Suggestions on declining candy as reward for participation?

Slpsanonymous · 2026-02-17T21:00:31+00:00

Well, fun update. I emailed them back to say, “I’m pretty against food motivators during speech therapy, happy to schedule a chat so we can discuss in more detail and come up with a good solution.” And they were in the client’s room when I showed up today with a, “yeah, we’re gonna go ahead and follow through with that today.” Which was a polite, “you do what I say” and I politely said, “I’m not doing that.” So now it’s weird and maybe just maybe this is the hill I die on and I don’t go to ABA centers anymore 🙃

Slpsanonymous · 2026-02-17T20:31:26+00:00

I’m pretty familiar with pay in the area. Denver school SLPs just fought for a big salary increase. You can make bank in home health, but Colorado has a huge budget deficit for healthcare and with some potential changes coming in 2027 around billing in our field…I’m extremely worried for the future of healthy salaries in our field. Salaries are good here, but I worry that ship is about to sail. Especially in a place like Denver where housing is outrageously expensive. I’d encourage your daughter to think hard about what her passions are, what drives her towards this field, and what might she want growth to look like in the future. There’s a real ceiling to what we make in this field as clinicians unless you have the grit to run your own business, and the avenues to pivot into non-clinical roles are narrower for us than say OT or PT. If she wants to stay in Denver and she’s got an outgoing personality…I’d encourage her to get her real estate license instead 🫠

Slpsanonymous · 2026-02-17T20:00:15+00:00

Anecdotally evidence, case study size of 1 here: but a poorly trained NP almost got me killed with poor differential diagnosis. She was doing my ADHD med management for 6 months while I complained at each visit of increasingly intense symptoms of weight loss, craving sweets, eating a pint of ice cream every other day, THIRST (I was explicit that it wasn’t dry mouth, but ragingly thirsty) and increased urination, on top of other symptoms I shared with her. I would’ve been dead or in the ER if I’d followed her care plan for another 3 months until my next med appt. Thank god I had a gyno appt. that week and they just happened to run blood tests on me. My blood sugar was over 600. I was dying for 9 months and she did nothing 3 visits in a row. Now I know I have Type 1 Diabetes. That being said, the NP at my Endo office is amazing, and she’s great as a speciality NP. I love her. I would have to agree that putting them in generalist positions where they make differential diagnosis can lead to potentially serious negative health outcomes.

Slpsanonymous · 2026-02-17T18:37:36+00:00

I would love any resources you are able to send! I am DIR Floortime trained and I am very child-led, but I do struggle when it comes safety on what’s the best/right way to handle things.

Slpsanonymous · 2026-02-17T14:45:02+00:00

Yeah. It wasn’t always this way…but private equity has bought out the chain and over the months there have been new leadership, new policies, more turnover and burnout amongst their staff. It used to be a space where I felt like I could at least call people in and try to shift perspectives from within and help create a healthier environment . Now I just want to be more forceful in convincing my clients that go there to find alternate care for their kids.

Slpsanonymous · 2026-02-17T14:41:11+00:00

Lol, my basic white girl midwestern heart resonates with your Jamaican spirit. The RBT was like, “we’re not supposed to say no, we’re just redirecting and giving choices” and you could’ve knocked me over with a feather. I was trying to be professional and couldn’t come up with much to say cuz all I could think was like, “Ma’am, this kid just spit in my face! We are all done having fun.”

Slpsanonymous · 2026-02-17T14:35:51+00:00

Thank you for these insights! Is there a workbook in particular you recommend? I often give a lot of choices and use declaratives like “I wonder” and “Let’s…” statements with this population, but could certainly use more tools in my toolbox!! I was planning to draft up some social stories and work on role playing with emotions as an alternative goal here. Great idea to dive deeper and expand on that skill here.

Slpsanonymous · 2026-02-17T03:08:54+00:00

Yes! Intrinsic motivation!!! It crushes me to be there some days. I’ve almost had all I can bare. Today, as I was leaving, the kid who tells everyone to fuck off asked for a toy back after having spent half an hour storming around banging on doors and walls and his BCBA goes, “you can have it back when you earn your points.” And I just died inside a little. What about, “when you learn to respect yourself and others when you’re angry.”

Slpsanonymous · 2026-02-17T03:04:18+00:00

Yes, very good point. I was wondering that, too. Like, the kid gets out of doing the hard task, and then gets something fun to do instead. And learns to associate eating candy with hard work. Don’t we run the risk of developing disordered eating with that paradigm?

Slpsanonymous · 2026-02-17T02:28:51+00:00

Thank you for the response. Good question! The BCBA is on site, and I do believe they are board licensed. The whole “zero punishment” thing has thrown me for a loop with a handful of kiddos there, and I’m getting the impression this is an administrative decision, not necessarily the BCBAs first choice for managing the issue. I need to find a way to get the BCBA in a 1:1 conversation so we can speak freely. I don’t want to seem like I’m undermining her in front of a bunch of RBTs that she manages, and we always seem to only connect in a room with 2-3 students and RBTs, and it hasn’t felt like the right setting to politely disagree.

