Dear [ ],  

I am [an SLP or other] who is concerned about AAC Specialty Certification. I have numerous questions about this effort, but I cannot find any answers.  I write to you in the hope that you will be able to supply them, or point me to a source where this information is presented.  In particular: 

There really has been no clear explanation as to why this is needed for the field: 

• There has been no disclosure of the need for certification; what problem does specialty certification address; what question does it answer; what makes certification the most appropriate response; and what alternatives, if any, were considered and determined to be inappropriate as compared to certification?
• Anecdotal responses about the need for specialty certification are that there is inappropriate SLP service delivery related to AAC.  But anecdotes are not sufficient evidence to form conclusions about the quality of AAC service delivery generally.  Considering the extremely controversial nature of this claim, the most rigorously gathered and persuasive evidence should exist to support it.  Where is the evidence that such a problem actually exists?
• AAC specialty certification also presents risks.  Where is the evidence that these risks have been considered, and what is the strategy to avoid or respond to these risks? 
• There are risks to SLPs who may be excluded from reimbursement for AAC assessments, recommendations and treatment absent certification.  If there is concern that AAC service delivery issues are based on SLPs not having enough AAC experience these possible funding source practice restrictions will make it all the harder for SLPs to gain the very experience they need to overcome their experience deficits.  What strategy has been devised to overcome this obvious Catch 22?  
• There also are risks to clients who may experience delays or denial of access to necessary treatment because a certified SLP is not available.  AAC specialty certification has potential adverse effects on our clients as well as on SLPs.  Have their interests been considered?  How will causing the delay or denial of access to treatment to clients be addressed?
• Other discussion about certification has been about personal benefit to SLPs. But what are the potential benefits?  One assumption is that certification will persuade funding programs to increase reimbursement for AAC-related services.  But this outcome is not assured; it is speculation.  AAC services already are being provided by SLPs without certification and are being performed to the funding sources’ satisfaction as evidenced by their approval of funding requests for SGDs and for SLP assessments and treatment.  If a service can be at one rate, by generalist SLPs, what is the need to pay more for the same service to be provided by a specialist?
• I am aware that AAC specialty certification already has been considered and that the decision was not to proceed.  Why did it stop before? Why is it starting again? What are the changed circumstances to justify revisiting this question, and what are the changed circumstances that might justify reaching a different conclusion about certification?
• I am concerned that in an area of practice generally recognized as having insufficient clinicians available to provide service, that certification will cause a further reduction in service delivery capacity.  How will certification make the overall AAC service delivery environment better rather than worse? 

I am [an SLP or other] who is concerned about AAC Specialty Certification. I have numerous questions about this effort, but I cannot find any answers.  I write to you in the hope that you will be able to supply them, or point me to a source where this information is presented.  In particular: 

There really has been no clear explanation as to why this is needed for the field: 

• There has been no disclosure of the need for certification; what problem does specialty certification address; what question does it answer; what makes certification the most appropriate response; and what alternatives, if any, were considered and determined to be inappropriate as compared to certification?
• Anecdotal responses about the need for specialty certification are that there is inappropriate SLP service delivery related to AAC.  But anecdotes are not sufficient evidence to form conclusions about the quality of AAC service delivery generally.  Considering the extremely controversial nature of this claim, the most rigorously gathered and persuasive evidence should exist to support it.  Where is the evidence that such a problem actually exists?
• AAC specialty certification also presents risks.  Where is the evidence that these risks have been considered, and what is the strategy to avoid or respond to these risks? 
• There are risks to SLPs who may be excluded from reimbursement for AAC assessments, recommendations and treatment absent certification.  If there is concern that AAC service delivery issues are based on SLPs not having enough AAC experience these possible funding source practice restrictions will make it all the harder for SLPs to gain the very experience they need to overcome their experience deficits.  What strategy has been devised to overcome this obvious Catch 22?  
• There also are risks to clients who may experience delays or denial of access to necessary treatment because a certified SLP is not available.  AAC specialty certification has potential adverse effects on our clients as well as on SLPs.  Have their interests been considered?  How will causing the delay or denial of access to treatment to clients be addressed?
• Other discussion about certification has been about personal benefit to SLPs. But what are the potential benefits?  One assumption is that certification will persuade funding programs to increase reimbursement for AAC-related services.  But this outcome is not assured; it is speculation.  AAC services already are being provided by SLPs without certification and are being performed to the funding sources’ satisfaction as evidenced by their approval of funding requests for SGDs and for SLP assessments and treatment.  If a service can be at one rate, by generalist SLPs, what is the need to pay more for the same service to be provided by a specialist?
• I am aware that AAC specialty certification already has been considered and that the decision was not to proceed.  Why did it stop before? Why is it starting again? What are the changed circumstances to justify revisiting this question, and what are the changed circumstances that might justify reaching a different conclusion about certification?
• I am concerned that in an area of practice generally recognized as having insufficient clinicians available to provide service, that certification will cause a further reduction in service delivery capacity.  How will certification make the overall AAC service delivery environment better rather than worse?