Competency Areas

  1. ASSESSMENT, DIFFERENTIAL DIAGNOSIS, AND ELIGIBILITY DETERMINATION:  Implement appropriate procedures to conduct a multidimensional assessment by administering informal and formal measures of communication development, behavioral, cognitive-linguistic, affect, social, and linguistic components related to Autism Spectrum Disorders (ASD), social/social communication, and other speech, voice and language factors and differentially diagnose ASD in order to determine eligibility for services and plan treatment. 
    1. Screen individuals who present with language and communication difficulties by conducting development-behavioral observations and administering standardized tests to determine the need for further assessment and/or referral for other services.
    2. Observe the client in natural environments, especially with peer interactions, to assess (i.e., social communication, pragmatic skills, play, and prosody), interpret and integrate information from multiple sources (e.g., parents/caregivers, physicians, psychologists, special education personnel and other school staff, teachers, academic records, etc.) to determine a differential diagnosis, and identify any co-morbidities. 
    3. Assess the client using appropriate autism-specific standardized tests, developmental and behavioral assessments and identify core and associated communication related characteristics of autism spectrum disorders, and the developmental impact on social interaction, communication, behavior and learning. 
    4. Integrate multiple sources of information (e.g., review of case history, cultural factors and language differences; previous evaluation and treatment records; information collected from consultation with family members/caregivers, teachers and other professionals) to support a comprehensive, multidimensional communication assessment for ASD across the lifespan. 
    5. Adapt assessment and intervention procedures with respect to culture and linguistic diversity when conducting assessments, developing goals, and intervention for ASD. 
    6. Interpret informal and formal measures of developmental, behavioral, cognitive, affective, social, and linguistic components related to ASD to identify the potential short- and long-term life impacts of the characteristics, and the client’s strengths, coping strategies, resources, and supports. 
    7. Conduct a differential diagnosis of autism spectrum disorder, language delays, hearing impairment, childhood apraxia of speech, expressive and receptive language disorder, social (pragmatic) communication disorder, and speech (phonological) disorder to provide the most appropriate diagnosis and to accurately capture the individual’s profile.
    8. Analyze assessment results of the differential diagnosis to identify appropriate and effective evidence-based intervention using developmental and operant/learning theory frameworks.
    9. Provide options for augmentative and alternative communication (AAC) as a primary or supplemental mode of communication or to enhance communication for individuals with ASD when they have challenges with verbal expressive communication and/or have a severe speech disorder. 
    10. Identify non-communicative needs (e.g., medical, psychological, developmental, primary sensory [hearing, vision]) and refer the client for further consultation, assessment and/or treatment, when indicated. 
    11. Evaluate the family’s/individual’s/caregiver’s access to, and utilization of, community-based supports for the individual with ASD by conducting family/caregiver interviews or observations to identify potential enhancements to these supports that are evidenced-based practices. 
    12. Assess the family’s/caregiver’s capacity to engage and support social, communicative, and behavior interventions for the person with ASD. 
    13. Within the SLP’s scope of practice, identify sequelae such as primary sensory impairments (i.e., hearing loss) and biological factors such as potential health related conditions (i.e., gross motor impairments, attention deficit hyperactivity disorder) that can be associated with ASD and impact achievement and functional performance, and make appropriate referrals (e.g., to audiologists, occupational therapists, child psychologists, physicians or other relevant health care providers).
  2. COLLABORATION AND REFERRAL:  Collaborate with stakeholders (i.e., patient, family, caregivers, community members, and other professionals) on activities related to data collection, assessment, diagnosis, referral, daily functioning, and/or treatment.
    1. Provide individualized information to the family on strategies to support communication, social skills, learning, behavior, and speech and language development.
    2. Work collaboratively with a diagnostic team and/or other multidisciplinary collaborations, to differentially diagnose the presence or absence of ASD.
    3. Work collaboratively with an evaluation team and/or other multidisciplinary collaborations, to determine for eligibility for ASD services (e.g., special education services, insurance coverage).
    4. Partner with families in assessment and intervention with individuals with ASD to maximize positive life-long outcomes.
    5. Counsel persons with ASD and their families regarding communication-related concerns and provide education aimed at understanding the underlying characteristics and communicative aspects of ASD, and the link between behavior and communication. 
