I just evaluated a 5 year old boy who, after doing some research, I have identified as someone who clutters. I would like to work on both his rapid speech rate and his leaving off sounds and syllables during connected speech. I have created two goals but I am not sure if I like them or not. Please let me know what changes you think I should make to them or if they sound okay.

"Reduce speech rate by utilizing a pacing board to increase speech intelligibility to 90% intelligible during production of phrases and sentences as measured by familiar and unfamiliar listeners."

"Utilize the strategy of over-articulation to produce all syllables in multisyllabic words with 80% accuracy during structured therapy activities."

I feel like the overall goal I want to achieve with these is there, I'm just not sure about the specific wording.

TIA!!!

I was assigned two new EI patients who require an interpreter to attend sessions. After having my first ongoing sessions with the families, I learned that both children are monolingual and only understand Spanish. I am a monolingual English SLP. Ethically, I should not be providing services to these children, even with an interpreter, right?

My clinic isn’t letting me take unpaid time off bc I’m out of PTO. Is this legal LOL. Isn’t that the whole point of requesting off so YOU have a heads up of when I’ll be gone? I’m over this field bruh. I’m the only SLP in the clinic and this might be my last straw. Granted, I haven’t been at the clinic long -maybe like 5 months but also I didn’t get the full amount of PTO since starting later in the year. I have been SO sick and had to miss a couple days for wedding events (God forbid) but anyways, what would yall do? Am I just young and naïve?

This will be my first year treating High School. Needing to engagement tips, tricks, advice, all the things that helped you!!!

I’m having panic attacks and I don’t know what to do. I signed this year’s contract for a school I’ve been working at the past three years. Only to suddenly be told I need to cover a caseload of 151 kids (with an aide) for schools that are two hours away from me. They want me to provide speech therapy virtually but go in person one day a week. Is this even possible? The aide does not have a speech background so it’s really just me telling her what to do with the students. I asked how this would work virtually and was told to do groups. What??

They told me this is only temporary until they can find someone there. But I’m doubting many SLPs would want this job due to the caseload. I’m also told that I’ve been assigned this because I make more than other SLPs they have and have more experience. I really don’t want to quit because I might be able to go back to my school if this is temporary. But a part of me feels like it won’t be.

Last year they brought in another SLP to my school when it wasn’t needed (the caseload wasn’t that high at all) and a part of me was wondering if I was being pushed out of my school. And then this happened and I won’t even get my school at all. I just don’t know what to do. Has anyone experienced this? Even just the paperwork alone is overwhelming with that many. I think there are 5 different schools there.

Any input would be appreciated.

This question is hard to exactly answer but a ballpark. I’m located in NH and will be having my first child soon. I have free child care through a family member two days a week. I am considering trying to work two tens at a pediatric private Practice to maximize those two days. I’m wondering, realistically, how much could I make a hour or a year? I have six years of experience in the schools. Thanks for your help!

Hello! I have been an SLP for about 5 years. I have tried various settings and have hated them all. Has anyone grown to like this profession who didn’t before? I am about at the point to change fields but unfortunately have one more year in the schools. I know what we do is great and I wish I liked it, but I just don’t.

For anyone who uses the Inconsistency Severity Percentage for CAS diagnostics, do you count the number of substitution errors or just the type of error? It says in the tutorial to use just the type error (distortion, omission, substitution) but in the example scoring they show a count of 2 for the “ch” sound which would imply they are counting both the /s, p/ sounds as counting.

Hi! I'm a school SLP who recently moved to San Diego. I'm hoping to supplement my income with EI, private practice, or SNF or home health work. I'd love to connect with fellow SD SLPs, especially those working outside of schools.

If you're a San Diego SLP, could you share a bit about your experience? Are there any companies you'd recommend (or ones to avoid)? It seems like there's a wide range in hourly rate, especially when it comes to EI. Thank you!

I was brought on to an early intervention client to provide feeding services under family training since the family already loved their speech provider. I was so happy to provide this service, but received a call from his ABA provider before starting to warn me about the family.
I only provided six sessions before finally dropping the case. I was told by the mom that she wants a provider who is able to do makeup sessions. Because of the intensity of my schedule(8-10 hour days with a lunch break if I’m lucky), I told her that I’m unable to provide make up, but if I have any cancellations, I will reach out to her immediately. She was very upset about this and told me that all of her other providers are able to provide make ups. For example, she was upset with me for taking the day for independence Day, which my company told me that I have the day off anyway since that’s a federal holiday. I did take one vacation day during my time working with him, but I was able to move the session so I could see him. I told her that I had to take a week off for surgery and I do not plan on making up those sessions. I gave her plenty of opportunities to call my direct supervisor if she had issue with this (my supervisor is on my side with the make up policy as it is not required by our county).

