Monthly Archives: October 2010

School Speech Pathology Burnout

An article in the Pittsburgh Tribune-Review by Teresa G. Odle (October 10, 2010) carries the headline, “Hot Jobs: Speech Pathologist.” Such articles are appealing to university students in search of a career.  “This steadily growing profession has plenty of jobs in schools, hospitals, private clinics, public health departments and other settings….Federal laws have affected enrollment in special education programs and services for students add to the need for SLPs in schools.”



The Metro in Paris

On the other hand is the voice of experienced Maggie Horan of Albuquerque, NM.  While she likes her profession and the variety of cases, she notes the hardships for long-term SLPs. Interesting diversity in the field is a drawback.  “She says that for school workers, caseload can get out of hand.” 

 We have two ends of a professional continuum, from idealism to realism. 

The profession has to recruit SLPs, true. But the gap is enormous between the university perspective and the real world perspective. Some young clinicians don’t make it and change professions. They quickly experience burnout and don’t have sufficient understanding of it to make adjustments in skill and expectation.

New SLPs often take over jobs left behind by retiring SLPs. They not only get huge caseloads; they also get chaotic files and materials and school-to-school schedules no one else wants. They find special education directors who do not care about caseload size, and teachers who do not like the idea of collaboration. They meet parents who push for what they want and are used to getting what they want. Some teachers try to push children into the speech and language caseload.

There is also a need for a broad understanding of school speech pathology. SLPs are asked to engage in reading instruction for which they have no preparation whatsoever.  They do not know special education law and they do not know about special education trends like RTI.

The gap is not easily closed by continuing education. It should not be a replacement for preservice education. Grassroots advocacy without a national campaign is not really helpful to new SLPs sinking fast in a world controlled by national education politics.

Yes, the divide between university expectations and hands on service is too large to be easily bridged.  Some SLPS burnout before they even can get a handle on the problem.

Fall 2013 Update

Yes, this is all true. My present writing is on ASHA organization for addressing practice and curriculum changes, where ASHA seems years behind in addressing the needs of school SLPs. The Board of Directors should step back away from the public relations viewpoint to see if ASHA can somehow catch up. This is of course all part of an historical pattern of downplaying the role of school clinicians.

John M. Panagos


Fighting School Speech Therapist Burnout

One way of reducing speech therapy caseload size and preventing burnout is to reduce the number of children needlessly placed and retained in special education. 

Speech therapists do not seem to recognize the problem.  They do not have background from college, there are no continuing education courses about the abuses of special education over-identification, and they know little about what the federal regulations forbidding over-identification.  The same can be said for other related services personnel and special education teachers.

We have noted many visitors to our blog conducting searches for information about how to combat burnout, but virtually no visitors interested in school misdiagnosis leading to errors of special education placement.

Some burnout arises from SLPs providing services to non-disabled minority children.

March, 2015

We posted this note in 2010, and has been no change in this area. We do not see that the ASHA leadership has any special interest in reducing over-identification. It is part of a pattern of neglecting old school problems, especially when they constitute public relations problems.

True SLP Collaboration – Indiana’s Model Program

A report written in Urban Perspectives (winter 2006), ” Adapting Speech Therapy Service Delivery through Data-Based Decision- Making and Response to Intervention (Lori Carmichael-Howell and Jennifer Dezarn-Lynch, Metropolitan School District of Wayne Township, Indianapolis, IN)  gets at issues critical to the future of school speech-language pathology. 

The SLPs were frozen in a survival mode: “They were not satisfied with the progress in student achievement; services were delivered separate from the curriculum, and large amounts of time were focused on assessment and placement rather than intervention.” 

A district-wide improvement project was developed. “When data was examined during this project, a lack of consistency was found not only in identification of disabilities but also in service delivery methods, use of evidence-based practices, and SLP involvement in the general education curriculum.” 

Service delivery was made more flexible, adapted to children and SLPs, and RTI was interfaced with therapy services. Collaboration and generalization goals were important.  Aggregate data were collected to evaluate progress, and phonological process instruction was incorporated into the program.  The need for pull out therapy was reduced. 

The program has become a model for Indiana.


In one fell swoop the Indiana project demonstrates how SLPs can plan for systemic change addressing a wide range of issues including SLP overload and burnout.

Failing Special Education Program

The Urban Special Education Leadership Collaborative, an evaluation group from Massachusetts, has filed an audit indicating that the San Francisco model of special education is “outdated.”  It should move toward mainstreaming special education pupils: “The report calls the district’s special education practices reactionary, discipline-specific and focused on compliance-related activities and crisis management. Put simply: Schools are babysitting these kids, not teaching them.”

Any school speech therapist will recognize these practices as the chief public policy issues dating back to before IDEA 1997, when Congress was very active in addressing special education issues.

The “discipline-specific” practice speaks to the non-collaborative approaches of related service and special education personnel, following the “diagnostic-prescriptive” methods of symptom treatment.  School speech-language pathologists across the country still rely heavily on small-room direct service. 

Dr. David Riley says: “Most students should be in general education classrooms with the right support. That means teachers are retrained, paraprofessionals are in the room.”

As we are advocating here, school SLPs and other specialists need to re-evaluate their placement criteria and judgments to reduce the number of non-disabled children placed in special education: “The report…calls for a reevaluation of the process to identify students who need special services. The auditors found disproportionate representation of particular ethnicities in some special-needs categories. African-American students in San Francisco, for example, account for only 11 percent of the total student population, but make up 24 percent of the special education population and 49.3 percent of the students identified as emotionally disturbed. The auditors are concerned that some of this “disproportionality” is the result of inappropriate identification.”  Certainly school psychologists are key players in contributing to the problems of misidentification of at risk children.

The need to change is placed on the administrative structures. It is very difficult if not impossible for SLPs to move toward reform from their isolated positions and from the “bottom up.”

Here is where reform advocacy must come from speech-language pathology professional groups. Not everything can be accomplished through “grassroots” advocacy.

Changing Identification Rates for Special Education Children


In September of 2009, Christina Samuels writing in Education News Colorado, reports on the drop of over-identification of learning disability enrollments:


The percentage of 3- to 21-year-old students nationwide classified as having a “specific learning disability” dropped steadily from 6.1 percent in the 2000-01 school year to 5.2 percent in 2007-08, according to the most recent data available, which comes from the U.S Department of Education’s 2009 Digest of Education Statistics. In numbers, that’s a drop from about 2.9 million students to 2.6 million students.


There is a small tendency for a decrease in special education enrollments overall.


One would argue the drop results from IDEA 1997 and 2004 regulations addressing issues of placement criteria, such as discouraging the the use of the discrepancy model by school psychologists.  Samuels reports though that many experts attribute the drop to better reading instruction through early intervention and response to intervention.


At the same time, though, enrollment of students classified as having an autism spectrum disorder or “other health impairment” rose.


The historic evidence indicates that minority children have been shuffled around special education categories.  Early on they were heavily placed in the mental retardation category, and later learning disability. Now it is possible that some minority children who are perceived as disruptive in the classroom are being shifted to autism and OHI (including hyperactivity).  The overall decrease in special education is relatively low.


School districts across states may receive high reimbusement from the autism and OHI categories.  




SLPs are often on the eligibility team to place LD children, and they render a vote for enrollment.  SLPs can vote against placement where  appropriate reading instruction is not evident. SLPs can promote preschool and RTI programming to improve reading and cut down on placements.  SLPs are chief evaluators in the school setting. They also make recommendations for children with articulation and phonological disorders, often linked to LD and processing problems.