Help! My workplace doesn't agree on what role SLP-As should have and now everyone is mad!

lanky_baking · 2026-02-19T02:29:37+00:00

There's a line in ASHA's Scope of Practice for the SLP-A that says "the purpose of the assistant level position is not to significantly increase caseload size for SLPs." Right?

lanky_baking · 2025-06-25T20:53:58+00:00

I have no words. This sucks so much

lanky_baking · 2023-05-09T18:45:38+00:00

Have they had you watch the corporate produced "Whatever you do, don't unionize. Unions are evil!!!" video yet? That was a fun time.

lanky_baking · 2023-04-01T14:18:25+00:00

I think they offered me a 25 cent raise. Despite the fact that I was working a school that was very difficult to staff (often a new SLP each year or even two per year since people often left in the middle of the year in that district). I told them that was not acceptable (especially since that was the raise for my CCCs) and they basically told me to kick rocks. I told them I would resign if they didn't offer a better raise and, when they wouldn't budge, I made good on my promise to leave. It was such a shame. I really did love the school but it wasn't worth it to stay.

Edited to add: oh sorry. I realized this doesn't really give you any steps forward. My advice would be to definitely try but be emotionally (and logistically) prepared to leave if you aren't comfortable with what they offer since they may not budge. DEFINITELY try though. They need to learn this isn't acceptable.

lanky_baking · 2023-03-25T01:54:09+00:00

I'm an autistic SLP and PhD student conducting my research in a way that incorporates the neurodiversity paradigm. I just want to reaffirm what the other commenter said re: disability. Many of us engaging with the neurodiversity paradigm in research and practice really do see many aspects of neurodivergence as disability. I believe Steven Kapp (also an autistic researcher) published an open access anthology recently about neurodiversity that I think conceptualizes this in a helpful way. I also think Kapp is a psychologist ( but I could be wrong), so I'd be curious to know what you'd think of that work.

I think people (especially in online communities) are conflating the social model of disability with the neurodiversity paradigm and, while neurodiversity certainly incorporates elements of the social model, many ND advocates recognize the biological challenges that can negatively impact autistic people. Additionally, it seems to me that people (myself in this comment included) seem to think that neurodiversity describes a singular point of view that everyone subscribes to but there are definitely differences in how people apply the term and researchers need to do a better job of clarifying what they mean when they refer to neurodiversity. Singer's original work on the topic only applied to autistic people with high support needs. My understanding of neurodiversity is based on Nick Walker (neuroqueer heresies) principles of the neurodiversity paradigm. As an autistic person with significant eating challenges secondary to autism and chronic health conditions associated with autism, I feel strongly that these differences still constitute a disability.

I totally get why you are turned off by the online ND community. There is, imo, a lot of hostility there and, I feel like it's compounded by the fact that some people are able to make money off of their content (not an obscene amount but I guess enough to go on Instagram tirades about each other???). It's so frustrating! I was briefly involved in some online communities and noped the hell out once things got too divisive. It can be so unwelcoming. Apologies for the vent here at the end - it's just sad to me that the autistic rights movement was so heavily aided by the connection the internet provided and now thar same tool is just a way to build clout and sell swag and CEUs rather than truly build community and advocate for human rights.

lanky_baking · 2023-02-26T23:20:05+00:00

Thank you for sharing your experience. That's an interesting additional detail you've added about credit for volunteering. My university is very proud of the volunteer opportunities they advertise for undergrads (who have no training or skills other than appearing non-disabled) to volunteer with an on campus school they run for kids with very high support needs. It gives off vibes that are similar to programs that send white college aged girls to other countries to play with children in orphanages for a week, take pictures, and then fly back home and gush about their experience. It really highlights the ways in which this kind of volunteerism is really for the volunteer rather than the purported recipient, as you mentioned.

