Professional Issues and Concerns in School Based Speech Language Pathology, A Survey. Senior Honors Thesis

Transcription

1 ProfessionalIssuesandConcernsinSchool BasedSpeech Language Pathology,ASurvey SeniorHonorsThesis PresentedinPartialFulfillmentoftheRequirementsforGraduationwith DistinctioninSpeechandHearingSciencesintheUndergraduateCollegesofThe OhioStateUniversity By SarahE.Yoho TheOhioStateUniversity June2009 ProjectAdvisors:Dr.RebeccaMcCauleyandDr.WayneSecord

2 TableofContents Acknowledgements.i Abstract...1 Introduction.3 LiteratureReview.5 Methods..8 ResultsandDiscussion 12 SummaryandConclusions 20 References AppendixI..25

3 Acknowledgements AspecialthankstoDr.RebeccaMcCauleyandDr.WayneSecord,Departmentof SpeechandHearingScience;andalsotoAnnSloan,OhioSEAL(StateEducation AdvocacyLeader);BrookeJolly;Dr.RobFox,DepartmentofSpeechandHearing Science;Dr.LawrenceFeth,DepartmentofSpeechandHearingScience. i

4 Abstract WiththeintroductionoftheNoChildLeftBehindAct,speech language pathologistshavebeenexpectedtofocusonlanguageandliteracyintheirwork withschoolagechildren.theeffectthisnewpushforspeech Language Pathologiststoworkwithchildrenwhohaveliteracydifficultieshasonjob performanceandsatisfactionislargelyunstudied.speech LanguagePathologists alreadystrugglewithlargecaseloads,alackofresources,andabroadrangeof disordersandcases,andthisnewfocusmayverywellbeunderfundedanddifficult toimplementwiththecurrentshortageofschool basedslps.thisstudyisan attempttobegintoevaluatetheseissues.theexpectationisthatschool based SLPswillreportissuessuchastoo largecaseloads,toobroadascopeofpractice, andagenerallackofsupportfromschooladministration;allcommonthemesin paststudies.themajorpointofinterestwillbeifandhowthenewlyadded guidelinesfromashahavechangedtheclimate.thestudywillbedoneusingan onlinesurveysentouttogroupofohioschool basedslps.theparticipantswill beaskedaseriesofquestionsaboutwhattheircurrentlevelofknowledgeisina particularareaandwhattheyfeeltheirideallevelofknowledgeshouldbeinthat area.theywillalsobeaskedhowtheydivideuptheirworktimeandiftheyfeel thatistheoptimalbreakdownforthejobtheyareexpectedtodo.attheendof thesurvey,demographicandpersonalinformationsuchasnumberofyearsin practiceandtheircurrentworksettingwillbeaskedtoascertainwhateffect,if any,thosefactorshaveontheirresponses.thissurveycouldbeusedtogive 1

5 feedbacktoashaaboutthecurrentattitudesandself assessedcompetencies prevailingintheschool basedslppopulation.thisstudycouldpotentiallybe usedasaproto typeforafuture,nationalsurvey. 2

6 LanguagePathologists(SLPs)andwhatthatmeansinpracticaltermsforthe therapists day to daylives.anotherundergraduatestudent,brookejolly,two researchadvisors,dr.rebeccamccauleyanddr.waynesecord,andmyself conductedthisproject.thefourofusjointlydesignedandimplementedasurvey, usingtheinternetsurveyservice,surveymonkey. Thissurveywasconductedatthispointintimeasaresponsetotherecent changesputintoeffectbytheamericanspeech LanguageHearingAssociation (ASHA)afterthepassingoftheNoChildLeftBehindAct.Dr.WayneSecordhad conductedonceinthe1980sandonceinthe1990ssimilarsurveys.thenew guidelinesfromashaputmuchmoreemphasisonlanguageandliteracyin Introduction Thisstudylooksatthechangingexpectationsforschool basedspeech therapy.thisisadrasticparadigmshiftintheworldofschool basedspeech LanguagePathology,astheareaofliteracyisnottraditionallythoughtofasbeing undertheprofession sscopeofpractice.thesechangeshaveforcedtherapiststo altermanyaspectsoftheirjobsincludingbutnotlimitedto,caseloadsize,division ofworkload,andtheimplementationofevidence basedpractices. TheseASHAstandardswereputintoeffectwithlittlefollow upintermsof evaluatingtherealityoftheirimpactonjobperformanceandjobsatisfactionfor SLPs.Thissurveyisanattempttobeginthatevaluation. Speech LanguagePathologists,particularlythosewhoareschool based, alreadyreportagenerallackofsufficienttimeduetolargecaseloadsandavery 3

