I work 10hr days at a pediatric clinic. Recently my caseload has increased to 17 clients a day for 30 minute sessions. I also supervise a CF so that eats up my doc block leaving me with only 30 mins to actually complete progress reports, aac evals, and any other notes.

I’ve mentioned my impending burn out to the owner and my manager- no changes. I have my two year review coming up and want to advocate for myself, am I being dramatic or is this caseload ridiculous. Also any tips for advocating?

I work 10hr days at a pediatric clinic. Recently my caseload has increased to 17 clients a day for 30 minute sessions. I also supervise a CF so that eats up my doc block leaving me with only 30 mins to actually complete progress reports, aac evals, and any other notes.

I’ve mentioned my impending burn out to the owner and my manager- no changes. I have my two year review coming up and want to advocate for myself, am I being dramatic or is this caseload ridiculous. Also any tips for advocating?

I work 10hr days at a pediatric clinic. Recently my caseload has increased to 17 clients a day for 30 minute sessions. I also supervise a CF so that eats up my doc block leaving me with only 30 mins to actually complete progress reports, aac evals, and any other notes.

I’ve mentioned my impending burn out to the owner and my manager- no changes. I have my two year review coming up and want to advocate for myself, am I being dramatic or is this caseload ridiculous. Also any tips for advocating?

I posted on here a few days ago about whether I should quit my 1099 EI SLP job for which I'd literally just had orientation, in order to accept a salaried, full-time W2 EI job offer - which fits all my needs for stability and health insurance at this time. After reviewing everyone's input on Reddit and consulting with colleagues/friends, I went ahead with quitting the 1099 and called, spoke on the phone, & followed up via email to let the 1099 agency know that I was very sorry, I'd been offered a W2 position that does not allow me to do additional 1099 work, that I would love to stay with their agency if possible, I think they are a wonderful company and I've enjoyed my brief time there, at this time I need the W2 but would love to work for this agency again if a W2 becomes available or as a 1099 if my circumstances change in the future, etc. etc.

The first person from this 1099 agency I spoke with on the phone said that they weren't sure if they would want me to start seeing the 2 families they had just assigned to me, or if it makes more sense to 'give them back' to the agency/referral list and find new SLP coverage. She said they'd be in touch. I thought about it overnight, consulted with more colleagues/friends, and decided to send an email stating that although I'd like to help and provide speech services for these 2 families until they find new coverage, I need to move forward with signing my W2 contract - that I was very sorry, and I reiterated all of the positive things I felt about their company and how I was disappointed to leave for the W2 position.

Next day, I end up playing phone tag *all day* with another admin contact from the 1099 agency - phone tag goes all the way until 7:30pm at which point I state in my voicemail I have dinner plans at 8, so if we aren't able to touch base by then, I'd love to set up a time to speak via phone the next day. Finally we talk as I'm getting ready for my dinner plans... big mistake, because what they said ruined my whole night. So, they were incredibly nice in all their voicemails during the day. Once they were speaking on the phone with me, they were incredibly cold, mildly argumentative, and defensive - they said that I signed a contract that stipulated 30 days of notice in the event of resignation. I know it's my responsibility to read over the contract, but they sort of pressured me into signing it quickly on the spot and did not explain anything that was stated in the contract - so this was the first time I'd heard about the 30 days. My state is "at-will" employment, and also as a 1099, I had assumed we had more freedom with giving notice... I feel so guilty and irresponsible.

I repeated that I had not even started seeing this 2 families yet and that the other admin person said it was 'possible' that they could find other SLP coverage. This current admin person said no, I signed the contract and agreed to give 30 days notice, so it's my responsibility to adhere to my contract and see these 2 kids for the next 30 days, or until they find new SLP coverage. I said that I would do my best to honor the 30 days but that I needed to review this first with my W2 job offer. I said I was sorry and would do my best.

I then asked what the repercussions would be if I was not able to honor the 30 day notice. This is where the phone call became even more upsetting and I ended up crying once I got off the phone. This admin person said - quoting from memory - "There will not be any repercussions for you. We can't do anything. We won't do anything. But, you are putting our agency in a horrible position, you are making us look bad in front of the state and everyone else, and you are *denying* services to these babies and toddlers. We trust those we hire, we trusted you, and it is a shame for you to leave us like this."

