plan (IEP) tailored to students’ needs. For individuals with little or no speech capability, speech-language pathologists may select augmentative or alternative communication methods, including automated devices and sign language, and teach their use. They teach patients how to make sounds, improve their voices, or increase their oral or written language skills to communicate more effectively. They also teach individuals how to strengthen muscles or use compensatory strategies to swallow without choking or inhaling food or liquid. Speech-language pathologists help patients develop, or recover, reliable communication and swallowing skills so patients can fulfill their educational, vocational, and social roles.
Speech-language pathologists keep records on the initial evaluation, progress, and discharge of clients. This helps pinpoint problems, tracks client progress, and justifies the cost of treatment when applying for reimbursement. They counsel individuals and their families concerning communication disorders and how to cope with the stress and misunderstanding that often accompany them. They also work with family members to recognize and change behavior patterns that impede communication and treatment and show them communication-enhancing techniques to use at home.
Most speech-language pathologists provide direct clinical services to individuals with communication or swallowing disorders. In educational settings, they may perform their job in conjunction with physicians’ referrals, social workers, psychologists, and other therapists. Speech-language pathologists in schools collaborate with teachers, special educators, interpreters, other school personnel, and parents to develop and implement individual or group programs, provide counseling, and support classroom activities.
Work Environment
Speech-language pathologists usually work at a desk or table in clean comfortable surroundings. In schools, they may work with students in an office or classroom. When an office is provided, the speech pathologist removes the students from the classroom to provide the service. Sometimes the therapist collaborates with the classroom teacher to provide speech support to the entire classroom. Some work in the client’s home. Although the work is not physically demanding, it requires attention to detail and intense concentration.
Education and Training
Most speech-language pathologist jobs require a master’s degree. In 2007, more than 230 colleges and universities offered graduate programs in speech-language pathology accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology. While graduation from an accredited program is not always required to become a speech-language pathologist, it may be helpful in obtaining a license or may be required to obtain a license in some states.
Speech-language pathology courses cover anatomy, physiology, and the development of the areas of the body involved in speech, language, and swallowing; the nature of disorders; principles of acoustics; and psychological aspects of communication. Graduate students also learn to evaluate and treat speech, language, and swallowing disorders and receive supervised clinical training in communication disorders.
Licensure and Certification
In 2007, 47 states regulated speech-language pathologists through licensure or registration. A passing score on the national examination on speech-language pathology, offered through the Praxis Series of the Educational Testing Service, is required. Other usual requirements include 300 to 375 hours of supervised clinical experience and 9 months of postgraduate professional clinical experience. Forty-one states have continuing education requirements for licensure renewal. Medicaid, Medicare, and private health insurers generally require a practitioner to be licensed to qualify for reimbursement.
Nature of the Elementary School Principal’s Work
Successful operation of an educational institution requires competent administrators. Educational administrators provide instructional leadership and manage the day-to-day activities in schools, preschools, day care centers, and colleges and universities. They also direct the educational programs of businesses, correctional institutions, museums, and job training and community service organizations.
Education administrators set educational standards and goals and establish the policies and procedures to achieve them. They also supervise managers, support staff, teachers, counselors, librarians, coaches, and other employees. They develop academic programs, monitor students’ educational progress, train and motivate teachers and other staff, manage career counseling and other student services, administer recordkeeping, prepare budgets, and perform many other duties. They also handle relations with parents, prospective and current students, employers, and the community. In an organization such as a small day care center, one administrator may handle all these functions. In universities or large school systems, responsibilities are divided among many administrators, each with a specific function. Educational administrators who manage elementary, middle, and secondary schools are called principals. They set the academic tone and actively work with teachers to develop and maintain high curriculum standards, develop mission statements, and set performance goals and objectives.
Principals confer with staff to advise, explain, or answer procedural questions. They hire, evaluate, and help improve the skills of teachers and other staff. They visit classrooms, observe teaching methods, review instructional objectives, and examine learning materials. Principals must use clear, objective guidelines for teacher appraisals, because pay often is based on performance ratings.
Principals also meet and interact with other administrators, students, parents, and representatives of community organizations. Decision-making authority has increasingly shifted from school district central offices to individual schools. School principals have greater flexibility in setting school policies and goals, but when making administrative decisions they must pay attention to the concerns of parents, teachers, and other members of the community.
Preparing budgets and reports on various subjects, including finances and attendance, and overseeing the requisition and allocation of supplies also is an important responsibility of principals. As school budgets become tighter, many principals have become more involved in public relations and fundraising to secure financial support for their schools from local businesses and the community.
Principals must take an active role to ensure that students meet national, state, and local academic standards. Many principals develop partnerships with local businesses and school-to-work transition programs for students. Increasingly, principals must be sensitive to the needs
