My First Year as a School-Based Clinician I recently completed my first—clinical fellowship—year working as a speech-language pathologist in an elementary school setting. My year was eye-opening, busy, and a continuous learning experience! I came in idealistic and full of confidence after completing four years of undergraduate and two years of graduate work in communication sciences and ... Features
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Features  |   September 01, 2002
My First Year as a School-Based Clinician
Author Notes
  • Zena Robertson, is an SLP in an elementary school in Sharon, MA. She received her master’s in communication disorders in 2001 from Emerson College. Contact her by email at Zrobertsonslp@yahoo.com.
    Zena Robertson, is an SLP in an elementary school in Sharon, MA. She received her master’s in communication disorders in 2001 from Emerson College. Contact her by email at Zrobertsonslp@yahoo.com.×
Article Information
School-Based Settings / Regulatory, Legislative & Advocacy / Features
Features   |   September 01, 2002
My First Year as a School-Based Clinician
The ASHA Leader, September 2002, Vol. 7, 6-19. doi:10.1044/leader.FTR2.07162002.6
The ASHA Leader, September 2002, Vol. 7, 6-19. doi:10.1044/leader.FTR2.07162002.6
I recently completed my first—clinical fellowship—year working as a speech-language pathologist in an elementary school setting. My year was eye-opening, busy, and a continuous learning experience!
I came in idealistic and full of confidence after completing four years of undergraduate and two years of graduate work in communication sciences and disorders. I felt ready for anything related to speech and language! I quickly realized that the transition from an academic to a school setting would not be as smooth as anticipated, and that working in a school entailed so much more than my knowledge of speech and language diagnostics and treatment.
First Experiences
I first met most of the teachers when I was attempting to schedule the children on my caseload. I had approximately 35 children on my caseload, many of whom were seen three times per week. Some teachers didn’t see how speech and language treatment could help children succeed in the classroom setting. Others welcomed me with open arms and wanted to know how we could work together. Still other teachers seemed irritated that children had to leave the room for treatment or that I would be interrupting their classroom time. I quickly realized how much of an SLP’s position includes advocacy. I had to advocate not only for children but for speech and language treatment as well.
I encountered my first “scheduling saga” in the fall. I used a pencil and eraser from September until June and still never quite established a set schedule! Plus, the amount of times that I walked into a classroom to find that the student wasn’t there, the class was in gym, a special speaker had arrived, or my language time was switched to math time was more than I could have predicted. I was flexible and either tried to reschedule or adjust my treatment plans on the spot. Of course, since my schedule was already over-packed, rescheduling often proved difficult, if not impossible. Adjusting my plans sometimes made me feel ineffective, more like a teacher’s aide than a clinician. Sometimes, I would have to cancel treatment to conduct testing, to attend a meeting, or to work with a student who was having a particularly difficult day.
Don’t get me wrong—I know I’m not the only clinician to encounter this constant juggling of schedules. Everyone I spoke with, rookies and veterans alike, could relate to some extent. I began to feel very frustrated. I felt I had little control over my treatment schedule. I also felt as if this inability to organize my schedule was compromising my ability to best serve the children on my caseload. As it is my first year in the business, I am not ready to accept this as status quo. I do not, however, have the solution just yet.
One of the most challenging aspects of this past year was creating a balance of power. I believe that true teamwork is a balance of ideas, thoughts, and recommendations from parents, teachers, and specialists. If one member of the team possesses more power than the other members, the others tend to become less willing to work together, and creating a plan of action becomes more difficult. I strove to achieve this balance during the past year.
As in any school, we had some children on IEPs who were having difficulty making effective academic progress, even with support in and out of the classroom. Essentially, the IEP was not meeting the child’s needs at that point. It quickly became evident that the “blame game” provided no solutions. Even though there was a lot of complaining occurring at meetings, I still found it difficult to suggest and implement new classroom modifications with some teachers. Sometimes the solution required a teacher to change a particular style or classroom routine for one student. There were some veteran teachers who had a difficult time receiving and taking advice from me. This is something that I struggled with throughout my first year.
Advocacy
I mentioned that I was unaware of how much advocacy work I would have to do. I was not only recommending and implementing modifications this year, but I had to “sell” teachers on the justification for why they should carry out the language modifications when I am not in the room. This ties into achieving a balance of power. I found that, ultimately, a teacher has a choice about whether to use modifications. I’m starting to believe that perhaps teachers should not be able to choose whether or not to put language-related modifications in place for a child with a language disability. I understand that, under the Individuals with Disabilities Education Act (IDEA), modifications are not a choice; however, how, how often, and what modifications are chosen does remain a personal choice.
