Ethics in Speech-Language Pathology – Study Notes
Attendance and Session Overview
Instructor notes that students should log attendance and that today’s session focuses on ethics with a collaborative learning activity coming later in the session. No graded submission is required today; group work and discussion only.
Reflections are weekly but are not submitted yet. The first submission of reflections (for weeks –) will occur in week along with other class submissions beyond the syllabus acknowledgment.
No quiz or formal assessment for today; purpose is preparation for collaborative activity.
Preparation and Resources for Today
Pre-reading task: read the ASHA Code of Ethics to prepare for the collaborative activity. The instructor emphasizes you do not need to memorize all details; know where to find accurate information when needed.
Practical tip: save/download the ASHA Code of Ethics and keep it accessible; the instructor keeps a copy on the bulletin board to reference in cases of potential ethical issues. This emphasizes the importance of accessibility to the document.
Where to find documents: resources section in Canvas, under Seminar Resources, which links to Google Drive containing the relevant documents.
Rationale: ethics topics can affect licensure and professional credentials; a single egregious violation can jeopardize credentials and career prospects.
Core Ethical Concepts and Sanctions (Overview)
Ethical violations can trigger sanctions from ASHA and/or state licensure boards; it’s important to verify information rather than rely on informal advice.
Guarding your professional investment is essential: it takes time, money, and credibility to maintain licensure and credentials.
The aim of ethics discussions is to protect clients, uphold the integrity of the profession, and maintain public trust.
The ethics discussion connects to broader professional expectations: presentations, publications, and avoiding behaviors that would harm reputation.
Confidentiality, Social Media, and Representation of Credentials
Social media risks:
Breach of client confidentiality if client details or identifiable information are posted (e.g., discussing a client’s behavior or family details). This could reveal the client’s identity and violate confidentiality.
Misrepresentation of credentials or expertise: claiming CCCs or other credentials before officially receiving them from ASHA is considered misrepresentation.
Defamation: avoid posting negative statements about colleagues or clients; once posted, content can be screenshotted or shared widely and cannot be fully controlled.
Practical guidance:
Do not post about clients or coworkers in a way that could identify them.
Do not present yourself as a credentialed clinician if you have not yet obtained the credential (e.g., “CCC” before official notification from ASHA).
If you need to vent or express concerns, write it privately and delete it; avoid public posting.
Real-world example discussed: social media misuse could lead to ethical violations and enforcement actions.
Documentation, Billing, and Practice Management Ethics
Documentation lapses are a common ethical risk: failing to document progress, data, and IEP outcomes can constitute ethical violations.
Billing for services not rendered is both unethical and illegal; ensure that billing reflects actual services provided and accurate documentation.
Data and progress notes: ensure accurate data (e.g., progress percentages) and avoid fabricating or altering records; a snowball effect can occur if data are not kept up-to-date.
Reimbursement and productivity expectations: some settings have productivity requirements; failure to meet these could result in adverse outcomes, including terminations.
Client abandonment: leaving a client without ensuring continuity of care or providing referrals and a discharge plan constitutes client abandonment; document referrals and provide a handoff list or home program when possible.
Continuity of services: when resigning or moving, provide a referral list and, if possible, a transition plan to maintain service continuity; document communications and obtain client acknowledgment of discharge materials.
Documentation practices when leaving a caseload: keep copies of documents (two copies of important communications) and retain electronic copies for several years.
Ethical implications: billing for non-rendered services and inaccurate discharge documentation undermines clinical integrity and can trigger sanctions.
Supervision, Mentoring, and Credentialing
Supervision: some SLPs may under-supervise CFs, SLPAs, or graduate students; supervision is an educational process and should not be treated as free labor.
Fellowship and mentoring: these processes have ethical expectations and supervisory requirements; ensure proper oversight and compliance with standards.
Credentialing clarity: ASHA credentials (e.g., CCC) are earned, not assumed; do not advertise or practice under credentials you have not been officially granted.
Licensure timing: you must await official notification of licensure or credential grant before practicing under those credentials; do not begin working based on mere application status.
Ethical implications: misrepresenting credentials can lead to sanctions and harm professional reputation.
Self-Reporting and Disclosure
Self-reporting requirement: if you have a felony, misdemeanor, or disciplinary action by another board, you must self-report to ASHA and/or state boards.
Consequences of failing to self-report: ASHA can discover through platforms that list licensure boards; failure to disclose can result in sanctions.
Illustration: a driver’s license-related issue (e.g., speeding) may or may not require self-disclosure depending on severity; more serious offenses (e.g., reckless driving) could require disclosure if they pertain to professional duties.
Practical advice: be transparent about issues, as self-disclosure can mitigate consequences; do not try to hide information.
Example discussed: a participant’s speeding could have required self-disclosure depending on jurisdiction and circumstances; the instructor emphasizes caution and honesty.
Ethical Decision-Making Model (ASHA-aligned)
Core idea: use a structured, common-sense approach to resolve ethical dilemmas.
