Elaine M. McNiece, Ed.D.
University of Central Arkansas
Good Morning. I am pleased to welcome you to the 21st Annual Meeting of the Council of Academic Programs in Communication Sciences and Disorders. It is indeed a privilege to address you as President of the Council. The focus of my comments this morning will be threefold. I want to encourage you to take full advantage of the opportunity afforded by this meeting to dialogue about issues of importance to you, your programs, and the discipline. Secondly, I wish to acknowledge the contributions of several of you to the activities and successes of the Council during the past year. And finally, I plan to summarize what I believe to be a few of the challenges and opportunities facing us as leaders in academic programs in communication sciences and disorders. At the close of my remarks, I am excited to be able to present the first Singular Publishing Group Scholarship.
Introductions and Acknowledgments
Again this year we have a record number of attendees, 302 to be exact. For those of you who are long-standing program representatives and participants in Council meetings, thank you for your continued support. You know to expect that the next three days will provide valuable information relevant to the challenges you face individually and what we need collectively as an organization. For the approximately ninety of you who are newcomers and particularly to those representatives of the six non-member programs that are here, I extend a special welcome. As first-time attendees, you are identifiable by the blue dot on your name tag to allow the rest of us to make a special effort to make you feel a part of the group. The group of individuals here is a potent collection of minds responsible for the future of our sciences and of our professions. Full participation in this meeting will provide access to the broad range of opinions and issues needed to make informed decisions and develop creative solutions to challenges posed by rapidly changing times.
Next, I would like to introduce and extend my appreciation to several colleagues with whom I have had the pleasure to work and from whom I have learned a great deal. The contributions of these individuals will be apparent throughout the meeting but I want to thank them collectively for the excellent work they continue to do on behalf of the Council and for their willingness to volunteer their time and wisdom to our efforts. Please stand to be recognized as I introduce you. First, I want to personally congratulate and thank the Program Committee: Gip Seaver, chair; Jane Lieberman, assistant chair; Jerry Carney, board liaison; and Mary Ambroe of the Council office. The committee has done an excellent job selecting and organizing the topics, issues, and presentations. They have assembled an outstanding group of speakers and presenters, discussion group facilitators, and recorders for this year's meeting. These individuals will be introduced to you as they appear on the program. More than 100 of you attended yesterday's preconference workshops for clinic directors and for programs directors which provided practical advice and solutions for some of our day-to-day problems. We have a record number of emerging issue topics scheduled on Friday afternoon and informative "How-to" sessions for Friday evening. The issues addressed this week are critical to all of us as we prepare for numerous changes impacting academe.
This past year of Council activities could not have been successful without the hard work of the Council Executive Board: Past President, Kim Wilcox; President-Elect, Jerry Carney; Secretary, Rick Talbott; Treasurer, Denny Nash; Chair of the Professional Development and Advocacy Committee, Jon Miller; Chair of the Information Exchange Committee, Linda Petrosino; and Chair of the Publications Committee, Trish Hargrove.
Other committee and working group chairs include: John Saxman, Standards and Credentials; Barbara Shadden, Archives; Maurice Mendel, Web Master and official Council photographer; John Ferraro, Honors and Awards; Brooke Hallowell, Working Group on Outcomes; and Harriett Gregg, Working Group on Diversity. You will hear more from these individuals during the next three days. Thanks also to Ro Scudder who was serving as Past President when I became a member of the Board. She has continued to provide support and wise counsel, for which I am very grateful. And last, but certainly not least, Mary Ambroe and Francis Levan of Executive Administrative Services. Their assistance is invaluable and their commitment to the Council exceptional.
I realize there is a risk that I will inadvertently omit someone, but there are individuals here from other organizations that I would like for you to meet. My apologies to any I do not mention. Would you also please stand as I call your name: NSSHLA representative, Beverly Straub; attendees representing ASHA's Executive Board and ASHA Boards and Committees related to higher education (several of whom are our own member program representatives); Donna Geffner, ASHA past-president; John Bernthal, President-Elect; Noma Anderson, Vice President for Academic Affairs; Jan Ingham, Vice President for Research and Technology; Lyn Goldberg, VP for Administration and Planning; Alex Johnson, VP for Professional Practices in Speech-Language Pathology; Jay Lubinsky, Chair, Council on Academic Accreditation; Arlene Carney, Chair of the Council on Professional Standards; Michael Flahive, Chair of the Academic Affairs Board; and Jean Blosser, SID 10 Chair. ASHA National Office personnel include Sharon Moss, ASHA Director of Research, Resources and Advocacy; Deborah Busccaco, Director of Academic Affairs; Vic Gladstone, Associate Director for Audiology; Tess Kirsch, Accreditation Program Manager; and from the American Speech and Hearing Foundation, Nancy Minghetti.
