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VOLUME 10 ISSUE 3 • FALL 2012
Opening a Private Prac ce
Deb Zelisko: Bringing Different Perspec ves
The Best of CASLPO TODAY!
Publications Agreement Number 40025049 • ISSN 1713-8922
OFFICIAL PUBLICATION OF THE COLLEGE OF AUDIOLOGISTS AND
SPEECH-LANGUAGE PATHOLOGISTS OF ONTARIO
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CASLPO TODAY
5 Registrar’s Message - Time for RenewalBy Brian O’Riordan,
Registrar
7 Council Highlights
CASLPO NEWS9 2011 Annual Report
2012-2013 Registra on Renewal Reminder – Deadline: October 1,
2012New Registra on Regula onsBy Colleen Myrie, Director of
Registra on Services
CASLPO Regional SeminarsBy Carol Bock, Deputy Registrar
Interprofessional Collabora on: 2012 Launch of an Online Toolkit
by FHRCO
CASLPO Elec on Results
Social Media: What the Professions ThinkBy Carol Bock, Deputy
Registrar
FEATURE18 Agatha Chris e – Helping to Unravel
the Mystery of Alzheimer’s DiseaseBy Sherry HinmanOriginally
Featured in Volume 8, Issue 2 - May 2010
Winning in Life, Health, and SportOntario Audiologist Makes
Hearing a Priority for Special Olympics AthletesBy Heather
Angus-LeeOriginally Featured in Volume 6, Issue 2 - August 2008
Research CornerBy Alexandra Carling-Rowland Director of
Professional Prac ce and Quality Assurance
DEPARTMENTS
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OSLA UPDATE8 Changes Coming to the
Home/Community Care Sector, October 1, 2012 – “Quality and Value
in Home Care Project”By Mary Cook, Execu ve Director, OSLA
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Official Publica on of The College of Audiologists And
Speech-languagePathologists of Ontario
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What Inspires a Clinician to Become a Peer Assessor?By Alexandra
Carling-Rowland Director of Professional Prac ce and Quality
Assurance
Opening a Private Prac ceBy Alexandra Carling-Rowland Director
of Professional Prac ce and Quality Assurance and Carol Bock Deputy
Registrar
Deb Zelisko: Bringing Different Perspec vesBy Sherry Hinman
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www.caslpo.com
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CASLPO NEWS
Time for RenewalBy Brian O’Riordan, Registrar
REGISTRAR’S MESSAGE
As September approaches, the phrase “Back toSchool” is
inevitably in the air. Those affected includeschool-age students
and the SLPs and audiologistswho stand ready to assist any of them
withcommunication disorders. University students returnto campus,
including those enrolled in master’sprograms in speech-language
pathology andaudiology at the University of Toronto, Western,
theUniversity of Ottawa, and, for the first time this
fall,Laurentian University in Sudbury. It is also back toschool
time for the many dedicated professors and
lecturers in SLP and audiology, who are also a crucial part of
the membershipof the College.
“Back to School” suggests a time of renewal for all of us,
including membersof the College, who, as we go to publication, are
receiving notices to renewtheir annual membership in the
College.
Here at the College, we are ever mindful of our responsibility
to assistmembers in renewing their long-term commitments to the
professions interms of continuing education and quality assurance
in order that membersare constantly upgrading and polishing their
skill levels as practitioners. Tothis end, CASLPO will soon be
offering a series of E-learning modules overthe next year on such
topics as: Consent to Treatment; Use of Social Media;Jurisprudence;
and Evidence-Based Practice. As well, our Quality
AssuranceCommittee is reviewing our entire QA process, with a view
to introducingenhancements in the Self-Assessment and Peer
Assessment processes. Wewill also continue with our Regional
Education Seminars for membersthroughout the province. We will be
visiting students enrolled in all theprovincial master’s programs
to acquaint them with the principles andmeaning of self-regulation
and the work of the College.
The Council of the College will also meet this fall for a
full-day educationalmodule focusing on matters of good governance
and Council performanceself-assessment.
The College has engaged an Information Technology (IT) advisor
to assist usin revamping our website to make it more user-friendly
and to integrate ourdatabase of information so that information
gathered therein can be utilizedmore efficiently to assist in
College administration.
Our public awareness program will kick off in the fall with a
special two-pageadvertorial spread in the “Back to School” issue of
Today’s Parent.
CASLPO College of Audiologists and Speech-Language Pathologists
of OntarioOrdre des audiologistes et des orthophonistes de
l’Ontario
A: 3080 Yonge St., Suite 5060, Box 71, Toronto, ON M4N 3N1T:
416-975-5347/1-800-993-9459F: 416-975-8394E: [email protected] | W:
www.caslpo.com
R E G I S T R A R
Brian O'Riordan, BA, MA Ext: 215 | [email protected]
D E P U T Y R E G I S T R A R
Carol Bock, M.H.Sc., Reg. CASLPO ext 227 | [email protected]
D I R E C T O R O F F I N A N C E A N D O P E R A T I O N S
Gregory Katchin, MBA, CAExt: 217 | [email protected]
D I R E C T O R O F R E G I S T R A T I O N S E R V I C E S
Colleen Myrie, BAExt: 211 | [email protected]
E X E C U T I V E A S S I S T A N T T O T H E R E G I S T R A
R
Carol LammersExt: 214 | [email protected]
P R O G R A M A S S I S T A N T ( R E G I S T R A T I O N S E R
V I C E S )
Camille PrashadExt: 213 | [email protected]
A D M I N I S T R A T I V E A S S I S T A N T ( C O R P O R A T
E )
Julie McFarlandExt: 210 | [email protected]
M A N A G I N G E D I T O R
Scott [email protected]
A R T D I R E C T O R / D E S I G N E R
Andrea Brierley905.522.0788 | [email protected]
S A L E S A N D C I R C U L A T I O N C O O R D I N A T O R
Brenda Robinson905.628.4309
[email protected]
A C C O U N T I N G
Susan McClung
C L A S S I F I E D A D V E R T I S I N G :
Brenda Robinson905.628.4309
[email protected]
G R O U P P U B L I S H E R
John D. Birkby
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CASLPO Today is published quarterly by Andrew John Publishing
Inc. withoffices located at 115 King Street West, Suite 220 Dundas,
ON L9H 1V1. Wewelcome editorial submissions but cannot assume
responsibility or commit-ment for unsolicited material. Any
editorial materials, including photographs,that are accepted from
an unsolicited contributor will become the property ofAndrew John
Publishing Inc. The publisher shall not be liable for any of
theviews expressed by the authors of articles or letters published
in CASLPOToday, nor shall theses opinions necessarily reflect those
of the publisher.
F E E D B A C K : We welcome your views and comments.Please send
them to:115 King Street West, Suite 220 Dundas, ON L9H 1V1
Copyright 2012 by Andrew John Publishing Inc. All rights
reserved.Reprinting in whole or in part is forbidden without the
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Publications Agreement Number 40025049 | ISSN 1713-8922Return
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D I R E C T O R O F P R O F E S S I O N A L P R A C T I C E
& Q U A L I T Y A S S U R A N C E
Alexandra Carling-Rowland, PhDext. 226 |
[email protected]
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The College will be involved in presentations in September at
the Councilof Licensure, Enforcement and Regulation (CLEAR)
conference and inOctober at the National Council of State Boards of
Speech-LanguagePathology and Audiology (NCSB). We will also be
attending the CanadianNetwork of National Associations of
Regulators (CNNAR) conference inOttawa.
Many members will be opening private practices this fall and
this issue ofCASLPO Today contains some practical advice for those
members on theregulatory compliance matters which they will need to
address.
Our Annual Report for 2011 is now available online, and
information onhow to obtain a copy is provided in this issue.
We hope that you are preparing this fall for a renewal of your
commitmentto excellence in providing quality care to your
patients/clients. In doingso, please know that the College is here
to assist you as a registeredmember of a self-governing and
self-regulated profession. I invite you tocontact us with any
questions or comments and to make full use of all theCollege’s
resources which you fund through your annual membership fees.
REGISTRAR’S MESSAGE
O F F I C E R S
Vicky Papaioannou, Vice-President (AUD)Nancy Blake,
Vice-President, SLPDeb Zelisko, Vice-President, AUD
____________________
P R O F E S S I O N A L M E M B E R S
D i s t r i c t 1 ( E a s t e r n O n t a r i o )
Rosanne Lavallée-McNamee, AUDPaulina Finak, SLP
D i s t r i c t 2 ( C e n t r a l O n t a r i o )
Vicky Papaioannou, AUDMary Suddick, SLP
D i s t r i c t 3 ( S o u t h w e s t e r n O n t a r i o )
Debra Zelisko, AUDNancy Blake, SLP
D i s t r i c t 4 ( N o r t h w e s t e r n O n t a r i o )
Sandra (Sandi) Singbeil, SLP
D i s t r i c t 5 ( N o r t h e a s t e r n O n t a r i o )
Carolyn Moran, SLP
D i s t r i c t 6 ( O n t a r i o - a t - L a r g e )
Bob Kroll, SLP____________________
A C A D E M I C M E M B E R S
Josée Lagacé, AUDRandi Fisher, SLP
____________________
P U B L I C M E M B E R S
Ferne DezenhousePauline Faubert
John KrawchenkoJosie Rose
Estrella Tolentino
C A S L P O C O U N C I L
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CASLPO NEWS
Council met on June 8th and reviewedthe following:
1. B. O’Riordan provided an update onhis activities
including:Recruitment of IT staff has been finalized and Baron
French will beginhis 1-year contract with CASLPO on June 25th.
