Recent FAQs

The College recommends that at least a third of the mentored hours (16 hours minimum) should be direct in nature - i.e. the guidance should be face-to-face. If face-to-face guidance is not feasible, the College must pre-approve a written request for direct guidance to be conducted by audio and/or visual tape recordings of clinical sessions. This should be indicated in the proposed contract.

Normally, both direct and indirect guidance should be provided. The needs of the employment setting and of the initial registrant should determine the proportion of direct to indirect guidance. For initial registrants employed in under-serviced areas or at some distance from a mentor, the guidance may need to be largely indirect. (TOP)

Can the IPP mentorship required for an initially registered member of the College be combined with the supervision period required for certification with ASHA?

It is possible for an initially registered member of the College to have the same mentor/supervisor for both the IPP required by the College, and for the period of supervised professional practice required for certification with ASHA, as long as the mentor/supervisor is a fully registered member of the College and meets the College’s requirements as a mentor. That mentor/supervisor would have to follow the requirements for both types of supervision, as well as complete the reporting forms required for each supervisory commitment. An initial registrant must submit a mentorship guidance contract to the College for their IPP within thirty days of beginning employment in Ontario. (TOP)

In my current position, I do not have clinical responsibilities, but I do see a couple of clients privately. I have not completed 250 clinical practice hours in the past year. Should I switch to non-practicing status? Can I continue to see clients privately?

To maintain a General certificate of registration, members are required to provide a minimum of 250 hours of patient care or related work in speech-language pathology or audiology annually or 500 hours over two years. The College defines "related work" as professional activities that require the member to make judgments or decisions based, in whole or in part, on knowledge of the practice of the professions of speech-language pathology or audiology. Some examples of activities that may meet this definition of "related work" are:

Administration of clinical speech-language pathology or audiology services where the member engages in one or more of the following:
- oversees or evaluates the clinical work of speech-language pathologists or audiologists (e.g., conducts performance evaluations or case reviews, assesses written reports, monitors professional standards).
- makes decisions on the organization and delivery of clinical services in speech-language pathology or audiology.
- determines, on professional grounds, whether individual clients should receive or be discharged from speech-language pathology or audiology services.
Research in speech-language pathology or audiology that involves the assessment or the management of patients with communication disorders.
Education of speech-language pathologists or audiologists concerning services or products that may be employed in the assessment or management of patients with communication disorders.
Administration within professional organizations where the member sets or maintains professional standards of practice for speech-language pathologists or audiologists. (TOP)

Members who hold a non-practicing certificate of registration are not allowed to treat any clients or engage in related work. General members who do not have the required hours will be referred to the College’s Registration Committee for review.

The Registration Committee is also considering a new class of certificate for professionals whose primary responsibilities fall into categories that are currently defined as related work. (TOP)

Do part-time employees have to pay full-time fees to be registered with the College?

Yes. Regulatory bodies, as a general rule, do not provide a part-time registration certificate or licensure status for members. Part-time registration status was not an option under the Regulated Health Professions Act, 1991 (RHPA).
There are two principle reasons for not considering part-time registration status:

A person who is a registered professional is a professional all the time, not just while they are in their employment setting. It is not possible to assure that any member of a profession will cease to call themselves or to hold themselves out as a member of their profession outside of their specific hours of practice; and,
It requires the same financial resources to effect the processes of the College (especially the complaints and discipline process which is extremely costly) for any member of the College, whether he/she is employed on a part-time or full-time basis. (TOP)

Does the College provide a refund to a general registrant who applies for a non-practicing certificate of registration during the payment year?

No, general registration status is required to practice for any time period within a payment year. (TOP)

I work in an academic setting. Should I register for general or academic status?

A person who is registered with academic status cannot provide clinical services to any patients outside of the academic setting. If there is any possibility of working outside of the academic setting, even part time, you should register for general status. That will enable you to see patients both inside and outside of the academic setting. (TOP)

If I plan to return to general practice after having worked for 15 years in an academic setting or after a leave of absence of more than three years, are there any limitations on the kinds of clients I may see?

