Cross-Training In Dysphagia Still Unacceptable In times of personnel shortages or budget limitations, employers sometimes search for a quick and inexpensive solution. Not enough speech-language pathologists? The thought might occur to the employer to ask-or maybe even tell-SLPs to train other professionals to “do” their jobs. This pressure to cross-train has occurred in many settings ... ASHA News
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ASHA News  |   May 01, 2006
Cross-Training In Dysphagia Still Unacceptable
Author Notes
  • Nancy B Swigert, is a former ASHA president and coordinator of Special Interest Division 13, Swallowing and Swallowing Disorders.
    Nancy B Swigert, is a former ASHA president and coordinator of Special Interest Division 13, Swallowing and Swallowing Disorders.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / ASHA News
ASHA News   |   May 01, 2006
Cross-Training In Dysphagia Still Unacceptable
The ASHA Leader, May 2006, Vol. 11, 3-14. doi:10.1044/leader.AN2.11072006.3
The ASHA Leader, May 2006, Vol. 11, 3-14. doi:10.1044/leader.AN2.11072006.3
In times of personnel shortages or budget limitations, employers sometimes search for a quick and inexpensive solution. Not enough speech-language pathologists? The thought might occur to the employer to ask-or maybe even tell-SLPs to train other professionals to “do” their jobs. This pressure to cross-train has occurred in many settings related to different areas of practice. Several years ago, SLPs providing dysphagia services were experiencing just such pressure. They asked ASHA for a document that would help them address the problem.
In November 2003, ASHA’s Legislative Council (LC) [Speech-Language Pathology/Speech-Language Hearing Science Assembly] approved a resolution submitted by Division 13, Swallowing and Swallowing Disorders.
The resolution stated in part:
It is the position of the American Speech-Language-Hearing Association that speech-language pathologists (SLPs) should not train, via professional education courses or on-the-job training, or provide direct clinical supervision to individuals or groups of individuals from other professions in the delivery of evaluation and treatment for infants, children, and adults with swallowing and feeding disorders.
Members in clinical practice settings reported that the document was indeed helpful. However, when the ASHA CE Board operationalized the statement, the board developed a process that required CE providers to sign a form affirming their adherence to the Position Statement. When CE providers were offering courses to multi-disciplinary audiences (e.g. physicians, nurses, occupational therapists), they had to restrict attendance to SLPs if the course taught assessments or intervention techniques.
At the Division 13 business meeting in November 2005, there was unanimous support to draft a resolution to rescind the Position Statement based on the difficulties encountered by CE providers. The LC [Speech-Language Pathology/Speech-Language Science Assembly] approved the resolution and rescinded the Position Statement in March 2006.
This Legislative Council decision does not mean that ASHA endorses training by SLPs of others to deliver services in dysphagia. Indeed, many current ASHA policy documents clearly delineate ASHA’s views, including those listed below.
  • The 1997 Position Statement on Multi-skilled Personneladdresses cross-training. It states “cross-training of clinical skills is not appropriate at the professional level of practice.” The Glossary of Terms defines cross-training of clinical skills as involving “training practitioners in one discipline to perform services traditionally regarded as within the purview or scope of practice of another discipline in an attempt to more efficiently deploy the clinical workforce to meet the needs of the patient caseload as it fluctuates at any particular point in time”.

  • The 2001 Position Statement, “Roles of SLPs in Swallowing and Feeding Disorders states the SLP plays a “primary role in the evaluation and treatment of infants, children, and adults with swallowing and feeding disorders” and lists 12 appropriate roles for SLPs. The three roles regarding training are:

    • Teaching and counseling individuals and their families about swallowing and feeding disorders

    • Educating other professionals regarding the needs of individuals with dysphagia, and the speech-language pathologists’ role in the evaluation and management of swallowing and feeding disorders

    • Advancing the knowledge base on swallowing and swallowing disorders through research activities

None of these roles involves training others to provide dysphagia services. These and other ASHA documents provide guidance to members to advocate for provision of services by SLPs.
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May 2006
Volume 11, Issue 7