Office security has been upgraded recently, after advice from
Legal Counsel to do so.
CASLPO/OSLA conference meetings continue. A memorandum of
agreement is being finalized.
B. O’Riordan has been elected as Vice-President of the
Federation of Health Regulatory Colleges of Ontario (FHRCO).
2. N. Blake & P. Faubert reported on their recent attendance
at the CLEAReducation sessions held in Toronto.
N. Blake suggested that informationprovided during the Executive
Leadership 3-day conference be included in a future Council
meetingas a learning opportunity; external consultants be invited
to assist Council meetings; and discussions ofCouncil member roles
and staff rolesbe pursued.
P. Faubert appreciated the information provided on how important
it is for Councils to understand their role and that the public
interest must be the focus at all times.
3. Council reviewed and approved the 2011 Annual Report.
4. N. Blake updated Council on the status of the Peer Assessment
Extension and Deferral Policy, and Council approved the document,
with amendments.
5. A. Carling-Rowland updated Councilon the status of the
Practice Standards and Guidelines (PSG) on the Assessment of Adults
by SLPs
and Council approved this document.
6. M. Drent provided an update on thestatus of the Use of
Support Personnel by Audiologists Position Statement and Council
approved thisdocument.
7. B. O’Riordan and C. Bock updated Council on the status of the
StrategicPlan thus far. Council agreed that anover-arching
statement is a critical and needed component. Following abrief
brain-storming session, it was decided that the overarching
statement be “Rooted in Quality. Strong in Commitment. Working in
the Public Interest.”
8. C. Bock and N. Blake updated Councilon the Quality Assurance
Regulation.Council agreed that the QA regulation, as amended, be
approved.
9. B. O’Riordan updated Council on theRegional Seminar, held in
Windsor on May 22. Special thanks to R. Grant-Rennie, SLP, for
assisting in thecoordination of this event.
10. B. O’Riordan updated Council on therecent board of directors
meeting ofthe Canadian Alliance of Audiology and Speech-Language
Pathology Regulators (CAASPR), held in St. John’s, Newfoundland,
which he andthe President attended. The meeting was very positive
and collegial and there is a good workingrelationship with all our
colleagues across the country.
11. B. O’Riordan updated Council on theFHRCO Registrars' retreat
in May anddistributed the 2011 FHRCO yearhighlights.
12. B. O’Riordan and C. Myrie updated Council on the Ontario
Fairness Commission Annual Review, noting nine items for follow-up
for the Registration area.
13. B. O’Riordan updated Council on therecent ADP consultations,
noting
hearing aid policy consultations willbegin over the summer.
14. B. O’Riordan and G. Katchin updatedCouncil on the Auditor’s
Report re: College of Denturists and the implications this may have
for CASLPO. They noted that various Committees of Council will be
reviewing the Denturist audit reportin light of our own best
practices, policies and compliance standards, with a view to making
any improvements internally.
15. A. Carling-Rowland updated Councilon the DSM-V. V.
Papaioannou thanked M. Suddick for bringing thisto CASLPO’s
attention and A. Carling-Rowland for all the research undertaken
and outreach to CASLPA,OSLA and ASHA.
16. Council reviewed reports from the following committees:
Executive, SLPPAC, Registration, Quality Assurance,ICRC, AUD PAC,
Patient Relations, Finance, Initial Practice Period Task Force,
SCERP Task Force.
17. Staffing Matters – B. O’Riordan updated Council on several
staffing issues including the review of COI issues, resignation of
M. Drent, whois leaving for a position with the LawSociety of Upper
Canada.
Performance Appraisal of Registrar –V. Papaioannou reviewed the
Regi-strar Performance Appraisal Processfor 2012. Council offered
suggestionsfor the Process in the future. Councilprovided
recommendations for topics for the September Council Meeting.
18. Next Council meeting will be held onThurs, Sept 27 and
Friday Sept 28, 2012.
COUNCIL HIGHLIGHTS
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On April 2, 2012, the CommunityProvider Associations
Committee(CPAC) members received a clearmessage from both the
minister’s staffand the Ministry of Health and Long-Term Care that
the health care systemis not immune to the unprecedentedchallenges
that service providers arefacing in the home care sector. Withouta
change in the way we currentlydeliver health care services,
healthcosts will continue to rise. Ontario’sAction Plan for Health
Care is directingour sector to reform the current homeand community
care delivery model tosupport the evolution to a more
client-centred, integrated model focused onachieving high quality
outcomes andvalue for money.
As a result, CPAC, whose members in-clude the Ontario Home Care
Associa-tion, Ontario Community SupportAssociation, Ontario
Association ofCommunity Care Access Centres (OAC-CAC) and the
Alliance of ProfessionalAssociations of Community-BasedTherapy
Services (APACTS), of whichOSLA is a member and active
partici-pant, met to explore the opportunity todevelop a plan for
moving forward withthe creation of new service contractsby October
1, 2012.
As an initial step towards achieving thislong-term vision,
starting on October 1,
2012, a new, flexible 2-year contract willbe in place for
service providers. Thisprocess will give CCACs and serviceproviders
the flexibility to begin thephased implementation of one or
morechanges in accordance with provincialdirection and local
priorities. In view ofthis commitment, the changes that willbe
implemented will therefore build onthe quality of care already
beingdelivered; ensuring stability ismaintained throughout the
transitionperiod for providers, CCACs and first andforemost for the
clients/patients.
The roadmap moving forwardrecognizes the magnitude of the
workahead, and the collective efforts willfollow a phased
approach:
Phase 1 Readiness – April to September 2012.
Phase 2Early Transitional – October 1, 2012 to March 2014
(initial flexibletwo-year contract period).
Phase 3Late Transitional – April 2014 to March 2016 (renewed and
revisedcontracts).
Phase 4 Outcomes – 2016 and beyond.
OSLA has participated at all four“Tables” to provide guidance to
the
government and OACCAC in the newdelivery model and each have
specificproject deliverables.
1. Contracts,2. Performance Indicators,3. Funding, and4.
Education and Change
Management Tables.
OSLA also has representation, HeatherHeaman, at the main
“SteeringCommittee” to coordinate all tabledeliverables.
Initially, business is expected tocontinue as usual for most
CCACs andservice providers as we begin todevelop and apply the
parameters andsupports required to operationalizechanges, while at
the same timeproviding continued care. Some CCACsand service
providers may have morereadiness than others and willtherefore move
at a measured pace toimplement the changes.
OSLA wishes to thank our memberrepresentatives at the various
tables,Heather Heaman, Sue McLean, andDebbie Jones-Snyders for
theircommitment to this project.
OSLA UPDATE
Changes Coming to the Home/Community Care
Sector, October 1, 2012 – “Quality and Value in
Home Care Project”By Mary Cook, Executive Director, OSLA
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transparent
innovative
accountable
collaborative
strategic
protecting the public
leading inregulation
ethical
Rooted in quality. Strong in commitment.COLLEGE OF AUDIOLOGISTS
AND SPEECH-LANGUAGE PATHOLOGISTS OF ONTARIO
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CASLPO NEWSCASLPO NEWS
2011 ANNUAL REPORTCASLPO’s 2011 Annual Report is now available.
To view or download a copy, please visit www.caslpo.com, and click
on the“About the College” tab. A copy can also be obtained by
contacting the CASLPO office.
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2012-2013 Registration Renewal Reminder –
Deadline: October 1, 2012
CASLPO NEWS
Colleen Myrie, Director of Registration Services
The College’s online renewalsystem is now available. You
canrenew your registration online and
pay your fees online using a credit card(Visa or MasterCard)
through CASLPO’swebsite at www.caslpo.com. It’s a fastand easy way
to renew your registrationand pay your fees.
The deadline for renewal this year isMonday, October 1, 2012.
Your renewalforms and fees must be received by theCollege office by
mail or completedonline on or before October 1st.Renewals received
after October 1st willincur a 20% late penalty.
NEW REGISTRATION
REQUIREMENTSThe College’s new RegistrationRegulation, Ontario
Regulation 21/12came into force on February 17, 2012.Due to the new
regulation and someother developments, you will see thefollowing on
your 2012-2013Registration Renewal Application form:
CITIZENSHIP/RESIDENCY STATUSMembers of the College have a duty
toprovide the College with details of anychanges in the past 12
months to theircitizenship, residency status oremployment
authorization under theImmigration and Refugee Protection
Act(Canada), in order to engage in thepractice of the professions
of audiologyor speech-language pathology.
PRIVATE PRACTICEMembers are asked to indicate if theyprovide
private speech-languagepathology or audiology services andwhich age
groups that they provide
services to.PATIENT CARE OR RELATED WORKGeneral members are
required to meetthe following condition for patient careor related
work:• Members must provide at least 750
hours of patient care or related
work in audiology or speech-language pathology during every
three-year period that begins on the day that the member is issued
ageneral certificate of registration. The period currently under
review is from October 1, 2009 to September 30, 2012.
QUALITY ASSURANCE A General Member must indicate ifhe/she has:•
completed their Self-Assessment
Tool;• written three Learning Goals for the
current year; and• collected and documented
Continuous Learning Activity Credits (CLAC).
An Academic member must indicate ifhe/she has:• written three
Learning Goals for the
current year; and• collected and documented
Continuous Learning Activity Credits (CLAC).
CONDUCTMembers of the College have a duty toprovide the College
with details of anyoffences, findings and proceedings thatrelate to
the member. Informationregarding the following activities/current
registration/licenses that youhold must be declared and full
details
provided:1. Have you been convicted of a
criminal offence in Ontario or in another jurisdiction in or out
of Canada?
