Portland State University s4

PORTLAND STATE UNIVERSITY

SPEECH-LANGUAGE AND HEARING CLINIC

CLINIC MANUAL 2012-13 TABLE OF CONTENTS

General Information 3 Ethics/Client Welfare 4 Knowledge and Skills Acquisition (KASA) 5-6 Clock Hour Requirements 6 ASHA Certification Standards IV-6 7-8 SLP Skill Competencies 8 PSU Clinics 9-10 Externships 10-11 Other Clinic Opportunities 11 Clinic Policies 12-14 Infection Control Policies and Procedures 15-17 Professional Atmosphere 18-21 Absences and Cancellations 21-22 Tests, Equipment, Materials 22-23 Student Computer Lab 23 Directed Clinical Assistants 24 Clinic Procedures (On-Campus) 25-29 Supervisor Evaluation of Student Clinician 30-31 Assistance for Student Clinicians Who Demonstrate the Need for a Clinical Support Plan 32-33

2 GENERAL INFORMATION

The Speech-Language and Hearing Clinic at Portland State University is located in the basement of Neuberger Hall. The clinic area consists of observable and non-observable clinic rooms, audiology testing suites, a hearing aid fitting room, a laboratory containing assessment and intervention materials, a student computer lab, a clinic reception area, and a client waiting room. Also situated in the clinic area are faculty offices and laboratories, classrooms, and conference rooms.

The Speech-Language and Hearing Clinic provides assessment and intervention services for individuals with communication disorders. The Clinic also serves as a learning laboratory for students in the Department of Speech and Hearing Sciences.

Clients are referred by physicians, school professionals, health agencies, private practitioners, and by self-referral. The Clinic provides services primarily to individuals from Oregon and southern Washington. Application forms are available through the Speech and Hearing Sciences office.

Specific services include diagnostic/evaluation and treatment services in the following disability groups for both children and adults:

 Audiological and Hearing Aid evaluation  Articulation/Phonological delays or disorders  Language delay or disorders  Voice disorders  Fluency disorders  Disorders of speech and language due to neurological disorders or disease  Disorders of speech and language due to Traumatic Brain Injury

Fees for clinical services vary according to the nature of the services rendered and on a sliding scale fee basis. Fee schedules are on file in the Speech and Hearing Sciences office.

The Speech-Language and Hearing Clinic follows the Portland State University calendar.

3 ETHICS/CLIENT WELFARE

AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION (ASHA) CODE OF ETHICS

Student clinicians are expected to adhere to the ASHA Code of Ethics

The principles of the ASHA Code of Ethics will be addressed throughout your graduate program, both in academic classes and in clinical activities. You should become well acquainted with the Code of Ethics so that the judgments and decisions you make as a graduate student form a solid ethical foundation for your future as a speech-language pathologist. If you have any questions or concerns regarding the Code of Ethics or considerations of ethical behavior, discuss them with the Clinic Director or another clinical faculty member.

Principle of Ethics I Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or participate in research and scholarly activities and shall treat animals involved in research in a humane manner.

Principles of Ethics II Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence.

Principles of Ethics III Individuals shall honor their responsibility to the public by promoting public understanding of the professions, by supporting the development of services designed to fulfill the unmet needs of the public, and by providing accurate information in all communications involving any aspect of the professions, including dissemination of research findings and scholarly activities.

Principles of Ethics IV Individuals shall honor their responsibilities to the professions and their relationships with colleagues, students, and members of allied professions. Individuals shall uphold the dignity and autonomy of the professions, maintain harmonious interprofessional and intraprofessional relationships, and accept the professions’ self-imposed standards.

A full copy of the ASHA Code of Ethics can be found on the ASHA website at asha.org.

KNOWLEDGE AND SKILLS ACQUISITION (KASA) 4 According to the Standards for the Certificates of Clinical Competence in Speech-Language Pathology, students must complete a minimum of 400 clock hours of supervised clinical experience in the practice of speech-language pathology. Twenty-five hours must be spent in clinical observation, and 375 hours must be spent in direct client/patient contact. The student must demonstrate through the Knowledge and Skills Acquisition (KASA) form the acquisition of skills as outlined in the ASHA Standards. The Department of Speech and Hearing Sciences at PSU is using the on-line Student Assessment Management System (SAMS) to document knowledge and skill acquisition. Clock hour totals are also documented in SAMS. Skill acquisition in the 9 disorder areas will be updated at the end of each term for each student. Clock hours will also be updated on SAMS at the end of each term. The clinic will be transitioning to a new program for the year 2012-2013. We will keep you all posted of changes as we make the transition.

Confirmation of clock hours and completion of the KASA form is required when a student applies for ASHA certification. Therefore, it is extremely important that an ongoing and accurate record be kept.

Each student will have a clock hour file which is kept securely in the Speech and Hearing Sciences office. This file contains signed clock hour forms and student evaluations by on-campus and off-campus clinical educators. Students may have access to their clock hour file only with permission and supervision of their advisor, clinical faculty, clinical director, or other faculty member.

 Major decisions regarding evaluation and treatment of a client are implemented or communicated to the client and/or parent only after approval by the supervisor.

 Student clinicians should be assigned practicum only after they have sufficient coursework to qualify for such experience.

 Clinical practicum hours must be supervised by individuals who hold a current CCC in the area in which the observation and practicum hours are being obtained.

 A person holding an appropriate credential is available for consultation as appropriate for the client’s disorder when a student is providing clinical services.

 Clock hours can be obtained only for the time during which the student clinician is providing direct evaluation or treatment services for clients who present communication disorders or with the client’s family. Ancillary activities such as writing lesson plans, scoring tests, transcribing language samples, and preparing treatment activities, and meetings with practicum supervisors may not be counted as clock hours.

 A minimum of 25% of total contact time in treatment with each client must be observed 5 directly by the supervisor.

 The nature and amount of clinical supervision are adjusted to the experience and ability of the student, and the appropriate guidance and feedback are provided to the student.

CLOCK HOUR REQUIREMENTS

 Admitted Speech and Hearing Sciences graduate students are provided the opportunity to meet the ASHA Certification of Clinical Competence clock hour requirements:

o 25 clock hours of supervised observation o 375 clock hours of supervised practicum o 325 hours - Speech-Language Pathology at the graduate level

 Suggested minimum clock hour requirements for Speech-Language Pathology (SLP) at PSU are:

o 20 hours - Evaluation: Speech disorders in children o 20 hours - Evaluation: Speech disorders in adults o 20 hours - Evaluation: Language disorders in children o 20 hours - Evaluation: Language disorders in adults o 20 hours - Treatment: Speech disorders in children o 20 hours - Treatment: Speech disorders in adults o 20 hours - Treatment: Language disorders in children o 20 hours - Treatment: Language disorders in adults o 20 hours - Hearing (screening and/or habilitation/rehabilitation)

6 ASHA CERTIFICATION STANDARD IV-G

Graduate students must complete a program of study that includes supervised clinical experiences sufficient in breadth and depth to achieve the following skills outcomes:

