A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in the Schools: Technical Report

What Are “Caseload” and “Workload”? How Does Caseload Relate to Workload?

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) that 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, 2000b). 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 the roles, responsibilities, and activities in the workloads of school SLPs is presented in the Guidelines document that accompanies this Technical Report.

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 mandated paperwork, multidisciplinary team conferences, parent and teacher contacts, and many other responsibilities. Multiplying the number of students on the speech-language caseload by the number of forms that must be completed per student and the number of meetings that must be attended gives a rough indication of the time implications of this factor (ASHA, 1993). Table 1 presents an example from a Midwestern urban school district of the required forms and meetings added to SLPs' workloads when just one student is added to the caseload.

Thus, when a student is added to the caseload for direct or face-to-face services, significant amounts of time within the school day, week, or month must be allocated for other important workload activities necessary to support that student's education programs and meet education agency mandates.

Return to Top

Caseload Concerns in Special Education

Concerns about caseload size in the schools are not limited to speech-language services (McCrea, 1996; Russ, Chiang, Rylance, & Bongers, 2001; Rylance, Chiang, Russ, & Dobbs-Whitcomb, 1999). Caseloads for special education teachers have been called “unmanageable” (Council for Exceptional Children [CEC], 2001), and the caseload issue has become a priority for special education professional and advocacy groups (CEC, 2001), as well as state and local education agencies (e.g., Minnesota Department of Children, Families & Learning, 2000; Ohio Legislative Office of Education Oversight, 1999). Russ et al. (2001) found that 72% of the special education teachers they surveyed reported that large caseloads had a negative impact on their ability to meet the needs of the students, including a decrease in 1:1 instruction and a decrease in student-teacher contact time. In addition, larger caseloads were strongly associated with teacher perceptions of diminished student progress in meeting IEP goals. The Council for Exceptional Children has recently stated that large caseloads are the most pressing problem facing special education teachers today. They maintain that current caseload regulations do not take into account each child's disability and education needs, and make it nearly impossible to individualize and provide quality instruction (CEC, 2000).

Return to Top

Federal, State, and Local Caseload Policies

Caseload size in special education programs (including speech-language programs) for students with disabilities is not mentioned in federal special education laws, leaving control of this matter to state law and regulations. However, the U.S. Department of Education does have oversight of state requirements through its monitoring responsibility because the caseload issue is related to provision of a free, appropriate public education in the least restrictive environment. There is extensive variation among state requirements in this area. No two states have the same, or even very similar, regulations on caseload for special education (National Association of State Directors of Special Education [NASDSE], 2000).

Recent reviews of state regulations on special education caseload/class size (Ahearn, 1995; McCrea, 1996; NASDSE, 2000; Rylance, Chiang, Russ & Dobbs-Whitcomb, 1999) reveal that some states specify special education class size by students' age span or grade level, with preschool student-to-teacher ratios specified separately. Another common criterion is the type of service that students receive, with different student-to-teacher ratios for resource rooms, self-contained classes, speech-language treatment, and other related services. Most states include a combination of criteria for caseload/class size in their regulations, for example, specifying different mandated student-to-teacher ratios based on the severity of each student's disability and how many intervention services are necessary. In many states, the issues of class size and caseloads for special education and related services are left to local education agencies appropriate to the need of students (NASDSE, 2000). Many states are in the process of revising their regulations to comply with the 1997 amendments to the Individuals with Disabilities Education Act (IDEA) and associated regulations. However, since federal law does not address caseload or class size, it is likely that state requirements in this area will not be changed as part of that update effort.

State and local policies on caseloads for SLPs demonstrate variability similar to caseload/class size regulations for other special education services. Although 28 states (56%) establish maximum caseload guidelines for school SLPs, 22 states (44%) leave determinations to local districts (Rylance et al., 1999). For states with numerical guidelines, speech-language caseload limits extend from a low of 40 students for one SLP in Hawaii and Wisconsin to highs of 80:1 in Ohio (Chiang & Rylance, 2000).