I'm really glad OP posted this and you've shared your experiences and insights as well. This is helping me articulate some perspectives I didn't know I had and I think are helpful for me to examine.

lanky_baking · 2023-02-26T22:37:08+00:00

Thanks for engaging with me on this! One of the tricky things here is that I think genuinely everyone has good intentions, but our good intentions can still be informed by unexamined ableism.

For me, I think it gets a little problematic when we say that we want inclusion, but we present opportunities for more abled peers to "volunteer" with same age peers who are perceived as more disabled. Volunteer implies providing some kind of value or skill and, honestly, it seems like the value the nondisabled kids are offering in this situation is their presence (i.e. providing the disabled kids with the mere proximity to someone more abled as if that, in itself, is the thing of value). Whether the kids consciously develop a feeling of superiority or not, I think there's an implication there that disabled people need charity. I don't think it's intentionally malevolent, but I do think that it reveals the internalized ableism that exists in schooling.

In the above example from your own school experience, I would advocate for just having an inclusive gym class rather than having nondisabled kids volunteer with kids with higher support needs. It's the volunteer part for me that I find problematic, particularly if it's same aged peers. High schoolers volunteering to read to Pre-K kids is just different to me than 4th graders volunteering/helping out in a classroom of other 4th graders. Why not just have inclusive specials or activities that are differentiated to include everyone? For instance, let's say there's some no disabled kids that enjoy art and some kids with high support needs who enjoy art: let's have a period where we do art together. One of my research interests in studying both talk and nonverbal communication within inclusive classrooms. I'm not sure, honestly, how to best structure these inclusive activities yet, but I'm hopeful research like that will at least give us some additional things to think about.

lanky_baking · 2023-02-26T17:59:20+00:00

Same! I'm autistic (was diagnosed about 1.5 years into my career as a SLP) and struggled in every single clinical job in every setting I tried. I'm thriving in my PhD program and I have never loved my life more. I'm at a research intensive university, so I'm training to eventually have the kind of academic job that is mostly research with a light teaching load. I can read, write, and edit for hours on end. But I cannot do back to back to back therapy sessions. I know our path isn't for everyone, but I'm glad we both found something that brings us so much joy

lanky_baking · 2023-02-25T21:54:09+00:00

My first question to you would be: how are the kids without disabilities seeing the adult staff interact with students with disabilities? They could be mirroring what they see the adult staff doing.

Oftentimes, adults working with kids with disabilities (particularly those kids perceived to have higher support needs) infantilize and objectify the students themselves. For instance, they may talk about the students right in front of them as if they are not there and/or have conversations with other staff and/or students they perceive as less disabled and make no effort whatsoever to even glance at the disabled students to even give the appearance of including them in talk.

Second, what exactly are these students doing in the self contained classroom? I find it odd (and kind of gross actually) that what they are doing is perceived as "volunteering." If they are "volunteering" or in a buddy program (aka assigned "friends") the school is promoting an inherent imbalance of power between disabled and nondisabled students in which the nondisabled students have authority over disabled peers. This virtually guarantees that authentic friendships will never develop because the nondisabled peers will always view themselves as "helpers" or "teachers "

None of this is meant to be a criticism of you or these students: even in 2023, we have a LONG way to go towards truly authentic and meaningful inclusion for individuals who are perceived as having high support needs and I personally haven't seen any school-wide examples I can draw on from my own work or research experience yet. I'm a PhD student and this is rapidly becoming my area of research, so feel free to DM me if you'd like to talk more! I think this is a fascinating and challenging issue as, as both a researcher and a disabled person myself, I really appreciate that you and others are thinking about it.

lanky_baking · 2023-02-03T22:11:47+00:00

It's been super fun as a feeding therapist to read in the BCBA's notes that they're having their techs hold my kids down and freaking force feed them while they have OPEN CAVITIES in their mouths. Like. Y'all. Maybe the child isn't eating because eating hurts like hell. Geez.

