Recent growing interests in the welfare, rehabilitation, and development have brought rapid quantitative growth of social support services and developmental rehabilitation services. Along with the increase in demand of those services, the children and... Recent growing interests in the welfare, rehabilitation, and development have brought rapid quantitative growth of social support services and developmental rehabilitation services. Along with the increase in demand of those services, the children and guidance who need speech therapy request a high quality service. The qualification of speech-language pathologist (SLP) has been managed at the national level and the continuous education was mandated to ensure the expertise of SLP. In order to improve the quality of the speech therapy process and enhance the professionalism of speech-language intervention, the efforts to improve the clinical competence of SLP is important. On the other hand, although the importance of the attitude to playfulness and the relationship of SLP are recognized in the speech therapy for children, it is the lack of empirical research on this. Therefore, the purpose of this study is to construct elements of clinical competence of SLP and investigate the validation on the development of a clinical competence scale of SLP through this research in the circumstances in which there is no tool to determine or measure the clinical competence of SLP. In addition, it will help to increase the clinical competence through the study of the variables to affect the clinical competence of SLP by using the clinical competence scale. This study was designed to have study 1 and study 2. The study 1 reviewed the previous studies and literature to construct the contents of the clinical competence scale of SLP. Due to the shortage of information related to the clinical competence of SLP, the data were collected from the occupational information work (O*T) which is operated in conjunction with American Speech–Language-Hearing Association (ASHA). Based on the information presented in O*T, 75 items of the core competence were extracted. 75 items were based on the competency theory. It was consisted of two characteristics, 47 professional capacities and 28 inner capacities. A group of professional capacities includes tasks, knowledge, skills that are essential to carry out speech therapy as SLP. A group of inner capacities includes career interests, attitude to work, and value to work that allow SLP to better exercise in performing the professional competence. The extracted core items were translated by a professor who has worked at the department of speech-language therapy in the United States over 10 years, in which the domestic situation of speech therapy was considered. After the translation of them, they were verified under the guidance of the thesis director. Primarily, the content validity of the translated items was verified by a total of 42 people (30 SLPs and 12 professors who have more than the assistant professor position in the department of speech-language therapy in Korea) who satisfied all three requirements such as “more than a graduate education, clinical experience of more than 10 years, class 1 certification.”After that, 281 SLPs participated in this study and filled out 75 preliminary questionnaires about the clinical competence of SLP. They have worked at the nationwide hospitals, welfare centers, private treatment agencies, educational institutions (schools, day care), labs within Universities, and etc. The data were analyzed with SPSS 22.0 and AMOS 22.0, in which the reliability was analyzed as exploratory factor analysis, confirmatory factor analysis, and Cronbach's α. The modified competence index of the Korean occupational therapists was used to evaluate the criterion-related validity of the survey data. The study 2 investigated previous studies and literature to predict variables related to the clinical competence of SLP, through which it was expected that variables of the playfulness and the therapeutic relationship may have an impact on the clinical competence. 287 SLPs participated in this study from all over the country and completed the survey. The collected data were analyzed with SPSS 22.0. Frequency, mean, standard deviation, independent sample t-test, one-way ANOVA, Pearson correlation analysis were carried out to examine the relationship among the socio-demographic variables, the playfulness, the therapeutic relationship, and the clinical competence. In addition, utilizing the clinical competence scale developed in the Study 1, the mediation effect was investigated in the relationship of how the playfulness of SLP affects the clinical competence of SLP. And it was analyzed with stepwise multiple regression analysis and sobel test. The results of this study were summarized as follows. First, this study reviewed previous studies and literature in order to construct the clinical competence scale. The core contents of professional capacities of SLP were collected from the occupational Information work in the United States. On the basis of the competency theory, it was organized in 47 items of the group of professional capacities (tasks, knowledge, skills) and 28 items of the group of inner capacities (interests, attitudes, values). Second, a total of 75 items were translated into the question items of the preliminary clinical competence scale of SLP, and the validity and reliability of the content were investigated. The survey of the main study utilized the preliminary clinical competence scale with the proven content validity. And the constructive validity relating to the inner criteria were examined with the exploratory factor analysis and the confirmatory factor analysis. With regard to criterion-related validity as external criteria, the concurrent validity was secured through the relationship with the clinical competence of Korean occupational therapist. In the 30 items from the final version of the clinical competence of Korean SLP, the suitability was confirmed such as RMSEA (absolute fit index) = 0.047, CFI (incremental fit index) = .935, TLI (simplicity suitable index) = .928, SRMR (non-conforming index) = 0.049, NC (standardized chi-square value) = 1.63. Third, according to the individual variables, the results of the clinical competence, playfulness, and therapeutic relationship revealed that the variables of the clinical competence were more significantly influenced by older in age or more careers, higher education or job position, higher certificate, and more men than woman. In the therapeutic relationship, the possession of the psychological treatment certificate and the preference of the child-centered approach influenced the clinical competence. Fourth, the playfulness and the therapeutic relationship of SLP was found to be the variables that affect the clinical competence. Multiple regression analysis were performed to investigate how each variable influences the clinical competence. The playfulness of SLP explained 27% of the clinical competence, the clinical competence was significantly predicted with the fun initiative (β=.422,<.000), fun reactivity (β=.191,<.01), and improvisation (β=-.147,<.05) among sub-variables of the playfulness. The therapeutic relationship explained 20.18% of the clinical competence. Therapeutic Cooperation (β=4.384, <.000) and positive emotions (β=2.707, <.000) significantly predicted the clinical competence among the sub-variables of the therapeutic relationship. In addition, in the analysis of how the playfulness of SLP influences therapeutic relationship, the playfulness of SLP explained 11.1% of the therapeutic relationship. And fun initiative (β=.278,<.001) among the sub-variables of the playfulness significantly predicted the therapeutic relationship. Fifth, a stepwise multiple regression analysis was conducted to explore whether the role of the therapeutic relationship is mediating variables in relation to the playfulness and the clinical competence of SLP. The results showed that the playfulness of SLP explained 13.0% of the clinical competence. A model including both the playfulness and the therapeutic relationship explained 50.2% of the clinical competence. It was found that the therapeutic relationship had a partial mediation effects in the process of that the playfulness of SLP affects the clinical competence. Also, the sobel test confirmed that mediation effects were significant with =3.18 which value was greater than 1.96 as the threshold. Based on the above results, the significance of this study are as follows. This study was significant in the point of that the factors of SLP’s clinical competence were presented and verified based on the competence theory and the tool available measuring the clinical competence of SLP was developed in the circumstances that there was not capable of measuring the clinical competence of SLP. In addition, it was significant that the scale developed in this study can lead to various studies, the professional capacity of SLP, and the criterion to stimulate the change of inner capacity growth. On the other hand, this study on factors related to the clinical competence of SLP confirmed that the playfulness of SLP and the therapeutic relationship is important in the course of the speech therapy. The results of this study suggested that the presentation of interesting stimuli, positive and emotional relationship, cooperative relations and etc. were the essential elements in the clinical practice for children. The study is expected to be the starting point of the study of the clinical competence of SLP that can help enhance the clinical competence of SLP in the future.
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