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Caseload and Workload

Overview

Caseload refers to the number of students with Individualized Education Programs (IEPs), Individualized Family Service Plans (IFSPs), and 504 Plans served by school-based SLPs and other professionals through direct and/or indirect service delivery options. In some school districts, caseloads may also include students who receive intervention and other services within general education designed to help prevent future difficulties with speech, language learning, and literacy. Caseloads can also be quantified in terms of the number of intervention sessions in a given time frame.

Workload refers to all activities required and performed by school-based SLPs and other professionals. Workload includes the time for face-to-face direct services to students, as well as time spent performing other activities necessary to support students' education programs, implement best practices for school speech-language services, and ensure compliance with the Individuals with Disabilities Education Improvement Act of 2004 (IDEA, 2004) and other mandates.

Traditionally, a school SLP's workload has been conceptualized as being almost exclusively synonymous with caseload; but the reality is that caseload is only one part of the picture. When a student is added to a caseload for direct services, significant amounts of time within the school day, week, or month must be allocated for additional important and necessary workload activities.

While issues related to caseload and workload are relevant for professionals in a variety of settings, this document focuses on caseload and workload issues specific to the school SLP.

The total number of workload activities required and performed by school-based speech-language pathologists (SLPs) should be taken into account when establishing caseloads. ASHA does not recommend a maximum caseload number, but recommends taking a workload analysis approach to setting caseloads to ensure that students receive the services they need to support their educational programs.

Key Issues

Caseload Characteristics

Nationwide, school SLPs provide services to students from at least four different groups:

According to the ASHA 2012 Schools Survey [PDF], the median monthly caseload size of ASHA-certified, school-based SLPs who were clinical service providers working full-time was 47, with an individual caseload range of 1 to 240.

Some states have established maximum caseload guidelines for school SLPs, but others leave these determinations to local districts. Contact individual state departments of education for current information regarding caseload guidelines.

Impact of Large Caseloads

Large caseloads are those that are difficult to manage, because of the number of students and/or the complexity of their needs. Large caseloads may impact

In addition, a higher caseload impacts

Factors Impacting Workload

ASHA's 2012 Schools Survey (ASHA, 2012) indicates that the average number of students on speech-language caseloads has remained relatively unchanged over the past decade, while the role and related responsibilities of the school-based SLP have increased dramatically. These increases in responsibilities necessitate the shift to a workload approach if SLPs are to continue to add value to the students' classroom experiences.

Factors impacting increased workload include:

Thus, caseload can be viewed as only one of many factors that affect the overall workload of the school SLP.

Factors Impacting Workload

Factors Impacting Workload

Advocating for a Workload Approach to Assigning SLPs

Given the expanding roles and responsibilities of school-based SLPs (ASHA, 2002) and the impact of larger caseloads on service delivery options and student outcomes, it is imperative that there be a conceptual shift from "caseload" to "workload" in order to ensure delivery of appropriate services to students with disabilities, consistent with the intent of IDEA and best practices in school speech-language pathology. That is, the total workload activities required and performed by school-based SLPs must be taken into account to set appropriate caseload standards.

Conducting a Workload Analysis

In order to establish an appropriate caseload, a workload analysis must be conducted. This allows education agencies to take into consideration how much time is available in the SLP's school day, week, or month to determine the number of children who can be adequately and appropriately served.

Steps in Conducting a Workload Analysis

Step 1: Document current roles and responsibilities.

The first step in conducting a workload analysis is to document current workload activities. The roles and responsibilities of school-based SLPs can be organized into four major activity clusters:

Prior to documenting and analyzing their workloads, SLPs should identify a comprehensive list of all roles, responsibilities, and activities necessary for the provision of services in their specific school settings and then sort these activities into the four major activity clusters described above. See below for sample roles and responsibilities documentation.

Direct services to students

Indirect services that support students' educational programs

Indirect activities that support students in the least restrictive environment and in the general education curriculum

Activities that support compliance with federal, state, and local mandates

See also Examples and Worksheets for the Workload Analysis Approach.