Several important but unanswered questions emerge from reviews of caseload policies and caseload sizes across the country. Does a general guideline that merely sets a goal of “appropriate to the needs of each student with an IEP” (NASDSE, 2000) designate enough protection for the delivery of individualized services? Does setting a maximum caseload result in flexibility for education agencies, or are they used to define a number that is often interpreted as a minimum threshold to add on to, rather than a true index of maximum capacity? Recently these questions appear to have concerned decision makers at federal, state, and local levels, as suggested by the following statement from K. Warlick, Director of Special Education Programs, U.S. Department of Education:

“Setting caseloads is a local and state issue, but excessive caseloads can potentially impede the ability to provide a free, appropriate public education to students. I believe that caseloads over 35 impede the ability to meet the individual needs of students. Some therapists should have even lower caseloads commensurate with the intensity of services needed by the students” (cited in Annett, 2001).

Workload Time Activities of SLPs

As reported by ASHA (ASHA, 2001e), recent data suggest that school-based, ASHA-certified SLPs spend more time now in direct contact with students than they did 5 years ago, leaving less time for consultation and other indirect services, collaboration, planning, paperwork, and other professional responsibilities. School-based SLPs report (ASHA, 2000b) that they spend an average of 6 hours per day on direct contact with students. In a typical week, SLPs report that they spend approximately 70% of their time providing direct intervention and evaluations. The remainder of their time is spent on other required work-related activities, including record keeping, paperwork, and report writing; planning and preparation for intervention; and parent and staff meetings.

A comparison between data from the 2000 and 1995 Schools Surveys (ASHA, 2001e) on the average amount of time spent per week on professional activities reveals that the percentage of time spent on direct intervention increased from 54% in 1995 to 62% in 2000. At the same time, there was a corresponding decrease in the time available for other mandated workload activities including time for evaluations (9% to 7%), planning with teachers (8% to 6%), and record keeping and paperwork (9% to 8%).

Other studies suggest that some SLPs spend even more time in direct student service (Chiang & Rylance, 2000; Vance, Hayden, & Eaves, 1989). For example, Chiang and Rylance (2000) reported that 75% of school SLPs' time at work is spent delivering student intervention services, with a corresponding decrease in the time left for other work activities. None of the studies reviewed in this section looked specifically at indirect or consultative speech-language services even though these are important service options and have received considerable attention in the literature on best practices in schools (e.g., Cirrin & Penner, 1995).

Return to Top

Recent Influences on School SLP Caseloads, Responsibilities and Workload

Although the average number of students on speech-language caseloads has remained essentially unchanged over the past decade (ASHA, 2000b; Peters-Johnson, 1992), the role of the school-based SLP has changed dramatically (ASHA, 1991; 1999, 2001a, 2002; Beck & Dennis, 1997; Cirrin & Penner, 1995; Eger, 1992; Ehren, 2000; Elksnin & Capilouto, 1994; Prelock, 2000; Whitmire, 2001). Additional federal and state requirements to ensure increased student access to general education programs and curriculum, consideration of assistive technology, and billing government agencies and health insurance companies are just a few examples of mandated responsibilities that did not exist a decade ago. Similarly, increased workload responsibilities have been noted in such areas as communication with parents, general and special education teachers, and administrators; participation on teams; paperwork requirements; and supervising the work of paraprofessionals. As a result, the standards of what constitute a “reasonable” caseload are different today from 10 years ago.

IDEA, in particular, has increased the responsibilities of the school-based SLP. With the IDEA reauthorization, school SLPs now:

• Serve more children and adolescents who have complex communication disorders that require intensive, long-term interventions. Children and adolescents with more severe disabilities may require greater use of individualized and smaller group models of service delivery as well as more frequent contact every week (U.S. Department of Education, 2000).

