Want a Career as a Speech-Language Pathologist? Ask a Professional

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So…moving on…where can you work as a speech language pathologist? There are many many options…MANY.

  1. Public schools. There are speech pathologists in just about every public school. If you choose to work in the schools, you likely will need to be certified by the state department of education. In my state, you actually need to be licensed first to apply for SDE certification. Most school districts want their SLPs to have the CCC from the American Speech Language Hearing Association. SLPs can work with students preschool-age 21. School based SLPs work as part of their special education team. In addition, SLPs are often called on to help parents and staff members understand communication disorders.

  2. Private schools- there are some special education private schools that have speech pathologists on their staff. Some regular private schools also hire SLPs to work with students.

  3. Clinics- there are many types of clinical groups that hire SLPs. Some have SLPs only. Others have OT, PT, sometimes special education staff, sometimes psychologists. It all depends. But there is a great variety in terms of clinical types of work. Clinical SLPs work with all ages, though most have a specialty within their practice.

  4. Hospitals. Many hospitals have SLPs on staff who work in a variety of capacities. Some have evaluation teams for specific issues (e.g. feeding, craniofacial issue, strokes, etc….more on all the different disabilities SLPs work with in a later post). Again…usually hospital based SLPs work as part of some sort of team.

  5. Skilled Care/rehab- some SLPs specialize in geriatric issues affecting communication. Others are well tuned into what happens if someone has a stroke or some other medical emergency where they are sent for rehab. Many different options here too.

  6. Private practice- SLPs can also have their own private practice. They can specialize in anything they choose. Lots of different options here, with great flexibility…especially if you want to own your own business.

I feel like I’m leaving something out!

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So…what do SLPs do? In short…they give people a voice. We work with folks who are having difficulty communicating in one way or another. This can be expressive issues, or receptive ones. So…here are some of the things:

Phonological disorders (sound errors)
Language both receptive and expressive (includes lots of things like sentence and word structures, vocabulary, grammar, etc)
Social Communication (so important)
Fluency (some call this stuttering, but fluency can be a variety if things)
Voice (using one’s vocal mechanism so as not to damage it)
Apraxia (a motor speech issue that often results in very unintelligible speech)
Feeding and Swallowing (a specialty area some are trained in)
Literacy as it relates to language usage (again, many are specifically trained)
Accent Reduction (another specialty area)
Functional Communication (being able to express things that are functional!)
Work on rehab after things like strokes

And yes, you will receive training in all of these things…at least to some degree…in your training programs.

Bottom line…you are giving folks the ability to communicate with others! You are giving them the ability to understand, and talk in a more efficient way.

It’s really a joy when you work with someone and see the improvement they make…and their ability to do these new skills on a day to day basis!

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Thank you @thumper1; this is all so interesting!

I know a young man whose undergraduate degree is in Voice Performance. He is transitioning from classical singer to SLP and currently in a post-bacc program to get the prerequisites. He feels his vocal training is useful experience.

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One of my masters degree colleagues was a vocal performance major as an undergrad. His focus as a SLP was working with performers on good vocal usage to prevent vocal loss.

A great blend of these two things!!

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I am an SLP. I worked with a professional opera singer who was also an SLP.

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So…what about salaries?

Of course, these vary depending on the site and area of the country…and in some cases (like schools) your level of experience. I will say, I have never felt underpaid, and have always been able to easily pay my bills.

I worked in a school setting. My salary and benefits were based on the same contract the teachers had (and I actually was head negotiator for that contract for 12 years). Salary was good, and benefits were as well. If you are interested in school work, the contracts for teachers are a matter of public record. School based SLPs work the school calendar. Work will be with school aged children, doing a lot of different things!

Hospitals where I am pay a tad less salary (not much…but a little less) than school based work. Again benefits are good. These are usually year round salary positions with a certain amount of PTO annually. Many of my hospital based SLP friends actually have specialized in some way. They might work on a craniofacial team, or doing evaluations and therapy with stroke patients, or working with developmental pediatric evaluation teams.

Clinics are another option. These can be “therapy clinics” that have speech, OT, PT. Or they can be clinics with SLP services only. They are privately owned. In most cases I know of, the SLPs get an hourly rate if pay. Most are part time, and don’t get benefits. This offers a lot of flexibility, however, in time worked. The hourly rate of pay is usually a good one for the area in which you reside. You would be working with whatever age the clinic services.

Skilled Care/Rehab- where I am, most of these are part time jobs. Some are full time but involve traveling to more than one site. Compensation is usually good. Benefits are provided if you are above a certain number of hours a week. Work is with folks who are either elderly, have had a significant medical trauma affecting communication…or both.

Private practice is really running your own business. The overhead will be yours. You will be responsible for billing and knowing exactly how you are able to do this. It’s a great way to have full flexibility in determining your schedule, the types of services you provide, etc. Your compensation will vary depending on what you actually are doing…and how many clients you see weekly.

Early Intervention- this is for students who have not yet become old enough to receive services through the schools. In some states this is B-3, and in others B-5. If you love working with the very little ones, this is where you want to be. Early intervention SLPs do just about all of their work with families and students in the student home. In addition to providing some direct therapy with the kids, they are also helping the parents provide an environment that facilitates communication.

I guess I didn’t really answer specifically what salaries are…because they vary so much. Where I am, an entering school based SLP will make about $70,000 a year with full benefits. Private practice…well, I charge $100 an hour. Some folks have told me I’m undercharging.

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So I hear about caseload. What is a realistic caseload per /day /week and how is it managed?

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Ah…caseload management.

This so is site dependent.

In the schools, caseloads for a full time SLP can easily get into the 70’s (which I think is too high). Most school districts do have some limits on caseload sizes for very high needs populations like autism programs, programs for very low cognitive students, and even preschool.

