/r/slp

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A community of Speech-Language Pathologists (SLPs), Speech Therapists (STs), Speech-Language Therapists (SLTs), Clinical Fellowship Clinicians (SLP-CFs), Speech-Language Pathology Assistants (SLPAs), graduate clinicians and students. We discuss ideas, stories, information, and give general advice through our personal experience and research.

Please join /r/SLPGradSchool for pre-graduate school and graduate school related discussion.

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A community of Speech-Language Pathologists (SLPs), Speech Therapists (STs), Speech-Language Therapists (SLTs), Clinical Fellowship Clinicians (SLP-CFs), Speech-Language Pathology Assistants (SLPAs), graduate students, graduate clinicians, and undergraduate students. We discuss therapy ideas, share stories, share informative links, and give general advice through our personal experience and research.


Speech-Language Pathologists, sometimes called speech therapists, assess, diagnose, treat, and help to prevent communication and swallowing disorders in patients. Speech, language, and swallowing disorders result from a variety of causes such as a stroke, brain injury, hearing loss, developmental delay, a cleft palate, cerebral palsy, or emotional problems.

Speech-language pathologists work with patients who have problems with speech, such as being unable to speak at all or speaking with difficulty, or with rhythm and fluency, such as stuttering. They may work with those who are unable to understand language or with people who have voice disorders, such as inappropriate pitch or a harsh voice. Find out more about SLPs here and here.


If you have a speech or language concern, please contact your local speech therapist. You can find a therapist in your area using ASHA's Professional Finder. Speech pathologists can talk about language, development, and the field in general, but they cannot diagnose or treat in this subreddit.


Feeling burn out or job stress? Consider talking to a mental health professional or researching strategies for anxiety, stress, and depression. Just as we cannot diagnose/treat speech and language disorders in this subereddit, we can only offer support, not true mental health counseling. * NIMH: National Institute of Mental Health * NAMI: National Alliance on Mental Illness


Official r/slp FAQ

caramelcashew is a Speech-Language Pathologist who has worked in 8 schools in 3 states over the last 3 years. Ask Her Anything.

Let's talk salary - SLP redditors discuss salary

Why did we choose SLP?


THIS SUBREDDIT IS IN NO WAY AFFILIATED WITH ASHA, SAC, OR ANY OF THE WEBSITES LISTED BELOW.



Related subreddits:

/r/slpGradSchool

/r/SpeechAssistant

/r/CFY

r/autism

r/stutter

r/audiology

r/specialed

r/linguistics

r/occupationaltherapy

r/rehabtherapy

r/neuro

r/cogsci

r/education

r/dementia

r/healthcare

r/disabilitysupport


Credit goes to /u/taximes for our logo.

Credit goes to /u/stophauntingme for our subreddit design.

/r/slp

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1

Using Special Interests in Therapy

I have a student who is a GLP. She really loves Hello Kitty & friends. I want to start using those things to get her more engaged in therapy. I don’t really have trouble engaging her with toys, but I want the language based activities to be more salient and functional/high interest to her. Is this a bad idea?? Any tips on how to integrate special interests into therapy sessions?? TIA!

0 Comments
2024/12/02
23:52 UTC

1

case load

Hello! I am in a situation where I have just over 50 students on my caseload. I am only supposed to do 5 sessions a day but I end up doing like 6-8 sessions depending on the day to meet the needs of the job. Some students are in completely separate classes/schools - same building - and also some have very specific issues for instance one kid has cleft palate, another kid has difficulty with /r/ - and other one with /s/ - you get the picture. In response to asking for per session compensation for some of the work I'm doing, I am now being asked to release students from the caseload and have a schedule with 5-6 sessions per day. But this doesn't seem realistic, since I'm the only slp on site. Can someone with knowledge of the nyc public schools help me understand how it works, please explain like I'm 5. I feel too ashamed to keep asking my sup to repeat herself. I thought this was the whole reason per session exists? What do I need to do to cover my bases. TIA!

0 Comments
2024/12/02
23:12 UTC

1

Outpatient Peds to Psych and Behavioral Health

I am transitioning from a pediatric outpatient clinic to a psychiatric and behavioral clinic for peds. I've tried to do some research on assessments I'll need and how my treatment might vary from the typical ST I'm doing right now. Does anyone have any experience with this? Thanks!

0 Comments
2024/12/02
21:50 UTC

1

Kid inserts /sh/ into every word

I’m in my CFY and first kid on my caseload inserts /sh/ into every word. For example, piano becomes piasho. Lucy - lushe. I can’t figure out what’s going on. The SLP before me was targeting /h and /p/ but his mom wants to change targets because he hadn’t made progress in a year and a half. Would love any tips to point me in the right direction.

Edited - he’s 4. Doesn’t appear he can discriminate between the sounds.