• Serve more children and adolescents who are medically fragile or who have multiple disabilities. The U.S. Department of Education (2000) reports that the most common service for children and adolescents with two or more co-occurring disabilities was speech-language intervention. In addition, students with co-occurring disabilities often receive services from a variety of providers, resulting in a need for greater collaboration in planning and providing these services.

• Provide services in the least restrictive environment and through the general education curriculum. This requires additional planning and collaboration time with other teachers and professionals as well as time for SLPs to better understand the general education curriculum.

• Play many important direct and indirect roles in facilitating literacy for children and adolescents with and without communication disorders (ASHA, 2001b) as a result of the focus on measurement of student progress in the general education curriculum. Appropriate roles for SLPs with respect to literacy include, but are not limited to, prevention, identification, assessment, intervention, monitoring, and follow-up.

• Report on student progress more frequently and attend more meetings with general education teachers and parents.

A number of specific provisions in IDEA affect many workload activities of SLPs in schools. Table 2 presents the major tenets of IDEA that mandate the type of services that students with disabilities receive in schools, and thus affect the required workload activities of school-based SLPs. Summaries of other selected legislation and court decisions related to expanded SLP responsibilities are presented in Appendix B .

One federal mandate that warrants attention is that education agencies must ensure that each student with a disability is provided a continuum of service options that will guarantee a free, appropriate public education based on the student's individual needs. Both ASHA (2002) and the National Joint Committee on Learning Disabilities (1993) support the use of a continuum of services and reject the arbitrary placement of all students in any one setting for administrative convenience. These groups have recommended the use of a variety of models through which inclusive practices can be provided, including resource (pull-out) programs, classroom-based service options, and consultative interventions. The current literature on best practices in school speech-language pathology has reinforced this aspect of IDEA as well, as illustrated by the following quotation.

“Meeting the mandates of IDEA requires that SLPs move away from exclusive use of the traditional clinical model of individual and small-group pullout therapy and instead engage in collaborative consultation, authentic assessment, curriculum-based intervention programs, and classroom-based services. This provides us with a rich opportunity to benefit from the strength of collaborative team models, and to offer our students educationally relevant and functional programs” (Whitmire, 2000).

The scope of practice for speech-language pathology (ASHA, 2002) has also continued to expand and evolve in response to significant changes in the severity and complexity of disabilities of students currently enrolled in schools. These changes have exerted a strong influence on the workloads and roles played by school-based SLPs. The scope of practice reflects the new knowledge bases and clinical skills necessary to fulfill these expanded SLP roles. For example, SLPs in schools must now have expertise in areas that include, but are not limited to, language and literacy development, articulation and phonology development and disorders, fluency disorders, voice disorders, language-based learning disabilities including reading and writing disorders, expressive and receptive language disorders, feeding and swallowing disorders, augmentative and alternative communication, auditory processing disorders, traumatic brain injury, autism spectrum disorders, neurogenic disorders including cognitive impairment, deafness and hearing impairment, and linguistic and cultural diversity.

Caseload Effects and Service Delivery Options Used With Students

ASHA's 2000 Omnibus Survey (ASHA, 2001c) and 2000 Schools Survey (ASHA, 2001e) describe speech-language practice as it is currently conducted in the schools. Despite IDEA's focus on collaboration and evidence that collaboration and consultation support notions of best practice, most treatment services continue to be delivered through a pullout model (average 23 hours per week), primarily with groups versus individuals. Consultation and collaboration currently take up an average of only 2 hours per week, with classroom-based/curriculum-based intervention averaging 1 hour per week. This limited involvement in collaboration, consultation, and classroom-based services appears to be due in large part to the major workload challenges identified by school-based SLPs: large caseload sizes; lack of time for planning, collaborating and meeting with teachers; and burdensome amounts of paperwork (e.g., ASHA, 2001a; Chiang & Rylance, 2000). ASHA NOMS data confirm that the vast majority of students with disabilities (up to 92%) receive speech-language intervention in pullout groups regardless of the disorder being treated. Two-thirds of students are seen for intervention two times per week, and more than 75% of those sessions are 21–30 minutes in length (ASHA, 2000a).

