Interview with Arlene Pietranton Ph.D., Executive Director, American Speech Language Hearing Association (ASHA)
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Beck:Good Morning Arlene. Thanks again for taking time to meet with me. For those not familiar with your background, I wonder if you would start by briefly reviewing your education?Pietranton: Sure Doug. All of my degrees are from George Washington University in Washington, DC. I earned my master's
Beck:Good Morning Arlene. Thanks again for taking time to meet with me. For those not familiar with your background, I wonder if you would start by briefly reviewing your education?
Pietranton: Sure Doug. All of my degrees are from George Washington University in Washington, DC. I earned my master's in Speech Pathology in 1976. I left the DC area for a few years and eventually took a position as Chief of Speech-Language Pathology and Audiology Services at George Washington University Medical Center in 1978. In 1993, I was awarded a PhD in Psychology from George Washington University.
Beck:And then in 1994 you joined ASHA?
Pietranton: Yes. I joined ASHA in 1994 as Director of the Health Services Division. From 1996 until 2003, I served as ASHA's Chief Staff Officer for Speech-Language Pathology and I became Executive Director of ASHA on January 1, 2004.
Beck:Arlene, I wonder what your thoughts are when you reflect back on your first year in office?
Pietranton:The first year was great. I had so much professional and personal support and I was really very pleased. I must admit, there was a definite learning curve, but overall, it's been a terrific first year and I thoroughly enjoyed it.
Beck: How many members does ASHA have, as of 12-31-2004?
Pietranton:There are about 115 thousand members and certificate holders in total...We have about 100,000 thousand SLPs, about 13 thousand audiologists, and the remainder are various speech and hearing scientists.
Beck:Arlene, which goals have you been working on?
Pietranton:Doug, as you'll recall, ASHA has specific organizational goals and initiatives, and in fact, there were four focused initiatives which we've been working on throughout 2004, and we have some new and continuing initiatives for 2005. The 2004 issues were: the Ph.D shortage, healthcare reimbursement, linguistically and culturally diverse populations, and the needs of professionals in the school setting (www.asha.org/about/leadership-projects/national-office/focused-initiatives/fi-04-default.htm). In 2005 we're continuing the focus on the PhD shortage and health care reimbursement and have added focused initiatives on evidence-based practice and personnel issues & IDEA personnel qualifications (www.asha.org/about/leadership-projects/national-office/focused-initiatives/fi-05-default).
Beck:Please tell me more about the ASHA initiative on evidence-based practice?
Pietranton:Our professions and ASHA have a long history of working on issues related to evidence - through research, scholarly publications, outcomes, etc. The focused initiative is an enhanced commitment to assuring that audiologists and speech language pathologists use an evidence-based approach to determine best practices and guide our clinical decision-making. In other words, that our practices and protocols, as used daily in clinics and offices, are based on rigorous statistical and scientific models that have been demonstrated to be effective.
Beck:That would be nothing short of fantastic! I have to applaud this effort as patients and professionals will benefit enormously from the incorporation of evidence based practices (EBP).
Pietranton:I agree. EBP will help better prepare clinicians for practice, and will help all clinicians maximize their time and management of patients with communication disorders. Members of ASHA will start to see a significant emphasis on EBP as we increase our activities and resources in this area via educational materials and information to better embrace these concepts. As you may know, there was a study some ten years ago, which stated that in general, across all clinical disciplines, only about 20 percent of clinical services are based on evidence. Maybe - and hopefully - that number has changed over the last few years, but the point is - clinical education and practice traditionally have not been based on evidence, and we can all do better in that regard. ASHA has created a new "Center for Evidence Based Practice in Communication Disorders" to coordinate these efforts, and a newly appointed Evidence-Based Advisory committee who will also play a pivotal role in advancing this effort.
Beck:That's a monumental step forward, and an excellent idea. Switching topics, would you please tell me your thoughts regarding the SLP-D, and why it is so slow to gather traction?
Pietranton:Doctoral education in audiology is moving ahead - by 2012 an earned doctoral degree in audiology will be required for the CCC-A. However, there are no current plans for a similar requirement for SLPs. I view the SLP-D as a viable degree, but unless a rigorous skills validation study in the future determines that a doctoral degree in SLP is needed, I would not anticipate ASHA supporting such a requirement. As you know, that determination was made a number of years ago for audiology, and audiology is now transitioning over a 10 to 15 year period of time.
Beck:So the determination as to whether or not SLP moves toward a mandated doctorate, is actually determined by the profession?
