CASLPO News

On May 11, 2026, the Ontario Ministry of Health (MOH) announced that they would make changes to the scope of practice for speech-language pathologists as well as other regulated health professions. Once these changes are implemented, SLPs will be able to: 

• independently order videofluoroscopic swallowing studies and  
• order and apply diagnostic ultrasound within SLP scope.  

No.  Among other things, there will need to be legislative amendments for the changes to take effect.  Legislative amendments are the responsibility of the Ontario Government and would require legislative approval. The timing of this is unknown.  CASLPO will need to revise existing Practice Standards and develop new ones. It will also be necessary for CASLPO to develop required competencies for these tasks.  

Videofluoroscopic swallowing study, or VFSS, is a radiographic procedure that provides a dynamic view of the swallowing process. It involves the patient swallowing various consistencies of food and liquid mixed with a contrast material like barium, which allows the bolus to be visualized in real-time on an X-ray during the swallow. This is used to assess swallow function and to develop a treatment plan. 

Because videofluoroscopy is a type of x-ray, which involves radiation, access to ordering videofluoroscopy (i.e., request that one be done) is limited to health care professionals specified in the Healing Arts and Radiation Protection Act, 1990.  

This means that SLPs need to request an order, typically from a physician or nurse practitioner, when they think their patient needs a videofluoroscopy.  When the scope of practice change takes effect, it will mean that speech-language pathologists will be able to independently order a VFSS.  These studies will still be performed at sites equipped with fluoroscopy units and authorized diagnostic imaging professionals like radiation imaging technologists.   

SLPs use ultrasound in intervention as a way for patients to see where their oral structures (tongue, hard palate, etc.) are during speech or swallowing. SLPs are interested in using ultrasound as a therapeutic tool.  

Researchers and SLPs are finding that ultrasound biofeedback is an effective intervention that is low risk and achieves positive results for patients.  

However, currently, for SLPs to offer visual biofeedback using ultrasound, they need a physician to delegate the controlled act of ordering and applying this form of energy (they are not permitted either to order or apply it). In most settings, it is challenging for SLPs to receive this delegation from physicians, particularly when there may be no physician on site.   

These changes will benefit the Ontario public by facilitating access to important and effective speech-language pathology services from competent and regulated professionals. 

Given that legislative changes are involved, these changes will take some time to implement.   

Yes, input from SLPs is important and valuable. CASLPO will be identifying opportunities for registrant collaboration.  

The changes announced on May 11, 2026, corresponded to the Ministry of Health’s consultation on proposed expanded access to diagnostic imaging in the Fall of 2025. The Ministry’s consultation was specific to certain diagnostic imaging procedures that focused on the following regulated health professionals: 

• dental hygienists  
• denturists  
• speech-language pathologists 
• physiotherapists 
• chiropractors 
• chiropodists 

Yes. Please contact the CASLPO Practice Advisory Service - [email protected]. Media inquiries should be directed to the Registrar and CEO, Margaret Drent at [email protected].