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KNOWLEDGE AND SKILLS ACQUISITION (KASA)SUMMARY FORM FOR

CERTIFICATION IN SPEECH-LANGUAGE PATHOLOGY

Staci D. Sullivan

Knowledge and Skills Acquisition (KASA) Summary Form For Certification in Speech-Language Pathology March, 2003

KNOWLEDGE AND SKILLS ACQUISITION (KASA)

SUMMARY FORM FOR

SPEECH-LANGUAGE PATHOLOGY

Instructions for Use

The Knowledge and Skills Acquisition (KASA) form summarizes a student's acquisition of the knowledge and skills delineated in the Standards for the Certificate of

Clinical Competence (SCCC). Entries are made only upon acquisition of the knowledge or skill; thus the KASA is not an evaluation, but only a record that a particular

knowledge or skill has been acquired.

Required Documentation

1. Students from CAA-accredited programs (Refer to "Automatic Approval" language in Standard I. Degree) must submit the "Verification by Program Director" pageof the KASA when applying for certification.

2. All other applicants must submit the entire, completed document, including the "Verification by Program Director" page when applying for certification.

Use of the KASA Form

1. The CFCC encourages programs to use the KASA to demonstrate compliance with accreditation standards related to preparing students to meet ASHA certificationrequirements. However, programs may develop other documents to verify student's acquisition of knowledge and skills.2. For students who must submit the entire KASA, and for academic programs wishing to use the KASA as a tracking document, indicate with a check mark inColumn B whether each knowledge and skill was achieved. If a particular knowledge or skill was acquired through work completed in a specific course or courses, thetitle and number of the course(s) should be entered in Column C. If the knowledge or skills were acquired in clinical practicum, enter the title and number of thepracticum in Column D. If the knowledge or skill was acquired through course work and/or clinical practicum, and/or lab or research activities, there should be entriesin all of the applicable columns: C, D, and/or E.3. Students and programs using the KASA are advised to keep a copy in a safe place, should they need to provide information to the Council For Clinical Certificationat a later date (e.g., upon application for reinstatement).4. CFCC encourages programs and students to periodically review the KASA (or other tracking documents developed by the program) to assist students indetermining knowledge and skills already acquired and those yet to be attained.

Knowledge And Skills Acquisition (KASA) Summary Form

For Certification in Speech-Language Pathology

The KASA form is intended for use by the certification applicant during the graduate program to track the processes by which the knowledge and skills specified inthe 2005 Standards for the CCC are being acquired. Each student should review the KASA form at the beginning of graduate study, and update it at intervalsthroughout the graduate program and at the conclusion of the program.

The student, with input and monitoring of program faculty, must enter a check mark in column B as each of the knowledge and skills is acquired. It is expected thatmany entries will appear in the course work and the clinical practicum columns, with some entries, as appropriate, in the "Other" (lab, research, etc.) columns.Please enter the course or practicum number and title and description of other applicable activity.

I. KNOWLEDGE AREAS

How Achieved?

A B C D E

Standards

Knowledge/Skill Met?(check ) Course # and Title

Practicum Experiences # andTitle

Other (e.g. labs, research) (Includedescription of activity)

Standard III-A. The applicant mustdemonstrate knowledge of theprinciples of:

● Biological sciences BIOL 2401 Anat & Phys

● Physical sciences CHEM 1375 Chem

PrinciplesGEOL 1403 Gen Geol I

● Mathematics College Algebra

PSYC 2471 Intro toStatistical Mthds

● Social/Behavioral sciences

PSYC 2301 Gen PsyCMDS 5321 ResearchMethods in Comm. Dis.

Compiled information relevant to researching atopic through the library including a one pageessay for quantitative methodology using CMDSresearch and a reflection paper regardingplagiarism. Completed an annotatedbibliography on five published articles regardinga focused area of research. Completed a writtenevaluation of assigned articles. Grouppresentation on researched topic (proposed aresearch question and a research design) andprovided a written research proposal.

Standard III-B. The applicant mustdemonstrate knowledge of basichuman communication andswallowing processes, includingtheir biological, neurological,acoustic, psychological,developmental, and linguistic andcultural bases

● Basic Human CommunicationProcesses

● Biological CMDS 2373 SpeechAnatomyCMDS 2371 HearingAnatomy

Completed a descriptive chart of the muscles ofthe tongue including origin, course, insertion,and function. Completed descriptive chart of thefacial and cranial bones of the skeletonincluding: articulations and related structures,contribution to the formation of the skeletalframework, landmarks and characteristics.

