ASHA uses the term speech-language pathology assistant (SLPA) to refer to one category of support personnel with a specific scope of practice (see Speech-Language Pathology Assistant Scope of Practice). The terminology used in the SLPA Scope of Practice may not be consistent with definitions used in individual states.

While ASHA endorses the use of trained and supervised support personnel, ASHA does not require the use of support personnel. Speech-language pathologists (SLPs) should not be expected to use support personnel, particularly if they feel that quality of service may be compromised. ASHA expects SLPs to use support personnel in accordance with the ASHA Code of Ethics and may impose sanctions on SLPs if assistants are used inappropriately.

SLPAs and supervising SLPs are required to determine the specific requirements in their respective work settings and states.  See ASHA’s State-by-State page for the Summary of State Requirements for Support Personnel.

Informing Consumers

SLPs must inform consumers when services are provided by support personnel.  See the Assistant Code of Conduct for more information.

ASHA Assistants Program

ASHA has established a program for support personnel in speech-language pathology and audiology.  See the Assistants Program page for more information and to learn about eligibility pathways.

Scope of Practice for Speech-Language Pathology Assistants

Supervising SLPs retain full legal and ethical responsibility for the students, patients, and clients served but may delegate specific tasks to an SLPA. The SLPA may execute specific components of a speech, language, or feeding program as specified in treatment plans developed by the SLP.

ASHA's Speech-Language Pathology Assistant Scope of Practice includes guidance on

• responsibilities within the scope of practice for SLPAs,
• responsibilities outside the scope of practice for SLPAs,
• appropriate practice settings for SLPAs,
• minimal qualifications for SLPAs,
• SLPAs as interpreters (also see ASHA's Practice Portal page, Collaborating with Interpreters, Transliterators, and Translators).

Ethical Considerations for SLPs and SLPAs

See the Code of Ethics for the ethical obligations of SLPs. See ASHA's Assistant Code of Conduct to guide certified assistants in their clinical practice and maintain the highest standards of integrity and ethical conduct. See Issues in Ethics:  Speech-Language Pathology Assistants to learn more about the responsibility of the SLP for duties performed by the SLPA.

SLPs may delegate certain tasks to support personnel, but the SLP retains the legal and ethical responsibility for all services provided or omitted.

At the same time, SLPs must ensure that they are providing SLPAs with appropriate supervision and are fully and timely complying with all ASHA certification and supervisory requirements. 

Liability Issues

The ASHA Speech-Language Pathology Assistant Scope of Practice addresses liability issues for supervising SLPs and SLPAs.  Individuals who engage in service delivery are potentially vulnerable to litigation.  SLPs and SLPAs should consider the need for professional liability insurance A benefit of the ASHA Associate Program is the ability to purchase liability insurance at a group rate through AMBA.

Educational and Training Requirements for SLPAs

See the 2020 Standards for ASHA Speech-Language Pathology Assistants Certification and Frequently Asked Questions:  Speech-Language Pathology Assistants (SLPAs) for information regarding general and technical education requirements, observation, and fieldwork experience.

ASHA maintains a list of self-identified technical training programs for SLPAs. Placement on this list does not indicate any endorsement by ASHA, nor is this list meant to be exhaustive.

Verification of Technical Proficiency of SLPAs

In addition to employer-provided assessment tools, ASHA offers a Speech-Language Pathology Assistant (SLPA) Skills Inventory [PDF]. This is a checklist that covers administrative and interpersonal skills as well as work setting conduct and clinical skills prescribed by the SLP.

Supervision of SLPAs

See the Speech-Language Pathology Assistant Scope of Practice for specific guidance for supervisors of SLPAs, including

• qualifications for a supervising SLP,
• minimum requirements for frequency and amount of supervision,
• guidelines for supervising SLPAs,
• SLP to SLPA ratio.

See ASHA’s Frequently Asked Questions:  Speech-Language Pathology Assistants (SLPAs) and 2020 Standards for ASHA Speech-Language Pathology Assistants Certification for additional information.

State/Federal Laws and Regulations

Regulations for speech-language pathology support personnel in educational and other practice settings vary from state to state. Differences may be reflected in a number of requirements, including education, supervision, continuing education, titles used for support personnel, or the lack of regulation or laws. See ASHA's State Support Personnel Trends chart [PDF].

ASHA's State-by-State page provides summaries of state requirements for support personnel. For the most current information, prospective SLPAs should check with the state licensure board and department of education for the requirements for specific practice settings.

Issues may arise when SLPAs or other support personnel practice across state lines. Their activity may not be recognized by various funding sources, and different states may not recognize the SLPA's credentials.

The Individuals with Disabilities Education Improvement Act of 2004 (IDEA 2004): Section 300.156(b)(2)(iii) of the IDEA 2004 "allows paraprofessionals and assistants who are appropriately trained and supervised, in accordance with State law, regulation, or written policy,...to be used to assist in the provision of special education and related services...to children with disabilities."

