I work in ICF for the state. We have 50 school-age and 420 adults with developmental disabilities. We have our own special education department that runs year round. I’ve been seeing this boy for 9 years in direct speech. He has moderate ID with Autism. Guardian (Mom) is on the spectrum herself and we have had a lot of issues in the last several years with her. He’s 18 now and is not making progress and has most definitely met his potential. I have assessments and reports to back this up. The team agreed with me last year on him being dismissed but we had a strange situation where his Mom would not participate in the meeting and wrote a letter afterward saying she didn’t agree. I was pushed to keep him in to keep the peace (many more issue than this was going on) and I went ahead and kept him another year. Well today she was there and again I recommended dismissal. She said she had to think about it but at this time she does not give consent. I didn’t even know what to say and no one else did either. She told the special ed director she would call her by Friday. My coworkers said it was my decision along with the team and told me to stick to it and write the dismissal report. I know we are bound by a code of ethics and I absolutely don’t feel right keeping him in speech when he’s not benefiting just to appease Mom. Help please! What would you guys do? I should add that I get paid a flat rate and we don’t do any billing for direct hours served.

I've been following all the For the Love of Gabe drama and can't stop thinking about this autism blog I used to follow in the 2010s. It's still out there as an archive, but I don't want to link to it because this family were in no way grifters like Gabe's family - I think they were very genuine in their beliefs. But aside from that, they had a pretty similar trajectory.

The blogger had a nonverbal autistic son who one day suddenly learned to write to communicate, with the mother's hand holding his. I think he was about 10. He started answering questions, requesting advanced school subjects, showing understanding of complicated topics, etc. I was of course immediately skeptical and recognized this as facilitated communication. The mother insisted the writing was coming from him, and began to transition him to "supported typing" in the hopes of getting his school to recognize his skills.

Seems like a pretty standard, sad story of FC... but the really odd thing is that she managed to transition from supporting his hand, to touching only his shoulder, to not touching him at all but standing behind him, to then sitting outside the room he was in and offering generic words of support. She actually posted videos of this process (the links are dead now, unfortunately), otherwise I would assume she was being less than truthful. I recall clearly seeing the video of her cheerleading him from outside the room as he pecked away at the keyboard.

What I want to know is... how is this possible? It seemed to have all the hallmarks of FC. The boy suddenly "unlocking" the ability to write when being otherwise completely non-verbal and seemingly unaware of his surroundings, the claims of apraxia and a body that wouldn't behave, an odd writing style with words in an unexpected order, the school not supporting him and the mother pulling him out... it's the classic story. But I am really tripped up on how he was able to write for himself with his mother outside of the room. Any thoughts? Does anyone else remember this blog? I wonder what became of that kid. He would be an adult now.

EDIT: I didn't realize I needed to include more background on facilitated communication. Apologies, I thought this was more general knowledge. This is NOT a case of an autistic child naturally learning to read, write and type. It had all the hallmarks of FC. More reading here: https://asatonline.org/for-parents/learn-more-about-specific-treatments/facilitated-communication/

GUYS I DID IT 😭 I accepted the school contract position!!!
I negotiated and got the rate I wanted, AND I even got 2 PTO days. I know 2 days might not sound like much, but for a 32-week school contract, I will absolutely take it lol.
I genuinely could cry right now. My husband has been having a really hard time finding a job, so financially things have been incredibly stressful for us. I had gotten to the point where I felt like I could not catch up no matter what I did. Every bill felt like another thing I couldn’t get ahead of, and I was honestly just exhausted and overwhelmed.
This new position should bring in over $2,000 more per month than I’m currently making in private practice. That is HUGE for us. For the first time in a while, I feel like I can actually see what’s ahead of me instead of constantly worrying about how we’re going to make everything work.
The craziest part is that this time last year I was starting a travel position and making great money with the tax-free stipends. When I left travel therapy, I really thought I’d never get close to that income again unless I traveled. But I went back into the school contract world, stuck to the number I wanted, negotiated, and somehow got pretty damn close. It’ll be taxed this time, obviously, but I don’t even care. 😭
I’m just so freaking relieved. And proud of myself for advocating for what I needed instead of accepting less because I was scared to lose the opportunity.
Private practice was just not it for me. I tried. I really did. But I feel like I can finally breathe and be excited about my life again.

