A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in the Schools: Guidelines
Ad Hoc Committee on Caseload Size
About this Document
These guidelines are an official statement of the American Speech-Language-Hearing Association (ASHA). They were approved by ASHA's Legislative Council in July 2002. Members of the Ad Hoc Committee on Caseload Size were co-chairs Frank Cirrin and Ann Bird, Larry Biehl, Sally Disney, Ellen Estomin, Judy Rudebusch, Trici Schraeder, and Kathleen Whitmire (ex officio). Vice President for Professional Practices in Speech-Language Pathology Alex Johnson (2000–2002) provided guidance and support.
The position statement, guidelines, and technical report that make up A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in the Schools were developed by ASHA to address member concerns that many school service programs require caseloads for speech-language pathologists (SLPs) that are too high in number to provide quality services. A major goal of ASHA's focused initiative for school-based programs and services is to increase the number of states and school districts that use total SLP workload time and activities to determine the number of children who can be appropriately served on a caseload. Strategies to achieve this outcome include a revision of ASHA's policy documents on caseload size, which had been developed to provide clear guidelines for determining maximum school caseloads (ASHA, 1984, 1993a). The revised documents are intended to serve as a template for education agencies to determine SLP caseload size based on an analysis of total workload activities. These may include, but are not limited to, IEP meetings, administrative tasks, evaluation time, paperwork, consultation, planning time, and direct and indirect intervention services. The documents are consistent with requirements of the Individuals with Disabilities Education Act Amendments of 1997 (IDEA; U.S. Congress, 1997; U.S. Dept. of Education, 2000) that (a) each student with a disability be provided a continuum of service options that will guarantee a free, appropriate public education based on the student's individual needs, and (b) special education and related services be linked to progress within the general education curriculum. They also are consistent with ASHA's guidelines for the roles and responsibilities of the school-based speech-language pathologist (1999), the scope of practice in speech-language pathology (2002) and the position statement on roles and responsibilities of speech-language pathologists with respect to reading and writing in children and adolescents (2001b).
These guidelines describe a rationale and conceptual framework for using an analysis of the total work activities of school-based SLPs to help determine the number of students who can be served. This framework is based on the assumption that the primary emphasis of school SLP services must be on meeting the individual needs of students, consistent with the intent of IDEA and current information on best practices in school speech-language pathology. These guidelines begin with an introduction to the concept of workload followed by an overview of the factors that influence school SLPs' workloads and caseloads. Next, a workload analysis process is presented that can help to organize and document necessary SLP workload activities, and compare the time needed for their implementation to the time available. Finally, strategies and resources that can help school SLPs advocate for improved working conditions are discussed.
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Caseload size is a major concern of school-based SLPs across the country (ASHA, 1993; 2000c; Chiang & Rylance, 2000; Whitmire; 2000). Data from annual ASHA surveys support the notion that caseloads in many school districts are too large. A specific concern of SLPs in schools is that large caseloads impede their ability to provide appropriate and adequate services to students with disabilities (ASHA, 2000c; Chiang & Rylance, 2000; Pezzei & Oratio, 1991). In the decade since ASHA recommended that school SLP caseloads not exceed 40 under any circumstances—with special populations and circumstances dictating a maximum caseload of 25 or less—(ASHA, 1984; 1993a), the average number of students on caseloads has remained significantly higher than these recommended caseload standards. Recent surveys indicate an average caseload size of 53; some members report caseloads as large as 110 (ASHA, 2000c).
In addition, recent data suggest that large caseloads have limited SLPs' available service delivery options to providing almost exclusively direct intervention services to students (ASHA, 1991, 1995, 2000c, Chiang & Rylance, 2000). When the vast majority of the school day or week is filled with direct face-to-face services to students, many SLPs report that not enough time is left to adequately perform the many other activities and responsibilities required to meet the needs of students, implement best practices in school speech-language services, and be in compliance with federal, state, and local special education mandates. The impact of caseload size on student outcomes is one of the most important issues facing school-based SLPs, as administrators and decision makers attempt to balance the need for efficient use of staff resources with the desire to maximize student outcomes (ASHA, 2000b).