1. Evaluation: a. conduct screening and prevention procedures (including prevention activities) b. collect case history information and integrate information from clients/patients, family, caregivers, teachers, relevant others, and other professionals c. select and administer appropriate evaluation procedures, such as behavioral observations, nonstandardized and standardized tests, and instrumental procedures d. adapt evaluation procedures to meet client/patient needs e. interpret, integrate, and synthesize all information to develop diagnoses and make appropriate recommendations for intervention f. complete administrative and reporting functions necessary to support evaluation g. refer clients/patients for appropriate services 2. Intervention: a. develop setting-appropriate intervention plans with measurable and achievable goals that meet clients'/patients' needs. Collaborate with clients/patients and relevant others in the planning process. b. implement intervention plans (involve clients/patients and relevant others in the intervention process) c. select or develop and use appropriate materials and instrumentation for prevention and intervention d. measure and evaluate clients'/patients' performance and progress e. modify intervention plans, strategies, materials, or instrumentation as appropriate to meet the needs of clients/patients f. complete administrative and reporting functions necessary to support intervention g. identify and refer clients/patients for services as appropriate 3. Interaction and Personal Qualities: a. communicate effectively, recognizing the needs, values, preferred mode of communication, and cultural/linguistic background of the client/patient, family, caregivers, and relevant others b. collaborate with other professionals in case management c. provide counseling regarding communication and swallowing disorders to clients/patients, family, caregivers, and relevant others d. adhere to the ASHA Code of Ethics and behave professionally

7 These standards must be met in the following areas:

 Articulation  Fluency  Voice and resonance, including respiration and phonation  Receptive and expressive language (phonology, morphology, syntax, semantics, and pragmatics) in speaking, listening, reading, writing, and manual modalities  Hearing, including the impact on speech and language  Swallowing (oral, pharyngeal, esophageal, and related functions, including oral function for feeding; orofacial myofunction)  Cognitive aspects of communication (attention, memory, sequencing, problem- solving, executive functioning)  Social aspects of communication (including challenging behavior, ineffective social skills, lack of communication opportunities)  Communication modalities (including oral, manual, augmentative, and alternative communication techniques and assistive technologies)

SLP Skills Competencies

At the end of each term students are assessed on a 4-point rubric for each of the skills areas in the disorder areas listed above. By the end of the graduate program, students must obtain a “4” in each skill area for each disorder area. Students have the opportunity to do that through their clinical experiences. Some of the clinical skills in various disorder areas are infused into academic coursework. The rubric for the skill competencies corresponds with the rubric used for the clinic grading scale. The rubric is as follows:

 1 Not Evident o Student earns a score of '1' on clinical evaluation in designated area

 2 Emerging o Student earns a score of '2' or '3' on clinical evaluation in designated area

 3 Practicum Level Mastery o Student earns a score of '4' or '5' on clinical evaluation in designated area

 4 Entry Level Mastery o Student earns a score of '6' or '7' on clinical evaluation in designated area or instructor discretion

8 PSU CLINIC

Graduate students rotate through the various PSU clinics. Clinic assignments are made by the Clinic Director.

Practicum SPHR 509 (PSU clinics) The PSU 509 clinics are a variety of clinical experiences and are sequenced throughout the 7 terms of your graduate program. This clinic can be any of the following experiences:

Individual Client Clinic In this clinic, each graduate clinician will typically work with 1-3 clients individually and may also participate in a group. Clinicians attend a weekly seminar class taught by the clinical faculty. This clinic also includes partnerships with community organizations and can take place at other facilities.

Urban Language Clinic This is a speech and language classroom program in partnership with the Community Transitional School for children from homeless families. This clinic takes place at the Community Transitional School in Portland. Four to six graduate clinicians participate each term. Clinicians work with the children in large and small groups. Clinicians attend a weekly seminar.

Adult Language Clinic This clinic involves evaluation and treatment of adult clients with neurological disorders related primarily to stroke or head injury, stuttering disorders and voice disorders. Students will work with 1-3 clients individually and may also participate in a group. Clients typically attend two sessions per week. Clinicians attend a twice weekly seminar. Included in adult clinic is an accent modification clinic in collaboration with the Intensive English Language Program at PSU.

Speech-Language-Hearing Screenings and Assessments Students are required to participate in speech-language, hearing screenings and assessments in the community and at the PSU Clinic. These opportunities will be scheduled for Friday mornings and other days and times as coordinated with community agencies. Students will rotate through a minimum of 2 assessments and screenings over the course of 7 terms. Screening and assessment opportunities will be coordinated by the clinical faculty.

Prerequisite: Completion of Audiometric Practicum

Audiometric Practicum Students complete this required workshop to review hearing screening procedures. Upon completion, students may participate in off-campus hearing screenings as set up by the Clinic Director and/or Clinical Audiology Instructor.

9 Term Completed: Workshop is completed fall of 1st year; students do not need to register for additional credits, but are expected to participate in a minimum of 2 screenings over the course of the 7 terms of their graduate program Screenings are managed by the Clinical Audiologist who will inform students when the screenings are offered.

*Completion of the hearing and speech and language screenings may be adjusted on an individual basis taking into consideration the externship opportunities that students participate in.

EXTERNSHIPS

Graduate students have the opportunity to complete 2 full time off-campus externships. The clinical faculty coordinate the process for placing students in their externships.

Practicum SPHR 509 (Externship) Graduate students in speech-language pathology at Portland State University receive the opportunity to complete 2 full time externships. Students must register for credit hours for externships or will not receive clock hours. Students will register for a total of 18 clinical practicum hours over the 7 terms of the graduate program. This practicum may be in a medical, clinical or educational setting. Planning for this practicum begins in the winter term of the first year. All externships are coordinated by the clinical faculty.

Prerequisites: Successful completion of at least 2 PSU Clinics and approval by faculty Terms Completed: Typically in your 4th-7th terms of your graduate program

Externship options:

Student Teaching/School age placements All students who wish to complete requirements for an Initial Teaching License to work in the schools as a speech-language pathologist must complete one term of full-time student teaching in the schools. In addition, students will participate in a seminar. All student teaching placements are set up by the clinical faculty according to procedures outlined in the Clinic Manual and according to Teacher Standards and Practice Commission (TSPC) procedures.

All students regardless of their interest in pursuing an Intial Teaching License will complete an educationally-based practicum either in a school or an early intervention site.

10 Medical placements Many students will complete an externship in a medical setting including: hospitals, clinics, acute care facilities, home health placements, etc. Many settings have a required application and interview process that student’s will be required to participate in if they are interested in externships at certain sites. Placement at these sites is facilitated by the clinical faculty, but cannot be guaranteed for every student. There will be a meeting to explore options and learn about procedures for medical placements in winter term.

Early Intervention placements There are many Education Service Districts that provide services for the birth-5 population. These sites offer classroom settings for intervention, assessment teams, home-based intervention, and specialty teams for feeding and AAC.

OTHER CLINIC OPPORTUNITIES

Thesis/Project Clients Students may be involved assessment and/or intervention with clients as part of their master’s thesis or culminating project and can receive clock hours. This may be on or off-campus. Arrangements for clients will be made with the faculty thesis/project advisor.

11 CLINIC POLICIES

General Policies

 Students must receive a course grade of B- or above in order to complete the practicum course satisfactorily, earn clock hours, and meet clinical skill competencies. If a student does not earn a B- or above in the practicum course, they will be required to repeat the practicum.

 Student must be registered in a practicum in order to obtain clock hours for that experience.

 Professional liability insurance is required for all student clinicians enrolled in off-campus practica. Information regarding professional liability insurance is provided by the Clinic Director.

 Upon entering the graduate program, students must show documentation of the following immunizations: Hepatitis B; Measles, Mumps, Rubella; Varicella; TB Surveillance

 Graduate students must complete a Background Check which includes criminal history, social security number trace report and Office of Inspector General (OIG) Sanctions list. A certificate of completion and detailed summary report must be retained in the student’s SPHR clinic file. Information regarding completion of the background check is provided by the Clinic Director.