2. Have you been the subject of a finding of professional
misconduct,incompetency or incapacity or other similar finding:a.
in relation to the profession in
Ontario or in another jurisdiction in or out of Canada,or
b. in relation to another health profession in Ontario or in
another jurisdiction in or out ofCanada?
3. Are you currently the subject of a proceeding for
professional misconduct, incompetency or incapacity:a. in relation
to the profession in
Ontario or in another jurisdiction in or out of Canada,or
b. in relation to another health profession in Ontario in
another jurisdiction in or out ofCanada?
4. Have you been denied registration,licensure or similar status
by a regulatory body in Ontario that is responsible for the
regulation of another health profession or by a regulatory body in
another jurisdiction in or out of Canada thatis responsible for the
regulation of the profession or another health profession?
5. Has your registration, licensure or similar status in Ontario
in relation to another health profession or in any other
jurisdiction in or out of
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CASLPO NEWS
Canada in relation to the professionor another health profession
been revoked or suspended?
DECLARATIONThe declaration for each class ofregistration has
been updated. Membersare reminded that completion of
theRegistration Renewal Form has legalconsequences. Any false or
misleadingstatements will be considered to be anact of professional
misconduct and maylead to discipline and other proceedings.
HEALTH PROFESSIONS DATABASEThe Regulated Health Professions
Act
(RHPA) requires Colleges to collectinformation directly from
members ofthe College for the purpose of ministryhealth human
resources planning.Information for the Health ProfessionsDatabase
is derived from yourcompleted renewal form. Membersmust take the
time to answer eachquestion fully. Your answers to thesequestions
will help the ministry developpolicies and programs that
addresssupply and distribution, education,recruitment and retention
for yourprofession.
RESIGNATIONMembers who decide not to renewtheir certificate of
registration for 2012-2013 must notify the College in writingby
completing the Resignation Sectionof the paper version of CASLPO’s
2012-2013 Registration Renewal Applicationform and return it to the
College beforeOctober 1, 2012. If you fail to renewyour
registration and do not resign, your
certificate of registration will besuspended for non-payment of
theannual fee.
NOTICE OF INTENTION TOSUSPENDCASLPO members have an obligation
tocomplete their registration renewal onor before October 1st each
year,whether or not a notice has beenreceived.
On November 1st, a Notice of Intentionto Suspend will be mailed
out tomembers who have not completed arenewal form and submitted an
annualfee or provided the College with writtennotice of their wish
to resign.
Members who receive a Notice ofIntention to Suspend have 30 days
tocomplete CASLPO’s Registration RenewalForm and pay all applicable
fees.
A member who has not completed theirRegistration Renewal Form
and paid allapplicable fees or notified the Collegethat the member
wishes to resign,within two months of the October 1stdeadline, will
be suspended and thesuspension will be reflected on theonline
public register. Employers ofsuspended members will also
benotified.
EMAIL RENEWAL REMINDER NOTICESThe College will send members
renewalreminder notices by email. The Collegeencourages all members
to maintain acurrent email address with the College
to allow for greater efficiency andcommunication. Whenever you
changeyour email address, please remember tonotify the College. A
quick email to the College at [email protected],giving your new
email address, yourname and your registration number
willsuffice.
TO CHANGE YOUR REGISTEREDNAMETo change your registered name,
youmust provide the College with aphotocopy of a legal document
thatsupports the change (i.e., marriagecertificate or evidence of
legal namechange). Please fax this documentationto the College at
416-975-8394 or senda scanned attachment via email
[email protected]. Please indicateon the fax cover page or in
your emailmessage, how you would like your newname to appear on the
register. Onlyname change requests received within15 days of the
completion of your onlinerenewal will be reflected on your
2012-2013 registration card.
QUESTIONS ABOUT THE RENEWALIf you have any questions about
therenewal process, please contactColleen Myrie, Director of
RegistrationServices at 416-975-5347 ext. 211 orGregory Katchin,
Director of Finance at 416-975-5347 ext. 217, toll free inOntario
at 1-800-993-9459 or by email at [email protected]
[email protected].
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CASLPO NEWS
Brian O’Riordan (Registrar) and Iwere thrilled to visit Windsor
thispast spring (May, 2012) to deliver ourregional seminar to over
25 membersfrom the region. We were fortunate tohave one of our
members, Rose Grant-Rennie, initiate and graciously host thesession
at the Windsor RegionalHospital. In addition, we were pleasedto
have one of our peer assessors, TerriCooper, offer her knowledge
andexperience. Topics covered includedthe Proposed Records
Regulation,2011, consent, the quality assuranceprogram as well as
new initiatives ofthe College, including the on-goingmember
consultation regarding ourconduct regulations and our scopes
ofpractice. Our post survey suggested
the information was well received:100% would consider
attendinganother regional seminar and over 90%would consider
recommending aregional seminar to a colleague. Brianand I also
learned a lot, as we usuallydo at our regional seminars, about
ourmembers, their practice challenges andtheir views on upcoming
Collegeinitiatives.
We are planning more seminars for therest of 2012, with Barrie,
Mississaugaand Sudbury as potential locations.Please stay tuned for
exact dates andlocations that will be announcedthrough our email
blasts and on ourwebsite, www.caslpo.com!
CASLPO Regional SeminarsBy Carol Bock, Deputy Registrar
Terri Cooper, Peer Assessor
L to R Alexandria Giordano, Cathy Coppens, Sheila Devaney, Rose
Grant-Rennie
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CASLPO NEWS
As Co-Chairs of the FHRCOInterprofessional CollaborationProject,
Shenda Tanchak, Registrar forthe College of Physiotherapists
ofOntario, and I are very excited thatFHRCO will soon launch the
muchanticipated “IPC Toolkit.”
The Federation of Health RegulatoryColleges of Ontario (FHRCO)
comprisesall of Ontario’s 21 health regulatorycolleges, which
govern over 260,000health professional, and fivetransitional
councils for colleges thatare soon to regulate those
professions’members. The Federation provides aforum for
collaboration on regulatoryissues of mutual interest and
benefitwhile it continues to advance itsmandate to maintain a
strategic focuson regulatory matters and to promoteeffective
communication andcooperation among its members. Moreinformation
about the Federation isavailable at
www.regulatedhealth-professions.on.ca.
Building on the consensus achieved byColleges in the
“InterprofessionalGuide on Orders, Directives andDelegation,” the
Federation hassponsored a project to assistinterprofessional teams
to coordinatecare within the expanded (andoverlapping) scopes and
authoritiesestablished by the Regulated HealthProfessions Statute
Law Amendment
Act.
Targeted for completion in 2012, atoolkit is being developed
that willprovide a framework through whichinterprofessional teams
will quickly
and safely be able to resolve questionsof individual or
professional roles andresponsibilities, including such issuesas
record keeping, transfer of care andprovision of specific elements
ofpatient care. The tools will bedesigned to be customizable to
uniquepoint of care circumstances and toassist but not direct team
members indecision-making. Their use will beoptional.
The toolkit is a three-part, web-basedonline resource available
to all healthcare professionals. It will be comprisedof a
customizable checklist for use byinterprofessional teams, a set
ofFrequently Asked Questions (FAQs)and a comprehensive resource
sectionoutlining all scopes of practice,authorized controlled acts,
and links torelevant College policies or standardsfor each
regulated health careprofession in Ontario.
1. The checklist will be based onpatient/client-centred
milestones:
• The team (or team lead) will be prompted to identify critical
review points (“milestones”) thatwill or may arise in the course of
patient/client treatment or intervention. The checklist includes a
drop down menu of possible milestones (e.g., intake, transfer,
change in status, changein setting) to prompt the user to consider
critical milestones.
• Having identified milestones, as each arises, the team will be
prompted to review a checklist of
Interprofessional Collaboration:
2012 Launch of an Online Toolkit
by FHRCO
Elections were held this spring forseats in Districts 2, 4, and
5. Thefollowing are the results:
District 2Audiologist – Vicky Papaioannou,
re-elected.Speech-Language Pathologist – MarySuddick,
re-elected.
District 4Sandra (Sandi) Singbeil, SLP,acclaimed.
Distri ct 5Carolyn Moran, SLP, acclaimed.
We thank all those who put theirnames forward as well as all
thosemembers who voted in this election.
Council also bid farewell to our twoacademic members on Council,
LucDeNil, SLP and Jack Scott, audiologist.Replacing them for a
three-year termare Randi Fisher, SLP, WesternUniversity and Josée
Lagacé,audiologist, University of Ottawa.
At its June meeting, Council held anelection for executive
members toserve for a one-year term. Thefollowing are the
results:
President: Vicky Papaioannou (AUD)VP – AUD: Deb ZeliskoVP – SLP:
Nancy BlakeExec. Members: Mary Suddick (SLP),Pauline Faubert
(public), FerneDezenhouse (public)
CASLPO Election
Results
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“critical questions.”• The checklist is designed to ensure
that the team has considered aspects of patient/client care
thatare known to contribute to patientsafety in an
interprofessional model of care delivery (e.g., Whatare the needs?
Are their controlledacts required? Who can do it? Who will do it?
Has appropriate consent been obtained?).
• Teams may use the checklist as a planning tool when developing
medical directives or population health action plans. (e.g., “Has
each of the relevant critical questions been considered at various
points during implantationof the planned activity?”).
