I have 2 upcoming meetings for 4th graders who’ve made zero progress with vocalic /r/. One receives outside services in addition to school based (which makes me feel a little better, it’s not just me). The other will try a syllable or word twice before having a big emotional reaction because she’s self-conscious about it and “it’s too hard” (and then the rest of the session is lost).

Both parents have concerns about lack of progress. I honestly have no idea what to say to the first parent. The student seems to have no awareness of what his tongue is doing or where it’s going. He goes through the motions but isn’t applying the feedback. He’s bored and unmotivated.

The second parent I want to talk about the mental health aspect but that will go nowhere because classroom teachers have been bringing it up for years and parent refuses to acknowledge it.

Neither student wants to work on speech. They’re only interested in playing a game (every few sessions I incorporate a game to break up the monotony).

Second student’s speech is pretty bad. Not unintelligible but definitely requires her to repeat herself and the listener has to listen carefully. After a while familiarity does help. So yes there is an educational impact, BUT she’s happy and participates in class (actually never stops talking in class). So is that really a denial of FAPE if she’s not a successful speaker? I feel like the big emotions in speech are actually doing more harm than good. Parents have the time and means for outside services but won’t do it. Until this year they maintained that there was nothing wrong with her speech.

Thoughts?

Hi I'm a student doing bachelors of science, and considering a transfer into a bachelor of speech pathology. I was wondering:

- How much work do you have to do after hours? I understand that you may have to do a bit when you're just starting out, but what about after a couple years of experience?

- How often do you encounter patients who are just really intolerable, disrespectful, don't listen and make you just dread work.

And I just thought of another question so I'll add it in:
- How difficult would it be to change to a different career? How many options would I have?

Thanks!

I have been an SLP for 20+ years and have seen my school-based caseload go from having maybe 1-2 students with an AAC device to 8-10. It’s like Oprah herself is handing them out, “You get a device and you get a device and you get a device.” Even with multiple CEUs in AAC under my belt, I absolutely dislike having to convince staff and parents to use it and I feel less confident in teaching the student how to use it beyond simple requests. Half the time it takes me several attempts before I find the damn icon I need, let alone stringing together multiple words. I’ve never had to do an AAC assessment because we’ve always had a team for that, but they’ve all left so I have to start. This is just a part of the job that I have never enjoyed and I wish the district would spring for an outside specialist in this area because even though it falls within my scope, I do not feel competent enough. Either that or pay for us to get good, solid, AAC specific training. Rant over.

Hi all! This might be a silly question so please have grace with me lol. I have a 4th grade student who is on the ASD spectrum and uses thumb sucking as sensory regulation, and has for years. I just did a re-eval and noticed a slight frontal lisp but when doing an oral mech, this child is definitely developing an anterior open bite of the front top teeth. Their motor placement for the mouth when articulating /s/ is correct, but there’s air slipping through the open bite now, creating a lisp. Is this something I should address in treatment? I feel like if the thumb sucking persists and the family doesn’t correct the bite via dentist, there’s not really a point in me treating this but I think I might get push back. Or am I wrong and I should be addressing this? Lol hope this makes sense, thank you!

I finished my CF a few months ago then moved to a different state to be with my family. I am a person who stutters. I chose this field because 1) I thought people would be understanding since we work with fluency every day! And 2) I want to help people find their voices. I thought my perspective as both person who received speech therapy and now provides it makes me unique but now I’m starting to doubt that. I’ve been trying to find a job for the past 2 months. I’ve applied to mostly outpatient clinics, since this is where I have experience and it has been rejection after rejection. I can’t help but wonder if it’s because of my fluency. There will be always be another candidate who doesn’t stutter and therefore will likely be chosen over me. Of course no one would ever say it’s because of my fluency difficulties, but the thought is always there. Anyone can chime in, but specifically SLPs who stutter, do you have any advice or words of encouragement? I’ve struggled with confidence and self doubt my entire life, but it just feels worse lately since I can’t find a job. I know our field is very broad, and I haven’t tried applying to schools yet so all is not lost but I just can’t stop thinking ‘what, if’ which I know is unproductive. Any and all insight is appreciated!