● Neurological CMDS 4304 Neurology Completed two annotated bibliographies.

How Achieved?

A B C D E

Standards

Knowledge/Skill Met?(check ) Course # and Title

Practicum Experiences # andTitle

Other (e.g. labs, research) (Includedescription of activity)

● Acoustic CMDS 2374 SpeechScienceCMDS 2372 HearingScienceCMDS 1372 PhoneticsCMDS 5307 Artic/PhonoDis

Completed a review of phonological theories.Completed three speech sample analyses.Provided a case history, a treatment for anarticulation disorder was completed utilizingefficacy data to support treatment strategies.Provided a case history, a treatment for aphonological disorder was completed utilizingefficacy data to support treatment strategies.Presented two resent articles regardingdiagnostic and clinical issues in developmentalapraxia of speech.

● Psychological CMDS 1373 TheoreticalBases/LanguageCMDS 5321 ResearchMethods in Comm. Dis.

Compiled information relevant to researching atopic through the library including a one pageessay for quantitative methodology using CMDSresearch and a reflection paper regardingplagiarism. Completed an annotatedbibliography on five published articles regardinga focused area of research. Completed a writtenevaluation of assigned articles. Grouppresentation on researched topic (proposed aresearch question and a research design) andprovided a written research proposal.

● Developmental/Lifespan CMDS 1375 Lang. Acq.CMDS 5304 Lang. DisSchool-AgeCMDS 5307 Artic/PhonoDisCMDS 5306 Lang. DisPreschool

Conducted a review of literature regardingemergent literacy. Conducted a review ofliterature regarding phonological awareness.Completed standardized test analysis, variouslanguage sample analysis and a reading miscueanalysis with a written summary andinterpretation of findings. Review of literatureregarding service delivery models includingASHA guidelines and current educational laws.Completed treatment plan and provided clinicalstrategies and rationale with supporting efficacydata. Carried out a case study involving the useof graphic organizers in the treatment oflanguage learning based disorders.

Completed a review of phonological theories.Completed three speech sample analyses.Provided a case history, a treatment for anarticulation disorder was completed utilizingefficacy data to support treatment strategies.Provided a case history, a treatment for aphonological disorder was completed utilizingefficacy data to support treatment strategies.

Presented two resent articles regardingdiagnostic and clinical issues in developmentalapraxia of speech.

Compiled a learning portfolio of knowledgegained through lecture, handouts, textbook, andjournal readings regarding preschool language.Completed a research project regarding fetalalcohol and fragile X syndromes and presentedthese to the class. Completed developmentallevel project for age 3 to 5 including:descriptions, general characteristics, prevention,assessment considerations with recommendedtests, treatment plans, and samplingprocedures.

● Linguistic CMDS 1373 TheoreticalBases/LanguageCMDS 1372 PhoneticsCMDS 1375 Lang. Acq.CMDS 5304 Lang. DisSchool-AgeCMDS 5307 Artic/PhonoDisCMDS 5306 Lang. DisPreschool




● Cultural CMDS 1375 Lang. Acq.CMDS 1373 TheoreticalBases/LanguageCMDS 5304 Lang. DisSchool-AgeCMDS 5307 Artic/PhonoDisCMDS 5306 Lang. DisPreschool




● Swallowing Processes

● Biological CMDS 4301 Organically-Based CDCMDS 5308Neuropathologies II

Presented current research on the effectivenessof using oral motor treatment with swallowingdisorders. Accurately interpreted a modifiedbarium swallow and provided a written report ofthe findings including treatment strategies.

● Neurological CMDS 4304 Neurology Completed two annotated bibliographiesregarding current research.

● Acoustic CMDS 2374 SpeechScience

Completed a speech spectrogram.

● Psychological CMDS 4301 Organically-Based CDCMDS 5308Neuropathologies II

Presented current research on the effectivenessof using oral motor treatment with swallowingdisorders. Accurately interpreted a modifiedbarium swallow and provided a written report of

the findings including treatment strategies.

