Foundations and Professional Practice: Credentialing, Ethics, and Legal Frameworks
Domain 1 covers the regulatory and ethical scaffolding of practice: the CCC-SLP pathway, the ASHA Code of Ethics (2023), supervision and delegation limits, and the laws that define confidentiality, consent, and eligibility. Items are scenario-based - they ask what your next best step is, not what a term means.
Credentialing: what each gate actually requires
- Master's degree, at least 400 supervised practicum clock hours (25 observation, 375 direct client contact), the Praxis (5331) at the qualifying score, then a Clinical Fellowship of 1,260 hours across a minimum of 36 weeks with documented supervisory activities.
- Certification maintenance: 30 certification maintenance hours (CMHs) per 3-year interval, logged and auditable. State licensure renews on its own cycle with its own hour requirements.
- Certification, state licensure, department-of-education certification, and payer enrollment are four separate gates. Clearing one does not clear the others.
Applying the Code of Ethics
Four principles: I, responsibility to persons served and research participants; II, responsibility for professional competence; III, responsibility to the public; IV, responsibility for professional relationships. Practical consequences:
- Informed consent precedes assessment, treatment, recording, and research; never guarantee a cure; correct misrepresentation of services.
- Do not delegate tasks requiring your professional judgment to assistants or aides; supervisees must not practice independently.
- Confidentiality: HIPAA governs protected health information held by covered entities (hospitals, clinics); FERPA governs education records in schools.
- Conflicts of interest, self-reporting of impairment, and mandated reporting are explicit rules, not etiquette.
Worked example
An administrator asks you to bill Medicaid for three sessions you never delivered and to add a fluency goal to an IEP whose eligibility rests on language impairment. Reasoning: billing for undelivered services is fraud, breaching Principles I and III; writing a goal with no assessment data violates the requirement that intervention target documented need. Correct sequence: decline, document the request in writing, address it first with the person who made it, then escalate (supervisor, compliance officer, licensing board, ASHA ethics) only if unresolved. Formal reporting is not the automatic first step.
Traps that cost marks
- Jumping to "report to ASHA or the board" when the item's keyed answer is "discuss with the individual and document."
- Swapping HIPAA and FERPA.
- Treating a school eligibility category as a clinical diagnosis, or assuming CF hours and licensure hours accrue simultaneously.
- Using a family member as interpreter instead of a trained interpreter.