510 Notes on ASHA Certification, Licensure, Accreditation, CASA, and Program Structure

Certification and Licensure Landscape

• ASHA credentials and terminology

  • CCCSLP behind your name indicates you meet a set of standards defined by ASHA for professional certification (not a state license). This certification signals to the public, employers, and clients that you meet ASHA’s professional standards. $CCC ext{SLP}$
  • Licensure is a state-level requirement; it typically follows ASHA certification for master’s-degree SLPs, but the SLPA (Speech-Language Pathology Assistant) licensure landscape is not uniform across states.

• SLPA licensure reality across states

  • Licensure standards for SLPAs are “all over the place.” Some states require a SLPA license, some do not; variations include:
  • bachelor’s degree vs. associate’s degree plus fieldwork;
  • hours requirements (e.g., $24$ hours, or none);
  • additional credentialing or coursework requirements.
  • There is an expectation that licensure standards may align with ASHA’s SLPA certification in the future, just as master’s SLP licensure often aligns with ASHA CCC-SLP.

• Pathways and practical considerations for licensure

  • For master’s-level SLPs, CCC-SLP is often a pathway toward licensure, but having CCC-SLP is not always required to practice in a state (the license is what authorizes practice).
  • The CCC-SLP helps you obtain the license; you do not need the CCC-SLP to work in a state, but you typically need the state license to practice.
  • Are there pathways to licensure in states without the CCC-SLP? In most states, yes; in some states, no. Always consult the state’s licensing board.
  • How to find state licensure requirements: search for "SLP license" + state name (e.g., "SLP license New Mexico"). This is the quickest way to locate the regulation and licensing bureau requirements.

• State credentialing and school practice nuances

  • Some states will allow practice in schools with only a state license; others require a school credential in addition to the state license (e.g., in California and New Mexico).
  • California example: to work in schools you may need a teaching credential and a practicum in K–12 settings; some programs require K–12 public school experience to graduate to ensure licensure eligibility in that state.
  • New Mexico example: you must apply for a license to work in the school; a school credential may also be required.
  • Some Southern states still use older ASHA evaluation standards for school licensure (e.g., 25 hours in evaluation, 10 hours in stuttering, 15 hours in voice). These may be separate from state licensure standards.

• Practical steps for students planning licensure

  • Research your state’s licensure and school-credential requirements early.
  • Check if your program aligns with state standards and ASHA certification requirements.
  • When applying for a state license, you may be asked to demonstrate that you can practice under the state’s rules and, in some cases, under additional school-credential rules.
  • If your program is accredited, licensure processes are typically smoother; if not, ASHA may review your coursework to determine equivalency. Expedited review may apply for degrees from certain countries via inter-country agreements.

• ASHA accreditation vs. state licensure in practice

  • Accrediting bodies (CAA and CFCC) evaluate program compliance to standards; certification standards (CFCC) determine eligibility for CCC-SLP; state boards determine licensure for practice.
  • ASHA accreditation standards influence program design (e.g., clock hours, knowledge and skills outcomes) and provide a framework for what graduates should be able to do; state licensure governs actual practice in the given state.