● Developmental/Lifespan CMDS 4301 Organically-Based CDCMDS 5308Neuropathologies II


● Cultural

CMDS 5308Neuropathologies II


Standard III-C. The applicant mustdemonstrate knowledge of thenature of speech, language,hearing, and communicationdisorders and differences andswallowing disorders, includingtheir etiologies, characteristics,anatomical/physiological, acoustic,psychological, developmental, andlinguistic and cultural correlates.Specific knowledge must bedemonstrated in the followingareas:

Articulation

● Etiologies

CMDS 3301 Lang/PhonoDisCMDS 5307 Artic/PhonoDisCMDS 5350Motor/Speech Dis


● Characteristics



Fluency

● Etiologies

CMDS 3303 Voice &Fluency DisCMDS 5302 Fluency Dis

Completed a written report comparing/contrasting theories of stuttering. Completed areflection paper over one assessment and onetherapy session of a client who stutters.Completed a systematic disfluency analysis ontwo clients (one adult, one child). Completedthree annotated bibliographies on publishedjournal articles. Presented research regardingtreatment procedures for adolescents whostutter. Completed a learning portfolio consistingof: reflections, annotated bibliographies,independent learning, chapter outlines, webreferences, and lecture notes.

● Characteristics



How Achieved?

A B C D E

Knowledge/Skill Met? Practicum Experiences # and Other (e.g. labs, research) (Include

Standards (check ) Course # and Title Title description of activity)

Voice and resonance, including

respiration and phonation

● Etiologies

CMDS 3303 Voice &Fluency DisCMDS 5403 VoiceDis/Cleft PalateCMDS 5350Motor/Speech Dis

Completed thorough voice diagnostic protocolfor an adult. Completed five annotatebibliographies for five current voice journalarticles. Completed thorough cleft palatediagnostic protocol for a child. Completedthorough treatment plan including long term andshort term treatment objective and one dailytreatment plan.

● Characteristics


Completed thorough voice diagnostic protocolfor an adult. Completed five annotatebibliographies for five current voice journalarticles. Completed thorough cleft palatediagnostic protocol for a child. Completedthorough treatment plan including long term and

short term treatment objective and one dailytreatment plan.

Receptive and expressivelanguage(phonology, morphology, syntax,

semantics, and pragmatics) in

speaking, listening, reading,writing,and manual modalities

● Etiologies

CMDS 3301 Lang/PhonoDisCMDS 5304 Lang. DisSchool-AgeCMDS 5301 Aphasia /Neurogenic DisCMDS 5306 Lang. DisPreschool

Presented a research paper about memory andits relation to aphasia/ Alzheimer’s disease.Presented standardized comprehensiveassessment tool for use with adults withacquired neurogenic communication disorders.



● Characteristics



Conducted a review of literature regardingemergent literacy. Conducted a review ofliterature regarding phonological awareness.Completed standardized test analysis, various

language sample analysis and a reading miscueanalysis with a written summary andinterpretation of findings. Review of literatureregarding service delivery models includingASHA guidelines and current educational laws.Completed treatment plan and provided clinicalstrategies and rationale with supporting efficacydata. Carried out a case study involving the useof graphic organizers in the treatment oflanguage learning based disorders.

Compiled a learning portfolio of knowledgegained through lecture, handouts, textbook, andjournal readings regarding preschool language.Completed a research project regarding fetalalcohol and fragile X syndromes and presentedthese to the class. Completed developmentallevel project for age 3 to 5 including:descriptions, general characteristics,prevention, assessment considerations withrecommended tests, treatment plans, andsampling procedures.

Hearing, including the impact on

speech and language

● Etiologies

CMDS 3302 Intro to AudCMDS 4327 Aural RehabCMDS 4302 AdvancedAud

Completed 18 essays regarding issues in auralrehabilitation. Completed a question and answerassignment regarding common issues withamplification.

Provided a basic hearing evaluation test on twopeople including: case history, pure tone air andbone conduction, masking, speech recognitiontesting, tympanometry and acoustic reflextesting. Completed a handbook of audiologyincluded: ear anatomy, screening guidelines andprocedures, audiogram, tuning fork tests, puretone testing, emmittance testing, speech testing,and hearing impairments.

● Characteristics




Swallowing (oral, pharyngeal,

esophageal, and related functions,

including oral function for feeding;

orofacial myofunction)

● Etiologies

CMDS 4301 Organically-Based CDCMDS 5308Neuropathologies II


● Characteristics



Cognitive aspects ofcommunication(attention, memory, sequencing,

problem-solving, executive

functioning

● Etiologies

CMDS 5301 Aphasia /Neurogenic DisCMDS 1375 Lang Acq


● Characteristics

CMDS 5301 Aphasia /Neurogenic DisCMDS 1375 Lang Acq


How Achieved?