3 Comments
2024/12/02
22:43 UTC

7

High school pragmatics vs psych vs just dark

I have a new scenario and was hoping for some insight. I just was handed a student who is in hs and met their pragmatic goals and passed all tests with flying colors - IEP is coming up and they don’t qualify any longer. The student is very into “dark” things, watches murder cartoons and makes lots of comments like “I could kill x” and if someone is annoying them in class, will make asides like “what if we just kill them?” Student knows this isn’t appropriate and what the correct things to say are. Family supports the teen’s love of murder and buys murder show dolls/figurines….. Is there anything I should be doing in this situation? Or end svcs and refer to psych? Has a nyone been here?

3 Comments
2024/12/02
22:34 UTC

1

OWLS II or RESCA-E

Hi all,

Looking for some opinions. I have some Medi-Cal $$ I am thinking about using to get a new language assessment for my site. We currently have the CELF (which I don’t love using due to the executive fx a lot of those subtests require) and the CASL (which I really like but takes SO long to administer). I see a lot of other SLPs in my district use the RESCA and the OWLS & I’m curious if any of you have any options on whether one would be a better investment than the other. I’m also open to any other suggestions outside of those two assessments! Thanks!

0 Comments
2024/12/02
22:02 UTC

3

How to take care of your back (specially lower back) during interventions?

Okay so I'm 23 years old, I've been working for a year as an SLPA and lately I've been going home with my lower back hurting so much. I usually see 13-15 kids a day. We use small kids tables but also regular ones. Small chairs too but they're office chairs, not children's. We don't usually sit on the floor tho.

I usually stretch but it seems like it's not enough, I don't want to start seeing a chiropractor because I'm afraid lol, any suggestions??

6 Comments
2024/12/02
21:47 UTC

1

Outpatient hospital interview coming up...What are some possible questions they can ask?

It's adults only and they do a lot of MBS. My most recent experience is with pediatrics, and I have just obtained my C's. I haven't had hospital experience since I was a graduate student 2 years ago. I want to prepare, but am not sure of the questions they might ask me.

Thank you!

2 Comments
2024/12/02
20:38 UTC

106

WTF

Shopping on Amazon for therapy materials and came across this. What in the actual fck.

56 Comments
2024/12/02
20:21 UTC

5

Difference between ADHD pragmatics issues and ASD

A lot of my students have diagnoses for both ADHD and ASD, and they get referred to me to work on social language. When I assess them, they tend to do very well on formalized tests like the SLDT but their teachers complain they’re not behaving appropriately in class (such as blurting, talking at inappropriate times, saying rude things because they didn’t think it through first). A lot of these kids, even if they’re AuDHD seem primarily ADHD and I find myself questioning how they got an ASD diagnosis but ultimately I tell myself I don’t know as much as the psychologists. But then recently I was talking to my school psych about one of these kids and she said, “they were certain about ADHD. They weren’t sure if she has ASD or not” but she was diagnosed with ASD and referred to me for social skills regardless of how unsure they were. Then I have to explain I don’t work on impulsivity and yes she has an ASD diagnosis but she showed me in testing she has the skills. Just wondering if anyone is dealing with this and if they have any advice?

1 Comment
2024/12/02
19:59 UTC

2

Need some advice..

I’m facing a bit of a dilemma at work, and I could really use some advice. My school is paying me on the teacher’s pay scale, and I’m contributing to OT/PT retirement benefits, not the teacher’s retirement system (which is considered the “better” retirement). The problem is, I’m not a certified teacher (nor can I become one), so technically I shouldn’t be on that pay scale. As a result, I’m earning $10,000 less than my colleagues in the OT/PT field who are doing similar work.

This seems like an issue of pay misalignment, and I’m wondering if I should bring this up with HR. Has anyone else dealt with a similar situation, or have advice on how to approach HR about this without causing too much tension? It’s tricky because I don’t want to make waves, but I also feel this is something that needs to be addressed.

3 Comments
2024/12/02
19:18 UTC

53

I am not motivated by this field anymore

I hate that I have to work to prepare for work. I'm in the schools and I'm so over the whole fucking thing. My caseload is never lower than 55. I can't stand the low quality of services kids get and the paperwork is crippling. Idk how people with caseloads above 60 are even surviving.

I'm contemplating starting my own PP, but I'm scared it'll be just a different kind of "go go go" that's equally as exhausting. However, I feel like the sheer decrease in the caseload and freedom from the red tape of the school system would be a relief.

Is the grass really greener?

31 Comments
2024/12/02
19:08 UTC

5

Are sentence strips bad for ASD

I’m a CF, I just started working at a school, and I have some students which ASD or Downs Syndrome and they have goals that say “XX will describe an visual image by generating a complete grammatically correct sentence to include Who, What, and Where with X% accuracy”

In reading the previous SLPs notes, it seems as if she utilized Sentence strips that say “(Who) is (Doing what?) in the (Where)” to try and teach that skill.