Accreditation and Certification Bodies: Who Does What

• Two main bodies that govern professional education and credentialing
  • CAA (Council on Academic Accreditation in Audiology and Speech-Language Pathology): monitors program accreditation and compliance with program accreditation standards.
  • CFCC (Council for Clinical Certification in Audiology and Speech-Language Pathology): determines whether a graduate can obtain the CCC-SLP (clinical certification) and the eligibility for certification.
• What accreditation covers
  • The program must align its curriculum with CFCC and CAA standards, plus state requirements where applicable.
  • Accreditation standards cover multiple domains, including administrative structure, faculty qualifications, curriculum content, clinical education, assessment, and resources. A typical accreditation document can be extensive (e.g., 41 pages of rules and standards).
• Program-level standards and organization
  • Standard 1: Administrative structure and governance.
  • Standard 2: Faculty qualifications and composition.
  • Standard 3: Curriculum design and sequencing.
  • Standard 4: Academic and clinical education standards (speech-language pathology; audiology has its own sections but shares similar structure).
  • Standard 4A–4F: Detailed components within academic and clinical education, including prevention, assessment, intervention, ethical conduct, and research.
• The big nine knowledge and skills (foundational to CASA outcomes)
  • Intervention and professional practice competencies (including counseling skills and professional behaviors).
  • Foundations: knowledge and understanding underpinning practice.
  • Speech production, fluency and voice/resonance, language, hearing, swallowing, cognition, social aspects, AAC.
  • The mapping of content areas to standard numbers (e.g., speech sound production mapped to specific CFCC standards like CDIS 526; fluency to 525; voice to 513; language to 515/516; phonology to 511; morphology/syntax; assessment 515/516; intervention 517; and related areas like AAC at 531 and hearing at 531).
• How programs demonstrate compliance
  • Programs must provide evidence of how they meet these standards on an ongoing basis, including annual reports and six-year reaccreditation site visits.
  • Accreditation requires ongoing review of curriculum, pedagogical methods, and alignment with standards; ASHA visits the program to verify compliance.
• How this drives program structure
  • Curricula must be designed to cover knowledge and skills outcomes (CASA outcomes) and align with accreditation standards.
  • The plan of study, course sequencing, and clinical education experiences are structured to meet the big nine and the CFCC/CA standards, with explicit mapping to outcomes.

CASA: Knowledge and Skills Acquisition and Outcome Tracking

• What CASA stands for and why it exists
  • CASA stands for Knowledge and Skills Acquisition (ASHA terminology).
  • CASA outcomes define the knowledge and skills graduates must demonstrate; programs develop their own outcomes and map courses to these standards.
• CASA workflow and governance in the program
  • Each student is assigned a CASA checklist and has an annual/biannual review (typically March and October) to confirm which outcomes have been met.
  • Students receive CASA spreadsheets, showing which outcomes are met, in progress, or not met; students should check their CASA portions after each class and semester.
• Course-level outcomes and remediation
  • Each course syllabus lists outcomes; instructors send outcome-based communications (e.g., congratulations when all outcomes for a course are met, or remediation steps when a specific outcome is not met).
  • If an outcome is not met, students may enter a remediation process tied to the course and instructor instructions.
• Practical example: five-ten (5.10) outcome mapping
  • Outcomes are mapped to the “big nine” areas and to specific CFCC/ASHA standards (e.g., 5.10 mapping to a course’s admin/outcome).
  • Academic outcomes vs. clinical outcomes are tracked; the CASA system distinguishes between coursework outcomes (academic) and clinical practicum outcomes (CPSA).
• The role of faculty and staff in CASA
  • Faculty (including the course instructor and practicum supervisor) are responsible for marking outcomes as met, not met, or needing remediation.
  • The clinical supervisor notes CPSA outcomes, which include administrative behaviors and professional behaviors.
• Documentation and record-keeping
  • Students and instructors must preserve emails and documents confirming outcomes met; if a student is told they met an outcome, that communication should be saved for future reference (e.g., in case of record discrepancies).
• CASAs across different components
  • Academic outcomes: core knowledge and science prerequisites and course-based outcomes.
  • Capstone requirements: prevention activity, in-service in practicum, research conference presentation, and related academic activities.
  • Praxis/NESPA considerations: NESPA scores and caseloads may appear in degree completion checks.
  • Clinical outcomes: CPSA ratings, clinical lab outcomes, and practicum performance. These feed into the overall clinical competency and graduation eligibility.
• Remediation and consequences for clinical performance
  • CPSA scores are interpreted with thresholds. A scale may have categories such as: Always met, Consistently, Mostly, Occasionally, Not met, Never met.
  • If the clinical average across evaluation and treatment outcomes is 3.5 or higher, the competency is considered met; lower scores trigger remediation or potential grade penalties.
  • If a student has a remediation plan, it is mandated when scores fall into the 3.5–4.49 range; scores below 3.49 may result in a grade reduction and potential delay of graduation.
  • The “Letter of Reprimand” has been updated to “Letter of Improvement” to reflect remediation and corrective actions.
• The seven components of the CASA-tracked outcomes
  • 1) Academic outcomes (knowledge-based courses and prereqs).
  • 2) Clinical outcomes (CPSA, practicum performance).
  • 3) Capstone and professional activities (prevention activity, practicum in-service, research conference, etc.).
  • 4) NESPA/degree plan completion and Praxis-related elements.
  • 5) DEI/Professional practice elements (ethics and DEI training, now reframed as person- and family-centered or culturally responsive practice).
  • 6) Professional behaviors (accountability, ethical conduct, confidentiality, documentation).
  • 7) Case-based and portfolio-related evidence (outcomes demonstrated through case work and documentation).
• Practical use in the program
  • COSA outcomes are used to determine when a student is ready to graduate; completion of NESPA, CASAs, and all required outcomes is necessary for graduation.
  • If a student struggles in clinical areas, the clinical supervisory team may review CASA and CPSA records to determine if a remediation plan is needed.