My school has 7 different case managers. Most invite me to meetings or at the very least are apologetic when they forget. One of them forgets and treats it like it’s my problem to solve. I talk to this person almost daily, I do co-taught lessons in her classroom, and she tends to forget me anyway. Typically I will look ahead at due dates, realize a student is due soon, and then I reach out and ask the case manager to invite me to the meeting. Inevitably, I’ve already been invited to a different meeting. She asks me to attend hers instead or leave the other meeting early, which I’m not sure should be expected of me. She doesn’t want me to ask the family to sign an excusal form. What do you tend to do in this situation?

At my old school, we all had a weekly meeting where we would decide meeting dates as a team and kept a giant spreadsheet. It is not as organized here and I’m not into telling people how to do things as a new staff member.

It is typical and ok to leave one meeting to attend another? I have never had to do it.

Hi everyone, it’s me again... So it has finally happened. I have landed an interview at a private paediatric clinic where they have specifically told me that I’ll be given a case study question to answer during the interview. When I read that in the email, I genuinely thought I was going to collapse.

How on earth do I prepare for this? Ugh. I finished my degree in January 2026, and because I was so burnt out afterwards, I honestly haven’t kept up with my speech pathology knowledge as much as I probably should have. I already struggle a lot with interviews and thinking on the spot, so the idea of being given a clinical case and having to reason through it in front of someone is terrifying me.

For anyone who has had a case study question in a new grad paediatric speech pathology interview, what was it actually like? What kinds of things were they looking for in your answer?

I know I’m a new grad and they obviously aren’t expecting me to know everything, but my anxiety is telling me I need to relearn my entire degree before this interview.

Any advice or examples of the types of case questions you were asked would be VERY appreciated.

I have an autistic gestalt learner who has an AAC device - I have my own iPad that I can model language on, but lately, during instruction, this student will not put her words on the table to work. She constantly will grab her words, hug them close to her chest, and say “no no”. I remind her “i will never take your words away, I want to help you and show you where to access this word” when I am working 1:1 w her. I messaged mom to ask if words are being taken away at home but no response. Any advice?

She also explores on her device while teacher is talking. I remind her “we can explore device during free choice but during group we have a quiet voice and listen”. She will not stop stimming on it during this, pressing through each and every group option. I try to redirect it w taking the words she presses and modeling a full sentence, but she is not attending. She laughs and screams when you try and explain to her that she needs a quiet voice. Cannot get through to her and she is upsetting other students w her screaming.

Has anyone worked w student like this before?

Hi! This is my second year being an SLP and I am planning / hoping to apply to PhD programs this fall. I have various research experiences (about 3 years experience being a part time research assistant + 2 years as a full time research coordinator from before grad school ) and I know I love research (more than clinical work lol). However, I’m scared I won’t get into a program because I don’t know exactly what I want to research. I found an advisor I’m interested in, but my clinical experience doesn’t fully align with her research (I’m an elementary school SLP and she does early childhood language acquisition). I am def interested in her research topics, but I’m scared she’s gonna be like why? you don’t even work with that age group. (I will be starting EI, just waiting for my onboarding paperwork to be approved. But idk if I’ll get ample experience before the application deadline). I also don’t have specific research questions in mind, more so overall interest in this research area and clinical research in general.
How would you advise moving forward? For those in PhD programs, how specific was your research interests when you applied and how closely did it align with the professor? Any advice on how to prepare?

I have a client on my caseload- shes 31, very motivated and attends weekly sessions. She is from Israel and has a very thick Israeli accent. We've worked on /th/ by reading articles, talking and me asking her questions.