I DID IT 😭

I’m interested in how many people would leave their current job and retire from their SLP career right after or soon after hitting their 30 years, making them eligible for their full pension, (I live in Florida ) if this were their situation.
-Single- no kids or family
-34 years as an SLP full pension starting in October 48K a year +225 extra per month for health insurance
-net worth of $1 million home equity of 300 K, 300k liquid retirement account currently 430 K Roth.
-no debt
****health issues related to menopause, anxiety and a caseload of 100 including about 40 consultations.

I feel like a such a failure to myself and possibly the school/staff

For insight I took an Slpa position at a small preschool self contained. With 4 classes with AM session and PM. I thought it was how it was at my old school where we pushed in for 45min then we want back another time during that week for another 30 to spend time on 2 kids and collect data. Different kids every week to gather data. Thats how my old slp had it set up.

I did the mistake of not asking what their model looked like. I didn’t realize we were spending basically all day pushing in. Which I understand why we do that now seeing the needs. I’m having to manage a lot more than I thought. Plus the physical toll.

I have endometriosis and since I started my pelvic area is hurting everyday!! I’m going through a fibromyalgia flare up and it’s made it worse.

I feel so screwed. I can’t leave because it’ll make me and my contracting company look bad. I’m worried about what things are going to look like when I get surgery for my endometriosis. I originally thought 2 weeks would be fine but apparently since I’m lifting, sitting up and down. I’m going to have to take at least 2 more weeks. I’m worried about the school is going to take this.

I screwed myself up sooo bad 😭😭😭 and idk how I’m going to make it this year.

Virtual SLPs please give me all your tips and tricks to successful provide telehealth (bonus if it’s within a school setting)

Also- pros and cons as well as what made you make the switch to virtual

I work in elementary schools and typically have taken data and notes on physical paper because I don't like being on a screen during sessions, wondering what you all do? I want to keep it organized and in one place so am thinking of switching to a computer / word doc situation.

I have been working with an agency since May, they were supposed to find me a placement in a school district. I've had everything done for a while and they finally found a position this last week. I interviewed and the district said they wanted me. Last week the agency told me I was supposed to start on Monday, I emailed Friday afternoon because I had no specifics. On Monday they told me that it's in the district's hands and I should be starting tomorrow, again, I have no specific start time/location so I'm just waiting.

Today I was emailed about an interview for my local district and they want to interview me Thursday. The agency is at-will employment, but I'm just sitting around waiting. If they get the information over to me, is there a problem with me telling them fine, I can start, but I have a personal appointment that I made on Thursday because I had not heard from you? Is it unreasonable to want my site information less than 24 hours before I start?

Both positions are temporary, but I'd rather have the closer commute and get my foot in the door at the local district. Also, I'm a CF and the district will supervise me in-house as opposed to the agency who will provide me with their own supervisor. Anyone else experience this?

School based SLP here. My caseload is PreK-4th grade. Lots of groups. Found myself struggling to be patient with the kids today mostly because I myself have sensory stuff and there was a lot of noise happening around the school that was hard for me to tune out. Usually I fair fine but today was an exception.

What activities do you guys reach for when you have low cognitive bandwidth and/or energy but the show must go on? Also any tips for overcoming that afternoon slump are much appreciated.

Hi all, I have an interesting case at my elementary school and am wondering if anyone has seen something similar or has advice on what goals to target. I am relatively newer to the field still, so appreciate if people are nice if I'm missing something obvious!

A student I am evaluating for a 3-year assessment has current goals for telling cohesive narratives, producing age appropriate speech sounds (with a past goal for vowel production), and self advocacy. He is in 1st grade. He did the GFTA and his only error is some vocalic r's. It sounds like he has an accent and some of his vowels are distorted and almost nasalized. For example, when he says "cat", it sounds nasalized and I had him plug his nose and say it again and his production changed. He also has a very slow rate, often holding out some vowels and syllables in words. He has no visible tension as he talks or discoordination. He also is hyperprosidic (is that a word??) and almost sing song like or questioning every time he says something. His teacher said she sometimes has a hard time understanding him and that he speaks very quietly in class.

There were sometimes I had a hard time understanding him and from my classroom observations, he does tend to not speak up or talk unless called on.

Has anyone worked with a similar student? Or have ideas for goals to target? I am leaning towards a prosody goal where we differentiate between intonation for a question and a statement etc., but beyond that I am not sure where else to go!

Hi!

