A Guide to the ASHA Clinical Fellowship Experience

About the Clinical Fellowship (CF)

This page is intended to offer further detail on Standard VII of the 2020 Speech-Language Pathology (SLP) Certification Standards; it is not intended to replace the language. The SLP standards must be adhered to in order to be eligible to earn the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP).

The SLP CF is a mentored professional experience that begins after the completion of academic course work and clinical practicum. The goal of the CF is to allow the Clinical Fellow to transition between being a student enrolled in a communication sciences and disorders (CSD) program and being an independent provider of speech-language pathology clinical services.

The purpose of the CF is to integrate and apply the knowledge from academic education and clinical training, evaluate strengths and identify limitations, develop and refine clinical skills consistent with the Scope of Practice in Speech-Language Pathology, and advance the Clinical Fellow from needing constant supervision to being an independent practitioner.

The role of mentor is to (a) oversee the duration of the CF experience; (b) verify completion of required hours, segments, and activities; (c) provide structured feedback on a regular basis; and (d) sign off on independence of skills by the end of the CF.

Duration of the CF Experience

As a Clinical Fellow, you must work at least 36 weeks and 1,260 hours to meet the ASHA CF experience requirement. In addition, you must work at least 5 hours per week to be able to count the hours/week toward the minimum requirement. Travel, lunch, vacations or holidays, leaves of absence, and other forms of paid or unpaid time off cannot be counted toward your number of hours worked per week. The CF experience should be divided into 3 segments with each segment representing one-third of the total. Each third should include the observations and supervisory activities that are required by the CF mentor.

Important Reminders About the CF Experience

• The CF cannot begin until you have completed all required graduate credit hours, academic coursework, and clinical experiences necessary to meet the knowledge and skills listed in Standards IV and V.
• Working more than 35 hours per week does not shorten the length of the CF experience.
• The Clinical Fellow is responsible for tracking their hours worked per week.
• The CF experience must be completed within four years (48 months) from the date the CF began.

Clinical Requirements of a CF Experience

In order to track regular clinical mentorship and skill acquisition, the CF experience is divided into three segments, each at least 12 weeks long and representing one third of the total experience.

A minimum of 80% of the CF experience must be spent in direct clinical contact related to the management of disorders that fit within the ASHA Scope of Practice in Speech-Language Pathology. Examples of direct clinical contact include the following:

• Screening, Response to Intervention (RtI), and/or observations of the client/patient
• Assessment/diagnostic evaluations
• Treatment
• Writing of reports, notes; billing
• Family/client consultation
• Family/client counseling
• Individualized Education Program (IEP) meetings, Individualized Family Service Plan (IFSP) meetings, rounds, or other meetings related to the management of a client/patient’s diagnosis and treatment plan

Up to 20% of the CF experience may be spent doing other activities such as attending in-services or providing trainings and presentations.

If you have multiple CF mentors and/or segments, all CF experiences/segments related to your certification application must be completed within 48 months of the date of your first CF experience/segment.

Information for the Clinical Fellow

Qualifications to Initiate the CF Experience

The ASHA CF experience may be started only after all academic coursework and supervised clinical practicum have been completed and verified by your graduate program director, as outlined in the ASHA SLP Certification Standards, including all prerequisite coursework (Standard IV-A), core coursework (Standard IV-C), and supervised clinical practicum (Standard V). Professional experiences prior to the completion of all academic coursework and practicum cannot be used or applied toward your CF experience.

Responsibilities for Finding a Mentor

Before beginning the CF, it is important that a Clinical Fellow ensures that their CF mentor meets all of the required qualifications listed in Standard VII-B: In order to count the hours that you have earned, mentoring SLPs must

• hold a current CCC-SLP;
• have a minimum of 9 months of full-time (or its part-time equivalent) clinical experience after earning the CCC-SLP; and
• have completed a minimum of 2 hours of professional development in the area of supervision after earning the CCC-SLP.

It is a Clinical Fellow's responsibility to verify their CF mentor's status to ensure their mentor's certification remains current throughout the duration of the CF experience. Periodic verification of your mentor's status is a good practice to follow, such as

• before your first day on the job,
• at the beginning of each segment of the experience,
• before each mentor feedback session, and
• before you submit your completed certification application.

Important: A Clinical Fellow may not count hours earned during any period of time that the CF mentor does not meet the SLP standards' supervision requirements.

Check your CF mentor’s status anytime here:

ASHA Certification Online Verification Portal

Required Actions for a Valid CF Experience

As a Clinical Fellow, you must do the following:

State Licensure

• Contact your state regulatory agency/licensing board for licensure requirements.

