WORKING WITH PARAPROFESSIONALS IN YOUR SCHOOL
Related Services Paraprofessionals
A variety of non-instructional roles currently are performed by paraprofessionals in schools today. Under federal legislation, schools must ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living.
Related services may include health-care services, therapies, or psychological services according to the individual needs of students. These non-instructional roles have federal and state regulations reflecting specific standards. This issue of the NASET’s Working with Paraprofessionals in Your School addresses the unique aspects of supervising health assistants, paraprofessionals assisting with speech-language programs, and occupational and physical therapy assistants.
Health Aides or Health Assistants
IDEA stipulated that paraprofessionals and assistants may assist in providing special education and related services. Adequate supervision and training are required of health assistants just as they are with special education paraprofessionals.
According to French (2003), adequate supervision of paraprofessionals employed as health-care assistants includes three elements. They are:
- Training for all school personnel working with students who have health needs.
- Educating all school personnel regarding the legal limitations placed on them by the state’s nurse practice act.
- Providing job descriptions that clearly define the roles and responsibilities of all school personnel regarding the health needs of students.
Paraprofessionals Assisting with Speech-Language Programs
Due to the growing numbers of medically fragile children, children with multiple or severe disabilities, and children who receive homebound services, the demand for school-based, speech-language services is expected to continue to rise (ASHA, 1997). Additionally, federal special education laws (IDEA, 1997) and proposed new special education laws, mandate access to assistive technology for students in school, when appropriate. One way schools have responded to these changes is with the use of speech-language pathology assistants (SLPAs).
IDEA and state regulations specify as the responsibility of qualified providers:
- Evaluation
- Preparation of evaluation report
- Representation of speech-language services in evaluation, eligibility and IEP meetings
- Direct instruction of skills.
Further, an SLPA may not represent her/himself as an SLP.
The American Speech-Language Hearing Association (ASHA) recognizes the role of an SLPA as a person who can “perform tasks prescribed, directed, and supervised by ASHA certified speech-language pathologists (ASHA 2000). Direct and indirect supervision of SLPAs by speech-language pathologists expands the speech-language pathologists’ role as a service provider to include responsibility for the work of support personnel (ASHA, 2000). Supervision of these paraprofessionals requires a new knowledge base of the supervisory process by speech-language pathologists. ASHA (2002) has created a list of 17 specific skills required of a supervisor of SLPAs. Many of these skills parallel those of supervision for classroom supervision. The knowledge and skills required of supervisors of SLPAs are the ability to:
- Select and assign appropriate patients/clients to the SLPA
- Determine the nature of supervision that is appropriate for each SLPA
- Establish and maintain an effective relationship with the SLPA
- Direct the SLPA in following screening protocols
- Demonstrate for and participate with the SLPA in the clinical process
- Direct the SLPA in following individualized treatment plans that have been developed by the speech-language pathologist
- Direct the SLPA in the maintenance of clinical records
- Interact with the SLPA in planning and executing supervisory conferences
- Provide feedback to the SLPA regarding skills
- Assist the SLPA in effectively selecting, preparing, and presenting treatment materials and organizing treatment environments
- Share information regarding ethical, legal, regulatory, and reimbursement aspects of professional practice
- Model and facilitate professional conduct
- Direct the SLPA in the implementation of research procedures, in-service training, and public relations programs
- Train the SLPA to check and maintain equipment and to observe universal precautions
- Assist the SLPA in using appropriate language (oral and written) when interacting with patients/clients and others
- Establish a system of accountability for document use and supervision of the SLPA (ASHA, 2002).
ASHA also suggests the amount and type of supervision required should be based on the skills and experience of the speech-language pathology assistant, the needs of patients or clients served, the service setting, the tasks assigned, and other factors (ASHA, 1997). Guidelines created declare that the minimum amount of supervision is 30 percent weekly (at least 20 percent direct) for the first 90 workdays and 20 percent (at least 10 percent direct) after the initial work period. The guidelines also recommend that a speech-language pathologist supervise no more than three SLPAs.
According to ASHA (2003) a speech-language pathology assistant may conduct the following tasks under the supervision of a speech-language pathologist:
- May assist the speech-language pathologist with speech-language and hearing screenings (without interpretation)
- May follow documented treatment plans or protocols developed by the supervising speech-language pathologist
- May document patient/client performance (e.g., tally data for the speech-language pathologist to use; prepare charts, records and graphs) and report this information to the supervising speech-language pathologist
- May assist the speech-language pathologist during assessment of patients/clients
- May assist with informal documentation as directed by the speech-language pathologist
- May assist with clerical duties, such as preparing materials and scheduling activities as directed by the speech language pathologist
- May perform checks and maintenance of equipment
- May support the supervising speech-language in research projects, in-service training, and public relations program
- May assist with departmental operations (scheduling, record-keeping, safety/maintenance of supplies and equipment)
- May collect data for quality improvement
- May exhibit compliance with regulations, reimbursement requirements, and speech-language pathology assistant’s job responsibilities (ASHA, 2003, p. 5-6).
Occupational and Physical Therapy Assistants
As mandated in federal and state legislation, local educational agencies are required to provide occupational and/or physical therapy when the student needs the services to benefit from special education. Similar to responsibilities of other related service paraprofessionals, an occupational therapy or a physical therapy assistant provides therapy services to assigned students under the direction and supervision of a certified OT/PT.
Responsibilities of these personnel may include assisting a therapist in assessment, program planning, education, documentation, and service delivery. As with other paraprofessionals, the occupational and physical therapy assistants do not perform initial evaluations of student, develop a student’s IEP, or therapy plan.
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