A B C D E



Social aspects of communication

(challenging behavior, ineffective

social skills, lack ofcommunicationopportunities)

● EtiologiesCMDS 5304 Lang. DisSchool-AgeCMDS 5301 Aphasia /

Presented a research paper about memory andits relation to aphasia/ Alzheimer’s disease.Presented standardized comprehensive

Neurogenic DisCMDS 5308Neuropathologies IICMDS 5302 Fluency DisCMDS 5306 Lang. DisPreschool

assessment tool for use with adults withacquired neurogenic communication disorders.




● Characteristics

CMDS 5304 Lang. DisSchool-AgeCMDS 5301 Aphasia /Neurogenic DisCMDS 5308Neuropathologies IICMDS 5302 Fluency DisCMDS 5306 Lang. DisPreschool


Conducted a review of literature regardingemergent literacy. Conducted a review ofliterature regarding phonological awareness.Completed standardized test analysis, various

language sample analysis and a reading miscueanalysis with a written summary andinterpretation of findings. Review of literatureregarding service delivery models includingASHA guidelines and current educational laws.Completed treatment plan and provided clinicalstrategies and rationale with supporting efficacydata. Carried out a case study involving the useof graphic organizers in the treatment oflanguage learning based disorders.



Communication modalities(includingoral, manual, augmentative and

alternative communication

techniques, and assistive

technologies)

● Characteristics CMDS 5351 Comm MgmtSevere DisCMDS 5301 Aphasia /Neurogenic Dis


Completed a chapter overview assignmentincluding an oral presentation aboutaugmentative devices. Created a library crate of

commonly used catalogs in the field of AAC.

Standard III-D: The applicant must

possess knowledge of theprinciplesand methods of prevention,

assessment, and intervention for

people with communication and

swallowing disorders, including

consideration of

anatomical/physiological,

psychological, developmental, and

linguistic and cultural correlates of

the disorders.

Articulation

● Prevention



● Assessment



● Intervention



Fluency

● Prevention



● Assessment



How Achieved?

A B C D E



● Intervention



Voice and Resonance

● PreventionCMDS 3303 Voice &Fluency Dis

Completed thorough voice diagnostic protocolfor an adult. Completed five annotate

CMDS 5403 VoiceDis/Cleft PalateCMDS 5350Motor/Speech Dis

bibliographies for five current voice journalarticles. Completed thorough cleft palatediagnostic protocol for a child. Completedthorough treatment plan including long term andshort term treatment objective and one dailytreatment plan.

● Assessment



● Intervention



Receptive and ExpressiveLanguage

● Prevention




Compiled a learning portfolio of knowledgegained through lecture, handouts, textbook, andjournal readings regarding preschool language.Completed a research project regarding fetalalcohol and fragile X syndromes and presentedthese to the class. Completed developmentallevel project for age 3 to 5 including:

descriptions, general characteristics, prevention,assessment considerations with recommendedtests, treatment plans, and samplingprocedures.

● Assessment





● Intervention



Conducted a review of literature regardingemergent literacy. Conducted a review ofliterature regarding phonological awareness.Completed standardized test analysis, variouslanguage sample analysis and a reading miscueanalysis with a written summary andinterpretation of findings. Review of literatureregarding service delivery models includingASHA guidelines and current educational laws.Completed treatment plan and provided clinicalstrategies and rationale with supporting efficacy

data. Carried out a case study involving the useof graphic organizers in the treatment oflanguage learning based disorders.


Hearing, including the impact on

speech and language

● Prevention




● Assessment




● Intervention



Provided a basic hearing evaluation test on two

people including: case history, pure tone air andbone conduction, masking, speech recognitiontesting, tympanometry and acoustic reflextesting. Completed a handbook of audiologyincluded: ear anatomy, screening guidelines andprocedures, audiogram, tuning fork tests, puretone testing, emmittance testing, speech testing,and hearing impairments.

