What the Freak? How do you make it WORK???

Dear Speechies,

I am beginning to think that the profession of speech pathology is not for me. I am in the elementary school setting and not matter what I do---I ALWAYS FEEL OVERWHELMED and DISCOURAGED.

This year I have managed to decrease my caseload from 60 to 45 by dismissing or placing students on monitor who were ready to 'graduate'. Yet, I still have the constant screenings, formal assessments, Annual IEP meetings, interim meetings, Medicaid billing, and report writing.

I NEVER have time to actually plan a lesson. My groups are so diverse that I can't seem to come up with one lesson to target every student's goals. I spend more time herding children to and from class than actual administering treatment itself. Then when I do sit them down behaviors seems to undermine progress. For the older students, 3rd through 6th grade, there just seems to be a lack of motivation.

There's this push to incorporate Common Core in the speech/language resource room but I can't even get curriculum/books for each grade.

Who has time to make homework packets?

I refuse to take work home because I have to set boundaries. But I never feel organized. Can anyone else relate???
Um, yes I can relate 99% (I am not thinking slp is not for me). This is my first year out and I have all of the things you have to do as well. It is tricky, and I am learning, but the kids make me smile and laugh every day so it keeps things in perspective. I am hoping to spend some time developing materials/activities over the summer to prepare for next year.
I just received a few items I ordered from SuperDuper and I hope to incorporate these materials soon. This is my second year and I still feel like the schools require too much of me. I even thought of making materials over the weekends and breaks but when I leave work its the last thing I want to do...same goes for the summer. Thanks for replying. Its nice to know I am not in it alone!
Yes, I can relate, and honestly it's the reason I left the school and now work in an outpatient peds clinic. Schools can be very challenging for the reasons you mentioned above and more. A few tips I found to make things somewhat better:

1) For your kids who are older (like maybe 2nd or 3rd grade and up) and can handle it, send reminders to their teachers of their speech times and have them start coming on their own. That saves you the time and hassle of having to go get them and walk with them back to class, and it really does add valuable minutes to your day.

2) Throw some money at the problem. Teachers Pay Teachers has some products that I found really helpful and worth the money:
-From Allison's Speech Peeps: IEP Goals by Common Core Standards (gives you language/pragmatics goals aligned to the common core for each grade level) and Common Core-based informal assessments (I gave these to all my kids at the beginning of the year and before annual IEPs to quickly determine their progress and new goal areas. For artic kids I used the free artic screen from Mommy Speech Therapy.)

-From CC (If I Only Had Super Powers blog): leveled homework packets for speech language--these are homework sheets for the entire year with 3 different levels of complexity. No making homework packets, just grab one of these for each kid on your caseload from the appropriate level. Each sheet has several different language activities linked to common core that parents can do with their kids at home.

3) Think about writing/targeting your language goals differently. This was a really hard one for me, because in grad school I learned to write very specific goals (Client will do X given Y stimuli and Z cueing level in 8/10 trials). Obviously writing goals this way makes them much more measurable, but it makes them a lot harder to target in mixed groups, which are pretty unavoidable in the school setting. Think about the core areas that most of your students seem to be demonstrating weaknesses in: sentence formulation, vocabulary, basic concepts, etc.--and develop a goal bank with a finite number of broader goals for these areas. So instead of "John will produce irregular verbs in sentences given picture stimuli and auditory closure cues in 8/10 trials," your IEP goal could be "John will produce age-appropriate word structures given fading cues." I know that sounds more like a long-term goal than an objective, but when you write IEPs for an ENTIRE YEAR, it makes more sense to me to have your objective specify general areas you will target, which gives you more flexibility AND makes it more likely that you will be able to work on more similar things with your groups. Another option is to continue to write your goals specifically and have "progress monitoring" days where you take data on that specific goal for individual students, but not every session.

