A Multi Year Perspective of Changes in SpeechLanguage Pathology

1
A Multi Year Perspective of Changes in
Speech-Language Pathology

• Margery Whites, Carey Anderson, Ashleigh Hinsz,
  Anne Kalar, Darcy Krippner, Monica Kuehn, Sue
  Murdy
• Contact first author mwhites_at_stcloudstate.edu
• Communication Sciences and Disorders
• St. Cloud State University
• St. Cloud, Minnesota
• American Speech-Language-Hearing Association
• National Convention
• Boston, MA - November 2007

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Introduction

• Speech-language pathology is reputed to be a
  dynamic and changing profession. We wanted to
  investigate these changes more systematically due
  to the effect on training needs of both current
  and future speech-language pathologists (SLPs).
  The data will also be analyzed to predict future
  trends that may benefit the future of the
  profession.

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Purpose of Study

• We wanted to find out the following
• What has changed?
• What has stayed the same?
• What are the implications of the trends?

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Participants

• Original Study
• 64 Speech-Language Pathologists
• 41 Educational
• 23 Health Care
• Follow-Up Study
• 36 of the original 64
• 26 Educational
• 10 Health Care

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Procedures

• Ten years ago, students collected data on actual
  changes and predicted changes in the field of
  speech-language pathology.
• The current study replicated the procedures of
  the original study.
• Students in a graduate research class interviewed
  the participants. Both open- and closed-ended
  interview questions were developed to determine
  what the SLPs thought had changed in the
  profession and their job duties over the past ten
  years, and what they predicted would change in
  the next ten years.
• Prior to the interviews, students role-played
  with one another to become proficient in the
  observation-interview process. Interviews were
  conducted on-site or by phone.

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Results of Original StudyDecember 1996 and
January 1997
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How has your job changed since you started
working as an SLP?

• Populations served/Job settings 39 (25/64)
• Therapy site/Type of therapy used 25 (16/64)
• More classroom therapy
• More stringent funding and legal requirements
  23 (15/64)
• Stricter qualifying standards
• Shorter length of time to treat
• Caseload size 20 (13/64)

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• Diversity/Complexity of clientele 19
• (12/64)
• More complex diagnoses
• Wider range of disabilities
• More paperwork 17 (11/64)
• More responsibility 17 (11/64)
• Scope of Practice expanded
• Dysphagia
• More collaboration with other professionals 13
  (8/64)
• More technology 11 (7/64)

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How do you think your job will change in the
future?

• Increases in
• Funding and legal requirements 39 (25/64)
• Caseload size 20 (13/64)
• Consultative and family services 16 (10/64)
• Scope of practice and training requirements 16
  (10/64)
• Dysphagia and dementia services 9 (6/64)
  
• SLP Assistants 9 (6/64)
• More monetary restrictions 39 (25/64)
• 3rd party payers will be more strict
• Length of treatment will be shortened
• Restrictions on who gets services
• Cost-effectiveness of treatment will be monitored
  more closely
• Treatment location 13 (8/64)
• More in-home, pull-out, or classroom

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• In 1996, results were mixed for the following
  survey statement Specialization in a specific
  area of practice will become necessary in my
  position.
• Disagreed 37.5
• Neutral 25
• Agreed 37.5

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• Two-thirds of SLPs (68) predicted that third
  party payers will continue to influence the type
  and length of treatment allowed.

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Results of Follow-Up StudyNovember and December
2006
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What has changed over the past 10 years?

• Educational SLP Results
• Increases in
• Caseload size and referrals 32 (8/26)
• Paperwork/Documentation 24 (6/26)
• Autism spectrum disorders 24 (6/26)
• Third party billing 20 (5/26)
• Complex cases/Multiple disorders 20 (5/26)
• Computer use for documentation and assessment
  16 (4/26)
• Use of augmentative technology 16 (4/26)

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• Medical SLP Results
• Increases in
• Swallowing issues 27 (3/10)
• Paperwork/Documentation 27 (3/10)
• Medically complex cases 27 (3/10)
• Variety of disorders 9 (1/10)
• Need for knowledge of prescriptions 9 (1/10)
• Changes in
• Job setting/Type of clients seen 18 (2/10)
• Both educational and medical SLPs reported
  changes

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How do you think your job will change in the
future?

• Increases in
• Specialization 31 (11/36)
• SLP shortages/Paraprofessionals 22 (8/36)
• Technology 22 (8/36)
• Consultation 19 (7/36)
• Caseload size 11 (4/36)
• Paperwork 6 (2/36)
• Complex cases 6 (2/36)
• Collaboration 8 (3/36)
• Drug babies 6 (2/36)
• Multicultural issues 8 (3/36)

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• In 2006, almost half of SLPs agreed with the
  following statement Specialization in a
  specific area of practice will become necessary
  in my position.
• Disagreed 18
• Neutral 33
• Agreed 49

17

• Nearly half of SLPs (48) felt that third party
  providers will continue to influence the type and
  length of treatment allowed.

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Reaction to Changes Within the Profession

• Results were mixed for the following survey
  statement The changes that have taken place in
  the profession have been beneficial to my job.
• 1996
• Disagreed 30
• Neutral 38
• Agreed 31

• 2006
• Disagreed 21
• Neutral 45
• Agreed 30

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Optimism About the Field of Speech-Language
Pathology

• 1996 The majority of SLPs were optimistic about
  the future of speech-language pathology.
• 60.9 were optimistic
• 17.2 were not optimistic
• 20.3 were neutral
• 2006 Similar to the original study, over half of
  SLPs stated that they are optimistic about the
  future of speech-language pathology.
• 60 are optimistic
• 15 are not optimistic
• 25 are neutral

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Implications

• More training needed
• Treatment for individuals with multiple disorders
• Treatment of new disorders
• Working with larger caseloads
• Third party billing
• Co-teaching and consulting due to SLP shortages
• Future questions for consideration
• Should university programs train for
  specialization?
• What is the need for paraprofessionals?
• What are the trends affecting third party billing?

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Acknowledgments

• We would like to thank all of the participants of
  this study who graciously took time out of their
  busy schedules to help us learn more about
  changes in the profession of speech-language
  pathology.
• We would also like to thank all of the graduate
  students in our graduate research class who
  helped collect and analyze the data for this
  study.