When data from the 2000 ASHA Schools Survey are compared to data from the 1995 ASHA Schools Survey (Peters-Johnson, 1996, 1998), there appears to be virtually no change in the service delivery options used by school SLPs in the past decade. Paralleling the 2000 survey data, the pullout group treatment model was the most common service provided in 1995 (total 86% of the time, 51% in group sessions and 35% in individual sessions).

The NOMS data report reveals that caseload size appears to play a significant role in the way speech-language services are delivered (ASHA, 2000a; Karr & Schooling, 2001; Whitmire, Karr, & Mullen, 2000). Analyses indicate that two of the immediate impacts of increasing caseload size are a shift from individual to group treatment, and an increase in the size of the treatment groups. For SLPs with caseloads greater than 60 students, treatment groups of 5 or more were much more commonly used (31% of the time vs. 6% for caseloads under 40) and individual treatment was nonexistent (0% of the time). In contrast, children served by SLPs with fewer than 40 children were more likely (13%) to receive individual treatment than SLPs with larger caseloads. In addition, SLPs with caseloads fewer than 40 were more likely to use other service delivery models (classroom-based, collaborative consultation, etc.) to treat their students. These data suggest that a wider range of service delivery options is available to a student if the SLP has a caseload of fewer than 40 students. Figure 1 illustrates the relationship between caseload size and the percentage of students receiving individual treatment for speech sound production.

Current ASHA NOMS results are confirmed by other independent research. For example, Chiang and Rylance (2000) conducted surveys of a random sample of 210 Wisconsin school-based SLPs in one of the most comprehensive studies published on speech-language caseloads. As would be predicted, SLPs with large caseloads (over 40) conducted a high percentage of treatment in pullout/resource settings (68%), which they felt allowed them to offer treatment to the largest number of students in the least amount of time. Caseload also affected the type of intervention provided; SLPs with large caseloads tended to serve larger numbers of students in group settings (66%). The majority of respondents indicated that the size of their caseload had a critical influence on their ability to deliver an appropriate education to their students. These findings led the authors to make several recommendations to decision makers in state and local education agencies: (a) the IEPs and the needs of individual students must be given priority when choosing service delivery options; (b) caseloads should be of a size to allow SLPs to provide intervention, collaborate and co-teach, and complete the necessary paperwork in working hours; (c) caseloads of students with communication disorders should not exceed 40 under any circumstances; and (d) caseloads containing students with severe and complex disabilities (e.g., autism, cognitive disabilities, fetal alcohol syndrome, and severe developmental delays) require substantial reduction to provide appropriate services. These authors make the following conclusion:

“In a profession dedicated to serving children based on their disability needs, these trends sound warning alarms. Indeed, with the new and increased paperwork demands mandated by IDEA, the recent move for schools to bill other agencies, and an increase in the number of children with severe involved disabilities, a caseload of 40 strains even a dedicated professional. Based on the findings from this study, the tensions between more paperwork and quality services will only be exacerbated by increasing numbers of children” (Chiang & Rylance, 2000).

The effects of large caseloads on the service options chosen by special education professionals is not limited to school SLPs. Olmstead (1995) analyzed results from a survey of caseloads and working conditions for itinerant vision teachers. As caseloads increased, the teachers felt that the level of service on students' IEPs was determined primarily by how much time was available in their schedules, rather than according to student needs. Teachers also indicated that expanding caseloads had left insufficient time in the school day to conduct necessary duties such as adapting materials and meeting with teachers. Keith (1992) conducted a survey of randomly selected school psychologists. Results indicated that caseload size influenced the amount of time psychologists could spend on interventions: as caseloads increased, psychologists had less time to spend on direct intervention with students and virtually no time to meet with teachers. Just as important, teachers' ratings of psychologists' effectiveness were directly influenced by caseload size; the higher the caseloads, the lower the teachers rated the effectiveness of the psychologist. The studies reviewed here suggest that large caseloads limit the type of services that SLPs, special education teachers, and other related service providers give to students with disabilities, even though the intent of federal and state special education regulations is for service decisions to be based on students' individual needs.

