Administrators: Know Your SLP’s

We and ASHA have not done a good job defining our role in schools

Posted by Teresa Sadowski MA CCC-SLP on May 18, 2024 in Administrators Page, pictures, slider | 0 comments

May 18, 2024 #6 reflection series

What exactly is our role in schools?  If you asked 100 different Speech Language Pathologists you’d get 100 different answers.  Part of the problem is that so much falls under our scope of practice.  Let’s think about that.  The school SLP works with students who present with any of the following.

• Identified receptive and expressive language disabilities
• Delayed language development
• Language disabilities specific to syndromes or physical impairments
• Developmental disabilities
• Cognitive disabilities
• Specific learning disabilities 
• Autism or autism spectrum disorder
• Impaired development of higher order language skills 
• Difficulty in the pragmatic or social skill realm
• Oral motor difficulties (affecting articulation or feeding issues)
• Hearing impairments and cochlear implants
• Dysfluent speech
• Developmental articulation needs
• Central Auditory Processing Disorder
• Non-verbal due to physical impairment
• Voice disorders

That is one heck of a checklist and I probably could add many more.  Now many SLP’s are also dabbling in literacy in schools with good reason.  So you can understand why administrators and teachers may be unclear about all the areas we are trained to address.  However, when defining our roles in schools administrators rarely ask SLPs and SLP’s rarely speak up.  Part of the issue is with usually only one SLP in building or district you have no power to do anything.  SLP’s in a district could band together to effect change and define roles, I’ve actually seen this happen.  But usually SLPs in districts are too busy to even get together.  In smaller districts there usually are not enough of us to effect change.

Our title change in the 80ies to Speech Language Pathologist muddied the waters even more.  At that time we were entering with masters degrees and our role really getting ready to expand.  Administration probably didn’t like they had to pay us more.  At that time not as many administrators had a masters so I’m sure on some level that was an issue.  ASHA didn’t do a lot of administrator education or public education on our expanded training and new skill set.  Back then we didn’t have the internet so providing the information on the Speech Language Pathologists expanding role would have been difficult.  With that said ASHA has had a lot of years to get it right and they haven’t.  Yes, there is a lot of very good information on the ASHA web site but there are few administrators who would have access to it and even fewer who would take the time to research the role of the SLP.  I’ve always wondered why ASHA had never, to my knowledge, offer continuing ed to administrators.  And why administrators never ask the best way to use our skill set to benefit students and programs.  

So I guess I see most of the fault with school administration.  However, school administration doesn’t know what they don’t know because ASHA hasn’t told them and school SLP’s for various reasons don’t speak up.  I will also add that school principals and special ed team chairs/directors do have a lot on their plate to begin with.  I believe they feel we know our job and as long as the paper work is filled out correctly and parents are happy all is right with the world.  We do have more autonomy than teachers these days.

Back in 2015 I wrote a little book called, The School Speech Language Pathologist An Administrator’s Guide to understanding the role of the SLP in schools along with strategies to aid staffing, workload management and student success.  I will admit, writing this book was a therapeutic assignment to deal with my own frustrations.  The few administrators that I gave a copy to did not receive it well.  Passed one on to ASHA and even that wasn’t received well. (Apparently I gave it to someone whose husband was a school administrator).  I presented a poster session at ASHA which was well received by attendees but again never heard a peep from ASHA (not that I really expected to).

What school administrators and ASHA do not seem to understand is that in any given year our workload can vary greatly.  If you have a caseload heavy with students with more severe disabilities, that is going to create a much heavier workload than say a caseload heavy with articulation needs and developmental needs.  In a classroom, teachers may have more challenging years than others given the make-up of their classes.  However, teachers usually know that they will never have more than 20-25 kids in a classroom, per their contract and the union will advocate for assistance.  That is a luxury I’ve never had.  There is no way an SLP can be effective with caseloads of 30-80, you know you’re providing band aid services.  I’ve had a few years where I knew this was going to happen and guess what …..I left. 

You can also somewhat understand the misunderstanding of our role because underlying language skill development and especially pragmatic skill development is very abstract and subjective.  Try explaining all you do to someone.

My Thoughts

• ASHA need to do better with education of administrators, principals and teachers regarding the role of the SLP in schools.
• SLP’s need to speak up about their role and when workloads/caseloads are too high.
• Lack of understanding of the role of the SLP contributes to high workloads/caseloads.
• Any therapist with extremely high caseloads is fooling themselves if they think they are servicing the students appropriately.  It is not a badge of honor to have a high workload or caseload.
• If I read one more article written in an ASHA publication on caseload management I may scream.  Given my years of experience I am expert at caseload management and scheduling. The articles seem to miss the point that numbers and workload need to be lessened to provide appropriate services.

Schools still don’t know what we do

Posted by Teresa Sadowski MA CCC-SLP on May 13, 2024 in Administrators Page, slider, SLP Chat | 0 comments

May 13, 2024 #5 reflection series

I still find it amazing that so many teachers, administrators and some team members have no idea the extent of our knowledge.  They sit in meetings with us, listening to us explain in depth evaluations, progress and service plans and seem to pick up nothing.  

Why don’t people know what we do beyond working with articulation skills or getting words out?  We are somewhat responsible for this, however ASHA is the bigger problem.  Changing our title to Speech Language Pathologist back in the early 80ies didn’t help with clarification.  ASHA has never put in specific guidelines about our roles in schools, areas we address, skills we may have or even caseload limits.  As a school speech language pathologist, I have always felt abandoned by ASHA and any suggestions/questions/ concerns I’ve presented over the years have fallen on deaf ears.

