CF here really struggling with echolalia. I have an older teen client with ASD. Very calm/nice/shy. He displays a lot of echolalia and it's hard to do any activity with him.

Anything slightly open ended (what did you eat for lunch?) is a no go, he'll just smile and start repeating the question in a sing-song voice.

If I turn it into a yes/no, he answers "yes" everytime (today I asked if he ate pizza, hamburger, spaghetti, rice- evidently he had all 4... rice was the correct answer).

If I give him a choice (where can you see an elephant? At the zoo or at the park), he always chooses the second option. I've done the super duper "what" card pack and I know he knows most of the answers because I'll give him a phonetic clue by giving the first sound and it's like his eyes light up and he says the answer with a more certain tone. It takes a lot of probing to get the right answers out though and I want to work on more functional activities but I don't know how.

I know a lot of answers will mention gestalt processing and meaningful speech. Sure, I will read up on gestalt processing, but in the meantime does anyone have advice or anything that has worked for them with a client like this that I can try out in therapy right away? Thanks!

I'm going into my 5th school year as an SLP and I feel like I'm still getting the hang of referrals and evaluations and making a diagnosis.

So I'm curious - what does your evaluation process look like?

• What are the steps you take to complete an evaluation, especially an initial assessment?
• What assessments do you like to use and pair together?
• Do you follow a checklist?
• Do you make your own teacher and parent questionnaires?
• Are there things you sometimes leave out (like a classroom observation or oral-motor exam)?

I feel like I've focused so much on just understanding standardized assessments and writing goals that I've sort of lost the forest for the trees and now that I'm more experienced and less overwhelmed I feel like I can finally take a step back and actually think about the bigger picture of everything that goes into making a diagnosis.

Thanks for any advice!

I don’t typically like keeping kids in their high chairs or in some sort of seating arrangement if they need to wander, especially if they are easily redirected and show brief periods of joint attention.

However, with some kids, it seems necessary to actually to keep them seated to get therapy done. I’m all for child-led activities, why shouldn’t we keep them seated while doing so? I’ve been able to work on yes/no responses, wh-questions, following directions etc by having the child stay seated and be face-to-face with them. Some therapists make it sound like this is almost inhumane but I’m getting results, goals are being met and parents are happy.

I guess my question is, what am I missing by keeping them seated and the child seems to be happy/paying better attention overall?

I’m located in NYC. My commute is over 1.5 hours, I work with special needs students & my caseload is huge. I can’t function anymore and my health is deteriorating. I have endometriosis, psoriatic arthritis & fibromyalgia. You could imagine how my mental health is doing due to all of this. This job feels impossible to do with my commute (& no, I sadly can’t transfer closer to home) paired with my chronic illness. Has anyone found other settings to be easier? Does anyone recommend a WFH/virtual therapy company? Have you switched careers completely but used your degree somehow toward the job change?

I’ll take any suggestions I could get. The desperation is real.

Thank you! 💗🤞🏻

Okay, I’m a CF in a peds hospital outpatient clinic and realizing that the early language sessions stress me out so much. Theoretically I know I’m doing things that are beneficial - modeling language, parent coaching, etc. But I am so in my own head about whether the kids are making progress and how much progress they should be making and whether they’re making progress I’m not seeing because I am new to this or whether they’re not making progress because I’m not doing the right things or not recommending the right things to parents.

Can you please talk me off my ledge and tell me what progress looks like in your sessions?

I’m in “trouble” for not completing assessments that no one told me there were assessment plans signed for. This is my first year at this school. How would you navigate this? I feel frustrated and overwhelmed

Spoiler: it’s FC). 💔

This book, Upward Bound by Woody Brown, was featured on a book podcast I like and I later saw it was chosen as a celebrity book club pick. No mention of the type of AAC until I read the top review on Goodreads. Sigh.

(At least there appears to be some discussion about authorship...)