ASHA's position statement on caseload standards indicates the need for education agencies and professionals to make a conceptual shift from “caseload” as an arbitrary maximum number to consideration of the total workload activities required and performed by school-based SLPs. A workload analysis approach is necessary to provide students the services they need, rather than the services that SLPs have time to offer or services that are administratively convenient. It is necessary for education agencies to consider how the amount of time available in each school day, week, or month can be divided across services to students.
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Traditionally, a school SLP's workload has been conceptualized as being almost exclusively synonymous with caseload. Caseload is more accurately conceptualized as only one part of SLPs' total workload. The term caseload typically refers to the number of students with Individualized Education Programs (IEPs) or Individualized Family Service Plans (IFSPs) school SLPs serve through direct and/or indirect service delivery options. In some school districts, SLP caseloads may also include students who do not have identified disabilities, and who receive prereferral intervention and other services designed to help prevent future difficulties with language learning and literacy (ASHA, 2000c). School SLPs may also serve as case managers for all or some students on their caseload, which adds significant responsibilities and time for writing and managing IEPs, as well as assuring compliance with special education regulations. Workload refers to all activities required and performed by school-based SLPs. SLP workloads include considerable time for face-to-face direct services to students. Workloads also include many other activities necessary to support students' education programs, implement best practices for school speech-language services, and ensure compliance with IDEA and other mandates. A more detailed discussion of school SLPs' workload activities is presented in the section on Balanced Workload Analysis Process later in this document.
How does caseload relate to workload? Special educators and SLPs have reported that increases in caseloads correspond with simultaneous increases in meetings and paperwork demands (e.g., Russ, Chiang, Rylance, & Bongers, 2001). Each student added to the caseload increases the time needed not only for evaluation, diagnosis, and direct and indirect services, but also for ongoing assessment, mandated paperwork, multidisciplinary team conferences, parent and teacher contacts, and many other responsibilities.
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School SLPs' workload (and caseload size) is a difficult issue to understand and resolve because of the complex interaction of many factors that influence the number of children and adolescents the SLP must serve (Chiang & Rylance, 2001; Whitmire, 2001). For example, state and local policies for determining eligibility and dismissal criteria for speech-language services are major factors that directly affect school SLP caseloads (ASHA, 2000a). The number of students who can be appropriately served is also influenced by the age and severity of disabilities of students, as well as student service team recommendations on where and how services can most effectively be delivered (e.g., in pullout settings, classroom settings, through consultation, or some combination; (ASHA, 1991, 1993b, 1996). A recent report on special education caseloads summarizes:
“In the end, caseload size symbiotically affects some of the very conditions that give rise to it. Reciprocally, caseload size impacts the ability of teachers to meet the diversity and intensity needs of students. It influences the roles and responsibilities of special educators. It exerts an impact on the extent of direct service time provided to students. Finally, caseload bears a direct relationship on the quality of education provided to students with disabilities” (Chiang & Rylance, 2000).
Figure 1 illustrates a number of important outside influences and factors that affect the workload of school SLPs. These factors include the following:
Caseload: The number of children and adolescents the SLP must serve.
IDEA mandates: Provisions in federal law, such as the requirements of free, appropriate public education (FAPE) and least restrictive environment (LRE) strongly and directly influence both the numbers of students SLPs see and the contexts in which they are served.
Student factors: The expanding range and severity of disabilities of students served under IDEA influences the number of students on the SLP caseload, and the range and time of professional activities necessary to meet their needs.
State/local regulations: Caseloads and workloads are directly affected by other state and local education regulations, such as rules for eligibility and dismissal criteria for students identified as speech-language disabled.
School policies and expectations: Every school and school district has additional expectations and requirements that are a major part of school SLPs' workload. Examples include contract preparation periods, travel between assignments, paperwork for compliance with special education regulations and third party billing, and student and program data collection.
Professional influences: Major professional factors include an increase in school SLP roles and responsibilities, and an increase in the school SLP scope of practice (for example, literacy and language-learning disabilities).
State certification requirements: State and local education agencies' requirements for staff development and continuing education influence SLPs' workloads.
State and local budgets: School districts' operating budgets significantly affect allocation of resources, especially approval of additional SLPs to reduce caseloads and improve services to students.