 Graduate students are required to complete their finger prints for the Teachers Standards and Practices Commission (TSPC) prior to entry into the graduate program.

Privacy and Confidentiality Policies

The PSU Speech-Language and Hearing Clinic is committed to protecting the privacy of clients. Discussion regarding evaluation and intervention of clients will be conducted in academic and seminar classes or in private faculty offices only. Be aware that discussions in the hallway or in clinic rooms may be overheard through the observation system.

One principle covered in the ASHA Code of Ethics involves the protection of clients’ rights to confidentiality. This practice includes issues of maintaining client records, release of information, and video and/or audio taping client sessions.

Client Files

 All client files are kept in a locked file cabinet in Neuberger Hall Room 85H. Graduate student clinicians have access to these files on Monday – Friday, between 8:30 am – 5:00 pm. o It is the student’s responsibility to return the file to the file cabinet by 5:00 pm. 12 o Client files must be signed out using the full-sized sign-out card which is then inserted in the place where the file had been.

 Client files may not leave the clinic area and may not be taken home.

 All information in the files is confidential and may not be shared with anyone not involved in the clinic process.

 Any document or information in client files may not be photocopied.

 Student clinicians are responsible for placing clinic reports, signed release forms, and other relevant documents in the client files.

Clinic Reports

 No identifying information should be on rough drafts of reports. Use client’s initials only. All rough drafts will be turned in at the end of each term for shredding.

 Reports may not be transmitted electronically.

 To maintain confidentiality, students may not print clinic reports in university computer labs.

 Student clinicians are responsible for placing clinical reports in the client’s file chronologically in the appropriate section.

Release of Information

 Exchange of information will occur only with a signed Request for Release of Confidential Information form. One form is designated for release of information from PSU and one form is designated for release of information to PSU.

 All signed release forms should be current and placed in the client’s file in the appropriate section.

 To fax information, the PSU Speech-Language and Hearing Clinic Fax Cover Sheet will be used.

 There will be no electronic exchange of information.

Video and Audio Taping

13  Clients will sign and date the Video/Audio Agreement form each academic year. The form explains our practice of audio and/or video taping sessions for educational and/or research purposes for students and faculty employed in the Department of Speech and Hearing Sciences at Portland State University and will not be used outside the university without written permission.

 The Video/Audio Agreement form will be placed in the client file by the graduate student clinician in the appropriate section.

 For use of an audio or video tape outside of PSU, an additional Release for use of and Video/Audio Taping outside of PSU form must be signed and dated by the client.

 Video tapes/DVDs/Flash drives/Memory cards are the property of the PSU Speech- Language and Hearing Clinic and are to be collected by the clinic faculty at the end of each term. Video/Audio tapes not collected by the clinical faculty must be destroyed/deleted at the end of each term.

Observations

 The Permission for Observations form explains that departmental students and faculty may observe clinic sessions. All clients who participate in the PSU Speech-Language and Hearing Clinic will be asked to sign this form.

 Clinic sessions may be observed by faculty, SPHR students, including graduate, undergraduate and post-baccalaureate students, and family members.

 Observers are asked to be considerate of family members and offer them chairs closest to the observation window.

 Observers are encouraged to quietly introduce themselves to family members and indicate that they are students in the SPHR Department.

 Observers are asked not to talk while observing and not to ask family members questions about the client.

 A faculty member may take the opportunity to talk about the clinical session and to answer questions from student observers, as appropriate.

 No food or beverages are allowed in the observation rooms.

INFECTION CONTROL POLICIES AND PROCEDURES

14 Speech-language pathologists are highly susceptible to contracting diseases by working in close proximity to clients (i.e. from droplet transfer of small particles of moisture such as those expelled during speech or a sneeze). Routine adoption of aseptic procedures reduces the probability of disease transmission. Student clinicians have an ethical and legal obligation to provide an atmosphere of safety for their clients, themselves, fellow student clinicians and clinic staff. Below are listed the aseptic procedures for the Portland State University Speech-Language and Hearing Clinic. These procedures are to be followed by all student clinicians:

Hand Washing

Student clinicians will wash their hands thoroughly prior to and after each contact with clients. Students may use the washroom or the sink in the Clinic Lab for hand-washing. The prescribed hand-washing procedure is:

 Moisten hands completely with warm water and scrubbed vigorously with a liquid antibacterial soap  Lather hands wrists and forearms  Rub vigorously, interlacing fingers. Rinse thoroughly, allowing water to drain from fingertips to forearms  Repeat entire procedure and dry hands with paper towels.

Wearing Disposable Gloves

Student clinicians shall wear disposable gloves whenever contact with client body/fluid substances (e.g. saliva, cerumen) is anticipated. This is typically during an oral or otoscopic exam. Gloves are available in the clinic rooms. Removal and disposal of gloves should be as follows:

 Remove one glove so that it is inside-out when removed with fingertips from the other hand.  Hold the removed glove that is inside-out in the non-gloved hand and use it to remove the remaining glove so that it is also inside-out and includes the first glove inside of it.  Place used gloves in a plastic bag and dispose of in a covered waste can outside of the clinic room.

15 Handling of Contaminated Items

Student clinicians may come into contact with consumable and non-consumable contaminated items. Consumable items include disposable gloves, tongue depressors, and otoscope specula. Non-consumable items include ear tips and toys. Plastic bags with twist ties are available in the clinic rooms. Disposal and decontamination of these items should be as follows:

 Consumable items which have been in contact with body fluids should be placed in a plastic bag, sealed with a twist tie and disposed of in a covered waste can outside of the clinic room.  Non-consumerable items which have been in contact with body fluids should be decontaminated according to prescribed procedures. Toys should be washed with disinfectant detergent and rinsed in hot water.  Student clinicians should notify a clinical faculty member or the clinic receptionist whenever bodily fluids such as urine or vomit need to be removed and the area cleaned. The university facilitites department will be notified and they will clean the area. The area should be vacated until cleaning is completed.

Disinfecting Clinical Areas, Equipment and Materials

Student clinicians should disinfect tables, doorknobs, chairs, materials, toys, equipment, etc. following each clinic session. Disinfectant is available in the Clinic Lab. The following procedures should be followed:

 The surface to be disinfected should be wiped with a strong rubbing action using the disinfectant provided or with disinfectant wipes provided in the clinic rooms and/or Clinic Lab.  Disinfectant procedures should be implemented after the client leaves the clinic room.  Wear a disposable glove on the hand engaged in wiping down the surfaces.  Toys and other clinic materials should be disinfected using the designated disinfected solution in the Clinic Lab. Items should be sprayed with the solution and wiped down with a paper towel. After use, dispose of the paper towels in a covered waste can outside of the clinic room.

Injuries, Illness or other Contagious Conditions

Any injuries that occur in the clinic area must be reported according to university guidelines. The injury should also be reported to the clinical faculty. The following procedures should be followed in the case of illness:

 Student clinicians should not provide clinical services if they have a body temperature of 99.9 degrees or higher or if they have a bad cough, cold or other illness. 16  Clients and their caregivers will be requested not to attend the clinic if they have a body temperature of 99.9 degrees or higher or if they have a bad cough, cold or other illness.  Student clinicians should cover their mouth with their elbow or tissue when coughing.  If a student has a concern about a contagious condition, they should contact their clinical supervisor or the Clinic Director.