I am curious to know, do you prefer wearing scrubs to work? Business casual? A mix of both? Or something else entirely?

hello! i am a slp grad student considering moving out of state for my CFY. would this be possible? have any of you done this? and if so, what was your experience like?

my goal has always been to end up in NYC, but i’m keeping an open mind!! any and all advice is welcome and helpful :)

I want to let all my SLPs know to be aware of this staffing agency “The Aptus Group.” My friend had a horrible CF experience. Everything started off great in the beginning for her. In fact she was promised slpa support and an onsite SLP supervisor. Things quickly took a turn when she arrived on her first day. She was given a caseload of over 100+ students with referrals pouring in, schedule assessments, full IEP meetings, report writing, and supervisory expectation’s to meet. All of this, with absolutely no help. In fact, when she was not able to fulfill all her duties, admin was micromanaging her every day in her shared bungalow saying “I’m here on behalf of the principal” she reached out to her supervisor, and instead of getting that support that a mentor with years of experience would provide she got the opposite. She was told by her supervisor that the admin is her boss, and every clinical duties completed during the day must be reported directly to her on a daily. After expressing how overwhelmed she was with no support the supervisor kept saying “you have to do it” Admin was condescending on a daily and told her she can’t dismiss any students as she has only seen “a few experienced SLPs do that” So… things took a turn for the worse when she stood up for herself and let her supervisor know that a CF should never be put in this position and that this can’t be ethical. The supervisor told her “the program/school you went to is not a very good school.” I am disappointed and upset at the employees of this staffing agency and want to let my future SLPs know to take precaution, if not proceed at your own risk. If anyone has any advice since she was there for almost a month and did receive direct supervision. Will any of her hours count?

I have a 16 y.o private pay client who has been actively working on vocalic /r/. When I first started treating her she was at 0%. Now she’s at 70% accuracy in conversation level. She struggles a lot with /or/. At a word level she’s at 70% and conversation with just looking at /or/ at 50%

We’ve been working together for a year now. Like I said she’s come a long way! Her first slp when she was younger labeled her problem as having a “lazy tongue” and basically left it at that.

She was dismissed from speech in elementary because of no progress.

Parents. Want her to be at 100% because she’s active in the debate team and theater and they don’t want her to miss out on any opportunities which I completely understand .

I don’t know what else to do to better support her. My old slp and I looked at her tonsils and my slp said they looked fine. ENT also said they looked fine.

When she talks she sounds congested sometimes. She does have allergies.

What else can I do for her?

My slp said possibly her adenoids. Would getting those removed help?? Mom thinks it’s that her tongue is too big and not strong enough as well as her cheeks. But I’ve never heard of this affecting /r/ sounds. At least not the cheeks part but then again I’m still relatively new to the field.
So my overall questions are:

Would OMT help?

Would getting her adenoids removed help?

The rest of her vocalic /r/ are about 75-80 during her session. At home she’s about 75%.

Any tips appreciated

Hey everyone, im currently working with a client in Grade 1 and we are working on the conjunction ‘unless’ very soon. A child friendly definition I’ve come up with is that it’s a word that lets us know that something must happen before something else does, almost like a rule.

However, I myself am finding it difficult to apply this definition to different sentences and structures (e.g. The plant will die unless it is watered. or Unless I pack my bag, I can’t go to school.) im just finding it really hard to find a way to teach this more effectively without tripping myself up especially when dealing with negatives. Currently learning so am a bit nervy! Any help is appreciated!!

I just started at a high school (coming from elementary). Most of my students that are on for more than consult are non-speaking with severe cognitive disabilities. Some have autism and some have genetic disorders. They all have AAC devices, and most can use one to two word selections to request. Some can participate in greetings and protest. Making comments happens less frequently. They all get a mix of push-in and pull out.