So now I am feeling even worse than I already was, and I'm trying to decide what I should do... My friends (non-SLPs) say I should never speak to the 1099 agency again after how they spoke to me last night. What should I do? Should I honor the 30 day notice for 1099 and see if my W2 job can wait a month for me to start? I can't live off the income of only seeing 2 kids per week as a 1099 for the next month, though... Part of me feels like if this agency needs me so badly, it's kind of on them for hiring me as a 1099 - if they want stability, continuity of services, and to control how people leave, I feel they should hire W2s...? Anyway, I would appreciate hearing any advice about how I should handle this in the most professional and responsible way? Thank you :)

Has anyone had to submit their plan of care (frequency/duration/goals) and evaluations to be signed off by a supervising physician (in a private clinic setting working with predominantly speech/language kids with some feeding)? If so, why?

My boss just laid off all of our OT and Speech department because her only insurance provider (Tricare) has refused to pay her since Nov 2023, before I started working with this company. I found paperwork in the office regarding her being flagged after an audit for: fraudulent use of CPT codes, use of unauthorized providers (SLPAs), and fraudulent signing of SOAP notes (she signed the notes for SLPAs/CFs). She gave notice to us of the layoff and to all of the families of the patients the same day. Then closed the clinic the next day. She didn’t provide them with a list of nearby clinics or hospitals. I’m afraid of retribution as reporting on ASHA is not anonymous.

CF here!

I’m going to have my first EI session soon. The family is coming to the clinic I work at so it is not home based. Any tips/ideas for my first session? Materials/toys I should get?

I don’t really have much EI experience from grad school & I primarily work with preschool-high school aged clients.

Any help would be great!

Hiii I’m in between taking a contract with Stepping Stones or going direct with the district, which I probably will do. However, SSG has an unbeatable foundations program as an essential ‘how to’ for CFs, like caseload scheduling, IEP stuff, etc. Does anyone know of another great resources like this that can supplement if I end up going direct hire?

Im a newly qualified slt in the working in paeds And we set targets for children and see them termly My supervisor told me that we are always assessing and doing therapy so we would notice some errors during therapy session as well.

And I find it difficult to just notice the errors the child and making and to just write those erorrs down

Alot of time, I am just copying what the child is saying word by word. And I felt like its not practical as I would have too much data

Is it better to just do a new assessment when i want to set new targets 🤦‍♀️

Hi peeps - I currently work in the north of England UK as a speech pathologist, and have lived here my whole life.

I am growing increasingly aware that I could be making so much more in Aus or the US, and so just wondering if anyone else has moved elsewhere from the UK - and found it to be worth or not worth it?

I would be moving with my fiancé who currently works in IT, though he is happy to work in anything else if needs be.

Thanks in advance.🌻

Hi all! I am currently employed with a contract company for the schools. My contract runs out in May. What do you do during the summers to make up for lack of income or benefits?

I received both of my only externship placements in a public and private specialized school. I am graduating with no adult experience and originally came into the field wanting to go the adult/medical route. My program seems to refuse to change the placement. Is it worth escalating the concern to the dean or further or will I be fine with whatever route I decide to go after grad?? I feel disserviced graduating with such a narrow experience and understanding of the field. Please advise

Hi everyone, I would love some insight into choosing a formal standardized assessment for a child suspecting ASD/pragmatic language deficits. What do you like to use that only assesses or focuses on areas of pragmatics? I know TOPL (age 6-7) is dedicated to evaluating pragmatics, but in my case, age goes over 6-7 yr old (8yr). Any thoughts? Thanks for your comment!

I’ve been looking to get into the NJ school system and was wondering if any current school SLPs hired by districts would be able to provide some insight on the interview process.

I was told to familiarize myself with the different “codes” and was wondering if anyone could provide a list of the codes, etc. Thank you in advance!

Hi, all!

I'm on week two of a school based tele health position in a school that hasn't used virtual services before. I've got 4-6 different facilitators that help me get students logged in. The facilitators that communicate well with me are a tremendous help. On the other hand, I do have some that can't ever seem to make time to meet with me that need facilitator training. These are the ones that answer the questions for the students and/or just let the kids run around the room. Since I can't seem to get responses to emails or time to talk in their schedules to lay out what I need from a facilitator, I'm working on a doc in canva with visuals that I can share with them and my building point of contact to hopefully get us on the right page. I also plan to share it with some of my other teleprovider friends.

