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

May 8, 2024 by

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.

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