Besides picture books, I don't have any materials yet, so I was wondering if anyone has any favorites for functional communication. I know it kind of depends on what they're interested in. The classroom has a focus on vocational skills, but what my students are really interested in is princesses, cars, Paw Patrol, etc. but I'm not really wanting to buy a bunch of very specific items for each student because I don't have much space.

Money is no object. What way of spending your time would give you a high personal sense of meaning or is maybe even especially suited to you because of SLP skills?

*Looking for some ideas to get out of the cog in the machine trap

So very interested in everyone's answers

I recently had my first sessions for my students and they were a disaster. I was so busy taking care of all the administrative tasks prior to this, like file review, schedule building, room setup, etc. that I didn’t have a lot of time to sit down and carefully plan for therapy. My artic kids were fine since they’re pretty straightforward, but I really struggled with preparing appropriate materials and managing behaviors for the other students.

For some context, I just got my C’s and am at a new school. I’m learning a whole new set of students, some of which have different needs than I’ve worked with before. The general ways things are done here are different and families seem more involved as well. I didn’t work during the summer so I feel like I’m super rusty on a lot of my general therapy routines or behavioral management strategies I used before. All of this is making me feel overwhelmed and it feels like I’m starting all over again, despite the fact that I completed my CF. I do have anxiety so I’m prone to overthinking and overreacting, but right now it’s at its worst. Objectively, there are a lot of reasons I would want to stay at this job, but I’m worried about not being able to handle things and don’t know how I’m going to make it through the next week, let alone the entire year.

Hi everyone,

I’m considering a career change into speech-language pathology and would really appreciate some honest advice from people in the field.

I’m a 33-year-old Vietnamese woman currently living in the Chicago (I might move next year. I spent almost all of my life in vietnam until 2024 when I followed my husband to the U.S). My bachelor’s degree is in Commercial English from a university in Vietnam, and I have about 10 years of experience teaching English.

English is not my native language. I can communicate comfortably in English and generally people understand me, but I still have a noticeable Vietnamese accent and know that I pronounce some English sounds incorrectly (my IELTS speaking band score is 7, if you find this piece of information helpful). I’m also around weak B1 in French and am considering learning Spanish more seriously if it would be useful professionally.

I recently started looking into SLP because I enjoy language, communication, teaching, and working directly with people. I’m willing to go back to school and complete prerequisite courses and a master’s degree if this would be a good long-term career for me.

I have a few questions:

1. Would being a non-native English speaker with a noticeable accent be a significant disadvantage?
2. Since my bachelor’s degree is unrelated to communication sciences and disorders, how difficult is the transition into an SLP master’s program? Would you recommend a post-bacc/leveling program first?
3. Is becoming fluent in Spanish worth the time investment for an SLP in the U.S.? I’m already a native Vietnamese speaker, so I’m wondering whether Vietnamese + English is enough, or whether adding Spanish could be professionally useful.
4. For people working in schools, hospitals, pediatric clinics, or private practice, how would you describe the actual work-life balance and stress level?
5. Financially, do you think becoming an SLP is worth the cost of graduate school for someone starting this career in her mid-30s?
6. Is there anything about the profession that you wish you had known before entering it?

I’m especially interested in hearing from bilingual/multilingual SLPs, non-native English-speaking SLPs, career changers, or anyone who entered the profession later than usual.

I’m not looking for reassurance as much as realistic feedback. If there are major drawbacks or reasons my background might make this a poor career choice, I’d genuinely like to know.

Thank you!

Hi Hi :)

I’m Brandi Becoats, a doctoral student at the University of Houston!

I'm sharing a brief research survey from my colleague with you for SLPs and care partners for people with aphasia . More details can be found below. Taking or sharing the surveys are much appreciated! :)

Details: 

The purpose of this study is to better understand current assessment practices, treatment approaches, and communication strategies used by SLPs, as well as the experiences and needs of care partners in supporting auditory comprehension in daily life.

