This page focuses on caseload and workload issues specific to the school-based speech-language pathologist (SLP). Many of the topics discussed in this page are also relevant for professionals in a variety of other settings.
Caseload refers to the number of students with Individualized Education Programs (IEPs), Individualized Family Service Plans (IFSPs), and 504 plans served by school-based speech-language pathologists (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. Workload includes the time spent providing face-to-face direct services to students as well as the 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 almost exclusively synonymous with caseload; 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.
The total number of workload activities required and performed by school-based SLPs should be taken into account when establishing caseloads. ASHA recommends taking a workload analysis approach to setting caseloads to ensure that students receive the services they need to support their educational programs (ASHA, 2002).
In the past, ASHA has recommended a maximum caseload number. However, some states and districts interpreted the number as a minimum rather than a maximum. Others ignored the recommendation, citing that there is no research to support a specific caseload size.
ASHA no longer recommends a specific caseload number for the following reasons:
For these reasons, ASHA encourages assignment of SLPs based on workload rather than caseload.
Nationwide, school-based SLPs provide services to students from at least five different groups:
According to the ASHA 2016 Schools Survey [PDF], the median monthly caseload size of ASHA-certified, school-based SLPs who were clinical service providers working full time was 48, with an individual caseload range of 31–64 (ASHA, 2016).
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. See also ASHA's State Caseload Chart [PDF].
Students on smaller caseloads are more likely to make measurable progress on functional communication measures than those on large caseloads (Schooling, 2003).
These positive student outcomes may be less likely when SLPs have large caseloads and expanded responsibilities. For example, large caseloads may necessitate a shift from individual to group treatment and from smaller to larger group sizes, when such changes are not necessarily ideal for the student.
Student outcomes also depend on the SLP's ability to provide services that integrate the child's curriculum. Large caseloads often limit the time available to become familiar with curriculum and standards (e.g., Common Core State Standards [CCSS] or other state standards) across all grade levels served. See Common Core State Standards Initiative (National Governors Association Center for Best Practices, Council of Chief State School Officers, 2010) and ASHA's Common Core State Standards: A Resource for SLPs.
Large caseload may also constrain service delivery options. In fact, caseload size, rather than student characteristics, frequently influences recommendations about program intensity and/or model of service delivery (Brandel & Loeb, 2011; Schooling, 2003). Larger caseloads may necessitate the use of service models that are not appropriate for some students and that may affect the SLP's ability to provide FAPE. See ASHA's resource on IDEA's influence on student needs and expanded SLP responsibilities in schools.
Students benefit from classroom-based models in which the SLP and the classroom teacher co-teach language lessons (McGinty & Justice, 2006). Large caseloads limit the time available to the SLP for collaboration with teachers and other professionals. See ASHA's resources on interprofessional education/interprofessional practice (IPE/IPP).
Large caseloads can also limit opportunities for SLPs to (a) work with interpreters to effectively communicate with students, parents, and caregivers about assessment procedures and results, IEP goals, and other services and (b) work with translators for written translation of documentation as needed. See ASHA's Practice Portal page on Collaborating With Interpreters, Transliterators, and Translators.
Large caseloads also have an impact on the following:
ASHA's Schools Surveys indicate that the average number of students on speech-language caseloads has remained relatively unchanged over the past decade, whereas the roles 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 adding value to the students' classroom experiences and improving student outcomes.
Factors that may lead to increased workload include the following:
Thus, caseload can be viewed as only one of many factors that affect the overall workload of the school SLP.
Factors Impacting Workload
All workload activities required and performed by school-based SLPs must be taken into account when setting appropriate caseload standards. 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." This shift is consistent with the intent of IDEA and best practices in school speech-language pathology and will ensure delivery of appropriate services to students with disabilities.
Use of a workload model is foundational to
A workload analysis must be conducted in order to establish an appropriate caseload. This allows education agencies to take into consideration how much time is available in the SLP's schedule when determining the number of children who can adequately and appropriately be served.
