The speech referral process influences our caseload size and impacts how teachers and parents view the role of SLPs. Working in the school setting, you will get speech referrals from teachers, parents and the RTI general education process. Today, I want to share why I have a speech referral process.
Why I have A Speech Referral Process
Having a speech referral process helps you make better clinical decisions when deciding if you should test a student. Many SLPs work with a large number of students who speak English as a second language. So, although, the student may not be meeting common core standards in the classroom, it may not be related to a language disorder. A student could be struggling because he or she is learning a second language. Furthermore, environmental factors may impact a student’s communication development. For example, a student starting Kindergarten without attending preschool may not be exhibiting language skills equivalent to his or her peers. The student’s language abilities may be due to lack of exposure to the school environment. RTI can help the SST team determine if it is a language disorder or lack of exposure to school.
More Considerations For Why Having A Speech Referral Process Is Important
In a school setting, it is important confirm that general education interventions were performed for any students with language and social pragmatic concerns. This should be done before moving toward a speech assessment. This is in alignment with IDEA whereby we ensure that we are providing a free and appropriate education in the least restrictive environment. When the least restrictive environment isn’t being successful with general education interventions, that is when a discussion about a special education assessment is warranted.
One reason to conduct general education interventions is that we do not want to inaccurately identify a child with a speech and/or language disorder. Additionally, if general education interventions are working for the student, completing an assessment may not be recommended at that time.
It is highly recommended that you discuss your referral guidelines with your administration and speech department. Every state has different education codes for special education and being well-versed on your state’s education laws is paramount.
Here Is What The Speech Referral Process Looks Like In My World
All articulation, speech fluency and voice concerns come directly to me via a google form I created. You can read more about how to electronically gather speech referrals with google forms/docs HERE.
I follow up with the teacher to review concerns and determine if errors are developmental or a dialectal difference. This is when you can ask the teacher questions about speech intelligibility, and frequency/duration of dysfluencies. Then, follow up with how the speech concern is adversely impacting the student (this is key).
Then, you can conduct a classroom observation. If you need parent permission to informally talk to a student, then this would be the time to get a parent permission slip signed. If you notice red flags that this student may possibly need a speech assessment, you can do RTI for 6-8 weeks or initiate an initial assessment. SLPs needing an articulation & language screener for elementary, can use this one that I created HERE.
What To Do If The Student Is Stimuable For Their Sound Or Strategy
If the student is stimuable for the speech sound in some contexts and intelligibility is not significantly impacted, you may address the need through RTI speech improvement class. You typically would need to get parent permission. Discuss with your speech department how RTI speech improvement will look for SLPs. , I do RTI speech improvement for 6-8 weeks for my students that have only 1-2 sounds in error, or not demonstrating a year delay with sounds. If I observe multiple sound errors, decreased speech intelligibility and it is adversely impacting them in the classroom, I typically initiate a speech assessment. Sometimes, I will do RTI intervention and then make a decision to test after that 6-8 week intervention.
This is the process that was approved in my current district. I have worked in other districts that did not want me working with students that did not have an IEP.
How I Handle Language & Social Pragmatic Concerns
Any language and/or social pragmatic concerns I refer the teacher back to the Student Study Team (SST) general education process (your district may call it something else). In my district we have a pre-referral Student Assistant Program (SAP) in which a school team documents and discusses tier I and tier II interventions. I have let my schools and teachers know that if there are concerns with language and/or social pragmatics to include me in those meetings. Looking for information from ASHA regarding RTI? Check out their RTI page and ASHA’s position about Early Intervention.
Why Attending RTI or SST Meetings Is Worth Your Time
I go to any SST meetings that have language and/or social skill concerns for the following reasons:
Staff and parents can see my professional expertise in the areas of speech and language when I am present at the meeting.
SLPs can ask questions to the parents and collect background information on the spot. The background information is documented if a speech and language assessment is recommended or a full team assessment. Then, you don’t have to call the parent again for background information. You can also have parents fill out forms before or after the SST meeting.