In the recent past I’ve attended 2 ASHA conventions.  I have felt the School SLP was pretty much ignored as a focus, even though I would bet most of the SLPs who attend are school based.  Two things have lead me to this conclusion.  First, at the last ASHA convention I attended in Boston, I went to the opening welcome session.  During that session they went on and on about the good things ASHA was doing mostly medical based, political or international.  I was paying attention, the contributions/needs of the school-based therapist were mention only once and that was in passing.  I also noticed that any session that I was interested in as a school-based therapist was being held in a space that was too small.  Just about every session I attended, I was put in overflow sometimes sitting on the floor.  I don’t know too many other professions that put up with sitting on the floor during a professional conference.

We may have to take a little responsibility for not being understood.  A big part of the issue is there is usually only one SLP in a building.  I’ve only worked in one school system where there was a solidarity among the SLPs, where we could really point out and ask for things.  I’ve never been recognized as different from a teacher in a union.  Maybe we just haven’t done enough to point out the very real differences in our job compared to teachers.  Teachers usually get an hour a day for planning but we often need that hour and more for testing/paperwork.  Even if you have an administrator that understands, their hands are tied.  

 I’ve tried to do some education about our field, presenting a workshop for teaching assistants, writing articles for parents in school newsletters and presenting topics at Ed Camp.  I even wrote a book for administrators.  You would think hearing us present our reports would clue them in a little.  Listening and learning from others is how I learned a lot about motor skills and vestibular skills, perceptual skills and the list goes on.

Some School Psychologists might “get” what we do but it really doesn’t impact them so much. They present their report and we’re left to follow up.  The rest of the team….few read our stuff, less than few take notes during meetings or even ask relevant questions.  Schools just know they have to have us on staff.  They don’t like the fact that we overlap with medical (which is a much bigger deal in schools than most even know).  I do believe that’s where we run into problems, we know so much tied into medical. It is amazing they sometimes don’t even see that there might be a connection with learning.

Side Story….

I’ve approached so called reading specialists pointing out that students are missing key underlying skills (never in a meeting but off to the side).  It was like talking to a wall.  They seem to have little understanding how underlying listening, memory, auditory perceptual skills and other skills affect reading. They put students in whatever reading program is the flavor of the day.   A couple of years pass, the reading specialists try a few other programs by then the student is in 4^th grade and barely reading because the underlying skills were not addressed.  Now if you are a therapist that has dual certification or just a vast knowledge in reading be careful because, if they do finally see the light they will have you doing the work of two.  (My thoughts on our role in literacy will be discussed in a later reflection article)

Side story…..

At one ASHA convention I went to the Sig meeting for school therapists.  They stood up there and went on and on about school therapists getting more involved in the Sig.  They felt sure our districts would give us time off to be involved.  The therapists were too polite to laugh out loud.  However, are our jaws hanging open.  No school therapist is going to have time to sit on a committee and few if any schools would allow even unpaid time off for such a venture (I’m not sure ASHA knows we are mandated to see students as scheduled).  The ASHA reps were so far off base in regards to the school SLP.  The SLP’s attending the meeting couldn’t wait to get out of there since there was nothing of substance discussed. 

So after the meeting I go up to talk to the ASHA reps and to give them a copy of my book.  It was not a warm reception.  I ended up talking to the one rep whose husband was a school administrator.  You would think I just insulted the man.  It was just so clear to me that ASHA was also either clueless, had little to no respect for the lowly school SLP and frankly didn’t want to change.  Plus they clearly did not want to make connections even with someone advocating for the school SLP.

Side Story…..

These days I don’t run into too many syndromes, medical issues or disabilities that I have never heard of before. In the recent past I was seeing a student with Tubular Sclerosis. That was a new one on me. Now before sitting down with the team I did some simple research on the disorder. Discussing things with the team I was surprised to hear that no one at the table really knew what disease entailed. I had just showed up on the scene and they had worked with the student for 3 years. Not that it really made a difference in how this student was serviced. I was just taken aback that know one was curious enough to research the disease. Research is so easy these days why wouldn’t you. My brief research explained so much to the team.

My Advice:  We have a very large scope of practice.  Do your best to try and explain your role in schools as situations arise. That is really all you can do.  Don’t wait till you’re old and brave to speak up for yourself.  Don’t take on extra roles, even if you have the expertise.  Don’t work on reading and writing as formal goals/objectives.  School SLPs are not given the time in their day/week to address reading and writing efficiently. 

The field of speech language pathology has changed significantly over the course of my career and has become more technical.

Posted by Teresa Sadowski MA CCC-SLP on May 8, 2024 in Administrators Page, pictures, slider | 0 comments

May 8, 2024 #3

When I first started working most of my caseload was made up primarily of students with developmental articulation and grammatical issues.  Students were rarely serviced beyond early grade school.  This was before the big integration push and students with more challenging needs were often sent to other specialized schools.  Many schools did not have specialized programs within their districts.  

