1. (A) To be licensed as a Speech-Language Pathology Assistant an applicant must:

   1. (1) submit an application on forms approved by the board;
   2. (2) submit an application fee as prescribed by the board;
   3. (3) present evidence of a bachelor’s degree in Speech-Language Pathology from a regionally accredited institution; and
   4. (4) present evidence of a supervised clinical experience that consists of 100 clock hours of supervised clinical fieldwork with direct client contact/clinical practicum that meets the requirements in (C).

2. (B) A bachelor’s degree in Speech-Language Pathology from a regionally accredited institution must include as a minimum the following core curriculum of 36 semester hours:

   (1)	Basic Area
   	Anatomy, physiology, mechanics, and function of the ear and vocal mechanism.
   	Semantics
   	Speech and Voice Science
   	Psychology of Speech
   	Introduction to Phonetics
   (2)	Speech-Language Pathology Courses	(12 Semester Hours)
   	Stuttering
   	Articulation
   	Voice Disorders
   	Cleft Palate
   	Aphasia
   	Cerebral Palsy
   	Speech-Language Disorders
   	Neurogenics
   (3)	Audiology	(3 Semester Hours)
   	Testing of Hearing
   	Introduction to Audiology
   	Auditory Training
   	Speechreading
   	Speech for the Deaf or Hard of Hearing
   (4)	Psychology	(6 Semester Hours)
   	Human Growth and Development
   	Psychology of Adjustment or
   	Abnormal Psychology
   (5)	Basic Course in Public Speaking	(3 Semester Hours)

3. (C) Supervised Clinical Experience.

   1. (1) Observation hours cannot be used to satisfy the required 100 hours of clinical fieldwork.
   2. (2) Hours must be completed before the speech-language pathology assistant license can be issued by the Board.

   3. (3) The supervised clinical experience may be obtained as follows:

      1. (a) as part of an academic program that is acceptable to the Board; or
      2. (b) an on-the-job training/work program completed in another state in accordance with that state’s laws; or

      3. (c) completion within a four (4) month period of a Board-approved plan to fulfill the 100 clinical clock hours under the supervision of a South Carolina licensed speech-language pathologist subject to the following:

         1. (i) The plan to obtain the 100 clinical clock hours must be on a Board-approved form signed by the applicant and the South Carolina licensed speech-language pathologist providing the supervision; and

         2. (ii) The plan must be submitted with a completed application for speech-language pathology assistant licensure that includes all required documentation; and

            (iii) The plan must be approved by the Board before the applicant begins the clinical clock hours; and

         3. (iv) If the plan is not completed within the four (4) month period, the applicant must submit a new plan to be approved by the Board.
   4. (4) Applicant may submit an ASHA Speech-Language Pathology Assistant Certification as evidence of the 100 clinical clock hours obtained under (3)(a) or (3)(b).
   5. (5) Family members or individuals related to an applicant may not serve as clinical supervisors.

4. (D) General Guidelines.

   1. (1) No speech-language pathology assistant may begin working in direct contact with clients/patients without the board’s written approval of the supervisory agreement and on the job training plan.
   2. (2) Only a speech-language pathologist with an active license in good standing and a minimum of three years of work experience may supervise speech-language pathology assistants.
   3. (3) A speech-language pathologist shall supervise no more than two full-time or three part-time speech-language pathology assistants, not to exceed more than three speech-language pathology assistants whether part-time or full-time. Full time is defined as a minimum of 30 work hours per week.
   4. (4) If, for any reason, there is a change in supervising speech-language pathologist, it is the responsibility of the supervising speech-language pathologist to notify the board in writing within seven (7) working days that the supervisory agreement has been discontinued.
   5. (5) The assistant’s license shall become void when the authorized supervisor is no longer available for supervision. The license will be reactivated upon receipt and approval by the board of a new supervisory agreement and the change in supervising speech-language pathologist fee specified in Reg. 10-41(E).
   6. (6) At the time of license renewal, supervising speech-language pathologists are to list the names of all those speech-language pathology assistants they are supervising.
   7. (7) A speech-language pathology assistant may work part-time for more than one supervising speech-language pathologist provided that the board has approved supervisory agreements for each supervising speech-language pathologist.
   8. (8) A licensed speech-language pathologist who supervises any speech-language pathology assistant must provide each speech-language pathology assistant with on the job training and must maintain responsibility for all services performed or omitted by such speech-language pathology assistant(s).

5. (E) On-the-Job Training (OJT).

   1. (1) Step-by-step instruction of each and every service or task the speech-language pathology assistant is to perform;
   2. (2) Continuous visual observation by the supervising speech-language pathologist of the speech-language pathology assistant’s performance of each service or task until the supervising speech-language pathologist establishes the speech-language pathology assistant’s competence.
   3. (3) The supervising speech-language pathologist must maintain a written record of each service or task indicating the activity, date, time, and location of the training demonstration and observations. This record must be signed by both the supervising speech-language pathologist and the speech-language pathology assistant and a copy must be provided to the speech-language pathology assistant. The supervising speech-language pathologist and the speech-language pathology assistant must maintain such records for a period of four (4) years and such records must be made available to the director or the designee upon request.

   At a minimum, on-the-job training (OJT) must include:

6. (F) Supervision - General.