Swallowing

● Prevention



● Assessment



● Intervention



Cognitive aspects ofcommunication

● Prevention

CMDS 5301 Aphasia /Neurogenic Dis


● Assessment



● Intervention



Social aspects of communication

● Prevention

CMDS 5304 Lang. DisSchool-AgeCMDS 5301 Aphasia /Neurogenic DisCMDS 5308Neuropathologies IICMDS 5302 Fluency DisCMDS 5306 Lang. Dis


Conducted a review of literature regardingemergent literacy. Conducted a review of

Preschool literature regarding phonological awareness.Completed standardized test analysis, variouslanguage sample analysis and a reading miscueanalysis with a written summary andinterpretation of findings. Review of literatureregarding service delivery models includingASHA guidelines and current educational laws.Completed treatment plan and provided clinicalstrategies and rationale with supporting efficacydata. Carried out a case study involving the useof graphic organizers in the treatment oflanguage learning based disorders.



● Assessment



Conducted a review of literature regardingemergent literacy. Conducted a review ofliterature regarding phonological awareness.Completed standardized test analysis, variouslanguage sample analysis and a reading miscueanalysis with a written summary andinterpretation of findings. Review of literatureregarding service delivery models includingASHA guidelines and current educational laws.

Completed treatment plan and provided clinicalstrategies and rationale with supporting efficacydata. Carried out a case study involving the useof graphic organizers in the treatment oflanguage learning based disorders.



How Achieved?

A B C D E



● Intervention



Conducted a review of literature regardingemergent literacy. Conducted a review ofliterature regarding phonological awareness.Completed standardized test analysis, variouslanguage sample analysis and a reading miscueanalysis with a written summary and

interpretation of findings. Review of literatureregarding service delivery models includingASHA guidelines and current educational laws.Completed treatment plan and provided clinicalstrategies and rationale with supporting efficacydata. Carried out a case study involving the useof graphic organizers in the treatment oflanguage learning based disorders.


Completed a written report comparing/contrasting theories of stuttering. Completed areflection paper over one assessment and onetherapy session of a client who stutters.Completed a systematic disfluency analysis ontwo clients (one adult, one child). Completedthree annotated bibliographies on publishedjournal articles. Presented research regardingtreatment procedures for adolescents whostutter. Completed a learning portfolio consistingof: reflections, annotated bibliographies,independent learning, chapter outlines, webreferences, and lecture notes.`

Communication Modalities

● (Prevention not applicable)

● Assessment

CMDS 5351 Comm MgmtSevere DisCMDS 5301 Aphasia /Neurogenic Dis


Completed a chapter overview assignmentincluding an oral presentation aboutaugmentative devices. Created a library crate ofcommonly used catalogs in the field of AAC.

● Intervention

CMDS 5351 Comm MgmtSevere DisCMDS 5301 Aphasia /Neurogenic Dis


Completed a chapter overview assignmentincluding an oral presentation aboutaugmentative devices. Created a library crate ofcommonly used catalogs in the field of AAC.

Standard IV-G: The applicant for

certification must complete a

program of study that includes

supervised clinical experiences

sufficient in breadth and depth to

achieve the following skills

outcomes (in addition to clinical

experiences, skills may be

demonstrated through successful

performance on academic course

work and examinations,independentprojects, or other appropriate

alternative methods):

1. Evaluation (must include all skill

outcomes listed in a-g below for

each of the 9 major areas)

a. Conduct screening andpreventionprocedures (including prevention

activities)

b. Collect case history informationand integrate information from

clients/patients, family, caregivers,

teachers, relevant others, andotherprofessionals

How Achieved?

A B C D E



c. Select and administerappropriate

evaluation procedures, such as

behavioral observations

nonstandardized and standardized

tests, and instrumental procedures

d. Adapt evaluation procedures to

meet client/patient needs

e. Interpret, integrate, andsynthesizeall information to developdiagnosesand make appropriate

recommendations for intervention

f. Complete administrative and

reporting functions necessary to

support evaluation

g. Refer clients/patients for

appropriate services

● Articulation

CMDS 5309 Adv ClinPracticum

Lamar University Speech andHearing Clinic, Beaumont, TexasBen Taub Hospital, Houston, TexasChina Elementary School, China,Texas

6.5 child artic diagnostic hours at ChinaElementary School; 4.75 child artic diagnostichours at Lamar University Speech and HearingClinic; 4.75 adult artic diagnostic hours at LamarUniversity Speech and Hearing Clinic; 10 adultartic diagnostic hours at Ben Taub Hospital,Houston TX.

