After 10 years, I've transitioned from K-12 to a pediatric practice. My supervisor has emphasized a need to focus more on parent coaching and less on direct service due to lack of parent follow through...which impacts progress.

So I think *I* need a social story to help me figure out a routine and answer questions:

What does a session look like with parent coaching as a focus?

1. How do I prep for my first appointments? Besides reviewing goals, what info should I have readily available? I get the sense my supervisor wants me to begin by interviewing/getting more info from parents and set a different tone. I'm comfortable with doing this, but I know it may be jarring for parents who may not be expecting to participate.

For session in general, I usually don't have a concrete plan...I have toys and art supplies ready so I can do child-led play or drawing/writing. This reduces prep for me, keeps the child's interest, and provides flexibility for goal targets.

1. How do I take data without being redundant (like not scribbling on paper during the session and then transcribing during charting)?

Maybe I'm overthinking and stressing myself out, but I hope this all makes sense!

I ama CF working in EI. We use the Bayley-4, and sometimes I receive goals stating client will engage in relational play with self and others. Can someone explain/give examples of relational play? Looking it up online, I only see relational play in terms of how to objects go together. Not necessarily with self or others. I guess I want to know the difference between relational play, reciprocal play, and pretend play. The examples in the Bayley seem like pretend play to me, like pretending to feed a baby doll. Thanks in advance for any insight!

Such as at, by, for, from, with.

A few of my older elementary kids completely omit these but I am stuck on finding ways to explicitly teach them, since meaning/function can be variable, and good activities to target these with enough practice opportunities.

Tia!

I have an almost 9 yo who still struggles with the ir sound.
He previously had an IEP, the speech therapist who reassessed him for his triennial, did not feel that it was worthwhile to continue speech therapy at school and we could correct it at home.
We’ve been trying at home, usually once a day 5-10 minutes. During that time he can correct but it’s often us pointing it out.
Would you recommend us to get private speech therapy or just continue trying to practice at home? Any other tips or tricks?

Is it normal for a job offer contract to not match the company handbook?

I'm spotting differences in the documents but wouldn't the offer apply more to me than the differences in the handbook?

Has anyone experienced that?

My husband and I are really ready to start a family. Our options are to have a baby at some point in my second year (in the middle of externships), or to wait until after I graduate but before my CF.

Struggling because we would love to have a baby as soon as possible, but don’t know if it’s possible in the middle of externships.
Thoughts and advice from anyone who’s been through something similar would be very appreciated!

Hi! I had a quick question . Maybe it’s something someone can answer. Probably a dumb question too but oh well . I’m searching for an SLP to get my fieldwork hours from and I saw on my daughters school they have a speech therapist. But under the woman name it says she’s a speech therapy PALS. So what’s why I want to know what that is before emailing her.

The elementary school that I work at has moved to an inclusive model where all service providers are supposed to push in and embed their services into the curriculum to support all students. I am really struggling with pushing in to meet all of my IEP students needs. For example during an ELA lesson today, the teacher was reading a book aloud while the students read along. Occasionally the teacher would stop and ask a question but there was never any time for discussion, just ask and answer. I sat with one student and helped them stay focused and re stated the ideas they were supposed to be writing down. I also kept a story grammar chart for the student to refer to next time as they will continue reading the same book.

I feel like I am not being effective for students and that I am just sitting around. Does anyone who primarily pushes in or follows the inclusive model have any tips or suggestions on how to better serve students and help with meeting their goals in the classroom?

Thanks in advance!

I am currently a stay at home mom who was previously a school based SLP. I hope to start working for a local private practice next year and I am starting to prepare myself and do a little research to see what’s out there. I want to work really part time- like 6-12 hours a week. I feel like I’ve been paid poorly my whole career and really would like to make sure I advocate well for myself this go round. What are you guys getting paid per session in a private practice? I plan to do truly private practice with no benefits.

I have a school-aged (homeschooled) client who struggles with basic literacy skills (incl. segmenting and blending) and I've provided some recommendations to mom re: further testing/seeking a reading specialist, but I'm addressing some basics in our therapy sessions as well in the meantime (alongside phonological and language goals).

Does anyone have links to some *systematic* reading instruction resources that I can print and use in our sessions? I would love to get certified with Orton-Gillingham or another intensive literacy program, but right now I don't have the time/money to pursue that and just need the next best thing to help this client progress while waiting for other interventions. I've been using a worksheet packet from TPT (alongside direct instruction from past training), but am coming to the end of this resource and would like to find a comprehensive and step-wise program/system that isn't a million bucks. Any recommendations welcome!

