I’ve heard kids say unexpected things to me as an SLP and in my everyday life, but I feel like today was one of the rare times their comment was hurtful. I’m at a different school this year and a couple of my new students pointed out that my teeth were yellow. I can see where they’re coming from because I drink a lot of caffeinated drinks which stains them.

I tried to redirect the conversation by explaining that we don’t comment on people’s bodies because it’s unkind and makes the person feel upset, but it still threw me off guard and left me in a funk for the rest of the day. I’ve definitely felt self conscious about my teeth before so I guess it was a sensitive area to begin with. Now I’m researching how to whiten my teeth. I feel like I would have gotten around to it eventually since it’s an area I feel less confident about in general, but the fact that it was prompted by a kid is both funny and sad…

I feel like I don’t have a good grasp on data collection and that makes me upset bc I wanna be really good at my job. Okay so let’s say a student’s goal is that they will produce /k, g, s blends, l blends, th, and r/ in all positions of words at sentence level. I inherited lots of goals like this. So obviously the whole point of them going to therapy is to be EXPLICITLY taught those skills, that’s why we have specially designed instruction. So what would make sense IN MY BRAIN is so teach teach teach practice practice practice in all sessions, then once a marking period before progress notes, I pull them and do progress monitoring (or is the word probe? This confuses me too) and target those specific sounds in sentences and take data on it, NOT HELPING THEM. Bc all the work we’ve been putting in over the whole MP would hopefully be translating to the goal. The only other thing that makes sense to me is to take 10-20 data points at the beginning of sessions where I don’t correct any sounds at all and then pencil down and teach. That would be another thing that would make sense to monitor actual progress consistently.

So for those of you who take data during your sessions and while teaching, what are you doing? What I typically do is something like + - verbal, visual, gesture, tactile, and then the levels min mod max. But I hate doing this! It doesn’t make sense to me and I feel that it’s hard to be consistent across sessions. Like what would be nice is to put they got 60% acc independently, but they’re able to increase acc with verbal cues, rather than actually putting a percentage there.

I use SLP toolkit and I desperately want to take my data using their plus/minus right on the screen. So what I was doing was creating objectives that separate the specific sounds and level and taking data on those, bc it doesn’t make sense to me to take data on a huge goal with many sounds in one session. They could get 80% acc but maybe the g’s were all incorrect but not represented. They do have a drop down to select things like self correct, verbal cue, visual cue, etc. but once you pick an option, u can’t switch between them (like I do with my handwritten notes) so you can’t differentiate how the target was elicited in that trial.

Guys my brain seriously just doesn’t work this way. This keeps me up at night bc like I said, I wanna take GOOD data and I wanna FOCUS on teaching and being a good therapist, I feel like I’m worried about writing stuff down that doesn’t feel completely accurate anyway but not as focused on my session! And I wanna do a good job - I want my district to be happy with my performance :( help, sorry for typos

Hi all! First Reddit post ever here :) I’m a 27yo 4th year SLP in the school setting, and I work with 3rd-8th graders. I love and care for my students like crazy. BUT… as much as my job fulfills me, it takes from my sanity/ personal life. I care so much that I feel like crap when I miss kids or short them. And most days I come home with very little left. I have a caseload of 50-60 with a handful of more intense cases… if it we’re mostly elementary speech-only I’d be good, but I have several nonverbal AAC users, older kids still with significant syntactical or artic issues, etc. Our back to back 20 minute sessions leave me running around the school like a chicken with its head cut off. I don’t pull from academic time, so the transitions are messy in getting them from one special to another. I love my speedy speech, but I barely have time for it, and I’m constantly running so far behind I miss my lunch. At the end of the year, once I’ve dismissed 10 or so kids, it becomes bearable, but the cycle repeats. I use SLPToolkit and AI to supplement my PLAAPF writing, but still stay after work most days just to complete what feels like the bare minimum.

All this to say, I’m looking for where to cut corners in ways that save my sanity and still leave the students getting what they need. As of rn, I’m thinking of really focusing on my speech, syntax, and AAC kids, while in a sense “shorting” my language kids by doing more games instead of literacy based therapy like I’ve been trying to do. I figure my 20min 2x a week is no match to the other academic help they get anyway, so I’m basically a data recorder for the language goals. I also personalize goals, but I think I need to be more generic with them, as well as with report writing.

Any advice would be appreciated. I know I need to set boundaries, but doing it at the expense of the kids that I care for so much and know I could help… it’s so hard. But I’m so burnt out that something needs to change, and I don’t see us getting anymore SLPs anytime soon…

TLDR: Where can I cut corners (or optimize workflow) as a school SLP with the least impact on the kids?

Thanks ❤️

Needed to give myself a reminder, and perhaps to some of you.