If students required testing beyond the basic battery back then they went to hospitals to have testing done.  Now we pretty much do the testing I use to see in these extensive evaluations.  My evaluations back in the day were a few hand written pages, typed out by a secretary.  Yes, for the first few years of my career I had a secretary to do my typing because computers were just coming in to common usage.  We’d get these extensive hospital evaluations with way over the top recommendations.  Interestingly, these evaluations and their recommendations carried a lot more weight than our recommendations.   Hospital SLP back then were considered way more knowledgeable than the lowly school SLP.  When we tried to explain that we had the same qualifications and totally understood the needs and recommendations it fell on deaf ears.  Unfortunately, that is still the case.

The push for integration changed everything.  Within a few years our caseloads doubled, tripled and quadrupled.  We were doing testing well beyond our basic battery.  Yet we still were not allowed to diagnosis and still cannot today.  Nor, were we given any more hours in the week to do this.  Students with significant needs were often dropped into classrooms with teachers who had no idea how students learned differently. Administrations often saw this as a one size fits all and a way to save big money.  The idea was that putting disabled students with regular education students was somehow going to make them less disabled and improve their social life.  It rarely did and many student did not get the education they needed.

This would have all taken place only a few years after the requirements changed requiring us to have a masters degree.  ASHA did very little if anything to help define our role in schools with the changes going on in education.  With only one SLP in a school or district at the time and things moving so fast, we were rarely able to help define our role or advocate for change in staffing.  Needless to say we were never consulted by school administration.

With our testing becoming more encompassing we were writing longer reports and providing more analysis. Yet we were never given more time to actually do the testing or write up.  With caseloads increasing we were never given more time to service kids.  School schedules were rarely conducive to scheduling students. Thus we ended up seeing kids in bigger and bigger groups meaning each student received less and less time.

Now please don’t get me started on push in services (I will do a post on that).  Except for the rare student transitioning out of direct therapy, push in services do not provide adequate support.  Now if a school was supportive of a true co-teaching model that might be another story but I never saw that happen.

My Thoughts:  As our role became more technical in schools, I wish ASHA would have taken a more active role in providing schools guidance on the role of the SLP in schools.  I was never asked about my skill set or the best way to provide service. Caseloads/workloads grew based on who showed up that year not what was appropriate or best for the kids.  Workload not just caseload grew to the point for many that we just provide band aid services with groups that were too large and perhaps not so carefully crafted paperwork (many don’t understand our paperwork are often legal documents that have to be able to hold up in court).   I like the fact that I have been able to develop my skill set and quite frankly the situation made me become more knowledgeable.  I also believe integration has been a wonderful thing for many students but not all. If ASHA writes one more article on how to manage a caseload I may scream.

Would I do it Again?

Posted by Teresa Sadowski MA CCC-SLP on May 7, 2024 in Administrators Page, pictures, slider, SLP Chat | 0 comments

May 7, 2024 #2

I have frequently asked myself if I had to do things over again would I become a Speech Language Pathologist.  The answer is I really don’t know.  

First you have to understand that when I graduated from high school in 1979 women in general still didn’t have (or knew about) as many options as they do today.  At my all girls high school we were put basically on 3 tracks, medical/science (which meant nursing, although one of my besties from HS became a doctor), educational or secretarial.  I knew I did not want to be a nurse and had no idea how important secretarial skills would become so that left education.  Growing up in the neighborhood I did we really didn’t know about the larger universe or the intricacies of certain fields.  In my neighborhood the Dads were building cars not designing them.  I had no idea there was even a field called engineering.  The only engineer I knew drove a train.  I only knew about speech therapy because I had a younger brother who had severe dyspraxia, so my mom (a nurse) knew a little about that field.  

When I applied to college the major was still called “speech therapy” and Eastern Michigan University offered one of the first 5-year masters degree programs in the country.  While I was in college the title changed to “Speech Language Pathologist” and masters was required.  By this time I was excited about the new things I was learning.  However, looking back I probably would have been excited about learning things in any field.  I remember one class that did interest me more than others and that was Acoustics of Sound.  I thought briefly about becoming a sound engineer but did not feel I had the math abilities to do it.  Perhaps if I had known more about the field of sound engineering I maybe would have considered it a little more seriously.  

One other piece about college that kept me from veering off the SLP tract was time and money.  If you took another class of interest that meant that it would cost more and you could feasibly have to be in school another semester.  I don’t know how it is now but back then courses/student teaching and internships were so packed/planned you really couldn’t go off track.  With the high cost of education I imagine that the pressure to stay on track is even more today.  Speech Language Pathology course credits don’t really carryover to too many other fields.

So was I stuck?  Yes, I was but at least there were a lot of different things you could do in the field.  The hours were not bad.  You could get a job anywhere.  

What really made me rethink things was after being in a few years I realized that I really wasn’t valued in the school setting.  We are still seen as a requirement not an asset.  I also realized that if I worked hard it was only going to give me intrinsic gratification.  I do love helping others so that was wonderful.  Then I realized I wasn’t ever going to make enough money to really support myself unless I worked a million hours.  Keep in mind this was long before most people were thinking outside the box and being creative.  I would never in my career get a bonus.  Advancement without going back to school was never going to happen no matter how hard I worked.  Not to mention in schools there’s nowhere for an SLP to go.  It would mean a job change to advance in schools.

My own work ethic made me put in too many hours, spend too much of my money on materials/supplies and never saying no (I will have a post on this one) and caused some significant stress when dealing with administration or contentious IEP situations (mostly caused by schools not servicing kids properly).