This prevents professionals writing in recommendations for speech and language assessments to be completed without getting your professional insights. I know you may be think, “But, I don’t have time for more meetings.” I hear you. None of us have time for more meetings. But, when you think about how much time a full assessment can take to complete, you may re-consider. Testing the child, writing the report, IEP and holding the IEP meeting can take 8-15 hours of work. Attend 1 hour meeting or do a 15 hour assessment? If your team is signing you up for assessments that you know will not meet special education eligibility, you are opening yourself to work that could be spent more effectively. For example, if you aren’t doing that 15 hour assessment, you could be providing RTI intervention. Or you could be providing visual supports for teachers with that time.
Being at the meeting allows me to identify any red flags for a possible speech/language disorder
When a teacher has language and social pragmatic concerns, I may consult with them for strategies to implement in the classroom during the meeting or right after the meeting.
What To Do If You Can’t Attend The SST Meeting
If I can’t attend the meeting, I pre-staff the meeting with the psychologist or head person running the SST. I give examples of red flags that may warrant a language assessment or provide questions to ask the parent and team. Furthermore, if the team is feeling that language is a big concern, I ask them to document “consult with the speech pathologist” under actions. This allows me to see the SST notes, and consult teacher/parent before giving recommendations. If I see that RTI interventions haven’t been done or the student is an ELL learner, I want to make sure those things have been put in place before moving forward.
How To Stay Organized With Your Referral Process
If you are more of a visual learner, you can check out my Facebook LIVE video about how to streamline your speech referral process HERE.
One way that I stay organized with incoming referrals is by making a binder. That way, when you have educators handing you forms, you can shove it all into one place! You can support teachers by having an electronic version of your speech referral process. Send this process through email when a teacher has a question. You can get my referral process HERE and add/change what you need.
Helpful Forms and Resources For Your Speech Referral Binder
You can include helpful developmental milestones, and parent permission slips. Put your screener forms, or cheat sheet guides in your binder too. Here are some links to organizational forms that you can include in your speech binder:
Data Binder Forms that include parent permission slips for RTI intervention from The Speech Bubble SLP (My district has their own template, so if you don’t have a template, I recommend using these).
What forms or important information do you include in your speech referral binder?
Share Your Experience With The Speech Referral Process
All in all, a speech referral process is a guide. The speech referral process is there to help SLPs make more informed clinical decisions. Do you have a speech referral process? Why or why not? What roadblocks have you faced with trying to implement your speech referral process? Did you find any solutions that you can share with other SLPs? I would love to know your thoughts around this topic in the comments!
This year, I am trying to streamline some caseload management processes into a digital format. What I love about using Google Docs for speech referrals is that you can view and share information digitally. This means fewer piles of paper to organize, and that I can store the info digitally and then can print out the referral information if needed.
Why I love using google docs for speech referrals
There are some tasks for which I prefer to use pen and paper, but sing Google Docs for speech referrals is one tool I am very glad to have in my belt. Here are a few reasons why I love using Google Docs:
Once you’ve created your Google Doc with your speech referral process, you can email it to your entire staff with one quick click!
Sometimes my staff need a reminder about my process. Instead of writing out new emails with the same answers, I have been able to automate this process. I can just re-send the referral process to teachers.
I have fewer piles of paper. I can store information digitally and print referrals only when I need to (or not at all)!
I can access the information at no matter where I am. If I need to access the information to help me plan for the week, I always can.
Teachers can send me their referrals for students using Google Forms. They can easily check off sound errors and answer questions about their student’s communication.
I have a paper trail for when someone sent me a referral. I don’t have to worry about losing the referral form because it is all digitally stored.
How to access and use my Google Docs for speech referrals
One of the great features of google docs and forms is that you can share them with people! So, you can access the google docs and forms that I have already created.
This will show in view only, so you’ll need to save it to your drive first. To do this, go to File –> Make a Copy –> then save it to your drive! This will allow you to edit the file as you need for your own caseload.
If you hit request access, it will send me an email and I will not be able to respond to requests. If you follow the method above, you will get access and be able to edit for your own use.
Have you made any speech therapy Google Doc forms? I would love to add some digital forms and docs to my stash. It’s saved me so much time and helps me communicate effectively while completing all my necessary tasks.