I just started working for a practice virtually during after school hours. I didn’t realize the sessions would be as short as they are. They’re 15 minute sessions? So nine kids were scheduled for two hours worth of sessions. Not all came, but I found it to be very chaotic.

Is this allowed?? I want to make sure this is ethical. I didn’t realize that sessions could be this short.

I’m looking for something where I can enter student name, minutes, maybe a goal, IEP due date, etc. I know people like Google Sheets, but it’s intimidating for me to try to make something from scratch!

This is going to be long so please sit back and enjoy. Apologies for the typos, I’m typing with fiery passion and my thumbs aren’t moving fast enough for my brain.

Okay so, Im a NYC based sLP who work in HH. All the info is based on what mom has shared and working with the family for a few months.

I took on a case, the Pt is a male 5yr old DX with ASD, non verbal and history of DV with his father. Pt lives with mom, older brother (10) and occasionally two older siblings but they are in college and grandpa.
Mom had a court order and order of protection against dad so he is unable to contact mom. Dad communicates via 10 year old son.
My pt has shown behaviors of kicking, pinching, head budding and everything you can think off. Throwing chairs, throwing his body, putting his hand by the door frame and closing the door on it !!! which yes are all attention seeking behaviors. He laughs as he does it and especially with family. He jumped on mom’s stomach as she was falling asleep and she has bruises!

As educators and therapist we know this is the result of trauma and learned behaviors. The team (OT and ST) is doing all they can to help mom but she is mentally unable from all the manipulation dad is doing she cannot be present in the session and carry over strategy. He is getting ABA soon.

Dad makes plans to pick up the kids and wants to spend time but cancels and makes it seem the mom is “a unfit mother, she is crazy and doesn’t allow the father to see the kids”. The father is friends with the landlord and trying to push her out of the apartment but she just making ends meet. They pay cash for the apt and the landlord has increase rent multiple times and claims she has not paid for a few months.

There are prior hospitalization from the 10 year of when he was younger. ( a fractured ankle from a hammer, dislocated elbow.. ) now the 10 year old records the mom and her actions when she overstimulated and reports back to dad. The 10 yr old has been reported to hit and kick the younger brother. It’s so heartbreaking. This mom was crying and venting wishing her son (my Pt) was “normal”. Don’t would all be easier
Mom is dealing with a lot. She has a free city lawyer and stated the lawyer is making her say certain things that don’t align with her needs.

I know we are SLPs and our scope is Vast but there is something we can do. Refer out? Find probono good lawyers to help with the housing? The abuse ?

The Pt is going to get worse if intervention is not taken. I understand how difficult it is to get out of these situation when you are all by yourself with no support. There has to be something !

Thanks in advance.
I understand we can’t help everyone but if it’s in my power I will because I would want someone to do the same for me.

This isn't specific to being an SLP, but its about working with kids.

So, I don't have kids and I'm not sure what is the proper way to react to this.

If you have a student who always makes up obviously fake stories about their life, do you call them out on the lying or do you just play along like you believe them and ask questions about their fake story?

I don't want to ENCOURAGE lying, but if they feel they need to lie because maybe they don't feel like they have much interesting going on at home...is that my business.

I wouldn't call out a random adult on their lying but if it was a family member or friend I probably wouldn't want to be around someone telling lies constantly.

Hey guys! I am familiar with LGasp and NBSLH - is there an affinity group for neurodiverse SLPs? I have ADHD and I am working with some newer clinicians who are ND. I’d love for us to have “home.” Somewhere reliable I can refer my autistic and ADHD, all ND professionals. Thanks!

anyone else in a medical setting with ENTs firmly believing in "gavage feeding" to bypass a severely impaired oral phase? aka cutting off red rubber catheter, putting on catheter tip syringe, passing it through the oral cavity into the pharynx, and sending the trials straight in?

I'm about to start my 4th year of my degree and I really don't understand what's wrong with the term patient as opposed to "user" or even "client". I say this as someone who's had many health issues myself, overwhelmingly mental health, I have ADHD and, I suspect, undiagnosed autism. I've never felt like me being a patient was in any way a derogatory term. I remember my therapist (psychologist) telling me how they didn't like me to refer to myself as their patient, and professors have said the same, that it's not the preferred term, that it has baggage. But I just don't get it? What's wrong with being called a patient?