PROFESSIONAL ATMOSTPHERE 17 The PSU Speech-Language and Hearing Clinic maintains high professional standards at all times. This includes, but is not limited to:

Professional Etiquette

 Appropriate conduct during clinical sessions and while in the clinic area o Respect to client confidentiality o Appropriate conversation o Appropriate tone and loudness for clinic area

 Promptness for all clinical sessions

 Ending sessions on time and leaving rooms clean and ready for the next session

 Informing client, family, and/or caregivers of any changes in the schedule such as illness or unplanned absences

 No smoking or consumptions of intoxicants on the PSU campus

 No cell phones or pagers used during clinic sessions

Relationships with Clients and/or Families

It is important to maintain a professional relationship with clients and their families and one that is not personal in nature.

 Student clinicians should not socialize with clients/families outside of the clinic setting.

 Student clinicians should not exchange personal gifts with clients.

 Student clinicians should review clients’ needs for assistance with their clinical supervisor, and together determine how much assistance can or cannot be provided. This should be clearly communicated to the client/family.

 Student clinicians should be aware of food allergies, side effects to medication, reactions to specific types of stimuli, and also observance/non-observance of specific holidays. It is best not to make assumptions, but to learn as much as possible about all such issues which relate to your work with your client.

Dress Code

18 Student clinicians should maintain a professional appearance appropriate to the setting they are in. Be aware that off-campus sites may have specific guidelines and/or dress codes for students at their sites. Please adhere to the following guidelines for the on-campus clinic:

 No jeans, shorts or athletic wear (sweat pants and sweat shirts)

 No low necklines

 No bare skin showing between the top of pants/skirt and top

 No athletic shoes or flip flops

 No excessive ear piercing

 No oral (tongue) or facial ornaments

 No strong perfume

Clinic Phone Calls

 A telephone is available for student use in NH 66. Local calls only can be made from this telephone. Dial ‘9’ and then the area code and phone number.

 To call a PSU campus number, dial ‘5’ and then the extension.

 Please be considerate of those working in the computer lab and those in a nearby observation room when you are using the telephone in Room 66.

 If a long distance call is necessary to call a client, ask your clinical supervisor if you may use their office phone for the call.

 Take care not to discuss confidential clinic/client business in a location which is not private.

 Important phone numbers

o Department of Speech and Hearing Sciences 503-725-3533 o Department of Speech and Hearing Sciences Fax 503-725-9171 o Speech-Language and Hearing Clinic 503-725-3070 o Clinic Director 503-725-5364

Bulletin Boards and Clinic Schedule Board

19  There are several bulletin boards in the Clinic Lab, NH 91. The following will be posted on the bulletin boards:

o Clinic schedules and room assignments o Sign-ups for supervisory meetings o Clinic announcements o Emergency information o Client cancellations o Correspondence between clinic faculty and students

 The master clinic schedule for each term is posted outside NH 74. The schedule is color- coded for adults and children. Sessions are listed by clinicians’ first names and room numbers only.

 Departmental information and the course schedule for each term are posted on the bulletin board outside the SPHR Department office, NH 85.

 The NSSHLA bulletin board is in the main hallway outside the Clinic Lab.

 The bulletin board in the Clinic Waiting Room, contains information for clients and families.

 Other bulletin boards include a job board, an advising board for undergraduates and post- baccalaureate students, and a research board.

 Please do not post anything on departmental bulletin boards without permission of a faculty member.

Emergency and Caution Procedures

There are occasionally instances of theft of backpacks, purses, wallets and clinic equipment, such as video cameras in our clinic area. These areas can include restrooms, clinic room, the Lab, other study spaces, and faculty offices. In some cases, the items have been in plain sight, though unattended. In other cases, the items have been concealed from view. Please consider the following tips and cautions:

 Do not leave personal items on sinks or shelves in public restrooms.

 Protect your purse and/or wallet by locking them in your locker.

 Protect your backpacks by never leaving them unattended, even for a short time.

20  If you bring a car to campus, keep it locked at all times and keep personal items and packages out of view.

 Report any suspicious activity to a faculty member and/or the campus police. Community members, students, faculty, staff, and guests are encouraged to report all crimes and public safety related incidents to the Campus Public Safety Office (CPSO) in a timely manner.

o To report a crime or an emergency on the Portland State University campus, call extension 5-4404 or, from outside the University phone system, 503-725-4404. o To report a non-emergency security or public safety related matter, call extension 5-4407 or, from outside the University phone system, 503-725-4407.

Evacuation Procedures

Evacuating the clinic and/or building may be necessary under certain conditions, such as an earthquake, fire or security breach. In this event, you will be asked to take your client outside the building to the area designated by campus security. If you hear a fire alarm, immediately leave the building. If you are not with a client at the time, please assist others in taking clients out of the building in the case of an emergency.

ABSENCES AND CANCELLATIONS

Clinician Absence

 Student clinicians are required to inform their faculty supervisor if they will be absent for a clinical session.

 Student clinicians should notify clients as far in advance as possible regarding known absences.

 There may be situations when another student clinician will be asked to work with the client when their regular clinician is unable to be there.

 Student clinicians are required to inform their Directed Clinical Assistant if they will be absent for a clinical session.

 Clinicians are responsible for contacting each of their clients to cancel or reschedule clinical sessions for the day. Be sure to record clients, caregivers and supervisor’s telephone numbers for home use.

21  Clinicians are required to offer make-up sessions for those that were cancelled. Students must consult their clinical supervisor before scheduling make-up sessions.

Client Absence

 Student clinicians are to instruct clients or parents to call the Speech and Hearing Sciences Clinic Office Coordinator (503-725-3070) to cancel clinical sessions. Messages of cancellation will be placed on the bulletin board in the Clinic Lab.

 Student clinicians are responsible for notifying their clinical supervisor and for recording absences on the Daily Attendance Form for that client.

 Student clinicians are responsible for notifying their Directed Clinical Assistant when a client cancels a session.

 Clinicians may offer make-up sessions for client absences, but always check your supervisor’s availability for the make-up sessions as well.

 It is up to each clinician whether or not to give clients/families their home or cell phone number or their email address to use when cancelling sessions.

 When the University closes due to inclement weather, all clinic sessions are cancelled and graduate student clinicians are responsible for contacting their clients.

TESTS, EQUIPMENT, MATERIALS

 Clinical assessments and intervention materials and supplies are available in the Clinic Lab for use by student clinicians. Graduate student mailboxes are also available in the Clinic Lab.

 The materials in the Lab are for graduate student clinician use for clinical sessions. Large bags are available in the Lab for students to use to carry materials to the clinic rooms.

 Standardized tests are stored in the cabinets on a numerical basis. A notebook cataloguing the tests is available on the bookshelf to help students locate each test. Tests must be returned to the correct spot in the cabinets.

 Protocol forms are available for student use in the Clinic Lab. They are kept in alphabetical order in an unlocked file cabinet.

22  Students must use published assessment protocols as indicated by copyright laws. Please do not use the last copy of a test protocol. Inform the Clinic Office Coordinator that there is only one copy left and new protocols will be ordered.

 The tables and chairs in the Clinic Lab are available for clinicians to use to plan clinical sessions. The tables and chairs in NH 77 are also available for students when not in use for groups or seminar classes.

 The furniture in the clinic rooms may be rearranged for sessions or put in the hallway during the session if not used in the clinic room. Students are responsible for putting all furniture back in the clinic rooms after each session.