I know I’m a good therapist because I care, I stay up to date on research, and I can see meaningful changes in my patients and their families. But the other day, I got a new patient and saw all of the graphic organizers, worksheets, and nice written and laminated materials she had provided for him, and I couldn’t help but think, “would I be a better therapist for my patients if I put in this much effort? Am I not doing enough?”

It can be so easy to compare ourselves to others in our field. Everyone has their own style and approach to therapy. Being a good therapist means monitoring your approach and modifying it to the needs of your patient. You can bring them worksheets galore or you can show up with your notebook and pen. At the end of the day, the patient’s response to therapy and how you address their individual needs should be the focus, not what everyone else is doing.

Hope you are all doing ok and having a good week!

My non-verbal kiddo was independently signing “please”, "more", and “help” but the BCBA told mom that it wouldn’t work in a crowded classroom because nobody could hear him.  So she replaced it with having him tap people on the shoulder. (I can't compete with 35 hours/week, so I automatically lose every time there are discrepancies in techniques and parent edu.) Mm, I wondered why he stopped signing and started smacking me all of a sudden. Thanks a lot, ABA. What am I even here for??

I’m an SLP on my first travel contract in a SNF, and I’m honestly looking for some perspective from other SLPs who have worked SNF/travel because I’m only a few days in and already questioning whether I should stay.

For context, I have previous SNF experience as well as acute care/inpatient rehab experience, so I knew going into this that SNFs can be understaffed, have limited resources, etc. I wasn’t expecting perfection. But this feels beyond what I’m used to.

A few things so far:

• The building itself is extremely run down. It’s very hot/musty, I’ve seen bugs in patient areas, and overall cleanliness is concerning.
• I found out after arriving that the actual DOR is out for about 6 weeks. I was not told this before starting.
• My “orientation” on day one was with someone who was ALSO essentially new to the building, so they couldn’t really orient me to the facility, staff, procedures, documentation expectations, etc. An SLP/DOR from another building did come later in the week, which helped somewhat.
• There apparently has not been a consistent SLP on-site in over a year, so I feel like I’m walking into a completely unmanaged dysphagia caseload with very little established carryover.
• I asked dietary/kitchen staff for small amounts of different food textures so I could complete therapeutic PO trials. I was told they couldn’t provide food outside of patients’ breakfast/lunch/dinner because of budget restrictions. I ended up going out and buying my own food/supplies so I could actually treat patients.
• Basic supplies I would normally expect for dysphagia/oral care are either extremely limited or unavailable — oral swabs, denture supplies/adhesive, etc.
• One of my biggest concerns is staff carryover. I’m making dysphagia/safety recommendations and am already seeing difficulty getting staff to consistently follow them, even for patients who require feeding assistance and have significant cognitive impairment.

Then today something happened that really bothered me. A patient with significant dementia/cognitive impairment was sitting reclined in a geri-chair at the nurses’ station around 2:30 PM with multiple staff members nearby. I was called over because the patient had a large amount of partially chewed food/secretions or possibly emesis sitting in/around their mouth. Given the patient’s cognition, positioning, dysphagia risk, and inability to independently manage the situation, it honestly scared me from an aspiration/safety standpoint.

I understand that SNFs are not hospitals and resources/staffing can be very different. I also understand that travel therapists sometimes get sent into facilities specifically because things are a mess.

But I’m trying to figure out where the line is between “this is unfortunately SNF life and you do the best you can” and “this assignment has systemic safety/resource issues that I should be reporting to my recruiter/company.”

I’m contracted here through December, so I don’t want to impulsively walk away from a contract after one week. At the same time, I don’t want to put my license in a situation where I’m making recommendations that cannot realistically be carried out or where patients aren’t receiving basic dysphagia precautions/care.

For SLPs who have traveled or worked in rough SNFs:

Would these be enough red flags for you to contact your recruiter and ask about getting out of the assignment?

What would you document/protect yourself with if you stayed?

And at what point have you personally decided that a facility was too unsafe to continue working in?

I’m especially interested in hearing from travel SLPs because I’m not sure what leverage I realistically have this early in the contract.

Hi everyone, I’ve got a 4th grade student that I inherited last year who absolutely cannot say the /k/ and /g/ sounds. I’m not kidding when I say that we are absolutely not stimulable at all, and after a year of working with the student, I’m at a complete loss for how to continue to try and treat.

The child is motivated but is honestly so discouraged at this point. I’ve reduced our sessions to shorter minutes because it’s all we’re working on and I would go insane working on trying to get these sounds in isolation for 20 minutes at a time. I feel like I’ve tried all the tricks in the book, literally that Secord book for eliciting sounds. I’ve tried it all. I’ve tried shaping from other sounds. I’ve tried tongue depressors, lollipops, etc. nothing has gotten us even remotely close.