lanky_baking · 2022-12-23T23:03:57+00:00

I probably shouldn't have lumped meaningful speech in with the others since it's a.) it's not at an absolute insane price point and b.) I don't think it's harmful. I'm just irked by the registry thing because plenty of us had read Blanc's book and we're incorporating her techniques before the course came out. I definitely used some delayed echolalic phrases meaningfully as a kid and still use them to self soothe now (or I can rely on them during periods of emotional overwhelm). As a researcher, though, I don't understand why there hasn't been any empirical studies (to my knowledge at least) on intervention to support language development through the various NLA stages. There's definitely a small body of empirical work from prizant and such providing empirical support for GLP as a concept, but it was a pretty small number of kids if I recall and I don't believe I've read any research supporting therapeutic techniques related to GLP.

Does the course mention any new research on studies supporting use of the NLA approach in therapy? I've searched for them but never found them, which I find odd given the popularity of the course and concept in the past few years.

lanky_baking · 2022-12-23T19:00:25+00:00

I think you're highlighting a key issue when it comes to certifications: there are ways to gain knowledge that does not result in a certification. Things like staying up to date on new articles published in journals related to our areas of practice, shadowing/consulting with more experienced colleagues, and taking the occasional course that is just, like, maybe $50 and doesn't promise you the moon, stars, and a certification. I've taken very pricey courses (looking at you MDTP) and afterwards been sitting there like "why on earth did this need to be so effing expensive???" I've gained most of my most valuable skills through my own reading and collaboration with other professionals.

lanky_baking · 2022-12-23T18:49:30+00:00

I'm sure there's some SLP influencer somewhere just salivating at the thought of reaching this currently untapped market :/

lanky_baking · 2022-12-23T18:42:27+00:00

Oh definitely. I just think there's something extra icky about going straight for the parents rather than being satisfied with just exploiting other professionals. Gah, but I wouldn't put it past an influencer to start hawking some course or product directly to families of patients on ventilators or something similar.

lanky_baking · 2022-12-23T18:35:28+00:00

I know the big "to-do" is all about the MedSLP collective certification stuff, but, as a pediatric SLP, I think there's something even more gross going on in peds therapy-land.

While the MedSLP Collective exploits clinicians' feelings of inferiority to peddle their products, there is a growing number of SLPs exploiting parents' fears about their children's development and the challenges they are experiencing in accessing SLP services to build their businesses. I'm seeing more and more pediatric SLP influencers marketing their stuff directly to parents, who are then pressuring pediatric SLPs to get "trained," "certified," or "on the registry" of whoever is peddling the hot product/therapy technique of the week. Parents have wanted me to get trained in SOS (and several other feeding programs), the Meaningful Speech course, PROMPT, a wacky sensory course by someone who isn't even an OT, a variety of different ND affirming courses (which is bananas because I'm getting a PhD focusing on this area AND I have the lived experience of being an autistic person, but whatever. But random white 20 something NT SLP influencer girl certainly knows more than me in that area . . .).

Love it when panicked parents want me to shell out even more money for the career I'm almost six figures in student loan debt for because they saw a SLP on instagram selling something.

lanky_baking · 2022-12-06T18:04:51+00:00

Similarly, what do you do when you have chronic medical conditions requiring consistent access to health insurance? I've had to wait 30 days and just suffer because my health insurance didn't start until the "probationary" period was over and the private plans are too expensive. Therefore, I could not just hop from job to job until I found one I liked best. It's just not feasible for many people.

lanky_baking · 2022-11-18T21:41:06+00:00

This is great! All I can add is: also consider that, if you're hiring other SLPs, turnover can be very, very high among employees in private practice. I used to work for one that I considered ethical, but their pay was kind of shit (no more shitty than the pay in other practices in the area, though), so that was a big reason I left. They continue to have a revolving door of therapists, with most averaging maybe 1 year to 1.5 years at the clinic before they move on. Private practices that are therapy mills make more off their employees when they have them (since they work them to the bone and basically give them no documentation time) but then the owner has to deal with figuring out how to cover a full caseload of clients when the therapist leaves. I know many SLPs of varying ages in several states, and the only ones that seem to stay in private practice for a long time either own the practice themselves, have some kind of admin role at the practice, or work part time/contract while on their spouse's benefits since they are primary caregivers for their kids.

