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From: Lee
Date: 10/13/02
Time: 3:18:22 PM
Remote Name: 208.188.16.15
Hi Andy, Yes, the issue of ethics can be a real delima for school based SLP's and I sympathize with their position. However, referring a case to someone more qualified to treat a child who stutters does not necessarily mean someone outside of the school district. I believe excellent therapy for stuttering can be done and IS being done by many school based SLP's. You are a wonderful example of this. Not only are you providing outstanding therapy yourself you are providing in-service and internet opportunities for clinicians in the districts where you work. I assume that you are available for direct consultation and hopefully for referral as well. Allowing you to either consult or actually take over the case has very little fiscal impact on the district. Advocating for this kind of model is important. In fact I always encourage school districts to identify individual SLP's with specific interests or skills and provide them with the resources necessary to create district "experts" in various areas of speech and language. It seems to me that this is a win-win-win situation( district,SLP, student). I am fully aware that recommending a child receive services outside of a school setting or calling in a consultant that the school district has to pay for may put the clinician at odds with the administrators. However, this is a labor issue not an ethical one. I don't want to diminish the magnitude of what you are talking about. But I believe the labor issue should be addressed by your state and national associations. If a referral is indicated it should be based on what is in the best interest of the client/student not what is best for the school district or the clinician. Naturally, it would be best for the district if the services could be provided "in house" but that should not be the determining factor. The ASHA Rules of Ethics are very clear under "Principals of Ethics I" : A. Individuals shall provide all services competently. B. Individuals shall use every resource, including referral when appropriate, to ensure that high quality service is provided.
As I stated in the article we should applaud and encourage the efforts of individuals like yourself as well as those seeking continuing eduacation in the area of stuttering. We should also support those who choose to refer stuttering cases to others more qualified. In my opinion referral does not diminish the stature of the professional...it enhances it.