What is a CDA?

The CDAAC Position Statement below specifically outlines our stance on the use of formally trained and non-formally trained supportive personnel in the field of communication disorders.

CDAAC Position Statement

Supportive personnel are defined as “individuals who are directly assigned clinical tasks and related work and are supervised by the [CASLPO] member to assist in the provision of speech language pathology intervention” (The Use of Support Personnel by Speech Language Pathologists, March 2017). The use of supportive personnel in the field of communication disorders is increasing. As a result, the Communicative Disorders Assistant Association of Canada (CDAAC) is often approached by its members, their employers and the public with questions about the difference between individuals who are formally trained and non-formally trained to work as supportive staff with a Speech-Language Pathologist or Audiologist.

CDAAC believes that there may be a place for formally trained individuals and those who are trained on the job in a mediator model of service delivery. While CDAAC supports the use of both types of supportive personnel where appropriate, it is the association’s belief that it is important to distinguish between them. This position statement will highlight the differences and similarities in areas of education, supervision and client care for each type of supportive personnel.

1. Education

Supportive personnel working in the communication disorders field may come from a variety of different educational backgrounds. Those who are formally trained hold a post-graduate diploma or certificate from a recognized¹ Communicative Disorders Assistant program. While these graduates may be employed under many different titles (e.g., Communicative Disorders Assistant, Communication Health Assistants, Speech-Language Pathologist Assistants, Audiometric Assistant, Communication Technician), they will henceforth in this paper be referred to as CDAs.

a diploma and/or an undergraduate degree, typically in human services or social sciences,
a post-graduate CDA diploma or certificate,
and, in most cases, prior work or volunteer experience in the field of communication disorders.

speech (including anatomy and physiology, sound acquisition and developmental errors, phonological processes, apraxia, dysarthria, transcribing using the international phonetic alphabet, fluency and voice),
language (including typical development, special populations, language sampling and calculating mean length of utterance),
pragmatics,
adult neurogenic disorders,
audiology (including anatomy of the ear, basic audiometric screenings and hearing aid technology),
augmentative and alternative communication (including Voice Output Communication Aids, the Picture Exchange Communication System and use of communication software such as Boardmaker),
how to work as supportive personnel,
and two 6-8 week placements in the field of communication disorders.

Non-formally trained supportive personnel also have a variety of educational backgrounds; however, they are not graduates of a CDAAC recognized CDA program. They will henceforth be referred to as on-the-job-trained or “OJTs” in this paper.

An OJT’s education and training may consist of any of the following:

high school diploma,
college diploma and/or certificate (other than CDA),
undergraduate degree,
training as a Speech-Language Pathologist or Audiologist in a different country.

An OJT’s education or training may be concentrated in one particular area (e.g., B.A. in Linguistics) or may be geared toward a certain population (e.g., ECE diploma). OJTs have not been specifically trained to work as a supportive personnel role in the field of communication disorders or have not graduated from a CDAAC recognized program.

As the number of CDA programs continues to grow, and as the programs become more recognized, CDAAC believes that the use of the CDA title by OJTs may mislead the public with respect to the education and training of that individual. Based on the course work and training covered in CDAAC recognized programs, CDAAC encourages only those who have graduated from a CDAAC recognized program individuals to use the CDA title.

Supervision

CDAAC believes that mediated intervention can augment services when clinical supervision is provided in accordance with the guidelines set forth by the supervising clinician’s provincial regulatory body (e.g., CASLPO in Ontario) and/or national professional association (i.e., Canadian Association of Speech-Language Pathologists and Audiologists or “CASLPA”).

CDAAC believes that the supervising clinicians must recognize the differences between CDAs and OJTs in order to provide appropriate supervision. As CASLPO states in its 2017 position statement, “Support personnel must demonstrate the knowledge, skill and judgement associated with assigned tasks.”. Additionally, they state “The amount and method of ongoing supervision the support personnel requires will depend on the following: Complexity of the patient and presenting disorders, issues and concerns, risk of harm associated with the assigned task, the specific competence of the support personnel, experience and level of comfort of the support personnel, experience and level of comfort of the SLP”. The variation in training between CDAs and OJTs dictates that their supervisory schedules must be different. The amount of supervision should be inversely proportionate to the training and skills of the individual. ]

Client Care

CDAAC believes that recognizing and respecting the differences between CDAs and OJTs will enhance client care. This can be achieved by:

assessing the needs of the organization before hiring a support person to ensure that the skills of the applicant can fulfill these needs,
clearly identifying the distinct roles and responsibilities of CDAs and OJTs through separate job descriptions,
training OJTs to work as supportive personnel (e.g., reviewing supervision requirements and scope of practice),
educating the clients regarding the different personnel with whom they might be working; for example, the Ontario Association for Speech-Language Pathologists and Audiologists states “clients should be informed of the assistant’s qualifications” (Guidelines for the employment and utilization of supportive personnel, 1988),
support staff confining themselves “to clinical practices in which [they] have been educated” (CDAAC Bylaws, Sec.12.3.a.v).

One of the goals in the field of communication disorders is to provide responsible service in a professional manner. CDAAC feels that this goal can be achieved when all professionals involved, including supervising clinicians, CDAs and OJTs, have a clear understanding and respect for each others’ distinct education, training and role in providing mediated treatment.

^{1. For the purposes of this paper, “recognized” refers to those programs whose graduates are eligible for membership with CDAAC, as determined by the CDAAC Executive Committee. These programs currently include: Georgian College, Durham College, Lambton and St. Lawrence College.↩}

REFERENCES

1. Canadian Association of Speech-Language Pathologists and Audiologists. “Position Paper on Support Personnel in Speech-Language Pathology and Audiology.” J. Speech-Language Pathology and Audiology 30 (December 1996): 267-268.

2. College of Speech-Language Pathologists and Audiologists of Ontario. “Position Statement: Guidelines for the Use of Supportive Personnel.” Approved by the CASLPO Council (July, 1997).

3. Communicative Disorders Assistant Association of Canada. “The Communicative Disorders Assistant Association of Canada By-Laws.” Revised and approved by the CDAAC Executive Committee (2003).

4. Ontario Association of Speech-Language Pathologists and Audiologists. “Guidelines for the employment and utilization of supportive personnel.” Submitted by the Ad Hoc Committee on Supportive Personnel. (1988).