And finally by way of introductions, I want to offer a special thanks to our corporate sponsors whose generous support continues to make this meeting the successful event it is. John Butler, Senior Editor of Lippincott Williams & Wilkins, was the sponsor for the reception last night. Thank you John for your hospitality. Our morning break will be provided by a long time sponsor, the Psychological Corporation. The afternoon break will be sponsored by Prentke Romich Company, whose representative here is Teri Madak. Publication of the Proceedings of the meeting, of which you will each receive a copy, will be supported by Kay Elemetrics Corporation. Paul Arcell the National Sales Manager for Kay is here; thank-you, Paul. This evening, Dr. and Mrs. Sadanand Singh of Singular Thomson Learning have invited all of the Council attendees for dinner at their home in La Jolla. Those of you who were here for the Council meeting in 1996 know that a special treat and breathtaking view await us. Sadanand and Angie, we truly appreciate you. As many of you are aware, Singular Publishing Group is now part of a much larger company, Singular Thomson Learning of San Diego and New York. It is significant to note that at dinner tonight and in attendance this morning is almost all of the top management of Delmar, Greg Burnell, President and CEO could not get here because of the snow in Albany. Please stand and be recognized as you are identified: Mark Goldstein, Vice President and Chief Financial Officer; Nancy Roberson, Vice President of Publishing; and Bill Brottmiller, Director, Health Care Publishing. Singular's staff includes Marie Linville, Executive Editor, and Kathryn Little, Marketing Director.
All of our corporate sponsors will be available to talk with you throughout the meeting. During the emerging issues presentations on Friday afternoon, they will be available near their exhibits and in a round-table format in the foyer to answer your specific questions and demonstrate new products. Please join me in showing our appreciation for all our sponsors.
State of the Council
At this point in the president's remarks it is customary to present the traditional "State of the Council" address, a summary of Council initiatives and highlights for the past year. At the risk of disappointing you, I am not going to do it the way we have always done it. Instead, I refer you to the Status Reports and minutes of Board and Business meetings which you have received and are on the Council Web page. I invite you to listen carefully to the reports of officers and chairpersons this week and encourage you to dialogue with the individuals introduced earlier. I am sure you will be convinced that the Council has had a busy and productive year. Our membership continues to grow and expand with more undergraduate only programs and international programs. Our visibility and voice are strong, particularly as it relates to standards and credentials. We are expanding our advocacy efforts and our continued dialogue with ASHA and other related professional organizations has resulted in joint initiatives, where appropriate, that are mutually beneficial. We are well on our way to implementing the long-range plan presented last year as will be apparent when we discuss the proposed revisions to our Articles and Bylaws at the Plenary session on Saturday.
The bottom line is the "State of the Council" is strong, perhaps stronger, than ever. We are in an excellent position to provide leadership in securing the successful future as a discipline.
The Challenge of Change
Because we are here in California, a scenerio described by the authors of The Leadership Challenge (Kouzes & Posner, 1995) seems particularly appropriate. Printed at the top of a pamphlet describing a particular stretch of the Pacific Ocean was this warning, "Never turn your back on the ocean." Why can't we turn and look inland, to catch a view of the town? A rogue wave may come along when our backs are turned and sweep us out to sea, as it has many unsuspecting travelers. This warning offers good advice for travelers and academic leaders alike. When we take our eyes off the external realities, turning inward to admire the beauty of our own institutions and organization, we may be swept away by the swirling waters of change. We must always scan the external realities.