 Electronic Equipment, such as video cameras and tape recorders are kept in a secure area in NH Room 85H and are available to students on a sign-out basis.

 Student clinicians are responsible for maintaining all equipment and materials in good condition and for placing these items in their designated storage area.

 All equipment and clinical materials are for use in the PSU Speech-Language and Hearing Clinic area ONLY and MAY NOT be removed from this area

STUDENT COMPUTER LAB

 The main purpose of the computer lab in NH 91 is to provide computers for graduate students to use to generate clinic reports, while maintaining client confidentiality and to provide clinic related software students for use with their clients.

 A printer is available for printing clinic reports and other clinic materials only. Students may not use the printer to print academic course assignments or other personal documents.

 Software for clinical use, such as SALT and Boardmaker, are available on the computers in the student computer lab.

23 DIRECTED CLINICAL ASSISTANTS

Graduate student clinicians may have a Directed Clinical Assistant (DCA) assigned to observe and participate in clinical sessions with one or more of their clients. DCAs are undergraduate or post-baccalaureate students who are enrolled in a course designed to acquaint students with the direct management of clients by giving them the opportunity to participate in clinic sessions with a graduate student clinician. Graduate students who are assigned a DCA are asked to:

 Respond to the initial contact from the DCA and arrange a time to meet and exchange contact information.

 Provide information to the DCA regarding the client and your initial assessment plan.

 Instruct the DCA whether to observe in the observation room during assessment and/or the first 1-2 sessions or whether to be in the clinic room.

 Introduce the DCA to your client and family members.

 Suggested ways to incorporate the DCA are:

o Assist in gathering materials o Assist in scoring assessments o Assist in tracking responses during intervention o Assist in setting up the clinic room o Assist in putting materials away and in cleaning the room at the end of the session o Engage the client as you meet with family members o Include the DCA in clinical activities

24 CLINIC PROCEDURES (ON CAMPUS)

Opening Clinic

The scheduling of clients is completed by the clinic receptionist and the clinical faculty. The clinical supervisor will assign clients to graduate student clinicians on specified days and times. It is the student’s responsibility to:

 Review client files  Contact client/family to confirm start date and clinic times  During the first week of clinic, review and obtain client/parent signature on appropriate forms in Client Packets

Client Packets

Graduate student clinicians will give each of their clients a New Client Packet or a Returning Client Packet. Included in the packets are:

 Welcome and information letter which includes student clinician’s name, appointment days and times, clinical supervisor’s name and phone number  Privacy Policy  Consent for Evaluation and Treatment  Permission for Observations  Video/Audio Agreement  Fee Schedule

Client Files

Client files will be kept at all times in a locked file cabinet in Room 85H. Student clinicians may have access to the files and may sign out a file during business hours (Monday – Friday, 8:00 am – 5:00 pm). Student should refer to the Privacy Policy for specific guidelines regarding client files.

Room Assignments

Clinic rooms will be assigned by the clinical supervisor. It is the student’s responsibility to:

 Turn on the sound system in the observation room  Show client/parent/family member observation room  End the session on time and remove all materials 5 minutes before the next session is to begin  Clean up the room after use according to Infection Control Procedures Lesson Plan Folders

25 Student clinicians will maintain a working file for each client. The lesson plan folders are to be kept in a file cabinet in the Lab, NH 79 and filed by the client’s appointment time. All lesson plans are kept in the folder. Each lesson plan must be completed and filed before the session begins. Daily progress notes and a reflection of the session are due before the next session. It is the student’s responsibility to:

 Maintain daily attendance form in this file  Maintain weekly supervisor observation form in this file  Complete daily lesson plans and place in file before each session  Complete progress notes and reflection at the end of each session  Keep the file available at PSU for supervisor review at all times

Supervisor Observation Percentages

ASHA requires that students be directly observed by a supervisor a minimum of 25% of client contact time over the course of the term. Clinical supervisors will inform students of the time observed for each clinic session. It is the student’s responsibility to:

 Keep a record of supervisor’s observation time of each session  Calculate observation percentages on a weekly basis, recording this on the appropriate form that is kept in the clinician’s file  Inform clinical supervisor if percentages are falling below the required 25%

Lesson Plans

Students will use lesson plan forms as instructed by the clinical supervisor. Lesson plans must be typed or written in ink. Lesson plan templates can be found in the appendix of the Clinic Manual. It is the student’s responsibility to:

 Place completed daily lesson plans in the lesson plan file before each clinic session.  Keep all lesson plans from the term in this file, with the most recent one in the front of the folder  Make a duplicate, if desired, for use in the clinic room or to give to a clinical assistant

Progress Notes

Students will complete progress notes following each clinical session. The progress notes will be in the form of SOAP notes. SOAP is an acronym for Subjective, Objective, Assessment and Plan. Each component is described below: 26  Subjective: This includes subjective observations. Impressions of client behavior and participation in the session are described.  Objective: Measurable information is included in this section. State the goal using a behavioral objective format and then indicate the client’s performance. If applicable, compare the client’s performance with that of his previous session. Assessment results are also included in this section.  Assessment: In this section, assess and briefly summarize your objective data. This section includes client strengths and weaknesses and may include hypotheses for why changes did or did not occur.  Plan: This section outlines the continued course of treatment. Specifically state objectives for the next session, written in a behavioral objective format. Objectives may include further assessment.

*Note that all SOAP notes and lesson plans are part of the client’s permanent file and will collected at the end of the term

Self-Reflection

Student clinicians will complete a self-reflection following each clinic session. This is a description of how the session as a whole was perceived and how successful specific activities were. The self-reflection should address strengths and weaknesses of the session.

Clinic Reports

Students will complete clinic reports each term as instructed by the clinical faculty. There are several report formats that are used in the clinic and the clinical faculty will inform students which format should be used at that time. Outlines for each report format can be found in the appendix of the Clinic Manual.

The report formats include:

 Initial Summary (narrative)  Progress Report (narrative)  Combined Initial Summary and Progress Report (narrative)  Intervention Plan (chart format)  Progress Report (chart format)

Reporting Standardized Test Results

In order to report standardized test results in a consistent manner, it is imperative to include specific data. Use the following guidelines when scoring tests and generating written reports:

27  Full name of test with acronym in parentheses the first time the test is mentioned  Acronym may be used in the rest of the report  Purpose of the test; what the test assesses specifically  Raw scores  Standard scores, percentiles, z-scores, etc.  Severity rating, if appropriate  Do not report age equivalents  Statement as to whether the scores fall within one standard deviation of the mean score for same-age peers or whether the scores fall more than one standard deviation below the mean  Comparison to previous testing, if appropriate and available  Description of overall performance; strengths and weaknesses demonstrated

Signatures on Reports

All clinic reports need to be signed by the graduate student clinician and the clinical supervisor, with degree and title included:

__Name/Degree______Name/Degree/CCC-SLP Graduate Student Clinician Clinical Supervisor

Closing Clinic

At the end of each term, the clinical supervisor will meet with students to complete end of term paperwork, record clock hours and complete evaluation of clinic forms. The following items must be completed by students prior to closing clinic and receiving a grade:

 Hand out evaluation of clinic forms to client/parent.  Complete and sign end-of-term reports.  Discuss end-of-term results, recommendations, and disposition with client/parent.  Obtain names and addresses of individuals and agencies to whom reports should be sent and make sufficient copies of each report with envelopes prepared.  Place the signed end-of-term report in client’s chart and complete all appropriate charting information and forms.