• Teams may use the generic checklist to satisfy themselves
that
the questions have been addressed, without providing the answers
to the questions (e.g., One of the critical questions is whether
consent to treatment hasbeen obtained. In reviewing this item on
the checklist, a team mayfeel that it has been satisfactorily
addressed by virtue of having an established protocol for
obtainingconsent.)
2. The Frequently Asked Questions (FAQs) will be an easily
searchablesection that will address concernsregarding consent,
privacy, accountability, team communication,etc. Each question will
have a comprehensive, plain languageresponse and will also include
linksto the relevant documents each
Collage has pertaining to the question.
3. The comprehensive resource for scopes of practice will be a
point and click, searchable resource allowing the user to quickly
identify the scopes of practice, professional activities, and the
authorized controlled acts that areunder the purview of any
specific profession.
Expectations are that the tool will belaunched on the FHRCO
website(www.regulatedhealthprofessions.on.ca)in the fall of 2012.
Watch for additionalannouncements as we approachproject
completion!
CASLPO NEWS
DID
KNOW?
Did you know ONE OF THE COLLEGE’S PRIORITy PROGRAMS IS
“PRACTICEADvICE”?
CASLPO receives over 100 calls and emails per month from members
with questions regarding theapplication of legislation,
regulations, and practice standards in their own practice
environment.
CASLPO devotes significant resources to this program because we
believe that supporting membersso that they may provide quality
practice is in the best interest of the public.
We encourage you to contact our staff with any questions
regarding your practice environmentand the application of practice
standards. You will receive relevant information, guidance and
support.
We can be reached at [email protected], 416-975-5347 or
1-800-993-9459 .
-
CASLPO NEWS
Congratulations!
Council and staff of CASLPO took theopportunity at the December
Councilmeeting to acknowledge andcelebrate the 10th anniversary
ofCarol Lammers working as theExecutive Assistant to the
Registrar.Carol began working for CASLPO in2001 as the Executive
Assistant andhas been an integral part of all facetsof the College
functions. Herknowledge, skill and dedication havebeen invaluable.
Council and stafflook forward to many more years ofworking
alongside Carol.
You may recall recently being askedto participate in a CASLPO
surveyregarding social media use. An emailwent out to all our
members in mid-June explaining that CASLPO wasengaged in an
interprofessionalcollaborative project with six otherregulated
health colleges in Ontario todevelop an e-learning module on
thetopic of social media. In an effort tocreate a highly useful and
educationaltool, we surveyed our professionalsregarding their use
of social media.This Social Media e-Learning project isnow well
underway and you cananticipate a product announcement inearly
spring, 2013. In the interim, wethought you may be interested in
theresults of that survey.
We had an impressive response,especially given the short
turn-aroundtime provided (one week), of close to600 members
providing detailed input(thank you all!). This interest in
socialmedia is not surprising when youconsider how pervasive social
media
usage is in both personal andprofessional worlds. It is, of
course,the professional use that is of mostinterest. A brief search
of websitesreveals a wide-spread use of socialmedia amongst big and
smallprofessional, educational and govern-mental organizations. For
example, aTwitter and Facebook presence existsfor organizations
such as the TorontoDistrict School Board, The OttawaHospital,
Children’s Hospital ofEastern Ontario, Peel District SchoolBoard,
the Ministry of Children andYouth Services, Ministry of Health
andLong-Term Care and the Ministry ofEducation, not to mention, the
vastmajority of private practice sites.Clearly, there is a culture
that isfostering members and theiremployers to engage in the
socialmedia world.
Given this environment, it is notsurprising that 84% of our
membersuse some form of social media forboth personal and
professional use,
Social Media: What the
Professions ThinkBy Carol Bock, Deputy Registrar
CASLPO President Vicky Papaioannou (left)
present Carol Lammers with an award
recognizing her 10 years of outstanding service to
CASLPO.
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although personal use far outweighs professional.Depending on
the particular type of social medium,the degree of professional use
varies but the topthree media used for professional purposes
areYouTube, LinkedIn, and Google (in that order). The“other”
category includes Facetime and Pinterest,primarily, and those were
identified as personal use.
When you reported through the survey the purposesof your
professional use of social media, certaintrends appeared. The more
common purposes werenot surprising: seeking information,
professionaldevelopment and networking. All of which speak tothe
very nature of social media. However, it wassurprising to see that
the biggest professional usecame under “other.” We clearly did not
anticipatesome other common social media uses. What wefound when we
looked further was that many of youalso use the “cloud,” through
products such asDropbox, for storing agendas, files, assessment
andtreatment materials, etc. This appears to beparticularly useful
for those who are not located inone space or use a variety of
computers. In addition,frequently mentioned in the “other” category
wasuse of YouTube for segments to view withpatients/clients that
are related to the theraputicgoals (e.g., use of augmentative and
alternativecommunication).
There is no doubt that you are embracing the powerof social
media for enhancing and facilitating yourpractice and providing
improved quality of serviceto your pateints/clients. The survey
results revealedthat over 75% of you felt social media was“somewhat
beneficial” to “extremely beneficial” toyour patients/clients.
However, you also appear to recognize that socialmedia is not
simply a benevolent tool: there are risksinherent in the
technology. When asked about yourconcerns with the use of social
media, yourresponses reflected similar concerns identified byother
regulatory bodies and pinpointed what our e-learning module needs
to cover. The top concernsyou identified were confidentiality and
privacy,maintaining professional boundaries, andprofessional image.
You also you want the College todevelop guidelines.
We will be incorporating into our e-learning module
CASLPO NEWS
-
CASLPO NEWS
what appear to be the commonconcerns articulated by our
membersthrough the survey and variousfeedback over recent years.
Specificallythe topic areas will include:
• Communication and boundaries: when does personal use blur
intoprofessional?
• Patient/client Privacy: what are the safeguards?
• Advertising: what are the principles?
The module will explore theresponsible use of social media
byregulatory health professionalsthrough provision of: basic
informationabout social media and the relatedpractice standards;
practice scenarios;reflection exercises; frequently askedquestions;
references and glossary.
Please keep your ear to the ground, orshould I say, your eye on
the website,for announcements regarding thelaunch of the Social
Media e-LearningModule.
If you have any questions orcomments regarding the Social
Mediae-Learning Module, please contactCarol Bock, Deputy Registrar
[email protected].
DID
KNOW?
Did you know THE DIFFERENCES bETWEEN A REGULATORy AGENCy AND AN
ASSOCIATION?
Regulator Association1 Acts in the interest of the public Acts
in the interest of the profession2 Governed by a Council consisting
Governed by a Board of Directors
of professional members and government consisting of
professionalsappointed public members
3 Registers members based on legislated Accepts members based on
criteria. Membership is mandatory in association-determined
criteria. order to practice. Membership is voluntary.
4 Requires members to participate in Provides members with
opportunitieslegislated quality assurance programs for continuing
education
5 Sets standards of practice to ensure safe Provides competency
enhancing and competent service for the public opportunities for
members seeking
to work to a “gold “ standard6 Engages the public in order to
inform Engages the members in order
them of the value of regulated to serve their professional
needsprofessionals
7 Required to have a complaints process in The provincial
association is not requiredplace to respond to members who do to
have a complaints process in placenot practice to the set
standards
8 Advocates for the public in order to Advocates for the
profession in order to effectensure safe, effective and equitable
service changes to service delivery, to developacross the province.
specialty certificates, increase public
awareness of professional services.9 Provides accessible
information to the Provides accessible information to its
public regarding the professions, the members regarding
professional developmentregistry of members, expected practice
opportunities, developments in the standards and the complaints
process professional fields, political developments that
affect the professions10 Accountable to the public, the
Accountable to the members
government and the members
-
Hercule Poirot and Miss Marple solvedmany a mystery under
British crimewriter Agatha Christie’s pen, but thegrande dame of
mystery novels herselfmay help unravel one of the greatestmysteries
– Alzheimer’s disease.
At a conference in March 2009,University of Toronto English
professorIan Lancashire and computer scienceprofessor Graeme Hirst
presented apaper entitled, “Vocabulary Changes inAgatha Christie’s
Mysteries as anIndication of Dementia: A Case Study.”This paper
describes the results of afascinating study in which the works
ofAgatha Christie were analyzed andcompared for specific aspects
ofwritten language. The results werenothing short of
astounding.
Regina Jokel, speech-language path-ologist, part-time scientist
at Baycrestand assistant professor of speechpathology at the
University of Toronto,
was approached as a consultant to theresearch because of her
expertise in dementia, through her course,Neurocognitive
Communication Dis-orders.
The researchers examined the first50,000 words within 14 of
Christie’sworks, spanning her 53-year writingcareer. These 14
included her earliesttitles, The Mysterious Affair at
Styles,published in 1920 when she was 30,and The Secret Adversary,
publishedtwo years later at age 32, as well as herfinal three
novels, which she wrote inher 80s: Nemesis (1971), Elephants
CanRemember (1972), and Postern of Fate(1973), as well as nine
others over herlifetime. Jokel says they examinedthree aspects of
Christie’s writing:vocabulary richness, specificity ofwords, and
amount of repetition.
The first aspect, vocabulary richness,was based on the number of
differentwords she used in each book. Theydiscovered a significant
decline withage in the size of her vocabulary fromher earlier to
her later works. In fact,the word types fell by one fifth, and
bythe time she wrote Elephants CanRemember, when she was 81,
hervocabulary had dropped by nearly31%.
The second aspect they looked at wasthe frequency of use of
indefiniteterms, such as “thing,” “anything,” or“something.” The
analysis showed thatChristie’s use of vague terms
increasedsignificantly with age, from 0.27% inher first book to
1.23% in her last. Thefinal aspect studied was the number of
repeated phrases. Once again, theyfound a decline in her writing
as sheaged, which they described as a declinein lexical richness.