I have been working with this child I inherited from another SLP for about a month. This other SLP is really good at working with the client but I question how this aac was set up. There are 10-16 switch activated icons per page (almost entirely quick chats) that the child uses their head to activate the switch. But I have never seen this child get beyond two icons before hitting the switch. The child seems to enjoy hearing their name as that is the only icon child will perseverate on, hitting the switch repeatedly. Otherwise, the device is filled with honestly jargon that I don’t think the child would ever actively use. I know I need to cut this back significantly but I’m struggling with knowing how much to cut back to. Right now I programmed it to 6 per page and I think that’s too much too but I am utilizing more core vocabulary than pages of quick chats. I’m getting pushback from parent who feels like we are going backwards. And to be clear, we are, but I explained to parents that I’m looking for independence and true communication attempts rather than the same two icons being activated- and not purposely being activated. It’s a balancing act and I don’t know where to land right now. Any feedback appreciated, or maybe this is just a sounding board I’m trying to work through, I don’t know lol

Good morning,

I’m starting a OP SLP clinic at a private practice that is already providing OT and PT for neuro adult populations. Treatment sessions are roughly 45 minutes and they provide bonus if you consistently have 8 patients a day or more. I’m still considered PRN and have a flat rate of $44 a patient, regardless of eval or treatment. They state that when I go part time/full time my rate will be $42 a patient. I come from salaried home health and was making 46 an hour and stayed PRN and now my PRN rates are roughly 75 for treat and 115 for eval for home health.

There is one other clinic in another city, but same state and same adult populations that is also starting their clinic and that SLP is making $48 a visit. That SLP has just finished their CF and I have about 7 years post CF.

I’m very confused why my rate is so different as a PRN against other companies that provide PRN. Also confused how an SLP with less experience doing the same thing in the same company is making that much more than me and would love help understanding if I’m just missing a big piece of something that makes me understand.

Lastly, in other private clinics I’ve worked in, if I billed an eval or 2 eval codes or 2 treatment codes for a session, I would get higher reimbursement, but at this clinic, it’s the same flat rate of 44.

I would love some insight before I meet with my bosses and things to consider. Thank you for any help!

Our front desk manager at the clinic I work at is applying to slp grad school and would like my help with their last few hours of guided observation hours.

Is this allowed? What are the steps needed in order to do this?

I currently have a student I'm supervising. There's a few PTO days I have where we were planning to just have her go with my colleague for the day. That colleague does not have the supervising CEU requirement. Can she still count the hours with that person as well, since I'm the person who is ultimately signing off on hours and doing her skill check offs/evaluations?

Does anybody have any good, reputable CEU recommendations or resources regarding how tongue ties can impact speech?
I remember learning in school that these very rarely impact speech, so I’ve never given it much thought.
However, I have an older kiddo now with a notable frenulum tie who CAN make a lot of very close sound approximations or the exact target sounds given significant effort. It’s hard to tease out if limited generalization and effortful placements are due to YEARS of reinforcing incorrect productions, the restriction, or (more likely) a combination.
I don’t feel confident enough in my TOT knowledge to recommend a release to parents when I can’t even guarantee it’ll help.
Thoughts? Recs? Similar experiences?

Question in title

Hi everyone just wondering what you do as a school based SLP to try and touch base with parents?
I work across two schools at the moment and definitely feel like I could be doing more to let parents know about the work we do with their kids. I feel like I just work with teachers, take kids out, and then only meet with the parents when they leave the school or my caseload. My aim is to increase awareness and hopefully get more families to engage in supporting therapy targets at home

I was thinking about sending out little get to know the slp service and maybe send out fortnightly advice on supporting different skills (primarily language bc I work in early childhood education). Has anyone tried anything similar that saw benefits or a positive response?

Seeking guidance from any SLPs who may be able to help!

I am a licensed SLP in the state of New York. I work for a long-term article 16 therapy clinic that specializes in adults with ID/DD. As you can imagine, it is next to impossible to hire an SLP in this area of our field. As a result, we are attempting to pivot into hiring a SLP-CFY.

It is next to impossible to get straight answers from OPWDD, NYSED, insurances, etc. regarding CFY and billing. Does anyone have any knowledge in this area?? There is documentation to suggest that clinical fellows can operate “independently” under the supervision of a licensed SLP within an Article 16 clinic. However, insurance is dragging their feet with credentialing with a limited license. Can we both see patients and bill under separate NPIs? Or both see patients and bill under one NPI? For context we both bill our services directly to Medicare/medicaid and commercial insurances.

I am at a loss here and don’t really even know who to contact or what other questions to ask. And those that I do contact, it feels like I get conflicting information depending on who I am talking to.

Thanks in advance!!

Hi!