7 widescopeofpracticesothatitisoftendifficulttobecompletelyproficientin everyarea.thissurveyhadanexpectationthatthosecomplaintswouldholdtrue withthenewstandardsinplace.otherpointsofinterestinthesurveyarehow SLPsbreakdowntheirtimeintermsoftimespentinthetherapyroomversusin collaborationwithteachersaswellashowproficienttheyfeeltheyarein individualareasofpracticeversushowproficienttheyfeeltheyshouldbe. 4

8 LiteratureReview School basedspeech LanguagePathologistsareexpectedtobeproficientin awide rangeofclinicaldiagnosisandtreatmentareas.ithasbeensuggestedthat verylargeworkloadshavenegativeeffectsonthesatisfactionofschool based professionals(bloodetal.,2002).althoughschoolspeech LanguagePathologists areuniqueintheworldofeducationalprofessionals,astheyhaveaverydefined andspecificroleascomparedtospecialeducators,theyhaveanexcessiverangeof practicestoberesponsiblefor.sincethe1970s,theperceptionofwhatfallsunder thedescriptionof language hasexpandeddramatically.ithasevolvedfrom vocabularyandgrammartoencompasspragmatics,oral language,andphonemic awarenesstonamejustafewcomponents.mostrecently,writtenlanguageskills havefallenundertheumbrellaoflanguagethatslpsmustaddress.readingand writingproficiencyinallschool ageclientsfrompre schooltohighschoolarenow theconcernofspeech LanguagePathologists(UkrainetzandFrequez,2003). ThenewASHAguidelinesforscopeofpracticeofSLPsincludetheareaof languageandliteracyaswellasallformerareasofpractice.theguidelinesdonot, however,giveanideaofwhatisoutsideofthescopeofpracticeandhowtodrawa dividinglinebetweenthatwhichistheclassroomteacher sresponsibilityandthat orthespeech LanguagePathologist.Inthepast,thisdivisionbetweenclassroom teachersandtherapistswasasourceofdissatisfactionforslps.itcreatedasense ofisolationandineffectivetherapy(ukrainetzandfrequez,2003).many 5

9 therapists,toalleviatethisfeeling,haveincreasinglyadoptedtheintegrated service deliverymodel. Intheintegratedservice deliverymodel,thespeech LanguagePathologists strength orexpertiseiscommonlythoughtofasbeingintheareaoflanguage development.theclassroomteacher sperceivedexpertiseisoftenintheareaof curriculumandclassroomcontent.studieshavefoundthatmostifnotallslpsuse integratedservicesintheareaoflanguagebutveryfewtherapistsusethemodelin theareasoffluencyandvoice(16%and5%respectively).mostslpsarein agreementthatcollaborationbetweenthemselvesandclassroomteacherscanbe beneficialinthatbothpartieshaveknowledgethatwhensharedcanincrease successfulness(elksninandcapilouto,1994). Anotherrelativelynewapproachintherapyistheideaofevidence based practice.thenewpolicy drivenguidelinesoftheprofessionarecallingfor evidenced basedresultsinthetherapyroom.thispracticeisheavilyinfluencing thewaysinwhichtherapistsareapproachingnewliteracytraining.thecatalystof thisnewemphasisisindisputablypresidentbush s NoChildLeftBehindAct of 2001,whichcallsforscientificallybasedresearchforprofessionalsinthepublic schools.unfortunately,itremainsthatmanyslpsareunacquaintedwiththese newmeasuresintheareasofliteracyandevidenced basedpractice(justice,2006). Legislationplaysacrucialroleinshapingtheday to daypracticesofthe schoolslp.theindividualswithdisabilitieseducationact(idea)of1991wasone ofmanysuchlegislativeactsthatservedtoredefinetheroleofthespeech 6

