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Speech Language Pathologist Skills Checklist

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1 – 2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

AGE OF PATIENTS CARED FOR

Newborn/ Neonate (birth to 30 days)(Required)
Infant (31 days to 12 months)(Required)
Toddler/Preschool (13 months to 5 years)(Required)
School Age Child/adolescent (6 years to 18 years)(Required)
Young Adults Middle Adult (19 years to 64 years)(Required)
Adolescents (12 years to 18 years)(Required)
Older Adults/Elderly (65+ years)(Required)

GENERAL SKILLS

Electronic Documentation(Required)
Universal Precautions(Required)
Working with patients in isolation(Required)
Working with patients in restraints(Required)
Patient/Family teaching(Required)
Patient Identification(Required)
Specialty beds(Required)
End of life care/palliative care(Required)
Knowledge of "Do Not Use Abbreviations"(Required)
Do you have charge/supervisor experience?(Required)
Knowledge of current Joint Commission National Patient Safety Goals(Required)
Knowledge/familiarity with HCAHPS scores(Required)

SETTINGS

Acute Care/ Hospital(Required)
Rehabilitation - Acute(Required)
Rehabilitation - Long Term(Required)
Home Health(Required)
Outpatient(Required)
Day Treatment Centers(Required)
Skilled Nursing Facility(Required)
Physician's Office(Required)
School(Required)
Early Intervention(Required)

PATIENT POPULATIONS/DISORDERS

Alzheimer's(Required)
Amyotrophic Lateral Sclerosis (ALS)(Required)
Anoxia(Required)
Aphasia(Required)
Apraxia(Required)
Autism(Required)
Adult Mental Retardation (Mild-Moderate)(Required)
Pediatric Mental retardation (Mild-Moderate)(Required)
Pediatric Mental Retardation (Severe-Profound)(Required)
Brain Injury(Required)
Cleft Palate(Required)
Coma Stimulation(Required)
Cognitive Impairment(Required)
CVA(Required)
Dysarthria(Required)
Feeding Disorders(Required)
Feeding Disorders(Required)
Fluency(Required)
Hearing Impairment(Required)
Head Trauma(Required)
Learning disabilities/Early Intervention(Required)
Laryngectomy(Required)
Muscular Dystrophy(Required)
Multiple Sclerosis(Required)
Muscular Dystrophy(Required)
Parkinson's Disease(Required)
Progressive Neurological Disease(Required)
TIA(Required)
Trachs(Required)
Ventilator Dependent patients(Required)

ASSESSMENT

Aphasia Language Performance Scale(Required)
Augmentative Devices(Required)
Bedside Swallow Testing(Required)
Boston(Required)
Blue Dye Test(Required)
Cervical Auscultation(Required)
CADL (Communication Ability for Daily Living)(Required)
Detroit(Required)
FEES (Flexible Endoscopic Evaluation of Swallowing)(Required)
Fiber optic Voice Evaluation(Required)
Modified Barium Swallow Study(Required)
Minnesota (Schuell)(Required)
PICA (Porch Index of Communication Ability)(Required)
Pure Tone Screening(Required)
Reading comprehension battery for aphasia(Required)
Ross information processing assessment - geriatric(Required)
Rossetti Infant-Toddler Language Scale(Required)
Rehabilitation Institute of Chicago evaluation of communication(Required)

TREATMENT

Individual(Required)
Co-Treatment(Required)
Cognitive Training(Required)
Community Re-Entry(Required)
Computer(Required)
Group(Required)
Dysphagia management(Required)
Feeding Equipment(Required)
Memory Aids(Required)
Safety Awareness(Required)
Total Communication(Required)
Vital Stimulation(Required)

REGULATIONS/DOCUMENTATION

FIMS(Required)
Home Health Documentation(Required)
Medi-Cal(Required)
Medicare(Required)
Omnibus budget reconciliation(Required)
RUG levels(Required)

OTHER SKILLS

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