For the longest time we’d do a head nod every time we’d make the attempt, like thrusting our head down. I got to the point where I had to hold the head so it wouldn’t jump forward so I could see what the tongue is doing. If we hold the tip down into place, the rest of the tongue moves forward to make those front sounds. I’m at a loss for how to train this kid to make the tongue go up for the sound. All other sounds with the exception of /r/ are great. I only just added the /r/ goal last year so we’ve not had a lot of work on it. I’m trying to get some last tries in for this student before I go to the parent and say I’m at a loss. It doesn’t help that the parent is also someone who works in one of the schools I’m at.

Hello! I am still new to the field (2nd year) and this year I have 2 new severe/profound classes at my school. A lot of them have multiple disabilities, in wheelchairs, mix of mid and high tech devices. I am really struggling thinking of therapy ideas for this population! I typically do a whole group since the classes are somewhat smaller and ranging from 3rd to 8th grade. A lot of them have a goal somewhere along the lines of using total communication for a variety of purposes. A few of them are very hard to engage. I am new to this type of population and would love any sort of ideas!

This is my 2nd year at my school site and this year we don’t have one dedicated speech space to hold groups (we have a tiny closet office that’s just big enough for my and my co slp’s desks). Admins solution is that we are now sharing group spaces with other intervention groups which isn’t ideal but better than the hallway lol. Those of you that have a similar situation and/ or move between schools- what system do you have for getting all your materials from place to place??
Our office is upstairs and I’ll mostly be seeing kids downstairs so it would really be a hassle to be going back and forth all day to get materials. If anyone has a link to where I can purchase a magical mary poppies bag, that would probably just solve all my problems🙃

I’m totally panicking :) please help. I live and work in Illinois and I graduated last year and completed my CF in a private practice. I took the PEL 232 exam over the summer to work in a school and I passed. I did all the other steps required to get my PEL so I got a job at a school thinking it was just a matter of it getting approved in a matter of a week or two. I’ve been working at the school where I got hired and have been seeing kids for the past two weeks.
My college hadn’t approved the completion of the program and that was taking awhile so I contacted them and they said that they won’t approve the completion because I got a D in a clinical seminar class with attendance-based grading during the semester that I took a week off because my mom died. I contacted the ROE for my school and they said that all I can do is try to retake that class. I don’t currently have $3,000 anywhere to take that class, and even if I could take it would I even be able to keep my job???? I can’t lose this job I am for real panicking and freaking out. PLEASE tell me there’s something I can do or that I can work in the school for a year before needing my PEL or something

TLDR; got a D in grad school in a 1 credit course when my mom died and now can’t get my PEL but am currently working in a school??? what am i supposed to do?????

Hello, I work with a 1st grader who often states the opposite of what they mean. For instance, I asked, "Who is this?", probing for a firefighter; he said, "Arsonist". He is so smart, but I am thinking there is a word-retrieval issue, and I want to help. It impacts his functioning within the classroom setting because if you ask him if he needs to go to the bathroom, he might say no when he means yes. Has anyone observed similar behavior? If so, what helped your student? I have thought about maybe working on synonyms and antonyms, but wondering if anyone has tried other avenues that helped a similar student communicate their thoughts and needs.

Admittedly, I’m new to the school-based SLP world…I’m working for a virtual school and I’m just curious about what’s really happening. The biggest struggle I am having when scheduling times with my students is that the students who go to ABA, in a specific region of my state, are attending M-F from 9-3 or 10-4.

Is this typical? Basically, parents are having IEP amendments to remove speech therapy or change to monitor in order to attend ABA 30+ hours a week. They’re being homeschooled, essentially to attend the ABA clinic.

From what I can tell, they are not doing school while at the ABA clinic, these are kindergartners or early elementary students fitting in their virtual school requirements in between their ABA schedules.

I’m confused, and concerned, this just doesn’t seem right. Is it money driven? I know ABA clinics in my area bill medical insurance and charge a co-pay per day.

Again, this is a whole new world to me, not trying to be rude just want to understand…

I'm currently a high school teacher. I'm trying to leave due to the high-demand, low-reward environment of teaching (power struggles and disrespect all day from students who care very little about the hard work I'm putting in front of them; nervous system is wrecked all day from the harsh environment).

I have someone in my life who can pay for my education if I pursued a master's to do SLP.

I'm wondering if anyone in a similar position has found the transition worth it in terms of pay, respect, and workload.

I absolutely love the idea of doing home health early intervention. However, I’m in my third year as an SLP and all of my experience has been in middle and high school. I ALSO love this population, but want to branch out. Any advice? Resources? Books? I want to learn it all!

I work with many clients who have cognitive communication disorders post TBI. Lately I am feeling more and more like I am doing things or asked to do things outside of my scope. Can anyone let me know if you ever address/treat the following with clients or if you defer completely to another field?