To return to general practice, a general certificate is required. Applications for a general certificate of registration received from academic members who have been working in an academic setting or from members who have not practiced for more than three years will be referred to the College’s Registration Committee for review prior to the issuance of a general certificate of registration.

The Registration Committee, after a review of the member’s application, may decide to impose specified terms, conditions or limitations on the member’s certificate of registration. Members may be expected to complete a period of supervised practice and/or be required to successfully complete the CASLPA certification exam within a specified period, as a condition of their certificate of registration. After receiving a general certificate, the Code of Ethics states that members are required to practice within their limits of competence as determined by their education, training and experience.

Members who have not treated a specific client population for more than five years are encouraged to develop an individualized learning plan to increase their competence in the practice area or seek a colleague who is experienced with this clinical population to act as a consultant/mentor. (TOP)

When should I consider changing to non-practicing status?

Non-practicing status is intended for at least a year’s leave of absence from practice in the profession. It is not for short-term leaves (e.g., summer holidays, brief periods of unemployment) or periods of time less than a full registration year (October 1 to September 30).

Members who hold non-practicing status are not allowed to assess or treat any clients. If you practice audiology or speech-language pathology during any part of a registration year, you must hold a certificate of registration (General or Academic). The following are some circumstances in which a member may consider changing to a non-practicing certificate of registration:

the member will be out of the country and not practicing for a period of at least one registration year;
the member is retiring from practice but wishes to use the title "speech-language pathologist" or "audiologist" and continue to receive correspondence from the College; or
the member is on long-term disability and is not practicing for a period of at least one registration year. (TOP)

Are there any rules describing the use and supervision of supportive personnel?

Members must follow the Position Statement "Guidelines for Use of Supportive Personnel", which has been provided to every registrant and should be filed in their CASLPO Handbook. (TOP)

What is a rehabilitation therapist/specialist and can they provide speech therapy?

A rehabilitation therapist could be anybody. There are no standards or minimum qualifications. Often a rehabilitation therapist has a degree in psychology or a related field. Companies or facilities that provide therapy covered by insurance payouts generally employ them.
If a speech-language pathologist works with a rehabilitation specialist, or employs them, their use of rehabilitation therapists must follow the same guidelines outlined in the Position Statement "Guidelines for the Use of Supportive Personnel." (TOP)

How long do we have to keep records in our facility and to whom do they belong?

Records must be retained for 10 years following patient discharge. In the case of a child, records must be retained for 10 years following their 18th birthday. It is strongly recommended that audio and videotapes be treated as any other record and be retained for the same amount of time. The records belong to the facility, although they can be released to other facilities and/or persons with a signed release by the patient or appropriate person, such as a legal guardian.

Files must be disposed of in a confidential manner. They must either be shredded or burned. Audio and videotapes must be erased. Please refer to the Proposed Regulation for Records, which each registrant should have in their CASLPO Handbook. (TOP)

When a patient’s/client’s record has been requested by a third party (e.g., a lawyer or insurance company), does everything have to be released or just the report?

A record can only be released with a release of information signed by the patient, or appropriate person. The patient/client’s caregiver may specify what portion may be released to a third party. Please consult the Records Regulations for more information. (TOP)

For how long is an assessment valid?

It depends on the patient/client and the likelihood of change. Reassessment would be indicated if the member felt that there was a reasonable expectation of change. Each assessment, however, should be retained according to the Regulation on Record Keeping. (TOP)

What is a Controlled Act?

The RHPA lists thirteen procedures that, if not performed correctly and by a competent person, have a high element of risk. A physician and/or another health care professional designated by the RHPA can only perform these procedures. These are known as controlled acts. There is one controlled act that can be performed by audiologists - prescription of a hearing aid to a hearing impaired person. Speech-Language Pathologists do not have any controlled acts. (TOP)

Can an audiologist change the hearing aid prescription of another audiologist?