Step 2: Analyze the current workload relative to the needs of students receiving services.
Step 3: Determine if the workload is balanced.

When all time slots are filled but required activities or student services remain unscheduled, an imbalance exists between the SLP's assigned workload and the amount of time available to fulfill those responsibilities. To address this imbalance

Step 4: Collaborate with SLPs, teachers, administrators, union representatives, parents, and other service providers to address workload issues.

The use of multiple advocacy strategies and partnerships is often necessary to influence workload and caseload issues within state and local education agencies.

ASHA has developed a variety of resource materials that can strengthen local SLP advocacy efforts. Working for Change: A Guide for Speech-Language Pathologists and Audiologists in Schools [PDF] (2010) outlines a number of strategies for collaborating with teachers' unions and local and state education agencies to improve working conditions. These strategies can also be used to establish a joint workload review committee between union and district representatives.

Approaches To Managing Existing Workload

Administrative Solutions

School districts have implemented a variety of administrative solutions to assist SLPs in managing their existing workloads.

Contract Language: Teacher contracts may be written to prescribe maximum caseloads and/or the use of workload when establishing a caseload. Contracts may also prescribe other activities in which an SLP may and may not engage.

Expansion of Response to Intervention (RTI): Trial direct services can be delivered within the context of RTI. Progress monitoring determines the need for continuation in RTI or for consideration for special education services. The workload model provides for this kind of service.

IEP Factors: IEP documents can be written to reflect a variety of service delivery options, including frequency, location, and amount of service. Amount of service can be specified in various clusters (e.g., weekly, monthly, biannually, annually). Changes in service delivery can be triggered by goal mastery.

Staffing: Additional SLPs can be hired if the workload analysis indicates that additional staffing is required to deliver all specified services, or existing staff can be redistributed to ensure equity of workload within a district.

Telepractice: Telepractice offers the potential (a) to extend clinical services to students who qualify for service but are unable to attend school or (b) to provide services in more than one setting, thus reducing the need to travel. 

Use of SLPAs: Support personnel can be used to work with SLPs to deliver some of the services.

Use of Technology: Efficiency can be increased by using computerized IEP systems, report-writing formats, and programs/technologies to schedule sessions and collect/analyze data.

Use of Staff Specialists: SLPs can be hired for specific jobs. For example, in this staffing model, most SLPs would provide direct and indirect services, but a smaller team (e.g., a diagnostic team) would conduct assessments and write diagnostic reports.

Weighted Caseloads: "Weights" are assigned to reflect the intensity of services [specified on the IEP] needed to meet the severity and complexity of the students' needs. The district determines a total weight that represents a reasonable caseload.

Scheduling Strategies

Scheduling should be clearly noted on the IEP; SLPs should ensure that scheduling decisions are individualized and that parents, caregivers, and educators understand the strategy or strategies selected. Although federal regulations allow for significant flexibility in designating frequency of service on the IEP, local and state jurisdictions may operate differently.

3:1 Model: Direct services are provided for 3 weeks, followed by indirect services provided for 1 week.

Cyclical Schedule (e.g., Block scheduling): Direct services are provided for a specified period of time followed by a similar time of indirect services (e.g., 9 weeks of direct intervention, followed by 9 weeks of indirect services).

Flex Schedule: The frequency, amount, and type of services vary based on student progress toward IEP goals or changing classroom demands.

Receding Schedule: Initial service involves intense amounts of direct services, which is then reduced over time based on student progress.

Weekly Schedule: Direct services are provided on a weekly basis-for example, two 30-minute sessions per week.

Service Delivery

The following are examples of various service delivery models. SLPs have the responsibility to select the most appropriate service delivery model, using evidence-based decision making. Models should be chosen with consideration for those that afford the most flexible and efficient delivery of services, while ensuring FAPE, according to IDEA.

Pull-Out (small group or one-on-one): Direct services are provided in a location outside of the general education classroom, typically in the speech-language pathology treatment room.