So rather than focus inward on our past successes, in the time I have remaining I want to mention some of the specific external realities we need to continue to discuss or to begin to address while we're here. Discussions focused on change are not new to the Council as the title or themes for our annual meetings reflect. Many here will remember that for three straight meetings we discussed issues related to the theme of Restructure. In fact, Restructure II was here in San Diego in 1996. It is clear that member programs have, in fact, been changing. But there remains much to be done. Knowledge of change forces has been and continues to be critical to the development of any action plan for preparing personnel for the 21st century. I raise questions which are far from resolved. We must continue to search for answers to the following:
(1) Doctoral Entry-Level in Audiology. How will we transition to the doctoral level entry in audiology while simultaneously insuring educational access and individual program flexibility? The position of the Council has been clear and reaffirmed several times, but the reality is that collectively we must move forward. This is not a challenge to be shouldered only by AuD programs. There are questions for us at all levels of the educational continuum. Can we develop consortia arrangements so that students with undergraduate degrees in communication sciences and disorders will still have reasonable and affordable access to graduate programs in audiology? Will Au.D. programs further shrink the number of individuals entering Ph.D. programs in audiology/hearing science? Will an institution such as mine, that offers only programs in speech-language pathology, be able to hire a person with a terminal degree in audiology, a requirement for graduate faculty and tenure-track appointment? My own institution offers both a DPT (doctorate of physical therapy), the professional entry-level degree, and the Ph.D. in physical therapy; thus, our Graduate Council members clearly understand the distinction between entry-level and terminal degree designators and would not approve for graduate faculty status an individual who meets only the entry-level standards for a profession. In the past we have hadsome success in encouraging and supporting master's level audiologists to return for a Ph.D. Will it be possible to convince someone who holds an entry-level AuD to return to school for a terminal Ph.D? Creative out-of-the box thinking is clearly needed. Maybe a model similar to the MD/PhD used in some medical schools would provide an alternative.
(2) Shortage of Teacher-Scholars. What specific strategies can be developed to address the shortage of available teacher scholars in communication sciences and disorders? This has reached a national crisis that threatens our ability to replenish the professoriate. Again, the problem obviously impacts us all, but the solution should also be our joint responsibility. Promising students in all of our programs should have preparation and opportunities to participate in meaningful research and be encouraged to consider a career as a teacher scholar. If we heeded the plea from Hockberg (1996), Minifee (1997), Alfonzo (1997), Wilcox (1997) and numerous others in the past to deprofessionalize the undergraduate curriculum and strengthen the scientific bases of that curriculum, would we increase the pool of individuals interested in joining the academy?
(3) Third-Party Reimbursement Issues. How will we position ourselves in the future to respond to external factors, such as reimbursement trends, which have impacted the educational preparation of our students? At this meeting last year clinic directors were reporting serious difficulties in obtaining quality practicum placements, especially in adult rehabilitation settings and skilled nursing facilities. Although the magnitude of the problem was diminished with a temporary moratorium on the $1500 cap, the fact remains that current economic and societal trends will increase rather than decrease the challenges we face. Can faculty, clinical supervisors, prospective employers and students work collaboratively to develop new models for effective clinical practicum? The ASHA Academic Affairs Board is asking the question, "Can we use technology to establish virtual experiences as a portion of the practicum?" We must not wait until the next crisis to develop strategies for change.
(4) Skills Validation Study in Speech-Language Pathology. A skills validation study for the profession of speech-language pathology was conducted in 1997 for ASHA by the Educational Testing Service (ETS). The purpose of the study was to identify and document the clinical activities and knowledge areas judged to be important for the "competent" performance of newly certified speech-language pathologists. As part of the study a survey was sent to educators (i.e., academic and clinical program directors), practicing speech-language pathologists, clinical fellowship supervisors, and clinic directors in health care delivery programs. More than 2,800 speech-language pathologists responded to the survey. While there was considerable agreement among the respondents regarding the importance of clinical activities and knowledge, there was a significant discrepancy between the perceptions of educators and practitioners as to where and when students are and should be acquiring the knowledge and skills. Practitioners, clinical fellowship supervisors, and clinic directors believed that the majority of clinical activities and knowledge areas should be learned in graduate school but were not. Educators, on the other hand were satisfied with the knowledge and skill levels of our graduates. Employers expect the new professional to "hit the ground running" regardless of how much the scope of practice is constantly expanding; while we in the academy, perhaps, believe we are educating students to be life-long learners with the skills to access, understand, and apply new knowledge (ASHA, 2000). After all, as Celia Hooper pointed out last weekend, language disorders wasn't invented when she and I were in graduate school. That actually made me wonder, do you think in their graduate programs that John Bernthal or Nick Bankson had a course in phonological disorders or that Jeri Logemann had a course in swallowing disorders? The current environment does not allow the learning curve that many of us enjoyed. It seems to me we have two choices. We can continue to expand and lengthen our training programs or we must develop a clearer understanding and communication between educators, our students, and the employers of our graduates concerning the aspects of professional education and training that are to be provided by each group. There must be shared responsibility for the entire continuum of professional development.