Curriculum, Sequencing, and Program Structure: How It Fits Together

• Why the curriculum is sequenced the way it is
  • The program is designed to integrate coursework with clinical practicum (clinic interleaved with classes). Students may have class, then clinic, then more classes, and so on.
  • The sequencing aims to ensure practice-informed learning and to reinforce skills as you move through the program.
  • If students complete all coursework before practicum, the curriculum effectiveness can decline; thus, the program requires ongoing clinical experiences during the degree.
• Clock hours and hour-tracking specifics
  • The program tracks clock hours across the scope of practice and lifespan.
  • In-person hours are required (minimum is $250$ in-person hours).
  • There is a mix of in-person, simulated, and telepractice hours. Telepractice hours are allowed in some portions; simulation hours also count toward the clock hours.
  • Observation hours must be conducted with a cooperating institution; self-observation hours do not count. In-person observation hours must be clearly documented as such.
• The “big nine” and how they appear in the curriculum
  • The big nine areas (and related subareas) guide where content is placed in the curriculum:
  • Speech sound production (CDIS 526) – part of the articulation/phonology content.
  • Fluency – (CDIS 525)
  • Voice and resonance – (CDIS 513)
  • Language – (CDIS 515/516)
  • Phonology – (CDIS 511)
  • Morphology and syntax – integrated into language-related content.
  • Assessment – (CDIS 515/516, assessment-specific content)
  • Intervention – (CDIS 517) and related clinical practice
  • Speaking, listening, reading, writing – including AAC content (e.g., 531 for AAC)
  • Hearing – (531)
  • Swallowing and feeding – (CDIS 528; part of this overlaps with 511)
  • Cognition (Cog) – (CDIS 529, with limited overlap elsewhere)
  • Social aspects – distributed across multiple standards; DEI/cultural responsiveness content implements these in practice.
• DEI and related standards
  • DEI has been renamed in some contexts (e.g., person- and family-centered services or culturally responsive practice) but the accreditation standard requirement remains.
  • Programs teach DEI and culturally responsive practice to address diverse populations, second-language considerations, and cultural differences in testing and assessment.
• Knowledge and skills outcomes as a basis for curriculum design
  • The program must align its program of study with ASHA’s knowledge and skills outcomes (CASA outcomes).
  • Programs define their own course-level objectives to meet the CASA outcomes and track progress through the CASA matrices.
• Why biology, physics, and chemistry appear in the curriculum
  • ASHA standards require foundational sciences; certain sciences are required to fulfill these prerequisites (biology preferred over plant biology; physics/chemistry required; astronomy not on the approved list).
• The role of assessment, ethics, and contemporary professional issues
  • Standard four includes current knowledge, prevention, assessment, intervention.
  • Ethics and professional practice are integral, with required coursework in ethics and professional conduct.
  • Contemporary prep and professional issues appear in courses (e.g., 05:10 and 05:14/05:54 year references).
• The role of the program in demonstrating compliance to ASHA and state requirements
  • The program must explain its pedagogical methods to ASHA during annual reviews.
  • Programs must show how courses map to outcomes and how the curriculum meets both certification standards and state licensure expectations.
• Practicalities of reporting and site visits
  • Annual reports, six-year reaccreditation with site visits, and consultations with students (including input from students during reviews).