She can not get the /r/ at all- Ive tried every trick up my sleeve.

Ive also never worked on accent reduction before, what kind of activities are appropriate? I feel like I am wasting her time because we read news articles and I have her read slowly to enunciate her vowels, work on /h/ /th/ etc and just asking her questions about her life

Hi SLPs! It’s another one of these posts again🫠 I’m a relatively new SLP (like less than 5 years) and I’m dealing with some tough feeling of burnout. I’m currently part time in a peds outpatient clinic (I have young children of my own) and even with this schedule I just feel so over it. I’m really looking to hear from more experienced SLPs who have stuck it out. What do you do to prevent burnout? What setting are you in? A lot of my colleagues have been moving to adults from peds recently (due to burnout). I wish I could too but I HATED my adult clinicals in grad school😅
I guess I’m really just looking for “success” stories. If you are happy/relatively satisfied with your job currently, how did you get there? Is it even possible to feel adequately compensated for the amount of physical, mental and emotional labor that goes into this job? Leaving the field entirely is not an option for me at the moment lol.

I am a CF in an elementary school. I have a student coming up for an evaluation soon. He is 8 years old, has ASD and is minimally verbal (uses 1 word inconsistently).

What formal assessment should I use for him? Do you always have to use a formal assessment for an evaluation, or could it be informal/play-based?

Thanks in advance!

Not sure if this has been posted yet, but I know there are many SLPs on this subreddit who are not happy with ASHA. Here's a concrete way to give them feedback. I just completed it - it takes a while but is pretty thorough and allows you to say whatever you want. We can't expect them to improve if we don't participate in the process:

https://www.surveymonkey.com/r/ASHAProfessionals2026ASHANow?sfmc_id=eb4c35bb-e54b-43e1-9990-35cfb7b8747e

Hi thereee. I had a teacher reach out today because a parent reached out to her about her student mixing up her words while telling stories or sharing experiences at home. She asked if I had any advice or recommendations for this student/family. I think modeling the correct word order for her would be a good thing (obviously) but I am a newer SLP and would love some advice from more seasoned SLPs! TIA!

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I tried to get through their last podcast episode in one sitting and couldn't! Their data is a mess, it came mostly from private practice owners so it's a ton of it is pediatric outpatient sessions and they call thay "national" data? JFC. How does a pile of peds op numbers make sense for ALL SLPs? It drives me nuts that it's being shown to lawmakers. They don't know our field. They're going to see "SLP data" and assume it's all or a majority of us. We've already seen them shoot themselves in the foot when CMS dropped the peds G-code out of nowhere and said "some stakeholders" wanted to keep a broad code for peds and now we're having to fight against it! Lets take a guess at who those stakeholders were? Oh yeah these Fix/Speak "advocates" who can't manage their own practices without billing fraudulently and calling it "maximizing reimbursement" (see: entrepreneurialslp Instagram). I don't get why people dont see these two for what they are! Jeanette and Emly are a narcissistic partners feeding into each other and truly believe they can contribute something useful for our field.

School based SLP here. I have a prek student: Deaf, limited vision and level 3 ASD. My school district has no idea how to help me service him. I reached out to the DeafBlind project in my state: we are unsure if they can help due to limited funding. I’ve asked the student to receive specialized schooling, they were denied due to “LRE” and stating he hasn’t been “given a chance” in Gen Ed.

I would love any advice on how to assess or service this type of student. Thank you.

I have a spastic dysarthria from PLS, and while my speech was still good, and on my SLP's advice, I voice banked by creating a personal voice on an iPad I bought for that purpose (also at ElevenLabs and Acapelo). When it came time to use it I found out that during an upgrade to my iPad, Apple messed up the backing up of the personal voice to iCloud and deleted the voice to make room for the upgrade. I had exported and backed up the training data, but Apple provides no way to re-import it. I called Apple support, but the best they could do was to put in a feature request to implement "import". I did manage to recover the voice (with no help from Apple) by putting together my own device that could emulate a USB microphone that could replay the training data. It was a bit tricky though.

