u/Natural-Bobcat-4695

I have a vision impaired (no light perception) client with CP non verbal.

I’ve had so much fun with her over the last year! But I’m wondering what else I can do to make our sessions exciting and more interactive.

Has anyone else treated a client whose vision is impaired? If so what would you do?
I’ve done all sensory activities. ASL, songs, puzzles, stories cause and effect toys.. But I want to do more with her.

What would you do?

I have been recently been given a client who lives in an extreme rural area. So their only option is telehealth.

This would be my first time doing tele for a 4 year old. if it doesn’t work out I will not force it and let them go.

Have you guys done it before? If so what did the session look like? What activities did you do?

I have not been given any further information besides an ASD diagnosis.

Thankss in advance!

I just posted on SLPAs that there seems to be wayyyy less jobs for us than there were a couple years ago.

I have been thinking about going back home to California and I looked up jobs in my county and there are only 12 positions posted! It’s a county made of 7 big cities!

So I wanted to see how it was for you guys. I know slps have more opportunities. But I wanted to see if they’re good opportunities. My old Slp supervisor was stressing bc she wasn’t sure what she was going to do and she ended up taking a virtual role for an out of state school.

I know it chatted about this not that long ago and so have others. But I want to make sure I’m seeing this correctly online and it’s just not me.

But are there less and less jobs for SLPAs?? Compared to like 2 years ago?

I’m thinking about going back home to CA for a bit before I settle on another state, I went to check for Slpa jobs in my county and there’s like 12!!! Not kidding! And it’s a county that covers like 7 major cities! I’m like wait what!

So how is it looking in your area?

I recently found out that I didn’t get a job because I was “more” expensive due to my experience and preferred a new grad. Is that what’s happening?? I knew this was thing but no way.

I have a 6-year-old client with Down syndrome and no additional diagnoses at this time.

I’m an SLPA and have been working with her for about 9 months. I feel like I’ve exhausted what I know, and my supervising SLP is also unsure of what direction to take beyond recommending an autism evaluation and possibly ABA.

She has made tremendous progress since I started working with her. Initially, she wasn’t imitating sounds or words. She is now imitating words in both English and her native language, which has been amazing progress.

One area I’m struggling with is her response to certain sounds/music.

When I first started working with her, she would immediately cover her ears, scream, and say “no” whenever I made environmental sounds such as “beep” or “moo.” Because of this, I stopped using environmental sounds, cause-and-effect toys, music, and singing during therapy. I also recommended that Mom have her hearing checked, and everything came back normal.
More recently, Mom has told me that she tolerates environmental sounds in videos at a normal volume without becoming upset. However, she still becomes extremely distressed if Mom sings or plays music. She will sometimes lower the volume on her tablet specifically to check whether Mom is singing or music is playing. If she hears either, she will scream, cover her ears, and repeatedly say “no.”

This has made me wonder if there may be a learned/behavioral component in addition to sensory sensitivity.
She is very much a child who associates specific people and activities with specific routines. If something occurs outside of what she expects, she can have a significant meltdown.
For example, I wonder if she has learned an association of “therapist + singing = something I don’t like.” We see something similar with her AAC device. She strongly associates the device with speech therapy and refuses to use it in other settings. She becomes upset if Mom attempts to interact with it. I’ve encouraged Mom to keep it available throughout the day, but she will sometimes hide it herself. I do want to clarify that I do not force AAC use. I model language on the device and keep it accessible without requiring her to communicate with it.She also becomes very upset when Mom touches my iPad to sign for the visit. She will scream “no,” cover her ears, and become visibly distressed.

My question is:
Does this sound more like sensory/auditory sensitivity, rigidity around routines/associations, a learned response, or potentially a combination?

Also I’m writing this down. I notice she does it to when brother comes out of his room, she’ll scream no and try to get him back in his room. Mom has shared that she does the no thing (covering ears and screaming no) when dad tries to watch tv or mom and dad try to talk.

Sharing this here because I have no friends to talk to about this or community lol.

I became an Slpa about five years ago. I was a preschool teacher before this and I knew I wanted something more. I knew I wanted to help families and children on a deeper level. So I looked into becoming an slp then learned I could be an Slpa. Now 5 years later and after many clients and students, I have decided to end my journey here. I’m not sure exactly where I’ll land. I think achieved my purpose in life with this role and have now outgrown it. I’d still like to keep my home health clients. I know I still want to help people on some level but not sure how. Maybe I’ll go in college advising help people find their dream career or such. I love commenting on here and answering your guys DMs and give you guys advice that perhaps that’s my next calling.

Thanks for making it this far!!

.

1. Check the job market in your area based on your interest. I’d you want clinic, look up Slpa clinic jobs or home health or school. Check the pay. Check if your state has caseload caps.

2. I’ve seen some posts that say “is it worth it” well that depends on your goal and what you mean by “worth it”. If you want to make sure this is for you before you get your masters then yeah possibly. It’s a very rewarding career that comes with its ups and downs. All settings have their struggles.
   - clinic settings can be ran as therapy mills.
   -home health can be exhausting. With all the driving. Maybe not worth it if you live in extreme weather areas
   -schools, are fine. If you don’t mind group therapy. You can have a high case load depending on school and state I’ve had as low as 57 and as many as 120.