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:
SLPs should make a comprehensive list of all roles, responsibilities, and activities necessary for providing services in their specific school settings and then sort these activities into the four major activity clusters.
Sample roles and responsibilities, organized by activity cluster, include the following:
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
For examples and worksheets for the workload analysis approach, see ASHA's resource titled, Implementation Guide: A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in Schools. See also the Ohio Workload Calculator for SLPs [xlxs] (Carlin, 2015).
The Supreme Court Decision on Endrew v. Douglas County (2017) states that "[the] child's educational program must be appropriately ambitious in light of his circumstances, just as advancement from grade to grade is appropriately ambitious for most children in the regular classroom. The goals may differ, but every child should have the chance to meet challenging objectives" (p. 3). This standard is more demanding than the "merely more than de minimis" test requiring educational programs to demonstrate merely more than minimum progress for a child from year to year.
Keeping this in mind, the second step in conducting a workload analysis is to review current service delivery to ensure that models support adequate progress and address the changing needs of students. In this review,
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,
The use of multiple advocacy strategies and partnerships is often necessary to influence workload and caseload issues within state and local education agencies. If the current service delivery is not sufficient to produce appropriate progress, suggest options to enhance services.
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] (ASHA, 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.
School districts have implemented a variety of administrative solutions to assist SLPs in managing their existing workloads.
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. It is helpful to write the amount of SLP services into the IEP as a quarterly, semester-based, or annual amount of time to allow for some flexibility.
The following are examples of various service delivery models. Using evidence-based decision making, SLPs have the responsibility to select the most appropriate service delivery model. Models should be chosen with consideration for those models that afford the most flexible and efficient delivery of services, while ensuring FAPE, according to IDEA.
See ASHA's resource on school-based service delivery in speech-language pathology.
Appropriate and consistent identification of children who qualify for speech and language services will help prevent over identification that unnecessarily expands caseload and workload. See ASHA's resource on eligibility and dismissal in schools for information and guidance on eligibility, dismissal, adverse effect on educational performance, and cognitive referencing, as well as examples of eligibility guidelines from various states. Many states have also developed guidelines, so check with your state department of education.
Over the years, numerous ASHA members have reported a successful transition 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 SLPs and stipends for SLPs when they supervise SLPAs. Another district reported gaining an additional SLP position.
One state included a workload analysis approach in its statewide SLP policies and procedures and provided training in this approach to SLPs throughout the state. Another state adopted flexible and varied service delivery models (e.g., changing frequency, duration, and location of services) that can be written into the IEP and implemented accordingly, as students achieve various benchmarks.
In 2000, the Texas Speech-Language-Hearing Association (TSHA) began the effort to develop guidelines for identifying students with speech impairments (see TSHA Speech Impairment Eligibility Guidelines). This effort, combined with workload approach strategies, has resulted in a number of positive consequences in Texas schools, including
Within a 4-year period, the city of Houston went from 38 vacancies and about 50 uncovered campuses to only seven vacancies (see Wright & Bankston, 2009).
Student-Centered Service — Sharon Soliday, Portland, OR
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).
For students who receive articulation services only, we have been setting anticipated remediation dates for articulation goals. We all shy away from suggesting any time frame for the most part; however, NOMS [National Outcomes Measurement System] 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 [therapy] much more quickly if a target date (if only an estimate) were in place.
2017 Update: Although the pilot is long over, SLPs in the Salem-Keizer School District have the freedom now (and administrator encouragement) to consistently modify their schedules based on student progress. I can't speak to how many do so, but many individuals appreciated knowing a framework in which to expect growth. Naturally, the SLP's professional judgment guides any prognosis.
The Phonology Program (hereafter, called simply "Phonology") is a speech-language option within the Madison Metropolitan School District in Wisconsin. This program, staffed by two SLPs, 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
A 3:1 Cycles Approach — Sharon Soliday, Portland, OR
Portland was one of the first districts to introduce the 3:1 service delivery model as a way to deal with the expanding workload of their SLPs. The implementation project began with a pilot in which SLPs used a typical schedule for 3 weeks, then set aside the 4th week for a variety of work, including observations, assessments, consultations, meetings (with teachers, other staff, and parents), and compliance activities.