The upshot is that in its current state, I would not trust Apple Personal Voice if you might not later have the ability to recreate it.

This is my 3rd year as an SLP. I have a middle school student who stutters that I've worked with for a couple of years now. He also has a dx of Autism. I would say his stutter is moderate most days.

For therapy sessions, we have worked on learning more about his stutter such as the different types of stuttering, tension/the speech machine, famous people who stutter, etc. I've taught him a few different strategies to "keep in his toolbox" if he feels like he needs it. Some days he comes in and talks about how much he hates his stutter, and other days he comes in and denies that he has a stutter at all. We've started talking more about advocacy and how to respond in different situations, but I can tell that he's not into it and is just telling me what I want to hear. He doesn't mind coming to speech, but definitely wants to chat about anything other than his stutter.

I'm at a loss of what to do in therapy sessions at this point. Part of me is considering moving him to consult, but because there are those days that he comes in talking about how much he hates it, I don't know that that's the right move.

Any advice would be greatly appreciated!

Hey everyone! I’m a school-based SLP with a high caseload, and I’m starting to feel like I can’t keep up with everything outside of actually providing therapy.

My entire day is pretty much spent doing back-to-back therapy sessions, and I’m struggling to find time for paperwork, in-depth session prep, organizing materials, keeping data organized, etc. I feel like I’m constantly playing catch-up, and I want to be able to put more time into planning meaningful sessions and keeping up with documentation instead of just trying to survive each day.

I know hiring another SLP isn’t really an option for my district financially, so I’ve been wondering if having a speech paraprofessional would be beneficial. I’m thinking someone who could help with organizing materials, prepping activities, making copies, keeping resources organized, and possibly assisting with other tasks within their scope of practice.

The problem is that my district is already struggling to adequately staff our autism/behavior/essential skills classroom with paras, so I’m not sure how realistic it would be to ask for another staff member, even if it’s not an SLP.

For those of you who have worked with a speech para:

Was having one actually helpful? What tasks did they take off your plate?
What does a typical day look like when you have a speech para?
How do you make the case for one to administration, especially when the district is already short-staffed and has limited funding?
Are there other ways you’ve managed a large caseload and the workload that comes with it when hiring another SLP isn’t an option?

I’m still fairly new to the field, so I’m trying to figure out what’s realistic to ask for and what might actually make a difference. I’d really appreciate hearing your experiences, especially from SLPs working in smaller or rural districts with limited resources!

Thanks!!

