Newsletter
Volume 29 | 2006 | Number 3
Trends at the American Speech-Language-Hearing Association
By Barbara E. Esch
Speech pathology (SLP), as a profession, has been interested in behavior analysis for some time (see Koenig & Gerenser, 2006 for an historical review). Increasingly, speech pathologists are joining the Association for Behavior Analysis (ABA) and are dynamically participating in its activities. SLP involvement at ABA resulted in the 2005 establishment of the Speech Pathology SIG (www.behavioralspeech.com) whose mission, in part, is to promote dissemination of evidence-based practices to speech and language professionals.
ASHA
The American Speech-Language-Hearing Association (ASHA) is the professional organization for speech-language pathologists, audiologists, and speech and hearing scientists who practice in the United States and internationally. Through ASHA, members can access the credentialing process as well as address issues of interest and priority (see ASHA’s 2006 Focused Initiatives at http://www.asha.org/about/leadership-projects/national-office/focused-initiatives/).
SLP and ABA
Many speech pathologists, having already met rigorous standards for certification (i.e., Certificate of Clinical Competence), are additionally seeking a behavior analysis credential through the Behavior Analyst Certification Board (BACB; www.bacb.com). This implies a strong commitment to acquire accepted competencies in behavior analysis, to adhere to the professional standards of its community, and to work collaboratively with behavior analysts to enhance interdisciplinary services to consumers and advocates. As professional interaction between speech pathologists and behavior analysts has increased, it has become apparent that our mutual interests can be advanced by addressing several issues, variously articulated, but highly prioritized, by both ASHA and ABA.
1: Collaboration and Dissemination of Evidence-Based Practices
Professional collaboration is part of a multidisciplinary communication system supporting efforts to identify, prioritize, and solve complex research and clinical issues so that best practices are effectively disseminated. Such collaboration is promoted by ASHA in that it has established multiple venues (e.g., joint committees, special interest divisions, training modules, professional development events, practice documents, legislative and advocacy teams, policy initiatives, on-line public access) that provide opportunities and impetus for ASHA members to develop and extend communication with scientists and practitioners from disciplines related to speech pathology. However, for maximum benefit (ultimately to consumers), professionals must necessarily speak the same language, provide and accept opportunities for interaction, and objectively evaluate the efficacy of shared information. Notwithstanding the role for SLPs, these strongly interrelated issues provide valuable opportunities for behavior analysts.
Terminology
Persons outside the field of behavior analysis are largely unfamiliar with, or often misinterpret, its terminology. Although efficient for us, our verbal precision and parsimony may lack the redundancy or common usage needed for non-behaviorists to cross the intraverbal bridge or even meet us halfway. This is not to suggest that we dilute our science (indeed, we should continue to strive for clarity in articulating our theories and technologies), but, as others (e.g., Baer, 1991; Bailey, 1991; Schlinger, 2006) have pointed out, we have much to gain by perfecting the way we market it. To its benefit, ASHA has adopted many of the marketing strategies already proposed to our own profession (see Bailey, 2000). We should follow this lead, and that of other professions (e.g., medicine), and work for acceptance, not just among ourselves, but also throughout our entire consumer base (which includes related professions). This requires that we develop multiple, but equivalent, verbal repertoires and discriminations about the functions (i.e., utility for consumers) of these repertoires. In doing so, we are more likely to fulfill the charge set forth by Skinner (1948) to promote the welfare of all members of our culture and not just our own.
Interaction
Behaviorally-oriented speech pathologists have embraced the opportunity to promote empirical support for, and application of, a behavior analytic approach to communication disorders . At ABA 2005 and 2006, for example, members of the Speech Pathology SIG made 15 and 12 presentations, respectively. In contrast, SIG members reported having four proposals accepted for the ASHA 2005 convention; an acceptance rate that has been halved for the 2006 convention (held in November). Of the eight proposals submitted by SIG members to ASHA 2006, the two that were accepted cover functional assessment, Functional Communication Training (FCT), and computer-assisted instruction to facilitate picture exchange. Rejected proposals (n = 6) spanned a variety of behavioral topics such as verbal behavior analysis, errorless learning, teaching sign language through shaping, establishing the teacher as a conditioned reinforcer, replacing challenging behaviors (FCT), behavioral teaching strategies to improve joint attention and early language skills, and the use of shaping to teach requesting and echoic behaviors. It is unclear why particular proposals were rejected, but feedback from ASHA reviewers indicated unfamiliarity or difficulty with behavior analysis in terms of its theoretical underpinnings (e.g., [does not consider] the child’s ability to construct meaning from an experience; will evidence contrary to [these] views be provided), the current research base supporting behavioral practices (e.g., this is outdated information), and its treatment efficacy (e.g., this approach not widely held).