Clinical Practice

• Ensure that the setting will provide you with the opportunity to provide the full range of services to evaluate, habilitate, or rehabilitate individuals with speech and language disabilities.
• Confirm that at least 80% of your time will be spent on activities directly related to the care and management of individuals with speech and language disorders.
• Verify your role within your company/employer. In some instances, Clinical Fellows are considered interns, and in others they are full staff members. Check company and state policies and procedures regarding billing practices and how to sign off on documentation.
• Confirm that each setting will be able to provide you with a minimum of 5 hours per week.

Mentorship and Supervision

• Verify that the setting provides the full range of services and opportunities to have each skill as outlined in the Clinical Fellowship Skills Inventory (CFSI) [PDF] appropriately supervised. All skills must be rated during each segment (or part-segment) for the segment to count toward your CF.
• Verify that your CF mentors will each be providing the minimum supervisory activities (a minimum of 6 hours of on-site and in-person) direct supervision and 6 hours of indirect supervision per segment). You may use this template for tracking supervisory activities [PDF].

On Your ASHA Certification Application for the CCC-SLP

• Enter each period/portion of the experience as a separate report on your certification online application if you change settings, supervisors, or the number of hours you work per week (e.g., full-time to part-time, part-time to full-time, multiple part-time positions, etc.). Important: 6 hours of direct supervision and 6 hours of indirect supervision is required from each mentor during each segment (or part-segment) for the time to count toward your CF.

Submit a written request to the Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC) if you and your CF mentor are considering alternative methods of supervision/telesupervision—and have the request approved—prior to starting the CF experience. (See 2020 Standard VII-B for instructions.)

The CFCC approved the use of telesupervision without prior authorization during the COVID-19 pandemic.

Tips for Selecting a CF Mentor

• Confirm that the minimum 6 hours of on-site and in-person direct supervision and 6 hours of indirect supervision activities will occur during each third of the CF experience from each CF mentor. Meet with the individual to determine his or her previous supervisory experience.
• Discuss what the CF experience means to the mentor and about his or her experiences as a Clinical Fellow.
• Determine that they have experience working with the populations that most interest you and that you will have an opportunity to work with these clients.
• Find out how many other Clinical Fellows they may be mentoring and the impact this will have on the time they have available to meet with you.
• If possible, talk with other professionals who have been mentored by this individual. Ask how their experience was, how accessible the mentoring SLP was, and how quickly the required paperwork was completed.
• Discuss how the supervisory activities will be completed and, if possible, outline a plan and stick with it.
• Discuss your preferred supervision styles.

Information for the CF Mentor

Required Qualifications

In order to be eligible to mentor a Clinical Fellow, all CF mentors must meet the following requirements:

• Hold a current CCC-SLP throughout the entire CF experience.
• The CF mentor and Clinical Fellow cannot be related in any way.
• Must have 9 months of full-time experience (or its part-time equivalent) working as a speech-language pathologist after earning the CCC-SLP.
• Must have completed 2 hours of professional development in the area of supervision after being awarded the CCC-SLP.

A Clinical Fellow may not count hours earned during any time that the CF mentor does not meet the SLP standards' supervision requirements.

Responsibilities of the Mentor

• Help improve the clinical effectiveness of the Clinical Fellow through meaningful mentoring and feedback and assists the Clinical Fellow in developing independent clinical skills.
• Keep their ASHA certification status current during the entire CF experience in order for the Clinical Fellow to use those hours to apply for ASHA certification.
• Read ASHA's Issues in Ethics statement, Responsibilities of Individuals Who Mentor Clinical Fellows in Speech-Language Pathology.
• Complete all records and feedback/ratings within a timely manner. See 2020 Standard VII.
• Provide opportunities to view and accurately rate all skills listed in the 2020 CFSI [PDF].
• Provide the minimum required on-site and in-person supervisory activities per segment in order for the hours and weeks earned during that segment to count. See below for additional information.

Observations and Supervisory Activities

In order to provide an accurate rating of a Clinical Fellow's independence with each skill on the CFSI, each mentor must complete a minimum of 6 hours of on-site and in-person direct and 6 hours indirect observation during each segment (or part-segment) that you serve as their CF mentor. This equates to 18 hours of direct and 18 hours of indirect supervision during the full CF experience. You may provide more supervision if your local or state policies require more, or if you feel that your Clinical Fellow would benefit from more supervision.

During each segment of the CF experience, each CF mentor must provide a minimum of 6 hours of direct observation of the Clinical Fellow as they provide evaluation or treatment services to the patient/client. Remember, a segment is equal to one third of the CF experience. At least 3 direct observation hours per segment and per mentor must occur in person.