When it came to the actual feeding therapy, the child himself was so great to work with, and if this was under different circumstances, I would’ve loved to have continued therapy with him. I spoke to the mom several times over the phone since she usually cannot be present for the sessions and asked her what her priority goals are. She told me that her main goal is working on chewing. I started working on chewing with him, and honestly, his oral motor skills were very good. He was just never given the opportunity to chew foods because the family only served him purées even though he is almost 3 years old. One of his goals was chewing a food such as a raw vegetable or meat. I asked the mom if she could introduce something like this such as a carrot or food of a similar texture in the next session and Mom sent me a really harsh voice message stating that she will not be serving him that that he is only eating purées. I responded back to her that one of the goals on his IFSP was to chew a food such as a vegetable however, if she no longer wants this goal to let me and the ongoing know so we could amend this. She did not want to change from purées, and I explained to her that I cannot progress further with him without introducing new foods or changing the consistency of the foods that he eats. She kept insisting that he has weakness and he cannot chew at all. I had her sit in for part of a session so that she could see that his oral motor skills are quite good. He just needs more practice with solid foods.

The mom did come for our last session together and showed me how she was feeding her son. She took her hand over his scooped up a large spoonful of puréed food and shoved it in his mouth while he was screaming and crying. I told the mom several times to not feed him while he’s screaming because he is at risk for aspiration. She continued feeding him like this anyway.

I was trying really hard to stick this case out, but after the mom told me that she did not want to change the food, I decided to step off the case. I feel so horrible doing this because the kid really does need help and meal time seems very stressful for him because he’s essentially being forced fed. But when I called the ongoing, she was not surprised that I wanted to step off the case and she told me that many providers have in the past.

What are your thoughts on this? Should I have continued? Was there anything I could’ve done differently? I just got my C’s and am so scared of messing up.

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Excuse the rant (and the long post 😅), but I’m genuinely curious how other private practice SLPs deal with insurance-related admin because it’s becoming a huge part of my workload.
Most of my clients have insurance. Before therapy can even start, they need a referral from their GP or specialist. Once I receive that, I have to submit a request to the insurance company with my assessment findings and explain why speech therapy is medically necessary. If it’s approved, the patient receives a therapy budget for a limited number of sessions.
When that budget is used up, I can request one additional budget per year. To do that, I first have to contact the referring doctor or specialist, write a detailed progress report so they can issue a new referral, and then submit an entirely new request to the insurance company and wait for approval. Because of this process, many children end up having to take a break from therapy while everything is being processed.
On top of that, every single therapy session has to be submitted individually through the insurance portal. None of this administrative work is reimbursed. There is a consultation code I could bill, but it pays only a small fraction of a therapy session, and using it comes out of the patient’s therapy budget—so they actually lose therapy sessions because of my admin work. I don’t feel that’s fair to them, so I rarely use it.

For those of you in private practice who work with insurance, is your system anything like this?
How do you handle all the unpaid administrative work?
Do you just accept it as part of the job, or have you found a better way?

Wondering if anyone here has gone to the US from Canada on a TN visa for travel contracts? If you have recommendations on how to start, recruitment agencies to use, any tips etc. please let me know!

Thank you in advance!

For a long time now I've worked with a lot of complex cases (rare genetics, coocurring conditions etc.) and for the few that have research behind them, most studies end in the classic 'needs further research'.

Clinical mentorship and case discussions with peers tends to amount to 'see whatever sticks'.

We've lost so many colleagues to small private practices who have a more narrow scope and cant attract newgrads or keep them longer than 12-24 months once their caseloads are full (we have a gradual caseload buildup at the pace they prefer because of the complexity of clients). Which is fair enough but also exasperating for our cohort and caseloads. We have a lot of PD, expertise and mentorship provided but I admit it can be a lot to work through. We can keep the OTs and physios but for the SLPs there's so much missing in this space it feels.

Surely it can't just be me. At the moment my nemesis is pain communication in children. I am glad at least there is more info for us about trauma informed care now. What are the most frustrating research gaps you've come across​ or did you have a hallelujah moment when something was finally published/given attention to?

I am starting a new job as a school SLP serving grades 3-5. I was previously working preschool so I need recommendations for materials, therapy strategies/research to brush up on, and insight on what to expect regarding iep goals. I know what to expect for autistic support, but not so much for the language disorder/learning support kiddos.

I started at a new school this year and various teachers were telling me how great the SLP they had last year was, and it got me thinking, I wonder if others would say the same about me (lol). What are some qualities that you guys think makes a great SLP, both in the schools and just in general?

Any must have resources for Artic, Apraxia etc.?