The Position Statement "Changing a Hearing Aid Prescription" addresses that issue. Any changes to a hearing aid prescription must be made for the benefit of the patient, thus the audiologist who wants to change the prescription must have sufficient information to do so. The original audiologist must be contacted, with permission from the patient, or the audiologist who wants to change the prescription must establish a relationship with the patient which must include taking a history, making a decision on whether a reassessment is necessary, making recommendations and instituting a course of rehabilitation.

The audiologist must follow the Preferred Practice Guidelines on hearing aid prescriptions and must receive informed consent from the patient. Changes that do not alter the initial prescription, such as buffing or grinding, may be completed in order to maximize the patient’s comfort. (TOP)

Am I allowed to accept the delegation of a controlled act?

Yes. The controlled act most likely to be delegated would be putting an instrument, hand or finger into an artificial opening or beyond the larynx. The procedure for accepting delegation is described in the Position Statement, "Acceptance of Delegation of a Controlled Act." The delegation and the act being delegated must be clearly stated, in writing. It is the clinician’s responsibility to ensure that his/her facility provides appropriate support, safety procedures and equipment to implement the procedure. Additionally,

only individuals who possess the knowledge, skill and judgment to perform the controlled act procedure may do so;
the decision to delegate should be made in the best interests of the patient/client; and,
both the delegator and the delegatee are responsible for documenting the delegation and the conditions under which the delegation occurred.

There must be an analysis completed of any possible risks involved. Most importantly, the clinician and the delegator must be able to perform the delegated act, and outline the specific conditions in which the controlled act is to be performed. (TOP)

Can I treat a relative?

At this time, there are no regulations addressing the issue of treating relatives. A member may do so, but should keep in mind the possible complications that sometimes arise in such a situation. The member is advised to read the Conflict of Interest Regulations to ensure that such a situation does not arise. This topic may be addressed in a future Position Statement. (TOP)

Is it a Conflict of Interest to refer a client that you are seeing in a hospital or clinic to your own private practice or to another clinic in which you or a family member are working?

The Proposed Conflict of Interest Regulation states that a member can provide professional services to a client, independently of his or her employer, providing that all of the conditions listed beneath are met. The conditions include:

informing the client that the service is being provided independently of the employer;
providing a range of alternative service providers or at least one other comparable facility;
informing the client of any fees for the service to be provided; and,
having the client express a preference for the service in question.

Similarly, when referring a client to a clinic or facility in which the member or a related person has any interest or could receive any benefit directly or indirectly, the member must disclose the conflict to the client, provide a range of alternative service providers or facilities. Finally, the client must express a preference for the service or product. (TOP)

Is it okay to attend a conference when invited and funded by a hearing aid manufacturer?

Yes, it is okay, as long as there is the understanding that the audiologist will not increase the amount of prescriptions of the manufacturer’s hearing aids in return for the attending the conference. With constant advances in technology and lack of continuing education funding, sometimes it is necessary for the audiologist to accept such an invitation. (TOP)

Can a speech-language pathologist or audiologist who has a Ph.D. use the title "Doctor"?

The RHPA states that, with the exception of Chiropractors, Optometrists, Physicians, Psychologists and Dentists, "no person shall use the title Doctor, a variation or abbreviation or an equivalent in another language, in the course of providing or offering to provide, in Ontario, health care to individuals." The government has defined audiology and speech-language pathology services as health care services. This means that even though members have a Ph.D., they may not use the title Doctor when providing audiology or speech-language pathology services, even if these services are provided in an academic setting such as a university clinic. Two examples of when members may use the title Doctor are in academic settings when the member is not providing health care services and at social settings. For further information, please refer to the Professional Misconduct Regulations. (TOP)

What is the professional's obligation if a client stops showing up for appointments?

The Professional Misconduct Regulation outlines the steps that clinicians must take when they are discontinuing professional services (i.e., discharging clients). A member may discharge a client from service if any one of the provisions applies. Under the terms of the Health Care Consent Act, consent to treatment can be either expressed or implied.