I’ve had a grad supervisor who was heavily against sentence strips, and she said sentence strips were very old fashioned and it locked them into producing a specific sentence one type of way, and that there were better ways of making describing more functional for those specific populations of students (neuro divergent).

Just wanted to get some thoughts on using sentence strips to teach grammar and expressive language with out neurodivergent population

4 Comments
2024/12/02
19:04 UTC

3

Personal Goals for 2025

So after a 10 year journey I got my CCCs this year. While I am very proud and happy to finally be working, I am struggling with professional goals. Like I have spent my entire adulthood focusing on this one goal… now what…

So I would like some advice on goals I can work towards. Of course I have goals like staying on top of my notes, becoming more knowledgeable and skilled SLP but I am hoping for some more concrete goals if that makes since.

FYI I am working in K-8 school.

Any suggestions would be greatly appreciated!

4 Comments
2024/12/02
17:19 UTC

1

Feeding Therapy for Older Child

I see an older child in my PP OP clinic. She has seen OT and SLP to help facilitate her feeding skills because she has a lot of difficulty. The OT recently quit, so she only has speech currently. She has a malocclusion (very significantly misaligned throughout), a narrow palate, lingual deviation/weakness/reduced ROM, and a hyperactive gag reflex. Ortho is not providing any intervention at this time for reasons unknown, but I check in with Mom and ask every week to make sure. Previous imaging r/o any stroke or other determinable neurological impairment. Speech-wise, we’ve been working on /k,g/ with little success given her gag reflex (she literally gags with almost every attempt) and distorted /s/ (much more successful). Feeding wise, she eats only purées (most foods get puréed), very few soft solids like fruits, and is perfectly fine w/ thins. That said, we have worked on approximating lateral teeth for mastication/bolus preparation using a silicone fruit feeder and small pieces of fruit, lateralizing the tongue for manipulation, and other tongue strength/ROM exercises. We’ve also talked about doing a digital sweep or placement to move bolus i/s/o difficulty w/ tongue lateralization when she eats any solids (the bolus seems to often return to midline). She often swallows small pieces of fruit without complete/adequate mastication, hence her current diet. She had an MBS ~5 years ago and oropharyngeally was WFL per previous SLP but struggles with oral prep phase. My question is, does anyone have any additional strategies or recommendations to support me supporting her? Her parents want make her diet less restrictive and are very willing to do whatever they need. They (divorced) are both coming and sitting in with us this week to learn what we practice to try things at home, and I want to make sure we can all do what is best for her. Considered rec an updated MBS to assess current status of oral prep phase, but didn’t know if that would be well-recommended given consistent, continued difficulties. Also thought about adding some advanced textures in puree (e.g., crushed graham cracker in applesauce) to promote some awareness of texture and support oral manipulation. Thanks in advance!

0 Comments
2024/12/02
06:05 UTC

10

If you do feeding therapy, tell me why you love it (or why you don’t)

I’ve been a peds SLP for 10 years and am debating taking AEIOU and diving into feeding. I have kids on my caseload who need feeding therapy and can’t find anyone and I know this is an issue in my area. I own a private practice and am prone to burnout already so I’m not sure if this will just be too much. I’ve always been interested in feeding though and am curious about why you love or don’t love it.

8 Comments
2024/12/02
15:56 UTC

2

Breaking a School Contract Mid-year

Has anyone found themselves needing to break a contract mid-year? Did you have any issues finding another job? If your new employer asked about your reasons for leaving, what did you say?

(Contract is through an agency.)

10 Comments
2024/12/02
15:53 UTC

3

Favorite autistic SLP creators?

I’m doing a group presentation to my district about autism and my topic is going to be about neurodiverse-affirming care in SLP. A big emphasis I’m placing on my topic is to listen to the autistic community first & foremost. I’d like to possibly add some autistic SLP creators to my presentation to help guide and head-start everyone and amplify some autistic voices in the community. Who are your favorite autistic creators in SLP?

3 Comments
2024/12/02
15:27 UTC

20

ASHA (all the wrongs)

Since my first undergraduate SLP class i’ve heard that ASHA is horrible, but none of my professors have ever told me WHY.

From your personal experience, why does ASHA suck?

37 Comments
2024/12/02
13:59 UTC

2

Remote- Changes

On our last day before break, my para informed me it was her last day and she will be transferring to another campus when we come back. Super sad; I liked her a lot as she was dependable and we got along well. I emailed asking who our new one will be.

First day back, no response and no idea who/if we have a new para. Guess I will have to make missed visit notes (due to lack of on-site support) and catch up on paperwork. Also, my SLPA called in sick so not even supervision to do.

What would you do? Honestly, if I didn't have IEP meetings I would also call in sick and go see Wicked for the umpteenth time.