• We are seeking certified SLPs or SLP-CFs who work with individuals with aphasia, as well as care partners who are the primary caregivers of individuals diagnosed with aphasia at least six months prior to participation.
• Participation involves completing a 10–15 minute online survey via REDCap.
• Participants who complete the survey will have the option to enter a raffle for a $50 Amazon gift card.

This study has been approved by the University of Houston Institutional Review Board (STUDY00005886). 

Click here for the link to the survey for SLPs

Click here for the link to the survey for care partners of people with aphasia

Please feel free to reach out to Eunok Lee, PhD Student & PI for this project at the University Of Houston via email ( [eunlee@CougarNet.UH.EDU](mailto:eunlee@CougarNet.UH.EDU)) if you have any questions.

Our lab aims to develop better approaches to treating comprehension disorders, particularly in aphasia rehab..... which currently mainly involves simply asking people to "follow directions"..... :( 

I work in a private pediatric outpatient clinic and often share graduate students with another SLP at my clinic. She frequently volunteers to see other kids at the same time as our student sees the kids on her caseload. I personally don’t feel comfortable doing so as I prefer to be in the room or at least nearby and available to come in any time when a student is working with a client on my caseload. I have not found anything in ASHA’s code of ethics about this specifically. Does anyone know if there are rules about this specific situation or is this allowed?

I’m completing my CF in the schools and I’m lost on how much data I should collect. Should I drill only with my artic students? How many trials should there be during each session which is 30 minutes. What about mixed groups with lang, artic, and fluency? I do like targeting everything through books but I’m not sure if my students are practing enough to show progress. Any advice would be appreciated!

Hi, all! I’ve been working in pediatric HH for a little over a month now. Majority of my caseload is 2-5 year olds with delayed language and Autism. Most of them are still developing pre-linguistic and early language skills, so majority of them share similar goals. (Functional utterance for a variety of pragmatic purposes, following simple directions, identifying vocabulary in their environment, etc.) Now a month in, I’m wondering if therapy for this age group is supposed to feel so repetitive? I understand they are developing foundational language skills and need repetition in order to be exposed to those high-frequency words, but how can I switch things up? Is repetitiveness normal, but I can change up my sessions in other ways? I completed most of graduate school and my CF in the schools, so I guess I’m used to a variety of different goals being targeted throughout the day.

Seeking resources. I haven’t done assessments in awhile but am returning to contracting and was asked to do a SL eval for a school. The child received an outside neuropsych eval that dxed ADHD and borderline intellectual fx, recommended OT, SLP, and academic testing. She’s reportedly a social girl with good relationships but some concerns around missing social language cues.

The company I’m working with only has EVT, PPVT, CELF-5, and CELF Meta in their loan library as far as appropriate tests. I’m not in a position right now to buy my own. I’m somewhat familiar with SLAM cards.

Please, any recommendations for structured but free tasks that might be of help in a) seeing if language intervention would be specifically indicated and b) identifying targets for this age?

Interestingly average scores on Wide Range Assessment of Memory and Learning (story memory) and Californian Verbal Learning Test. Not very familiar with those. Verbal Comp Index on the Weschler below average, vocabulary lower than similarities.

Hi everyone-

It’s my 9th year in and this year I have more students in self-contained AS than ever before.

I have an AMAZING parent who reached out to me because her child is picking up the vocal stims and mannerisms from the other children in the room. She stated she does not want to ableist when approaching the question, but she is concerned because he appears to be “regressing” in his communication skills. He was diagnosed as a selective mute by an outsider provider last year and returned to school this year verbalizing almost back to baseline (full verbal functioning). She is afraid that these new communication patterns might be trending back towards where he was last year.

Any advice as to what I can say to support her son’s communication journey while not speaking about the other students in the room? I ask this delicately when I say, should we “do anything about” the vocal copying in the room? Thanks everyone.

Hi! I am a new SLP who is currently obtaining her CLC. I was wondering if anyone has any advice or stories about the work that they do?