Speech Language Pathologist Checklist

Job Skills Checklist Instructions

This self-evaluation is for assessing your experience in specific clinical areas. This self-evaluation will not be a determining factor in accepting your application to become an employee of Operis Workforce.

Please select ONE answer per line item.

0 = Not Applicable
1 = No Experience
2 = Some Experience
3 = Intermittent Experience
4 = Experienced
5 = Very Experienced

*Required field

Speech Therapy Experience

Adaptive Equipment

Assessments 012345
Augmentative Communication 012345
Computer-based Treatment/Adaptive Microswitches 012345

Speech/Language/Hearing Disabilities

Feeding Disorders 012345
Cleft Palate 012345
Cognitive Rehab 012345
Coma Stimulation 012345
CVA/Stroke Rehab 012345
Dysphagia 012345
Fluency/Stuttering 012345
Head Injury 012345
Hearing Impaired 012345
Laryngectomy 012345
Neurological 012345
Voice 012345


Cerebral Palsy 012345
Early Intervention 012345
Mental Retardation 012345
Learning Language Disabilities 012345
NDT for Speech 012345

Other Skills

Accent Reduction 012345
Aural Rehabilitation/Speech Reading 012345
Biofeedback-EMG 012345
Cognitive Assessment 012345
Co-Treatment with OT 012345
Co-Treatment with PT 012345
Family Education 012345
Group Activities 012345
In-service Education 012345
Myofunctional Therapies 012345
Prosthetics-Cleft Palate 012345
Rehab Feeding Group 012345
Sign Language 012345
Tracheostomy 012345
Ventilator 012345
Videofluoroscopy 012345
FEEST 012345

Age-Appropriate Care

Ability to adapt care to incorporate normal growth and development, adapt method and terminology of client instructions as it relates to the age and comprehension level of the client, and to ensure a safe environment - reflecting specific needs of the client and various age groups.

Age Groups

Newborn (birth-30 days)* 012345
Infant (30 days-1 year)* 012345
Toddler (1-3 years)* 012345
Preschooler (3-5 years)* 012345
School Age (5-12 years)* 012345
Adolescents (12-18 years)* 012345
Young Adults (18-39 years)* 012345
Middle Adults (39-64 years)* 012345
Older Adults (64+ years)* 012345

Application Agreement*

By filling out the information below, I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified within the last 2 years. The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Operis Workforce to release this Skills Checklist to staffing clients. Submit this skills evaluation with your initial application. To be updated annually.