Withdrawal of consent can also be expressed or implied. If a client repeatedly does not show up for appointments, it may be assumed that the client has withdrawn consent for treatment and thus agreed to the discontinuation of services.

Most agencies have attendance policies that are provided to clients at the beginning of treatment. Typically, clients are made aware that their file will be closed if they do not show up for a certain number of appointments without contacting the agency. Attempts should be made to contact the clients if they miss a certain number of sessions to confirm withdrawal from treatment. Alternatively, a letter may be sent to the clients informing them that their file will be closed by a certain date unless the client contacts the agency. These are recommended practices but they are not required under the Professional Misconduct Regulation. (TOP)

I am providing services to a patient who has threatened me. Am I obligated to continue to treat this patient?

No, you are not. You are obligated, however, to attempt to locate alternative services for the patient whenever possible. You do not have to put yourself in a situation that you judge to be unsafe. For further information, please refer to the Professional Misconduct Regulations. (TOP)

I am setting up a private practice and developing my business cards and brochures. Can I call myself a "specialist" in a certain area of practice?

No. Audiologists and speech-language pathologists do not have areas of specialty. Within the regulated health professions, the term specialist refers to someone who has completed a prescribed course of training beyond that required for initial practice and has completed an examination evaluating their knowledge in that specialty (e.g., neurologist). The Professional Misconduct Regulations prohibits the use of the term, title, or designation indicating a specialization in the profession. A member may indicate additional training in a particular area of practice or that the practice is restricted to a certain practice area. Members are encouraged to present factual information in their brochures. For example, it is better to state "10 years of experience in pediatrics" rather than "extensive experience in pediatrics." This is an issue that CASLPO may address in the future. (TOP)

Can a physician force an audiologist to complete only certain audiologic procedures and prevent others, even if deemed necessary by the audiologist?

No, unless there is a medical reason for not performing the test (e.g., calorics on a patient with a perforated eardrum). If there is a disagreement between an audiologist and a physician, the audiologist must make every effort to contact the physician in order to work out the problem. If a solution cannot be found, the audiologist must perform any and all tests (or refer) that the audiologists feel are necessary to ensure patient health and safety. The audiologist should document the procedure and the results, as well as why the procedure was completed or referred. Patient health and safety comes first. For further information, please refer to the Professional Misconduct Regulations. (TOP)

What is considered sexual abuse towards a patient?

The RHPA defines sexual abuse of a patient by a member as:

Sexual intercourse or other forms of physical sexual relations between the member and the patient;
Touching, of a sexual nature, of the patient by the member; or
Behaviour or remarks of a sexual nature by the member towards the patient.

Sexual abuse does not include touching, behaviour or remarks of a clinical nature appropriate to the service provided. The College must investigate all complaints involving sexual abuse.

The penalty for sexual abuse is loss of license to practice for five years. (TOP)

What is considered to be sexual harassment?

Sexual harassment is similar to the definition of sexual abuse, except it involves employees, students or colleagues rather than patients. Sexual harassment violates other statutes such as the Human Rights Code and is also considered to be professional misconduct. The College will investigate such complaints to determine whether the member’s conduct was appropriate. (TOP)

What are considered to be the High Risk areas of Practice for SLPs/Audiologists?

The areas of greatest risk for allegations relating to sexual abuse or misconduct are:

Working with pediatric populations;
Working with other vulnerable populations, such as clients whose verbal skills are limited - i.e., post stroke, ABI, autistic children and adults;
Working alone with clients in their homes;
Working with clients whose behavior may be erratic and unpredictable such as hyperactive children, ABI clients; and,
Working relationships that involve contact with the client’s significant other(s). (TOP)

A patient tells me that a member of a regulated health profession has sexually abused him/her. Am I obligated to report it, and to whom?

