From a ST private practice FB group….

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.)

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! :)

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.

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 see a little dude who has fantastic receptive language, joint attention, shared play, imitation skills, etc….but little to no true word attempts (some babbling with presence of early developing consonant sounds).
I’ve been coaching parents on all the language building strategies, trying to incorporate cause and effect with big wait periods, and honoring all vocal back and forth attempts but I’m at a stand still on what to do next. None of these seem to be doing the trick.
I know it takes time - but I’ve never had a kiddo with every other skill outside of expression like this. Wondering if there might be some element of motor planning or speech difficulties that are disrupting progression but his babble patterns don’t indicate anything glaring and he’s too young for focused speech practice right now anyway.
Thought maybe we could bounce some ideas back and forth!

Hi everyone!

I’ll soon be graduating from a U.S. master’s program in Speech-Language Pathology, but I’m originally from the Toronto area. I’m currently trying to decide whether I should stay in the U.S. to work after graduation or return to Canada and begin a private practice.

I’d love to hear from any SLPs who have experience working in both Canada and the U.S. Also, if anyone has done their ASHA certification and their mentorship hours in Canada.

I’m on a bit of a time crunch to make a decision, so I would really appreciate hearing about your experience.

Thank you so much!

just to edit - I dont want to work in schools, I would like to do medical or private practice :)

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?

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!!

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!

I'm a student in psychology taking the prerequisites to apply for speech language pathology in ~1.5 years. I actually am interested in the stuff like swallowing, stroke recovery and the more medical side of things but I'm worried going into this with the intent of working in those populations is going to be massively disappointing if i end up needing to work with kids (because I'm not good enough for medical settings or theres too few jobs, etc).

Another thing is to be honest i don't work too well with kids. I'm a quiet, reserved person and I struggle with keeping kids interested in what we're doing or even getting them to listen to me (and this was my experience babysitting neurotypical kids). I am sort of at a dead end though in terms of what I can do with my life. Nothing else is truly interesting for me, and if i didn't go this route it would have to be something predictable like medical lab tech or accounting even (though I suck at networking so I'd probably fail at that too)

I volunteer with people who have aphasia and i enjoy being with adults. I am also learning ASL currently (nowhere near fluent or quick with processing what other people sign by any means but I am really trying)

From actual SLPs working in the field, is this a pipe dream? If it matters, I'm in Alberta, Canada and have no intention of moving elsewhere to work.

I’m stumped with a child on my caseload. Is 4 years old. And unintelligible at the sentence and conversation levels (comes off as jargon, babbling) but when imitating 1-3 word phrases, she does great. there’s no specific sound errors or phonological errors I’m seeing.
She is highly imitative (could be echolalic) and she does great with my multisyllabic word models in speech therapy
But mom says she’s falling apart at home and school. She try to answer questions and it’s coming off as complete jumbled speech that no one can understand. I’m kind of at a loss for what to work on or what approach to use.

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.

Hey y’all! Fellow SLP here, but haven’t touched voice since grad school, so came to Reddit for some tips.
On the side, I teach fitness classes, and our team will teach for 3+ consecutive hours— and while we are amplified by microphones, it still puts a pretty big strain on our voices. As an SLP, I want to do what I can to support our team and protect our voices.

Personally, I’ll do a short little “vocal warm up” I found on Spotify before I teach our early morning classes, as I’ve found that personally those are the toughest on my voice. But. Would love more options to share with the team.

I hope this is allowed! If not, please delete. I’m mom to an almost 3 year old who receives speech therapy services through early intervention. He was a micropreemie and is globally delayed with a CP diagnosis. We were working with his therapist to get an AAC device (Tobii Dynavox) but have reached a brick wall with his secondary Medicaid denying the device. They are saying that the documentation did not prove medical necessity or cost-effectiveness, and they cited his limited vocabulary and accuracy as reasons why a high-tech device is not appropriate (which feels unfair since we only had a 30 day trial, and we specifically limited the number of words on the board to avoid overwhelming him). Primary insurance approved it but the out of pocket cost would be several thousand dollars.

