Speech Language Pathologist Checklist


Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Total Stars:

Obtained Stars:

Ranking: 0%

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

  Work Settings         Rating Stars (Click) 1 2 3 4
  Acute care  
  Daily treatment center  
  Home health care  
  Inpatient acute rehab  
  Neonatal intensive care  
  Outpatient/outpatient community re-entry  
  Pediatrics  
  Psychiatric hospital  
  Private practice  
  School setting  
  Early intervention  
  Skilled nursing facility  
  Patient Populations         Rating Stars (Click) 1 2 3 4
  Geriatrics  
  Hearing impaired  
  Learning disabilities  
  Pediatrics/school age  
  Progressive neurologic disease  
  Trachs/ventilators  
  Transient Ischemic Attach (TIA)  
  Traumatic brain injury  
  Voice/laryngectomy  
  Assessment Tools         Rating Stars (Click) 1 2 3 4
  Boston assessment of severe aphasia  
  Boston diagnostic aphasia examination  
  Minnesota test for differential diagnosis of aphasia  
  Informal testing  
  Porch index of communicative abilities  
  Reading comprehension battery for aphasia  
  Ross information processing assessment-geriatric  
  Western aphasia battery  
  Bedside swallow evaluation  
  Blue dye test  
  Cervical auscultation  
  Fiber endoscopic evaluation study  
  Modified barium swallow study  
  Rehab Institute of Chicago evaluation of communication  
  Augmentative devices  
  Pure tone screening  
  Types of Disorders         Rating Stars (Click) 1 2 3 4
  Aphasia  
  Apraxia  
  Autism  
  Cleft palate  
  CVA/stroke  
  Fluency  
  Dementia/alzheimers  
  Dysarthria  
  Dysphagia  
  Hearing loss  
  Learning disabilities  
  Traumatic brain injury  
  Treatment         Rating Stars (Click) 1 2 3 4
  Augmentative devices  
  Behavior modification  
  Cognitive training  
  Community re-entry  
  Computer  
  Co-treatment  
  Treatment - cont.         Rating Stars (Click) 1 2 3 4
  Group  
  Individual  
  Safety awareness  
  Total communication  
  Vital stimulation  
  Dysphagia across the age-spectrum  
  Age Specific Competencies         Rating Stars (Click) 1 2 3 4
  Infant (birth to 1 year)  
  Toddler (ages 1-3 years)  
  Preschooler (ages 3-5 years)  
  Childhood (ages 6-12 years)  
  Adolescents (ages 12-21 years)  
  Young Adults (ages 21-39 years)  
  Adults (ages 40-64 years)  
  Older Adults (ages 65-79 years)  
  Elderly (ages 80+ years)