Unfunded mandates: Requirements to locate, identify, and serve all children and adolescents with disabilities with no provision for waiting lists place the weight of timely action on SLPs without a corresponding mechanism to fund the resources necessary to respond. This results in the creation of required work without funding for personnel to complete the work.
Figure 1. Factors that affect school SLP workloads.
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It is becoming clear to speech-language pathologists, special education teachers, and administrators across the country that a conceptual shift from “caseload” to “workload” is necessary to deliver appropriate services to students with disabilities consistent with the intent of IDEA and best practices in school speech-language pathology. The total workload activities required and performed by school-based SLPs must be taken into account to set appropriate caseload standards (ASHA, 2001a). The use of a workload analysis approach to determine the number of children who can be adequately and appropriately served is currently receiving serious attention in special education and other professions, including state and local education agencies, school-based occupational and physical therapy programs (Hylton, 1987), clinical supervisors in university training programs (Johnson & Meline, 1997), school psychologists (Keith, 1992), child welfare workers (Stein, Callaghan, McGee, & Douglas, 1990; Mills & Ivery, 1991), and itinerant teachers of the vision impaired (Olmstead, 1995).
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The expanded scope of roles and responsibilities of school-based SLPs can be better understood when they are organized into several major clusters of work activities. These activity clusters may be represented using a circle divided into sections as a graphic organizer. The circle represents all work-related activity, with each section standing for one of the activity clusters discussed below. The four workload activity clusters that serve as examples in this document are illustrated in Figure 2. [1]
Figure 2. SLP Workload Activity Clusters
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These activities make up the bulk of what has been traditionally defined as SLPs' caseload. The focus is on the direct or face-to-face implementation of IEPs and IFSPs and includes evaluations to identify students with disabilities and reevaluations as required by federal and state special education regulations.
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In addition to direct services, students with disabilities need multiple support activities from SLPs in order to make progress on IEP/IFSP goals and generalize these skills to other environments. These activities are referred to as indirect services because they do not involve face-to-face contact with students, yet they are just as important to students' education programs as are face-to-face services. For example, the design, maintenance, programming, and staff training for augmentative communication systems are vital work activities necessary for students to learn to communicate across school and other environments. Other required indirect activities include student-centered planning and collaboration with other teachers and professionals, designing curriculum and instructional modifications, serving on student planning teams, designing student service plans, collecting and analyzing student performance data, communicating and meeting with parents and nonpublic school staff, and planning for student transitions.
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Students with identified disabilities require additional indirect services to ensure that they progress in the least restrictive environment and in the general education curriculum. For students with IEPs, these activities require the SLP to become familiar with all aspects of the general education curriculum, and to meet, consult, and collaborate with classroom teachers, paraprofessionals, and others who provide education services to students. Indirect activities in this cluster include classroom observations, teacher interviews, designing and implementing pre-referral interventions for students at risk for problems, modifying curriculum, and adapting instructional materials.
In addition, this activity cluster can include face-to-face and indirect services to students who are at risk for academic problems, especially in the general education curriculum areas of language arts and literacy. SLPs play a number of important roles to prevent reading and writing problems for students with and without identified disabilities (ASHA, 2001b).
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A wide range of time-consuming activities in the workload of school SLPs are required to comply with an expanding set of federal, state, and local mandates. Some of these responsibilities are administrative and management tasks. Many of these compliance-related activities involve extensive documentation, and include numerous required written products such as student evaluation reports, IEPs, IFSPs, student progress reports, daily intervention charts and logs, third party billing statements and logs, funding reports for assistive technology, and student child count reports. Travel between schools also can be considered to be a management activity that can add significantly to SLPs' workloads.
This workload activity cluster can include activities and responsibilities that must be addressed simply because SLPs are professional members of a school community. For example, SLPs may need to participate in building staff meetings, school or district committees, and a host of other duties assigned by school administration (e.g., bus duty). Workload responsibilities such as professional development, program development, service in professional organizations, and other professional activities should also find a place in this or some other workload cluster.