Pietranton:Yes, exactly right. If a methodologically-sound assessment of the knowledge and skills required to practice SLP determined that a doctorate would be necessary, I would predict that ASHA endorse such a requirement. However, the decision would have to be made based on such an assessment with credibility and integrity that indicate a clear cut need. But as you know is the case for audiology, the doctoral degree requirement applies to individuals applying for vs. maintaining their certification.
Beck:So it would be the same sort of transition as we witnessed with audiology?
Pietranton:I would expect that there would be many similarities. But again, this is all totally speculative and none of this has been required or mandated for SLPs as of 2005!
Beck:Arlene, before I let you go, if you could just spend a moment or two on IDEA 2004? I know there are some issues and problems there?
Pietranton:IDEA as reauthorized by Congress in November 2004 eliminated the requirement that state education personnel standards meet the highest requirement for a profession or discipline in that state. The new law also stipulates that school-based related services providers must not have had their certification or licensure requirements waived on an emergency, temporary, or provisional basis. We are concerned that this could lead to substantial variation in personnel standards among states. For example, those states that now waive certification or licensure requirements in school settings for related services personnel, including audiologists and speech-language pathologists, on an emergency, temporary, or provisional basis can no longer use such a waiver. These states may act swiftly to modify their personnel standards so that related services providers who now meet emergency qualifications can be given a full credential. Other states who have tried to lower standards in the recent past for other reasons may also act quickly before the U.S. Department of Education regulations potentially restrict their options. Still other states will take no action because they believe that their standards are in the best interest of their school children. ASHA has implemented a comprehensive plan to address possible challenges to speech-language pathology and audiology credentials required to provide appropriate speech, language and hearing services in schools. The plan provides for a series of strategic initiatives to: 1) collect data and information related to personnel issues and develop advocacy resources; 2) work with state associations to identify, outreach to and engage key stakeholders in advocacy efforts on these issues; and 3) collaborate with state associations to assist in providing the resources needed to deal with threats to reducing state certification and licensure requirements for school-based practitioner.
Beck:Thanks Arlene, I'm glad you mentioned that. The IDEA legislation in general appears to be a good and progressive thing, but the details do matter, and I appreciate your concerns in this regard.
Thanks so much for your time and energy Arlene. As always, it's a pleasure working with you.
Pietranton: Thank you too, Doug.
-------------------------
For more information, please contact the American Speech Language Hearing Association (ASHA). Visit the ASHA website at www.ASHA.org.
Pietranton: Sure Doug. All of my degrees are from George Washington University in Washington, DC. I earned my master's in Speech Pathology in 1976. I left the DC area for a few years and eventually took a position as Chief of Speech-Language Pathology and Audiology Services at George Washington University Medical Center in 1978. In 1993, I was awarded a PhD in Psychology from George Washington University.
Beck:And then in 1994 you joined ASHA?
Pietranton: Yes. I joined ASHA in 1994 as Director of the Health Services Division. From 1996 until 2003, I served as ASHA's Chief Staff Officer for Speech-Language Pathology and I became Executive Director of ASHA on January 1, 2004.
Beck:Arlene, I wonder what your thoughts are when you reflect back on your first year in office?
Pietranton:The first year was great. I had so much professional and personal support and I was really very pleased. I must admit, there was a definite learning curve, but overall, it's been a terrific first year and I thoroughly enjoyed it.
Beck: How many members does ASHA have, as of 12-31-2004?
Pietranton:There are about 115 thousand members and certificate holders in total...We have about 100,000 thousand SLPs, about 13 thousand audiologists, and the remainder are various speech and hearing scientists.
Beck:Arlene, which goals have you been working on?
Pietranton:Doug, as you'll recall, ASHA has specific organizational goals and initiatives, and in fact, there were four focused initiatives which we've been working on throughout 2004, and we have some new and continuing initiatives for 2005. The 2004 issues were: the Ph.D shortage, healthcare reimbursement, linguistically and culturally diverse populations, and the needs of professionals in the school setting (www.asha.org/about/leadership-projects/national-office/focused-initiatives/fi-04-default.htm). In 2005 we're continuing the focus on the PhD shortage and health care reimbursement and have added focused initiatives on evidence-based practice and personnel issues & IDEA personnel qualifications (www.asha.org/about/leadership-projects/national-office/focused-initiatives/fi-05-default).
Beck:Please tell me more about the ASHA initiative on evidence-based practice?
