Service Delivery Resources  

Audiologists and SLPs experience increasing demand to demonstrate the value of their professional services while managing challenging caseloads. Remaining successful and relevant may require changes to your current model of service delivery regardless of your work setting. ASHA's Envisioned Future 2025 calls for a "continuum of service providers, including certified speech-language pathologists and audiologists, certified clinical specialists in speech-language pathology and audiology, and assistants/associates supervised by ASHA-certified speech-language pathologists and audiologists, consistently and fully utilized in service delivery." The topics below describe different solutions for achieving this vision. 

Top of the License 

Simply stated, practicing at the top of the license means the professional is practicing to the full extent of the license and engaging in only those clinical management activities that require the audiologist or SLP's unique expertise and skills. This has also been call "skilled delegation." Practicing at the “top of the license” (TOL) should increase efficiency while improving outcomes.

For SLPs, this may include using clinical expertise for decision making, for customizing the goals and intensity of treatment to the individual’s rate of progress, and using extenders to reinforce the individual’s developing skills.

For audiologists, this may mean delegating less-skilled tasks such as scheduling, packaging and mailing ear molds and device repairs, pure tone reassessment, preparing patients for testing and reserving highly skilled tasks that require expert knowledge and skills to the professional. 

Both audiologists and SLPs may find it necessary to enhance their supervision skills.

ASHA Top of the License Resources 

• Practicing at the Top of the Audiology License
• Using the International Classification of Functioning, Disability and Health to develop functional goals
• IDEA continuum of service delivery options including locations, frequency and duration of treatment sessions as well as consultations
• PACs: A Framework for Determining Appropriate Service Delivery Options
• Service Delivery Resource Sheet [PDF]

Assistants  

Audiology assistants and speech-language pathology assistants (support personnel) are not a new concept. Since the 1960s both types of support personnel have been used to varying degrees of regulation and success in the field of communication sciences and disorders. This area of supervision is often new and confusing for some audiologists and SLPs who have never worked with an assistant before and they often have many questions. Also, there is not a current national credentialing standard of education, clinical experience, or uniform regulation of support personnel. Indeed, part of the challenges in working with support personnel is knowing what activities are appropriate and inappropriate for the assistant to do in terms of clinical practice. However, new resources are continuously emerging and becoming more prominent each day. These resources are available now and will help even novice clinicians learn how to supervise audiology assistants and speech-language pathology assistants and maximize clinical management and workloads. 

ASHA Assistants Resources

• Assistants Certification Program 
• Speech-Language Pathology Assistant Scope of Practice
• Audiology Assistants (via ASHA Practice Portal, Professional Issues)
• Speech-Language Pathology Assistants (via ASHA Practice Portal, Professional Issues)
• Issues in Ethics: Audiology Assistants and Speech-Language Pathology Assistants
• Assistants Resource Sheet [PDF]

IPE/IPP

Audiologists and SLPs across service delivery settings had a history of collaborating with professionals from other backgrounds. However, with the trend toward reimbursement for outcomes rather than fee for services, clinicians are members of service delivery teams, with collective efforts focused on achieving efficient, high quality care and shared outcomes. ASHA has collected and developed resources to assist in developing competence in collaborative practice. 

ASHA IPE/IPP Resources

• ASHA’s resource center on IPE/IPP
• ASHA’s Strategic Pathway and You: Focus on Objective 2 
• Simulated Patients, Real IPE Lessons
• Interprofessional Practice (IPP) Resource Sheet [PDF]

Telepractice 

Individuals may not utilize needed audiology or speech-language pathology services due to barriers like:

1. distance from service providers,
2. limited access to transportation or caregiver assistance to travel to appointments, or
3. lack of qualified or specialized service providers.

Telepractice can increase access to clients, and allow greater flexibility in customizing the length and frequency of sessions to the client's needs. Clinicians need to develop knowledge and skills in telepractice to deliver services that ensure the quality service delivery.

ASHA Telepractice Resources

• Practice Portal: Telepractice
• State telepractice requirements 
• ASHA Store 
• Telepractice Resource Sheet [PDF]