2 Comments
2024/12/02
13:26 UTC

3

EI in NYC

I recently moved to Astoria from out of state to work in Midtown in a medical setting 8-4 M-F.

Thinking about picking up some clients in EI/ECE on the side. I have experience with 3-5 but none with 0–3 so 3-5 would be my preference.

I’ve heard horror stories about the currrent state of EI in NYC! Is this a good idea or not? If so are good agencies?

6 Comments
2024/12/02
12:20 UTC

6

Private solo practice?

I would love to open a private practice where I’m hired privately to go into daycares to do speech therapy. Since I’d be solo, I feel like that’ll help with up front fees - no building to rent, no employees to pay, yes to liability insurance but no to the others relating to employees (I’d get mine through husband’s work). I already have a good client base from working many years in the schools and multiple families and colleagues asking for me to help their kids outside of the school day/over the summer. From people running a PP already, here are the questions:

  1. What am I missing in terms of how to set this up?
  2. I know the answer is probably no…but with the high demand of SLPs would it be stupid to not accept insurance? That is the biggest worry of mine, and the people who have reached out to me, said they would pay cash, so I’m just curious.
  3. I’d like to do this in conjunction with my school job until I have a large enough caseload to sustain me. Is that too big of a burden?

Thank you!

4 Comments
2024/12/02
06:55 UTC

1

Can SLPA’s get emergency certified?

Can anybody offer any insight into SLPA’s getting temporarily certified to do speech therapy work? I know schools can emergency certify teachers if there is inadequate staffing, but my school is talking about getting my SLPA emergency certified so she can complete IEPs and evaluations, and perform treatment without a supervisor. I am in Pennsylvania. Can anyone confirm if this is a thing? Seems questionable to me. Thank you!

Just a footnote I am posting this for a friend who does not have Reddit, but wanted advice from this community, thanks again!

5 Comments
2024/12/02
04:28 UTC

109

Wicked

Did anyone see Wicked and feel deeply unsatisfied with how they wrote Dr. Dillamond’s explanation for why he couldn’t pronounce Galinda’s name? Top teeth have nothing to do with the omission of the first vowel!

Great movie, but that definitely threw me out of the film for a second! Being an SLP in the real world is funny!

16 Comments
2024/12/02
03:57 UTC

14

Help explaining why an EL student doesn’t qualify for services

Hi all, I really need help with wording this in my report. I assessed a 10 year old student whose primary language is Spanish. He began school in first grade, however EVERY year he has left in December to go to Mexico with his family. So he is only in school here like 4 months a year. (I am annoyed an AP was even signed in the first place I wasn’t there for it). The main concern is that he is not speaking or picking up English (eye roll!) I tested him with an interpreter for language and he scored in the low average range across the board. No articulation concerns, he is easily understood in Spanish and very talkative. He speaks basically no English besides “yes/no”.

Does anyone have a good statement I can add in my report explaining why he does not qualify for services to parents? I am a CF and struggling to word it. Help!

14 Comments
2024/12/02
03:56 UTC

29

Oh thanks so much ASHA for my “non-member affiliate” card

Wasted $446 of my hard earned money to apply for my CCC’s only to get this useless card in the mail. Another reason why I hate ASHA

16 Comments
2024/12/02
03:32 UTC

1

CASL and CELF indexes

Hey everyone! Which index scores do you typically like to get when administering the CASL (GLAI or the RLI & ELI)? What about the CELF (CLS or the RLI & ELI)? I know it can be situational, but I’m curious to know your typical “rule of thumb” and which you find gives the best overall picture of a students abilities.

Thanks!

0 Comments
2024/12/02
01:57 UTC

2

SNF TPT resources

I’m a new grad in the process of getting a job at a SNF and I’m looking to acquire some resources from TPT (or elsewhere, but I have a gift card for TPT). Any suggestions?

0 Comments
2024/12/02
01:53 UTC

3

Middle School Fluency Student Question

Middle school CF here. I have a 7th grade student on my case load who has a stutter (my first fluency client ever). He successfully utilizes shaping techniques while speaking, though he is definitely self-conscious about his speech which impacts his social life/willingness to self-advocate. He has significant expressive/receptive language challenges, which are the main targets of our sessions, especially since I usually see him in a group of other students who do not have fluency goals. His IEP is coming up and I am wondering whether I should remove or modify his fluency goal in some way to reflect that he is a. utilizing the shaping techniques b. any fluency-focused treatment we will do will likely focus on role-playing everyday situations/social engagement in order to increase his confidence while speaking.

For reference, his current IEP speech goal:
Within one year, student will decrease his disfluencies by using fluency shaping techniques (e.g., easy onset, full and breath, stretching words) at the word, sentence, and paragraph level during reading and conversational tasks, provided with faded visual, verbal, and tactile prompts.

4 Comments
2024/12/02
01:18 UTC

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