What is the ASHA Clinical Fellowship?

The ASHA clinical fellowship (CF) is a mentored professional experience for aspiring speech-language pathologists. The purpose of a CF is to integrate and apply the knowledge acquired during schooling, while under the direct supervision of a licensed practitioner. In addition to executing and refining their skills, clinical fellows can use this experience to get a feel of what setting they’d be best suited to serve in or what population they’d like to work with.

Through a speech language pathology clinical fellowship, you can advance from a supervised practitioner to an independent one. Learn about more topics related to the ASHA Clinical Fellowship.

About the Speech Language Pathology Clinical Fellowship

As a speech language pathology (SLP) student, you’re working toward joining a group of highly-trained professionals in the field. These professionals work to evaluate and treat children and adults that have speech or language impairments. SLP students and graduates focus on communication sciences and disorders. While in school, they learn how to assess, prevent, diagnose and treat for speech and cognitive difficulties. 

After you have completed your academic coursework and clinical practicum, you can begin the ASHA clinical fellowship. So, you may start preparing for it before that by researching clinical sites or talking to previous fellows. ASHA grants the CCC-SLP certification upon successful completion of the speech pathology fellowship, and that certification is a sign to others that you possess the relevant skills, knowledge, and expertise to provide high-quality speech pathology clinical services. CCC-SLP stands for Certificate of Clinical Competence for Speech-Language Pathologists.

Tips on How  to Qualify for the ASHA Clinical Fellowship

To qualify for the ASHA Clinical Fellowship (CF), all academic coursework and supervised clinical practicum must be complete. Academic coursework includes prerequisite and core classes.

It is important to note that any professional experiences that took place prior to the completion of all academic coursework and your practicum, may not be applied toward your CF experience which should be a minimum of 1,260 hours

Once you have earned your master’s in speech language pathology and completed your speech language pathology clinical practicum, you can begin the fellowship application process. When you apply for your (CCC-SLP), you must pay your application fee and submit the following materials:

  • Praxis exam scores. The Praxis exam is a national exam that tests aspiring speech language pathologists on what they have learned in the classroom. It is an important component in determining an individual’s preparedness to practice as an SLP. 
  • Official graduate transcript. This must verify the date and degree awarded.
  • Your Speech-Language Pathology Clinical Fellowship (SLPCF) report and rating form. This detailed form contains basic information about your clinical site and your mentor. But most importantly, it is used to assess your mastery of 18 core skills for SLPs.    
  • Any disclosure forms or legal documents. These may be required if you answer “yes” to one of a few questions about criminal history on the CCC-SLP application.

How Long is the Speech Pathology Clinical Fellowship?

How long does it take to complete the ASHA clinical fellowship? Full-time clinical fellows should complete the fellowship in no less than 36 weeks. Part-time students may take longer than the 36 weeks to hit the required clinical hours. As a clinical fellow, you must complete your clinical fellowship experience within four years (48 months) or less from the date you begin your CF. 

Required Clinical Hours and Number of Weeks

As previously mentioned, the time it takes to complete the clinical fellowship depends on if you work with your clinical fellowship mentor on a full-time or part-time basis. Whichever option you choose—full-time clinical fellowship or part-time fellowship—the minimum hours required for the CF is 1,260. In the full-time CF, fellows complete 35 hours per week for 36 weeks, while the part-time fellows must fulfill at least 5 hours per week to be counted toward the 1,260 minimum hour requirement. 

Many students complete the full-time experience with one mentor in one location, but there are also those who may need or choose to complete their CF at multiple locations and with multiple mentors.  This option may be suitable for individuals seeking flexibility within their schedules. If a student requires multiple mentors and multiple locations, it may take longer than 36 weeks to hit all of the required minimum hours. However, regardless of the number of weeks it takes a student to complete the hours, they must meet both requirements for hours and time. 

Can You Work More than 35 Hours per Week?

While you can work more than 35 hours per week, it is not necessary. According to ASHA’s requirements, your clinical fellowship needs to span at least 36 weeks, and you must work at least 1,260 hours. There is no speeding up this process. 

What Happens During Your Clinical Fellowship Year (CFY)?

During the CF experience, a CF SLP demonstrates their ability to:

  • Apply theoretical knowledge in the field
  • Evaluate their strengths
  • Apply the ASHA Code of Ethics into their professional practice

They also have the opportunity to identify their limitations and refine their clinical skills. After a student shelves their books and heads out into the field, they have to spend at least 36 weeks, or even up to four years to meet all of the requirements for their ASHA certification.  