I don’t think I have met an SLP or any educator for that matter that has said, “Stress. That never happens to me.” Working as a school SLP is very stressful. Raise your hand if you feel like a “stressed out SLP”!? Today, I wanted to talk about chronic stress on the SLP and how it can effect our well being and job performance. Some of the biggest “stresses” with the job of an SLP is the paperwork, managing IEP’s, planning and conducting therapy and progress monitoring all of your students on your caseload. There have been days when I have wanted to cry, hide and go get my job back at Starbuck’s.
Acute stress vs. chronic stress
Stress is how our body and brain reacts to any demand that is placed on us. SLPs have lots of demands placed on them, hence, why we are stressed lol. Acute stress is caused by those unpredictable events or situations that happen outside of our control. When we experience acute stress, our bodies release hormones to help our bodies/brains deal with the situation. For example, we may have acute stress from running an intense IEP meeting or having to write three speech reports in a week.
Chronic stress is caused from situations and events that are repeatedly happening to us, resulting in the release of the stress hormones. Many scientists feel that the human body was not designed to endure constant stress. When our bodies over produce the stress hormone, it can have negative affects on our bodies. Examples of chronic stress could be going through a divorce, while having to manage a caseload of 70 with many IEP meetings, not having supportive co-workers and trying to raise two children on your own.
When To Know You Have Chronic Stress
Stress is a funny term because as an SLP community, I think we often associate stress as a negative impact on our lives. Research shows that stress can be good if it helps us to be more productive. It is when we have hit our level of “overwhelm” that stress begins to negatively impact us. There is a fine balance of allowing stress in our jobs and personal lives. When we do not manage our stress, it can impact our lives significantly. Furthermore, stress is very personal to the individual. That being said, stress varies from person to person and that feeling of “overwhelm” may look different from one SLP to another.
Below is a list of different symptoms that people with chronic stress may be exhibiting. This may help you gauge if you are managing your stress well. Exhibiting many of these symptoms may mean that you are dealing with chronic stress in your life.
Why is chronic Stress Harmful
Chronic stress impacts our mind and body. It can begin to rob us of the physical and emotional things we want to enjoy in life.
How Chronic Stress Impacted Me
I took some time this year to reflect on the BIG stresses in my life and made an action plan for how I was going to manage the stress until the end of the school year. I know that MUCH of my stress were external factors that were out of my control and I needed to find a better way to survive. When I looked at the list of symptoms, I as exhibiting some insomnia, memory issues, mild depression and physical body aches and pains. I loved reading this post about the 5 Year Burn Out from the Queen’s Speech. It really gave me some good perspective about my job as an SLP and as a person.
Solutions To Help Reduce Chronic Stress
Advocate for your needs. Let your employer know that you are overwhelmed and need assistance.
Acting as if you can complete all the job tasks in a reasonable work day only makes administration think YOU can do the job successfully.
Exercise at least 3 times a week. This has helped me release my stress and manage my weight and eating better. I have more energy for my job and my focus has improved.
Limited coffee or energy drinks. I will admit that I have not given up coffee, but I reduced my intake of caffeine. When the effects of caffeine wear off, you can feel sleepy and sluggish.
Boost your mood. I have a music ready to play at the end of the day or when I have to cook dinner. Find something that helps boost your mood.
Work on getting a good night’s rest. I try to turn off the electronics an hour before bed and read a book and/or the bible. Sleep makes all the difference and stimulating your brain with TV or computer doesn’t help your body get ready for sleep.
Get organized. Invest time to set up systems and ways for your to stay on top of everything in your job and life. When you plan ahead, you reduce a lot of stress.
SLPs need to remember to take care of themselves
Most SLPs got into this field because they wanted to help people. We are naturally giving spirits and often put others first before ourselves. I think it is a very admirable quality, but when we don’t remember ourselves, we chip away at that giving, loving spirit. You don’t know how hard it has been for me to put these next steps of advice into place, but I have and continue to work on these things.
Let your YES be YES and your NO be NO. Don’t commit to something that internally you don’t have the time to complete. People pleasing will get you in a negative mindset and causes you to busy up your life. You can read about my 10 Phrases Every SLP should say at work to help with setting boundaries at work.
Seek counseling or some sort of support group. I attended some counseling sessions to help with the stress in my life and also went to a bible study that was geared towards drawing me back to relying on God for support in times of trials and STRESS.
Do something YOU enjoy every day……I take a hot shower to help ease my mind, hang with my kids, chill with my hubby, and listen to music when I need to revive my spirit.