The Every Student Succeeds Act (ESSA) 2015, was designed to help disadvantaged children and allows the use of "properly trained paraprofessionals" who work under the direct supervision of highly qualified teachers and may be used to "reinforce and augment a teacher's effort in the classroom." The role and use of paraprofessionals is defined in this non-regulatory guidance paper [PDF] from the U.S. Dept of ED.

Reimbursement

The use of assistants can improve access to and reduce costs of quality services. It is appropriate to bill for the service provided.  Reimbursement practices vary by payer.  Please see ASHA's Frequently Asked Questions:  Speech-Language Pathology Assistants (SLPAs).

ASHA Resources

• Ad Hoc Committee on Supervision Report on Knowledge, Skills and Training Consideration for Individuals Serving as Supervisors [PDF]
• Frequently Asked Questions: Speech-Language Pathology Assistants
• Issues in Ethics: Speech-Language Pathology Assistants
• State Support Personnel Trends Chart [PDF]
• SIG 11's Perspectives
• SIG 16's Perspectives
• Supervision of Speech-Language Pathology Assistants
• California SLP-SLPA Team Forge Successful Partnership

American Speech-Language-Hearing Association. (n.d.) ASHA's Associate affiliation category. 

American Speech-Language-Hearing Association. (n.d.) ASHA state-by-state. Available from www.asha.org/advocacy/state/.

American Speech-Language-Hearing Association. (n.d.) Technical training programs for speech-language pathology assistants. Available from www.asha.org/assistants/SLPA-Technical-Training-Programs/.

American Speech-Language-Hearing Association. (2004). Support personnel [Issues in Ethics]. Available from www.asha.org/policy/.

American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics]. Available from www.asha.org/policy/.

American Speech-Language-Hearing Association. (2012 ). Model bill for state licensure of audiologists, speech-language pathologists, and audiology and speech-language pathology assistants. Retrieved from www.asha.org/siteassets/uploadedfiles/State-Licensure-Model-Bill.pdf.

American Speech-Language-Hearing Association. (2013). Scope of practice for speech-language pathology assistants [Scope of practice]. Available from www.asha.org/policy/.

U. S. Department of Education. (2004). Elementary and Secondary Education Act (ESEA). Available from www.ed.gov/esea.

U. S. Department of Education. (2004). Elementary and Secondary Education Act (ESEA): Title I Paraprofessionals Non-Regulatory Guidance. Retrieved from www.k12.wa.us/TitleI/TitleI/pubdocs/TitleIParaprofessionalsNon-RegulatoryGuidance.pdf.

U. S. Department of Education. (2004). Individuals with Disabilities Education Improvement Act (IDEA 2004). Retrieved from http://idea.ed.gov.

U. S. Department of Education. (2004). Individuals with Disabilities Education Improvement Act (IDEA 2004): Section 300.156(b)(2)(iii). United States Department of Education. Available from http://idea.ed.gov.

National Association of Medicaid Directors (NAMD).(n.d.) Retrieved from http://medicaiddirectors.org/about.

Acknowledgements 

Content for ASHA's Practice Portal pages is developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the SLP Assistants Practice Portal page:

• Jean L. Blosser, EdD, CCC-SLP
• Victoria L. Chesterley, MS, CCC-SLP
• Hilary A. Hardwick, MA/ME, CCC-SLP
• Linda Wortman Lowe, MA, CCC-SLP
• Rosemary Scott, MA, CCC-SLP
• Kathy J. Wheat, PhD, CCC-SLP

In addition, ASHA thanks the members of the Task Force on Support Personnel and the Working Group on Supervision of Speech Language Assistants whose work was foundational to the development of this content.

Members of the Task Force on Support Personnel were Dennis J. Arnst, Kenneth D. Baker, Ann Olsen Bird, Sheila Bridges, Linda S. DeYoung, Katherine Formichella, Nena M. Germany, Gilbert C. Hanke, Ann M. Horton, DeAnne M. Owre, Sidney L. Ramsey, Cathy A. Rummels, Brenda Terrell, Gerry W. Werven, Denise West, Patricia A. Mercaitis (consultant), Lisa C. O’Connor (consultant), Frederick T. Spahr (coordinator), Diane R. Paul (associate coordinator) and Ann L. Carey (Executive Board liaison).

Members of the Working Group on Supervision of Speech-Language Pathology Assistants were Elizabeth McCrea (chair), Laura Billetdeaux, Judy Brasseur, Deborah Carlson, Leisha Eiten, Anita Halper, Wren Newman, Jeanne Mullins, Lisa O'Connor and Diane Paul-Brown (ex officio). The monitoring vice president was Alex P. Johnson.

ASHA seeks input from subject matter experts representing differing perspectives and backgrounds. At times a subject matter expert may request to have their name removed from our acknowledgment. We continue to appreciate their work.

Citing Practice Portal Pages 

Recommended citation:

American Speech-Language-Hearing Association (n.d.). Speech-Language Pathology Assistants. (Practice Portal). Retrieved month, day, year, from www.asha.org/Practice-Portal/Professional-Issues/Speech-Language-Pathology-Assistants/.