NATIONALLY SPEAKING Specialized Accreditation: Endangered Species In . an Era of Change Charles H. Christiansen T he American public tends to place a great deal of trust in those mechanisms that protect or serve the public interest. For ex- ample, we usually take it for granted that the hair stylist, plumber, or exterminator are com- petent because we recognize that each of these practitioners must pass a test or meet specified stan- dards to qualify for a license. Sim- ilarly, we assume that public water supplies meet acceptable standards throughout the country, and we almost never ask to see the health permits required of restaurants- even when we travel. In short, we expect our interests to be served through the enforcement of stan- dards-even if we aren't quite sure which agency is responsible for protecting us in a given situation. This may help explain why there is little interest and even less un- derstanding of the mechanism known as accreditation that is de- signed to ensure that minimum ed- ucational standards are maintained among postsecondary and profes- sional education programs in the United States. In fact, a recent study (1) showed that even faculty and administrators in higher edu- cation may have a limited under- standing of the nature or types of the accreditation p'-ocesses that af- fect their activities. Charles H. Christiansen, EdD, OTR, FAOTA, is Director, Program in Occupational Therapy, University of Texas Health Science Center, San Antonio, TX 78284. He is also Pro- fessor of Physical Medicine and Re- habilitation at the University. He currently serves as the Chairman of the Accreditation Committee, Com- mission on Standards and Ethics, American Occupational Therapy As- sociation. This limited understanding of accreditation may reflect an edu- cation heritage intended by our na- tion's founders. They sought to avoid the development of a na- tional system of education and fed- eral involvement in the regulation of educational programs. Instead, these rights of oversight and con- trol were specifica]]y delegated to the states. In turn, the various states exercised minimal control over postsecondary education, pre- ferring to sanction the conduct of educational standard setting and peer review by educators and mem bers of other professional groups. Thus evolved the accredi- tation process whereby a nongov- ernmental agency or organization evaluates and recognizes an insti- tution or program of study as hav- ing met certain predetermined qualifications or standards. The evaluation of educational institu- tions or programs seeking accredi- tation usually takes place through written reporting mechanisms along with periodic visits to cam- puses. Recognition for compliance with standards occurs through the granting of accredited status by a recognized agency. Presently, nine regional bodies and four national associations as- sume responsibility for the institu- tional accreditation activities in this country. When institutional ac- creditation is granted, a college or university as a total entity has met prescribed standards. This proce- dure is in contrast to specialized or programmatic accreditation, which is designed to recognize the quality of an individual program of study that may be housed within a college or university. Specialized accredi- tation is most often granted by professional associations holding claim to the expertise required for the evaluation of a given field of study. Specialized Accreditation and Its Emergence in the Health Professions The history of medical education provides a good example of the development of specialized accred- itation. During the nineteenth cen- tury, it was common for medical The American Journal of Occupational Therapy 363 Downloaded From: http://ajot.aota.org/ on 10/21/2018 Terms of Use: http://AOTA.org/terms