The role of the speech therapist is characterised by a methodical approach to speech therapy: eliciting a medical history and carrying out an examination, making a diagnosis, and supervising, training and/or coaching according to an action plan developed in consultation with the client. The speech therapist draws on professional knowledge and skills and demonstrates a professional attitude when offering high-quality, safe and client-oriented care within the field of communication and swallowing. This role forms the core of the speech therapy profession. Depending on the context, the speech therapist will also take on the role of communicator, collaborator, health coach, innovator, leader and professional. In accordance with ICF, methodical speech therapy is geared towards the health domain in its entirety: in their diagnoses and interventions, speech therapists identify and take into account functional disorders, limitations, participation problems and personal circumstances and external factors that may be of influence. Speech therapists are evidence-based and efficient in their performance, taking into account the code of ethics and the limitations of the profession. Speech therapists consult their clients on all phases of methodical speech therapy; they stimulate the participation, self-management and sense of responsibility together with the client. Speech therapists also involve the client in the decision-making process
Methodical speech therapy consists of:
- Registering clients and conducting an intake interview;
- Eliciting a medical history and performing a medical exam;
- Analysing and interpreting results;
- Defining communication and/or swallowing problems;
- Sharing prognoses and recommendations;
- Determining goals;
- Developing a treatment plan;
- Executing a treatment plan and making adjustments where necessary;
- Evaluating and concluding.
Examples of professional activities
- Identify the request for help and the background in consultation with the client;
Develop a specific research plan, make decisions using valid and reliable research tools and justify these according to the principles of evidence-based practice;
- Execute and evaluate speech therapy research in a targeted, methodical and flexible way, tailored to the needs of the client and other involved parties;
- Analyse and interpret the medical history and research data in consultation with the client to reach a diagnosis and/or conclusion;
- Formulate functional problems according to the established guidelines in terms of functional disorders, functional limitations and participation problems, drawing on medical, environmental and personal factors of influence and including a description of the recovery until the diagnosis was made;
- Identify any missing information and contact relevant parties to discuss this information;
- Determine and explain the expected recovery and assess how the wishes and requirements of the client can be achieved;
- Discuss the diagnostic results with the client and provide tailored advice;
- Use the diagnosis to define goals that meet the client’s needs in terms of functioning, activities, participation and personal and external factors;
- Make a decision and agreements on the speech therapy approach in consultation with all involved parties. In doing so, the speech therapist will take into account the perspective of all those involved;
- Develop a speech therapy treatment plan and act in accordance with the principles of evidence-based practice;
- Execute, evaluate and conclude a speech therapy treatment plan tailored to the client’s needs in a targeted, deliberate and systematic way;
- Apply clinical reasoning throughout the methodical speech therapy process when weighing and justifying choices;
- Use information technology in accordance with the applicable guidelines:
- Respect the privacy of the client.
Level 1: Novice
In a simulated situation, at the indication of and under the supervision of an educator, the speech therapy student will select relevant information, create a research plan, elicit a (partial) medical history and perform an examination. The student correctly interprets the medical history and research results of a simple case, formulates a suitable diagnosis and reflects on the argumentation behind their decisions. The student develops a treatment plan in a structured and simple simulation and carries out elements of this plan under the supervision of an educator. The student follows guidelines and protocols. The student selects the necessary information and understands the factors that play a role in behavioural change.
Level 2: Advanced beginner
The student selects all or part of the required information in a simulated or professional situation, at the request and under the supervision of an educator for a specified case that involves common, single or compound communicative or swallowing problems. The student develops and implements a research plan, elicits a medical history, carries out research, correctly interprets the medical history and research results, formulates a suitable diagnosis/conclusion and provides the client with tailored advice. The student develops a speech therapy treatment plan and asks targeted questions to a speech therapist or lecturer about ways to improve this plan. The student carries out the treatment plan (in whole or in part) and evaluates their own performance under the supervision of a speech therapist in order to expand their therapeutic skills. The student works systematically and takes initiative in accordance with the regulations and protocols governing the execution of tasks. The student critically assesses information sources of relevance to the chosen intervention and includes the perspectives of the client and the therapist when justifying the decisions made during the execution of the task. The student evaluates and reflects on the execution of the task.
Level 3: Competent
The speech therapist elicits a medical history, carries out research, formulates a diagnosis or conclusion and provides the client with tailored advice independently, in an unfamiliar and changing practical situation, in consultation with the client and other professionals, and in accordance with methodical speech therapy.
The speech therapist develops a treatment plan in consultation with clients, carries out this plan independently and evaluates this plan critically. The speech therapist acts in accordance with the principles of immediate accessibility. The speech therapist analyses complex problems and solves these in tactical, strategic and creative ways. The speech therapist consults colleagues to assess their own performance or to expand their therapeutic repertoire. The speech therapist acts in accordance with evidence-based practice by independently choosing speech therapy interventions based on their specialised knowledge and insights in their own field and in relevant fields, and by taking into account the requirements and preferences of clients. The speech therapist justifies decisions with regard to efficiency, effectiveness and the best available evidence.