   1. (1) Informing, in writing, all the clients (or their legal guardians), referring agencies, and third-party payers.
   2. (2) It is the supervisor’s responsibility to ensure that the assistant is clearly identified at all times as an assistant by means of a name tag or similar identification.
   3. (3) At no time may a speech-language pathology assistant perform tasks when the supervising speech-language pathologist cannot be reached by personal contact, phone, e-mail, or other immediate or electronic means.
   4. (4) The supervisor must make provisions, in writing, for emergency situations including designation of another licensed speech-language pathologist who has agreed to be available on an as needed basis to provide supervision and consultation to the assistant when the supervisor is not available.
   5. (5) If for any reason (i.e., maternity leave, illness, change of job) a supervisor is not able to provide the level of supervision stipulated, the assistant may not perform client contact tasks.

   Supervising speech-language pathologists are responsible for all the clinical services provided or omitted by the speech-language pathology assistant(s). When speech-language pathology assistants provide direct services, the supervising speech-language pathologist is responsible for:

7. (G) Direct Supervision.

   1. (1) This direct supervision must be on-site, in person, and documented in writing.
   2. (2) This documentation must be maintained by the supervising speech-language pathologist for a period of four years and must be made available to the director or the designee upon request.

   Following initial OJT, direct supervision of each speech-language pathology assistant must consist of a minimum of one of every seven therapy sessions per patient of direct, visual supervision of client contact to include a sampling of each assigned service or task.

8. (H) Indirect Supervision.

   In addition to direct supervision, indirect supervision is required a minimum of 5% (e.g., 2 hours per 40 hour work week) and must include review of written records and may include demonstrations, review and evaluation of audio- or video- taped sessions, and/or supervisory conferences.

9. (I) Quarterly Reviews.

   1. (1) Signed by both the supervising speech-language pathologist and the speech-language pathology assistant;
   2. (2) Maintained by the supervising speech-language pathologist for a period of four (4) years;
   3. (3) Made available to the director or the designee upon request for an audit that the Board may conduct.

   In addition to direct and indirect supervision, the supervising speech-language pathologist must conduct quarterly performance reviews of each speech-language pathology assistant’s performance of each assigned service or task. Such quarterly reviews must document, on a form approved by the board, direct observation of each task or service assigned to the speech-language pathology assistant. These reviews must be:

10. (J) Scope of Practice.

    1. (1) Conduct speech-language or hearing screenings (without interpretation) following specified screening protocols developed by the supervising speech-language pathologist.
    2. (2) Provide direct treatment assistance to patients/clients identified by the supervising speech-language pathologist.
    3. (3) Follow documented treatment plans or protocols developed by the supervising speech-language pathologist.
    4. (4) Document patient/client progress toward meeting established objectives as stated in the treatment plan.
    5. (5) Assist the supervising speech-language pathologist during assessment of patients/clients.
    6. (6) Assist with tallying patient/client responses, prepare therapy materials, schedule activities, prepare charts and assist with other clerical tasks as directed by the supervising speech-language pathologist.
    7. (7) Perform checks and maintenance of equipment on a regular basis, and verified calibration at least annually on audiometric equipment.
    8. (8) Assist the supervising speech-language pathologist in research projects, in-service training and public relations programs.
    9. (9) Sign treatment notes which must be reviewed and co-signed by the supervising speech-language pathologist.
    10. (10) Discuss with the client, the guardian or family members specifically observed behaviors that have occurred during treatment when such behaviors are supported by documented objective data.

    The supervising speech-language pathologist accepts full and complete responsibility for all services and tasks performed or omitted by the speech-language pathology assistant. Provided that education, training, supervision and documentation are consistent with that defined in this chapter, the following tasks may be designated to the speech-language pathology assistant:

11. (K) Prohibited Activities.

    1. (1) Perform diagnostic tests of any kind, formal or informal evaluations, or interpret test results.
    2. (2) Participate in parent conferences, case conferences, or any interdisciplinary team meetings where diagnostic information is interpreted or treatment plans developed without the presence of the supervising speech-language pathologist or designated licensed speech-language pathologist.
    3. (3) Provide patient/client or family counseling.
    4. (4) Write, develop, or modify a patient/client’s treatment plan in any way.
    5. (5) Assist with patients/clients without following a documented treatment plan which has been prepared by a licensed speech-language pathologist and for which the speech-language pathology assistant has not received appropriately documented OJT.
    6. (6) Sign any formal documents (e.g., treatment plans, reimbursement forms or reports) without the signature of the supervising speech-language pathologist.
    7. (7) Select patients/clients for services.
    8. (8) Discharge patients/clients from services.
    9. (9) Disclose clinical or confidential information either orally or in writing to any one not designated in writing by the supervising speech-language pathologist.
    10. (10) Make referrals for additional services.
    11. (11) Provide any interpretation or elaboration of information that is contained in reports written by any licensed speech-language pathologist.
    12. (12) Represent oneself to be a speech-language pathologist.
    13. (13) Make advertisement or public announcement of services independent of the supervising speech-language pathologist.
    14. (14) Participate in feeding or swallowing activities as set forth in the ASHA Speech-Language Pathology Assistant Scope of Practice.
    15. (15) Treat a person who is medically fragile as defined by the ASHA Speech-Language Pathology Assistant Scope of Practice.

    The speech-language pathology assistant must not:

HISTORY: Amended by State Register Volume 22, Issue No. 6, Part 3, eff June 26, 1998; State Register Volume 36, Issue No. 6, eff June 22, 2012; State Register Volume 38, Issue No. 6, Doc. No. 4389, eff June 27, 2014; SCSR 43-5 Doc. No. 4858, eff May 24, 2019; SCSR 46-5 Doc. No. 5101, eff May 27, 2022; SCSR 48-5 Doc. No. 5237, eff May 24, 2024.