How to manage a big caseload
Organization is the key, because caseloads are always large. Do it in stages, working slowly to see what children need speech and how much. Not every child needs the same amount of therapy each week, whereas others will need more intense intervention. Later in the year, you can begin to thin out your caseload. Observation and assessment will go a long way to keep the caseload a reasonable size. Best practice requires some standard assessment and informal observation to warrant dismissal, although you can also point to their meeting of goals and objectives, or a plateau in performance. Talk to parents about changing service delivery models, which requires an addendum IEP. Help parents know that you are approachable, knowledgeable, and want their child to do the best.
You may not be able to do the paperwork of dismissal until you have completed your CFY and are well-established. Do what is appropriate for the child, and use good clinical decision-making. These might be difficult conversations to have with parents, especially if children have been in speech therapy for a long time. The average special education student costs the district $70,000/year.
As a new SLP, you’ll probably be given a large caseload. Some districts have caps, although the average caseload is 55.
ASHA introduced the 3:1 model, which is three weeks of therapy and one week of assessment (some districts use this). IEP-writing has been changed, in some districts, to required therapy hours per month or year versus per week. This allows you to draw therapy time back for children that are moving toward dismissal or need less time. A lot of this depends on the philosophy of the school district or SELPA that you belong to. Discuss these things with your superiors. Consider the intensity and severity of the disorders of children on your caseload, because this affects your workload level. Diagnosis, level of services, level of impairment are involved. Also monthly meetings, high-profile parents, IEP’s, etc, will take your time.
Having communication with the administration, teachers, and parents will help you on your caseload. A certain tone was set by your predecessor, who may or may not have developed a good reputation for the speech therapist. Be willing to explain your approach and how it may differ from the SLP who came before. These things will take time, and it will be a process.
Look at therapy with a triage approach. Kids with cerebral palsy, autism or unknown disorders have a higher priority than children with mild articulation problems. If you don’t know how to work with a particular student or situation, ask for advice from your colleagues. Move students to a consult model, vs. direct therapy, when possible.
If parents and children are happy, then the administration will be happy with you.
How to negotiate your contract
Negotiating your contract is hard as a first-year SLP. You need to be competent, confident and willing to work hard. Some SLP’s in the schools are on an itinerant contract basis, whereas others are hired by the school district. If you’re not sure where you want to settle permanently, working for an agency gives you a little more flexibility, and may cut through some of the red tape for working out of the state where you got your credential. Working for school districts requires you to honor your contract for the year. If you work directly for the district, collective bargaining units usually include SLP’s. Some districts have SLP’s on a separate salary schedule than teachers, because of the high need. Look at the benefit package (including health insurance) for the various districts in the area, especially if you have a family. If you want to negotiate through an agency such as Progressus Therapy, call to talk about salary, benefits, weekly hours, and vacation time (because you will get sick your first year!). If you are confident and know what you want and what you are willing to give, you will be able to advocate for yourself. Look at the school contracts and ask for something comparable. They will give you whatever they think they will be able to get out of the school district.
Pros and Cons
The school caseload Is variable, which keeps work interesting. Every day is completely different. There is a lot of energy in each day, and you and your kids will become attached. There is constant flexibility and change. You will see children on your caseload with medical problems, such as myasthenia gravis or TBI, and you might be the only one on campus with clinical training in these areas. You make good money for 181-192 days per year, and you don’t need to work weekends and holidays. This makes it a good job for parents. You’ll probably be done at 3:30 or 4:00 each day, depending on your contract, although your first year you will work much more. In the hospitals, you will rarely see things to completion due to death or transition to other settings for further services, and you will work long hours and often weekends.
In either hospitals or schools, you will see a lot of joys and pains of people you’re working with. Find out what your strengths and leanings are as an SLP, and you will find an environment that fits you well. Give yourself the opportunity to explore. You can even work in multiple settings part-time, or work per diem. When you work per diem, you’ll see patients on a one-time basis, or do intake assessments that other therapists will follow up with.
Common mistakes made by first clinicians
- Doing a full assessment for every single child that is referred to you; trying to please everybody by doing more than is reasonable or needed
- Lacking organizational skills; not planning ahead
- Being afraid to ask for help when needed (CFY supervisor, other SLP’s, other specialists in the district, online discussion boards)
See www.asha.org for more information on the CFY. You will get a packet once you graduate.
Speech-Language Pathology and Audiology Board (the board that gives your state license)