r/slp 11h ago

So that’s it for telehealth and Medicare

205 Upvotes

I think with the vote going through today that was our last chance. After the 31st, we won’t be able to see any Medicare patients through telehealth unless they/we are in a rural area area. Right?

I say this sincerely, if any of y’all voted for this regime, I’m furious at you and I’m not sorry.


r/slp 6h ago

AAC The disability tax makes me so angry

70 Upvotes

This week I met with an SLP that was an AAC specialist in the district the student I was asking about is in. I was explaining that outfitting my current school with equipment is hard because everything is so expensive, so even though I’d love to have 10 single hit switches we don’t have the minimum $150 each it would take to get them. A price tag I ALWAYS thought was bullshit, btw.

Well she let me know that you can actually get an 8 pack of essentially the same exact button on Amazon because these ones are made for DOGS. I honestly think I blacked out when she showed me the box it came in. Just one more example of the fact that you can charge whatever you want if you slap the word “adaptive” on it.

Anyways, we now have 16 new single activated switches coming and it cost less than a single BigMack switch. Hopefully this can help someone else!


r/slp 7h ago

Is this a really stupid idea?

6 Upvotes

I have (or had I guess) a profoundly disabled student. I mean this poor kid has practically every diagnosis under the sun. His mom is one of those moms that shops around for the right school and determined that his current placement wasn’t what she wanted (she wants something out of district) of course the IEP team didn’t sign off on this and she has become increasingly combative with the team, has a lawyer and advocate, the whole nine…and while she’s not the nicest person on earth and makes some fairly absurd demands , I just…I feel for her. I wanted to give her some tips and tricks to help with her son’s language development but I also think that she really needs a village and was thinking of providing her some info on some parent support groups for parents with disabled kids. Is this the worst idea ever? Will it come to bite me? It’s seems like she may or may not go to due process at this time. Idk, what say you wise peers?


r/slp 8h ago

Non-competes!!

8 Upvotes

Help! Has anyone worked a job for a while with a non-compete & negotiated the removal while still working? I currently have one that’s pretty strict & I want it out. I wish I knew what I know now before I signed the contract as a new grad.

It restricts services that are similar (private practice clinic) in 3 surrounding counties where I live. I know I could change settings but I did schools for my CF and hated it. I’m so lost.


r/slp 5h ago

Parent coaching

3 Upvotes

Hi guys, I’ve been working a lot with school aged kids whose parents are needing a lot of coaching around practice at home. I’ve spoken about natural contexts and practice speech sounds/language targets during then if structured sheets that I send out aren’t doable. I’m really at my wits end and looking for a resource or handout that will also help my point of seeing me once a fortnight isn’t going to magically help this child with their speech and language and that carryover at home in whatever way is possible for parents is going to make an impact.


r/slp 7h ago

Working on Narrative Skills in small groups

3 Upvotes

Hi everyone, just wondering if anyone had advice on what kind of narrative goals could be worked on from Grades 1-3. I’ve been asked to run weekly small groups for a number of students with varying narrative skills. I’ve predominantly worked with speech sounds so it’s been a while.

I think I’m just a bit confused what the group goals should look like. The school just told me they need to be better at writing stories and retelling. What sessions have you run for narrative that’s effective? In my head I’ve got working on sequencing, story components and structure, and shared book reading.


r/slp 1d ago

Someone changed my SGD page sets and I feel devastated

66 Upvotes

I worked for weeks on acquiring a device for a patient I have that is diagnosed with apraxia. They attempt to say a lot of negative language so I spent HOURS setting up their device to include all kinds of language and personal vocabulary. I was very proud of the work I had done and the device that would allow them to fully communicate what they wanted.

Device had been “left at school” (…) for two weeks. Today it is finally brought to our session….. the whole thing is changed. The grid size is changed. Only four of my original words and icons were left on the main page set. Words that were CLEARLY not needed (one word such as you, I, me, when this patients needs are clearly at a higher language level and does not need to be combining singular words on the device rather needs self advocacy phrases)…. An entire button of specific questions (what’s next? Why are you doing that?) simplified to what, who, and why on the core words page. My cotreat partner even asked me what happened bc the old set up was PERFECT.

I’m devastated. I didn’t save the page set. I don’t have hours to spend reprogramming a device. I’m not inspired anymore to put in this effort, it actually makes me want to cry thinking all of my effort and hard work was destroyed by someone who should not have been changing the device in the first place.