This model has allowed SLPs to spend more time in the classroom directly supporting teachers and students, and many SLPs are more involved in building literacy and reading programs and introducing new curriculum ideas to teachers. The 3:1 model has also been an effective recruitment tool when competition for SLPs is high.
Other benefits have included
Classroom-Based Speech Therapy — Cheval Bryant, Houston, TX
We continue to use the workload model; however, we no longer use a 3:1 approach. Frequency, duration, and location of services are determined based on the individual needs of each student; however, in 2012, we moved to a culture of inclusive practice by making Classroom-Based Speech Therapy our default service delivery model. As a result,
In addition, SLPs are involved in the Intervention Assistance Team (IAT) discussions regarding interventions and referral decisions for students with speech and/or language concerns. This participation leads to more appropriate referrals and avoidance of inappropriate labeling of students who only need a few weeks of intensive interventions.
We still have specialty teams, which include a small Speech Therapy Assessment Team (STAT), Bilingual Assessment Team, Dysphagia Team, Intake Team, and Private Schools Team. We have been fully staffed since the 2012–2013 school year, all campuses are covered, and staff retention is excellent!
Taking a Workload Approach — Mike Maykish, Brunswick County, NC
I work in the Brunswick County, North Carolina Schools, 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." Using a 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 it has led to a sharing of caseload responsibilities for those who have lower caseload numbers. Thankfully, our EC [Exceptional Children] 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 ASHA at email@example.com.
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, group of SLPs, or state association must consider.
See ASHA's resource on advocating for change.
This list of resources is not exhaustive and the inclusion of any specific resource does not imply endorsement from ASHA.
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/siteassets/uploadedfiles/Working-Change-Schools-SLPs-Audiologists-Guide.pdf
American Speech-Language-Hearing Association. (2016). 2016 Report: SLP caseload characteristics. Available from www.asha.org/siteassets/uploadedfiles/2016-Schools-Survey-SLP-Caseload-Characteristics.pdf
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.
Carlin, C. H. (2015). Workload guidance. Retrieved from The Ohio Center for Autism and Low Incidence website: http://www.omnie.ocali.org/user_mod.php
National Governors Association Center for Best Practices, Council of Chief State School Officers. (2010). Common Core State Standards Initiative. Available from www.corestandards.org/
Endrew F. v. Douglas County School District RE-1, 580 U.S. (2017). Retrieved from https://www.supremecourt.gov/opinions/16pdf/15-827_0pm1.pdf
Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. § 1400 et seq. (2004).
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.
McGinty, A., & Justice, L. (2006). Classroom-based versus pullout interventions: A review of the experimental evidence. EBP Briefs , 1, 3–25.
Rehabilitation Act of 1973, 29 U.S.C. § 701 et seq. (1973).
Schooling, T. L. (2003). Lessons from the National Outcomes Measurement System (NOMS). Seminars in Speech and Language, 24, 245–256.
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, 178–183.
Wright, C., & Bankston, D. (2009, March). Guidelines help Texas clinicians manage caseloads. The ASHA Leader, 14, 28–29. Retrieved from http://dx.doi.org/doi:10.1044/leader.AN2.14032009.28.
Content for ASHA's Practice Portal is developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Caseload/Workload page:
In addition, ASHA thanks the members of the Ad Hoc Committee on Caseload Size whose work was foundational to the development of this content. Members of the committee were co-chairs Frank Cirrin and Ann Bird, Larry Biehl, Sally Disney, Ellen Estomin, Judy Rudebusch, Trici Shraeder, and Kathleen Whitmire (ex officio). Alex Johnson, vice president for professional practices in speech-language pathology, provided guidance.
The recommended citation for this Practice Portal page is:
American Speech-Language-Hearing Association (n.d.). Caseload/Workload (Practice Portal). Retrieved month, day, year, from www.asha.org/practice-portal/professional-issues/Caseload-and-Workload/.