(5) Registry of Speech-Language Pathology Assistants and Approval of Technical Training Program for Assistants. Proposed guidelines for registration of speech-language pathology assistants and an approval process for technical programs designed to prepare them was distributed by Standards Council for side-spread peer review. It is my understanding from Standards Council members that more comments were returned in this review than any other in the history of Standards Council, with many comments expressing opposition to the use of assistants at all. The proposed guidelines clearly delineate a position that is not a part of the career ladder in the profession but one of technical support. If one reads the comments carefully, it is clear that the role described by Standards Council was not clearly understood by the respondents. Is that because 51% of our undergraduate programs continue to graduate students who receive a professional credential at the undergraduate level? Some of the states from which a large number of negative comments were received were those that continue to have bachelor's level practitioners working independently in the schools. There is clearly a need for a paradigm shift for many. The comments reminded me of the attitudes of speech-language pathologists in my own state of Arkansas in 1994 when we changed our licensure law to regulate support personnel. Our licensure law was being threatened by school superintendents because of a severe shortage of personnel in the schools and the state association board felt that allowing support personnel was our only recourse to preserve the master's entry level standard. We did so with tight control by our Licensure Board. The fears of many of my Arkansas colleagues simply did not materialize and negative perceptions have dissipated. In fact, between 1998-99 and this academic year, when many individuals were taking jobs in schools because of a decline in positions in health care, the number of speech-language assistants employed decreased 30% as qualified providers were available. Assistants have not replaced the qualified providers as was feared. The Licensure Board Chair reported that only one to two complaints have been received annually concerning the use of assistants. Following investigation, all were deemed to be the result of insufficient documentation rather than abuse. But many question remain. What role, if any, will academic programs play is preparing speech-language pathology assistants? Will academic programs include enough academic coursework and practicum experience related to supervision so that professionals have the knowledge and skills needed to effectively utilize support personnel to enhance patient care?
(6) New Certification Standards in Speech Language Pathology. Representatives of our Council have been actively involved in restructuring the accreditation process and accrediting bodies for nearly a decade. The result of the changes in the accreditation structure has given programs more flexibility to meet the current and future educational needs of students. In 1995, John Ferraro pointed out that it was incumbent on us to become equally involved in issues related to certification to insure the development of certification standards to accommodate the changes in accreditation. Less than two weeks ago, the proposed standards for the Certificate of Clinical Competence in Speech-Language Pathology was approved for peer review by the Council on Professional Standards in Speech-Language Pathology and Audiology. The new standards are what we asked for. The proposed standards increase the focus on outcome measures of academic experiences rather that the process measures of counting course credits. There is a focus on knowledge acquired at the introductory level and using higher-order thinking skills with demonstrated skills in oral and written communication and knowledge of research principles and ethical, professional, and regulatory issues. Practicum experiences must encompass the current Scope of Practice but there are no specific clock-hour requirements for given disorders or settings. Continuing education or academic course work is required for maintenance of certification. A combination of formative and summative assessment for the purpose of improving and measuring student learning is required. Arlene Carney, Chair of Council on Professional Standards has furnished us with a copy of the proposed standards and she will hold an emerging issues session to discuss them on Friday afternoon. As we break for lunch today we will distribute copies of the standards and review form. I urge you to review the document and join in the debate. Respond to the call for comments and encourage your faculty to do likewise. The new standards provide us with the opportunity for program redesign, to reconceptionalize the master's degree in speech-language pathology to develop critical thinking and foster independence, not dependence of our students. The change will not be an easy one. As the writer Christopher Morley said, "There is no squabbling so violent as that between people who accepted an idea yesterday and those who will accept the same idea tomorrow" (Kotter, 1996).
I offer a final challenge to you. For my first few months as Graduate Dean, in answer to almost ever question I asked (and as you have seen, I do ask lot of questions) "That's the way we've always done it" was the standard answer. I quickly came to detest that phrase and in a bold leadership move, I banned its use from our vernacular in the Graduate School. I challenge you to adopt my "no tolerance" policy when it comes to TTWWADI. That's the way we've always done it.. Presenters to Legislative Council last weekend summed up my feeling on the subject, "If you always do what you always did, your always gonna get what you always had" (Lea & Dea, April, 2000). While it is natural and understandable for people to resist change, the environment of today and tomorrow will be most rewarding to those who embrace and master the change process (Fullan & Stiegelbauer, 1991). I concur with Hockberg's assertion to this Council in 1996 that nothing less than bold, courageous and imaginative action for substantive change will do.
(Dr. McNiece presented the Singular Scholarship for Technology Innovation following her Presidential Address. The text of that presentation can be found in the Honors and Awards Section. )
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