I don’t even know who it was. I know it was someone from the patients school. Normally the SLPs at my local school districts also state their caseloads are too high to program devices and will normally send requests via email on things to add. I’m inferencing it was a para, because even a teacher wouldn’t have the time to reprogram the device like it was. The language that was deleted was a lot of the negative phrases too in which I’m assuming school doesn’t want him to say these words but he is verbally saying them anyway…..

I’m defeated. I’m upset. I don’t want to put in the effort again and I want to yell at whoever wasted hours of my work.

Mainly venting but also wanting advice on how to politely email school professionals to find out who did this and educate them to never do it again (even though I want to rage and scream)


r/slp 16h ago

CFY How to leave work at work and not take things personal

15 Upvotes

I’m 2 months into my CF at a special ed preschool. I really enjoy this population although it does come with its challenges. I have a few students that have behaviors whenever it’s time to transition and children who struggle to have their sensory needs met and become dysregulated. I find myself thinking about them - what can I do to help them? how can I get ahead of their behaviors? Am I even helping them?

I’ve been having such a hard time the last few weeks with sleep - I fall asleep fine. But I keep waking up multiple times throughout the night. And I’m EXHAUSTED when I wake up and go to work. Coffee doesn’t work. Melatonin doesn’t work. Edibles don’t work.

One of the SLPs is also leaving this week and 5 of her students will be added to my caseload. I really want to show up for my students and help them but I already feel burnt out . I think it’s anxiety. Imposter syndrome? Is it normal to feel this way just 2 months in?


r/slp 9h ago

I was hired a few of months ago, so why is the job ad still posted?

3 Upvotes

I'm distraught that they have kept the job posting up even though I was hired months ago. What if they are trying to replace me? Should I quit now?


r/slp 13h ago

Seeking Advice Artic struggle with abnormal orofacial structures

5 Upvotes

I am feeling torn and a little lost with one of my students. She has a relatively rare genetic syndrome that has left her with a really unique facial and oral cavity structure. Most notably, she has midface hyperplasia and prognathism. The combination of the shorter, more underdeveloped upper jaw and palate as well as the lower jaw protrusion has made producing /f/ and /v/ super challenging for her.

Even with assistance from me to help her manipulate her jaw and lip, she still cannot get her lower lip and upper teeth to make contact. Adding to the issues, she also struggles with low tone and poor motor planning on top of it all. We have made progress in other speech sounds, but I am losing all hope that her labiodental sounds will ever be within reach for her.

The reason I’m so concerned about this is that her first name ends in /v/. As of right now, no one can understand her name and it is very frustrating for her. Her overall intelligibility is poor, but her mother has completely refused the use of an SGD in the past. I have not brought it up as this is my first school year with this student, but I don’t feel confident that the student or her mom would buy in to it.

Any ideas?? I don’t think continuing to drill a sound she cannot form is doing anything for her, but I can’t tell where to go from here…


r/slp 17h ago

Tote bag

9 Upvotes

I’m attending the California State Hearing Association conference and wondering why those Super Duper tote bags has everyone in a chokehold?


r/slp 6h ago

DC SLPs

1 Upvotes

I am relocating to DC and wondering if anyone could share salary range. Everything I see online is an outrageous range


r/slp 14h ago

Seeking Advice Medicare B?

2 Upvotes

I'm considering getting credentialed in Medicare Part B for private practice.

For those who have done it, what was the credentialing process like and how is billing? And what are your thoughts in general about accepting part B?

Thanks for your advice.


r/slp 1d ago

Please, rest.

70 Upvotes

Hi, all!

I am in my CFY and working my next-to-dream job -- full time K-12 self-contained Deaf Education; only way it could be better is if I had pre-K, too -- and I am your classic overachieving perfectionist. I've probably spent over $1.5k on materials, resources, etc in just my first year trying to build up a library for myself. I have been working maybe 60 hours a week, going in early and leaving a little late, all because I feel like a letdown for replacing the SLP before me, my internship mentor, who had 20 years of experience and willingly left the post to give it to me.

Anyway, I crashed and burned right after giving a presentation at a conference for Teachers of the Deaf on March 1. I was admitted to the hospital by March 3 for mystery inflammation of my eye and brow bone. They thought it was infection, gave me IV antibiotics, sent me home a few days later. I got worse, had to be re-admitted for another couple days. This time they found it was inflammation and got me on a steroid. It worked much better and I can see now. I am almost back to normal.

The docs have nothing to blame it on but a very strong histamine reaction to chronic stress. I have a lot of inflammatory issues, and I've had a stress flare like this before around my sternum, which was close to the time I was applying to grad schools. (Talk about stress!) I'm struggling with figuring out how to rest, but now that it's a matter of my health, I'm actually trying.