Practicalities for Students: Keeping Track and Preparing for Graduation

• How you are tracked and evaluated
  • CASA checklists are used to monitor outcomes across coursework, clinical experiences, and capstone activities.
  • Individual course syllabi include their own outcomes that feed into CASA; instructors confirm and communicate when outcomes are met or require remediation.
  • The program uses Calypso (or equivalent) to track clock hours, outcomes, and compliance with accreditation standards.
• Academic and clinical milestones toward graduation
  • Complete all required coursework with outcomes met.
  • Complete NESPA (or equivalent licensure exam) as required by the state and program.
  • Complete all CASA outcomes, including both academic and clinical components.
  • Achieve an overall competency average of at least $3.5$ across evaluation and treatment components in the CPSA framework for each practicum; if below, remediation may be required.
  • Obtain required capstone and professional activity credits (prevention activity, practicum in-service, research conference presentation, etc.).
  • Ensure all professional behaviors and DEI requirements are fulfilled and documented.
• What happens if something goes wrong
  • If an outcome is not met, remediation steps are triggered within the course and CASA, and progress is tracked.
  • If there is a pattern of difficulty (e.g., not meeting the 3.5 standard across practicum experiences), the clinical supervisory team may initiate a formal remediation plan.
  • In severe cases, a letter of improvement (formerly “letter of reprimand”) documents necessary corrective actions; repeated issues can impact graduation timing.
• Documentation you should keep
  • Save emails confirming outcomes met (these should be kept in a folder for future reference).
  • Maintain records of remediation plans and communications with instructors or supervisors.
  • Keep your CASA checklists up to date and review them regularly (e.g., twice a year via the March and October cycles).
• How to navigate state-specific licensing while in the program
  • Early on, research your state’s SLCP/SLPA/licensure requirements, especially if you intend to work in schools.
  • Look for state-specific practicum requirements (e.g., required K–12 practicum experiences in California) and plan coursework accordingly.
  • Be mindful of whether a school credential is required in addition to a state license in your target state; adjust your practicum experiences to align with those requirements.
• Instructor and class expectations for the upcoming week
  • Expect case-based in-class work (e.g., randomized group work on case studies) and pre-class preparation (e.g., reading a case prior to class).
  • Group activities help you build professional collaboration skills and practice applying knowledge to real-world cases.
  • Feedback will come in the form of group discussions, instructor-led debriefs, and post-class remediation or guidance.
• Practical examples used in class to prepare for real-world practice
  • Case scenarios such as:
  • I stutter and I have an accent: how to handle case with accent considerations in evaluation and treatment.
  • Managing articulation differences with craniofacial differences.
  • These cases are designed to address ASHA rules and client-centered practice, including whether and how to adapt services to meet a client’s needs while adhering to ethical guidelines.

Key Takeaways for Exam Preparation

• Understand the difference between ASHA certification (CCC-SLP) and state licensure, including how they interact and why both matter for practice.
• Be aware that SLPA licensure requirements vary by state and may require different credentials, hours, or practicum experiences.
• Recognize the role of accreditation bodies (CAA and CFCC) and how they influence program design, curriculum alignment, and graduation readiness.
• Know the CASA framework: knowledge and skills acquisition outcomes, how they are tracked, and how remediation and professional behavior are integrated into graduation readiness.
• Comprehend how curriculum sequencing ties to clinical education, clock hours, and the big nine knowledge areas.
• Be able to explain the Praxis/NESPA considerations and the impact of degree type and program accreditation on licensure timelines.
• Remember the practical steps for confirming licensure requirements in your state and how to align practicum experiences to meet school-credential requirements when applicable.
• Keep in mind the importance of documentation, communication with instructors, and proactive remediation to maintain progress toward graduation.
• Expect the class to include case-based activities that mirror real-world clinical decision-making, including ethical considerations and client-centered care.
• Finally, appreciate that the system is designed to ensure you are adequately prepared for licensure, certification, and practice, with multiple layers of review and accountability to support safe and effective service delivery.