10 LanguagePathologistintheschools.AfterIDEA,therapistsservicedmore communicationdisordersaswellaschildrenwithmoreseveredisabilitiesand complications.thiscreatedadrasticincreaseincaseloadformanyslps,resulting inagreaterdemandfortherapistsineducationalsettings(rosa Lugo,Rivera, McKeown,1998).TheNoChildLeftBehindActhashadsimilareffectsonthe profession. Amorecomprehensivestudyoftheimpactofthebroadscopeofpracticeof school basedslpsisneededtounderstandthereal worldimplications.any changeinpracticeneedstobestudiedtobetterunderstandtheslpsroleinthe schools.thosestudiesshouldfocusonobtainingdataoneverydayrealistic practicesaswellastheidyllicandpreferredpracticesofthetherapist(ukrainetz andfresquez,2003).changesintrainingandeducationofslpsmustbemadeto reflectthoserealities. 7

11 Methods Subjects Surveyparticipantswereschool basedspeech LanguagePathologistswho workinohio(tworespondentsindicatedtheyworkedinastateotherthanohio). ParticipantswereASHAmembers.Outofthe1500certifiedSpeechLanguage PathologistsinOhio,160responded.Approximately70%oftherespondentswere 41yearsorolder.Approximately50%oftherespondentsindicatedtheyworkedin asuburbansetting.mostsubjectsworkedsolelyinthepublicschools,whileafew workedinpreschoolsettingsorwereemployedinprivatepracticeinadditionto theirschoolemployment.approximately50%heldamastersastheirhighest educationaldegree(tablea). Number of Responses 50.0% 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Highest Level of Degree Attained Bachelors (B) B+15 B+30 Masters (M) M+15 M+30 Doctorate (D) TableA 8

12 Materials Thesurveywasdesignedandhostedusingthesurveywebsite SurveyMonkey.com.AnoutsidesitewasusedtohostaPDFfilewhichparticipants receiveduponcompletionofthesurvey.thepdffilewas 101WaystoHelp ChildrenCommunicateandLearninSchool writtenbydr.waynesecord.e mail wasusedtodistributethesurveylink.statisticsonsurveydatawererunusingthe softwarespss(statisticalpackageforthesocialsciences). Procedures ThesurveywasdesignedandimplementedusingSurveyMonkey,an Internetsurveysite.Thesurveyformattingwasbasedontwopastsurveysdoneby Dr.WayneSecord.Thesurveylinkwase mailedouttoannsloan,ohiostate EducationAdvocacyLeader(SEAL).Shethendistributedthelinkviae mailto Ohioschool basedspeechlanguagepathologists.thesurveyconsistedof18 questionsregardingparticipants levelsofknowledgeinvariousareasfromtheir knowledgeofassessmentandinterventiontoknowledgeoflanguageandliteracy intervention.theparticipantswereaskedtoratehowknowledgeabletheyfeltthey wereineacharea,from1beinglittleknowledgeto7beingverythorough knowledge.theythenwereaskedtoratehowknowledgeabletheyfelttheyshould beinthatarea,againonascalefrom1to7.aftertheseriesof18questions,they werethenaskedtolistthetwoareasofknowledgethattheypersonallyfeltthey 9