In their paper, theresearchers explained that, while bothindefinite
words and repetitionsincrease with normal aging, they do
sosignificantly more in the language ofpeople with Alzheimer’s
disease.
This analysis was not the first of itskind. In fact, it
confirmed the results ofa 2004 study by Peter Garrard of
theInstitute of Cognitive Neuroscience atUniversity College London.
Garrardcarried out a similar study on the worksof British novelist
Iris Murdoch, whohad been diagnosed with Alzheimer’sdisease at the
age of 76, the yearfollowing the publication of her finalnovel.
Believing that evidence ofMurdoch’s dementia was apparent inher
writing prior to her diagnosis,Garrard and his colleagues
comparedher early books with her final one.Using the same three
aspects, theyfound very similar results to those inthe U of T study
– her language hadbecome simpler with age, and hervocabulary had
shrunk.
Though Christie was never assessed for,or diagnosed with,
Alzheimer’s diseaseor any other type of dementia, herlater works
were described as“muddled and meandering,” and somebelieve her
novel Elephants CanRemember might have been a sign ofher
defensiveness over her decliningmental function. In their paper,
theauthors say, “…her last novels reveal aninability to create a
crime solvable byclue-detection according to the rules of
Agatha Christie – Helping to Unravel the
Mystery of Alzheimer’s DiseaseBy Sherry Hinman
ORIGINALLY FEATURED IN
VOLUME 8 ISSUE 2 - MAY 2010
th
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ANNIVERSARY
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the genre that she helped to create.”
Jokel says this research was only abeginning. “What was
published wasthe first part of the research,” she says.But their
findings only opened up ahost of other questions, which led
tofurther research. “The second part isnot yet published so I can’t
say toomuch about it.” She did say that theyfound some things they
expected,some they didn’t expect, and somethey are still trying to
reconcile. “Thevocabulary findings are well docu-mented, but many
of the othermeasures had not been usedpreviously.”
It is reasonable to question the degreeto which these findings
are attributableto Alzheimer’s disease and are not justpart of the
normal aging process. Jokelsays there are “several really
goodstudies done on the written languageof Alzheimer’s. While some
aspects oflanguage do decline with normal aging,vocabulary is
something that ‘getsbetter with age,’ and this is especiallytrue of
seasoned writers. With normalaging, we get a little less specific,
andour retrieval is somewhat slower, butour vocabulary becomes
richer.”
Jokel points out that slower retrievaltime doesn’t affect
written languagenearly as much as it does spokenlanguage. “Written
language isforgiving,” she says. “We can slave overone word, and
this is more acceptablethan in speech.”
In a Macleans magazine article
published in April 2009, Dr. MorrisFreedman, head, Division of
Neurology,and Director, Behavioural NeurologyProgram at Baycrest,
is quoted assaying “Because writing is a learned,not a natural
skill, it breaks downearly.”
Jokel agrees with this statement. “Wetend to lose skills
acquired later,” shesays. “Writing is also one of the mostcomplex
tasks; if one componentbreaks down, the person can’tcompensate.
Impaired writing is one ofthe first language symptoms to
benoticeable in someone withAlzheimer’s.”
Jokel says it was fortunate to be able tocompare the findings
about Murdoch,who was diagnosed with Alzheimer’sdisease, with their
own about Christie,who was not. They are also comparingboth sets of
results with a detailedanalysis of the works of P.D. James.James is
an active, productive writerwhose books are still being publishedat
the age of 89, and whose writingdoes not show any signs of
decline.Interestingly, these three authors havemuch in common: all
are female, olderwriters, in the mystery genre.
While the findings are tantalizing, onemight ask how applicable
they are tothe general public. After all, not manypeople are
published authors; can theresults be extended in a useful way tothe
rest of the world? Jokel observesthat many people, after they
leaveschool, don’t write any more. But withthe Internet, there are
many more who
use written language to correspondthrough email, maintain a
website, orblog about their experiences. So theremay be more
opportunity for writingsamples. “People in their 60s and 70sare
more computer savvy,” shereminds us.
Jokel is unsure where the research willeventually lead. This
will be up to “thefathers of the project,” as she refers tothem.
Her own interest would be to doa similar analysis to
distinguishbetween non-fluent progressiveaphasia, semantic dementia
(fluentvariant of non-fluent progressiveaphasia) and Alzheimer’s
disease. Shewould like to see the computer analysisthey used
eventually become availableto clinicians working with an
agingpopulation, and use it for earlydiagnosis of Alzheimer’s and
otherdementias.
But that is the future. For now, Jokelsays she is thrilled with
how muchpublicity this research has garnered. “Ihave been doing
research on languagefor the past 20 years and there’s beenvery
little mention of it. This hasbrought language into focus
inmagazines that do not usually talkabout it.”
Sherry Hinman is a freelance writer and
editor. She is also a professor in the
Communicative Disorders Assistant
Program, Durham College; worked
clinically as an SLP for fourteen years;
and served three years on the CASLPO
Council.
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At the Special Olympics, childrenand adults with
intellectualdisabilities pull out all the stops tocompete for
bronze, silver, and gold;they’re athletes who overcome greatodds to
reach the podium.
Those odds go beyond developmentaldisadvantages, though; health
andwell-being can be a real challenge forSpecial Olympics athletes.
They face a40% greater risk of having preventableconditions such as
untreated orinadequately treated hearing, vision,dental, and
podiatry problems as wellas obesity, and nutritional deficits.
Poor awareness of, and access to,health care practitioners is a
leadingfactor in these health risks. To addressthat problem,
organizers for SpecialOlympics Ontario (SOO) have beenrunning the
Healthy Athletes Programsince 2003 – featuring screening
forhearing, eyes, feet, mouth/teeth,nutrition, and overall
fitness.
Originally, the screenings – offeredduring the Special Olympics
games –weren’t as well-attended as organizerswanted. “The athletes
viewed thescreenings as a fill-in activity betweencompetitions, so
our Healthy Athletesvolunteers were not being fullyutilized,” says
Linda Ashe, directororganizational development, SOO. Theprogram was
adjusted so that in 2008,the Healthy Athletes program was heldtwo
weeks before the games started –making the Special Olympics
Ontariomodel “the first of its type globally,”says Ashe. The
inaugural pre-gamesscreenings were held May 9 and 10.
Winning in Life, Health, and Sport
By Heather Angus-Lee
ORIGINALLY FEATURED IN
VOLUME 6 ISSUE 3 - AUGUST 2008
th
TH
E
ANNIVERSARY
Ontario Audiologist Makes Hearing a Priority for Special
Olympics Athletes
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Almost 200 Health CareProfessionals Give Their TimeThis year,
more than 180 health careprofessionals – doctors,
dentists,audiologists, podiatrists, and nutritionists– from across
Canada volunteered theirtime and knowledge to screen the
1,100athletes who attended the Healthy
Athletes Expo at Durham College inOshawa, Ontario. The health
careprofessionals were assisted by 170student volunteers from
various collegesand universities.
“The Expo concept is an excellentopportunity for the health
care
professionals to learn more aboutpeople with disabilities, the
varioustypes of disabilities, and the range ofconcerns that the
athletes haveregarding access to care,” says Ashe.“There is so much
work to do in thisarea, and by engaging healthprofessionals through
this fun and life-changing experience is seen as a majorstep to
community inclusion andattitudinal change.”
Most of the attending athletes, whoare between the ages of 5 and
77,typically don't participate beyond theSpecial Olympics local
level. Theyattended the expo accompanied by afamily member,
teacher, or grouphome worker.
Healthy Hearing was the first programinstated in the Healthy
Athletesprogram back in 2003 – in fact, it wasthe only screening
offered that firstyear, says Ashe. She developed thehearing
screening program with thehelp of speech pathologist PennyParnes of
the Canadian HearingAssociation. The next year, SOO addedthe Eyes,
Feet and Smiles programs,followed in 2006 by FUNfitness andHealth
Promotion.
Audiologist Joins to Gain
valuable ExperienceEach of the Healthy Athletes programsrequires
a clinical director – a role filledby audiologist Gayle Faiers for
HealthyHearing. In 2007, she attended a train-the-trainer session,
hosted by Ashe,where some 80 doctors and otherhealth care
professionals from Canada,the United States, and Mexico
learnedabout the Special Olympics and how tobring the Healthy
Athletes program totheir area. “Following the training,
Ivolunteered to supervise and screen togain valuable experience,”
says Faiers. Kim Tillery, department chair at SUNYFredonia and
trainer at the train-the-trainer course, came up from New York
-
to screen alongside Faiers at SOO thisyear. Faiers, who teaches
audiology inthe Communicative Disorders Assistantprogram at Durham
College, notes thatshe and Tillery were responsible for“the
ordering of audiological equip-ment and supplies for the
event,setting up the rooms for screening, thetraining and
supervision of the studentvolunteers who screened the hearingof
athletes – such as otoscopy, evoked otoacoustic emissions
(DPOAE)screening, tympanometry and puretone screenings – as well as
gatheringand analyzing data at the event forinclusion in the
database.”
High Fail Rates for Hearing
ScreeningsFaiers describes the process of theHealthy Hearing
screening: Athleteswere directed through the registrationdesks and
four screening stations.Many Special Olympics athletes
required only the first two stations,examining the ear canals
for cerumenand the DPOAE screening of both ears.But if an athlete
did not pass DPOAEs,he/she went to the third station(tympamometry)
and then the fourthstation for two-frequency
pure-toneaudiometry.