    6. Consult and collaborate with other professionals, family members, caregivers, and others to facilitate continual program development and implementation, and to provide supervision, evaluation, and/or expert testimony, as appropriate. 
    7. Serve as an integral member of an interdisciplinary team working with individuals with ASD and their families/caregivers, including transition planning across the lifespan and ongoing communication needs. 
    8. Communicate evaluation findings as they relate to the client’s environments (e.g., home, academic, social, cultural, professional) in a sensitive manner that ensures understanding by the client (i.e., using nontechnical terminology to communicate findings), support system and other professionals.
    9. Support family-centered determination of intervention priorities, including goal selection and sequencing, while also assisting with selecting individualized intervention approaches that are in accord with evidence-based practice.
    10. Promote collaborative practices that respect individual and family culture and values relative to the impact that autism spectrum disorders may have on the individual and family across the life span. 
  3. TREATMENT:  Select and implement ethical, evidence-based interventions/treatment procedures to address clients’ communication, social, behavior, and functional deficits associated with autism spectrum disorder.
    1. Develop, implement and modify differential treatment plans and rationales based on evidence-based guidelines (e.g., clinical data, family values), the client’s evolving needs, and treatment outcomes for individualized interventions, with accountability. 
    2. Develop, implement, and continually update an appropriate treatment plan for increasing the likelihood of long-term generalization and maintenance of skills across settings. 
    3. Complete dynamic assessment of individuals with ASD throughout their lifespan to ensure that goals and intervention approaches are in accordance with evidence-based-practice and are linked directly to supporting long-term educational, vocational and self-determination abilities, as well as continue to support daily needs as skills are acquired.
    4. Develop, implement, evaluate, and adjust individualized, culturally sensitive treatment plans for speech and language services (e.g., goals for social competencies, pragmatics, functional communication, self-regulation) with the objective of participating (or partial participation) in the mainstream curriculum, socializing and developing relationships with peers, securing and maintaining meaningful employment, and maximizing independence.  
    5. Select evidence-based interventions, determine progress toward individual goals, and determine necessary changes in selected interventions and treatment planning (including recommendations for discharge, when appropriate) based on relevant and clearly documented individual data, student/patient and family/caregiver needs, and professional knowledge of providers in accord with the ASHA Code of Ethics and SLP scope of practice in a timely manner to avoid unnecessary delays in access to data-driven care. 
    6. Decrease communication-related disruptive and/or self-injurious behaviors that have a communicative function by identifying and teaching alternative communicative responses to increase effective communication across peers and settings.
    7. Implement antecedent- and/or consequence-based interventions (e.g., environmental arrangement, teaching communication skills to replace aggression) to reduce interfering and disruptive behavior at the time of the episode and subsequently across settings (e.g., antecedent strategies: altering instruction, simplifying steps of given task(s), self-management; consequence strategies: increasing replacement communication acts using extinction and natural reinforcers).
    8. Improve social communication for children, adolescents, and adults with ASD to increase integration with the community by working with persons with ASD individually or in groups at home, school, the workplace or clinic.
    9. Address communication related repetitive behaviors that interfere with the individual’s learning and acquisition of novel skills to excel in their environment, to facilitate social engagement, and to promote social communication through positive behavior support, such as teaching replacement communication skills.
    10. Design instruction that considers the individual’s strengths, interests and skills, including restricted interests that may be utilized to enhance socialization, quality of life, and employment. 
    11. Facilitate communicative success by improving production and recognition of pragmatic features (e.g., prosodic and gestural) across environments using evidence-based interventions.
    12. Implement treatment approaches that will assist in reduction of autism-related feeding/eating behaviors that interfere with social communication and will expand the individual’s food repertoire.
    13. Develop plans to address the health and personal safety needs of clients with autism spectrum disorder, in collaboration with parents and medical professionals (e.g., devising plans for children who elope, seizure recognition and training, considerations for travel and/or going to public places, social and communication aspects of sexual behavior). 
    14. Complete an individualized risk assessment for communication-related disruptive and aggressive behavior and develop a proactive management plan including teaching persons with ASD replacement communication skills and calming strategies and coordinating with parents, teachers, and other community stakeholders (e.g., law enforcement, coaches) using appropriate non-aversive positive responses to disruptive and/or aggressive behavior.