My Advice:  I think I would do this again probably because I wouldn’t have known any better at the time.  I love working with kids and families.  I love being at the top of my field and very knowledgeable.  I wouldn’t recommend going into the field of education at this time for various reasons.  The hours did work out well for me, especially when I was raising my kids.  I was lucky I had a husband with a great income and access to much better benefits.  However, if I understood the economy better back then the low pay and so little chance for advancement, would have made me think twice.  If you are already an SLP, open that private practice sooner or find some other way to supplement your income using your vast knowledge.  

What have I learned as a Speech Language Pathologist the past 40 years?  A Reflection

Posted by Teresa Sadowski MA CCC-SLP on May 5, 2024 in Administrators Page, pictures, slider, SLP Chat | 0 comments

44 years ago I embarked on my career as a Speech Language Pathologist.  When I started college the course of study was still called the Speech Therapy program in the school’s catalog.  By the time I finished the program changed to the Speech Language Pathology program and a Masters was then required in order to work.  Eastern Michigan University was proactive with the change and I was fortunate enough to enter one of the first 5 year master degree programs in the country.  Most of the “Speech Therapists” at the time knew they were going to be grandfathered in but it was still an issue for many.  Basically we were also rebranded and at that time the distinction was Speech Therapists didn’t have a masters and Speech Language Pathologists did.  With that said even back then people were saying that the term Speech Language Pathologist was an odd moniker.  I couldn’t imagine that 40 years later our role in schools would still be loosely defined with most administrators not understanding our skill set.  I’m often called the “speech therapist” or “speech teacher” and you know what it doesn’t bother me too much.  I will however introduce myself as a speech language pathologist in meetings.  

So I graduated Eastern with a masters degree and added the letters SLP after my name.  I was on my way.

So now it’s May 2024 and a lifetime since I started working as a Speech Language Pathologist, 39 years to be exact.  While I started my career in early intervention, most of my work has been in the public schools with some private practice on the side.  In 2016, I stopped working for schools as an employee (I had had about all I could take) and went exclusively into private practice, contracting to schools instead.  

While I’ve loved working with kids in schools, I’ve tried to vary my career just to do a little something different and to expand my skill set.  I have been blogging on and off since 2007.  My first blog was Your Middle Schooler: A Unique Age and my second blog is this blog The School Speech Therapist.  I also wrote a book for school administrators called The School Speech Language Pathologist  an Administrator’s Guide to understanding the role of the SLP in schools along with strategies to aid staffing, workload management and student success, it wasn’t received well.  Blogging was and is a lot of fun, saying I wrote a book sound cool but the actual writing was a lot of work for very little return.  Plus I’m beginning to realize that blogging alone is perhaps a bit outdated these days. 

As I’m pondering retirement I’ve decided to close out my blog sometime in the near future.  However, always the person who wants to share their knowledge and expertise, I’ve decided to write a series of articles reflecting issues I’ve faced as a school SLP and the joys I’ve experienced as a school SLP.  I want to be able to impart my wisdom to the masses.  No really, my objectives would be to share what I’ve learned from experiences, provide guidance to help any school SLP avoid pitfalls, provide practical information, point out my concerns and share some of the good times.  I will admit that like my book this is probably going to be a bit of a therapeutic assignment for me.  I hope it will also help me remember that I did sometimes make a difference in the life of at least a few kids.    

During the month of May, which as we know is Better Speech and Hearing month, I plan to post an article a day (yes I am a few days behind already).  Now I know Better Speech and Hearing month is supposed to be for us to provide information to the community but this May I want to provide information to my SLP community.

I have a variety of topics planned.  However, if you have any specific topics, situations you want to ask about, any questions, concerns you’ve faced or just a fun story to share, I would love to hear from you.  Email me at teresa@tbsspeechtherapy.com

Please indulge this aging SLP and follow along through the month of May 2024

By the way, my domain name may be going up for sale at some point if anyone is interested.

Thinking about COVID 19, Schools and Speech Language Pathologists

Posted by Teresa Sadowski MA CCC-SLP on Jun 28, 2020 in Administrators Page, Parent Information, slider, SLP Chat | 1 comment

To all you Speech Language Pathologists working with unreasonable caseloads now is the time to advocate for yourselves and your students.  Think a lot about this as the guidelines for the “new normal” start coming out in every state.

This week in Massachusetts the guidelines for what school is going to look like were released.  It pretty much encompasses what I expected it would.  Earlier guidelines came out for summer opening only a couple of weeks ago.  Both these documents provide very generic guidelines and both read as if the people who wrote them have never spent a day working in a public schools or even remember going to school.  Again it is one more document that clearly shows that they do not know the role of the SLP in schools and how we work with kids.

According to what I read, here are some take-aways from the guidelines:

• Physical distancing-Students should be kept 3-6 feet away from each other and all face the same way.  I don’t know about you but I have never been put in a space where social distancing was possible with a small group of 3-4 students.
• Limiting travel within a school-We have to pick up and return kids, we travel around the building constantly.  I wonder if we are even going to be able to see kids in small groups.
• Based on what I read it appears that we would have to use a mask and a shield because face it we work closely with kids and spit flies
• We need to prepare for remote learning just in case.  Well I did get a little experience with that during this last shut down. The three factors that seemed to be the biggest problems were my lack of training, not enough time to see everyone (since on line sessions have to have time cushions on each side and small groups are really not feasible) and lack of materials.  I was able to convert many of my materials to on line but that took a lot of time. Will teachers and therapists be given the time to basically develop a whole new curriculum or find/buy/create new on line material? Will schools pony up for the cost? (As a side note, which has bothered me since shut down. Where, are the common core people on this?  If common core is so great and so important why don’t we have an on line version with materials ready to go.  Schools have incurred considerable costs trying to piece something together to get through the year.  Why doesn’t the department of education have an on line platform ready to go? Not that I want this since I am not a fan of common core but really why does every school district in the country have to reinvent the wheel during a crisis?)