In alignment with the findings ofprevious events, and with
national andinternational Special Olympics, thehearing tests of the
SOO athletesproduced high fail rates. Results of the2008 Healthy
Hearing screeningsincluded:
• 69.9% of athletes passed the overall hearing screening
• 33.1% of athletes failed the hearing screening in one or both
ears
• 55.9% of athletes failed the middleear screening
(tympanometry)
• 54.1% of athletes had blocked or partially blocked ear canals
in oneor both ears
Supporting A Lifestyle of
WellnessGeneral education about health – andsharing the
screening results with theadult caregiver accompanying eachSpecial
Olympics athlete – is a criticalpiece of the Healthy Athletes
program.Those results include a Healthy Hearingreport indicating
screening pass or fail,as well as a referral for medical
and/oraudiological services if necessary. Aswell, the athletes’
parent/caregivergets an opportunity to talk about theirconcerns
with the volunteer.
This practice addresses another factorin the athletes’ dramatic
health deficit:poorly supported lifestyles to promotewellness. For
example, “someindividuals did not know how to accessaudiologists in
their community” saysFaiers, “so I provided OSLA’sCommunication
Health Information
Line website and phone
number”(www.osla.on.ca/chil/enrolment.asp). The Healthy Athletes
Expo alsofeatured these health screenings:
• Opening Eyes: Assessing athletes’vision and providing
eyeglasses and protective goggles as necessary.
• Special Smiles: Teaching the importance of oral health and
providing mouth guards as necessary.
• FUNfitness: Assessing the athletes’general flexibility and
providing exercise routines and resources.
• Fit Feet: Examining athletes’ nails,bones, and joints.
• Health Promotion: Reinforcing good nutrition and healthy
lifestylechoices.
The Healthy Athletes Expo, funded inpart by the Ontario Trillium
Foundation,acted as a spring board event for theSpecial Olympics
Ontario 2008 SpringGames in Durham Region May 29 – 31.The games
were led by the DurhamRegional Police Service, a long-timesupporter
of Special Olympics Ontariothrough the Law Enforcement TorchRun.
The athletes competed inswimming, 5 and 10 pin
bowling,power-lifting, and basketball. Winnersfrom the Ontario
Games go on tocompete at the National Games inLondon Ontario in
2010.
“By all accounts, the expo was aresounding success. We were able
togather excellent data on each healthdiscipline, and work with
each athletewho needed follow-up assessment andcare,” says Ashe. As
of this writing 422new athletes and their families joinedlocal SOO
programs as a result of theHealthy Athletes Expo.
Gratifying Work, Meeting Great
AthletesGayle Faiers agrees that the expo
(Left) Kate Gauldie one of the Clinical
Directors of FunFitness with (Right)
Special Olympics Ontario Director
Organizational Development Linda Ashe.
-
achieved its goals – for her, personally,as well as for the SOO
and theirathletes. ‟The Healthy HearingProgram is definitely one of
the mostrewarding experiences that I’ve everhad the chance to do
professionally.Not only have I had the opportunity towork with
other audiologists,volunteers, and Special Olympics staff,but I
have gotten to know some reallygreat athletes!”
She notes that ‟most of the athleteswere excited about getting
their
hearing checked, although some wererather nervous. I was told by
a teacherthat one of the athletes has never hadher hearing checked
because shewould not go to the hearing clinic. Butshe was willing
to let us screen hersince her friends were there having itdone at
the Expo, too.”
Those little moments of connectionand accomplishment are
wonderful,Faiers says. ‟It’s gratifying knowing thatwe are helping
the athletes byreminding them of the importance of
hearing health care – and identifyingspecific athletes who need
audiologicalevaluations to determine if a hearingloss exists and
requires treatment.”Special Olympics Ontario is looking formore
volunteer audiologists to join theHealthy Athletes team; if
interested,Gayle Faiers can be reached [email protected].
Heather Angus-Lee, an award-winningjournalist, writes frequently
forCASLPO Today. She can be reached [email protected].
DID
KNOW?
Did you know CASLPO IS GOvERNED by A COUNCIL. THE COMPOSITION OF
THECOUNCIL IS MANDATED by THE Audiology And SPeeCH-lAnguAge
PAtHologyACt, 1991, WHICH ExPLICITLy STATES THAT THE COUNCIL
CONSISTS OF:
• professionals (8 to 9), • public members appointed by the
Lieutenant Governor in Council (6 to 7) and • academic members
(2).
Currently, CASLPO has nine professional members who represent
five electoral regions in theprovince of Ontario (6 SLPs and 3
Auds), two academic members (1 SLP and 1 Aud) and 5
publicmembers.
The professional members are voted in by you, themembership, and
serve a three year term. Each yearthere usually is two to four
professional members ofCouncil positions that open for election.
This year we hadopenings for four positions corresponding to
twopositions in district 2 (Central Region), one position eachin
districts 4 (North-Western Region) and 5 (North-Eastern
Region).
-
Title: A-FROM in Action at theAphasia InstituteAuthors: Aura
Kagan, PhDJournal: Seminars In Speech AndLanguage 2011;32(3).
Aphasia centers are in an excellentposition to contribute to the
broaddefinition of health by the World HealthOrganization: the
ability to live life to itsfull potential. An expansion of
thisdefinition by the World Health
Organization International Classificationof Functioning,
Disability and Health(ICF) forms the basis for a user-friendlyand
ICF-compatible framework forplanning interventions that
ensuremaximum real-life outcome and impactfor people with aphasia
and theirfamilies. This article describes Livingwith Aphasia:
Framework for OutcomeMeasurement and its practicalapplication to
aphasia centers in theareas of direct service, outcome
measurement, and advocacy andawareness. Examples will be
drawnfrom the Aphasia Institute in Toronto. Acase will be made for
all aphasia centersto use the ICF or an adaptation of it tofurther
the work of this sector andstrengthen its credibility.
KEYWORDS: Aphasia, aphasia centers,ICF, A-FROM, intervention
measures
FEATURE
By Alexandra Carling-Rowland Ph.D. Reg. CASLPO,
Director of Professional Practice and Quality Assurance
Research Corner
The first edition of Research Cornerwas very well received by
themembership. For this edition we haveturned to our research
colleaguesworking in research institutes andteaching hospitals who
have had articlespublished in peer reviewed journals in2011 and
2012. It is hoped that by
disseminating important clinical andtheoretical research
findings we will helpyou, the members, to remain current inyour
practice.
The inclusion criteria for Research Corner are as follows:• The
article appears in a Peer
Reviewed Journal• The article concerns the practices
of speech language pathology and audiology
• The article is published in the current or previous year
Abstracts can be forwarded to me atCASLPO at
[email protected]
Abstracts
Title: Longitudinal Detection ofDementia through Lexical
andSyntactic Changes in Writing: ACase Study of Three
BritishNovelistsAuthors: Xuan Le, Ian Lancashire,Graeme Hirst, and
Regina JokelJournal: Literary and LinguisticComputing
2011;26(4):435–461.
We present a large-scale longitudinalstudy of lexical and
syntactic changes inlanguage in Alzheimer’s disease using
complete, fully parsed texts and a largenumber of measures,
using as oursubjects the British novelists IrisMurdoch (who died
with Alzheimer’s),Agatha Christie (who was suspected ofit), and
P.D.James (who has agedhealthily). We avoid the limitations
anddeficiencies of Garrard et al.’s, Theeffects of very early
Alzheimer’s diseaseon the characteristics of writing by arenowned
author (Brain 2005;128[2]:250–60.) earlier study of IrisMurdoch.
Our results support the
hypothesis that signs of dementia canbe found in diachronic
analyses ofpatients’ writings, and in addition leadto new
understanding of the work of theindividual authors whom we studied.
Inparticular, we show that it is probablethat Agatha Christie
indeed sufferedfrom the onset of Alzheimer’s whilewriting her last
novels, and that IrisMurdoch exhibited a “trough” ofrelatively
impoverished vocabulary andsyntax in her writing in her late 40s
and50s that presaged her later dementia.
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Title: Binaural Interactions Developin the Auditory Brainstem
ofChildren Who Are Deaf: Effects ofPlace and Level of Bilateral
ElectricalStimulationAuthors: Gordon KA, Salloum C, Toor GS,van
Hoesel R, Papsin BC.Journal: The Journal of
Neuroscience2012;32(12):4212–23.
Bilateral cochlear implants (CIs) mightpromote development of
binauralhearing required to localize soundsources and hear speech
in noise forchildren who are deaf. These hearingskills improve in
children implantedbilaterally but remain poorer than
normal. We thus questioned whetherthe deaf and immature human
auditorysystem is able to integrate inputdelivered from bilateral
CIs. Usingelectrophysiological measures ofbrainstem activity that
include theBinaural Difference (BD), a measure ofbinaural
processing, we showed that aperiod of unilateral deprivation
beforebilateral CI use prolonged responselatencies but that
amplitudes were notsignificantly affected. Tonotopicorganization
was retained to someextent as evidenced by an elimination ofthe BD
with large mismatches in placeof stimulation between the two
CIs.Smaller place mismatches did not affect
BD latency or amplitude, indicating thatthe tonotopic
organization of theauditory brainstem is underdevelopedand/or not
well used by CI stimulation.Finally, BD amplitudes decreased
whenthe intensity of bilateral stimulationbecame weighted to one
side and thiscorresponded to a perceptual shift ofsound away from
midline toward theside of increased intensity. In summary,bilateral
CI stimulation is processed bythe developing human
auditorybrainstem leading to perceptualchanges in sound location
andpotentially improving hearing forchildren who are deaf.