● FluencyCMDS 5309 Adv ClinPracticum

Lamar University Speech andHearing Clinic, Beaumont, Texas

2 child fluency diagnostic hours at LamarUniversity Speech and Hearing Clinic.

● Voice and resonance, including CMDS 5309 Adv ClinPracticum

Lamar University Speech andHearing Clinic, Beaumont, TexasBen Taub Hospital, Houston, Texas

1.25 child voice diagnostic hours at LamarUniversity Speech and Hearing Clinic. 1.5 adultvoice diagnostic hours at Lamar UniversitySpeech and Hearing Clinic. 2 adult voicediagnostic hours at Ben Taub Hospital, HoustonTX.

respiration and phonation CMDS 5309 Adv ClinPracticum

Ben Taub Hospital, Houston, Texas 2 adult voice diagnostic hours at Ben TaubHospital, Houston TX.

● Receptive and expressive language CMDS 5309 Adv ClinPracticum


3 child receptive/ expressive languagediagnostic hours at Lamar University Speechand Hearing Clinic. 10.75 adult receptive/expressive language diagnostic hours at BenTaub Hospital, Houston TX. 8.5 receptive/expressive language diagnostic hours at ChinaElementary School.

(phonology, morphology, syntax, CMDS 5309 Adv ClinPracticum


3 child receptive/ expressive languagediagnostic hours at Lamar University Speechand Hearing Clinic. 10.75 adult receptive/expressive language diagnostic hours at BenTaub Hospital, Houston TX. 8.5 receptive/

expressive language diagnostic hours at ChinaElementary School.

semantics, and pragmatics) in CMDS 5309 Adv ClinPracticum



speaking, listening, reading, writing,and




manual modalities CMDS 5309 Adv ClinPracticum



● Hearing, including the impact on CMDS 5309 Adv ClinPracticum

Lamar University Speech andHearing Clinic, Beaumont, TexasChina Elementary School, China,Texas

.25 child hearing diagnostic hours at LamarUniversity Speech and Hearing Clinic. 2.25 adulthearing diagnostic hours at Lamar UniversitySpeech and Hearing Clinic. 5.75 child hearingdiagnostic hours at China Elementary School.

speech and language CMDS 5309 Adv ClinPracticum


.25 child hearing diagnostic hours at LamarUniversity Speech and Hearing Clinic. 2.25 adulthearing diagnostic hours at Lamar UniversitySpeech and Hearing Clinic. 5.75 child hearingdiagnostic hours at China Elementary School.

● Swallowing (oral, pharyngeal, CMDS 5309 Adv ClinPracticum

Ben Taub Hospital, Houston, Texas 10 child diagnostic dysphagia hours at Ben TaubHospital, Houston TX. 24.5 adult diagnosticdysphagia hours at Ben Taub Hospital, Houston,TX.

esophageal, and related functions, CMDS 5309 Adv ClinPracticum


including oral function for feeding; CMDS 5309 Adv ClinPracticum


orofacial myofunction) CMDS 5309 Adv ClinPracticum

Ben Taub Hospital, Houston, Texas 10 child diagnostic dysphagia hours at Ben TaubHospital, Houston TX. 24.5 adult diagnosticdysphagia hours at Ben Taub Hospital, Houston,TX. Completed thorough cleft palate diagnosticprotocol for a child. Completed thoroughtreatment plan including long term and shortterm treatment objective and one daily treatmentplan for CMDS 5403 .

How Achieved?

A B C D E



● Cognitive aspects of communication



5 child diagnostic cognitive hours at LamarUniversity Speech and Hearing Clinic. 1 adultdiagnostic cognitive hour at Ben Taub Hospital,Houston, TX. 6.25 child diagnostic cognitivehours at China Elementary School.

(attention, memory, sequencing, CMDS 5309 Adv ClinPracticum



problem-solving, executivefunctioning)




● Social aspects of communication CMDS 5309 Adv ClinPracticum

Ben Taub Hospital, Houston, Texas 1.5 adult pragmatic diagnostic hours at BenTaub Hospital, Houston, TX. Completed aclinical discourse analysis for a 32-utterancelanguage sample in CMDS 5304. Completed aclinical discourse analysis for 26 utterancelanguage sample in CMDS 3301.