  4. LEADERSHIP, SUPERVISION AND ETHICAL PRACTICE:  Participate in leadership, supervision and ethical practices that promote effective communication for individuals with ASD to support inclusion in social interactions and maximize the individual’s ability to function in daily life.
    1. Lead and supervise teams of interventionists as well as supervise practitioners in the assessment, diagnosis and treatment of individuals with ASD in accordance of the competencies of the BCS-ASD.
    2. Serve as an integral partner for individuals with autism and their families or caregivers in their social networks by advocating their rights and contributions to their communities by educating individuals with ASD in methods of self-advocacy and by modeling advocacy in your place of work, and at the local, state, and national levels.
    3. Adhere to the ASHA Code of Ethics and scope of practice for SLP to ensure ethical practice and to provide a model for best practice and professionalism and maintain membership in good standing.
    4. Develop ethical and non-aversive interventions as primary treatments for individuals with ASD. 
    5. Proactively ensure that aversive/unethical/inhumane approaches (e.g., time out/isolation rooms, restraint, electric shock) are not imposed on people with ASD during assessment and intervention.
  5. EDUCATION, RESEARCH AND PROFESSIONAL DEVELOPMENT:  Educate stakeholders and community partners about ASD, keep abreast of ASD evidence-based research, participate in professional development in area of autism and related disorders.
    1. Continually monitor the ASD literature on evidenced-based assessments and interventions in order to update the knowledge and skills of the clinician holding the BCS-ASD and incorporate this new information on the assessment and treatment of ASD in practice in a timely manner.
    2. Participate as a lead member of planning teams for early intervention/school districts/supportive living/employment (e.g., whose members may include teachers, special educators, counselors, psychologists, caregivers) to provide information on evidence-based communication interventions for individuals with ASD.
    3. When indicated in the communication assessment, provide information and training in the use of augmentative alternative communication (AAC) (e.g., pictures, gestures, technical devices, voice output systems) to persons with ASD, and provide communication partner training to support AAC use to families, caregivers, employers, and educators.
    4. Whenever possible, holders of the BCS-ASD contribute to the research base on the assessment and treatment of ASD and social communication disorders. 
    5. Develop training programs for community members (e.g., teachers, medical professionals, first responders) and families to ensure the health and safety of individuals with ASD, the training may include topics such as: elopement, police interactions, recognizing and responding to seizures, aggressive behavior, considerations for travel and/or going to public places.

For the safe and effective performance of tasks associated with the competencies, the BCS-ASD must have knowledge of:

  1. The core signs of autism including disruptions in social communication and displaying restricted and repetitive behaviors.
  2. Conditions associated with ASD, but not diagnostic criteria, such as eating disorders (feeding/swallowing), and self-injury.
  3. Developmental milestones for speech, language, and other nonverbal communicative areas, including play skills, knowledge of anatomical and physiological mechanisms supporting speech/language development and social communication development, and how these apply to ASD.
  4. Risk factors for autism and related disorders (i.e., genetic linkages or syndromes, severe infections that can cause brain damage, for example, rubella, meningitis and encephalitis, severe social neglect or abuse, premature birth, prenatal and/or perinatal complications, exposure to known environmental toxins such as lead).
  5. Terminology and techniques applicable to ASD (e.g., positive and negative reinforcement, Theory of Mind (ToM), social skills, social emotional ability, social cognitive skills, social communication skills, motivational hierarchies, executive function).
  6. Intervention accountability-data collection procedures (i.e., operationally defining target skills, establishing an appropriate data recording method, systematic data collection to monitor treatment, treatment dose, observational methods).
  7. Autism-specific assessment procedures and differential diagnosis.
  8. Testing for autism, including initial screening, developmental test administration and speech/language and social communication assessments.
  9. How to collect and interpret language samples and social communication assessments, especially as these relate to specific challenges in ASD.
  10. Core knowledge of human behavior and operant learning theory including the process and procedures for conducting assessment and intervention.
  11. Forms of communication, including verbal and nonverbal skills, and how to interpret these skills within specific contexts (i.e., home, school, employment, community settings).
  12. Communication-related functional assessment principles and procedures across settings (i.e., home, school, employment, community settings).
  13. Measures and procedures for the clinical assessment of ASD. 
  14. Recognition of pre-linguistic markers including initiating and responding to joint attention, social gestures and facial expression, social communication and social engagement, language comprehension and related social play behaviors.  