Classroom Based: Direct services are provided within the general education setting, using one-on-one, small-group or large-group models, as well as co-teaching and/or co-treatment.

Community Based: Direct or indirect services are provided within a community setting (e.g., in the context of transition activities, job coaching, or home-based services).

Combined Service Delivery Models: These models use more than one of the options listed above.

Service Delivery in Non-Academic and Extracurricular Settings: Services are provided within the context of clubs, playground activities, lunchroom, art class, etc.

Focus on Eligibility Criteria

Appropriate and consistent identification of children who qualify for speech and language services will help prevent over-identification that unnecessarily expands caseload and workload. Examples of state eligibility and entrance/exit criterion guidelines include

Kansas Speech-Language Guidelines for Schools (Kansas, 2005)

Texas Speech-Language Hearing Association Speech Impairment Eligibility Guidelines (Texas, 2011).

Wisconsin Department of Public Instruction Eligibility Checklist (Wisconsin, 2009)

Wisconsin's Speech and Language Impairments Assessment and Decision Making Technical Assistance Guide (Wisconsin, 2003).

Caseload/Workload Models in Practice

Over the years, ASHA's School Services team has received reports from numerous members who have successfully transitioned to a workload-analysis approach for establishing caseload numbers. In one district, a successful transition to workload resulted in a separate and higher salary scale for speech-language pathologists and stipends for supervising speech-language pathology assistants. Another district reported gaining an additional SLP position. One state included a workload analysis approach in its state-wide policy and procedures for SLPs and provided training to SLPs throughout the state. Still another state adopted flexible and varied service delivery models, such as making changes in the frequency, duration, and location of services that can be written into the IEP and implemented accordingly, as various benchmarks are achieved by the student. At one university, graduate students' practicum placements required workload and alternative models of service delivery.

In 1999, the Texas Speech-Language-Hearing Association (TSHA) began an effort to develop guidelines for identifying students with speech impairments. This effort, combined with workload approach strategies, has resulted in a number of positive consequences, including

For example, within a 4-year period, the city of Houston went from 38 vacancies and about 50 uncovered campuses to only 7 vacancies.

Examples of Workload Approaches

Service Delivery Models: Designated, Scheduled Prep Block: Heidi Becker (beckerh@verona.k12.wi.us)

The Designated, Scheduled Prep Block works the same way as the 3:1 Model. The difference is that the indirect service activities are scheduled in blocks of time across the entire month instead of being all done in one week. All of the SLPs in the Verona Area School District switched from the 3:1 Model to the Designated, Scheduled Prep Block, because of jealousy on the part of other special educators, who also said they wanted a "week off" from teaching students. The SLPs achieved better collaborative relationships by breaking up the 3:1 Model and distributing the same amount of indirect service time across the entire month instead of having it all in one week.

Scheduling Strategies: Student-Centered Service: Sharon Soliday (sharon.soliday@thehellofoundation.com)

I'm working with the Salem-Keizer School District on a pilot project this year that I've labeled, "Student-Centered Service." In a nutshell, I'm working with administration to specify time allocations for SLPs to do Prevention, and I've been mentoring and encouraging SLPs in the pilot program to abandon traditional scheduling (i.e., getting out of the therapy room or sticking to a schedule that was set in September but should be changed by November, based on student needs). And in the arena of students who receive services for articulation only, we have been, we have been setting some anticipated remediation dates for parents, children, therapists, and others to work toward achieving articulation goals. We are always asked "how long will therapy take," and we all shy away from suggesting any timeframe for the most part. NOMS data tells us that students remediate or make significant growth following 20-30 hours of service in the schools. It's not unreasonable that we should project growth. And I believe students could and should be out of speech much more quickly if a target date (if only an estimate) were in place.

We're having great success with pilot SLPs really engaged in some good work. Students are making the growth they should, and if not, SLPs are changing their efforts.