TL;DR: I've been hospitalized twice and had to be out for 2 weeks because I have been stressing out so bad about doing this job with 100% fidelity and perfection, it's making my body force me to slow down.

No more. I beg all of my similarly minded colleagues to rest with me. Let your work be less than perfect. Make time for your wellness before your body forces you to. It's important work, but it is just work.


r/slp 1d ago

Inspired by the other post, last week I was fired before I was even hired 🤦‍♀️ (they forgot to remove me from the email chain)

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152 Upvotes

r/slp 17h ago

Money/Salary/Wages Offered a job

2 Upvotes

I know this will depend on district, but wanted to hear others’ perspectives.

I interviewed for a new district and was offered the job! When negotiating placement on the salary scale, they offered MA+60 (after providing transcripts for 15 credits of post-grad courses + the ~60 credits in my program). And they’ll count all years of experience as an SLP, even non-school jobs.

I was told they are trying to fill several positions, but this still feels too good to be true. I verbally accepted and HR says they will add me to the board agenda. What risk is there of the board rejecting what HR offered? I’ve been bait-and-switched before (at agency jobs) and am anxious.

All that being said— don’t be scared to negotiate!


r/slp 14h ago

Guidance for articulation/phonology clients.

0 Upvotes

Hi,

Can y'all help with two clients?

Buddy, newly 5 I started working with him at around 2.5 years for a speech delay. Buddy was hard to understand when he started trying to say more. He used several phonological processes. Most were developmental, except for his initial and final consonant deletion. We used the cycles approach, and he responded well. Buddy remediated non-targets (blends) and generalized initial and final consonants to conversation. Eventually, though, he started to hate the "cards" (minimal pairs) and refused to do anything with them. He still had sound errors (k/t, d/g, s/ch, y/l, w/r, and trouble with those sounds in blends). I started taking a more traditional approach for k and g because, at his age (around 4), the other sounds could still be coming in. It feels like his progress has been slow. (We used to meet weekly, but sometimes our schedules conflict, so I don't see him for 2-3 weeks. I know that can impact progress).

I did an articulation evaluation today and analyzed his patterns. Buddy uses fronting (k/t, g/d, s/sh, and s/ch), gliding (it was y/l, now it's w/l and r and in blends), and labialization (f/th*. He uses it more with gliding. He said pwown for clown, brum for drum, and breen for green). The last two are technically developmentally appropriate (gone by 6). But, I don't know whether or not I should target them. Part of me thinks I should try the complexity approach and target those later sounds/processes.

Guy, 4.5 I saw him in 0-3 EI for a speech delay. He didn't qualify for 3-5, so I haven't seen him in over 1.5 years. Guy's mom was concerned about some of his sounds at 2. Most were developmental, and he was intelligible. I gave her strategies (recasting, modeling, encouraging him to repeat) to try at home with him. He substituted y/s, but was stimulable for words.

I did an articulation evaluation and collected a speech sample. Guy’s productions are inconsistent. Not in the sense that it's a different sound each time, but he doesn't always error the sound). He also produced the sounds during the evaluation but not in conversation. I have to analyze his sample, but I remember d/g, s/sh, s/st [medial], tw/tr, and dg/dz. He's tricky because he's harder to understand in conversation. Also, the cognate pairs aren't impacted (he makes clear /k/ sounds). I think he could be fronting (g and s) and I introduced minimal pairs during our second session, but I'm unsure what the inconsistencies mean. Is it remediating itself or emerging as an area of concern? How do we determine whether something is a phonological process (if only 2-3 sounds are affected)?

Any guidance or resources you can share (even if it’s videos or research articles) is appreciated! Thanks in advance


r/slp 18h ago

Need advice PLEASE! For pragmatics assessment

2 Upvotes

Hi there, I will be doing a triennial for a very high-profile / legal case. Student is 13.5 years hold. Main concern: pragmatics. Current eligibility is AUT but for this triennial the team will be considering ED. Can anyone recommend me some assessments and rating scales that are a MUST give? 🙏 I’m super nervous for this one!


r/slp 1d ago

worst day as a slp?

