Speech Therapists' Caseloads

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Advocating for School-Based SLPs

School speech therapists' caseloads have a tendency to be large. Sixty, seventy, or eighty children per one speech therapist is not uncommon, especially in states that either do not have a legislated maximum caseload limit or the maximum caseload limit provided for by the state'slegislature is very high.

See your state's caseload limit: SLP Caseloads by State.

This overload exists despite the American Speech-Language Hearing Association's (ASHA) recommendation that

"...in order to provide balance between the amount of time available for appropriate services and the amount of time needed to complete other required responsibilities, it is recommended that the maximum caseload size should not exceed 40 students, regardless of the type or number of service delivery models selected. Special populations and circumstances will dictate even fewer students on the caseload, since certain types of services and students are more time-intensive than others. Intervention provided to preschool students emphasizes family-focused service delivery and multi agency collaboration and coordination. When the caseload consists entirely of preschool students, the size should not exceed 25..."
From ASHA's "Guidelines for Caseload Size and Speech-Language Service Delivery in the Schools",

There can be pressure by school administrators to keep the SLP's caseload down by reducing therapy sessions and by grouping children in larger groups. Inclusive practices are an advancement for public schools, in that children with special needs are now more accepted within the regular education curriculum. However caregivers must be vigilant that the term "inclusion" isn't being applied in order to cut costs at the expense of the individualized needs of the child. Apraxia of speech is a disorder that so often requires intensive speech therapy services; speech therapists and parents must insure that unreasonably large caseloads are not affecting the recommendations on the IEP.

It is unlikely that children with moderate or severe speech-language disorders are likely to be adequately served by, for example, two half hour speech therapy sessions per week administered within a therapy session among four other children of varying ages who are at varying stages in their speech development. (See http://www.speechville.com/speech-therapy-matrix.html">Speech Language Eligibility Critera/Matrix for recommendations.)

To protect both the speech therapist's professional integrity, and the child(ren) being served, speech therapists must be sure to comply with IDEA in recommending that which the child needs. From an article from ADVANCE for Speech and Language Pathologists, "Doing More with Less; School-Based Clinicians Address Current Issues," by Mark Palacio, July 17, 2000, Vol 10, No.28,

"...If speaking with an administrator fails, clinicians should take steps to ensure their recommendation for best practice is documented at an individual education plan (IEP) meeting. 'No administrator has the right to interfere with an IEP,' observed Goldman. 'An IEP should include specifically what a child needs. If a child needs to be seen two times a week and one of those times needs to be a pull-out session in a small group, put the exact number of the group in the IEP.'"

The first step for a parent, who is concerned about the SLP's recommendations for speech therapy, is to speak to the speech therapist. Some questions to ask:

How many children are on your caseload?
Do you feel that it is manageable?
What might I do to help you to advocate for a more manageable caseload?

Speech therapists and parents may direct complaints to the school district's special education department's director or superintendent, the local teachers' union, the state's education agency or speech-language hearing association.

Find your State's Local Teachers' Unions: American Federation of Teachers' Links to State and Local Teachers' Unions
Find your State's Speech-Language-Hearing Association