Steps highlighted in the discussion (10-step process mentioned):
. Identify the problem or dilemma
. Determine the issues involved
. Review relevant ethical guidelines (ASHA Code of Ethics, state licensure rules)
. Consult with others while maintaining confidentiality (avoid sharing identifiable information)
. Use your gut reaction/check internal sense that something is wrong
. Consider possible courses of action
. Consider consequences of each course of action
. Make a decision
. Implement the decision
. Evaluate the outcome
Practical note: ASHA’s Board of Ethics is not a legal body; they assess ethical issues and can refer matters to licensure boards or prosecutors when appropriate.
The aim is to protect the public and maintain the integrity of the profession; decisions should be guided by both ethical guidelines and practical consequences.
ASHA Board of Ethics Decisions and Sanctions (Overview)
Purpose of sanctions: to educate, protect the public, and inform others about professional conduct and accountability.
Public perception: disciplinary actions can impact professional opportunities, including private practice prospects; reputation is critical in the field.
Sanction types (from ASHA Board of Ethics):
Reprimand (private): confidential; disclosed only to board members, complainant, and respondent.
Censure: public disclosure in professional communications (e.g., ASHA Leader magazine); name and sanction publicly noted.
Suspension: temporary loss of credential; eligibility to practice may be limited during the suspension period; re-entry requires meeting conditions and dues.
Revocation: permanent loss of credential; typically a lifetime loss of certification.
Withholding: denies credentialing or certification intake; used for students or applicants with unresolved issues; discretion based on context.
Cease and Desist: if misrepresentation or uncredentialed practice occurs, ASHA can demand stopping the activity.
Jurisdiction and overlap: ASHA decisions can influence state boards; some cases may escalate to the Attorney General depending on the severity and nature of the violation.
Public awareness: some sanctions become visible in public-facing publications (e.g., ASHA Leader) or licensure board releases.
Examples of Board Decisions and Sanctions (Illustrative Cases)
Billing for services not performed: a case where therapy sessions were billed but not provided; sanctions and membership consequences reported by state board.
Inappropriate client contact: conversations with a client that violated confidentiality; link to public decisions.
Medicaid overbilling: a clinician billed Medicaid for services provided to many recipients beyond reason; heavy penalties likely including loss of credential or long-term suspension.
Client abandonment: leaving a client without proper discharge documentation or referral; sanctions may include revocation or long-term suspension depending on severity and documentation.
Theft or fraud in billing: cases involving falsified documentation, forged signatures, and obtaining fees by fraud; severe sanctions including potential revocation.
Impaired practitioner: cases involving health or mental health impairments that affect clinical duties; corrective action and sanctions pursued.
One-session billing case (Virginia example): a practitioner billed one session that was not provided and submitted false discharge paperwork; highlighted as a particularly shocking example due to intentionality and documentation falsification; demonstrates the importance of accurate record-keeping and the serious risk of sanctions.
Takeaway: even single cases of incorrect billing or falsified records can lead to significant sanctions; emphasize meticulous documentation and audit trails, and proactively correct mistakes when discovered.
Group Collaborative Learning Activity (Today)
Structure: 6 groups; each group handles one scenario (Scenarios 1–6) during the session.
Time: approximately twenty minutes total for the activity; the instructor will announce with about five minutes left.
Deliverables (for the full group):
Summarize the scenario
Identify the ethical issues present
State what code or guideline was violated (don’t need to list specific principle numbers, but describe the violation such as “documentation lapse,” “client abandonment,” etc.)
Propose appropriate sanctions or disciplinary actions
Notes: there are no formal submissions; this is a discussion activity to develop ethical reasoning and decision-making skills.
Logistics: if a student cannot access a room, the instructor will add them; the activity includes a short debrief after returning to the full group.
Practical Guidance and Takeaways for Ethical Practice
Always verify information—don’t rely on informal advice; fact-check using official documents (ASHA Code of Ethics, state boards).
Maintain confidentiality in all forms of communication; avoid posting patient-specific information on social media.
Be precise in documentation and billing; ensure data, progress notes, and discharge statements are accurate and timely.
Proactively manage supervision and mentoring responsibilities; respect the educational nature of supervision and avoid treating it as free labor.
Self-report potential issues timely; ensure all relevant disclosures are made to ASHA and appropriate licensure boards.
Preserve client continuity of care during transitions; provide referrals and a clear discharge plan with documented communications.
Recognize the limits of professional credentials and status; do not claim credentials before official notification.
Consider ethical decision-making as a structured process; use the 10-step model to guide actions and consider consequences and stakeholders.
Resources and Final Reminders
Check Canvas: Seminar Resources for ASHA Code of Ethics documents and other materials.
Access to Google Drive links via Canvas resources for additional reading and case materials.
Remember: today’s activity is preparatory; reflections and some submissions will occur in Week , not today.
If you have questions about sanctions or ethical guidelines, use official channels (ASHA Board of Ethics, state licensure boards) and document communications for accountability.
Closing Thoughts and Context
The ethical landscape is designed to protect clients and maintain the integrity of the profession; even seemingly minor errors can escalate if not properly addressed.
Building a reputation as an ethical, transparent clinician opens doors for private practice and professional opportunities; unethical actions can have long-lasting consequences.
The instructor emphasizes practical, real-world considerations (e.g., confidentiality, documentation, and accurate billing) and encourages ongoing engagement with ethical resources beyond today’s session.