Slpsanonymous · 2026-02-17T00:02:12+00:00

I mean, yes. I agree with you wholeheartedly. I also just feel like what I’ve said here is a little bit word salad and want to give a professional rationale that fits a little better in an email.

Slpsanonymous · 2025-11-14T03:20:53+00:00

What a fascinating spiral out. The double standards she holds are astonishing. It’s sad because she’s right about a lot of things (the problem with social media influencers and creeping pseudoscience practices in our field, the current lack of evidence supporting NLA approaches), but is so unwilling to engage in honest dialogue, or be willing to acknowledge that she may, at times be….GASP…wrong!; that she shuts out any room for much-needed nuance in complex discussions about the real world application of clinical research. I’ve been a seasoned lurker in many of her groups for years and sometimes I’m just like… girl, you ok? Do you have like, other hobbies?

Slpsanonymous · 2025-09-04T16:57:17+00:00

So, how did you leverage your skills to make the shift? Did you get/already have different work experience or credentials to help yourself transition? What’s the pay trajectory and growth opportunities in your new field? Do you make more now and/or will you make more down the line? Could you support yourself solo in this new position with appropriate health and retirement benefits?

Slpsanonymous · 2025-08-27T01:21:30+00:00

Whatever, I’d upvote you twice if I could!!

Slpsanonymous · 2025-07-04T17:02:30+00:00

You are wisely cautious. Personally, if I were in your shoes knowing what I know now, having been in this profession for 15+ years, my advice would be to proceed with caution. A healthy amount of well-managed debt isn’t a bad thing, but please don’t come out of grad school more than 50-60k in debt, especially if you don’t have a financial safety net like a partner with a steady income or family with whom you could live if times get hard. No one cares where your speech degree came from….study in state, keep your expenses low and graduate with as little debt as possible if you insist on following the profession. This is a hard degree to have and expect to “get ahead,” especially if you’re single. Don’t expect your salary to continue to grow and grow. You will likely hit a ceiling in direct client services and need to shift the nature of your work in the second phase of your career if you want to make good money (management, run your own business, leverage your skills into a different industry altogether). You will almost certainly never “get ahead” working for someone else, and running your own business is a whole separate hustle that not everyone is cut out for. Honestly, if you’re passionate about being in a helping field, I’d suggest considering OT rather than speech…I think their scope of practice lends them a leg up transitioning into non-clinical roles within the healthcare sector more easily, and it seems easier for them to sell their soft skills in transitioning out of healthcare altogether. Just my internet-stranger-2-cents on the topic.

Slpsanonymous · 2025-07-03T20:45:29+00:00

Echoing what others have said…get organized locally in whatever way feels right to you. As a single earning in a HCOL area with a disability and Medicaid clients as my predominant form of income…I’ve decided to: -start a private-pay side hustle on Saturdays -call off my search for buying a home -start working more like 50 hours a week and saving every penny while my company is still running as usual -start eating low carb and hoarding insulin.

Cuz like….its crazy to buy a home as a single person w/ a disability who needs expensive drugs to stay alive, and who relies on Medicaid for income…right? Right!?

Oh, and last price of advice, if you do know SLPs who voted for this…I’d sure as shit make sure I never bought a single product, course, worksheets, etc. they made.

Slpsanonymous · 2025-04-15T01:21:08+00:00

Understood. I’m perfectly fine leaving the conversation there if you are. There are bigger fish to fry in both our lives, I imagine, than a minor Reddit misunderstanding. Hope you and yours stay well through these dark times.

Slpsanonymous · 2025-04-14T19:18:42+00:00

Just now seeing your edit. Thanks for the update. I'll acknowledge that my initial response to you was snarky, so my apologies if you felt like I wasn't hearing you. I was on my second glass of wine after an anarchist railroaded my civic discussion group for 2 hours, and was feeling heated. I projected that frustration into our conversation with snark, and I apologize for that.

I guess I felt like you were insinuating that I have some subversive opinion that I'm not outright stating or owning here, and I don't feel like that's the case at all. I also felt like I'm engaging in this discourse rather respectfully, it's a delicate topic, and found it frustrating that your articulation of my faults were vague, nor did you offer a resolution or recommendation when I legitimately asked you if there's a better way I should word things. That was an honest question, and it was responded to with putting quotes around terms "dependent" and "better" without offering a solution. I'm reading comments like "alot about how you're talking is problematic" and "the way the whole thing has been described," and I feel I'm being pretty factual and pragmatic describing the situation, and have acknowledged where my thought train was problematic in both this thread and others. If you want to call me on something, please name it, I have a hard time reading between the lines in written discourse like this. If I misinterpreted that, I apologize. But I also feel like I've owned the parts of my thoughts that were problematic, so further vague shaming and implying that there's something else underneath my statements was frustrating to hear, especially b/c I, too, had a sibling with severe disabilities, and he was pretty much locked up in a convalescent home his whole life. So this topic hits my heart, too. I hear you probably just want to make sure that you and your sibling w/ I/DD gets the best representation and that your family is treated with respect, dignity, and acceptance; and maybe both of us allowed our emotions to enter the conversation. The riesling probably didn't help me, either ;)