Can you guys share with me some Do's and Don'ts that you have found make your virtual sessions run more smoothly? How do you talk to your paras without feeling like you are scolding them? What do you think they should know about being in this role?

I'm a CFY working for a SNF (actually 4 buildings) in California and I'm about half way through.

We have a 90% productivity standard and I see some people do documentation during their lunch or clock out at the end of the day before finishing documentation to stay on par with the productivity and the max of 8 hours of pay/day. We rarely get approved for overtime, and would "need to get overtime pre-approved" which is basically impossible since we won't know we need extra time to do documentation or be with a patient for longer until that time comes since we DO try to schedule everything so it fits within the 8 hr day.

I've been told multiple times I need to take my unpaid lunch break at a specific time for a specific amount of time, but nobody's said anything about our PAID 10 minute breaks. I've even asked if I could waive my unpaid lunch break so I can leave earlier to do errands or whatever since it doesn't usually take me 30 minutes for lunch anyways. The company is adamant that unpaid lunch breaks are the law and I need to comply- but isn't it also the law for me to get a paid 10 minute break, so shouldn't SNFs account for that in your treatment schedule?

TLDR: Other SLPs in SNFs, do you guys take your 10 minute paid breaks? How does that work with your productivity and treatment schedule? What about working during your lunch and after you clock out? I know that the productivity standard is the hardest part about being in a SNF but can they really fire you for being below the standard? What happens if you consistently don't meet productivity?

Hi everyone! In my 3rd week of my CF at a SNF. I have a pt who is NPO, and had 2 strokes over 26 years ago that resulted in severe expressive and receptive aphasia and cognitive deficits. After her strokes many years ago, she had dysphagia but it was resolved and she was on a regular/thin diet. She was recently hospitalized and the dysphagia came back. She is now NPO and the main problem is a delayed swallow trigger. It takes her ~ 30-45 seconds to swallow (sometimes its only 8 seconds but this is not consistent). Lingual strength, coordination and ROM are also very weak. She does not voice well, she cant clear her throat on command, and cant cough on command. Her cough sounds like wheezing but outwardly instead of an inhaling wheeze.

She aspirated yesterday on ice chips (never has before and we have been doing it for a week or so at this point) and her reflexive cough kicked in-- its weak but there., so i know she CAN cough, just not on command.

When I explain what to do to her, she doesnt understand and typically cant imitate. What i have done thus far is try thermal stimulation with ice, warm water, and sour (lemons) to try and trigger a swallow reflex. I use a swab with the stimulus on it and sweep it on the part where soft and hard palate meet. She typically will swallow but it takes SO long. She is doing great in PT/OT but with speech, not so much. Her husband is adamant on her being able to swallow at least puree before discharging her from the facility.

Everytime she does swallow, i say "Good job, you swallowed" "thats a swallow" hoping that she will learn what "swallow" means and that when i tell her to swallow she will do it (not much luck so far).

Her original MBSS was inconclusive bc she was bolus holding for 1 min and 30 seconds so they just stopped the test since shes under radiation and not even swallowing.

Please help. I don't know what to do. I cant do any exercises or maneuvers with her because she cant swallow timely to begin with.

Hi guys- I have a monthly meeting with OT/PTs included. It’s my turn to share something with the group.

Does anyone have any interesting resources (CEU, website, handouts, etc,) that they’ve encountered lately that would be beneficial to share with the group? I have some ideas, but thought I would check here also.

I thought I left these sort of presentations in grad school, but here we are. 😅 Thanks for any ideas!

I’m an SLP-Assistant and I wanna stay in HH due to flexibility and I have found W2 jobs that I like.

I wanna stay away from schools because I am prone to getting sick and I do mask and sanitize stuff, but I don’t like being in daycares unless I have to.

I wanna move to a private practice, but I am not sure if that is smart since parenrs may not want me to mask. I do have multiple KN95 masks with a clear film on it so I am not sure if that helps.

Grad student struggling with scoring MBSImP

Any helpful videos or resources? I am struggling to identify the structures in the videos as they are so grainy so video resources would be the most helpful and I've practically memorized the scoring manual guide already. Thank you in advance!

Btw I've already posted in the slpgradschool forum, but I'm hoping to find resources from experienced clinicians so please don't delete my post:)

Hi all, I need help distinguishing the difference between the /r/ varieties in these two languages and how they are produced, and possibly some assistance teaching or setting a family up to assist their child in producing these sounds. I did some preliminary IPA chart reviews and digging on Youtube but I would love it if someone who is bilingual in one of these languages could comment and provide some direct assistance. Thank you in advance.

