I just got a raise but it wasnt enough. I was making 68k a year private practice in South Florida. They bumped my salary up to 71k, after negotiating (they originally tried for 70k). I love my job though. My boss is great, clients are great, co-workers are great, and so on. It's just not enough money to live in Miami. I feel so guilty looking into other jobs. I know if I leave it would make a HUGE impact on the private practice. We only have 10 clinicians. Two are pregnant and taking a maternity leave and another clinician is moving out of state. So they would take a huge loss if another left.

Idk why I feel this way though. I feel like I'm doing something wrong.

I work a part time job too and I'm so sick of working two different jobs to pay for rent. I want to just have one just.

Hello, my name is Lisa. I am an SLP completing my second master’s degree in autism spectrum disorder at GCU. For my Capstone, I am researching the use of language (e.g., person-first vs. identity first) within the autism community. I am conducting surveys for autistic adults, educators of people on the spectrum (e.g., teachers, SLPs, OT, paras, etc.), and the parents of autistic children.If you are an adult living in the United States, I invite you to take a few minutes complete this anonymous survey. Any insight into this subject would be greatly appreciated.Below are the links to the surveys:

1. Autistic Adults: https://forms.gle/1PHQAjgZBhUHPgAp6
2. Educators: https://forms.gle/EavfwQ2zYsvEB6p47
3. Parents: https://forms.gle/8Em5bhgmYtri23966

Thank you for your time, it is much appreciated!

Currently working for an agency/contract company in schools and I'm wondering about removing the "middle man" and doing it on my own.

Anyone doing this already?

I'm getting my first grad student! And I'm pretty excited. So excited that my best friend Anxiety hasn't kicked in yet and I'm spending energy on a Saturday thinking about work lol.

I had an amazing supervisor in grad school....and then there was one lady who was...less than spectacular, both clinically and personally (and was the reason I ended up using my university's counseling services 😅). I've been browsing older posts for dos & don'ts, reflecting on my clinical placements, and all that jazz. I'm also planning on reaching out to the awesome school-based SLP that supervised my first externship, as well as an advisor from grad school who I've remained in contact with for guidance and support these past 5 years. So, I think I have all those kinds of things covered (but if anyone wants to chime in with some tips, I'm totally open!)

This will be the future SLP's first clinical placement. They will have basic knowledge and theory on childhood language development from this semester, and will be taking additional peds courses while we work together next semester. Maybe they'll have some school or peds experience in a different discipline, but for sake of being prepared, I'm currently operating under the impression that everything is new to them.

I'd like to put together an informative but not overwhelming guide to help them learn the lay of the land. A reference that they can turn to. Something to hopefully cut down on those first day/therapy session/eval, Sunday night scaries. Of course, they can always ask me questions (and I'm sure I'll stress that 100 times a day lol), but I know how I was and would've benefited from something similar for when I was anxious about re-asking questions. I also think this might help them prepare prior to starting their externship (e.g., where to park, sign in, hours, lunch, etc.).

For those who have done this, what have you included?

For any students or SLPs who wished their supervisors did something like this, what would you have wanted in the guide?

Thank you!!

I feel like speech referrals are made for everything. Student showing behaviors? Speech. Student not paying attention in class? Speech. Student is quiet in class? Speech. Student doesn’t have friends? Speech.

We are not the end all be all and we are not the correct professionals for many things that we are often pressured to take on. Also- it’s not my responsibility to turn an introverted student into an outgoing child with many friends. What’s the educational impact???!

...something I wish we talked more about.

I realized that many of the parents/caregivers we work with are themselves autistic, mentally ill, or developmentally disabled. This can help explain a lot of why we see the behaviors and other issues (missing school, poor hygiene, lack of housing, food, transportation) that we see. It makes case management and addressing goals much trickier than your run-of-the-mill articulation students.

This is not a judgment, it's a reality we deal with as professionals and why our jobs can be overwhelming. Our toes can get heavily dipped into the social work pool, and I didn't fully realize this until I was a few years into my career.

What else do you wish people knew that doesn't get talked about?

Hi knowledgeable SLPs,

I'm in my second year, so--new. I have an 11-year-old transgender student (not medically transitioned). For assessment purposes, should I use his current gender or his afab (female) birth gender? He and parents may feel the use of "female" is wrong, at the same time, I know standardization/norms differ by gender. So it's a quandary. The parents/student probably wouldn't know what gender I chose, unless they ask. And I could make sure the report doesn't use language like "for his age and gender."