(including challenging behavior, CMDS 5309 Adv ClinPracticum


ineffective social skills, lack of CMDS 5309 Adv ClinPracticum


communication opportunities) CMDS 5309 Adv ClinPracticum


● Communication modalities(including


China Elementary School, China,Texas

1.25 child diagnostic AAC hours at ChinaElementary School. Completed a chapteroverview assignment including an oralpresentation about augmentative devices.Created a library crate of commonly used

catalogs in the field of AAC in CMDS 5351.

oral, manual, augmentative, and CMDS 5309 Adv ClinPracticum


1.25 child diagnostic AAC hours at ChinaElementary School. Completed a chapteroverview assignment including an oralpresentation about augmentative devices.Created a library crate of commonly usedcatalogs in the field of AAC.

alternative communication techniques CMDS 5309 Adv ClinPracticum


1.25 child diagnostic AAC hours at ChinaElementary School. Completed a chapteroverview assignment including an oralpresentation about augmentative devices.Created a library crate of commonly usedcatalogs in the field of AAC in CMDS .

and assistive technologies) CMDS 5309 Adv ClinPracticum


1.25 child diagnostic AAC hours at ChinaElementary School. Completed a chapteroverview assignment including an oralpresentation about augmentative devices.Created a library crate of commonly usedcatalogs in the field of AAC.

2. Intervention (must include allskilloutcomes listed in a-g below for

each of the 9 major areas)

a. Develop setting-appropriateintervention plans with measurable

and achievable goals that meet

clients'/patients' needs.Collaboratewith clients/patients and relevant

others in the planning process

b. Implement intervention plans(involve clients/patients andrelevantothers in the intervention process)

c. Select or develop and use

appropriate materials and

instrumentation for prevention and

intervention

d. Measure and evaluate

clients'/patients' performance and

progress

How Achieved?

A B C D E



e. Modify intervention plans,

strategies, materials, or

instrumentation as appropriate to

meet the needs of clients/patients

f. Complete administrative and

reporting functions necessary to

support intervention

g. Identify and refer clients/patientsfor services as appropriate

● Articulation



58.25 child artic therapy hours at LamarUniversity Speech and Hearing Clinic. 10.5 adultartic therapy hours at Ben Taub Hospital,Houston, TX. 17 child artic therapy hours atChina Elementary School.

● Fluency



5 child fluency therapy hours and 15.25 adultfluency therapy hours at Lamar UniversitySpeech and Hearing Clinic. 4.75 child fluencytherapy hours at China Elementary School.

● Voice and resonance CMDS 5309 Adv ClinPracticum

Ben Taub Hospital, Houston, TexasChina Elementary School, China,Texas

4.5 adult voice therapy hours at Ben TaubHospital, Houston, TX. 1 hour child voicetherapy at China Elementary School.

● Receptive and expressive language CMDS 5309 Adv ClinPracticum


41 child language therapy hours at LamarUniversity Speech and Hearing Clinic. 10 adultlanguage therapy hours at Ben Taub Hospital,Houston, TX. 23 hours child language therapy atChina Elementary School.

● Hearing, including the impact on CMDS 5309 Adv ClinPracticum

Lamar University Speech andHearing Clinic, Beaumont, Texas

1.75 hours hearing therapy at Lamar UniversitySpeech and Hearing Clinic.

speech and language CMDS 5309 Adv ClinPracticum


Provided a basic hearing evaluation test on twopeople including: case history, pure tone air andbone conduction, masking, speech recognitiontesting, tympanometry and acoustic reflextesting. Completed a handbook of audiologyincluded: ear anatomy, screening guidelines andprocedures, audiogram, tuning fork tests, pure

tone testing, emmittance testing, speech testing,and hearing impairments in CMDS 4327 and4302.

● Swallowing CMDS 5309 Adv ClinPracticum

Ben Taub Hospital, Houston, Texas 1.75 hours swallowing therapy at Ben TaubHospital, Houston, TX. Presented currentresearch on the effectiveness of using oralmotor treatment with swallowing disorders.Accurately interpreted a modified bariumswallow and provided a written report of thefindings including treatment strategies in CMDS5308.

● Cognitive aspects of communication


Ben Taub Hospital, Houston, TexasChina Elementary School, China,Texas

9 adult hours of cognitive therapy at Ben TaubHospital, Houston, TX. 28.5 hours child cognitivetherapy at China Elementary School.

