Nine-year-old Aaron faces some daunting challenges on his road to a good education. He comes from a low-income neighborhood in the heart of Baltimore, where he attends a school with such low performance that it is under a state consent decree, a mechanism for mandating school-wide improvement.

In the face of these environmental challenges, Aaron's speech-language difficulties might seem less important. But Aaron is lucky to attend a school that provides adequate speech-language services, unlike most high-need schools—those with a large percentage of students from low-income families or located in certain rural areas—that have difficulty attracting and retaining qualified speech-language pathologists.

SLPs and audiologists interested in working in a high-need school like the one Aaron attends are often concerned about the difficulties of working in such schools, including potentially lower pay. Many clinicians opt to work in a suburban setting where there are fewer environmental detractors and pay is often more generous. But a compelling—but largely unknown—incentive exists for new clinicians to work in high-need schools: student loan forgiveness.

Many states, and recently the federal government, have enacted student loan forgiveness programs that specifically designate SLPs and audiologists—along with other professions experiencing shortages—as eligible participants. Although many loan-forgiveness programs are not exclusive to high-need schools, they should be considered as a tool for attracting highly qualified SLPs and audiologists to this setting. Loan forgiveness programs may motivate SLPs and audiologists who would like to serve students who have the greatest need, but who cannot afford to ignore a sizeable monthly student loan bill.

Existing Programs

Various types of loan forgiveness programs are available at the state and federal levels. Each program has different eligibility requirements, such as the length of commitment to a school, and various amounts of loan forgiveness, ranging from a mandatory cap to full loan repayment.

At the state level, programs target four main groups of professionals (ASHA, 2007):

• Teachers who work in public schools and wish to pursue graduate studies in speech-language pathology
• Graduate students studying speech-language pathology who agree to work in public schools
• SLPs who agree to work in public schools for a minimum number of years
• SLPs working in public schools who receive a percentage of their loans forgiven with each year of service

At the federal level, several significant options exist for loan forgiveness for SLPs and audiologists. The College Cost Reduction and Access Act (H.R. 2669), signed into law in September 2007, offers school-based SLPs loan forgiveness in return for a commitment of 10 years of employment in a public school (Chitty & Draeger, 2007). SLPs are also eligible for Perkins loan forgiveness through the federal government (Federal Student Aid, 2008).

In addition, the College Opportunity and Affordability Act of 2008 (H.R. 4137), which just passed the U.S. House of Representatives, would permit loan forgiveness of up to $10,000 in loans in a five-year period.

Student loan forgiveness programs can be a strong incentive for clinicians, and they should consider both the risks—and rewards—involved when considering a position in a high-need school.

Risks and Rewards

An obvious reward is the loan forgiveness itself—a powerful incentive for a clinician with significant student loans. But the rewards are more than monetary. Students in high-need schools, like Aaron, are at risk for school failure because of their social circumstances. Helping these students navigate their way to academic success can be a tremendous reward in itself.

Children in high-need schools are often eager to learn and succeed in speech-language interventions, and are genuinely excited to receive extra attention. As SLPs, we know that the added exposure to language and its use can strengthen these students' overall academic performance in ways they may not experience outside of school.

The typical home environment of these children highlights a widespread lack of language stimulation. Research shows that by the time children of low socioeconomic status enter school, they have heard 10 million words in conversation; in contrast, children of parents with professional positions may have heard 50 million words before starting school (Hart & Risely, 1997).

The environmental stressors of poverty, including unsafe neighborhoods, pressing health concerns, and unstable financial and emotional domestic situations, often receive more parental attention than home-based educational support. Many of Aaron's classmates have no books in their homes and have little interactive dialogue with parents.

Because education has the potential to serve as a means to a better future for high-need students, providing them with qualified educational professionals is a critical factor for future success (Wenglinsky, 2002). Good teachers are, of course, part of the answer to this problem. But teachers alone are an incomplete solution. Administration and related services staff, such as SLPs and audiologists, are necessary to provide a continuum of education services.

Working in a high-need school brings rewards—and many challenges. The environmental stressors affecting students' lives permeate school walls and often impact school-wide student behavior. The schools themselves are frequently subject to school reform efforts dictated by No Child Left Behind with effects on funding and program removal. SLPs and audiologists should investigate or gain clinical experience in this environment before accepting a position in a high-need school in order to avoid culture shock that can lead to poor retention rates among new employees.

When it is the right fit, providing speech-language pathology services in a high-need school is undeniably rewarding. With student loan forgiveness as a powerful incentive, more SLPs and audiologists may well be drawn to high-need schools to make a difference in the life of a child like Aaron.