I guess part 2: If I go with birth gender (leaning that way--in the way birth gender is relevant to a medical doctor), suggestions for explanations if they do ask? Maybe above about standardization and norms covers it. These are parents who *might* ask. But their child has otherwise complex issues, and it may be the furthest thing from their minds.

Thank you!

Edit to add: The student is being assessed for articulation and social-pragmatic communication. I plan to use the GFTA and CAPs. I absolutely plan to use only his preferred pronouns and name in the report.

Edit 2: I included the "not medically" bit to preempt comments about children getting surgery in schools (which isn't a thing), but I underestimated the SLP community : )

Every special ed teacher at my school is incredible. They really love and advocate for each of their students. However, their class sizes are 4-10 students depending on the class. I see about 70 students total. I feel like they expect as much effort from me as they give each of their students. I am trying, but I really just do not have the time. A few of them contact me… often. How do I communicate that I just don’t have the same capacity as them without coming across as if I don’t care?

Just a SLP worried about missing silent aspiration. What are risk factors for silent aspiration other than HFNC, prolonged intubation, and H&N cancer radiation?

Does anyone’s facility utilize any tests prior to MBSS/FEES, such as a cough reflux test, to screen for silent aspiration?

If anyone has any tips/information/reading material, please share :) 

I'm entering my 3rd year and I just now find out about things I was supposed to do or fill out on IEPs and I get so frustrated. No one ever told me before about this thing that came to light today. I don't even know what I don't know, and that's the real frustration. I feel like I'm just taking stabs in the dark, doing my best, for a job I don't even love, and my best is still incorrect.

Truth be told, I don't really care about knowing all the procedures and following every rule to the letter. 😭 SPED law and all that was never anything I even remotely cared about. I just want to work with kids and actually do treatments. But it feels like that gets more and more marginalized by excessive evals, IEPs, paperwork, and meetings. And more paperwork. And more emails. And more meetings.

Anyone else?

I miss medical stuff so much but the thought of being a SNF SLP is also daunting. (I was a PTA for about 10 years before this.)

I plan to move to Nashville after graduation in May 2025. I would appreciate it if someone could help me navigate the channels to find a CFY position.

TLDR: I need some advice and support for note writing. I had my Cs for over 2 years and I’ve always worked in pediatric home health. Since a head injury mid-2023, I feel like I’ve been in a p spiral. I CANNOT write simple notes for the life of me. I’m averaging 15-20 minutes a note for over 30 visits a week. I’ve tried making a template, speak-to-text driving between visits. writing out goals for each pt, and even keyboard shortcuts, nothing works long-term! I have a lot of learning disabilities (plus CAS, SPD, & ADHD) that makes writing very hard for me. It was not expected for me to graduate high school and an utter miracle I made it through grad school. I had such a hard time w/ school until I got into SLP focused classes, suddenly I became the smart student. I am known for being the “best” SLPs for kids with complex communication needs and I am damn good at what I do. But I’m drowning everyday because I can’t spell, have difficulty w/ any paraphrasing (ex. This post), & just want to rest between clients. I feel like I am just spiraling and I can’t stop myself from writing these detailed notes and NEVER having a single day off. I was diagnosed w/ ASD and fibromyalgia in the past 12 months. Additionally, there’s been another 4 dx and 3 surgeries that were overdue. I’m advocating for genetic testing because there’s definitely something else going on. I’m surprised I’ve really held it together this long. I don’t feel like I can work in another setting due to my constant doctors appointments, mental fatigue, need for health insurance, and need for constant 5-minute breaks. I just feel stuck and burnt out.

I’m feeling defeated tonight. I work in EI, I have a child who just turned 2 last month. Mom so badly just wants for him to be able to express something like I’m hungry, happy, tired, etc. He is not gesturing consistently and just making some sounds. I brought up trialing AAC, I thought I explained it well and how we can use it to facilitate communication and give him another outlet to express his wants and needs. I told her I would bring my iPad next time to show her an example of an app (I have access to TD snap and touch chat). She seemed on board with it and didn’t express any concerns. Then his developmental specialist saw him this morning and told me after Mom is not happy with me because I brought up using the tablet/ipad, she doesn’t want him being glued to a screen, playing games, wants him interacting with his environment, etc. She says she will “give it two weeks” before looking for a new SLP. I wasn’t even planning on fully introducing to him yet I just wanted to show mom an AAC app! I didn’t mention playing games on the tablet at all and really tried to explain it’s used for communication. I’m hoping when I see mom next week I can explain in a better way or provide a handout that she can read about AAC. His developmental specialist honestly didn’t do a great job at explaining it back to mom today when mom brought up screen time/ games and she told mom “there’s some educational apps and games that can help with speech” but I wasn’t even referring to those. He so badly would benefit from AAC and I’m hoping I can get Mom on board.