Return to Top

Caseload Effects and Student Outcomes

Most research to date on the effects of caseload and instructional group size has looked at traditional pullout service settings. There is a lack of research on the effects of caseload size on services delivered through classroom-based, collaborative, or indirect-consultative options. Therefore, the literature reviewed in this section focuses on pullout services in a “resource room” model. For information on the continuum of service options now considered best practices for speech-language intervention in school settings, the reader is referred to ASHA (1991, 1999, 2001d), Cirrin and Penner (1995), Eger (1992), Ehren (2000), Elksnin and Capilouto (1994), Prelock (2000), and Whitmire (2001).

Return to Top

Students With Learning and Other Disabilities

Larger caseloads naturally increase instructional group sizes and minimize opportunities for individualization of interventions (Russ, Chiang, Rylance, & Bongers, 2001). Recent research has supported a link between instructional group size and student engagement for students with moderate disabilities (Algozzine, Hendrickson, Gable, & White, 1993; Thurlow, Ysseldyke, Wotruba, & Algozzine, 1993). For example, Thurlow et al. (1993) examined the effects across different student-to-staff ratios (1:1, 3:1, 6:1, 9:1) for students with learning and behavioral disabilities. These investigators found that groups with lower ratios (1:1 and 3:1) had significantly higher percentages of time when teachers used more effective instructional behaviors, and significantly higher percentages of time in which students made active academic responses. These included communication responses such as talking appropriately, answering academic questions, and asking academic questions. Better attending to task and less inappropriate behavior from students were also observed in lower ratio groups. These authors concluded that special education students in smaller instructional groups have more opportunities to participate, resulting in an increase in the frequency of participation. Forness and Kavale (1985) studied the effects of class size on the attention, communication, and disruption of children with mental retardation. Smaller instructional groups were associated with higher levels of verbalization and gestures, leading the researchers to conclude that there was more opportunity in smaller classes for interactive communication and less emphasis on activities such as passive listening and individual seatwork.

There also appears to be a relationship between instructional group size and academic achievement (Algozzine et al., 1993; Gottlieb & Alter, 1997; Thurlow et al., 1993). Torgeson, Wagner, Rashotte, Alexander, and Conway (1997) found that students with severe reading disabilities in resource rooms achieved much lower gains than did matched students receiving 1:1 instruction. Gottlieb and Alter (1997) studied the impact of increases in instructional group size when New York City schools were mandated to increase the number of students from 5 to 8 in resource rooms and speech-language groups. Even though speech-language providers increased the overall number of students seen by about 25%, surveys indicated that children were grouped to accommodate scheduling considerations rather than to meet their individualized language learning needs. There was also a significant reduction in the number of children able to be seen individually. For special education teachers and SLPs there was a marked decrease in time to collaborate and attend regularly scheduled meetings with general education teachers. No data were collected on how the increase in group size affected effectiveness of speech-language services; however, data did show a substantial decline in reading achievement scores of resource room students with the increase in group size. The authors stated that they had little reason to doubt that speech-language services were also delivered less effectively under larger instructional group conditions.

Although research has shown that small group instruction can be effective for teaching some students with severe disabilities (Fink & Sandall, 1980; Oliver & Scott, 1981; Reid & Favell, 1984), it also appears that instructional time is a critical variable that affects the performance gains of severely and profoundly handicapped children (Snart & Hillyard, 1985). The student-to-staff ratio directly affects the amount of instructional time available in classrooms. Snart and Hillyard (1985) studied effective teaching environments, and found that a 2:1 student-to-teacher ratio was the point at which teachers were able to provide more instructional time than noninstructional time/activities. Compared to other student-to-staff ratios, the 2:1 ratio resulted in increased performance for these students with severe disabilities. Similar results were obtained by Kemps, Walker, Locke, Delquadri, and Hall (1990) who found that for students with autism in a public school setting, instruction in small groups with student-to-staff ratios of between 1:1 and 3:1 were effective for teaching word recognition skills. These data from the studies reviewed in this section suggest that students served in smaller instructional groups (with student-to-teacher ratios of 3:1 or less) have improved performance and achievement. This appears to be true of students across a wide range of disabilities, and student communication responses, in particular, seem to be facilitated by lower group size.