13 hadthegreatestdisparityinbetweentheiractuallevelofknowledgeandtheir ideallevelofknowledge.theywereaskedtorankorderthecausesforthat disparityfromachoiceof7:lackoftime,lackofmoneytotakerelevant workshops,lackofsupportfromschooladministration,lackofconfidencein abilitytoacquiretheknowledgebase,toomanyareasofpracticerequiring expertise.theywerethenaskedtoratetheirlevelofinteractionwithclassroom teachersonascaleof5from1to2meetingsperyeartoweeklyorbiweekly meetings.thefollow upquestionaskedaboutthenatureofthoseinteractions; whatdidthespeechlanguagepathologistsfeeltheydidthemostintermsof teacherinteractions.thechoiceswereexplainingtoteachershowtoreinforceslp workintheclassroom,reviewingandplanningtheongoinginterventionprogram together,providingaknowledgebaseoncommunicationdisordersforteachers, providingprogressreportstoteachers,solicitingideasfromteachersforworkwith thecaseload,andworkingwiththeteachertogetanincreasedknowledgebaseof thecurriculum.theywerealsoaskedhowmuchtheyvaluethoseinteractions individually.thefinalsignificantquestionwasanevaluationofaservicedelivery model.participantswereaskedtodivideuptheamountoftimetheyfeltthey spentineachcapacityfromthetherapyroom,theclassroom,andinconsultation. Thequestionrequiredapercentageanswer,whichmustaddupto100%.For example,theycouldanswerthattheyspent50%oftheirtimeinthetherapyroom, 30%intheclassroom,and20%inconsultation.Nexttheywereaskedwhattheir idealdistributionwouldbefortheircaseload.theremainingquestionsasked 10

14 aboutpersonaldata;howmanyyearstheyhadbeenintheschools,whatwork setting(rural,suburban,urban)theycurrentlyworkedin,yearssincetheyhad receivedtheircccs(certificateofclinicalcompetence),theircurrentnumberof studentsontheircaseload,iftheyworkedinohio,theirage,andtheirhighest levelofeducationachieved.theywerealsogivenroomforcomments. Whentheparticipantsfinishedthesurvey,theywereredirectedtoasite hostingthesecordpdf.theirdatawasstoredinsurveymonkey,andwasanalyzed usingbothsurveymonkey sanalysistoolsandexportedintospssforfurther statisticallyanalysis. 11

15 ResultsandDiscussion Whenevaluatingtheresponsestothefirst18questionsregardingactual andideallevelsofknowledgeindifferingareas,ageneralpatternemerged. Participantstendedtofeelthattheyhadanaveragelevelofknowledgeforeachof theareasandfelttheyshouldhaveamuchmorethoroughknowledgebasefor eachparticulararea.thecurvesforactuallevelofknowledgetendtobeanormalcurveinallcategoriesasopposedtotheleft skewedcurvesforeachoftheideal levelofknowledge. Number of Responses PROFESSIONAL KNOWLEDGE: Knowledge of assessment & intervention for communication disabilities. Assessment - Your ACTUAL level of knowledge Assessment - Your IDEAL level of knowledge Intervention- Your ACTUAL level of knowledge Table1 Intervention - Your IDEAL level of knowledge 1 Little Knowledge Average Knowledge Very Thorough Knowledge EventhoughSpeechLanguagePathologiststendedtofeeltheyknewmore ingeneralaboutassessmentandinterventionofcommunicationdisabilities 12

16 (somethingthatwasexpectedtoberatedassuch),theystillfeltthattheyshould haveamorethoroughknowledgebase(table1). CLASSROOM-BASED INTERVENTION: Knowledge of how to provide language and communication intervention in the classroom. 120 Number of Responses Little Knowledge 4 Average Knowledge 20 0 Your ACTUAL level of knowledge Your IDEAL level of knowledge 7 Very Thorough Knowledge Table2 Whenaskedaboutmorecollaborativeactivitiessuchasclassroom based intervention(table2),wherethespeechpathologistwouldprovideservicesinthe regularclassroom,manymorerespondentsfelttheyhadlessknowledgethanthey should.approximately57%ratedtheiractuallevelofknowledgebetween4and5 (4beingaverageknowledge).Comparedtothe45%whoratedthequestionin Table1ashavinganactuallevelofknowledgeof6onthe7 pointscale. 13