Hey everyone! I’m a CF doing my first year at a middle school. I was just talking with a para the other day and she mentioned how she gets paid more than elementary school paras because our school day is 45 min longer than the elementary schools. I’m salaried, not hourly, so I make the same as the other SLPs in the district, but am apparently working 45 min longer than the elementary SLPs. I just wanted to know if this was typical for school SLPs? I didn’t realize that the elementary school days were shorter than secondary school days.

SLPs working in ECSE programs what is your pay like?

I just completed my CF at a school for kids with trauma and behaviors, I love working with these kiddos; however, the pay is awful and it is a toxic environment. I will be starting a new job at a nursing/rehab facility at the end of April. What are some must haves when it comes to materials, cheat sheets, and organizaitonal things to help me in my new placement?

My son is almost three, and he receives speech, OT, and infant development therapies through the regional center. I want to continue services through our insurance. He's been approved for ABA and OT, but not speech.

The evaluating SLP stated that he doesn't have sufficient prelinguistic skills to benefit from speech services. This is so frustrating! How can he improve his speech if he's not getting therapy??? My son is autistic, so of course he doesn't respond to linguistic input in the same way that a neurotypical child would.

What would you recommend? My son doesn't say many words, and it's true that he can't follow commands. Butt I don't think denying speech services is the best call.

i have a student with undiagnosed but obvious ASD who is currently in gen ed with speech and academic services because he is academically age appropriate.

his behaviors have been extremely challenging lately as he is violent with staff and other children when dysregulated. yesterday he hit me about 15 times when we were cleaning up despite being front loaded that we were almost done playing.

currently, i have all staff using small visuals held around their necks to help him with calm down strategies and reminders to keep hands to self etc.

they have para support in the classroom and he cannot be left unattended.

does anyone have suggestions for violent behaviors? we’ve recently been working more with our behaviorist and are trying things such as reward charts but sometimes he just doesn’t take to it. his triggers are sometimes identifiable and other times are not (i.e., if another kid says he can’t have something he will hit them without clear warning or physical cues)

thank you!

Hello everyone, I am a SLP-A and have been working in a pediatric therapy office for a little while. We are allowed to wear speech shirts and/or professional clothing but not scrubs. I am super excited to wear my speechie shirts in and out of work because I am so passionate about my career but I never see anyone else outside of work wearing speech shirts. Is it just me who thinks wear speech shirts outside of work are cool? Or am I crazy?

I work in peds private practice and I have an 11 y/o Autistic client who needs to close all doors and turn lights off in each room as we leave, even if my coworkers have a session going on in that room. It is getting to be very disruptive to the clinic as a whole, and its very hard to transition him out of the clinic because of this. He becomes extremely dysregulated/physical (hitting, yelling, crying) when we try to direct him away from other rooms and towards the lobby. I am certainly not one to try to extinguish self-calming behaviors in children with Autism, but I can't let him disrupt other sessions every time he leaves. Does anyone have any insight for how to go about this? He is a tall, strong kid, so his dysregulation when our sessions are over is beginning to really make me nervous. Parents don't come in the session, but I don't think they would have an influence over whether he would feel the need to open and close doors and turn lights off. TIA!

So I’ve been a little concerned about my son’s (19 months) speech for awhile now. I’ve never worked early intervention, but I’ve implemented the same strategies with my son that I use with my preschool students. I’ve taught my husband the various strategies, we constantly model all modes of communication and read to/play with my son. He does not go to daycare (my mom who is a retired teacher watches him daily), but does go around other kids and on play dates. His social skills are great, as well as his fine motor and gross motor (very very active!). His receptive language is also on track.

He currently uses gestures and vocalizations to let us know his wants and needs. He can babble “mamama” and is constantly using other sounds, grunts, and growls. My son is now really beginning to imitiate gestures (that he sees on tv like Miss Rachel pretending to climb etc), even though we have always modeled gestures to him.

Recently, he started making sounds with his mouth closed (sounds like d-d-d).

His 18 month wellness check is in 2 weeks. Idk if I should inquire about early intervention? I just feel stupid since this is my profession and I feel like early intervention is just teaching the parents strategies more so than play based therapy (which we do ALL DAY long).

Any thoughts or advice? Thank you ❤️