Laugh….I am trying to find the joy of laughter in my students, my kids, on youtube, talking with friends, reading funny books and watching movies that will give me a laugh. Laughter relieves stress, so put more in your life!!
When your current STRESS isn’t going away any time soon
Accept what you can or cannot do, cry, whine, and moan for a few minutes with a friend. Then, make a plan for how you are going to get through the stress. Don’t let your workload stay the same for next year!! Make the necessary changes now even if that means looking for new employment. With the help from your admin, you may be able to or reduce or change your assignment. This are all easier said that done, so make sure you have great friends that are there for you along the way!
How do you manage stress? What advice could you give to an incoming CFY for how to start their career off right?
Speech therapists are BUSY. We have caseloads with 55 children or MORE, do assessments, bill medi-cal, write reports, collaborate with teachers, create visual supports for students, hold IEP meetings, plan therapy and work with groups all day. Organizing speech materials seems to be the last thing on our list of priorities. In order to get everything else completed, we put organizing speech materials on the back burner.
I loved this quote from Christina Scalise (found it thanks to google. I have no idea who she is lol) “Organization isn’t about perfection. It’s about efficiency, reducing stress and clutter, saving time & money & improving your overall quality of life.”
Figuring out easy organizational systems for your materials will help with easier planning for therapy, make your room look orderly and will make cleaning up easier. This means you will feel less overwhelm and will have some extra time to focus on the BIG task items. Amazon affiliate links are provided for your convenience.
Organizing Speech Materials- Give yourself a clutter paper place
Total confession- One way that I keep things clutter free is I have a “clutter paper place”. When it is a busy month, I know that I can stack all those papers that I am not sure if I want to throw them away in one place and deal with them when I have time. This helps me to keep my desk clear when I don’t always have time to sort through everything.
Organizing Speech Materials- Use Your Wall Space
The secret to organizing speech materials is all about finding a functional place. I am more of a type B+ SLP. This basically means that I do strive to be organized, but also accept the organized chaos that happens in my speech room during the busy times of the year.
Hang your materials on your wall with thumb tacks and binder rings. Got task cards or my interactive articulation flipbooks? Attach your materials with binder rings and you can hang all over your room! If you want more ideas for FUNctional decor & organization, check out my post about it HERE.
Have a supplies basket in reach of your speech table. I fill my basket with all the supplies I may need on the fly for lessons, so I keep behavior visuals, timers, dry erase markers, etc. in my basket, so I am never without my supplies. I clean it up after each group and access it as necessary. Dollar store has some great bins!
Use those file folder boxes to organize your seasonal and skill based materials. I like to use this box to organize all of my craft templates for the year.
I love finding containers like this poly zip file that can keep all my similar things in one spot in different pouches. That way I can shove it all in there and can store it easily. This storage container has all of my AAC Low Tech Communication Tools and it keeps all the small visuals in one place.
Hang frequently used visuals or resources on magnetic hooks. The sides of your metal cabinets work perfectly! When I can see my materials that I use often, it is easier for me to remember to use them lol. These are my visual sentence starters that I use with all of my speech and language groups. I have a metal cabinet right near my therapy table, so I can grab these whenever I need them for a student!
I put all of my TPT resources in plastic bags or zip pouches. Then I store them in larger bins when I am not using them. So, every couple of months, I will look through my big bins and put the seasonal or skilled resources that I need for the upcoming months in my file folder crate that I keep near my therapy table. I use binder clips and washi tape to label the different files.
All of my themed resources that I either create or buy on TPT are placed all in one plastic container. I try to even fit the themed books that I like to use with the theme, so I can grab it and use everything in it. This way materials don’t get misplaced and I know in a pitch, I can grab that container and it will have enough materials to cover me for those days when I don’t have time to plan.
Have a quick organizational tip to share?
If you have a fabulous SLP hack or tip to make the #speechlife a little easier, then email me at firstname.lastname@example.org. I would love to feature more “quick tips” from school based SLPs on the blog.