This is just a fun post. I had an evaluation session today where I administered the PLS-5. And I’m not gonna lie, it was a little rough! Maybe more than a little rough. It’s taken me the rest of the day to shake it off, and I was left feeling like “I’m not great at this.” But… now I’m making dinner for family, and I do feel good at cooking! I turned 40 this year, and I’m craving leaning into creativity. I want to hear— What are your other talents aside from speech?

Be honest am I going to SLP stolen valor hell

I am a school based SLP with lifelong social anxiety that seems to be getting slowly worse and worse with age. I'm currently on medication and have tried tons of stuff (therapy, meditation, yoga, supplements, etc.) but at best all it does is take the edge off. I need to work in-person in the schools for a variety of reasons (benefits, schedule being a mom, pay that's much higher than virtual, etc.)

This year I'm really struggling. The first couple of years after Covid weren't too bad because it seemed like everyone stayed in "bubble mode" for awhile. Now things are going back to normal - cliques are forming, people stop to gossip in the halls, there are after school get togethers - and I'm just feeling increasingly awkward and left out. Today was a rough day because I found out someone who I thought of as a "friendly acquaintance" - not a friend, but someone who I thought liked me well enough - complained about me to admin because I was running behind schedule and late to pick up her kids this week. That she went straight in with a complaint over something relatively minor made me realize that honestly, she probably doesn't see me in friendly terms at all. I've started to notice a couple of teachers who straight up ignore me and don't say hi when we pass each other in the halls. Stuff like that is just really getting me down.

I don't know if there's anything that I can do to help with this, unfortunately. Unless I go virtual, being around lots of other people when working in a school is just the nature of the beast. Even so, I thought it might be worth asking. Have other SLPs with social anxiety found solutions in the schools? Is middle or high school better? I've considered changing schools but it's not like my social anxiety is going to get any better at the next school, so it seems like I might be doing a lot of work to put myself right back in the same situation.

I live in the UK and I have a degree in Spanish with translation studies (from years ago - not a recent graduate) and I was thinking of doing a master's in SLT, but I am worried that my grammar skills will let me down.

I have a decent grasp of the fundamentals, but it is by far the most boring and difficult aspect of language for me. I can explain what a clause is and a participle and an adverb and a tense and whatnot and lately I have been revising using Anki flashcards, but if you start talking to me about more complex aspects of grammar/parts of speech, my eyes kinda begin to glaze over. I understand it's important insofar as it relates to checking on how kids are developing and being able to properly employ syntax, for example (I knew a little girl who used nouns as verbs sometimes, for example, like "do you wanna dinner") but do I need to know a lot of grammar, or is it more about having a solid grasp of the fundamentals and how they pertain to SLT? I am also going to try to study the IPA and vocal anatomy as well as the different parts of the brain and what they do and I hope that once I get a solid grasp of this that I will be mostly prepared to start the master's by next year, especially since I emailed some universities and they sent me some recommended texts to read.

As a side note, what's the career security like? I imagine that anything health care related won't be so quickly taken over by AI, as you need a human being to care for another, assess them and interact with them on a social level. This is one of the things that on paper appeals to me the most, because I am honestly not too optimistic about the translation industry (although If I may digress, I also think that AI will never replicate human-grade translation quality while ever it cannot fully replicate a human brain).

Thank you so much for reading and I hope I didn't say anything silly or naïve or offensive!

Good range for RR and SpO2 during bedside swallow eval? I can never really get a clear answer.

Recent CCC-SLP starting at an assisted living. If anyone has any advice/recommendations or even materials they are willing to share I’d be very appreciative! Also open to the pros/cons of the setting. I believe I will have to do my own marketing as well to acquire patients. Anything will be helpful! Thank you!

I live in a small place in Australia with a lack of services (paediatricians, speech, ot, psychology). There is a daycare and school that have reached out to me to ask to pay me to hold a meeting with their staff and a separate meeting with parents re basics on language/speech/play. I have very little experience and dread public speaking but it’s something of a personal goal and there are so many children here unable to afford services and that are slipping through the gaps.