Return to Top

Students With Communication Disorders

NOMS data (ASHA, 2000a, 2001c) suggest that student communication outcomes appear to be influenced by caseload size. In comparing the proportion of students in kindergarten through twelfth grade who made at least one level of progress on articulation goals, the data reveal that students on caseloads of fewer than 40 were more likely (87%) to make measurable progress than those on caseloads of 60 and above (63%). This relationship is shown in Figure 2.

Additionally, NOMS data suggest an interaction between an SLP's caseload size and the teachers' perceptions of whether speech-language intervention improved students' reading comprehension and written language skills (Karr & Schooling, 2001). As illustrated in Figure 3, for children receiving treatment from SLPs with caseloads fewer than 40, 90% of regular education teachers reported that these children demonstrated improved reading skills that were related to the services the SLP had provided. When the caseload size increased to 70, only 60% of the teachers felt that speech-language pathology services made a difference in students' reading abilities.

As previously discussed, group treatment is much more commonly used by SLPs with large caseloads. ASHA NOMS data appear to demonstrate that this shift from individual to group treatment has a negative effect on student outcomes in treatment (Karr & Schooling, 2001). The data presented in Figure 4 reveal that children were more likely to make measurable progress in speech sound production skills when they received individual treatment as opposed to group treatment. A similar pattern was found for preschool children (ASHA, 2001c): 78% of children who received individual intervention services made significant progress in articulation, compared with 57% who received group treatment. Larger caseloads appear to be related to slower progress for children in treatment.

ASHA NOMS data (ASHA, 2001c) suggest that group treatment is an effective service delivery choice for preschool children with goals in the area of spoken language comprehension. However, group size is one factor that appears to affect students' verbal communication in ways that might in turn promote language development. Several studies lend some support to this idea. Lowenthal (1981) studied the effect of small-group instruction in comparison to large-group teaching as an approach to improving the oral language of language-delayed preschoolers. Students were assigned to control (large) or small treatment groups. Children in groups of three made significantly greater gains in receptive vocabulary, auditory comprehension, and verbal ability than children in control groups that had ten children. McCabe, Jenkins, Mills, Dale, Cole, and Pepler (1996) found differences between playgroup sizes of two and four in the expressive language that children with disabilities used with peers. Children with disabilities used significantly more utterances per minute when playing in groups of two. In the groups of four, the children had fewer utterances but used more different words.

Increased practice with talking appears to facilitate vocabulary growth and complex sentence production in children with disabilities (Hart & Risley, 1980). However, young children with communication disabilities talk approximately half as much as their typically developing peers, and are much less responsive to inquiries from teachers and peers (Warren & Rogers-Warren, 1982). Taken together, these results suggest that children whose language is least well developed tend not to engage in the practice they need for language development. The studies reviewed in this section suggest that intervention for children and adolescents in small groups (3:1 or less) provides more opportunities for conversational participation and verbal communication. It follows that the use of smaller student-to-staff ratios in speech-language intervention can maximize talking practice and lead to improved communication outcomes for students with disabilities.

The research reviewed in this section on effects of caseload and group size supports several conclusions. Education teams must consider these results when determining which service options can best meet individual student needs.

• Large caseloads affect available service options. Large caseloads relate to less individual treatment, more group treatment, and an increase in the size of treatment groups.

• Larger caseloads appear to minimize opportunities for individualization of interventions.

• When instructed in smaller size instructional groups, students with a wide range of disabilities are more engaged and have better student outcomes. Among desired student outcomes, communication skills, in particular, appear to be positively influenced by small treatment group size, and negatively influenced by larger treatment group size. This includes students with severe disabilities who verbalize and use gestures to communicate more in small group settings.