1. Clients who have challenges with emotional regulation / anger and impulsivity post TBI. For example, I have a client who notes that he often becomes angry during conversations with others and ends up speaking to them in an unkind way. He was able to pinpoint that one trigger is when others ask about his life and current circumstances (e.g. asking what he is doing for work or what he does at home if not working), as he feels he has to repeat himself and these questions remind him of his limitations since his TBI (he cannot work). He expressed a desire to work on controlling his emotions/actions so that he has fewer angry outbursts (including during interactions/ conversations with others). He has also broken several devices when he was angry. Not sure which elements of his difficulties would fall within SLP scope vs perhaps the scope of a social worker or psychotherapist/psychologist. The other issue is that I suspect many of his reactions stem from the fact that he has chronic pain and extreme sleep difficulties (I'd be angry too if I was in pain all the time and sleep deprived!) Part of me feels that once the sleep and pain piece improves with the help of other professionals, the improvements will trickle down to fewer outbursts and more pleasant interactions with others. We've explored a little bit how to regulate emotions, how to identify signs he is becoming angry, phrases/scripts to use to exit an interaction if he is feeling angry (though I don't feel in the moment he'd be able to actually use them), calming strategies to use before an interaction or when he starts to feel things are escalating (e.g. box breathing). However, I can't help but feel maybe this is actually best addressed by a mental health professional and I want to ensure I remain within scope.

2. Loss of sense of taste/smell after TBI. I've been asked by an OT for my thoughts on a client's difficulties in this area and if there are any recommendations I have. However, I would have thought this would fall more into the purview of an OT, so I'm a little confused. Has anyone worked on this with a client, such as exploring an olfactory training program? For reference, this client does NOT have dysphagia, so it's not being targeted within that context.

Hi everyone! I’m an adult medical SLP currently job searching and would love to hear from those of you who work primarily PRN.

Has anyone made PRN work as essentially a full-time job (either at one facility or by combining multiple PRN positions)?

Any advice or insight would be greatly appreciated!

How do others deal with a lack of clinical confidence when working with other clinicians, or is it even a factor for you?

I work in a transdisciplinary diagnostic field and I am struggling when I have other, more experienced clinicians in the room with me. I am relatively new to the job having only worked there for 5 weeks, and worked in private practice for 7 months before that after graduating.

Today, I had a joint OT/PT/SP assessment with another experienced speech pathologist work-shadowing as it’s her first week. She basically ended up running the assessment as I wasn’t doing a great job/became a bit stuck at points. It’s a relatively unfamiliar assessment to me and in hindsight it wasn’t the best choice for a joint assessment session, and the child was quite complex. But I can’t shake the feeling I have humiliated myself and that I look like I don’t know what I’m doing.

Did anyone else have these feelings as a new graduate? I imagine they did, or even still do, but I feel like when I see clinicians walk out of an assessment saying “that was fucking awful”, they don’t think it was awful because of them. However, my mind immediately jumps to me being the problem.

I am going to be supervising a SLP-A in a clinical setting through telehealth. I was wondering what the experience would be like? Do you have issues with parents wanting in persons evaluations, how do you deal with behaviors during evals online? Any advice/experiences are welcome.

I’m at a new school this year and I’ve already been sick twice. I keep getting my toddler sick. They’re getting sick from ME not their fucking daycare.

And yes I sanitize my speech closet. I open the window. I mask up. But nothing tickles my pickle quite like a first grade gen ed student telling me: “I am sick but my mom gave me cough syrup today.”

Guess who’s sick 2 days later? Me. We have a trip planned for this weekend staying with friends. I can’t go and bring them and their family a sickness.

I also have a medical condition and am getting surgery next month. I’m ready to just quit this school all together. Yes I understand things can happen anywhere but it’s not worth it anymore. I never got this sick anywhere else.

Does anyone know any affordable places to receive speech therapy services in or around Portland? Willing to drive up to 30 min outside of downtown as well. Thanks in advance!

Hi everyone. It's been awhile since I've had to use any type of AAC for my littlest ones since I am usually brought on for feeding. Are we still using PECS? Big mac switches? What are some of the best options.

Of note, the two little ones I'm considering this for have no visual difficulties or motor issues. One was recently diagnosed with autism (although I was somewhat surprised by the diagnosis).

Is it a conflict of interest to do part time work afterschool with EI in an area where I work full time at a preschool? I’d really like to do EI but I’m worried about having a future student. It would be two different organizations and there’s nothing contractually that forbids it.

As S2C seems to be trending again on online, I have noticed several SLP influencers that have shown their support for it, despite all the harm and damage it has caused. I have noticed some SLPs I used to follow show their support and will drop their users in the comments. It’s not to go and harass them, but simply stop giving them a follow/support as they continue to promote these harmful/grifting ideas