 Complete On-Campus Clock Hour Summary and obtain signatures from clinical supervisors.  Complete Evaluation of Clinical Supervision and Evaluation of Clinical Seminar forms.  Hand in all lesson plans and SOAP notes to be part of the client’s permanent file.  Hand in all drafts of client reports to be shredded. 28 Recording Clock Hours

At the end of each term, students will record their clinical hours and the SLP skill competencies in the disorder areas they had experience with that term. This is typically done on the official closing day of clinic during finals week. It is the student’s responsibility to:

 Complete the Clock Hour Summary form as instructed by clinical faculty.  Obtain signatures and ASHA Account Numbers of clinical faculty on the Clock Hour Summary Form.  Complete the SLP Skills Competency form as instructed by clinical faculty.

It is the Clinic Office Coordinator’s responsibility to enter clock hours and skill competency information into SAMS at the end of each term.

29 SUPERVISOR EVALUATION OF STUDENT CLINICIAN

A midterm and final evaluation, including an assigned grade, of clinical performance will be issued to each student clinician. Individual evaluation forms may vary depending on the clinical experience. Evaluations include competencies in the areas of:

 Interpersonal Skills  Professional/Technical Skills

Evaluations may include, but are not limited to, the following areas:

 Selection, administration, and scoring of standardized diagnostic measures  Formulating and implementing objectives and procedures  Lesson planning  Report writing  Record keeping  Self-evaluation  Professional conduct regarding clients, families, and other professionals  Ability to seek, accept, and utilize supervisory feedback

Clinical Levels

Student clinicians will be assigned a clinical level each term based on the number of supervised clock hours accumulated up to that point in time. In general, as the number of clock hours increases, so do the expectations for independent clinical activity. As students progress through the clinical levels, they will be expected to have a broader base of knowledge to apply to the clinical setting, and to implement clinical strategies more independently, efficiently and effectively. The clinic levels are as follows”

 Entry Level (0-25 supervised clock hours completed) o Student clinicians are expected to evidence particular skills with frequent supervisory input and instruction. Students at this level are expected to need general direction consisting of direct discussion with frequent repetition and further clarification of ideas.

 Primary Level (25-50 supervised clock hours completed) o Student clinicians are expected to be more independent in their planning and implementation of assessment tools and intervention activities, but still may have several skills which are emerging. Students at this level need general direction with limited repetition or clarification.

30  Intermediate Level (50-150 supervised clock hours completed) o Student clinicians are expected to be increasingly more independent, even though their skills might lack some consistency and need refinement. At this level, students show initiative, are able to problem-solve, and perform competently with limited discussion.

 Advanced Level (50+ supervised clock hours completed) o Student Clinicians are expected to be quite independent and take the lead in problem-solving, showing initiative and performing competently. Clinical skills are more developed and consistent at this level.

Clinic Grading Scale

As a student clinician, you will have the opportunity to evaluate and provide speech-language intervention to clients of all ages who present with a wide variety of communication challenges. A student who is just beginning their clinical experience is expected to require more assistance than one with more experience.

The evaluation grading scale is a 7-point scale which allows for increased supevisory input for less experienced clinicians and expects greater independence for those who have more experience.

Ratings for the grading scale are as follows:

 7 Independently problem solves, shows initiative and performs competently  6 With limited discussion, problem-solves, shows initiative and performs competently  5 Needs general direction with limited repetition or clarification  4 Needs general direction consisting of direct discussion with frequent repetition and further clarification of ideas  3 Needs specific direction but no demonstration  2 Needs step-by-step review of client’s needs and/or demonstration  1 Specific directions from supervisor does not alter unsatisfactory performance and ability to make changes

Suggested Grading Guidelines

LEVEL A B C (or below) Entry mainly 3-4 mainly 2-3 mainly 2 Primary mainly 4-5 mainly 3-4 mainly 2 Intermediate mainly 5-6 mainly 4-5 mainly 3 Advanced mainly 6-7 mainly 5-6 mainly 3-4 ASSISTANCE FOR STUDENT CLINICIANS WHO DEMONSTRATE THE 31 NEED FOR A CLINICAL SUPPORT PLAN

Students who are experiencing difficulty acquiring and/or demonstrating satisfactory clinical skills will have the opportunity to have a structured and individualized clinical support plan with intensive input from clinical faculty. The process for a clinic support plan is as follows:

 The need for a clinical support plan will be identified by the scheduled midterm evaluation week

o Student clinicians whose clinical performance is below expectations will be identified for remediation as soon as possible. Exceptions may occur due to decreased performance after the midterm evaluation or frequent cancellations by the client early in the term. Remediation will be recommended for any student earning below a B- for their midterm grade for any clinical faculty member.

 A meeting will be scheduled with the student clinician and supervising faculty member to review the midterm evaluation and to discuss the need for a clinic support plan. The process for support will be reviewed. The Clinic Director may be included in the meeting.

 The support plan procedure is as follows: o The student and clinical supervisor set up a planning meeting. Another clinical faculty member will also attend the meeting. This may be the Clinic Director. The student may invite another student or faculty member to the meeting. These individuals become the clinical support team.

o A formal support plan will be developed to address each area of concern and will include specific goals and objectives and an indication of the means and methods to be used. A timeline for meeting the goals and objectives will be included in the plan. The plan will be signed and dated by the members of the clinical support team.

o The clinical faculty member and student will establish how frequently they will meet – either weekly, or more often if necessary. The meeting should include at least one other member of the support team. The purpose of the support meeting is to facilitate and monitor progress toward the stated goals and objectives. Other members of the support team may be requested to observe sessions and provide other assistance as requested by the primary clinical faculty member and/or the student.

o If a student receives an overall final grade of below a B-, the student will be

32 required to retake that particular clinic course in a subsequent term. Students may not receive clock hours if they do not receive a grade of B- or above.

o Students who need to retake an on-campus clinic will meet with the supervising clinical faculty member(s) and the Clinic Director at the start of the term. At that meeting, the expectations for performance and performance evaluation, along with roles and responsibilities for the student and the clinical faculty members will be determined and documented. A written summary will be signed and dated by all parties.

Policy for Student Grievances in the Clinical Arena

In some cases, a student may disagree with a faculty member or clinical educator to the extent that the situation warrants communication and action to reach an optimal resolution. The Following policies and procedures have been established to guide the students and clinical faculty members:

 Students are encouraged to meet with the specific clinical faculty member who is directly involved in the situation. Both parties will discuss the concern and attempt to come to an agreement of the appropriate way to handle the situation. The student and/or clinical faculty member may invite the Clinic Director to this meeting.

 If the issues are not able to be addressed at this level, the student should meet with the Clinic Director to share the concerns. The Clinic Director and student can then discuss the situation and attempt to come to an agreement of the appropriate way to handle the situation.

