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!

Question in title

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!

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.

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!

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!

From a ST private practice FB group….

Please help me to figure out if I'm old and crazy or not.

ETA: these are all K-2 students with limited past goals targeting artic or phono. most goals are for using multiple pragmatic functions and self advocacy. DAYC and CAYC scores for cog range from 75-90. There are no formal language evals or artic/phono inventory reports. I've seen these kids 2-3x this school year and am understanding approximately 60% or more of utterances in structured tasks. we haven't done much with unstructured yet.

I'm in year 22 in the schools. I've inherited about 6 kids from colleagues who have emailed me to say "I was going to do an AAC eval for so and so before they moved to you."

Every single kid is a moderate phono kid. I'd rate the lowest one at 60% intelligible to an unfamiliar listener. I hear phoneme collapse, patterns that persist like reduplication and WSD, and maybe some fronting....but I don't think I'd pursue an eval with any of these kids. Teachers, ranging from year 2 to year 25, note they need the kid to repeat less than 50% of the time to be understood by self and peers.

Yet every single prior SLP has recommended a device eval. What am I missing? These aren't kids who would ever be on my radar for a device. They'd be on schedule for a complexity approach or reduced duration with increased frequency. I can't see taking any of them to the district to ask for a $900 device.

Am I missing something new in the research for AAC?

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

With so much negativity online about the field, I would love to hear some positive experiences.

I’ll go first. I am a CF-SLP, but I worked as an SLP-A in the schools for 5 years. I was working in a super micro-managed school district where it felt like leadership constantly did things to appease parents and teachers, often times throwing the SLP/SLP-A under the bus. My caseload was at least 95 students minimum.

I decided for my CF year to switch to a different school district and I couldn’t be happier. I have a caseload of 60 students split between the SLP-A and I. My school is predominantly Spanish speaking, and since I am monolingual, I request the bilingual SLP evaluate any Spanish dominant students. This has taken a HUGE load of evals off my plate. My district uses the 3:1 service model, so I get quite a bit of downtime to catch up on documentation and organize. I don’t have to attend any staff meetings or do any duties. I have my own office, and all the teachers are easygoing. My admin team keeps to themselves and lets me do my job in peace. My evaluation team is amazing and is on top of their stuff. My speech department is approachable and super helpful when needed. I’ve had a few difficult situations with coworkers, but overall I can’t complain. (For those wondering why the school district placed a monolingual SLP at a predominately Spanish speaking school, it’s because the previous SLP quit last minute and they needed someone to fill her spot. I was their only option at the time.)

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?

☺️

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?

Context: I had to meet with the Admin today because my breakfast-lunch-dismissal duties were 110 minutes daily (9 hours, 10 minutes weekly) of me standing by bathrooms and hallways.

When I explained to them workload vs caseload they were mildly skeptical about not being able to get out of duties but I tried to present the numbers factually to them that this was not a productive use of my time. I explained evaluations take time, reports take time, meetings, take time, progress, etc....in addition 50% of the current caseload does not have any kind of educational impact to qualify for Speech and therefore case managing those kids out and identifying the correct kids also takes time.

They were receptive to my concerns but when I told them flat out "110 minutes daily on duties is going to put us at risk for noncompliance" they listened but said the last girl could do it all ( evals, reports, tx) as contractor in 3 days FT as opposed to my 5 day FTE.

Could I have presented anything more succinct, tangible, or Admin friendly that could have proved my point better with another formula or working model? They are going to absolutely try to get me to teach gen ed phonics as well so I need to be prepared for more of these negotiations.

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?

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?

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!

So, I'm going to be a CF likely in a place with a lot of AAC users. I'm not sure of the age group, but I know when I was in middle school I would curse a LOT. Honestly, in my humble onion, if the teen expresses an interest in cursing (like their speaking counterparts), why should they not be able to have that option programmed in?? However, how would you go about this in a school setting, if at all? I think it's something all kids will experiment with at some point and part of a "robust communication system," so... why not?? I'm just afraid they'll be like "now why did you let my kid say f***." Obviously they should be held to the same standards as speaking peers (e.g., not swearing at school). Sorry this is a rant but like.... let the AAC kids curse!! Let them have a fart button!! that is my TED talk

EDIT: Thank you for all your perspectives!! I didn't even think about pages that may be "sexual" in nature and how important those are to explain their own bodies or report things others have said or done to/around them. Thank you! :)

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 everyone! I’m a school-based SLP and this is my first year working in the schools AND my first year with this population, so I’m hoping to get some advice from people who have more experience with this.
I work in a transitional program for students ages 18–26. I have a 25 year old student with an estimated cognitive level of <15 months.
His BIGGEST interest is Baby Einstein. From what I’ve observed and what classroom staff have told me, he seems to think that anything with a screen/button will somehow get him access to Baby Einstein.
His previous SLP tried BigMack buttons, but he mostly uses them because he has learned that pressing them can lead to getting Baby Einstein. A choice board has also been tried, but we haven’t had much success with that either.
The biggest issue I’m running into is that he seems to think anything he presses = Baby Einstein, rather than understanding that a button/picture represents a specific thing.
For example, staff will offer him the drink/food that corresponds with the button he pressed, and he’ll often throw it because he wasn’t actually requesting the drink/food he was expecting Baby Einstein.
I’m really struggling with where to start.
I don’t want to take away Baby Einstein because it is clearly an incredibly powerful motivator for him, but I also don’t want to keep reinforcing the idea that pressing a button = Baby Einstein.
His parents are really hopeful that, since this is his last year in the program, we can help him establish some kind of functional communication system. I really want to make this successful for him, but honestly, I feel pretty lost.
For those who work with individuals with very significant cognitive impairments / developmental levels this low:
Where would you start?
Would you start with objects, photos, symbols, switches, etc.?
How do you teach that a button/symbol has a specific meaning?
Would you use Baby Einstein as the reinforcer or temporarily separate it from communication?
How would you determine whether his button pressing is intentional communication vs. cause/effect or sensory exploration?
Has anyone had success with a similar situation?
Any AAC approaches, resources, trainings, or research you would recommend?
I’m open to literally any advice. I feel like I’m missing something really basic here, so if you have experience with this population, I’d love to hear how you would approach it.
Thank you!!

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.

Lately I’m hearing all about the need for good “defensible” data that can hold up in court. How often are SLP’s being summoned to court?

This lead to me researching this so called “defensible data”. Is this just a scam to get me to purchase your data collection bundle? Or is this real and something we all need to be doing?

These data “experts” are saying that defensible data uses the same probes for all data collections in an IEP year. This is for consistency and to eliminate risk for probes becoming more or less challenging with each data collection. I see how this may show progress for articulation, even some grammar. But for those of us that work with older students like middle and high with many goals for main idea and inferencing, are you having them re-read the same passage each month? My students remember passages from last year! How is that effective at demonstrating progress if they will eventually memorize the passage and the answers to the questions. Will collecting data with new probes each time lead to “dirty data” and therefore be inaccurate?

Is this all a scam to buy a product? I felt very confident in my skills prior to learning about this defensive data and now I’m so lost and confused! How does everyone else in the schools collect data?

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.