The RHPA imposes mandatory reporting obligations on health care professionals who are members of regulatory colleges and employers of regulated health professionals. A member is required to file a report with the alleged sexual abuser’s College if the member has reasonable grounds, based on information obtained while practicing their profession, that a client has been sexually abused by a member of a regulatory college.

The member must know the professional’s name in order to file the report. The report must be filed in writing to the Registrar of the College of the member who is the subject of the report within 30 days of learning of the abuse. The report must be filed immediately if there is reason to believe that the abuse is ongoing or that other patients may be at risk. The patient must be informed that a mandatory report is being filed, even if the patient refuses to allow his/her name to be disclosed. It is advisable to get signed consent if the patient allows use of his/her name.

If a report is not filed, the member to whom the information was disclosed is subject to a fine of up to $25,000. Please refer to CASLPO’s Sexual Abuse Prevention Plan in your binder for more information. (TOP)

Can I date a patient?

Dating during the therapeutic relationship is not acceptable under any circumstances. Restrictions may also extend beyond the treatment period. For example, a sexual or romantic relationship is inappropriate in cases where the therapeutic relationship has created a vulnerability or dependency on the part of the patient that affects the patient’s ability to act freely, such as when extensive supportive counseling has been provided. Sexual relationships are not acceptable between a registrant and a patient’s significant other(s), defined as anyone of emotional significance to the patient including, but not limited to, the patient’s spouse, parent, sibling or caregiver. Please refer to CASLPO’s Sexual Abuse Prevention Plan in your binder for more information. (TOP)

I am an employer who has recently terminated a registrant for reasons not related to sexual abuse - i.e. poor practice. Am I required to notify the College of the termination?

Yes. According to the RHPA, an employer who terminates an employee, or revokes, suspends or imposes restrictions on a member for reasons such as professional misconduct, incompetence or incapacity must report the termination to the College within thirty days. The report must outline the reasons for the for the termination. The purpose of the College is to protect the public from poor practice and unfit practitioners, so all effort must be made to prevent the terminated employee from "floating" from job to job, allowing him/her to continue the poor practices. (TOP)

Is cerumen management in an audiologist’s scope of practice?

Cerumen management is in an audiologist’s scope of practice. Most audiologists, however, have not been taught cerumen management procedures. There will be a Position Statement or a PPG on cerumen management procedures in 2001. Until that time, it is strongly recommended that cerumen management not be attempted without prior instruction either by an audiologist or a physician. Please refer to the Profession Misconduct Regulations for more information. (TOP)

Can other professionals (e.g., occupational therapists, dieticians) assess and treat dysphagia?

Dysphagia assessment and treatment are not covered by a controlled act. As a result, the assessment and treatment of dysphagia is within the public domain. Anyone can do it as long as they do not use a protected title or hold themselves out to be someone with a protected title. Members are advised to address this issue from a perspective of competency and risk of harm. The PPG for Dysphagia outlines the competencies required and risks in dysphagia management. (TOP)

Can a member of the College who files a complaint with the College remain anonymous?

The complainant cannot remain anonymous. It is a point of law that the accused has the right to be confronted with the allegations against him or her and the person who has made them, and the right to defend him or herself against the allegations. It is possible, due to the nature of a complaint or the manner in which it came to the attention of the College, that the identity of the complainant may not have to be revealed, but it is not possible to specify these circumstances in advance. The specific circumstances under which this might occur will only be known through "real" situations, which are brought to the attention of the College. (TOP)

I regularly see clients from many cultures in my practice. Are there any guidelines to help me provide culturally sensitive care?

Yes, the Position Statement, "Service Delivery to Culturally and Linguistically Diverse Populations" provides advice to assist with the provision of culturally sensitive care. It states, among other things, that numerous factors need to be taken into consideration when choosing the language of intervention and that cultural differences must be taken into account during the all intervention.

Applicants who change status during the registration year must pay a $75 administrative fee to cover costs incurred by the College in evaluating eligibility for re-instatement of a General or Academic certificate of registration at any time other then the registration renewal period. (TOP)