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A workload analysis process is necessary for SLPs to document all the workload activities that must be done to (a) provide appropriate services to meet students' individual needs, (b) ensure compliance with education agency mandates, and (c) implement best practices in school speech-language pathology. The time that it takes to perform these activities must then be compared to the time available during the school day, week, or month. A continuous cycle of analysis and planning is necessary to ensure that time is available for all activities and that the workload is “balanced” (Ferner, 1995). In the context of the workload analysis approach to setting caseload standards set out in this document, SLPs' workloads are balanced when full implementation of IDEA and best practices can be maintained for all identified students. SLPs' workloads shift out of balance when the number of students to be served and the number of mandated responsibilities make full implementation of IDEA and best practices no longer possible.
Prior to beginning efforts to document and analyze the workload, SLPs should identify a comprehensive list of all roles, responsibilities, and activities necessary in their own school setting. Table 1 presents an example of a list of mandated and best practice roles, responsibilities, and activities that characterize many school SLP workloads. Figure 3 illustrates one of several possible ways that these activities might be sorted into the four major SLP activity clusters described above.
Table 1. Brainstorm list of workload activities of school SLPs.
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Analyze and engineer environments to increase opportunities for communication
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Analyze demands of the curriculum and effects on students
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Attend staff/faculty meetings
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Attend student planning teams to solve specific problems
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Attend teacher/service provider meetings (planning, progress monitoring, modifications to program)
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Carry out assigned school duties (e.g., hall, lunch, bus, extracurricular)
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Collect and report student performance data
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Complete compliance paperwork
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Communicate and coordinate with outside agencies
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Complete daily logs of student services
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Complete parent contact logs
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Connect standards for the learner to the IEP
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Consult with teachers to match student learning style and teaching style
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Contribute to the development of IEPs, IFSPs
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Coordinate with private, nonpublic school teachers and staff
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Counsel students
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Design and engage in pre-referral intervention activities
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Design service plans
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Design and implement transition evaluations and transition goals
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Design/recommend adaptations to curriculum and delivery of instruction
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Design/recommend modifications to the curriculum to benefit students with special needs
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Design and program high, medium and low tech augmentative communication systems
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Document services to students and other activities
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Engage in special preparation to provide services to students (e.g., low incidence populations, research basis for intervention, best practices)
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Document third party billing activities
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Evaluate students for eligibility for special education
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Engage in dynamic assessment of students
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Identify students with speech and language impairment
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Implement IEPs and IFSPs
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Interview teachers
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Make referrals to other professionals
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Monitor implementation of IEP modifications
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Participate in parent/teacher conferences
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Participate in activities designed to help prevent academic and literacy problems
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Participate in professional association activities
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Participate in professional development
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Participate on school improvement teams
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Participate on school or district committees
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Plan and prepare lessons
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Plan for student transitions
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Provide staff development to school staff, parents, and others
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Program and maintain assistive technology/augmentative communication systems (AT/AC) and equipment
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Provide direct intervention to students using a continuum of service delivery options
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Observe students in classrooms
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Re-evaluate students
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Screen students for suspected problems with communication, learning and literacy
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Serve multiple schools and sites
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Supervise paraprofessionals, teacher aides, interns, CFs
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Train teachers and staff for AT/AC system use
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Travel between buildings
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Write funding reports for assistive technology and augmentative communication
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Write periodic student progress reports
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Write student evaluation reports
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Figure 3. SLP workload activity sorted into clusters
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An analysis of SLP workloads requires detailed information on the services and tasks necessary to meet each student's individual needs, the time it takes for each student-related service and activity, and the time available for these activities.
Each student should have an appropriate intervention or service plan, or an IEP/IFSP with team consensus on appropriate communication goal(s) and service options. To carry out a workload analysis, SLPs should determine the specific workload activities necessary to provide adequate services for every student for whom they are responsible. For the majority of students served by the SLP, the activities necessary to support the education plan appropriately should occur across all four workload activity clusters.
Accurate information must be available on the amount of time spent on each workload activity for each student per school day, week, or month. Data from individual SLPs or data aggregated across all SLPs in a unit should be collected and analyzed.