I am working toward helping create a school community where all teachers view my ideas or recommendations as ways to make a child succeed in their classrooms, not as ways to insult their current style of teaching.
In theory, providing classroom language modifications to promote generalization seemed an easy process. In practice, it is a continuous work in progress and has proved to be a real struggle at times, mainly because there is a certain lack of awareness about exactly what I know and what I do. Educating other teachers and advocating about and for children with language needs is an ongoing process for me.
Another large learning experience for me as I entered the “real world of speech-language pathology” was the evaluation process and the impact that time restraints have on the diagnostic process. In graduate school, time was no object. In the school system, time is of the essence. First of all, I had no designated testing time in my schedule for the majority of the school year. I consistently had to try not to cancel treatment sessions to test and observe children; however, it was often a juggling act.
I do want to be able to follow IDEA regulations all the time and not sacrifice treatment time. The federal government needs to be aware of the time constraints and additional demands on the school-based SLP. More funding is necessary to ensure that clinicians have adequate time to meet the regulations in the federal law. We cannot just be responding to public policy—we need to be directing it. I truly feel that until we, as educators and as SLPs, are directing political policy, that we will continue to face the current issues. This is why I think ASHA is so important. It gives individual clinicians a group voice in the political arena. It is important to me that ASHA is aware and as concerned as I am about the issues of school-based SLPs!
My testing measures varied for each child. I did not want to let myself become a diagnostician that consistently uses a standard battery with little consideration of a child’s particular issues. I also conducted observations on children in the classroom for initial evaluations in an attempt to make my evaluation more functional. Accurate diagnostics and interpretation are essential to the planning of effective treatment and to positive therapeutic results. Best practice takes time that is often unavailable. There needs to be a mandated amount of testing time made available to school-based clinicians.
At the risk of sounding naïve, I was shocked at how much federal and state education laws affected my ability to make therapeutic decisions. This is another instance where it has become more evident to me that, at times, educators are responding to educational policy instead of directing it. Best practice needs to be permeating all educational laws, because there are children who are unique and don’t quite fit the directions implied in the current laws. For example, there are children who have pragmatic or behavioral issues who would benefit tremendously from pragmatic language group therapy but who do not qualify because they are functioning at or above grade level academically.
I had no idea that people would have to approve my recommendations to see whether or not this child qualifies for my services according to the law. I also had no idea how much our lawmakers’ desire to cap special education funding would interfere with best practice. I am wondering what is the most effective way to deal with this.
Unique Issues
I really feel so strongly now that SLPs in the school setting are dealing with issues of time constraints, educational laws, and continuous advocacy work that are often a hindrance to overall job performance. These issues are unique to SLPs. I am a paying member of the teacher’s union, but they primarily advocate for the needs of classroom teachers, not speech-language specialists.
I feel more than ever that there is an increasing need for support and guidance for clinicians in the school setting. My CF supervisor was incredible at editing my reports and recommending treatment strategies. However, she was dealing with the same issues I was and, like all other SLPs I spoke with, was supportive but just as aggravated. I am joining ASHA as a full member with certification this year and am anxious to learn about what ASHA does to support school-based SLPs. My education has trained me to be a competent clinician. I am looking for my new professional organization to teach me how to deal with my present concerns.
There is a need for training programs to teach school-based SLPs strategies to approach the unique needs of a school setting. It is time we discuss and learn more about the issues of advocacy, scheduling, teaming, and time constraints. I feel that training programs should be offered free to ASHA members. School-based clinicians face double dues duty as we are bound not only to pay ASHA dues, but union dues as well. As a new SLP, I am in need of “real-world solutions,” not outlines that highlight the regulations of IDEA or best practice ideals.
I did not intend to make my experience sound overly negative because, to be honest, all in all, it was a positive one. I didn’t want to concentrate on my treatment time because I felt so unbelievably overwhelmed by school politics affecting me on a day-to-day basis. I really enjoyed getting to know the children on my caseload and in the school this past year. My therapy time is a time when there is often very little stress and politics involved. I also felt that therapy and formulating lessons was the smoothest transition of all. It was definitely the arena in which I felt most prepared, and it was the best part of my job by far!
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September 2002
Volume 7, Issue 16