Pietranton:Our professions and ASHA have a long history of working on issues related to evidence - through research, scholarly publications, outcomes, etc. The focused initiative is an enhanced commitment to assuring that audiologists and speech language pathologists use an evidence-based approach to determine best practices and guide our clinical decision-making. In other words, that our practices and protocols, as used daily in clinics and offices, are based on rigorous statistical and scientific models that have been demonstrated to be effective.
Beck:That would be nothing short of fantastic! I have to applaud this effort as patients and professionals will benefit enormously from the incorporation of evidence based practices (EBP).
Pietranton:I agree. EBP will help better prepare clinicians for practice, and will help all clinicians maximize their time and management of patients with communication disorders. Members of ASHA will start to see a significant emphasis on EBP as we increase our activities and resources in this area via educational materials and information to better embrace these concepts. As you may know, there was a study some ten years ago, which stated that in general, across all clinical disciplines, only about 20 percent of clinical services are based on evidence. Maybe - and hopefully - that number has changed over the last few years, but the point is - clinical education and practice traditionally have not been based on evidence, and we can all do better in that regard. ASHA has created a new "Center for Evidence Based Practice in Communication Disorders" to coordinate these efforts, and a newly appointed Evidence-Based Advisory committee who will also play a pivotal role in advancing this effort.
Beck:That's a monumental step forward, and an excellent idea. Switching topics, would you please tell me your thoughts regarding the SLP-D, and why it is so slow to gather traction?
Pietranton:Doctoral education in audiology is moving ahead - by 2012 an earned doctoral degree in audiology will be required for the CCC-A. However, there are no current plans for a similar requirement for SLPs. I view the SLP-D as a viable degree, but unless a rigorous skills validation study in the future determines that a doctoral degree in SLP is needed, I would not anticipate ASHA supporting such a requirement. As you know, that determination was made a number of years ago for audiology, and audiology is now transitioning over a 10 to 15 year period of time.
Beck:So the determination as to whether or not SLP moves toward a mandated doctorate, is actually determined by the profession?
Pietranton:Yes, exactly right. If a methodologically-sound assessment of the knowledge and skills required to practice SLP determined that a doctorate would be necessary, I would predict that ASHA endorse such a requirement. However, the decision would have to be made based on such an assessment with credibility and integrity that indicate a clear cut need. But as you know is the case for audiology, the doctoral degree requirement applies to individuals applying for vs. maintaining their certification.
Beck:So it would be the same sort of transition as we witnessed with audiology?
Pietranton:I would expect that there would be many similarities. But again, this is all totally speculative and none of this has been required or mandated for SLPs as of 2005!
Beck:Arlene, before I let you go, if you could just spend a moment or two on IDEA 2004? I know there are some issues and problems there?
Pietranton:IDEA as reauthorized by Congress in November 2004 eliminated the requirement that state education personnel standards meet the highest requirement for a profession or discipline in that state. The new law also stipulates that school-based related services providers must not have had their certification or licensure requirements waived on an emergency, temporary, or provisional basis. We are concerned that this could lead to substantial variation in personnel standards among states. For example, those states that now waive certification or licensure requirements in school settings for related services personnel, including audiologists and speech-language pathologists, on an emergency, temporary, or provisional basis can no longer use such a waiver. These states may act swiftly to modify their personnel standards so that related services providers who now meet emergency qualifications can be given a full credential. Other states who have tried to lower standards in the recent past for other reasons may also act quickly before the U.S. Department of Education regulations potentially restrict their options. Still other states will take no action because they believe that their standards are in the best interest of their school children. ASHA has implemented a comprehensive plan to address possible challenges to speech-language pathology and audiology credentials required to provide appropriate speech, language and hearing services in schools. The plan provides for a series of strategic initiatives to: 1) collect data and information related to personnel issues and develop advocacy resources; 2) work with state associations to identify, outreach to and engage key stakeholders in advocacy efforts on these issues; and 3) collaborate with state associations to assist in providing the resources needed to deal with threats to reducing state certification and licensure requirements for school-based practitioner.
Beck:Thanks Arlene, I'm glad you mentioned that. The IDEA legislation in general appears to be a good and progressive thing, but the details do matter, and I appreciate your concerns in this regard.
Thanks so much for your time and energy Arlene. As always, it's a pleasure working with you.
Pietranton: Thank you too, Doug.
-------------------------
For more information, please contact the American Speech Language Hearing Association (ASHA). Visit the ASHA website at www.ASHA.org.