Missouri's Speech Implementer Model

Missouri is the only state in the country which uses the Speech Implementer Model in its schools. This means that in addition to SLPs (Speech-Language Pathologists) and SLP-As (Speech-Language Pathologist Assistants), Speech Implementers can perform speech therapy with students in MO schools. Thankfully, we are happy to report that DESE has begun phasing out the speech implementer model and speech implementers will no longer be used beginning the 2022-23 school year.

We are thankful for the help of Rep. David Wood in making sure students with speech and language delays receive services by certified SLPs or SLP-As. In 2017, with the help of Rep. Wood, we began having conversations with DESE regarding our concerns related to the Speech Implementer Model, specifically the disproportionate number of SLPs, SLP-As, and Speech Implementers in MO schools. During the 2018-2019 school year, an audit was conducted of schools to make sure DESE had correct information regarding who was providing speech and language services to students. It was evident that the speech implementer method was not being used as it was designed and school districts were relying heavily on SIs to provide therapy. MoDE learned in the summer of 2019 that the SI method would slowly be phased away. By the 2022-23 school year, all speech and language therapies will be provided by SLPs or SLP-As.

What is the difference between an SLP, an SLP-A, and a Speech Implementer?

All three are able to perform speech and language services in Missouri schools, but they are different. 
 

SLP (Speech-Language Pathologist)
Education requirement: Masters degree in a Speech-Language Pathology; completion of a clinical fellowship

     year to obtain Certificate of Clinical Competence (CCCs)
Licensure: Must be licensed through the State Board of Healing Arts


SLP-A (Speech-Language Pathologist Assistant)

Education requirement: Bachelor’s Degree in Communication Sciences and Disorders from program ASHA

           approved to grant Master’s SLP degrees OR Bachelor’s Degree in other area with a total of 21 hours in

           five speech/language areas; 25 hours of SLP observation; 25 hours of SLP clinical assisting or

           practicum

Licensure: Must be licensed through the State Board of Healing Arts

Speech Implementer
Education requirement: Bachelors in Elementary or Secondary Education and a valid MO teaching 

           certificate
Licensure: None

School districts must attempt to hire an SLP or SLP-A before hiring a Speech Implementer. The Speech Implementer Model was created to offer a short-term solution to schools. In many rural areas, the Speech Implementer Model has become the preferred method, with Speech Implementers filling the role of the therapist for years. Some therapy clinics have tried to contract out SLPs or SLP-As into rural schools to perform speech and language services. While current DESE policy does require schools to try to hire SLPs or SLP-As before hiring an implementer, the policy does not require school district contract an SLP or SLP-A before hiring a speech implementer. This will all change come the 2022-2023 school year. 

What services can SLP-As and Speech Implementers perform?

While SLP-As and Speech Implementers perform speech and language services, the scope of what they can do is limited. They are able to provide the daily or weekly therapy sessions. They implement IEPs and document progress. They cannot perform evaluations, interpret data, or develop and write IEP goals. An SLP must do these activities. An SLP must also supervise the work of SLP-As and Speech Implementers.

How much supervision is required for SLP-As and Speech Implementers?

An SLP must supervise SLP-As and Speech Implementers. In rural areas, SLPs will often travel many miles between schools supervising multiple SLP-As and Speech Implementers. In February 2020, requirements for supervision of SIs was changed to match those of the requirements of an SLP-A.
 

Supervision Requirements
Ratio: An SLP can supervise 3 SLP-As or SIs at one time.
Level of Supervision: 1 hour per week -or- 1 of every 3 student sessions 

 

The above is a brief summary of SLPs, SLP-As, and Speech Implementers in MO.

Learn more about DESE's requirements for SLP-As and Speech Implementers.