33 APPENDIX

1 ASHA Code of Ethics 2. Clinic Seminar Evaluation 3. Student Evaluation 4. Infection Control Procedures

34 Ethics

Code of Ethics

Preamble The preservation of the highest standards of integrity and ethical principles is vital to the responsible discharge of obligations by speech-language pathologists, audiologists, and speech, language, and hearing scientists. This Code of Ethics sets forth the fundamental principles and rules considered essential to this purpose. Every individual who is (a) a member of the American Speech-Language-Hearing Association, whether certified or not, (b) a nonmember holding the Certificate of Clinical Competence from the Association, (c) an applicant for membership or certification, or (d) a Clinical Fellow seeking to fulfill standards for certification shall abide by this Code of Ethics. Any violation of the spirit and purpose of this Code shall be considered unethical. Failure to specify any particular responsibility or practice in this Code of Ethics shall not be construed as denial of the existence of such responsibilities or practices. The fundamentals of ethical conduct are described by Principles of Ethics and by Rules of Ethics as they relate to the conduct of research and scholarly activities and responsibility to persons served, the public, and speech-language pathologists, audiologists, and speech, language, and hearing scientists. Principles of Ethics, aspirational and inspirational in nature, form the underlying moral basis for the Code of Ethics. Individuals shall observe these principles as affirmative obligations under all conditions of professional activity. Rules of Ethics are specific statements of minimally acceptable professional conduct or of prohibitions and are applicable to all individuals. Principle of Ethics I Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or participants in research and scholarly activities and shall treat animals involved in research in a humane manner.

35 Rules of Ethics 1. Individuals shall provide all services competently. 2. Individuals shall use every resource, including referral when appropriate, to ensure that high-quality service is provided. 3. Individuals shall not discriminate in the delivery of professional services or the conduct of research and scholarly activities on the basis of race or ethnicity, gender, age, religion, national origin, sexual orientation, or disability. 4. Individuals shall not misrepresent the credentials of assistants, technicians, or support personnel and shall inform those they serve professionally of the name and professional credentials of persons providing services. 5. Individuals who hold the Certificates of Clinical Competence shall not delegate tasks that require the unique skills, knowledge, and judgment that are within the scope of their profession to assistants, technicians, support personnel, students, or any nonprofessionals over whom they have supervisory responsibility. An individual may delegate support services to assistants, technicians, support personnel, students, or any other persons only if those services are adequately supervised by an individual who holds the appropriate Certificate of Clinical Competence. 6. Individuals shall fully inform the persons they serve of the nature and possible effects of services rendered and products dispensed, and they shall inform participants in research about the possible effects of their participation in research conducted. 7. Individuals shall evaluate the effectiveness of services rendered and of products dispensed and shall provide services or dispense products only when benefit can reasonably be expected. 8. Individuals shall not guarantee the results of any treatment or procedure, directly or by implication; however, they may make a reasonable statement of prognosis. 9. Individuals shall not provide clinical services solely by correspondence. 10. Individuals may practice by telecommunication (for example, telehealth/e-health), where not prohibited by law. 11. Individuals shall adequately maintain and appropriately secure records of professional services rendered, research and scholarly activities conducted, and products dispensed and shall allow access to these records only when authorized or when required by law. 12. Individuals shall not reveal, without authorization, any professional or personal information about identified persons served professionally or identified participants involved in research and scholarly activities unless required by law to do so, or unless doing so is necessary to protect the welfare of the person or of the community or otherwise required by law.

36 13. Individuals shall not charge for services not rendered, nor shall they misrepresent services rendered, products dispensed, or research and scholarly activities conducted. 14. Individuals shall use persons in research or as subjects of teaching demonstrations only with their informed consent. 15. Individuals whose professional services are adversely affected by substance abuse or other health-related conditions shall seek professional assistance and, where appropriate, withdraw from the affected areas of practice. Principle of Ethics II Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence.

Rules of Ethics 1. Individuals shall engage in the provision of clinical services only when they hold the appropriate Certificate of Clinical Competence or when they are in the certification process and are supervised by an individual who holds the appropriate Certificate of Clinical Competence. 2. Individuals shall engage in only those aspects of the professions that are within the scope of their competence, considering their level of education, training, and experience. 3. Individuals shall continue their professional development throughout their careers. 4. Individuals shall delegate the provision of clinical services only to: (1) persons who hold the appropriate Certificate of Clinical Competence; (2) persons in the education or certification process who are appropriately supervised by an individual who holds the appropriate Certificate of Clinical Competence; or (3) assistants, technicians, or support personnel who are adequately supervised by an individual who holds the appropriate Certificate of Clinical Competence. 5. Individuals shall not require or permit their professional staff to provide services or conduct research activities that exceed the staff member's competence, level of education, training, and experience. 6. Individuals shall ensure that all equipment used in the provision of services or to conduct research and scholarly activities is in proper working order and is properly calibrated.

Principle of Ethics III Individuals shall honor their responsibility to the public by promoting public understanding of the professions, by supporting the development of services designed to fulfill the unmet needs of the public, and by providing accurate information in all communications involving any aspect of the professions, including dissemination of research findings and scholarly activities.

Rules of Ethics

37 1. Individuals shall not misrepresent their credentials, competence, education, training, experience, or scholarly or research contributions. 2. Individuals shall not participate in professional activities that constitute a conflict of interest. 3. Individuals shall refer those served professionally solely on the basis of the interest of those being referred and not on any personal financial interest. 4. Individuals shall not misrepresent diagnostic information, research, services rendered, or products dispensed; neither shall they engage in any scheme to defraud in connection with obtaining payment or reimbursement for such services or products. 5. Individuals' statements to the public shall provide accurate information about the nature and management of communication disorders, about the professions, about professional services, and about research and scholarly activities. 6. Individuals' statements to the public—advertising, announcing, and marketing their professional services, reporting research results, and promoting products—shall adhere to prevailing professional standards and shall not contain misrepresentations. Principle of Ethics IV Individuals shall honor their responsibilities to the professions and their relationships with colleagues, students, and members of allied professions. Individuals shall uphold the dignity and autonomy of the professions, maintain harmonious interprofessional and intraprofessional relationships, and accept the professions' self-imposed standards.

Rules of Ethics 1. Individuals shall prohibit anyone under their supervision from engaging in any practice that violates the Code of Ethics. 2. Individuals shall not engage in dishonesty, fraud, deceit, misrepresentation, sexual harrassment, or any other form of conduct that adversely reflects on the professions or on the individual's fitness to serve persons professionally. 3. Individuals shall not engage in sexual activities with clients or students over whom they exercise professional authority. 4. Individuals shall assign credit only to those who have contributed to a publication, presentation, or product. Credit shall be assigned in proportion to the contribution and only with the contributor's consent. 5. Individuals shall reference the source when using other persons' ideas, research, presentations, or products in written, oral, or any other media presentation or summary. 6. Individuals' statements to colleagues about professional services, research results, and products shall adhere to prevailing professional standards and shall contain no misrepresentations.

38 7. Individuals shall not provide professional services without exercising independent professional judgment, regardless of referral source or prescription. 8. Individuals shall not discriminate in their relationships with colleagues, students, and members of allied professions on the basis of race or ethnicity, gender, age, religion, national origin, sexual orientation, or disability. 9. Individuals who have reason to believe that the Code of Ethics has been violated shall inform the Board of Ethics. 10. Individuals shall comply fully with the policies of the Board of Ethics in its consideration and adjudication of complaints of violations of the Code of Ethics. Reference this material as: American Speech-Language-Hearing Association. (2003). Code of Ethics [Ethics]. Available from www.asha.org/policy. © Copyright 2003 American Speech-Language-Hearing Association. All rights reserved. Disclaimer: The American Speech-Language-Hearing Association disclaims any liability to any party for the accuracy, completeness, or availability of these documents, or for any damages arising out of the use of the documents and any information they contain. DOI: 10.1044/policy.ET2003-00166

39 SPEECH AND HEARING SCIENCES CLINICAL EVALUATION OF SUPERVISOR

Clinic name and course number______Term/Year______Instructor______

5 4 3 2 1 Strongly Agree Agree Somewhat Agree Disagree Disagree Strongly

1. The amount of time the supervisor directly observed was adequate. 5 4 3 2 1

2. The amount of time the supervisor met (individual/group conference session follow-up, etc. was adequate. 5 4 3 2 1

3. The supervisor was able to help me identify clinical strengths. 5 4 3 2 1

4. The supervisor was able to help me identify areas for growth and development. 5 4 3 2 1

5. Supervisory feedback enhanced my understanding of how I could be 5 4 3 2 1 helpful to my client over the course of the term.