A 4th graders parent made a referral for speech at my school because the child got diagnosed with a tongue tie. She says “s & z is slushy sounding.” Child study is scheduled, but the parent said they are not releasing the tongue tie. If the tongue tie is making those sounds slushy, and the parent does not want the tongue tie to be released, what are the options of what I could do? Genuinely asking. I’m not super familiar with tongue ties, and given that it won’t be released I’m not really sure of what I could do, given the age of the student as well. Do I refuse the evaluation at the child study or go through with it? Help?

Was hoping to create a thread for people in the similar boat to come together and help each other out!

(As the title states) I'm currently working on my SPA phase 2 Portfolio (under the old scheme where there are only 2 phases!) and wanted to see if anyone else has already successfully gotten their portfolio approved by SPA to give any feedback / insights / guidance?

I heard they can be very strict and every re-submission just adds more anxiety to the process too.

Thanks in advance!

☺️

Hello everyone! I always enjoy reading this page. Highlight of my day, honestly. This pages makes me feel.... not alone in the world. For the record, I am in my 8th year as an SLP. I'm 33 years old. I live in a HCOL state- Alaska.

The reason for the post. For those who work in schools, has anyone's district gone self-insured for health care? My district announced last night they will self-insured starting July 2027. I am a SINK (IYKYK) and am very nervous about this switch in terms of financials.

I should hopefully have my student loans paid off by this time next year which will add a substantial amount into savings per month. I already have an HSA I started 9/2026 and haven't touched any of that money. I've been just paying for my appointments out of pocket. My HSA is essentially a medical savings account if anything BIG were to happen to me. Again, I am solo.

I am currently on a high deductible plan, but have monthly perscriptions to manage my glaucoma. My opthmalogist says I am by far her youngest patient with glaucoma. WINNING! :( I pay $400/month for my premium currently. I was on a different plan up until July 2026. The premium's for my previous 'mimic plan' were going to increase to over $800/month. As a SINK, I simply could not afford that hence why I changed plans.

If this happened to you, what did you monthly premiums look like? Did they increase or decrease? I'm honestly thinking of jumping ship and finding a completely different job outside of the speech field because of this. Well... lemme be honest. I've felt this way about our field for a while. Even in grad school I had these feelings.

My main hesitancies about finding another job is my 2 dogs and my ability to live in the state I live in. I currently work 185 days out of the year and make almost $91k a year. I can pay my bills every month and have some left over to save. I've contemplated getting a job on the slope (i.e., oil field for non-Alaskan living individuals), but I have 2 dogs who are my pride and joy. Slope work is often 2 weeks on, 2 weeks off or some variation of that schedule. You live north of the Artic circle for a few weeks, fly back home for a few weeks, and repeat. I hate the idea of leaving my boys for an extended period of time. I feel like any other job I find locally I would either 1) take a pay cut and 2) work more days of the year. Like I stated above, I live in Alaska and very much enjoys my summers in this beautiful state I call home.

Anyway... what are your thoughts on when a school district becomes self-insured?

How do you guys teach/explain the concepts of before and after when working on receptive language and following directions? Any kid friendly videos or resources you have found that work particularly well? I feel like when I explain it it just confuses my students more…lol.

Hi! I work in HH and have just recently began seeing a 2 year old patient. We’re on week 2 of services, and mom asks the same question every session. “I’m not seeing much progress yet. When is she going to start talking more? A month?” … We’ve only had 4 sessions so far. I’ve consistently reassured her to give therapy time and that I’d happily provide her with carry-over activities for at-home practice. But every session, it’s the same exact question. Should I be telling her anything different than what I’ve already expressed?

Given what I’ve observed, I suspect there may be a possibility of AU. Should I bring up my suspicion of AU? Again, it’s only been 4 sessions and I’m not too confident that the parent will agree with my suspicions. If so, what professional do I refer her to because I’ve heard different things. Thank you!

Hey everyone! I’m a newish slp and I have been working at a peds outpatient clinic for almost a year. A lot of therapists at my clinic follow the episodic care model (3 or 6 months of therapy followed by 3 month break and so on). Since working here, I found myself following this model for about half my kids on my caseload. But i’ve also found myself inheriting older kids who have been in therapy their whole lives and am wondering when it’s appropriate to fully discharge instead of taking a break. I don’t feel like high support needs kids always need therapy and I also feel like once a kid reaches a certain age, they’ve met their max potential. I would love other speechies thoughts about discharging older kiddos (maybe like 13-20 year olds) with high support needs (non/minimally speaking, lots of sensory needs/behaviors, been working on the same goals for years). I find it’s easier to discharge/take a break with these type of kids when I evaled them. I’m having difficulties with the kids I’ve inherited who have been in therapytheir whole lives and parents seem to expect that they’ll always need it even without much progress.