While students are generally required to fulfill direct clinical work as part of their graduate program in communication sciences and disorders, those hours do not count toward their clinical fellowship year (CFY) CF hours.

Eighty percent of a CF fellow’s workweek must be spent in direct contact with clients. This direct clinical contact must fit within the ASHA scope of practice in order for it to be counted as hours worked. The other 20 percent of the week must be spent doing other activities such as attending in-services or providing training and presentations for peers or patients.

All work completed must be done under the mentorship of a CCC-SLP certified mentor, and any travel, vacations, leaves of absence, or other forms of paid or unpaid time off cannot be counted in the number of hours worked per week. 

Your ASHA Clinical Fellowship Mentor

To begin your clinical fellowship, you need to find and secure your clinical fellowship mentor. To do this, you first need to ensure that the facility you choose to do your fellowship is able to provide you with the chance to evaluate or rehabilitate individuals with speech and language disorders. Once you have identified the location of your clinical fellowship, finding your clinical fellowship mentor should be your next step. 

Choosing a CF mentor can often be a challenging decision. You may want to target a mentor whose work aligns with your career goals or one you admire and feel comfortable working with. To help you find a suitable mentor in your area, you can reach out to past teachers or peers and ask their advice. You can also conduct research of your own. Once you do find your mentor, make sure they meet these requirements:

  • Hold a current CCC-SLP throughout the entire fellowship
  • You are not related to your mentor in any way
  • Your CF mentor must have nine months of full-time experience (or the part-time equivalent) working as a speech language pathologist after being awarded the CCC-SLP
  • Your CF mentor must have completed two hours of professional development in the area of supervision at least once in their career after being awarded the CCC-SLP

What Are the ASHA Clinical Fellow Responsibilities?

Clinical fellowship responsibilities must be complete to make a successful transition from student to practitioner. These responsibilities include:

  • Ensuring your CF mentor(s) meet the required qualifications to mentor. Your CF mentor(s) should provide a minimum of six hours of direct supervision and six hours of indirect supervision per segment. 
  • Verifying that the chosen CF setting provides the full range of services and opportunities to demonstrate and refine each skill as outlined in the clinical fellowship skills inventory (CFSI).
  • Contacting your state’s regulatory agency or licensing board for licensure requirements. Some states may grant CFs temporary or provisional licensure.
  • Confirming that at least 80 percent of your CF time will be spent on activities that are related to the management and care of people with speech and language disorders.
  • Verifying your new role within the company you work for. Clinical fellows can be full staff members or even interns. 
  • Submitting a written request to the Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC) if you need alternative supervision methods. Your CF mentor will assist you in drafting the request and you must have the request approved before you start starting your CF. 
  • Confirming that each individual setting (if you are working in multiple) can provide you with at least five hours per week.
  • Submitting a separate form for each CF setting/change. This is only necessary if you need to change any of your settings, mentors, or the number of hours you work after the CF has begun.

Direct Clinical Contact During Your Clinical Fellowship Experience

The scope of a speech language pathologist position can be broad. Depending on the trajectory of their career in speech therapy, an SLP can work collaboratively in a variety of SLP career settings, from hospitals to schools. Since SLPs fill positions within a wide range of settings, their speech pathology clinical hours ideally should reflect the range of positions and services they can offer. 

During their fellowship experience, fellows will be exposed to the following skills: screening, assessment and diagnostic evaluations, treatment, writing reports, family and client consultation and consulting and individualized education program (IPE) meetings, and others. Mentors will work with each CF and rate them based on their progress. They need to achieve a score of “3” or higher on each of the 18 core skills on the CFSI, in the final segment of the fellowship. 

1. Screening

SLPs have the knowledge and skills to treat hearing and communication disorders, and screening programs are an important part of the diagnosis process. This screening process enables SLPs to facilitate referrals for appropriate follow-ups and diagnosis. They can also use the screening process to:

  • Analyze, review and learn from existing records
  • Consult with peers or supervisors about screenings results

During the CF, an SLP must be able to independently and accurately match and adapt screening instruments and procedures to each patient they encounter. Once the screening is complete, they must be able to accurately interpret the results and make appropriate recommendations. 