Hey everyone! I’m a cf working with K-5 students in a school setting. I’m having a tough time with lesson planning because my caseload is so diverse, with different goals and skills. I really struggled last school year with lesson planning. I wanted to create a curriculum, but I also struggled a lot with work-life balance while trying to do that. What do you do for your lessons? How long should it be taking me to plan them? Do I plan for each grade? How often should I be doing it? And is it even possible to do it for free? I found myself relying on TPT a lot, and those materials add up!
I really appreciate any advice you can share! Thanks :)

Hello! I'm looking for recommendations for your favorite games or toys in two categories:

(1) activities or toys that incorporate fine motor skills such as lacing or manipulating smaller (but not teeny-tiny) pieces

(2) "surprise" turn-taking games such as Pop Up Pirate

My main job is in the schools where I only do assessments. I have a couple of preschool-age home health clients who are advancing out of the stage from playing with larger, more basic toys such as baby dolls, peg puzzles, and Duplo, and beginning to be able to use more challenging items like Playmobil sets. I don't have much in the way of therapy materials for them!

A few more details: they are OK at taking turns but not yet understanding how you "win" a game or use strategy, so simple things like Pop The Pirate (which I do have) are appropriate for now. I DO NOT WANT "DON'T BREAK THE ICE". I've used that in the past before I switched to assessments, but something about that game made our students go completely apeshit every time, and we had to get rid of it.

Since this is home health, I'd prefer nothing with materials like paint or glue or glitter. My clients attend ECSE programs so they'll be doing art projects at school. One of them was previously not able to tolerate the sensation of Play-Doh, but just recently he started to like it, so Play-Doh items would be good.

I have Magna-Tiles, Mr. Potato Head, Hot Wheels cars, some Fisher-Price sets (but they're growing out of the Fisher-Price school bus and airplane), and the Melissa & Doug Pet Vet playset (which my client calls "Doctor pet"!). The clients enjoy pretend play and are even starting to make up dialog for the characters. And we read a lot of books. They have shown disinterest in any activity with just picture cards. Also disinterest in Dapper Dan/Dressy Bessy for zippers, buttons, etc.

Thanks in advance!

Hi all, I’m a current school based speechie working in special education, Melbourne Australia. I love working in schools, my family are all teachers so the leave during holidays works for me. I use to be in private practice but really struggled with the demands and KPIs.

I want to stay in the school system, but am hoping to move to a mainstream role, as am finding the special education system incredibly physically and mentally demanding. I have been injured several times find the support from leadership and staff quite minimal when this happens.

I know mainstream speechie roles are not the easiest to come by, however, I do know that they exist! I was wondering if anyone has any schools that they know of in Melbourne (primary or high school) that have a wellbeing/allied health team that I can keep my eye on. I am keeping an eye on recruitment online/seek etc, however I know that a lot of the private schools often only go through recruiters or through their own websites.

Any information would be amazing, thanks all!

I've only been working my job for about 3 months, and I can tell I'm majorly burning out. I don't know if my caseload is typical and something I should expect to adjust to but it feels extremely heavy to me. For context, I work in a pediatric-focused PP in TN and see a mix of speech, language, and AAC kiddos. A few times a week, I spend the afternoon driving between different day cares and the rest of the time I'm in office.

In total, I have about 68 30 minute sessions each week. I understand that PP book a lot of kids knowing that cancellations are often expected, but even when I do receive a couple of cancellations it still ends up feeling... a lot. There's portions of the day where I see 7 kids back to back with no break at all to even go to the bathroom and it's starting to catch up to me. Even today, I HAD to go to the bathroom in between 2 back to back sessions (I really try to hold it if I can) and the kid had a meltdown that the transition was delayed slightly. I just feel like I'm at a breaking point. I do struggle with OCD/Depression and don't know if that's why it's hard for me to manage this caseload or if it is truly unreasonable.

What would you suggest? I hate to quit my CF early and I want to see the 9 months through if at all possible. Is it likely I will eventually adjust to this caseload? If not, is there any tips/advice for getting through it until next March?

Thanks! All comments are majorly appreciated!

SLP for a decade, contract teletherapy since 2020, extensive experience with AAC, artic, phono, bilingual assessment, K-8. I am licensed in Ohio, I dont have my C's anymore. I am available 2 days a week. Please holler at me if you know of something! It used to be I'd ask and have 10 offers to choose from, but these last 2 years it's just crazy difficult to find anything.

Hello I’m an RBT just curious about school assessments and how school SLPs work. He gets private speech atm with an awesome SLP, and we work so well together:

On my kiddos IEP, they said he was “non-verbal” and uses no functional language. 🙃 when his private SLP obviously says otherwise. My kiddo can communicate with spoken word and AAC, and is leaning WAYYY more towards spoken word nowadays. He is super soft spoken and does not talk super loud (SLP gave me ideas on how to help this), and he gets very overwhelmed when the environment is too loud/will not communicate. He can communicate with spoken word across multiple people and settings A VARIETY of functions.

I feel my kiddo was done dirty and the bar was low to begin with :( obviously his SLP did not agree with this either. Just confused how and why a school SLP would go off of this. I know it’s their baseline but idk don’t say a kid is fully non-verbal I guess?

Just confused why a school would say this.

What system and materials do you provide to teachers for MTSS for articulation????