6. Supervisory feedback was presented in a timely manner during the 5 4 3 2 1 term.

7. The overall performance of the supervisor was appropriate for my 5 4 3 2 1 needs this term.

Open Questions:

1. During this term, my clinical instructor was most helpful by:

2. In the future it would be beneficial for the clinical instructor to (suggest changes or modifications that the clinical instructor might make):

40 Speech and Hearing Sciences Clinical Practicum Student Evaluation

Student Supervisor

Site Term/Year

Clinical Level: Entry Primary Intermediate Advanced

Midterm Comments:

Midterm Grade

Final Comments:

Final Grade

41 Speech and Hearing Sciences Evaluation Grading Criteria

Please fill out the evaluation form according to the following guidelines. Determination of grades will include both the clinical level of the student and the student’s achievement of interpersonal and professional/technical competencies. The student level is determined by the information below.

Clinical Levels

Entry 0-25 hours completed Primary 25-50 hours completed Intermediate 50-150 hours completed Advanced 150+ hours completed

Grading Scale

7 Independently problem solves, shows initiative and performs competently 6 With limited discussion, problem solves, shows initiative and performs competently 5 Needs general direction with limited repetition or clarification 4 Needs general direction consisting of direct discussion with frequent repetition and further clarification of ideas 3 Needs specific direction, but no demonstration 2 Needs step-by-step review and/or demonstration 1 Specific direction from supervisor does not alter unsatisfactory performance and student demonstrates little or no improvement in clinical skills

Suggested Grading Guidelines

Level A B C (or below) Entry mainly 3-4 mainly 2-3 mainly 2 Primary mainly 4-5 mainly 3-4 mainly 2 Intermediate mainly 5-6 mainly 4-5 mainly 3 Advanced mainly 6-7 mainly 5-6 mainly 3-4

42 Interpersonal Scale Competencies 1 2 3 4 5 6 7 NA Objective I: Demonstrates Practices that Support Professional Excellence Perceives verbal and non-verbal cues which indicate the client is not understanding the task; is unable to perform all or part of the task; or when emotional stress interferes with performance of the task. Appears confident. Sufficiently free from concerns about own performance to focus effectively on the needs of the client Easily responds to unexpected events with appropriate comments or controls Uses professionally appropriate communication skills

Conveys a professionally appropriate appearance

Responds appropriately to family members’ feelings, concerns and questions Respects confidentiality of all professional activities

Appears to recognize own professional limitations and stays within the boundaries of training Prepares for supervisory meetings and actively participates by asking questions and generating ideas If mistakes are made in assessment or intervention is able to generate ideas of what might have improved the situation Receptive to constructive feedback; is not defensive

Requests assistance from supervisor and/or other professionals when appropriate Reliably keeps scheduled appointments and meets deadlines Functions effectively as a team member

Takes into account cultural and socioeconomic diversity in assessment and intervention and adapts when necessary

Professional/Technical Scale Competencies 1 2 3 4 5 6 7 NA Objective II: Conducts Effective Assessment Designs an appropriate assessment plan

Effectively and appropriately communicates with the family to receive input about concerns and potential goals Explains assessment procedures and rationales clearly and accurately

43 Administers and scores assessment tools accurately

Demonstrates appropriate flexibility during assessment Provides feedback confidently and in a professional manner using appropriate language Makes good use of informal assessment, including observation

Professional/Technical Scale (continued) Competencies 1 2 3 4 5 6 7 NA Objective II: Conducts Effective Assessment (continued) Interprets assessment results accurately

Develops appropriate and thorough recommendations

Integrates all available information to form an impression and diagnosis Objective III: Demonstrates Careful Thought and Planning Applies academic information to the clinical process and seeks information from outside sources to support assessment and intervention decisions Reads the client record and identifies the major issues of assessment/intervention; develops objectives for intervention Uses results from one session to adequately plan for the next Develops theoretically sound lesson plans describing objectives, procedures and target responses Selects appropriate stimulus materials for age and ability of client Objective IV: Conducts Effective Intervention Sessions Gives clear, concise instructions in presenting materials and/or techniques in intervention and assessment Modifies own communication according to the needs of the client Modifies procedures in response to client feedback or behavior Records and tracks client’s daily progress accurately

Uses time efficiently in the session to meet objectives and paces sessions appropriately Uses effective reinforcement and motivational techniques Provides accurate and immediate feedback to client

Listens actively to client

44 Addresses target behaviors in a hierarchical and systematic fashion Sets and enforces limits in a positive and non-rejecting manner to manage behavior Objective V: Demonstrates Clinical Writing Skills Presents assessment results and intervention objectives completely and accurately following required formats Lesson plans reflect an integrated understanding of the client’s performance Lesson plans are written with sufficient detail and reflect supervisory feedback SOAP/progress notes are written accurately and in a timely manner Writes with technical accuracy (e.g. grammar, style) and presents content in a logically sequenced and organized manner

45 Standard Precautions For Infection Control Student clinicians have an ethical and legal obligation to provide an atmosphere of safety for their clients, themselves, fellow student clinicians and clinic staff.

Routine adoption of aseptic procedures reduces the probability of disease transmission.

These procedures are to be followed by all student clinicians:

►♦◄Student clinicians will wash their hands thoroughly prior to and after each contact with clients. Students may use the washroom or the sink in the Clinic Lab for hand-washing. The prescribed hand-washing procedure is: Moisten hands completely with warm water and scrub vigorously with a liquid antibacterial soap. Lather hands, wrists and forearms. Rub vigorously, interlacing fingers. Rinse thoroughly, allowing water to drain from fingertips to forearms. Repeat entire procedure and dry hands with paper towels. ►♦◄Wash hands thoroughly after barehanded touching of inanimate objects likely to be contaminated by blood, saliva, or respiratory secretions. ►♦◄Toys and equipment need to be thoroughly disinfected after each use. ►♦◄Wear disposable gloves whenever contact with client body/fluid substances is anticipated. ►♦◄Dispose of gloves (inside out), tongue depressors and otoscope specula in the designated garbage can. ►♦◄Disinfect tables, doorknobs, chairs, and equipment following each clinic session. ►♦◄Notify clinical faculty or the clinic receptionist whenever urine or vomit need to be removed and the area cleaned. ►♦◄Student clinicians should not provide clinical services if they have a body temperature of 99.9 degrees or higher or if they have a bad cough, cold or other illness. ►♦◄Clients and their caregivers will be requested not to attend the clinic if they have a body temperature of 99.9 degrees or higher or if they have a bad cough, cold or other illness. ►♦◄Student clinicians should cover their mouth with their elbow or tissue when coughing. ►♦◄If a student has a concern about a contagious condition, they should contact their clinical supervisor or the Clinic Director. ►♦◄Any injuries that occur in the clinic area must be reported to the clinical faculty.