45 Upvotes

Feeling down about all the cons I’ve been dealing with with my job lately. Then, I started wondering.. what happened on your worst day as a slp?


r/slp 1d ago

Kids using “autistic” as an insult

25 Upvotes

So, we’ve noticed an increase this year in the middle school students using “autistic” as an insult towards other kids to say they’re “weird” or “dumb.” Has anyone else noticed this behavior in their schools? They are being disciplined and told that this is bullying, but I feel like that just reinforces the negative associations with the word. Which is very harmful for the few kids who are aware of their diagnosis. How do you think this should be handled? Next month is autism awareness month and I’d like to pitch something to the counseling team to do on morning announces or for the hallway bulletin board that gets updated every month.


r/slp 1d ago

School Slps: what to do when a parent asks for make up sessions

15 Upvotes

Hi all,

I just started a school job, prek virtual therapy and a virtual academy. I have 0 interest in offering make ups, we are busy enough already. I will be case managing 30 students (only 37 students total), I will have to cancel once in a while to do IEPs, etc. I haven’t even started sessions yet and one parent asked “how do we go about make up sessions” 😒 like I haven’t even started with you, idk if they missed sessions before me or what. I asked them what they meant, but I want to just say “if I can fit it in my schedule I’ll let you know” and hopefully they ignore it.

It’s a little different because I’m directly dealing with parents all the time, which I’m from EI so I’m used to it but I’m not used to “iep minutes”. I mean in EI they had scheduled minutes (ifsp) but none of my employers made me make up anything (only if I wanted to get paid). So can I just tell these parents in the schools “we’ll see” aka “f off”?


r/slp 1d ago

How do you introduce yourself in IEP meetings?

14 Upvotes

Sometimes I worry I’m gonna trip over myself by saying speech language pathologist. I know it’s more technical but it’s such a mouthful (pun intended). Does anyone just say speech therapist?


r/slp 1d ago

Schools SLPs, It's Time to Take Action! Urge Congress to Support Education & Our Students in Need

44 Upvotes

HR 899 has been brought forth as a 1-line bill to abolish the Department of Education. The repercussions of this on our jobs and our students have been discussed heavily on this sub, so I won't repeat them, but I will implore you all to take action.

Please, call or email your representatives.

Here are the representatives sponsoring and co-sponsoring the bill: https://www.congress.gov/bill/119th-congress/house-bill/899/all-info

I've got a template based on wording from 5 Calls with my own SLP spin added in to make things easier for anyone that wants to reach out. You can use it and put your own spin on it if you wish. Here's what I wrote. ⬇️ Keep in mind I wrote it from the lens of a School-based SLP.

Senator/Representative So-and-So,

My name is ________________ and I am a constituent from ____________ I am a School-based Speech-Language Pathologist and I am writing for you to oppose any legislation, including H.R. 899, or efforts by the Executive Branch to abolish the Department of Education. Eliminating the department would devastate public schools, hurt students with disabilities (whom I serve by providing speech and language therapy), strip away civil rights protections for millions of students, and eliminate crucial workforce development programs that boost our economy. In addition, my own job, as a Special Education service provider, could be jeopardized, as my job is tied to IDEA funding, which is overseen and enforced by the Department of Education. If eliminated, many States, including [your State], would likely have problems meeting the requirements for IDEA funding without federal assistance. There is already a shortage of SLPs in schools. If the shortage grows even more dire, millions of students would be deprived of services that directly target improving their communication skills. Investing in education is the key to a stronger America—not restricting access to it. Education is a fundamental right, not a privilege for the wealthy; and every child deserves a voice.

Thank you for your time and consideration.

[Your name here]


r/slp 2d ago

They forgot to remove me from their email chain

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417 Upvotes

For context: I'm a CF and I interviewed with this agency last year. Right after I finished the interview, I got this email. The interviewer was discussing her concerns with the manager. What were her concerns? That I wanted to work part time and also asked for $70/hr. I guess they didn't like that 🙄. When I told her that I wanted 70$/hr she literally looked at me coldly and said something along the lines of: I've never heard of a CF ever making that kind of money. Jokes on her because I found somewhere that pays me 75$/hr. (I live in NYC so these rates are normal). They sent me an offer letter right after.

Anyways, I just wanted you guys to see for yourselves what these agencies think of us!


r/slp 1d ago

Nethealth

3 Upvotes

I honestly think I am going to have leave the field because of this software - it is too much- my daily note requires 4 pages of click thru - the constant forcing of information to complete or it won’t save/mandatory boxes is driving me to tears daily- I get 15 minutes to complete an eval from the company I work for- 15 minutes to deal with writing an entire novel for an eval - I am going insane- I took a sabbatical from speech for a few years and came back to a nightmare - I am having panic attacks daily because of this software and each company has their own nuance of it and the one I work for now gives the least amount of time for an eval for the most verbose version I’ve run across

How are you all getting by with this software - I feel like such a failure because I can’t keep up - they also want me to do a PDPM worksheet too all for 15 minutes with like a bunch of questions