17 Onepointofsignificantinterestinthesurveywasrespondent sresponseto thequestionconcerningevidence basedpractice(table3),asthistopicisgaining particularattentiononthenationalspeech pathologyscene.thesurveyfoundthat 64%ofrespondentsfelttheyhadaverage(4to5)levelsofknowledgeonfinding theevidenceand57%indicatedaverage(4to5)levelsofknowledgeonusingthe evidence.over80%felttheyshouldhaveverythoroughknowledge(6to7)levels inbothcategories.thisindicatesthattherapistsareawareoftheimportantofthis area,buthavenotfoundmanywaysofsuccessfullyimplementingitintotheir practiceasofyet. Number of Responses EVIDENCED BASED PRACTICE: Knowledge of the level of evidence supporting methods, strategies, or techniques used in the intervention process Finding the Evidence - Your ACTUAL level of knowledge Finding the Evidence - Your IDEAL level of knowledge Using the Evidence - Your ACTUAL level of knowledge Using the Evidence - Your IDEAL level of knowledge 1 Little Knowledge 4 Average Knowledge 7 Very Thorough Knowledge Table3 14

18 Whentherespondentswereaskedtorankorderthereasonswhytheyfelt theyhadsuchagreatdisparityinactualanddesiredlevelofknowledge,theresults wereconsistentwithexpectations:agenerallackoftimeandtoobroadascopeof practiceweretargetedasthemainreason.thereasontheyrankedashavingthe leastsignificancewasalackofconfidenceintheirabilitytoacquiretheknowledge, indicatingthattheyfeeltheyarecapableofbecomingbetterinformed,buttheydo nothavethetime. Number of Responses For the area that has the greatest disparity between your actual and ideal level of knowledge, rank order the causes from 1 (least important) to 7 (most important) that you believe are responsible for the difference. Lack Of Time Lack Of Money To Take Relevant Courses Or Workshops Lack Of Support From Your School Administration Lack of Confidence In Your Ability To Acquire The Knowledge Base Table4 Too Many Areas Of Practice (Scope Of Practice) Requiring Your Expertise 1 Least Important Somewhat important Most Important 15

19 ApossiblecausativefactorintheSpeechLanguagePathologists lackof timeistheirlargecaseloadsintheschools.over56%indicatedthattheyhad caseloadsofover50students(table5). Number of Responses Current caseload (approximate number) Response Count Table5 < TheSpeechLanguagePathologistsindicatedthattheymeetwithclassroom teachersfrequently;over50%reportedthattheymeetweeklyorbiweekly(table 6).However,thefollowingquestionaskedaboutthenaturesofthoseinteractions. Respondentsweregivenachoiceof6naturesofinteraction,threebeingwhatare typicallyconsidered expert activities,andthreebeingwhatareconsideredmore 16

20 collaborative.respondentsindicatedthattheinteractionstheyhavethemost frequentlyweretheexpertactivities,givingprogressreportstoteachers,soliciting ideasfromteachers,andprovidingideastoteachers(table7). Number of Responses INTERACTION WITH TEACHERS Response Count Little Interaction: 1 or 2 meetings per year Infrequent Meetings: once every 3 months Occasional Meetings: once every 2 months Regular Meetings: once every month Frequent Meetings: weekly or biweekly Table6 Cumulative Rating Average Please rate the nature of your interactions with teachers. Choose the frequency with which you engage in each activity Expert Activities Collaborative Activities Table7 Soliciting ideas from teachers for use with students on your caseload. Providing teachers with information about progress in therapy. Explaining to teachers how they can reinforce your work in the classroom. Working with the teacher to increase your knowledge about curriculum. Providing a knowledge base on communication disorders for the teacher. Reviewing and planning the ongoing intervention program together. 17