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Peer Assessors are the backbone of theQuality Assurance Program
here atCASLPO. They are working speech-language pathologists and
audiologistswho travel, sometimes great distances,across the
province to meet withmembers who have been randomlyselected to
participate in PeerAssessment.
Quality assurance is mandatory for allregulated health
professions. In orderto be self-regulated, every Collegemust have a
quality assurance programconsisting of: continuing education
andprofessional development; self, peerand practice assessment; and
amechanism for the College to monitorparticipation and
compliance.
Great efforts have been made toensure that Peer Assessment is
apositive learning process. Our PeerAssessors are practicing
clinicians andthey come to the process with a strongsense of what
is practical andreasonable. They may be your best“mentor.”
What Do you Need To become A
Peer Assessor?First and foremost, you need acommitment to
quality professionalpractice and a belief in continuingeducation
and professionaldevelopment. Secondly, all assessorsmust attend
training sessions atCASLPO where they learn aboutCASLPO,
self-regulation, the QualityAssurance program, and the
intricaciesof a successful site visit. Thirdly, all
assessors must have been PeerAssessed themselves. This means
thatthey know what it is like first hand toprepare for a site
visit, and how theprocess is time consuming anddemanding, but
worthwhile. Each PeerAssessor is an experienced clinicianhaving
practiced for at least six years.However, they are truly your
peers,and, as working speech languagepathologists and audiologists,
knowfirst-hand the challenges and obstaclesthat are faced while
pursuing aprofession to the highest standards.Finally, they must
commit to ongoingeducation themselves. Every year thegroup attends
a full-day workshop atCASLPO where different elements ofthe Peer
Assessment process arereviewed and new documentsintroduced.
Who Are Our Peer Assessors?Currently we have 16 Peer
Assessorsworking in the Quality Assuranceprogram, four audiologists
and 12 SLPs.It is important that the group of PeerAssessors
reflects the workingpractices of our membership, so wehave
representation from all areas ofpractice: publically funded and
private,pre-school, school age and adults. Weare fortunate to have
two bilingualPeer Assessors who regularly assessFrench speaking
members. The PeerAssessors come from all areas of theprovince:
Windsor, London, Niagara,Waterloo, Guelph, Hamilton,
Brantford,Mississauga, Toronto, Markham,Peterborough, Cornwall,
Ottawa ,andThunder Bay.
CASLPO’s Peer AssessorsSo, what inspired these busy cliniciansto
become a Peer Assessor?
We asked them, and here are some oftheir responses:
“I became a peer assessor because the
process intrigued me! I have remained a
peer assessor because of the opportunity
to interact with the variety of amazing
individuals who practice in this field. It
has also been my experience that the
program is supportive of members.”
“Getting to spend a day with SLPs in
different areas of the province to learn
about their programs, brainstorm
together and sometimes commiserate
together about similar practice
challenges.”
“Becoming part of the process seemed
to me the best way to ensure that I was
meeting College standards in my own
practice. I also believed that being more
involved with the College would help me
in my role as practice leader for the
speech-language pathology division of a
private company.”
“I like meeting other audiologists across
Ontario that face the same daily
challenges as I do. Sometimes, issues
that affect all clinicians are brought to
the attention of the College and changes
can be made that benefit everyone.”
“I enjoy meeting other colleagues the
most, and always walk away with a
renewed passion for being an SLP.”
FEATURE
What Inspires a Clinician to become a
Peer Assessor? By Alexandra Carling-Rowland Ph.D.,
Reg.CASLPO
Director of Professional Practice and Quality Assurance
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“Before becoming a peer assessor, I did
not realise how much the College is
open to feedback from its members in
terms of adapting, continually re-
evaluating and improving the process as
much as possible for us all as members.
It has also made me appreciate that
actually the peer assessment process is
a way of guaranteeing that we as SLPs
and AUDs are maintaining high
standards, and it ensures that if we are
complying, we really need have no
worries about any complaints should
they ever be made against us.”
“Great opportunity to do something
different in my role as an SLP and also
to “demystify” the perception of the
College and put a face on it.”
“I was interested initially in the PA
process as a means of ensuring that the
College was observing the needs and
challenges faced by those members
who worked with young people and in
education. In the early years of the PA
process development I would like to
think that I had some input into on-
going changes and interpretations
which applied to this population.”
“The main reason was to embrace the
opportunity to get involved with the
profession outside of my day-to-day
employment.”
“I was selected for peer assessment in
the first year. Of course I was extremely
anxious and my peer assessor did a
wonderful job guiding me through the
process. I thought I might be able to do
the same for others in the profession
and therefore became a peer assessor. I
have enjoyed meeting many peers over
the years and feel my own practice has
benefitted tremendously.”
“I really enjoy travelling outside of my
community to meet new people as I
always learn something new in every PA
experience either about what other SLPs
are doing clinically, challenges they face,
a new clinical idea or how I, myself, can
improve.”
“I highly value the perspective that the
Quality Assurance program is an
educational one. We all continue to
learn, improving our clinical skills,
caseload management skills and our
services to our clients and their families.”
“I became a peer assessor following my
own peer assessment which was a very
positive experience. I learned a lot
through the process and felt becoming
a peer assessor would be an excellent
opportunity for further skill
development and growth as well as
allowing me an opportunity to
contribute to the profession.”
SummaryCASLPO would like to take thisopportunity to thank our
PeerAssessors for their commitment toQuality Assurance. You might
seethem at a site visit, but they are doingmuch work behind the
scenes, notonly with individual Peer Assessments,but also with the
ongoing evaluationof the Quality Assurance program.They are the
face of the College, andthey carry out their task withobjectivity,
sensitivity, creativity and asense of pragmatism and fairness.
Wecould not run the program withoutthem – thank you.
Back row left to right: Carol Bock, Deputy Registrar, William
Krock SLP, Karen Fisher SLP, Dianne Height SLP, Karen Halvorson,
SLP, Sandra
Corte SLP, Juljia Adamonis Audiologist, Sarah Chapman Jay SLP,
Dana Parker Audiologist, Tenley Baker SLP, Chris Allan Audiologist,
Alex
Carling-Rowland, Director of Professional Practice and Quality
Assurance.
Front Row: David Beattie SLP, Lisa Sylvester SLP, Joanne Winckel
SLP, Terri Cooper SLP.
Absent: Hish Husein Audiologist, Stephanie Muir Derbyshire
SLP.
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The face of speech-languagepathology (SLP) and audiology
ischanging in response to external trendsin government policy,
constraints inhealth care and education, and theaging population.
More and more of ourmembers are contacting the College toinquire
about opening a privatepractice, either part time or full time.This
article has been written to providethe membership with
informationconcerning regulation that addressesthe most common
inquiries receivedhere at CASLPO.
When working as a sole privatepractitioner you no longer have
thestructure of employer’s or owner’spolicies and procedures which
usuallyincorporate CAS LPO’s regulations andpractice standards. You
have to ensurethat every element of your practiceabides by the
legislation, regulations,and bylaws and follows the
College’sProfessional Practice Standards. Pleaserefer to the
following:
1. Legislation such as the Audiology and Speech Language
Pathology
Act, the Regulated Health Professions Act (RHPA), the Health
Care Consent Act and Personal Health and Information Protection
Act (PHIPA). These Acts, and others, can be found on the CASLPO
website www.caslpo.com under Legislation and Regulations.
2. The rules of the College, including regulations and bylaws
which includes the Code of Ethics (By-law2011-8). These can also be
found on the CASLPO website www.caslpo.com under Legislationand
Regulations.
3. College Standards of Practice, Practice Standards and
Guidelines (PSGs) and Position Statements. These documents focus on
specificareas of practice. Practice Standards can be found on our
website www.caslpo.com
Frequently Asked QuestionsArea of PracticeI am a SLP working for
a school board,but I used to work with adults withaphasia. Can I
offer services to bothpopulations?
Consider not only your experience andarea of practice, but also
the College’sCode of Ethics, bylaw 2011-08
In the Code of Ethics, the section onProfessional Standards
GoverningPractice states: “Audiologists andSpeech Language
Pathologists shallpractice within the limits of theircompetence as
determined by theireducation, training and
professionalexperience.”
You may offer services in any area ofspeech-language pathology
as long as
you currently have the appropriatecompetencies, which are
developedthrough acquiring knowledge, skill, andjudgement in
specific practice areas. Itis therefore prudent to develop
LearningGoals for your Self-Assessment Tool(SAT) to further update
your knowledgeregarding current best practice in theprovision of
service to adults withacquired speech, language andcommunication
disorders. Professional Liability InsuranceDo I need extra or
special liabilityinsurance for private practice?No, but you must
make sure that youhave sufficient Professional LiabilityInsurance.
The Registration Regulation,2011 stipulates:
4. Every certificate of registration is subject to the following
conditions:
2. The member shall maintain professional liability insurance in
the amount and in the form as required by the bylaws. O. Reg.
21/12, s. 4.
The professional liability insurance musthave a limit of at
least $2,000,000 forany one incident and must not besubject to a
deductible.
Record KeepingI am an audiologist going into privatepractice
with an ENT. Which of us isresponsible for the records?