Scheduling Strategies: A Cycles Approach: Rebecca Zutter-Brose rzutter-bros@madison.k12.wi.us

Lisa Kirby-Mangas lkirbymangas@madison.k12.wi.us

The Phonology program is a speech-language option within the Madison Metropolitan School District. This program, staffed by two speech-language pathologists, focuses on facilitating preschool children's speech intelligibility. The program emphasis is on building the accuracy of sound patterns to promote rapid change in speech clarity.

Children attend Phonology Tuesday through Friday for half day sessions, on a 6-week cycle schedule.

One day per week (Monday) is provided for

Weighted Caseloads: A Working Model: Gail Rothwell (gailrothwell@hotmail.com)

The Tacoma School District has devised and utilized a weighted caseload system for 9 years. Revisions have been made as necessary. This information is utilized when individual SLP assignments are made in the spring for the upcoming school year. This system uses factors (e.g., troubleshooting a student's hearing aids, behavior problems that necessitate individual therapy or academic supports), rather than severity per student, which appears to be a more equitable means of analyzing caseload. The use of an Assignment Committee, caseload guidelines, and the role of the SLPA also helps with workload issues.

Taking a Workload Approach: Mike Maykish (mmaykish@bcswan.net)

I have been in the Brunswick County, North Carolina Schools for the past 2 years, and we use the workload approach. I feel as though most school-based SLPs, both in and out of our district, would consider themselves "very busy." The workload calculator helps individual SLPs to quantify their "busy-ness" in a meaningful way. This has led to several positive changes. It has encouraged SLPs with high caseload numbers with comparatively low workload numbers to reexamine service delivery models, and led to a sharing of caseload responsibilities for those who have lower. Thankfully, our EC director has been responsive to our needs. This has improved morale among the staff as well as our service to our students.

If you have a workload success story that you would like to share, please e-mail us at school@asha.org.

Advocacy

SLPs wishing to advocate for the adoption of a workload model in their district or state need to do "their homework" before launching any effort. As with any advocacy effort, there are many factors that an SLP or group of SLPs or state association must consider including

See Advocating for Change.

Resources

ASHA Resources

Advocacy in Action: A State Model of Change

Advocating for Change

Eligibility and Dismissal Criteria Including "Adverse Affect"

Frequently Asked Questions: Caseload and Workload

IDEA Influence

Implementation Guide: A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in the Schools

RTI in Action: Oral Language Activities for K–2 Classrooms

RTI in Action, Grades 3–5: Oral and Written Language Actitivities for the Common Core State Standards

State Guidebook for the Salary Supplement Initiative.

American Speech-Language-Hearing Association. (2000). National data report 1999–2000: National Outcomes Measurement System. Rockville, MD: Author.

Cirrin, F., Bird, A., Biehl, L., Disney, S., Estomin, E., Rudebusch, J. Schraeder, T., & Whitmire, K. (2003). Speech-language caseloads in the schools: A workload analysis approach to setting caseload standards. Seminars in Speech and Language, 24(3), 155–180.

Texas Speech Language Hearing Association. (2010). Implementation guidelines for speech impairment with a fluency disorder. Available from http://www4.esc13.net/uploads/speech/docs/TSHA_Fluency2010.pdf [PDF].

Texas Speech Language Hearing Association. (2010).Implementation guidelines for speech impairment with an articulation disorder: Cultural & linguistic diversity (CLD) companion. Retrieved from http://www4.esc13.net/uploads/speech/docs/TSHA_CLD_ArticGuide.pdf [PDF, 9.1MB].

Additional Resources

U.S. Department of Education. (n.d.). Special education programs. Available from http://www2.ed.gov/about/offices/list/osers/osep/index.html?src=mr.

Wrightslaw (n.d.). Special education and advocacy. Available from www.wrightslaw.com/.

References

American Speech-Language-Hearing Association. (n.d.). Common Core State Standards: A resource for SLPs. Available from http://www.asha.org/SLP/schools/Common-Core-State-Standards.htm.