I think that those 4 points alone will make it impossible to service extremely large caseloads.  Now is the time to approach your administrators and talk about your concerns not in the fall because they will be totally overwhelmed.

Beyond the 4 points mentioned above I have some personal concerns you might also want to point out

• How am I going to clean my materials and my room?  Does the room need to be sanitized after each student or group?  Where is the time to do this if your schedule is back to back?  Will someone be hired to help with this?  Will you be given adequate cleaning supplies that actually kill germs and absorb?  Where is the nearest water supply to wash hands and help with cleaning?  Say you regularly see 8-10 groups a day and you work in the office in between when is this cleaning suppose to take place?
• How effective can Speech Language Pathologists be with everyone in masks?  I think that is a valid question.   How do you work on articulation and pragmatics when you are wearing masks?  Is it possible to just wear shields during therapy?  
• Masks add a layer of distraction and your perception can be a little off both to the sides and down.  This will affect all learning and coordination for some.
• Scheduling will be next to impossible, yet we will be on the hook if the IEP isn’t followed. Specifically ask you administrator what is expected and ask them to make a schedule for you.  This is something I recommend all the time and it is the only way school admin will ever know the obstacles we face.  Be very candid about the time you will need for assessments, IEPs. progress notes and added cleaning.  Assessments will be up this year because many were skipped during the shut down.
• If kids don’t come to school every day, what will services look like?  Can IEPs be followed if the student is not in school everyday?  Will IEPs need to be rewritten?
• On line therapy seems to be the best thing since sliced bread.  It is a good alternative but it has its limitations.  There is no way I was as effective especially without experience, training and resources.  On line therapy has been around for years, it’s a specialty area. It really hasn’t taken off like you would have expect to and there is a reason for that.  So much of what we do needs to be hands on.  One point that was sorely overlooked during the covid shutdown is that when you do on line therapy there needs to be another adult either with the student to facilitate/monitor or another team member in the session with you.  Every in-service I have listened to has pointed this out as a safety measure.

No, I would not want to be the one who have to put any state guidelines together and I do understand why it has to be done.  The guidelines from Massachusetts looks impressive, citing almost 4 pages of research but I always question the validity of the research.  Is the research they used to come up with the guidelines reliable? I hope so but that doesn’t always happen with research especially now when there is so much question with the covid data and numbers overall.  Could the guidelines be picked apart? Easily. Do the guidelines often contradict each other? At times. I think it will be interesting to see how guidelines vary from state to state.  

Speech Language Pathologists will not be able to function in the same way given the “new normal”.  We as a profession should be deciding how we do our job along with what makes a reasonable caseload (within the guidelines being presented) and not let school administration tell us what our jobs will be. I believe the guidelines are somewhat generic so schools have some leeway on how things are implemented.  Just note if you were handling a caseload say even above 30 before covid, you will have a challenging time meeting the needs and the IEPs of these same 30 kids.  You may be doing both in school and on line therapy. Department of Education will get around to looking at what was provided and what wasn’t.  When that day comes it will not be pretty.  Just make sure you keep in touch with your administration on what you are able to provide within the limitations of a school day (whatever that looks like at your school) and documented it.  Say NO if you can’t take on more or can’t manage with the new restrictions.  When possible provide administration with solutions that might work.  Work as a team with other speech language pathologists in the district.  I rarely see this happen but when it does it is a very good thing.  

We will get through this, no choice we have to.  However, how you get through this is up to you.  I feel being proactive will make the situation a little bit better in the long run and your position in schools stronger.  Working with other SLPs in your district will frankly give you more autonomy and a bigger voice.  It is up to you to advocate for yourself and the students you service.

How are school SLPs handling their caseload during the Covid 19 crisis?

Posted by Teresa Sadowski MA CCC-SLP on Apr 11, 2020 in Administrators Page, slider, SLP Chat | 2 comments

We’ve been out of school now for 4 weeks here in the northeast because of Covid 19.  While I only have a small private practice that I put on hold, I have been wondering how school speech language pathologists across the country are managing their caseloads, especially those therapists who are put in positions where they have 30-50-80+ students on their caseload. Even when working in schools some very creative scheduling, often with help from an SLPA, has to take place to manage a large caseload.  

If you’re an SLP with a large caseload you’re often seeing kids in groups of 3-5 (basically each student is getting 6-10 minutes per session to work on their specific skills, less if you’re a big data collector).  I think of these as Band-Aid services, doing just enough for the students to say they’ve been to speech therapy.  Now I am not criticizing because I’ve been in that position and I know why/how SLPs end up in that position.  That’s a conversation for another time.  However, after this is over I hope SLP’s use this experience to help advocate for lower caseload numbers.  

Teletherapy sounds like the perfect solution on paper.  I imagine school administrators might think this is easy peasy.  I participated in a day long in-service on teletherapy and it seemed to be working well for those presenting.  However, it was clear that the presenters honed their skills over time and were basically experts in teletherapy, the same way many of us are experts in articulation/oral motor, working within a specific population or literacy.  This was not a step by step conference on how to set up teletherapy but more about how it can be used and aspect that need to be taken into consideration.  