Each school day or week has a fixed number of time slots available for SLPs to fulfill the roles and responsibilities described above. A number of time slots must be used for activities that are mandated by federal and state rule and law (for example, compliance with timelines for notice and evaluation of students), or local education agency policies and procedures (for example, travel between buildings, student team meetings, and teacher planning periods during the students' school day). Time slots when students are not available for face-to-face services should be used to the greatest extent possible for these administrative and management activities.
The remaining time slots will be filled with direct, indirect, and other activities from each workload cluster that are necessary to support the education of students who receive services from the SLP. When all available time slots are filled, the caseload maximum has been reached for any individual SLP. This maximum number will vary across settings and be a function of the needs of the specific students on the caseload, the activities in each cluster determined necessary to meet student needs, the time required to implement those activities, local logistic constraints (e.g., limitations on times teachers are free to collaborate and plan), and the amount of time available. Administratively convenient practices, such as serving more students by increasing intervention group sizes, are not appropriate if student needs are compromised and current research findings on the effects of caseload size are not considered.
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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. An outcome from this step is a list of services and activities required for full implementation of IDEA and best practices that cannot be completed given current workload conditions. Reasonably, this step also includes an objective assessment of how the local education agency might address these unmet needs. The technical assistance manual (in preparation) that accompanies these guidelines describes examples of student service, administrative, and teacher contract options to help address workload issues.
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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. One resource, Working for Change: A Guide for Speech-Language Pathologists and Audiologists in Schools (ASHA, 2000d) outlines a number of strategies for working with teachers' unions and local and state education agencies to improve working conditions. For example, school SLPs can:
Establish a committee of district-wide SLP and audiology representatives to work with local union representatives to address workload and caseload issues with decision-makers.
Gather local data to demonstrate how student achievement may be affected by workload conditions, including caseload and intervention group size.
Become familiar with the local teacher contract on class size and caseload policies, mandated ancillary teacher duties (e.g., lunch duty, bus duty), and other contract rights and policies pertaining to working conditions for general education and special education teachers.
Identify state and local decision makers for workload and caseload conditions, and become familiar with the process by which decisions are made.
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SLPs who work in schools can use a number of strategies to advocate for appropriate workload and caseload standards in their state and local school district (Ehren, 2001; Power-deFur, 2001). For example, SLPs and those in leadership positions can:
Use ASHA NOMS data to demonstrate the value of smaller caseload sizes in improving performance of children and adolescents.
Generate local data on the effects of factors such as workload responsibilities, caseload size, intervention group size, and severity of student disabilities on student progress.
Relate speech-language services to the general curriculum and literacy development, and identify how these services can better equip students to master the state and local accountability assessments.
Select students for service carefully and consistently in collaboration with others, using knowledge of best practices in school speech-language pathology, and state and local regulations for determining eligibility for services.
Communicate regularly and objectively about workload and caseload issues with principals, education administrators, union representatives, and parents.
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Recent research (reviewed in the accompanying Technical Report) indicates that large caseloads limit school SLPs' capacity to choose appropriate service options based on students' individual needs, as well as to collaborate with special education and general education teachers. Large caseloads appear to constrain SLPs' ability to engage in many of the workload activities necessary to implement the intent of IDEA and best practices in school speech-language pathology.
These guidelines describe a process for analyzing the total work activities of school-based SLPs to help determine the number of students who can be served. A workload analysis process is necessary for SLPs to document all of the workload activities that must be done to (a) provide appropriate services to meet students' individual needs, (b) ensure compliance with education agency mandates, and (c) implement best practices in school speech-language pathology.
Setting caseload standards by analyzing the workload will allow SLPs to engage in the broad range of professional activities necessary to implement appropriate and effective service options, and tailor intervention to meet individual student needs. Without consideration of the entire workload, school-based SLPs may be placed in the position of only offering services that are administratively convenient, forming treatment groups that are too large to ensure meaningful student progress, or filling all available time slots with face-to-face intervention services. ASHA members report that these common practices leave little or no time for the use of an array of service delivery options and the myriad of other activities necessary to support students' education programs.
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[1] The four activity clusters described in this document are intended to serve as an example and starting point for a workload analysis - different or additional activity clusters may be used as appropriate to specific work settings.
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