American Speech-Language-Hearing Association. (n.d.). Examples and worksheets for the workload analysis approach. Available from www.asha.org/slp/schools/examples/

American Speech-Language-Hearing Association. (n.d.). State and local workload activity. Available from www.asha.org/slp/schools/districtworkloadchart/.

American Speech-Language-Hearing Association (2002).  A workload analysis approach for establishing speech-language caseload standards in the school [Position statement].  Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2010). Working for change: A guide for speech-language pathologists and audiologists in schools. Available from www.asha.org/uploadedFiles/Working-Change-Schools-SLPs-Audiologists-Guide.pdf.

American Speech-Language-Hearing Association. (2012). 2012 Schools Survey report: SLP caseload characteristics. Available from www.asha.org/research/memberdata/schoolssurvey/.

Brandel, J., & Loeb, D. F. (2011). Program intensity and service delivery models in the schools: SLP survey results. Language, Speech, and Hearing Services in Schools, 42, 461-490.

Centers for Medicare and Medicaid Services. (n.d.). Medicaid. Available from www.medicaid.gov/.

Cirrin, F. M., Schooling, T. L., Nelson, N. W., Diehl, S. F., Flynn, P. F., Staskowski, M., Torrey, T. Z., & Adamczyk, D. F. (2010). Evidence-based systematic review: Effects of different service delivery models on communication outcomes for elementary school-age children. Language, Speech, and Hearing Services in Schools, 41, 233-264.

Giess, S. (n.d.). Implementing a workload approach to caseload: Methods and strategies. ASHA Professional Development CE Course. Available to order from http://www.asha.org/eweb/OLSDynamicPage.aspx?webcode=olsmainpage.

Kansas State Department of Education. (2005). Speech-language guidelines for schools. Available from www.omnie.org/literacyhome/Kansas%20Guidelines.pdf.

Katz, L. A., Maag, A., Fallon, K. A., Blenkarn, K., & Smith, M. K. (2010). What makes a caseload (un)manageable? School-based speech-language pathologists speak. Language, Speech, and Hearing Services in Schools. (41) 139-151.

National Governors Association Center for Best Practices, Council of Chief State School Officers. (2010). Common Core State Standards. Available from www.corestandards.org/.

Schooling, T. (2000). Crushed by growing caseloads? Arm yourself with outcomes data from K-6 component of NOMS. The ASHA Leader, 5(18), 1-6.

Schooling, T. L. (2003). Lessons from the national outcomes measurement system (NOMS). Seminars in Speech and Language, 24(3), 245-256.

Soliday, S. (n.d.). The 3:1 Service Delivery Model. ASHA Professional Development. CE Course. Available to order from www.asha.org/eweb/OLSDynamicPage.aspx?Webcode=olsdetails&title=The+3%3a1+Service+Delivery+Model .

Texas Speech Language Hearing Association. (2011). Eligibility guidelines for speech impairment. Available from www4.esc13.net/speechlang/tsha.

U.S. Department of Education. (n.d.). Free Appropriate Public Education: Section 504 of the Rehabilitation Act of 1973. Available from http://www2.ed.gov/about/offices/list/ocr/docs/edlite-FAPE504.html.

U.S. Department of Education. (n.d.). Individuals with Disabilities Education Improvement Act (IDEA 2004). Available from http://idea.ed.gov.

Wisconsin Department of Public Instruction. (2003). Speech and language impairments assessment and decision making: Technical assistance guide. Available from http://sped.dpi.wi.gov/files/sped/pdf/slguide.pdf.

Wisconsin Department of Public Instruction. (2009). Eligibility checklist: Speech & language impairment. Available from http://sped.dpi.wi.gov/files/forms/pdf/podelg-spl-001.pdf.

Woltmann, J., & Camron, S.C. (2009). Use of workload analysis for caseload establishment in the recruitment and retention of school-based speech-language pathologists. Journal of Disability Policy Studies, 20(3), 178-183.

Wright, C. & Bankston, D. (2009, March 3). Guidelines help texas clinicians manage caseloads. The ASHA Leader. Available from http://www.asha.org/Publications/leader/2009/090303/090303e/