21 Thelastquestionbeforethepersonaldatasectionwasaservicedelivery modelbreakdown.itwasexpectedthattherapistswouldindicatethattheyspend themosttimeinthetherapyroomandthat,althoughtheywouldliketherationto belessextreme,theywouldwanttocontinuetospendover50%oftheirtimein directtherapy.respondentsindicatedthattheyspend62%oftheirtimeinthe therapyroom,and38%oftheirtimeprovidingservicesoutsideofdirecttherapy (intheclassroomandconsultation).theywouldoptimallyliketospendonly46% ofthetimeintherapyand54%intheclassroomandconsultation(table8).that wasadeviationfromexpectations.thisindicatesthattherapistsareinagreement withthenewemphasisonthenationalorganizationlevelthatmoretimeshould bespentintheclassroomsandoutofthetherapyroom. Whentheresultsofthisquestionwerecross tabbedwithage,itwasfound thattheyoungestgroup(21 30yearsofage)felttheideaprogramshouldbe44% therapyroomand56%classroom/consultation.theoldestgroup(61 70yearsof age)feltverydifferently,55%therapyroomand45%classroom/consultation.this isperhapsduetothenewemphasisingraduateprogramstowardsprofessional collaboration. 18

22 Service Delivery Model - Percentage of Time Spent in Each Capacity % of Time Spent Actual Ideal Therapy Room Classroom Consultation Table8 Agewasoneofthemanyfactorsthatcouldbecross tabbedwiththedatato furtheranalyzetheresults.futureinvestigationintothesurveydatashouldbe donetodetermineotherprecipitatingfactorsinresponses. 19

23 SummaryandConclusions Asexpected,thelargecaseloadofmanyschool basedspeech Language Pathologistsandthebroadscopeofpracticeoftheprofessionistheleadingfactor holdingtherapistsbackfromadoptingtheemergingideasofcollaborative practice.theadditionofliteracyintothatscopeofpracticeisonlyonesmallfactor contributingtotheconcernsofspeechpathologists. Theresponsesconsistentlyindicatedthatrespondentsbelievedtheyshould haveamorethoroughknowledgeinallareasaddressedinthesurvey.therewere significantdifferencesinratingsbetweenactualandidealknowledgeineachofthe 18areaslisted.Theyindicatedthatlackoftimeandtoobroadascopeofpractice werethemaincausesofthatdisparity.theydidnotfeelthattheyhadaninability toacquiremoreknowledgeifgiventheproperamountoftimeandresources.this isagoodindicationthatiftheshortageofspeechlanguagepathologistsinthe schoolsweretobealleviated,moretherapistsmightbeabletoobtainthe knowledgebasesthattheydesireandneedtobeassuccessfulaspossibleintheir rolesasschool basedprofessionals. Whenaskedaboutinteractionwithteachers,respondentsreportedthat theyspendthemosttimesimplygivingprogressreportsofchildrentoteachers, theleastcollaborativeofthechoicesofnaturesofinteraction.theyfeltthatthey spenttheleasttimedoingthingssuchasworkingtogetherwiththeteacherto developaninterventionplan,themostcollaborativeofthenatures.unfortunately, whenaskedhowmuchtheyvalueeachofthoseinteractions,theyratedworking 20

24 ontheongoinginterventionplantogetherwithclassroomteachersastheleast valued.thiswouldbeassumedtobeacauseofconcernforasha,thenational organization,astheyplacehighvalueoncollaborativeactivitiessuchasthis.one arenawherethisattitudecouldpossiblybechangedisinthegraduatedegree programsoftheuniversities.ifthegraduateprogramsemphasizedtheimportance ofhavingahealthy,ongoingrelationshipwiththeteachersintheschools,more SpeechPathologistsmayseethisassomethingtheyshouldvaluehighly.Thereis evidencethatthiscouldbeasuccessasindicatedintheresultsofthesurvey questionregardingliteracy,thenewareaofscopeofpracticefortherapists.the youngestrespondents,whopossiblyhadsomesortofliteracyemphasisintheir graduateprograms,feltmuchstrongerabouttheimportanceofliteracy interventionunderstanding. Respondentsindicatedthattheyspendmostoftheirtimeinthetherapy room,andlessoftheirtimeprovidingservicesoutsideofdirecttherapy(inthe classroomandconsultation).theywouldoptimallyliketospendlessofthetime inthetherapyroomthanintheclassroomandinconsultation.thisisin agreementwiththenewemphasisonspeech LanguagePathologistsspendingless timeindirecttherapyandmoretimeintheclassrooms.thissurveyisthefirst timethatsecord ssurveysofthisnaturehaveseenthatresult,averypositivepoint tobenoted.therespondentswhofeltthestrongestaboutthisapproachshiftwere theyoungestgroupofrespondents.realchangemaybepossibleifthattrend continuesinnewlygraduatedtherapistsandiscoupledwithanimprovementin 21