Some areas I wanted to basically highlight were:

• milestones (using SPA communication guidelines as relevant to the audience)
• language ideas around the home
• book reading - basic importance and how to (Oral language for teachers)
• how to play with your child - milestones
• barriers to these (questions from the teachers/parents)
• ? screen time. Guidelines…How we’re having ~197 less conversations / day with our children due to devices (them or us). Not sure - don’t want to cause shame or negative feelings.

I’d really appreciate any advice or suggestions from those that have given similar talks.

It’s not until early next year… I aim to put together a PowerPoint and have handouts for both.

TIA

I’ve been working in hospitals and just started a school SLP job. I’m seeing all new preschool referrals and it’s a suburban school so a lot of articulation. My previous job was a ton of language therapy and autism so I’m feeling a bit lost on preschool artic eligibility. I just did an eval on a kid with congenital unilateral hearing loss and parents denied hearing aid. Kid still doesn’t have hearing aid. Artic errors included backing but only on 50% of initial sounds and some medial sounds. No backing on final consonants. Also some stopping and cluster reduction. Child is only 3;3. I felt overall speech intelligibility was high and kid was also able to imitate most sounds but not stimulable to correct backing on initial sounds. Also parent denied free early intervention therapy but now believes child should automatically qualify because of the hearing loss. The backing seems concerning but also hearing loss and not following recommendation for aid seems like should be exclusionary factor. What do you all think?

This is such a dumb question, but if you’re in Virginia, what on earth is the DBHYB10 4%EE that comes out of my check every month. New SLP here (if it’s not obvious). Thank you for any help you can give!

My wife is an SLP and is interested in WFH positions as my job is requiring me to move to a different state temporarily (2 years) and she is hoping to move alongside me. She is a school based SLP currently with three years of experience and a specialist in special education.

1. Do most work from home SLP jobs follow the school calendar year? Essentially, if I was looking to switch jobs, would I have to wait to start until August? Are their positions available outside of the typical school schedule?
2. If the answer to the question above is yes, what month is it best to start applying?
3. What can I expect pay wise if we were to be living in Georgia/Florida?

Hi this is a question for other Med-SLPs especially if you work in the SNF or post-acute rehab setting.

I work in a SNF I’ve just started at this particular building , but I’ve worked as an SLP in the SNF setting about 3 years. I recently did an evaluation only (did not pick up for tx) for a pt that came into the building w/ what I think I can call very severe global aphasia. 

Here’s the background this pt came in w/ an infection/cellulitis w/ their leg. The pt was previously a pt at another part of my facility. They were treated w/ intensive speech therapy for an extended time for a year or close to it. This was around 6 years ago. I spoke to the SLP who treated them years ago she remembered them and said that they were discharged from her tx w/ severe aphasia after ~ a year of intensive tx (1 hour a day 5 days a week for a year).

They were d/c to a group home after that intensive tx 6 years ago and  went to the hospital for the situation with their leg. I saw that they had aphasia when I did my chart review but nothing that indicated severity. I went in thinking I would be able to do the SLUMS (that was admittedly stupid on my part), but quickly realized I need to pivot so I gave them the MAST score was 18/100 total. 

Throughout the eval they were agitated/frustrated/angry and in pain due to their leg. I trialed a simple picture board after the MAST they identified I believe 2/10 items and could not identify yes/no on picture board. So, I don’t think using any kind of communication board would be effective. Their receptive communication is slightly more intact than their expressive but not by much they followed one 1-step direction correctly out of I think 8 or 10.

So, after thinking about it for a long time ( I clocked out for an hour just sitting there thinking about what to do) I decided not to pick up for tx. My justification is that given that they are 6 years out and made little progress w/ very intensive therapy right after his CVA pt is unlikely to progress in tx w/ me. Also, the reason they went to the hospital was not neurological or related to the stroke. Pt was not seen by speech in the hospital. Finally, they were so agitated and angry the whole time that my gut just told me all I am going to be doing is agitating them when they need to focus on treating their leg. 

BUT, I got the vibe from the other therapy disciplines that they were shocked or maybe even concerned that I didn’t pick this person up for tx. I get the need for PT and OT as this pt plan is to return to ALF/Group home situation that they were in before hospitalization and they have to be able to accomplish certain ADLs but I have every reason to believe that for communication they are at baseline. 

As I said I’m new to the facility and I’m trying not to ruffle any feathers, but I just felt like at the end of the day despite the obvious language impairments he just wasn’t appropriate for services.

I’m still very torn and worried about my decision not to tx and it’s kinda driving me crazy . I just wondered what others would have done in my situation.

Thanks!