How to manage? Grouping students with similar goals and objectives helps. Finding evidence based practices that can be used in shorter duration sessions (e.g. there is a five minute a day method for working with sound errors…works very well). Make sure that skills learned are reinforced in the classroom situation. Involve families for that reinforcement at home. IOW, create an environment where students can progress well…and be dismissed!

ASHA has a workload document and calculator that can be helpful in identifying when a SLP has reached the max in the schools.

Scheduling is sometimes used to help make the workload more manageable. For example, some districts use a 3:1 model whereby direct services are provided for three weeks, and the fourth week is used for other work like meetings testing, report writing, consultation, etc. This type of scheduling means sessions aren’t cancelled for that “other” work (which I will cover on a later post)

I think keeping administration well informed about your ability to meet the IEP requirements for all your students is key. So…good communication!!

In private practice, hospitals, clinics, etc…this doesn’t seem to be an issue.

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Do speech pathologist in private practice take insurance?Can one be successful just billing a fair hourly cash rate?

Also you mentioned about working for a school district. So do you take off the summer like teachers or do you work elsewhere in the summer.

I appreciate your answers.

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Yes, we accept most insurance plans. (My colleague specialized in phonological production {how kids make and produce sounds}. She charged, at that time, $200 per hour/cash and held sessions in her home office. She got it and had a waiting list. That was about 15 years ago. ) What I always suggested was that the child use their school based therapy, during the year, and come to us in the summer.

I can work in SNF’s ( pronounced “sniffs”/Skilled Nursing Facility) in the summer, but I often did not because I had children who wanted to do summer sports and activities.

Caseloads are hard because some districts go strictly by numbers but each child is unique in his/her needs. That’s the hard part:

I specialized in Augmentative communication (think Stephen Hawking). Those kids took me a LONG time and a LOT of hours to program and implement their devices. So, if I had a 55-caseload, five of those children could take me a week which would convert my 55 kids/11 per day to 70 for the 5 kids who took me 55 hours to change or program their devices.

It was always recommended that we carry our own liability insurance. I had HPSO. You can PM me about this. It’s not that expensive, but good to have to cover our primary homes and personal items.

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Do speech pathologist in private practice take insurance?Can one be successful just billing a fair hourly cash rate?

Speech pathologists in private practice can take insurance. They must become providers with the different insurance companies if they wish to do so.

You can charge an hourly rate, if you choose to do so. Many people (like me) do such a small number of private practice clients, I just bill the people directly.

I absolutely carry my own private liability insurance and even did so when I was employed by a school district.

Also you mentioned about working for a school district. So do you take off the summer like teachers or do you work elsewhere in the summer.

I want to be very clear. School district teachers contract folks are paid for the days they work. So if the academic year is 187 days (that’s what mine was), that is what I was paid under contract to do.

My days of work coincided with the school calendar. If the district wanted me to do summer work, they contracted with me separately to do so. This was not part of my salaried school position.

Some schools have year round school…so that would be a little different in those situations.

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I have worked in hospitals, private practice, and home care (Early Intervention). I also worked in center based programs.

I currently work in a school district and am on the teacher’s contract. I get paid a salary from September-June, and if I work during the summer it is for an hourly rate.

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Home care.

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Yes, there are SLPs who provide Home Care services. In my experience, they are hired by either a private agency, public agency (something like visiting nurses, some agency providing services to aging populations), rehab facilities who transition folks and offer home care services.

I also left out early intervention in my post about sites. I did address that in a later post. Early intervention folks work with students who are not yet old enough to receive services through the schools.

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I worked for Early Intervention and Preschool Special Education in 2 states doing home care. Preschool home care is not permitted in every state. Some need to be seen in their preschool or daycare, and others need to be seen in their home district preschool (depends on the state).

I also worked with adults through Visiting Nurse.

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I’m actually speaking about services for kids who are not usually old enough to attend any preschool, and some aren’t IN daycare. In my state these EI services are for kids under age three.

And yes…that could very well vary by state in terms of regulations.

These are the types of things you will learn about in YOUR state as your training progresses.

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I did home care for Early Intervention, birth-3, for 15 years. The children who were 3-5 were seen at home or school, depending.

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So adding to the information about this career. So far, I’ve really only discussed who and where services can be provided. But there is more to the job!

  1. As with any other client service, data must be collected to determine the efficacy of the services provided.

  2. Paper work…IEPs, testing reports, progress reports, daily schedules and your own therapy notes, Medicaid billing, state reporting…all of these can be part of your SLP job.

  3. Knowledge about the applicable laws. Special education laws for school based services. Knowledge about Medicaid and other types of billing. Knowledge of state, federal and local legislation and guidelines.

  4. Excellent familiarity with confidentiality, due process, FOI, and any other legal things that could impact you.

  5. Consults with outside consultants, and also with your team at your workplace.

  6. Adherence to your code of ethics!!

  7. Getting sufficient CEUs to enable you to renew your certifications and license.

  8. Understanding and interpreting assessments. Choosing ones that hone in on what you hope to find out.

  9. Writing goals and objectives. Really this is done in ALL settings.

  10. Figuring out how to best schedule and budget your work time. This can be challenging sometimes.

BUT…these things really didn’t get in the way of me doing the thing I loved best about this career…working with the students, parents and fellow teachers/care providers to move a person forward in their communication!!

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One other variation on private practice is to work for a larger private practice owned by another SLP. This way you get a salary and benefits and don’t need to be concerned with billing/scheduling clients etc. My D us doing this now and is hapoy.

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Yes…and some people really enjoy doing this! But I would still suggest having your own liability insurance. It’s not very costly…and well worth the peace of mind.

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