Although opinions may differ about the validity of this feedback, nevertheless, it provides us with useful information needed to effect change. The ASHA platform upon which to disseminate our work is an important opportunity, given its potential influence, and we would do well to strive for relevancy within this population. To that end, we offer a few suggestions: (1) continue to submit proposals to venues (e.g., conferences, product markets, publications, workshops) accessed by speech pathologists, (2) ensure proposals are user-friendly (i.e., informative for the reviewer audience) and maximally address review criteria, (3) establish ASHA-approved continuing education credits for speech pathologists attending ABA and ABA-related conferences, and (4) monitor ASHA’s Web site for priority issues that may present opportunities for professional interactions and contributions.
Efficacy
One of the challenges facing science practitioners today is how to define evidence-based practice (EBP). ASHA assists its members in considering this problem by providing a position statement (American Speech-Language-Hearing Association, 2005) as well as extensive references (http://search.asha.org/query.html?qt=evidence+based+practice) that allow members to connect with the current public discourse on this issue and to participate in forums that influence how EBP is defined. However, within this body of information, descriptions of single-case designs are notably absent, although the door is open for their inclusion (e.g., Dollaghan, 2004) and we have guidance and support for doing so (e.g., Horner et al., 2005). As a profession that has amassed an impressive research base demonstrating treatment efficacy through single-case experiments, we need to have a greater presence alongside other respected professional organizations (e.g., American Medical Association, American Psychological Association, ASHA) in this all-important public discussion.
2: Shortages
Certified practitioners
In the field of speech pathology, as in behavior analysis, the demand for qualified practitioners exceeds availability. ABA could assist speech pathologists in maintaining certification by offering ASHA CEUs at its conferences. This might also establish ABA events, in general, as more valuable for these professionals.
Ph.D.-level researchers
A ccording to ASHA, the number of skilled researchers investigating speech/language issues is not optimal (www.asha.org). This situation provides opportunities to promote research activities, perhaps interdisciplinary, by which behavioral experiments (and case studies) augment the empirical base currently available in speech and language.
Reimbursement
In some clinical areas (e.g., language instruction), there is considerable overlap in services provided by speech pathologists and behavior analysts. Thus, both have responsibility to support and clarify their services to consumers, healthcare insurers, and employers offering coverage plans. Professional organizations are well positioned to educate decision-makers about the efficacy and necessity of services provided by their members, thereby influencing demand for, and accessibility of, those services. ABA is far behind ASHA in this endeavor and the current healthcare marketplace makes it crucial for the profession to address this discrepancy.
3: Specialty Recognition
Professional credentialing organizations such as ASHA and BACB have begun to establish Specialty Recognition Programs that acknowledge an individual’s particular area of expertise within the organization’s professional scope of practice (see ASHA: http://www.asha.org/public/cert/gen_info.htm; BCBA: http://www.bacb.com/consum_frame.html). Currently, ASHA offers three such endorsements: child language, fluency, and swallowing. When available, the BACB Autism Specialty Credential will strongly underscore the credibility (i.e., value) of behavior analysts on interdisciplinary teams working to address this disorder.
References
American Speech-Language-Hearing Association (2005). Evidence-based practice in communication disorders [Position statement]. Available at http://www.asha.org/members/deskref-journals/deskref/default.
Baer, D. M. (1991). Tacting “to a fault.” Journal of Applied Behavior Analysis, 24, 429-431.
Bailey, J. S. (1991). Marketing behavior analysis requires different talk. Journal of Applied Behavior Analysis, 24, 445-448.
Bailey, J. S. (2000). A futurist perspective for applied behavior analysis. In J. Austin & J. E. Carr (Eds.), Handbook of applied behavior analysis (pp. 473-488). Reno, NV: Context Press.
Dollaghan, C. (2004, April 13). Evidence-based practice: Myths and realities. The ASHA Leader, 12, 4-5.
Horner , R. H., Carr, E. G., Halle, J., McGee, G., Odom, S., & Wolery, M. (2005). The use of single-subject research to identify evidence-based practice in special education. Exceptional Children, 71, 165-179.
Koenig, M., & Gerenser, J. (2006). SLP- ABA: Collaborating to support individuals with communication impairments. Journal of Speech Pathology-Applied Behavior Analysis, 1, 2-10.
Schlinger, H. (2006, May). Behavior analysis: All dressed up and nowhere to go. Paper presented at the meeting of the Association for Behavior Analysis, Atlanta, GA.
Skinner, B. F. (1948). Walden two. New York: The Macmillan Company.