FEATURE
Opening a Private
PracticeBy Alexandra Carling-Rowland Ph.D. Reg.CASLPO
Director of Professional Practice and Quality Assurance
and Carol Bock M.H.Sc. Reg CASLPO
Deputy Registrar
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This is something that you need todetermine with the ENT at the
outset ofyour professional relationship. Thereare a variety of
options regarding whomaintains the record. One option is tohave a
separate audiology record fromthe ENT record. If you are
maintainingthe audiology records, you are then theHealth
Information Custodian (HIC) andmust act accordingly. You
areresponsible for the safe and confidentialstoring of the record
according toPHIPA.
Alternatively, the ENT can be the HICand the “keeper of the
records.” If youarrange for the ENT to be responsiblefor
maintaining audiology records, youshould inform him or her about
ourProposed Records Regulation andensure as far as possible the
following:
1. A member shall, when working with others, take all reasonable
steps to ensure that records are made, used, maintained, retained
and disclosed in accordance with this Regulation.
9. (1) The member shall maintain his or her records in a manner
that ensures that a patient/client with a right to access his or
her health record is able to exercise that right.
Whatever is decided upon, it should bemade clear to the
patient/client whereand how they would access their record,
if they so choose. Also, the recordkeeping arrangement should
bedocumented in an agreement.
What Else You Need To Know about
Records
What records or charts do I need tokeep?Proposed Records
Regulation, 2011outlines the requirements for
collecting,documenting, storing, and maintainingrecords. The
regulation also outlineswhat information you must collect
anddocument, including financialinformation that needs to be in
therecord.
2. “A member shall ensure that his orher records are up to date
and made, used, maintained, retained and disclosed in accordance
with this Regulation.”
5 (1) “Each member shall maintain a financial record for each
patient/client, where the member bills for services and clinical
products to the patient/client directly or indirectly through a
third party.”
How long do I need to keep the chartsor records?Information
regarding record retentioncan also be found in the ProposedRecords
Regulation, 2011. Essentially,the record must be retained for 10
yearspast the last contact or 10 years after
the patient/client turns 18, whichever islonger. The regulation
states:
8. (1) Financial and patient/client health records shall be
retained following the patient/client’s last contact for the
following periods oftime:
(a) For patients/clients who are 18 years of age or older at the
time ofthe last contact: a period of at least10 years.
(b) For patients/clients who are less than 18 years of age at
the time of the last contact: period of at least 10 years following
the date at which they would have become 18years of age.
You will notice that the regulation usesthe word last “contact”
and not lasttreatment session. If you havesignificant contact with
the patient,client, parent or family member thatrequires
documentation, then therecord must be kept for the outlinedtime
following the contact. Examplescan include a parent calling
youregarding a previous child client who isstuttering. You might
provide them withtherapeutic suggestions and ask themto call you
again if the behaviourpersists. The spouse of a previouspatient
with apraxia may call you todiscuss a communication issue.
Youbrainstorm the issue with her and askher to contact you again if
a follow-up
-
appointment is needed. Both areexamples of “contact.”
ConfidentialityWhat steps do I need to take to
ensureconfidentiality and security?All patient/client health
informationmust be stored according to therequirements outlined in
PHIPA:
12. (1) A health information custodian shall take steps that are
reasonablein the circumstances to ensure thatpersonal health
information in the custodian’s custody or control is protected
against theft, loss and unauthorized use or disclosure andto ensure
that the records containing the information are protected against
unauthorized copying, modification or disposal. 2004, c. 3, Sched.
A, s. 12 (1).
The physical records should be kept in alocked filing cabinet.
If you are providingservice on an itinerant basis, keep therecords
in a locked box in the lockedtrunk of your car. At the end of the
daythe locked box containing the client’scharts or records should
be brought intoyour house/apartment and storedsecurely. Electronic
records requiresecure storage, especially if you areusing and
transporting a laptop.
Please refer to CASLPO Today (vol 10,issue 2) “Practicing
Securely in anInsecure World.”
AdvertisingI know that I cannot hold myself out asa specialist,
but can I includeinformation on my area of practice
inadvertising?Yes. The statement below can be foundin the Proposed
Advertising Regulation,1996.
A member cannot make: C. “a reference to specialization in
any area of practice or in any procedure or treatment unless
themember holds a specialist
certificate issued by the College, although nothing herein shall
prohibit an advertisement that contains a reference to the member’s
scope of practice, or statement that the member has additional
training in a particular area of practice, or a statement that the
member’s practice is restricted to a particular area of
practice.”
Can I advertise my services outsidetraditional venues such as
the yellowPages and newspapers?Yes you may, as long as you follow
theProposed Advertising Regulation, 1996.
Your advertisement, wherever it isplaced should be written in a
mannerthat is: tasteful, dignified, ethical andprofessional;
understood by the generalpublic; and not false or misleading.
Your advertisement must not containtestimonials of any kind,
including thosefrom current clients/patients,
formerclients/patients, or from family orfriends of
clients/patients.
Can I advertise using social media, forexample Google Maps or
Facebook?Yes, as long as you abide by theProposed Advertising
Regulation, 1996.
CASLPO is recommending, however,that you exercise extreme
caution whenconsidering the use of social media in aprofessional
context. Regardless of themedium, members should consider
theappropriateness of revealing anypersonal information to
patients/clientsdue to the potential for the blurring
ofprofessional and personal boundaries(see Position Statement:
ProfessionalRelationships and boundaries). At aminimum, consider
creating a separateFacebook or twitter account for yourprofessional
presence and closelymonitor any ensuing links to otherinappropriate
websites or pages orrequests to be a patient/client’s friend.We
strongly recommend that you don’t
use your personal accounts for workrelated matters.
Can I advertise and provide adiscount?The Professional
Misconduct Regulation,1991 lists the following as an act
ofprofessional misconduct:
“Charging a fee that exceeds the fee for services set out in the
schedule of fees published by the Ontario Association of
Speech-Language Pathologists and Audiologists, without the prior
informed consent of the patient orclient. Charging a fee that
exceeds the fee for services set out in the schedule of fees
published by the Ontario Association of Speech-Language
Pathologists and Audiologists, without the prior informed consent
of the patient orclient.”
However, there is no requirementregarding fees that may be lower
thanthat which the association recommends.Consequently, you may
offer discountedservices, such as the sort that are offeredthrough
Groupon or other discountedonline gift certificates. You must
alsoadhere to the Proposed AdvertisingRegulation, which stipulates
that youmust not state anything that is false ormisleading.
Therefore, the service musttruly be discounted. You must not tryand
recoup the discounted fee by raisingfees for other services, for
example. Alsoremember that your advertising shouldbe tasteful,
dignified, ethical, andprofessional, as set out in the
ProposedAdvertising Regulation.
Can I include my area of practice on mybusiness cards?Yes, as
long as you do not hold yourselfout as a specialist or an expert.
Also,remember that if you have a Ph.D. or aclinical doctorate such
as D.Aud, thatyou are not allowed to use the “doctor”title on your
business cards, website,signage within your practice enviro-
FEATURE
-
FEATURE
nment, etc. although you may placeafter your name, the name of
yourdegree followed by your profession.These restrictions do not
apply in non-clinical settings, such as academia,where you may use
the “doctor” title.For more information please review thePosition
Statement on the Use of theTitle “Doctor.”
Fees For ServiceI am new to private practice and I haveno idea
how much I can charge for myservices?
CASLPO does not determine how muchmembers should be charging
forscreening, assessment, treatment,consulting or education. The
OntarioAssociation of Speech-LanguagePathologists and Audiologists
(OSLA)produces a “Suggested Fee Schedule forPrivate Practice.” The
fees listed are therecommended maximum hourly rates.It is an act of
professional misconductunder the Professional MisconductRegulation
to charge excessive fees:
(24) Charging a fee that is excessivein relation to the services
charged for.(25) Charging a fee that exceeds the fee for services
set out in the schedule of fees published by the Ontario
Association of Speech-Language Pathologists and Audiologists,
without the prior informed consent of the patient orclient.
What should my fees include?You need to consider carefully what
isincluded in your fees, determine a feeschedule and whether or not
yoursession fees cover requests for extraservices such as writing
additionalreports and making copies of the clientfile.
Ask yourself the following questions:• How long do you need to
prepare
for the client and write up your chart note after the
session?
• Are you providing the client with an assessment report? This
is not a requirement of CASLPO, but many private practitioners do
provide one.
• If providing service in the client’s home, are you charging
for travel?
• Does the client have multiple needs that may require you to
communicate with other professionals, when you have consent to do
so?
• Is the client involved in a legal case,for example child
custody or motorvehicle accident (MVA), which maynecessitate
reports and copies of the patient/client file?
When you have decided on a fee, aschedule and a policy for
charging forextraneous services inform thepatient/client. Make sure
that theinformation is clear, understood by thepatient/client and
is documented in therecord.
I live in a low socio-economic area;families here cannot afford
therecommended fee schedule. Am Iallowed to offer a lower fee than
isrecommended?Yes, as long as you abide by the rules ofthe College
and practice in accordancewith CASLPO’s standards of practice.
Youmay want to consider providing shortersessions, for example 40
or 45 minutes,and reduce your fee accordingly. Thereare also some
charitable organizationswhich provide financial support forsome
families with fees for service.
Am I allowed to offer a free service, forexample a free hearing
test or speechlanguage screening?Yes, but the service must be truly
free;you cannot recoup the cost by elevatingyour fees in other
areas. All speech-language pathologists and audiologistsmust abide
by the Legal Standardsgoverning practice in the Code of
Ethics:4.1.3 shall be honourable and
truthful in all their professional relations;
4.1.2 shall respect patients’/clients’ choice of
practitioners;
4.1.4 shall respect patients’/clients’ right to decline
treatment
If an individual walks into a hearingclinic to avail themselves
of a freehearin
