March 29, 2021

Dear ASHA,

We took to social media to encourage SLPs working in the school setting to complete an anonymous survey, and the results from nearly 500 SLPs in this setting show that they are struggling, to say the least. One SLP noted, “I’m seven years from retirement and worried that the stress will cut my life by a couple of years.”

Because school SLPs make up over half of your members, we wanted to share the results with you and ask - how can we better support SLPs working in this setting? What supports exist that school SLPs may not be aware of? What can we do to prevent burn out and keep SLPs not just from leaving the schools, but the profession as a whole?

Caseloads

• 51.9% of SLPs have a caseload of at least 50.

• 6.8% of SLPs have a caseload of 75+ students.

“It’s hard to pinpoint what the biggest issue is as a school SLP, but it really is all of the juggling. Billing, progress reports, paper data sheets, IEPs, meetings, re-evals, screenings, filing paperwork, lawyers, uninvolved parents, small work spaces, low funding, low support from school staff, lack of understanding of our role as school SLPs. I feel like if caseloads could be capped to something like 40 instead of having 60 like I do now, I’d be able to manage all of these tasks. But right now, I barely meet deadlines, my therapy is mediocre quality, and I always wish I had time/energy to give more to my kids and focus on the IMPORTANT part of the job which is treating and diagnosing speech and language disorders efficiently and in a way that is individualized to each student. It’s what they deserve and it never feels possible when it COULD BE.”

IEPs

• 37.9% of school based SLPs do not feel confident with most IEPs that they write.

  “High profile cases and complicated legal cases are something I was not prepared for in grad school but have become a common part of my job.”

Progress Reports

• 69.7% of school SLPs take an entire day or more to complete progress reports for their caseload

• 6.6% of school SLPs named progress reports as their number one pain point

  “I love my job because of the diversity. I am never bored…unless I’m writing progress reports!”

Therapy

• 14.8% of school SLPs named planning therapy for their diverse caseloads their number one pain point in this setting.

• 37.8% of school SLPs do not lesson plan for their caseload.

  “Schools should adopt ASHA’s recommended 40 workload instead of caseload caps by state. Therapy feels watered down when you have to service so many students with diverse needs in ‘small’ groups. Public school SLPs were struggling before COVID; now, it’s even worse. I predict a lot of SLPs leaving public schools or the field altogether.”

The School SLP Role in General

• 90.4% of school SLPs experience imposter syndrome.

  “I constantly feel like other therapists know more than me or are better than me. I try so hard but always feel like I come up short. But I don’t have time to do anymore education with the overwhelming caseload and extra work that comes with the job.”

• On a scale of 1-10, with 10 being the highest, the average job enjoyment rating was 6.3.

• 38.5% of school SLPs name their biggest pain point as feeling like a jack of all trades, master of none.

  “I feel like a jack of all trades master of none but it’s because of my caseload size. I have no time to really look into the research, which I feel is a huge disservice to my students.”

• 75.6% of school SLPs have considered changing careers

  “The demands that are placed on school based SLPs are increasing. The job is less about the kids and more about the paperwork. We are juggling in person students, virtual students, all while traveling to multiple schools in the middle of a pandemic. It is truly not sustainable. If I was not dependent on my salary for my family, I would leave and make a career change.”

“It’s not that my own time management is poor, it’s that there’s too much to do in the time allotted in a day of work. We are therapists, diagnosticians, report writers, Medicaid billers, case managers (the biggest most annoying part of my job), administrators, hall duty monitors and car duty callers and much much more. It’s exhausting.”

• Only 25.1% of school SLPs feel consistently supported by their administrators at work.

  “Admin at the site level is amazing, but the Special Ed Director is a position that is a stepping stone for retirement in my district, so we have admins with zero SPED background consistently moving in and out of that position. Causes more work for us professionals to have to advocate for our students, appropriate placements, and even the ability to refer a student for additional assessment.”

“I feel like school leadership care about finances more than children. I never get asked about student progress, but I always get an email about how much Medicaid has been billed for the month. It is disheartening.”

Despite these challenges, 89.9% of school SLPs would recommend this career to others (although many said only with a warning). We interpret this as school SLPs being passionate about the students they serve despite the obstacles that come with managing their caseload (e.g. writing reports, Medicaid billing, scheduling, completing progress reports, writing truly individualized IEPs). We’ll leave you with this quote from a survey respondent:

“The actual act of speech therapy is incredibly fulfilling and even the planning is a labor of love. But the expectations on school SLPs is unrealistic. We can’t do it all. Nor should we have to. We need more administrative support from the district level. We need people in charge who have been ‘in the trenches’ recently. So often, our leaders forget how stressful the job is and how time consuming all of the prep work and documentation is. We are more than our case numbers and for every ‘easy artic’ kiddo we have that takes 2 minutes to prep, we could have 5 kiddos with multiple disabilities that take hours to prep every week.”