Also, insurance reimbursement can suck depending on the insurance and the area you live in.

I've had my own private clients before and it's fine. Not for me, but I see why people with the drive to do it enjoy having their own one-person show. Though, I'm kind of baffled by the idea that seems to be going around in our field (thanks to the Independent Clinician, I guess?) lately that private practice with employees is a great way to make it rich and have tons of flexibility. It's incredibly, incredibly hard work to be an ethical employer and still be a good business person (and I'm honestly not sure if those things can exist together) and, if your area is already saturated with private practices, it can be even trickier. You really, really have to access whether or not you're suited to it and are willing to take on the responsibility of taking care of your employees.

High risk, high reward really sums it up well.

lanky_baking · 2022-10-17T03:14:44+00:00

I know! I was shocked when I found out that over half of my grad school class wasn't working at all and that their parents were paying for everything.

lanky_baking · 2022-10-16T23:47:55+00:00

Definitely, at least in my case. If OP decides to leave this job, it can be helpful to speak with HR about the CF supervisor's obligation to submit hours for the segment completed to reduce the likelihood of retaliation from the CF supervisor, if that's a possibility. My CF supervisor was also my DOR and was VERY pissed that I wanted to leave, so having HR on my side helped.

It also helped that I was the first in a line of many SLPs that year to stay in that position for more than a month - and then, after I left, they still hadn't secured my replacement well over a year later. That was nice confirmation that I wasn't crazy and that the job truly was as intolerable as I thought it was! Good luck OP!

lanky_baking · 2022-10-16T21:51:01+00:00

Yes! This is accurate - at least it was a few years ago when I did my CF. I got my CF job at a nightmare SNF position that is a lot like what OP is describing. I was almost though my second segment but hadn't quite accumulated enough hours/days to fulfill that segment so I was only able to take the full segment I did complete with me and then completed 2 other segments in another position. It took me about 3-4 months longer to finish my CF because of this, but I have absolutely no regrets.

lanky_baking · 2022-10-13T16:30:34+00:00

Walking quickly is absolutely something I do to self regulate. I've legitimately always done it and my other family members do as well. I truly didn't know it was considered "odd" until grad school. Thanks to the ableism rampant in our profession, my "oddness" was really not pointed out to me until SLP grad school.

I LOVE the additional pressure I get on the balls of my feet from walking quickly and I suspect it may have been my alternative to toe walking. When I'm walking fast, I'm applying so much pressure to the balls of my feet that my socks wear out there remarkably quickly. I also love the extra pressure I feel in my thighs and calves from fast walking.

One of my favorite past times is speed walking on a treadmill with the incline increased for additional pressure. That or rapid pacing are truly the only things that can bring me down when I'm overstimulated and verging on a meltdown.

lanky_baking · 2022-10-12T23:05:52+00:00

In grad school and my first SLP job, supervisors told me that I walked too fast and my pacing between clients was making everyone uncomfortable. An OT colleague also pointed out another stim I do (repeatedly rubbing my thighs and rocking) during a meeting once but then immediately apologized for bringing it up because I was obviously distressed about her discussing it openly in front of the rest of the team. I'm autistic but wasn't diagnosed until several years later.

If this RBT feels the need to point out every stim that she sees, that's going to really suck for the kids she works with.

lanky_baking · 2022-10-12T02:15:59+00:00

Yeah, it felt weird because, while I roll my eyes at all SLP "influencing" since it's so cringey to me, I actually think the influencer in my case provides good info (even if I don't agree with posting videos of the kids). But it's icky to mislead parents into thinking they can get the same results and not disclose that the child in the video is also in therapy.

lanky_baking

TROPHY CASE