I actually thought some of the advanced things the presenters were doing within the teletherapy format were very cool and innovative.  However, a few things were pointed out (either during the conference or in conversations among other SLPs) that were significant that I can bet school administrators haven’t even taken into consideration when they tell their SLPs to just do teletherapy.  

• Rural and lower economic students may not have the internet access or updated equipment to participate in teletherapy.
• Parents need to have significant buy in and need to be present during teletherapy sessions. First because they have to be able to help their kids connect to teletherapy, second they may have to be facilitators for their child to access therapy and third is a safety issue, you don’t want to be alone on line with a student of any age.
• Seeing kids in groups during teletherapy is tricky.  Even with the so-called relaxed rules around HIPPA because of Covid 19, permission is needed to see kids in groups on line.  With the parent factor, you really never know if parents have history with each other.  Plus do you really want parents to find out that you see their kids with so many others?
• Because there are only so many hours in a day it will be almost impossible to follow any IEP to the letter of the law much less with students who receive extensive services. When all this is done it looks like parents will be allowed and entitled to request compensatory services.  I can’t even imagine what that will look like for some, even if only a few parents take advantage of this.
• Bottom line is, it is impossible to see large numbers of students through telepractice 
• There will be technical glitches on both ends.  Right now I’m reading about a lot of glitches.  I assume this is primarily because of volume and many people who are new to the platform that don’t know how to troubleshoot.  Is your school IT team prepared to trouble shoot these glitches, calling parents if needed?
• If a glitch happens, do administrators realize you’ve lost a session and how much time went into troubleshooting.  Is there a plan B if the teletherapy platform chosen won’t connect?  (This week my personal PT had to use a different platform, connecting through her phone, using her personal number).
• When using teletherapy it is unlikely that you will be able to schedule students back to back.   If a half hour session ends at 9:59 you are physically unable to make the connections and be ready to go for your next client/group at 10:00 on the dot.  If you do get behind, you have no secretary to call and let the groups know. (Again not criticizing because it has happened to me, during traditional therapy it often happens that once you’ve dropped off and rounded up the next group of students you might be 5-10 into the next session).  Scheduling half hour sessions 45 minutes apart seems to be the norm to avoid getting behind.
• Until you get very good at teletherapy and build up appropriate materials, teletherapy prep is going to take some time.  I would imagine in some cases a pre-email is sent with materials to print out.  While that is time well spent, unless pointed out to administrators they will not even think about it.  

Do phone calls and emails work any better?  Perhaps in some cases, who knows? These are very unusual times.  I think most people are grasping at straws and trying very hard to make remote learning work.  My thoughts are that teletherapy has a better chance of working well in a private practice or clinic setting.  If a school wants you to try teletherapy and sets up/pays for the platform, offers at least minimal training and want all district SLPs use the same teletherapy guidelines, try it out and consider it a learning experience.  Keep track of the pros and cons so you can report on it later. Also keep track of all contacts with parents and students phone, email or teletherapy.  

If your school administration is leaving it up to you alone to set up and use teletherapy, I would say no. That type of situation just leaves you hanging, especially if you don’t carry your own personal liability insurance.  I checked with Trust Risk Management, my liability insurance provider and my policy covers teletherapy.  Without school investment, there is no IT support when you need it.  If something goes wrong you will be blamed.  I’ve worked in schools long enough to know that when this is all over the blame game will be massive, so be prepared.  

I would love to know how school SLPs, especially those with large caseloads are managing.  Please comment on glitches and successes.  Is teletherapy even the term schools are using? Did your school jump into on line learning too soon without the proper research/training? One other thought …it’s too bad CEU’s are not available for those of us who are working on developing our skills in the use of teletherapy.  So many SLPs and educators in general are putting a lot of hours in to developing a totally new skill set.  I will bet that in the next few years teletherapy becomes a graduate course.  

The Marshalla Guide: Book Review

Posted by Teresa Sadowski MA CCC-SLP on Mar 2, 2020 in Administrators Page, slider, SLP Chat, SLP Conferences/Workshops Review | 0 comments

I was recently asked to review a new book.  The Marshalla Guide  A Topical Anthology of Speech Movement Techniques for Motor Speech Disorder and Articulation Deficits  By Pam Marshalla, M.A., CCC-SLP.  Being fairly familiar with the quality of Pam Marshalla’s previous works and using/owning many of her books myself I jumped at the opportunity to review her new book.  

The Marshalla Guide is basically Pam Marshalla’s life’s work in the areas of oral motor and articulation. Passing on Pam’s knowledge, research and remediation strategies in a structured and well organized manner,  the Marshalla Guide covers all things articulation. While in the process of reviewing this book I’ve already used it to refresh my knowledge on lateral lisp, jaw stabilization techniques and other ideas to achieve stimulability of challenging error sounds.

The Marshalla Guide is a pretty big book, almost 500 pages, which might appear overwhelming to some. However, scanning/reading the book I noted that there was quality and valuable information on every page.  Finding what you need is not a problem at all.  At the beginning of the book Pam Marshalla references the history of articulation therapy and traditional therapy methods. This was a fun read for me because Pam Marshalla and I would have gone to college around the same time and it was exactly what I was taught.  I always felt that knowing this underlying history and evolution of speech language pathology in general has helped me build on my skills as a clinician.