Each mentor must also provide, per segment, 6 hours of indirect observation, which typically include reviewing diagnostic reports/treatment records/plans of treatment, monitoring the Clinical Fellow's participation in case conferences or professional meetings, and/or evaluating the Clinical Fellow's work by consulting with colleagues or clients and their families. The CF mentor and the Clinical Fellow must coordinate the observation schedule to ensure that all skills are observed and evaluated during each segment of the CF experience. It is expected that the observations are spread over the duration of the CF experience, with no more than 6 total observation hours completed in 1 day. You may use this template for tracking supervisory activities [PDF].

For the purposes of ASHA certification, Clinical Fellows may work in more than one location and they may have more than one CF mentor. If the Clinical Fellow has more than one CF mentor, each CF mentor must complete the required supervisory activities for the weeks and hours to be counted toward the completed CF unless the CF mentors collaborate to provide a robust CF experience. In these instances, both mentors must share the same employer, and one CF mentor becomes the primary mentor and completes the CF report on the Clinical Fellow's online certification application.

If a Clinical Fellow changes settings (e.g., works full time in a school and works PRN at a skilled nursing facility), they must have the CF mentor evaluate all skills in each setting during each segment. In this example, the Clinical Fellow may choose to have two CF mentors; one at the school and one at the skilled nursing facility.

Clinical Fellow Changes Settings/Employers Between Segments
In order for hours/experiences to be counted, the minimum of 6 hours of direct and 6 hours of indirect supervision per segment (or part-segment) must be completed by each CF mentor. If a Clinical Fellow completes a partial segment that did not include at least 6 hours of direct and 6 hours of indirect supervision from their CF mentor prior to changing settings/employers, the new CF mentor cannot make up any supervisory hours that were deficient from the previous setting.

Feedback Sessions

• Feedback sessions are an integral part of the CF experience. During feedback sessions, the CF mentor and Clinical Fellow should discuss strengths or weaknesses in the Clinical Fellow's ability to independently practice as a clinician. Through discussion and goal-setting, these sessions should be used to assist the Clinical Fellow in developing the required skills.
• It is strongly encouraged for the CF mentor to provide copies of written feedback to the Clinical Fellow during each segment, and for both to keep copies of these feedback session notes for their records.
• The CF mentor must provide performance feedback to the Clinical Fellow at least once during each segment of the CF using the 2020 Clinical Fellowship Skills Inventory (CFSI) form [PDF].
• The Clinical Fellow must receive a score of "2" or better on all skills on the 2020 CFSI [PDF] during the final segment of the CF experience.
• Clinical Fellows enter the experience on their online application. Mentors verify the hours and enter the Clinical Fellow’s scores online. Paper copies should not be submitted to ASHA, but should be kept by mentors and Clinical Fellows for their records.

Negative Recommendations

If the CF mentor anticipates at any time during the CF that the Clinical Fellow will fail to meet requirements, the mentor must counsel the Clinical Fellow (both verbally and in writing) and maintain written records of all contacts and conferences that had been conducted during the experience. A negative recommendation for segments 1 or 2 will not impact certification eligibility unless there is evidence that the Clinical Fellow may have engaged in unethical practice. If the CF experience is terminated at any time before completion of the CF, or if the CF mentor does not recommend approval, the CF mentor must complete the online CF Mentor Verification page and provide justification for the negative recommendation.

CF experiences with negative recommendations related to unethical practice may not be applied toward the total number of hours/weeks required to complete the CF unless reviewed and approved by the CFCC.

Within 30 days of making the negative recommendation, the CF mentor must submit to the CFCC a letter of explanation with supporting documentation. This information must be shared with the Clinical Fellow. Following a negative recommendation, the Clinical Fellow may complete an entirely new CF, one or more segments of the CF, and/or request an appeal by the CFCC.

The CF mentor must complete the online CF Mentor Verification, when prompted to do so, and include justification for the negative recommendation.

Completion of the Clinical Fellowship

A complete CF experience must have

1. a minimum of 1,260 hours of clinical experience working under the mentorship of a CCC-SLP who meets the mentor requirements as outlined in 2020 Standard VII;
2. a minimum of 36 weeks (or its part-time equivalent) of clinical experience working under the mentorship of a CCC-SLP;
3. a minimum of 6 hours of direct supervision and 6 hours of indirect supervision completed during each segment or partial segment by each mentor;
4. a minimum rating of 2 under the 2020 CF experience in the final segment of the CF; and
5. all hours/segments recommended by each CF mentor so that they count toward the CF experience.

Applicants who have applied for ASHA certification through the online application process must login to their ASHA account and enter the CF experience details. CF mentors will then receive an e-mail requesting that they verify and complete the documentation on their CF mentor portals within their ASHA account. Verification must be completed within 90 days of the end of the CF experience.

In all cases, applicants should follow company and/or state policies and procedures regarding how long to keep this information in your records.

Apply for ASHA Certification

As a Clinical Fellow, you may apply for the CCC-SLP at any time. It is not necessary to wait until the conclusion of your CF experience.