25 theshortageofspeechpathologistsingeneral.perhapswithlessofashortageof professionals,smallercaseloadswouldbeseen,resultingintherapistshavingmore timetolearnaboutthoseareasofpracticethattheymaybelessfamiliarwith. Afuturepossibilityforthissurveycouldbeamorenationaldispersion.It wouldbeofgreatimportancetoseeiftheresultsfromohiowouldholdtruefor therestofthecountryasawhole.itwouldalsobeofgreatinteresttostatistically comparetheresultsofthissurveytothetwopast,similarsurveysdonebysecord inthepasttwodecades.thisanalysiswouldgivelongitudinaldata,whichwould beveryusefulinevaluatingdevelopmentinthefieldoveraperiodofthree decades.moreextensivecrosstabbingshouldbedoneonthecurrentdatasetsto ascertainifanystatisticallysignificanttrendsemerge. Ifthesurveyweretobeimplementedinamorenationalfashion,some revisionsshouldbemade.ifanysurvey biasexistsitshouldbecorrected,suchas wordingofcertainquestions.inparticular,respondentsshouldbeaskedto indicatetheirdegreeofemployment.manyrespondentsindicatedthattheyonly workedhalftimeintheschools.someworkedinpre schoolsorwithspecial populations,whichsignificantlyimpactedtheiranswers.aquestionofhigh concernformanyrespondentswasregardinghowlongagotheyhadobtained theircccs(certificateofclinicalcompetence,awardedbyasha).assomeolder therapistswere grandfathered in,andwerenotrequiredtoobtaincccs,this createdconfoundingfactorinthatthesurveyhadnooptionforthosewithout 22

26 CCCs.Afewrespondentsalsoindicatedadesireforclearerwordingofthesurvey questions. Overall,thedataobtainedfromthissurveyissignificantinthefactthatit reflectsthatspeechlanguagepathologistsinohiounderstandthatthereisan ongoingparadigmshiftintheirprofession.ifthefactorsdiscussedwereimproved upon,thiscouldpotentiallybeaveryimportantnationalsurvey. 23

27 References Blood,GordonW.,etal."PredictingJobSatisfactionAmongSpeech Language PathologistsWorkinginPublicSchools."Language,Speech,andHearing ServicesinSchools33(2002): Elksnin,LindaK.,andGilsonJ.Capilouto."Speech LanguagePathologists' PerceptionsofIntegratedServiceDeliveryinSchoolSettings."Language, Speech,andHearingServicesinSchools25(1994): Blanchard,MargorieM.,andE.H.Nober."TheImpactofStateandFederal LegislationonPublicSchoolSpeech,Language,andHearingClinicians." Language,Speech,andHearingServicesinSchoolsIX(1978): Ukrainetz,TeresaA.,andElenaF.Fresquez.""WhatIsn'tLanguage?":A QualitativeStudyoftheRoleoftheSchoolSpeech LanguagePathologist." Language,Speech,andHearingServicesinSchools34(2003): Rosa Lugo,LindaI.,ElizabethA.Rivera,andSusanW.McKeown."Meetingthe CriticalShortageofSpeech LanguagePathologiststoServethePublic Schools CollaborativeRewards."Language,Speech,andHearingServicesin Schools29(1998): Justice,LauraM."Evidence BasedPractice,ResponsetoIntervention,andthe PreventionofReadingDifficulties."Language,Speech,andHearingServices inschools37(2006):