Throughout the Marshalla Guide there are therapy techniques, guides, strategies, explanations and specific activities to aid just about any oral motor or articulation situation you may encounter.  For me some of this was a good review but I also noted several new strategies and theories to apply.   My first impression was that this would make a fantastic college text.  Not in dry sense of the term college textbook but in a more meaningful way with practical application.  I wish The Marshalla Guide had  been on my shelf the past 35 years.  It would have increased my confidence around providing appropriate oral motor and articulation therapy in many complex situations.  

Who knew there was so much to know about oral motor and articulation?  Well, speech Language Pathologists do and so did Pam Marshalla. She was able to take her training and extensive knowledge and organize it in an extremely helpful and user friendly way.  You won’t need any other books on articulation therapy other than the Marshalla guide.  It is a book you will keep on your shelf forever. A+

***The Marshalla Guide is available at Marshalla Speech and LanguageA launch sale is going on now with 10% off until April 30, 2020. Get an additional 5% off using the promo code schoolspeech.

How do administrators and teachers perceive language disabilities?

Posted by Teresa Sadowski MA CCC-SLP on Dec 9, 2019 in Administrators Page, conferences/workshops review, slider, SLP Chat, SLP Conferences/Workshops Review | 0 comments

It has been quite awhile since I posted anything. I apologize for that.  No real excuses, except that writing a blog is a job in itself.  Plus I think I have been a little disillusioned with the field.  However, I haven’t been sitting around feeling sorry for my situation.  After 30+ years in schools I’ve made a positive change.  I’m still running my own small private practice and it has been going well.  I take on a few private clients and a school contract here and there.  It has actually worked out well and I’ve learned a lot working as a consultant in a variety of settings with a variety of teams.

The other day I needed another half credit hour to renew my license.  I found a one-credit course through Northern Speech Services called Perceptions of Children in Speech Therapy-What the SLP needs to know, presented by Rhonda Wojcicki, MS. CCC-SLP.  Initially from the title, I thought it was going to be about the perceptions of the students who have to attend therapy but it was even better.  It was about how administrators/teachers perceive students with speech and language disabilities.  Which as you might know ties in with the information in my book The School Speech Therapist-An Administrator’s Guide to understanding the role of the SLP in Schools along with strategies to aid staffing, workload management and student success

After this short well researched on line course I got to thinking.  I’ve always known that most administrators have no idea about students and their disabilities.  I’ve also know that most administrators have no clue about the Speech Language Pathologist role in evaluating and treating students with language disabilities, along with all the duties that come with that.  My book published 2015 was written and published specifically for administrators regarding the role of the Speech Language Pathologist in schools.  My book on touches on the types of students we service and their disabilities but it was more about what SLPs do in schools.  This course made me realize that we might have to take things a step back, focusing more on educating administrators/teachers around language disabilities before focusing on what the SLP needs to manage their workload.

It was wonderful to listen to a course that basically drew the same conclusion I have over the years, that most administrators and teachers have little understanding how language disabilities (and disabilities in general) impact learning and life.  My own observations tell me they also have difficulty understanding how proper support and therapy can help students with disabilities.  If this was understood SLPs would not have such high caseloads, specific time would be built in for therapy, co-teaching models would be better, younger students would receive therapy more often, higher order language disabilities would be a priority and the list could go on and on.

Basically if administrators/teachers had a better understanding of language disabilities, child development and success with appropriate interventions, SLPs would not be spread so thin in schools.  Our contributions in meetings would hold more weight, students would receive therapy more often and we would be consulted on a regular basis.

Several years back when Response to Intervention (RTI) was becoming a thing, I worked in a school that tried to raise the level of understanding of language disabilities with teachers.  This was actually a good thing but it wasn’t done well and we had difficulty getting teacher buy in.  There were some a-ha moments for the teachers I worked with at the middle school level but they were few and far between.  Needless to say principals and administrators were not part of this training.

Lack of understanding of speech and language disabilities is nothing new but in the past our knowledge and role was more respected. Over the years the role of the SLP in schools has become more technical but we forgot to tell people that.  When I first started working my caseload primarily consisted of students working on grammar and articulation, with a much smaller overall workload.  Now a public school caseload will consist of students with mild to severe language needs covering the whole spectrum of language/learning disabilities. Students use to be sent out for more in depth testing to hospitals or clinics.  Now we do it all.  I remember that the hospital/clinic testing always held more weight in meetings even if the SLP was the only one at the table who really understood the findings.  It was a good bargaining chip for students to receive increased speech and language services. 

Now we do the same testing and yet often the team does not validate our findings.  In some cases we are not even allowed to spend the needed time to present our findings and explain things to the parents.  When we do get a chance to explain speech and language findings, rarely is anyone taking a note, commenting or asking a question. I often wonder if any of the accommodations or goals are read, much less followed or addressed in the classroom.  In years past, SLPs could at least count on the special education teacher or school psychologist having some understanding of language disabilities but that has seemed to wane.

Why do administrators, teachers and other team members have such a poor understanding of why/how underlying language disabilities impact learning?  Even if it wasn’t part of their initial training, wouldn’t years of sitting in IEP meetings, teaching children at all levels and talking with the SLP increase their levels of understanding to the point where they could say “I think that student has some sort of underlying language disability”.  For a lot of teachers and administrators it hasn’t.  I have several thoughts on why this has happened.