● Social aspects of communication CMDS 5309 Adv ClinPracticum

Lamar University Speech andHearing Clinic, Beaumont, TexasBen Taub Hospital, Houston, Texas

11 child hours pragmatic therapy at LamarUniversity Speech and Hearing Clinic. 3.5 adulthours cognitive therapy at Ben Taub Hospital,Houston, TX.

● Communication modalities CMDS 5309 Adv ClinPracticum


13.75 child hours of AAC therapy at ChinaElementary School. Completed a chapteroverview assignment including an oralpresentation about augmentative devices.Created a library crate of commonly usedcatalogs in the field of AAC in CMDS 5351.

3. Interaction and PersonalQualities

a. Communicate effectively, CMDS 5309 Adv ClinPracticum

recognizing the needs, values, CMDS 5309 Adv ClinPracticum

preferred mode of communication,and


cultural/linguistic background of the CMDS 5309 Adv ClinPracticum

client/patient, family, caregivers, and CMDS 5309 Adv ClinPracticum

relevant others. CMDS 5309 Adv ClinPracticum

b. Collaborate with otherprofessionals


in case management. CMDS 5309 Adv ClinPracticum

How Achieved?

A B C D E



c. Provide counseling regarding CMDS 5309 Adv ClinPracticum

communication and swallowing CMDS 5309 Adv ClinPracticum

disorders to clients/patients, family, CMDS 5309 Adv ClinPracticum

caregivers, and relevant others. CMDS 5309 Adv ClinPracticum

d. Adhere to the ASHA Code ofEthics


and behave professionally.CMDS 5309 Adv ClinPracticum

Knowledge and Skills Acquisition (KASA) Summary Form For Certification in Speech-Language Pathology

Verification by Program Director The applicant for certification:

□ Yes □ No Has a master's or doctoral degree. A minimum of 75 semester credit hours were completed in a course of study addressing theknowledge and skills pertinent to the field of speech-language pathology (Std. I)

□ Yes □ No Initiated and completed all graduate course work and graduate clinical practicum in an institution whose program was accredited by the CAA (Std. I)

□ Yes □ NoHas completed a program of study (a minimum of 75 semester credit hours overall, including at least 36 at the graduate level)thatincludes academic course work sufficient in depth and breadth to achieve the specified knowledge outcomes (Std. III-A,B,C)

□ Yes □ No Possesses knowledge of the principles and methods of prevention, assessment and intervention for people with communication

and swallowing disorders (Std. III-D)

□ Yes □ No Has demonstrated knowledge of standards of ethical conduct (Std. III-E)

□ Yes □ No Has knowledge of processes used in research and the integration of research principles into evidence-based clinical practice(Std.

□ Yes □ No Has demonstrated knowledge of contemporary professional issues (Std. III-G)

□ Yes □ No Has demonstrated knowledge about certification, specialty recognition, licensure, and other relevant professional credentials

□ Yes □ No Has completed a curriculum of academic and clinical education that follows an appropriate sequence of learning sufficient to

achieve the skills outcomes in Standard IV-G (Std. IV-A)

□ Yes □ No Possesses skill in oral and written and other forms of communication sufficient for entry into professional practice (Std. IV-B)□ Yes □ No Has completed a minimum of 400 clock hours of supervised clinical experience in the practice of speech-language pathology,

including 25 hours in clinical observation and 375 hours in direct client/patient contact (Std. IV-C)

□ Yes □ No Has completed at least 325 clock hours while engaged in graduate study (Std. IV-D)

□ Yes □ No Has been supervised by individuals holding a current ASHA Certificate of Clinical Competence in the appropriate area of practice.

The amount of supervision was appropriate to the student's level of knowledge, experience, and competence and the supervision

□ Yes □ Nowas sufficient to ensure the welfare of the client/patient populations (Std. IV-E) Has gained knowledge of and experience withindividuals from culturally/linguistically diverse backgrounds and with client/patientpopulations across the life span (Std. IV-F)

□ Yes □ No The applicant has met the education program's requirements for demonstrating satisfactory performance through ongoing

formative assessment of knowledge and skills. (Std. V-A)

The program director verifies that the student met each standard and has successfully met the education program's requirements fordemonstrating satisfactory performance through ongoing assessment of knowledge and skills.

Name Program Title Signature Date

Documents

KNOWLEDGE AND SKILLS ACQUISITION (KASA) SUMMARY … › fine-arts-communication › ... · Knowledge And Skills Acquisition (KASA) Summary Form For Certification in Speech-Language