Published in the May 2026 issue of the ISHA Voice.
By Christina (Tina) Panzl, co-chair of the Ethics Education Committee and Angelica Kielbus, SLP Graduate Student Clinician
As clinical supervisors, SLPs have the privilege of witnessing graduate student clinicians begin to wrestle with the real-world complexities of ethical practice. By encouraging ethical dialogue within clinical placements, supervisors can more effectively model problem-solving to help students develop the skills and confidence needed to navigate complex clinical decisions with integrity. When I asked my graduate clinician about challenges she might anticipate encountering post-graduation, here’s what she had to say:
As I wrap up my time as a student clinician, I have found myself wondering what other new clinicians will do in difficult situations as they transition from student to clinical fellow or early career professional. For example, in a school setting, a situation many new clinicians may encounter is outside pressure to qualify a student for speech services when the evaluation data does not support eligibility. The pressure might come from an administrator who wants to support a struggling student, a team member trying to respond to parent concerns, or a family strongly advocating for school services. Everyone’s intentions may be good. The student may truly be struggling. The challenge arises when both your clinical judgment and the data do not support special education eligibility. In these moments, you must align your decisions in accordance with the legal rights for a free appropriate public education (FAPE) under the Individuals with Disabilities Education Act (IDEA) and the ethical practices related to the field’s professional values and expectations outlined in the American Speech-Language-Hearing Association Code of Ethics.
When faced with this situation the first responsibility is to return to the data. Individuals need to review assessment results carefully to make sure they are accurate, culturally and linguistically appropriate, and clearly interpreted. Consulting with other SLPs could allow you to confirm that your conclusions are sound and defensible. Defensible decisions will align with the Individuals with Disabilities Education Act (IDEA), which is a U.S. federal law that ensures children with disabilities receive a free and appropriate public education tailored to their individual needs through special education and related services. You can use this resource to ensure you can clearly explain that a speech-language impairment must adversely affect educational performance in order to qualify the student for services. This is often the part families understandably struggle with because there is an important difference between the medical model, where a diagnosis alone can qualify someone for treatment, and the educational model under IDEA, which requires evidence that the disability affects the student’s ability to access and make progress in the educational environment. Even though emotions may be high and you may be nervous, aim to present your findings calmly and objectively. Reed and Farquharson (2024) reported that school-based SLPs with higher professional self-efficacy relied on multiple data sources when making eligibility decisions. This reinforces the importance of grounding special education determinations in comprehensive and defensible evidence rather than external pressures. If the student does not meet criteria a new clinician can still contribute to the student’s success and performance in the school setting by suggesting RTI/MTSS supports, recommending classroom strategies, or contributing to progress monitoring. Saying a student does not qualify for IEP services does not mean saying the student does not need support; it means identifying the most appropriate and least restrictive type of support.
There are also important legal considerations. IDEA requires that eligibility decisions be based on clearly defined disability categories and document educational impact. If a new clinician were to exaggerate or adjust findings to qualify a student that could be viewed as misrepresentation of educational records. This would also violate the ASHA Code of Ethics, specifically Principle of Ethics IV, Rule R, which prohibits misrepresentation of diagnostic information (ASHA, 2023). This could put the district at risk for complaints or litigation and could affect your professional license. Special education funding is designated for students who meet eligibility standards, and providing services outside of those standards can be considered a misuse of resources. Clinical fellow applicants for ASHA certification are still responsible for the accuracy and integrity of their reports before obtaining the Certificate of Clinical Competency.
The ethical and moral components can feel even more personal. We may feel empathy for the family and want to help. You may feel pressure to maintain positive relationships with your team. At the same time, you have a responsibility to uphold fairness and equity. If you qualify one student without justification you may be taking time and resources away from another student who truly meets criteria. Qualifying a student without sufficient evidence may also raise concerns under the ASHA Code of Ethics, Principle of Ethics I, Rule C, which requires clinicians to avoid discrimination in service delivery and ensure fair and equitable access to services (ASHA, 2023). Going against your professional judgment can also create moral distress and chip away at your confidence as a clinician. Practicing ethically means relying on evidence, maintaining integrity, and remembering that your role is to advocate for appropriate services, not just more services. The Code of Ethics serves as a framework for professional conduct and can be a great resource when encountering a questionable or difficult situation, especially for early career professionals.
Situations like this require both courage and preparation. Taking a stance does not mean being difficult. It means making decisions grounded in data, law, and professional ethics. When you document thoroughly, consult with other SLPs and team members, and clearly communicate your rationale, you protect yourself and your students.
References
American Speech-Language-Hearing Association. (2023). Code of Ethics [Ethics]. American Speech-Language-Hearing Association. https://www.asha.org/policy/code-of-ethics/
Reed, A. C., & Farquharson, K. (2024). Speech-Language Pathologist self-efficacy and job satisfaction: Resources in special education eligibility decisions. Language, Speech, and Hearing Services in Schools, 55(4), 1110–1124. https://doi.org/10.1044/2024_LSHSS-23-00195
Christina (Tina) Panzl, SLPD, CCC-SLP is a school-based speech-language pathologist currently practicing in the Glenview/Northbrook area. Her professional areas of interest include childhood language and literacy, AAC, supervision/mentoring and leadership.
Angelica Kielbus is a May 2026 graduate of Midwestern University - Downers Grove. She resides in Northfield Township. Her clinical interests include: early language development, literacy, articulation, ethical scenario discussions, as well as Alternative and Augmentative Communication (AAC).