Why is it that whenever progress report time comes around, I completely dig my heels in the dirt. I am the queen procrastinator doing this drawn out task. Let me will tell you why. Progress reporting periods seem to come right when I have 4 pending assessments and 5 IEP’s to write. I have hidden places in my speech room dedicated to shoving piles of paperwork that I know I need, but don’t want to lose. Right around progress report time, my tolerance for the “piles” has hit its max and I go in cleaning frenzy mode. Thus, neglecting my progress reporting adventure. Not to mention that you have 60-80 on your caseload, so the idea of writing progress on 80 students makes you want to apply for a job at Starbuck’s.
Please tell me I am not the only SLP that has thought about a career change to be a barista mid-year.
This year let’s all finish progress reports like an SLP rockstar! Growth mindset, right folks!?
Every year progress reports stress me out! This year I am determined to manage the stress better. There are some external factors that I believe make this case management task a little more manageable. First of all, my caseload is at 48 this year. I know, gasp, right!?
Over half my career, I have had a caseload of 65-83! So, cutting out 15-25 progress reports was a blessing!
How To Finish Progress Reports Like A Rock Star
Here are some tips that will help YOU complete progress reports in a timely manner:
Treat Yo Self
Budget some money and/or time to reward yourself for completing these ghastly things! Starbuck’s, manicure, happy hour with friends, a hike, date night, etc. Keep that reward on a post it note right next to your desk as you are cranking these fun things out. We all need motivation to complete undesirable tasks and progress monitoring is definitely one of them.
Try to take data during your sessions
I try to take data on goals during therapy when I can. Rubrics are a great tool to collect data on those kids that you couldn’t take discrete trial data during the session. I love The Speech Bubble’s Rubrics! SLP’s can play a generic game like Sneaky Snacky Squirrel, Go Fish, or Candyland, during a session. Grab stimulus items for each student’s goals in your group and have a progress monitoring game day! Before each turn, a student has to complete a question/stimulus item, so you can take data on each student. I have some of Natalie Synder’s progress monitoring tools that are great to use during the session. I also will do a “craft” day with students and use my craftivity sets to progress monitor. While each student is working on their craft, I will pull them aside to progress monitor their goals. The stimulus items on the crafts are also a way that I can “assess” their skills. So, if a students has the craft template with “categories”, I will have the student name three items in that category.
Block Out Time For Progress Monitoring
Block out time for progress monitoring. Batch a large chunk of time to grab students for progress monitoring. If you only have 10 minutes here and 15 minutes there to do this task, you will NEVER get it done. SLP’s can block off a day or a large portion of time to progress monitor your students.
Use Tools That Will Help You Get The Job Done
This year, I am using SLPToolKit to help me assess progress on my student’s goals! SLPtoolkit is an online progress monitoring caseload management tool. You can read all about it HERE! Some of my student’s have four to five goals, so this has been great to assess their growth. Everything is digital, but I can then print out a copy if I want to bring to an IEP or send home with parents!
Start Progress Monitoring Early
If you are not careful, progress reports will creep up on you! You need to get started three weeks before they are due. Some things you can start doing is printing out labels for addresses (if you have to mail them out), write out a cover letter for your progress notes, review goals, and find materials to help measure goals. Map out on your calendar when you will progress monitor students such as “Monday 8-10″ progress students with last names A-E.”
In order to remember all the steps to getting these progress reports completed, you need a checklist! I scribbled out a checklist with a column for “student”, “progress monitor”, “write in IEP”, “print progress report”, and “give to teacher/mail”. This helped me not to forget a step! Often times, I will forget where I left off in the progress monitoring adventure. Then, when I returned to finish the task, it leaves a higher chance that I will forget a few students. This has helped me to stay focused and make less errors. Click Here to get my progress monitoring checklist
You can click the yellow button if you want a copy of my checklist! I made a prettier version for you and I will now use this nice copy in the future.
Hide & Lock Your Door
Seriously. You need to stop talking to all your colleagues during lunch, before and after school. This is game time. You only have a certain amount of hours in the day and these bad boys need to be completed. So, lock your door and leave a note that says “This SLP is knee deep in progress reports, come back next week”. When you are doing your progress reports, don’t LOOK at your emails until your blocked time is finished. Reading emails will only side track you even further. Trust me!
These are my tips for how to finish progress reports like a rock star! What are you tips and tricks…..psst…this means all you OCD, super organized, have a place for everything SLP’s need to comment below (love you type A’s).