Clinical Competencies for the Burn Speech-Language Pathologist: A Multidisciplinary Development and Delphi Consensus Study

Clinical competency guidelines promote optimal, safe standard of care. While nationally established clinical competencies exist for burn occupational therapists and physiotherapists, no equivalent frameworks exist for burn speech-language pathologists (SLPs). To address this gap, we developed a burn-specific SLP competency tool. Led by the American Burn Association (ABA) Rehabilitation Committee, an expert panel of burn SLPs, Burn Therapists-Certified (BT-C) clinicians, and a physiatrist implemented a staged process. Current national and international practice guidelines were synthesized through modified Delphi methodology, with expert consensus meetings to create and refine a burn SLP competency tool. The ABA Burn Rehabilitation Therapists Competency Tool served as the model framework. Eighteen multidisciplinary burn clinicians representing 14 burn centers, across 3 countries, refined the burn SLP competency tool. A steering group (5 SLPs, 1 burn physiatrist) identified 103 competency statements spanning 15 core clinical domains. These were presented across 2 rounds of Delphi survey and consensus meetings. The tool was refined with each survey resulting in a final tool comprising 81 knowledge and application competency statements covering 17 domains, tailored to the burn SLP across the continuum of care for adult and pediatric populations. The tool is structured into 2 tiered levels of expertise: level 1: minimum level of specialist skill required to manage a patient with burn injury; level 2: expert level of specialist skill and recognized resource to other SLPs. This initiative has produced the first internationally developed and consensus-based competency tool for burn SLPs. It establishes a standardized reference for SLPs to deliver specialized burn care throughout the acute and rehabilitative continuum.