Hope this monstrously long comment was helpful in some way. I know it can be really challenging, but hang in there. In my limited experience, it does get easier with time as you figure out how to make things work for you, and if not, there are always other settings to try.
Thanks for the advice. I do have some upper grade students come on their own but many times I have to call for them because they don't remember. So, I will have some students and then others that dont show.
Maybe next year I will check into the materials you mentioned, as I have already spent the funds I was allocated at the beginning of the year.
As foe goal writing, most of the goals are VERY SPECIFIC because the district has come up with a goal bank so that EVERYONE in the district is on the same page when it comes to writing goals. Its definitely a catch 22.
I am going to keep trying. Thanks for the advice!
I want to assure you that you're not alone. Having a good support system at your school/in your district and good time management skills really helps. Our boss tells us we should have about 1/2 to 2/3 of our time seeing students and 1/2-1/3 of our time doing everything else. So most of my suggestions are based off of this model. All of these things are things that have worked for me, in my district. You may or may not be able to do some of these based on district policy.

I can't remember how many years you are in to SLP. I'm in my 3rd year and those first two years sucked. Things are SO much better now. They're not perfect by any means and I still have therapy to make up, but I'm slowly learning how to make things work for me. It takes time. If your district won't give you the support you need, find a new district.

Apologies in advance for the novel!!

1. Tweak your schedule so you have one day per week set aside for everything you need to do that is not therapy (or two half days). Evaluations, screenings, observations, IEP meetings, report writing, and whatever "interim meetings" are. If you can get it, take 1.5 days.

2. Leave 30-45 minutes at the beginning of your therapy day each day to plan what you're doing, or leave 30 minutes at the end of each day to help conquer medicaid billing. All teachers get these planning periods, you should too. Don't forget to schedule a lunch as well. Sometimes I work through lunch, other times I eat with my colleagues.

3. Limit yourself. Take no more than 5 evaluations at a time from your RTI committee. Put the others on a waiting list. Set a cut off date for RTI referrals (mine is March 7th) that will give you time to complete all of the necessary things before the end of the year. All other students are put down on a list to be tested next year. Plan your 3 years way in advance. If you have time at the beginning of the year (when referrals are low), try and get them all done then.

4. Restructure your groups. Group by grade level, then by each major domain - artic, language, fluency, artic/language, etc. Pull when you have to paying mind to the resource teacher's groups. She's the only one you should have conflicts with. If your principal protests that you're pulling from the core classes, explain that you have to see them per their IEP and there are not enough hours in the day to see everyone and provide worthwhile services during XYZ times. This might mean you have to increase the size of your groups. I try not to have more than 4.

5. Put your groups back to back and schedule each group an extra 5 minutes for going to and from class. If your group is usually 30 minutes, schedule 35. Pick up the next group while the previous group is going back to their classes. Knotknot suggested having the kids sent to you -- this never worked for me. The teacher usually forgot to send them.

6. Be very, very consistent in your discipline/reward system. If they can't behave, they don't get to participate in the fun things. They lose turns at games, they don't get to play the last few minutes, they don't get a sticker/prize. Using a token system can help. For my really off task ones, they get 4 tokens which means they get 4 chances. I take tokens away instead of correcting the behavior. They have to have at least one left at the end of the session in order to move their name up the reward chart.

7. Make friends with your librarian and plan around books. You can accomplish most language goals in a diverse group using a book. Many times, we'll read a book, talk about what happened and draw our favorite parts. We can sequence those parts, talk about characters, etc.

8. There are resources for common core on TpT. If you can't do it this year, don't worry about it. Make plans to do it next year and plan over the summmer. You can also plan units by theme over the summer. Jenna from Speech Room News has a TON of these packets for purchase on TpT. If you can't get the books for each grade level, just write your goals based on common core and do therapy using what you have.
9. I don't send homework. It never comes back. If a parent asks for homework, I will send it in that case. And I might send it for my artic kids who have mastered the sound in therapy but need to carry it over. I don't usually send it for language because a lot of their regular school work and homework is already language based. (Although I might send it for grammar).

10. Stay an extra 30-45 minutes after school (or come in early). I've had to do this this year because I'm crazy busy. It's really helped me accomplish things.

11. Consider seeing your students like this: Mild/Moderate Artic: 30 minutes/week; Severe Artic: 45-60 minutes per week; Language: 40 minutes/week.; Fluency: 30 minutes/week. I try and keep most of my students at once per week. I'll do 2x/Week for articulation in PK/K... but once they hit first, I drop them to once a week for 45 minutes.

