Title of Rule: WAC 246-828-105 Speech-language pathology--Minimum standards of practice.

Purpose: The rule is needed to provide guidance to consumers of speech-language pathology services, members of the public and speech-language pathologists regarding the expected and recognized minimum standards of practice.

Statutory Authority for Adoption: RCW 18.35.161 (3) and (10).

Statute Being Implemented: RCW 18.35.161(10).

Summary: The rule sets standards of practice for the profession of speech-language pathology that are accepted and defined by the national organizations for this profession. The proposed amendment is housekeeping only. To correct a spelling error and provide clarity.

Reasons Supporting Proposal: To correct a spelling error "dysphasia" to "dysphagia" and delete the term oro-pharyngeal, which causes confusion.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Department of Health, Board of Hearing and Speech, 1300 Quince Street, Olympia, WA, (360) [902]-4916.

Name of Proponent: Washington Speech and Hearing Association, private.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The rule defines the expected and recognized minimum standards of practice for speech-language pathology services. The amendments are anticipated to eliminate confusion caused by a misspelled word and by deleting a unclear term.

Proposal Changes the Following Existing Rules: The proposed amendment corrects a spelling error and deletes a confusing term.

December 4, 1998

Sheila Winkler, Chair

Board of Hearing and Speech

OTS-2695.1

AMENDATORY SECTION(Amending WSR 98-14-055, filed 6/26/98, effective 7/27/98)

WAC 246-828-105
Speech-language pathology--Minimum standards of practice.

Certified speech-language pathologists are independent practitioners who provide a comprehensive array of services related to the identification, assessment, habilitation/rehabilitation, of communication disorders and ((oro-pharyngeal and dysphasia)) dysphagia.  Speech-language pathologists serve in a number of roles including but not limited to clinician, therapist, teacher, consultant, researcher, and administrator.  Speech-language pathologists provide services in hospitals, clinics, schools, nursing facilities, care centers, private practice, and other settings in which speech-language pathology services are relevant.  Speech-language pathologists provide services to individuals of all ages.

Services must be provided and products dispensed only when benefit can reasonably be expected.  All services provided and products dispensed must be evaluated for effectiveness. A certified speech-language pathologist must engage in and supervise only those aspects of the profession that are within the scope of their education, training, and experience. Speech-language pathologists must provide services appropriate to each individual in his or her care, which may include one or more of the following standard procedures:

(1) Case history, to include the following:

(a) Documentation of referral.

(b) Review of the communication, cognitive and/or swallowing problem.

(c) Review of pertinent medical, pharmacological, social and educational status.

(2) Examination of the oral mechanism for the purposes of determining adequacy for speech communication and swallowing.

(3) Screening to include: Speech and language.

(a) Hearing screening, limited to pure-tone air conduction and screening tympanometry.

(b) Swallowing screening.  Children under the age of three years who are considered at risk are assessed, not screened;

(4) Assessment may include the following:

(a) Language may include parameters of phonology, morphology, syntax, semantics, and pragmatics; and include receptive and expressive communication in oral, written, graphic and manual modalities;

(b) Speech may include articulation, fluency, and voice (including respiration, phonation and resonance).  Treatment shall address appropriate areas;

(c) Swallowing;

(d) Cognitive aspects of communication may include communication disability and other functional disabilities associated with cognitive impairment;

(e) Central auditory processing disorders in collaboration with other qualified professionals;

(f) Social aspects of communication may include challenging behaviors, ineffective social skills, lack of communication opportunities;

(g) Augmentative and alternative communication include the development of techniques and strategies that include selecting, and dispensing of aids and devices (excluding hearing instruments) and providing training to individuals, their families, and other communication partners in their use.

(5) Habilitation/rehabilitation of communication and swallowing to include the following:

(a) Treatment of speech disorders including articulation, fluency and voice.

(b) Treatment of language disorders including phonology, morphology, syntax, semantics, and pragmatics; and include receptive and expressive communication in oral, written, graphic and manual modalities.

(c) Treatment of swallowing disorders.

(d) Treatment of the cognitive aspects of communication.

(e) Treatment of central auditory processing disorders in which there is evidence of speech, language, and/or other cognitive communication disorders.

(f) Treatment of individuals with hearing loss, including aural rehabilitation and related counseling.

(g) Treatment of social aspects of communication, including challenging behaviors, ineffective social skills, and lack of communication opportunities.

(6) All services must be provided with referral to other qualified resources when appropriate.

[Statutory Authority: RCW 18.35.161 (3) and (10).  98-14-055, § 246-828-105, filed 6/26/98, effective 7/27/98.]

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