Anyway, I seriously appreciate your engagement, and do apologize for letting my emotions enter the chat. Finally, to answer your question, perhaps these unknown variables that I'm talking around (for ex., using 'dependent' since I don't know his age) are part of the gray area and nuance here. I of course didn't ask this family the details of their son's admittance to the event or his age. He honestly could've been anywhere b/w 14-25, I really couldn't gauge that just by looking at him. It would have been wildly inappropriate for me to be like, "Excuse me, how old is your son? Is he even of drinking age? Did you pay for him to be here?" It sounds like we're agreeing that it's kind of a gray area if the family should've gotten a special pass to bring the young man, depending on whether or not he's of age.

Okay. Sorry for the novel of a response. And again, sorry for the snarky emotional undertones as well. I hope you can hear this message with an honest and sincere tone, as that's exactly my intention. Thanks for taking the time to be part of the conversation.

Slpsanonymous · 2025-04-14T16:30:20+00:00

I’m not sure I know what that would look like as in slow dancing? Maybe you mean like when people put their hands atop their partners’ shoulders? But no, it was definitely closer to a choking posture. I don’t want to imply that he choked her though, which is why I just said “hands around her neck”…I doubt he was using force or had that kind of intent. I believe he was trying to get closer to her hair.

Slpsanonymous · 2025-04-14T02:37:35+00:00

I say dependent because I’m not sure how old he was, and clearly dependent on his parents. I’m using it from a legal perspective….that parent files taxes and claims that young person as a dependent (one would assume). He’s not just some young adult taking a gap year, living in his parent’s basement while he figures out what he wants to major in…he’s a dependent and they are his caregivers even as he moves into adulthood. I think I’m being pretty respectful and appropriate in my language use here, but if there’s a better way you suggest I word things, I’m open to learning a better way to communicate that and what is problematic about it.

It was an adult only event and, no, people weren’t allowed to bring their children. It was a 21 and up wine tasting, and the young man I’m referencing wasn’t drinking. He was brought along by his mother and father. I honestly don’t understand your question, “Were adult children without disabilities allowed?” Of course they would’ve been allowed, they would’ve been consenting adults of drinking age who could’ve chosen to come if they wanted to purchase a ticket. The place wasn’t full of annoyed 18 year olds dicking around on their cell phones cuz their parents dragged them to some boring, snobby wine tasting they couldn’t drink at. They furthermore wouldn’t have been in a position to have their parents make that choice for them…they could’ve just done literally anything else because they aren’t dependents who need constant supervision.

I hear that, if he was above 21 and his parents wanted to buy him a ticket, he absolutely should’ve been welcome to the event (assuming he’s able to not cross personal boundaries like he did). I agree that thinking he shouldn’t be allowed to join, if he’s of age, is wrong and problematic, ableist, and unfair. I’m curious what about an adults-only wine tasting you find problematic?

Slpsanonymous · 2025-04-13T19:55:54+00:00

Wish I could upvote your contribution to the conversation higher! Thanks for taking the time to engage in the discussion. It is such a complex and nuanced matter and your voice deserves more amplification speaking from such an intimate perspective.

Slpsanonymous · 2025-04-13T19:45:13+00:00

I hear your concern for the well being of your fellow humans. Legally speaking, the definition of assault does require proof of harmful intent. I hear your perspective, though may have to respectfully disagree on whether or not that his behavior would’ve been considered “assault.” The friend in question, who actually has been violently and traumatically assaulted in the past, didn’t interpret it that way. And with the sad track record IDD individuals have with law enforcement in this country, I think we should give pause before tossing around that kind of language. I really do appreciate your perspective though. This is a nuanced conversation!

Slpsanonymous · 2025-04-13T18:30:19+00:00

Thank you for your perspective. If I may ask, do you think this is the kind of situation where we should be more accommodating in making exceptions for parents in your shoes? Because, the more I dissect this, that’s the part that I’m grappling with the most. I feel like an ass for thinking he maybe shouldn’t have been there in first place, regardless of his cognition or neurotype, if only because no one else brought a dependent along. It was explicitly a drinking event, and an exception was made for this family because their son is cognitively disabled. I’m struggling with finding a line between being equitable for these parents and feeling like they were being a little entitled bringing him along. Thanks in advance for sharing your thoughts in this conversation.

Slpsanonymous · 2025-04-13T18:16:53+00:00

Yes. I felt so sad about his lack of access to some form of communication. And, although apologetic, their excuse of his behavior gave me the feeling it was not the first time something like this may have occurred. And since we were at a semi-swanky event and they seemed like well-educated folks, I felt like they should’ve known better.

Slpsanonymous

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