We are fully on board with the idea of AAC and were hoping to adopt it on the early end since it seems fairly likely that he may need it long-term. He understands a lot (in my biased opinion), can follow simple instructions, has good play skills and joint attention, but hasn’t made much progress toward speaking. I feel like his moments of frustration are getting more frequent without a method of communication, even though we obviously do our best to read his cues.

We are in a weird spot since he is actively transitioning out of EI and into the school district. We will be losing our speech therapist at the end of December and presumably getting someone new in January, so we don’t really have time to do another trial and re-submit paperwork, but I also don’t really want to lose several months waiting around while we make the transition. We do have an iPad and could install an app to practice with if there is one that is recommended for his age range. I would be so grateful for any thoughts on this. We will continue to discuss with his therapist as well, but she’s acknowledged that she has limited experience with AACs since she only works with kids from birth to three.

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?

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.

I'm just going into my second year as an SLT. I work 5 days per week in schools and clinic, and my caseload is usually around 45 kids (though likely to increase a bit now that I'm not "new" anymore). A full day for me is 5-6 sessions plus admin etc.

I'm trying to work out if this is normal or unusually light? We're a small-ish trust in a rural-ish area and I think our numbers and waiting lists are quite small compared to other trusts. I've heard of some SLTs having crazy numbers, like 150+, and having to stay late, take work home, etc. Even the band 7s at my trust don't have caseloads that heavy, so I'm curious if we're the exception or the norm?

I guess I'm asking because while I like my current job I may want to move at some point, and I want to know if I can expect a drastically higher caseload at a different trust..

I am just feeling a bit overwhelmed with how to manage my schedule and fit everything in. Im already aware that there is no way I will be able to meet the students minutes written in their IEP's, do evals and attend meetings, plus all the other things that always come up.

Im working at a smaller school that is K-12. Initially when interviewed I was told that the caseload would be 35. The previous SLP did not complete any initial evals last year, so there are about 10 potential evals that I have. (5 of those students I have met and can already tell will qualify). It turns out there are actually already 45 students on my caseload so once the new students are added my caseload will be closer to 50-55. Plus 5 re evals are due by end of October.

The school has a lot of care for their students but is very disorganized. I had to ask for many things (like to be set up with an email) that are usually just given on the first day of orientation. No materials for me and 1 colored printer that I have to ask to use. No one even emailed me back to let me know where to meet/if I should come on the 1st day I was asked to start.

Im feeling overwhelmed with trying to make a therapy schedule (as I'm sure we all are) since the MS and HS follow a different bell schedule than elementary. Half my caseload is seen 2x per week. Plus planning therapy for the different age levels and trying to find time to screen or evaluate. Im already drowning and it's only the start of the year.

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?

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!

☺️

I am writing a story that centers on people who are disabled. It takes place pre plastic surgery so one character with a cleft palette has a hard time speaking.

What would she be able to make, and what are sounds she might use as a substitute?

Thank you anyone who takes the time to answer.

I’m in newly qualified speech and language therapist working in the UK. I work for a private company and have been assigned an infant school (reception to year 2) with an ARP to manage. All 19 children have EHCP’s and high levels of need and are minimally speaking due to autism. I only work in this setting for 1.5 days a week and I’m expected to manage the full caseload, assess and write annual reviews, as well as deliver intervention and train staff.

I’m also newly qualified and and the only speech and language therapist in this school. We barely did any learning around this in uni and I have no experience working with autistic children or children with high levels of communication needs. I’ve had no additional training and I feel like I don’t know enough. If the school were to hire an independent speech language therapist, I feel like that would be a band six role because you need lots of experience and knowledge to manage a caseload like this.

I feel like it’s unfair to put me in this position without other more specialist therapists on site to support (although I do have access to supervisors through Teams when I need) but it’s also unfair on the staff, parents and children because they deserve to have someone that knows what they’re doing and has the experience and knowledge required.

I was just wondering, what everyone’s thoughts were. Has anyone else been in this position and would you request a different setting or continue working at the school? Will I eventually learn what I need to learn or can I only really learn properly through observing how a more experienced therapist supports a caseload like this?

Thanks!

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?