My High School SLP Caseload

Speech therapy starts this week, so let's break down my '23-'24 caseload.

As part of my contract, speech services do not include the first 2 weeks of school. This gives students time to adjust to their schedules and teachers. It also gives me time to lesson plan, chart review, and make my therapy schedule. Some advice: if you're going to work in the schools, make sure you are super organized and good at planning! I have changed my schedule at least 10 times in the past week since students are still being shuffled around and new ones are being added to my caseload. Eventually, it'll work itself out. It's all part of the process.

So, what does a caseload of 55-ish high schoolers look like for a speech-language pathologist? Let's break down my caseload in 3 different ways: primary diagnosis, educational setting, and speech therapy targets.

Primary Diagnosis

By the time they get to high school, most 'speech only' students have graduated from speech services, which is amazing! These are students who only have an IEP for speech services -- they usually have an articulation disorder that is remediated in elementary or middle school. As you can see by the chart below, 9% of my caseload is 'speech only' (SLI = speech or language impairment). Shoutout to all the school-based SLPs working on artic non-stop to get those kids dismissed from speech! The primary diagnoses with the most students on my caseload are Intellectual Disability (ID) and Autism Spectrum Disorder, comprising over half of my caseload!

(SLI = Speech or Language Impairment; SLD = Specific Learning Disabilities; OHI = Other Health Impairment; ED = Emotional Disturbance; Deaf/HOH = Deaf or Hard of Hearing; ID = Intellectual Disability)

Educational Setting

The educational setting is how I am indicating where the student spends most of his/her time when at school. In my district, we have 4 categories: Special Day Class - Intensive, Special Day Class, Resource Specialist Program, and General Education. Now, I haven't worked in other schools and I went to private school most of my life, so I am not sure how widely these terms are used. I'll break them down in case you're not familiar. Special Day Class - Intensive (SDC-I) is our self-contained class. These students typically need extra support in activities of daily living (eating, bathroom, safety, etc.), and the class focuses on life skills to help the students become as independent as possible. Special Day Class (SDC) and Resource Specialist Program (RSP) are for students who need a modified curriculum; SDC is a more restrictive setting than RSP. General Education is the least restrictive environment and has college prep classes, APs, and electives.

40% of my caseload consists of students who spend most of their time in the SDC setting. At one of my schools, I do 2 social communication classes weekly during the SDC English. It's the highlight of my week! The students get so excited to share their ideas and opinions on different social skills and we all learn a lot about each other. I also spend a lot of my time with the SDC-I classes, targeting functional communication and life skills. The Gen Ed/Speech Only category is the 3rd largest category on my caseload. I labeled it that way since all of my students in Gen Ed are students with a primary diagnosis of SLI, with the exception of 1 or 2 students with ASD as the primary diagnosis. RSP is my smallest category, which I am starting to learn as to why. RSP can support higher-level language integration (figurative language, sarcasm, idioms, etc.) and many parents and students feel that being pulled out for speech therapy is not conducive to overall learning, especially if their language goals can be supported within the classroom. Most of the RSP students on my caseload have goals for pragmatics, which requires more direct support than a classroom can provide.

(RSP = Resource Specialist Program; SDC = Special Day Class; SDCI = Special Day Class Intensive)

Speech Therapy Targets

I'm using 'targets' instead of 'goals' for this category because many of my students have multiple speech goals that fall into different areas of speech and language. I wanted to focus on the ~essence~ of each student in order to paint a better picture for you.

I'm not gonna lie... the fact that artic is one of my largest categories this year... not a fan. For some reason, I had 4 or 5 freshmen come in with articulation goals -- yes, those dreaded /r/s. I have one student who has the most specific artic goal: articulation of /rl/ in the final position. To me, it's odd to keep someone on speech for final /rl/ words only. I mean, how many common final /rl/ words are there? The ones that come to mind from my frequent vocab are girl, curl, twirl, snarl, and cowgirl. If you need me, I will be cranking out artic for the unforeseeable future. Thankfully, my favorite category, Pragmatics, is also the one I get to target most with my students! I included the students with goals in social communication, figurative language, and cognitive communication here. I have a fair amount of consult-based students for who I check-in with periodically and collaborate with their teachers. Overall, I have a good variety of speech and language targets across my caseload, which means I never get bored!

I am very excited to see my returning students, meet my new ones, and hopefully graduate a few students from speech early this year as their triennials begin to trickle in! It's been 1.5 weeks of school so far, and I have already attended 2 IEP meetings and have 4 on the books. Not to mention 10 re-evaluations due before October :-) Luckily, assessments and report writing are my bread and butter. It's going to be a great year as a CCC-SLP!