12. Schedule your kids on the 3:1 or 5:1 model. I see most of my students in 5/6 weeks. Having that 6th week gives me time to get caught up on medicaid billing, planning therapy, and whatever else I need to do. Don't give your kids more or less than you've stated in the IEP. Be specific about what sessions will be made up - if you're absent, if they're on a field trip, state/district testing, inservice days, etc. I've seen other SLPs say "I'll see them 2x/week, but I'm only going to write 9 sessions in their IEP for a buffer." I don't like that and I feel it goes against the IEP.

14. Put in your minutes that therapy will begin the second week of school to allow them to adjust to their new class schedules and even will end the week before the last week of school if you want. Having that first week to get prepared really helps and I usually get off on the right foot with not already being stressed about makeup therapy.

15. Find an organizational system that works for you. I use spread sheets to keep track of things for the most part. I also have a paper that I use to keep track of new referrals and all of the dates that go with them. My kids have working folders with data sheets. Other SLPs I know just take data on their actual goal sheets and keep them in a spiral. Another keeps her data in a notebook. I also have an attendance sheet. I have a wall calendar that shows me my scheduled meeting dates, when IEPs are due, when FIEs are due, etc. If you want me to send you any of my organizational stuff - PM me with your e-mail address and I'll send it to you on Monday when I have access to my flash drive).

16. Don't take statistical data every session. I take it about 2x/six weeks. The other time I just write down the level of cueing or what we worked on and how the child did. IE: Targeted "wh" questions, Susan was able to answer "who" questions more often than "where" and "what" questions. "What" and "where" questions required moderate prompting. Obviously, I write it in short hand which looks more like: WH Q, +Who/-Where & What (Mod); I also document behavior on my data sheet. + for none, +1 for mild, +3 for moderate, and +5 for severe. Every once in a while I have a student who just flat out refuses to participate and I just note "attempted to target [insert goal]; Johnny refused to participate and did XYZ in lieu of participating".

17. Think seriously about "does this child have the language skills necessary to access the general education curriculum?" and "can they get what I'm targeting anywhere else?" (especially if they also get resource/inclusion. If the student is not motivated to work, dismiss or drop to consult/monitor.

This is my third year as an SLP (and in the schools). Everyone has their days, weeks, months, years when they feel overwhelmed. The schools are difficult for everyone who works in them and we do it because we love helping the children.

Here are my suggestions:

1) Always keep a day open for evaluations/paperwork. I prefer to have my Fridays for evaluations. I end every week on a slightly less hectic schedule.
2) Group students by grade level and disorder. I do my best to keep my purely artic students with similar peers. I mix them with language only if there is no other way to schedule them.
3) Inclusion. I love doing inclusion in the EC classroom. I get to work on their goals without having the burden of planning the entire lesson.
4) Monthly themes. This takes a huge weight off of my shoulders. I pull out a month's worth of books on a topic (like Valentines) and use them for the entire month. Most of my students have goals for wh- questions, sequencing, speaking in X amount of words, describing so the books really cover the entire group. I also use the Expanding Expression Tool to help with their vocabulary.
5) Sending homework only over long breaks. I never get homework back so I just don't send it on a weekly basis. I send out packets for Christmas and Summer. That's it. I use freebie calenders from TPT and add in student specific materials to each pack.
6) Look for freebies on TPT or the internet. There are plenty of fun activities for therapy sessions that you don't have to pay for as nice as things from the major SLP bloggers can be.
7) Pinterest. There are tons of great DIY or free resources on this site too. I use it to find craft activities to do with my students.
8) Find out what your students are interested in and try to find ways to incorporate that into therapy. I have quite a few students that are into Ninjas so I pull that into the activities as much as possible. I show them video clips of animals and pictures.

Good luck!
I spent 5 years in the schools and hated all of the things you just mentioned. Spent a year and 7 months in a clinic and LOVED it. I just moved so I have to look for a new position. Definitely avoiding the schools for now. I realized happiness is very linked to setting for me. I was treated so much better in the clinic, had the time I needed, resources, etc.

Edited at 2014-02-27 11:00 pm (UTC)