2. Assessment and Diagnostic Evaluations

SLPs are adept at diagnosing communication and swallowing disorders and consider many factors during an assessment. Assessing patients involves evaluation of body function, structure, activity, and even context from a patient’s at-home or work environment. The assessment process can include behavioral observation, criterion-referenced tools, instrumentation, record and case history reviews, family and case history reviews, and even collaboration with other professionals.

During the CF process, the fellow must be able to independently select a comprehensive assessment for every person they encounter. When selecting an assessment and diagnostic evaluation, they must take into consideration all relevant factors and the results of the screening process. Typically, this assessment will target the specific areas of strength and weakness and provide an overall picture. The fellow must then be able to efficiently and accurately administer the battery and score tests accurately.

3. Treatment

SLP services are designed to help individuals improve their quality of life through their ability to communicate and swallow. Part of an SLP’s main job is developing and implementing treatment plans that address symptoms or concerns of communication, swallowing, or any related functional issues. Treatment plans identify the problem and establish a way an SLP can help the patient restore an impaired skill or ability. 

During the CF, a fellow must be able to independently and accurately establish an appropriate treatment plan for every patient. The fellow will develop specific and reasonable treatment plans that include both long-term goals and short-term objectives. This treatment plan will reflect the most appropriate learning sequences and identify the best ways to serve every patient. The treatment option will explore all areas of service and find the most effective method of delivery and treatment.

4. Writing Reports

Writing reports and following up on patient progress is crucial for an SLP. The SLP needs to write a variety of reports from diagnostic to progress or discharge plans. The vast amount of reports and data that needs to be captured by an SLP makes it extremely important that all SLPs have the skills and experience to communicate via the written word. All reports an SLP writes must clearly communicate performance progress and also provide documentation of any additional client-related issues. 

During the CF, a fellow must independently and consistently compile reports of everything they have completed for their patients.  While some case notes can be brief and informal, most reports and documentation styles must be written in a professional and appropriate technical style.

5. Family and Client Consultation and Counseling

SLPs counsel their patients by providing support, education, and guidance. Individuals and their families or caregivers work together with the SLP to learn and understand their loved one’s condition and next steps. Being open and empathetic during the counseling process may help an SLP build a strong rapport with their patients.

During the CF, each fellow must be able to independently present all of the information and data logically, accurately, and concisely. Working on both interpersonal and oral communication skills is very important for these meetings. During the consultation and counseling, the fellow should always use terminology and phrasing that is understandable and digestible by the audience but also be accurate and informative. 

6. Individualized Education Program (IEP) Meetings and Others

The Individualized Education Program (IEP) is a plan developed for every public school child who is eligible for special education. This plan details the support and services (such as speech therapy or additional reading instruction) that an individual school will provide to meet the needs of a student with a disability who qualifies for special education. 

After a student is identified as someone who qualifies for special education, an Individualized Family Service Plan (IFSP) is set up where a group of qualified people map out a written treatment plan that identifies all the EI services a child will receive, as well as how and when those services will be administered.

During the CF, a fellow will work with clients to develop IFSP and EL services. They will monitor their patient’s progress and collect and interpret the data accurately. From this information, the fellow will learn how this information can be used to effectively modify treatment plans, strategies, materials, and instrumentation to meet the needs of the client. 

Does the ASHA Clinical Fellowship Differ from State Requirements?

By definition, state licensure is a designation that is designed to protect the public from harm, and certification is documentation to assure the public that an individual has voluntarily met rigorous and reviewed standards that have been endorsed by a national professional body.

When it comes to certification, state requirements for speech-language pathologists vary by state. Before you begin the process to become a certified clinical SLP in your state, find out if you require a provisional or temporary license as a clinical fellow. Some states do not require this type of license and you may be okay to continue with the clinical speech pathologist fellowship under the guidance of your mentor. 

Aside from a potential temporary certification for the CF, most states require a clinical fellowship of at least 36 weeks and 400 hours of supervised clinical practicumSome states may require the speech-language pathologist certification to include a CCC-SLP or similar educational standards such as passing the Praxis exam. Once you meet all of your state’s requirements, a speech pathology license can be obtained.

However, before you begin the process to become certified, make sure you check all of the state requirements for speech language pathologists. You may need to take additional steps to become a certified SLP in your state and researching before you begin your application process for the ASHA CF may help you make the most of the experience.  

Information last updated June 2020

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