  15. Recognition that symptomology and social communication needs of ASD change with language levels, including prelinguistic stages, early verbal stages, phrase speech, early conversational skills and adolescent and adult interaction.
  16. Patient-related information gathering, analysis, including how to evaluate and present information to persons with ASD, parents, teachers, physicians, relevant community members and other stakeholders. 
  17. Single subject research design, including the creation and interpretation of graphs depicting baseline and intervention phases, reversals, and generalization and maintenance.
  18. The current DSM, including: ASD, social communication disorders, intellectual disability, speech disorders, and language disorders, and the core features of each of these categories.
  19. State-specific legislative and state-level educational classification of autism and the approved procedures for establishing eligibility for services and differential diagnosis of ASD.  (This knowledge will not be covered on the examination.)
  20. State-specific insurance policies regarding diagnosis and treatment of ASD and the approved procedures for establishing eligibility for services and differential diagnosis of ASD. (This knowledge will not be covered on the examination.)
  21. Autism-specific intervention procedures, including evidence-based procedures based on developmental and/or operant/learning theory frameworks and Autism-specific interventions that do not have a supporting evidence base.
  22. Key features of echolalia and scripting associated with ASD, including the potential forms of echolalia, how to shape echolalia and scripting into purposeful communication and identifying features that differentiate echolalia from verbal imitation seen in typical development.
  23. Evidence-based treatment approaches developed and utilized by SLPs and issues of how to increase generalization through embedding treatment targets as much as possible.
  24. Common DSM comorbid disabilities seen is ASD, including speech disorder, ADHD, anxiety, selective mutism, depression, and intellectual disabilities.
  25. Controversial and unsubstantiated diagnoses such as Central Auditory Processing Disorder (CAPD) and sensory integration dysfunction (SID) that are sometimes applied to ASD. 
  26. Evidence-based treatment approaches developed and utilized by SLPs
  27. Issues of how to increase generalization through embedding treatment targets
  28. Evidence-based treatment strategies across the life span, from infancy through adulthood, to address a variety of functioning levels including those with the greatest support needs to those with mild support needs.
  29. ASD-specific knowledge of augmentative and alternative communication, or AAC, including picture systems, sign-gesture systems and assistive technology as adapted and applied to support development and communication needs of persons with ASD.
  30. Evidence-based treatment strategies across the life span, from infancy through adulthood, to address a variety of functioning levels including those with the greatest support needs to those with mild support needs.
  31. Fidelity of the training for treatment as carried out by interventionists with varied backgrounds (e.g., parents, aides, in-home therapists), patient management or coordination of needs, and implementation in varied service delivery models, i.e., treatment delivery across settings (e.g., home, school, community, hospitals, centers, universities), parent education, and supervision of ABA insurance-reimbursed services related to communication.
  32. Core features of operant learning theory and application of behavior analysis in the treatment of ASDs, including positive and negative reinforcement and positive and negative punishment and how to evaluate these in persons with ASD.
  33. Procedures for conducting communication-based functional analyses such that trainees can understand the communicative functions of problem and inappropriate behavior, and how to effectively reduce problem episodes using communication replacement interventions.
  34. How to identify replacement communication skills, either verbal or nonverbal for problem behavior and/or repetitive behavior so that trainees can learn variables related to developing and effectively teach replacement communication skills.
  35. Principles of ASD specific evidence-based practices, including systematic reviews, meta-analysis and up to date review of the current ASHA evidence maps for autism.
  36. ASD-specific considerations for protecting the human dignity of persons with ASD and their families, including ethical issues related to patient and family rights, intervention procedures, reporting procedures, humane responses to aggression, and a basic right to freedom from restraint and other aversive methods unless medically indicated.
  37. Cultural issues and sensitivity in relation to ASD, including bilingual issues, family and community views of autism and self-advocacy for persons with ASD.
  38. How to adapt and apply core knowledge gained during CCC-SLP training to teach language functions (e.g., initiations, greetings, sharing information, asking and answering questions, repairing communication breakdowns, etc.) that are often needed in children, adolescents, and adults with ASD.
  39. How to adapt and apply core knowledge gained during CCC-SLP training on normal speech, language and social developmental processes to promote functional language in persons with ASD.