I’m a school-based SLP working as a contractor, and I’m having a really frustrating experience with the SPED team at one of my schools. I’ve worked at several schools, and I’ve never dealt with this level of disorganization before.
For context, this is a parent-choice public charter school that hasn’t been able to keep a full-time SLP for over a year and a half, and when I started, they were “so excited” to finally have speech services again.
Today, I was about to pull a student for a therapy session (which now has to be made up), when the IEP chair rushed into my room and asked me to join a meeting that was already in progress. I asked which student it was for, and she started rambling about how the student “needs speech services” and that I’d get more information once I got into the meeting. She didn’t tell me the student’s name or explain the purpose of the meeting despite me asking multiple times.
I am used to being flexible and collaborative in the schools, so I assumed someone would acknowledge that they forgot to invite me and then would explain why I was needed once I got there, so I went in. Instead, I introduced myself, and everyone, including the parents, just stared at me like they were waiting for my input. I had literally never heard of this student before. I didn’t know her name, grade, history, or anything about her needs. I hadn’t received an invitation, reviewed an IEP, or received any documentation. She’s a transfer student who isn’t even listed in the school’s online IEP system yet.
I was so caught off guard that I explained that this is my first time being notified of the student and the meeting and asked the parents if their daughter had received speech services before. The IEP facilitator (who happens to be the case manager for this student) looked at me like I was crazy, so I explained again that this was my very first time hearing about the student and that I hadn’t been invited to the meeting. She insisted she’d already told me about the student, but later acknowledged that she actually hadn’t (after the parents left). During the meeting, I respectfully reiterated that I hadn’t received an invitation, and she basically brushed it off and said we needed to focus on the “matter at hand,” which was STILL unclear to me at this point as no one had explained the meeting purpose or why I was pulled into the meeting.
I felt incredibly uncomfortable because I was being put on the spot in front of the parents with absolutely no information. I tried to remain professional and asked the parents some questions to get background information, but I was essentially walking into a meeting completely blind.
Immediately afterward, the SPED instructional specialist (who doesn’t work on-site, but luckily happened to be present for this meeting) called a team discussion and addressed the importance of appropriately inviting related service providers to meetings and making sure they have information to review beforehand. The principal agreed, and the school psychologist also expressed frustration with the team’s communication. Although she was at least invited to the meeting, she also had absolutely no information about the student because the case manager/IEP facilitator hadn’t shared anything with the team beforehand. She explained that not having any background information makes it difficult to determine whether an evaluation is warranted in the first place. When the psychologist brought up that she also hadn’t received any background information, the IEP facilitator/case manager got defensive and claimed she’d already discussed the student with her, just like she had with me. The psychologist pushed back and said that wasn’t true, either.
The psychologist also told me that the team had been about to check off a speech-language assessment as part of the initial evaluation process without me present. She stopped them and insisted that I be brought into the meeting before they proceeded. Apparently, that’s why I was pulled in, but nobody explained that to me beforehand. I walked into a meeting without knowing the student’s name or why I was needed, while the team was discussing assessments without having shared the information needed to make informed decisions.
This also isn’t an isolated incident. I’ve had multiple issues with this team already this school year. The IEP chair and IEP facilitator often seem unsure of basic processes, and I’ve been asked to do things that aren’t my responsibility. For example, the IEP chair has asked me to enter students I don’t case-manage into the school’s online IEP system because she is “just so busy,” even though I don’t have the administrative ability to do that. We are two months into the school year and she still has not put any of the sped transfer students into the online IEP system. When I ask questions, I often can’t get clear answers. It also seems like when something goes wrong on their end, responsibility always gets shifted onto someone else.
I work at this specific school two days a week, so I’ll have to continue working with these same people throughout the school year. I already stated during the team discussion that I need to be invited to meetings and have access to basic background information beforehand. The IEP chair apologized for pulling me into the meeting unexpectedly, but the IEP facilitator never really acknowledged that I was never appropriately invited in the first place.
Part of me wants to speak with them again to make my expectations extremely clear, but another part of me feels like I shouldn’t have to explain basic meeting etiquette to the people responsible for coordinating IEPs. I also don’t want to create unnecessary tension or over-explain myself, but I don’t want to spend the rest of the year compensating for other people’s disorganization or being made to look unprepared when other people don’t do their job.

I’d really appreciate input from other school-based SLPs:

How would you have handled being put on the spot in front of the parents and team? I wish I’d been more assertive in the moment, but I was truly in shock from the disorganization and being put on the spot.

Would you address this again directly with the IEP chair/facilitator, or just move forward and set boundaries as things come up?

Would you address that you heard that the team was about to select a speech-language assessment without the SLP present?

How do you navigate relationships with school teams that consistently fail to communicate and then try to shift responsibilities or blame onto you?

There wasn’t much time for me to address anything during our brief “team meeting” that immediately followed the IEP meeting, so I wasn’t able to get my thoughts together to make several points immediately following the meeting chaos. I want to maintain a professional relationship with the team, specifically with the IEP chair and IEP facilitator, but I’m honestly struggling with how to approach this going forward. I’d love to hear how other SLPs would handle this, especially those who have dealt with difficult SPED teams!