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12 Mar 2014 12:46 PM | Ann Ninness (Administrator)



For approximately ten years the profession of Occupational Therapy has been seeking to update their scope of practice. One of the proposed elements of the updated scope of practice was the addition of work with swallowing as Occupational Therapists (OTs) have traditionally worked with feeding and eating. Due to the substantial differences in the basic education and training in dysphagia of the professions of Occupational Therapy and Speech-Language Pathology, over those ten years ISHA sought to achieve adequate consumer protections when Occupational Therapists work with clients with dysphagia. In recent years ISHA sought input from ASHA and formed a special task force to work on this issue. The task force consisted of Jeanne McMillan, Dawn Wetzel, Melissa McGrath, Dee Combs, Mary Jo Germani, and Elizabeth Baldwin.


In the 2013 Session of the General Assembly the Indiana Occupational Therapy Association and ISHA had extensive negotiations on how to address adequate consumer protections, but those negotiations did not result in a compromise. The negotiations resumed during the 2014 Session of the General Assembly, and during just the past few weeks the negotiations produced a compromise. That compromise is contained in House Bill 1045, which was just approved by the General Assembly on March 10. Please note that the Governor has not taken action on the bill yet, so at this time the bill is not law. If signed by the Governor, the law would take effect July 1, 2014.


HB 1045 requires that OTs demonstrate clinical competencies when working with dysphagia. Those continuing competencies consist of at a minimum professional development or similar advanced training, passage of a written test, and demonstration of clinical skills and knowledge. The competencies must be updated at least annually. The bill also requires OTs to take continuing education in swallowing disorders.


As part of the compromise, ISHA agreed to require a written test for SLPs who work with dysphagia. As with the OT written test, the test is merely the short exercise that would be administered during an annual clinical competency. It is not a new certification or anything of that nature. If current clinical competencies include a written test, those competencies would meet the law’s requirement. But in a practice setting where no clinical competencies currently exist that include a written test, SLPs would be required to pass a written test. It is envisioned that an employer would administer the test, but there are no parameters for content, length, or frequency. An employer could develop the test, ask a university to develop the test, obtain the test from ASHA, or use some other means to develop the test.


View House Bill 1045 at the following link:

To support and empower members to provide the highest quality, life changing communication, swallowing and hearing services to the people of the State of Indiana.

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