Workload Status of School-Based Speech-Language Pathologists in Texas

Abstract

In 1993, the American Speech-Language-Hearing Association (ASHA) recommended caseloads of 40 for speech-language pathologists (SLPs) practicing in the public schools, a recommendation that was not feasible for most school districts. In addition, new laws and policies substantially increased the paperwork, responsibilities, and time expenditures required of the school-based SLP. ASHA subsequently instigated extensive reviews of the problem and, in 2002, suggested that schools instead use a “workload analysis approach,” considering all of the required activities from prereferral to dismissal, in order to determine the number of children an SLP could appropriately serve. In our study, we attempted to catalog the status of Texas' efforts in using workload considerations. More than 400 school-based respondents indicated the percentages of time they spent fulfilling each professional responsibility at their school. Responses suggest that variation in caseload numbers corresponds to clinician role (SLP vs. supervising SLP vs. SLP Assistant). Most clinicians indicated that they were fairly satisfied with their job; however, many were employed 5 or fewer years in the schools and the average workweek was 48–49 hours. Although it appears that Texas is using workload considerations to some extent, efforts should continue to optimize the quality of treatment for Texas schoolchildren and retention of SLPs in the schools.

The Deployment and Utilization of the Allied Health Professions Support Workforce: A Scoping Review

“… 31 In pediatric speech and language pathology, SWAPs can work across varying numbers of schools, with the majority working between 2 schools, compared with 12% working across 5 or more. 34 …”

“…This study also showed that after some time had passed, their scope of practice was broadened to include the writing up of reports to be checked by registered practitioners. Another article 34 on SWAPs in speech and language pathology showed that SWAPs had a broad scope of practice, with the majority of their time spent on direct services to students.…”

“…Three articles examined the activities undertaken by SWAPs and the registered practitioners they work alongside, 34 , 38 , 58 which enabled comparisons to be made. One article 34 found that in speech and language pathology, caseloads are larger for SWAPs than for registered practitioners, and that SWAPs spend much less time on more complex activities such as evaluations, dynamic assessments, and little to no time conducting any supervisory activity or making referrals. However, despite these differences, there was not a great deal of variation in the many other activities completed, and the time spent on them.…”

It’s About Time: Initial Findings From a Feasibility Study of a Time-Study Tool for School Social Workers in Michigan

“…With the dearth of literature on time-study tools in school social work, our team turned to the fields of speech-language pathology (SLP), occupational therapy, physical therapy, medicine, and nursing, all of whom have begun developing a literature analyzing the difference between "caseload" and "workload" (Armstrong et al, 2012;Cecere, Crandall, Dixon, Schefkind & Williams, 2015;Nishigori et al, 2015;Storfjell et al, 2015). This literature resonated with us, as we both saw the disconnect between our own stated caseload as SSWs and our actual workload.…”

“…This concern about time is commonly shared by other school related-service professionals (e.g. occupational therapists, physical therapists, speech/language pathologists), who also report having too little time to carry out their work (American Occupational Therapy Association, 2015;Armstrong, White, Moorer-Cook, & Gill, 2012;Cecere, Crandall, Dixon, Schefkind & Williams, 2015). Other related-service research literatures and policy briefs have started to develop a distinction between "caseload" (how many youth are on a regular schedule to be seen by the school related-services professional in weekly or monthly time increments) and "workload" (what actual time is required to serve those students outside of their regularly scheduled time).…”