• Students on large caseloads appear to take longer to make progress on communication skills.

Return to Top

Caseload Effects and Working Conditions Related to Teacher Attrition and Shortages

The current trend of increasing caseloads and the expanded responsibilities of teachers in special education, including speech-language pathology, appear to be important factors contributing to high rates of teacher attrition. It has been predicted that if the current attrition rates continue, it is likely that some districts will not be able to meet the federal requirements of IDEA to ensure that all students with disabilities are provided with a free, appropriate public education (Wisniewski & Gargiulo, 1997). For speech-language pathology, over 50% of respondents to the 2000 ASHA Schools Survey reported a shortage of qualified SLPs in their school district (ASHA, 2000b). Effects of this shortage on service delivery, as indicated by the respondents, included increased caseload (80%), decreased opportunities for individual services (62%), and decreased quality of service (58%). Findings on school SLP shortages from 1995 are remarkably similar to current research. ASHA survey data reported by Peters-Johnson (1996, 1998) indicated that 60% of respondents reported SLP shortages in their districts. The major effects of the shortages on services to students were increased caseload and an accompanying decrease in the quality of service.

The majority of respondents to the ASHA 2000 Schools Survey on SLPs' working conditions reported that their greatest challenges were burdensome paperwork (88%); lack of time for planning, collaboration, and meeting with teachers (81%); and large caseload (60%). These results are similar to those of the 1995 ASHA Schools Survey (Peters-Johnson, 1996, 1998).

State education agencies are beginning to examine the impact of large caseloads on speech-language pathology services for children in schools. There appears to be a relationship between working conditions and SLP shortages. For example, special education administrators and SLPs in schools and health care settings were recently surveyed by the Ohio Legislative Office of Education Oversight (1999). Results indicated that schools had difficulty finding SLPs primarily because the working conditions in schools were less favorable than in most health care settings. Specifically, this study indicated that the public school work environment often included larger caseloads: in schools SLPs served over 50 students in groups; in health care they served between 16 and 30 clients in individual treatment sessions. School SLPs also reported that paperwork for reimbursement for treatment services from Medicaid was particularly burdensome. Data from this study also confirmed results from the 2000 ASHA survey on how SLP shortages affected students. When shortages occurred, approximately 60% of SLPs and school administrators surveyed in Ohio reported reduced frequency of intervention sessions; 57% reported reduced duration of sessions; 30% reported that students went without services; and 20% stated that students received intervention services from noncertified staff. Only 13% of respondents reported that students were not affected by SLP shortages.

Several studies have looked specifically at job satisfaction in school SLPs (Banks & Necco, 1990; Chiang & Rylance, 2000; Goldberg, 1993; Miller & Potter, 1982; Pezzei & Oratio, 1991). These studies have consistently shown that public school SLPs with large caseloads, increased paperwork, and funding cuts are particularly susceptible to burnout because they do not have the time to give each client the full attention needed. As the volume of workload or caseload increases, the degree of job burnout increases. These are the same factors that recent studies found to contribute to personnel shortages of SLPs in schools (e.g., Ohio Legislative Office of Education Oversight, 1999).

Chiang and Rylance (2000) researched school SLPs' perceptions of working conditions. With specific regard to caseloads, 75% reported that caseload affected job satisfaction; 81% indicated that caseload affected their job effectiveness; 83% reported that caseload affected the type of intervention used; 83% reported that caseload affected their ability to engage in collaboration with other teachers. These authors concluded that SLPs' responses clearly pointed to professional responsibilities that were being met minimally. These open-ended responses capture the majority of the respondents' attitudes on the current state of caseload and workload issues:

• “Time is the issue.”

• “It is impossible to provide appropriate treatment for students on a large caseload while doing paperwork, calls, and meetings.”

• “Caseload sizes are too large to truly address students' IEP goals appropriately.”