EDIT: I live in Spain so this taboo might not exist where you live but it does exist here. Although maybe not so much in practice? But my professors have certainly insisted to refer to them as "users", not "patients" (literally translated from Spanish). Also, obviously, if you work in education, then everyone agrees it's "students", lol

Any ideas for an older boy with only one preferred activity that is sprinkling things in close proximity to his face? He enjoys the visual stimuli for sure but balls, gear spinners, bubbles don’t give the same effect. He sprinkles ANYTHING. Paper, kinetic sand, play doh, trash from the trash can, his family even said he has started ripping the blinds at home. It’s also of note that it’s never sprinkled into a bucket or some contained space lol. He’ll get on the floor and try to stuff it under bookshelves, file cabinets, into openings of toys. Next best thing is water play but he can get pretty soaked and also just spits it out into the bin to get the visual effect (which admittedly gets germy and gross after a while) and anyway, we have hour long sessions so it’s hard to roll with it for that long!

Hello!

I work in the schools and I got a referral for a kindergarten student who has left unilateral vocal fold paralysis. Apparently it has been since birth. She had a trach tube placed around 3-4 years of age but had it taken out last year. I don’t have a full medical history but my supervisor suggests I do Tier II interventions first. As a school SLP I have never had a voice case so any suggestions would help! (She also has typical phonological errors we are working on eg stopping, fronting)

Former teachers who became an SLP, why did you choose to switch? Did the job live up to what you had hoped would be different/better?

This is more of a rant but I feel so frustrated and defeated by the licensing process for New York. I finished my CF at the end of June and had everything submitted by the beginning of July. Everywhere on the website tells you not to call until 6 weeks after submitting so I waited a bit. There is no way to check the status online. I called a month later since I never got anything and they told me I never submitted my Praxis even though I had the receipt that I sent it a month prior to the correct code. The error was on their end and they never correctly processed it so they put me in as “received everything” a month after I actually submitted. When I got confirmation everything was in, I was told it would be 2-3 weeks. 2-3 weeks passed and I called again last week. The person told me it would be in by the end of the week. I called again today and she told me it’s 4 weeks. I understand it’s a long process but I just wish they would be honest with me when I call about how long it will actually be. I moved to another city already since I thought I would’ve had a license by now and can’t get a job because no one wants to hire someone without a license (which is completely understandable on their end). I feel stuck and like I’ll never actually get my license. Is anyone else going through this or went through this?

Edit: I just got my license a couple hours ago but everyone’s responses go to show that NYS needs a better system for licensing. Even a status tracker online to show that the state received everything would be helpful.

Hi everyone! I’m looking for some perspective. I’m a 2nd year SLP and haven’t had the easiest start to the field. My CF was in the schools with about 100 students, and while I learned a lot, I was mostly in survival mode and didn’t feel like I had much opportunity for clinical growth.

I recently transitioned to private practice about a month ago and LOVE the setting so much more. However, I was basically thrown in on day one with very little formal onboarding. We have a lead SLP, but since everyone is paid per billable hour, it’s hard to find time to ask questions or get guidance from her unless it’s a quick text/email.

I struggle the most with pediatric feeding. I had almost no feeding experience in the schools or grad school, while everyone else has had additional training. The hiring manager knew this going in and said it wouldn’t be an issue, but I feel like I’m expected to evaluate/treat feeding because I’m getting evals with feeding concerns and inheriting clients with feeding goals.

I understand that I’m independently licensed and responsible for continuing to learn, but I guess I expected at least some guidance when starting somewhere new (especially in an area I have little experience with).

There are other practices in my area, including one that’s SLP-owned, and I’m wondering if I’d be better off somewhere with more mentorship, but maybe I’m expecting too much? Should I stick it out and figure things out, or look for a more supportive/involved workplace (if that’s even out there) :/

What kinds of activities are best for kids who are working on language concepts? I see a lot of conflicting research on receptive language activities. I also try to be very child led and engaging but also want to make sure I’m teaching and not just drilling and testing. I have a student who makes very slow progress with language concepts. Same for students with some grammatical targets. I would ideally like to do more fun activities that incorporate goals and looking for some fresh ideas. Or even reassurance that structured therapy activities that aren’t just games are fine sometimes. I have students that are unsafe with certain materials (mouthing, throwing, etc). I have kids who won’t do anything “boring”
Some things I’ve tried:
Books
Crafts
Sorting games where we go shopping or cooking
Scavenger hunts
Boom cards
Movement activities