• Teachers have a lot on their plate with little support
• You can’t easily “see” language disabilities 
• Teacher training even in this day and age, years after integration was the norm, still does not prepare teachers for the disabilities they may encounter in their classrooms
• Many years ago administrators were told they had to immediately integrate special education students with little understanding of disabilities, little to no training and no viable plan.  Many Administrators still see integration as a blanket policy without considering individual needs or teacher’s ability to do this successfully.   
• If a teacher suspects a disability they basically have to jump through hoops, take copious data and try several accommodations (often without guidance) before referring a student through the RTI process.  Once in the RTI process it is often a lot of work for the teachers. Not to mention precious time where the student could be receiving more appropriate services is lost and the child continues to fail.  I have known teachers to avoid the RTI process by telling parents to directly request an evaluation.  This was evident at one particular school when several evaluation requests came across my desk after the first parent-teacher conference several years in a row.
• In the past administrators have often come up through the ranks and would have a lot of experience actually working with students.  Today a lot of administrators go right into administration without any experience working with regular or special education students.
• Administrators running special education programs either as the head of the department or as team managers are not always required to have any special education experience.  My observation is that team meetings are run very differently depending on the level of special education experience/understanding of the team leader. 
• Schools offer very few continuing education opportunities having anything to do with language development.  They have experts in the schools so why don’t they use them.
• Special and regular education teachers are expected to focus on curriculum standards and passing that all-important standardized test.  They have little to no understanding of the gaps that language/learning disabled students have.  A very good example of this is when it comes to writing (again which is important to pass that standardized test).  If a language disabled student is unable to organize language, generate grammatically decent sentences and use a rich vocabulary, what makes them think they will be able to do it in writing.  There is clearly a gap or disconnection, which others at the IEP table often won’t acknowledge.  Their training tells them a template will solve all the problems, SLPs know it won’t.
• Lack of time to do things properly is a huge issue for everyone in schools.  Since there is a general lack of understanding of disabilities especially with administrators, there is usually never enough time built into the schedule to do what has to be done.  Almost every IEP has a consult piece, yet time is not built in to meet with teachers and most consulting is done when passing through the hallway.
• Schools do not use enough Universal Supports to aid learning for all.   
• The typical 2×30/week for therapy might fit the school schedule but does it fit the child’s needs?  Because of this lack of flexibility imposed by the school schedule this perhaps demonstrates that therapies in general are not perceived as important.
• Speech and language issues are often seen as medical needs not educational needs.  
• Administrators don’t know what they don’t know.  In over 30 years working in schools I’ve never once been asked what I need to manage the workload or what the students need to be successful.  It’s my impression that teachers are rarely asked either.  Given the structure and culture of most schools, school personnel are often afraid to speak up on such issues.

So what can be done at this point to raise the awareness and understanding of language disabilities and the impact on learning?  I wish I had the answer.  Administrators influence budgets and policies that directly impact the quality of programs and services thus impacting the success of students.  For them not to understand the varied learning style of a good chunk of their students is not good.  My experience is that administrators will support a new fad program with more enthusiasm than they will support direct services for language-disabled students. If the underlying cause is that they do not understand language disabilities or perceive language disabilities separate from learning, then clearly more education is required. Which was one of the basic conclusions taken from the course.  

The answer seems simple, provide administrators and teachers ongoing education around awareness and understanding of language disabilities and their impact on learning.  After over 30 years working in schools, I just can’t see that happening until someone with a lot more clout than the lowly single SLP working in a school starts pointing it out.  Creating workshops might be a good start but still you would have to get buy in.  

I enjoyed listening to Perception of Children in Speech Therapy-What the SLP needs to know.  It gave me a lot to think about.  I’d like to see a similar conference marketed toward administration and teachers.  I will be suggesting it to the author.

Smart Goals made easy

Posted by Teresa Sadowski MA CCC-SLP on Aug 15, 2018 in Administrators Page, slider, SLP Chat | 0 comments

Hey SLPs

If you are thinking about your personal “smart goal” for the next school year you might want to check out my site on Teachers Pay Teachers.   A few years back the SLPs in my district were asked to put together a short in-service for teaching assistants about the role of the SLP in schools, students we work with and how they can support language development in the classroom. This was to satisfy one of our “smart goal” requirements.  Since I did put a little bit of work into it I decided to make it available on TPT.  The in-service is titled Speech and Language Services In Schools In-service for Teaching Assistants.  It is made up of a presenter’s packet and a packet for participants.  The in-service is appropriate for all levels through middle school.  When I presented this in-service I supplemented with generic guidelines for over language development/language expectations based on the ages the participants were working with.  It is a quick and easy in-service.  Administrators are always looking for appropriate in-services for assistants/paraprofessionals.

The other “smart goal” activity I presented was to write a monthly/bimonthly blurb in the school newsletter on language development and what parents could do to engage and encourage their child’s language. Several of these can also be found in my TPT store, The School Speech Therapist.  They are available in Word so they can be edited to fit your newsletter or if you have other words of wisdom.

I would love to hear about other smart goal ideas.  So many SLPs think they have to reinvent the wheel or take copious amounts of data to achieve their smart goal.  Reality is it does not have to be that challenging and there is no reason not to share ideas.

One year many of my students had an objective to share 1-2 experiences.  I made that one of my student smart goals, that every student would share experience information during each session.  (They also had to show that the listened to each other by retelling others experiencesJ) That was so easy to keep track of and that’s how we started therapy.

I would love to hear about other personal and student based smart goals that have worked well.