3. As an slpa you’re always going to be working under an slp. You’ll have to be observed either 20% or 10%. Depending on your state. You cannot diagnose or eval. You can assist in and evals or do screenings but that’s it. Same with IEP meetings. You can be part of them make suggestions to the slp but you’re not the one running it alone. We don’t get paid enough to run them nor are we licensed to. Some SLPs are old school and will make you feel less or treat you as their assistant. Some will expect you to read their mind or lack communication (ironically). However, there’s lots of SLPs who are thankful to have you and are willing to collaborate on goals and such. I always suggest, if you can, meet your slp first. I’ve done that the last three times and it actually spoke volumes on myself and the company appreciated that.

4. There has been a crazy increase in SLPAs in just the last couple of years so the job market can get a little tough.

5. Lastly, I’ve heard lots of SLPAs say they thought this field was going to be easy which is why they became SLPAs. It’s not easy. It has its struggles. You have to do this because you’re passionate about the field and learning and holding your ethics and values.

I have grown to love this job and everything that comes with it. However, sometimes good things have to con to an end.

Hello everyone!

I’ve seen lots of post in regards to this topic and as someone that has done both, I thought I’d give you guys some information for those that are new to the field and are trying to decide. Just for disclaimer this could absolutely vary by district as well for the state that you are in.

If you go in as a contractor, depending on the contracting company, they will offer benefits, such as health insurance, possibly FSA account, and a 401(k). They will also pay you more if you go as a contractor. You will not have the state’s retirement system, but like I said, most companies offer a 401(k).
Depending on the contracting company, it actually may be better to go in as a contractor, especially as an Slpa, as sometimes not all the time, we can be taken advantage of such as being their personal assistant.
For example in my past experience, I had a situation where I was asked to facilitate an IEP meeting meaning there is no supervisor there and it was just me. I reached out to my contracting company and they stood up for me and advocated for me. They also were able to educate the district that Slpa’s are not to facilitate IEP meetings. We can be part of them but not be the one facilitating it.
But like I said, this absolutely depends on the contracting company. I have learned that the bigger the contracting company sometimes that could mean less support. I am lucky to be part of a contracting company that is SLP owned.

If you go direct hire
There’s a chance that you will make less, you are entitled to benefits if you are full-time in addition to disability and all the other stuff.
You do have to do everything that comes with being a district employee. Such as meetings and all that stuff. However, this also varies by district because I’ve been at districts where I’ve had to do all those things as a contractor, but in other districts, I didn’t have to, because I am a contractor and not a district employee.
I would say the only negative side to being a direct hire is that you just get paid less. Also, I have learned that some districts purposely make assistant positions 6 or 7 1/2 hours to purposely not give them benefit benefits.
unlike some contracting companies will give you benefits if you work more than 30 hours or in other companies if you work more than 37 hours
It is also a little bit harder to get rid of you/fire you. However, most districts have now implemented that if you quit before your contract is over you are to pay a fine. When I was in a situation where I really wanted to leave the district because it was a terrible district. My contracting company understood and was willing to find me another placement.

I just want to say thank you to everyone that “showed” up for me yesterday on my post! Truly thank you!

I hadn’t cried over a job in a while haha.

Yesterdays incident a was truly my final straw to this. Week. Don’t know if it was mercury retrograde as they say or the heat haha. But between that and finding a full time job with benefits it’s been hard.

I just want to say thank you!

So just for context, I absolutely am venting because I have no friends or community. But any words of encouragement or with them would be gratefully appreciated.

Today I went to go see a client at one of his family members home and I get there. I knock on the door nobody opens. I proceed to knock on the door for about five minutes. Nobody opens the door and then proceeded to text the parent and let them know that I am outside to let the family members know and I don’t hear from them. Mind you while I’m waiting outside. It’s about 105°. I am dripping in sweat I go in my car at this point. It’s about 20 minutes past the session time I’m waiting outside just in case they open the door or I hear from the parent and I hear nothing.

At this point, I absolutely started to sob and I don’t think it’s because of this incident itself. For the first time in years, I am struggling to find a school position and I do want to say that I am an assistant so I know also the reason behind this, and I also go through as a contractor and for the first time I cannot get a job. I can absolutely build a caseload for full-time, but I truly need benefits because I need my endometriosis surgery by the end of the year so overall it’s been a really rough day and week. If you made it this far into this post, thank you so much for reading and I hope you have a wonderful day or evening, and that your pillow stays cold. Oh and it’s 110° outside to make it better.

I have been debating on whether or not to let go of my client that I’ve been with for about two years. She is a 13 year-old girl with down syndrome who I absolutely adore and love seeing her however, I’ve noticed in the last two months she absolutely hates doing speech. She refuses to use her AAC device, which I typically don’t push too hard on because I don’t wanna create that negative relationship with it. I’ve noticed her tolerance to speech work has gone down significantly and typically I try not to make my sessions to where it seems like work. I try to make it fun and relatable to what they do and what they like, but like I said in the last couple of months, even if I ask her wh question and I try to model the answering her device she’ll scream and throw her device. so I’ve completely have stepped away from any sort of question and just modeling, social words, phrases or even sentences and even yet she absolutely hates it. This is also doing it with a video of her preference. She loses her mind if I even pause a video to tell her something so I stopped doing that too. I’m just feeling so lost everything that I know under my sleeve I have tried and nothing works things that she enjoys doesn’t work anymore. At this point it just feels like I’m just sitting there showing her a video.

I know she needs a break, but if I bring this up to Mom, she absolutely will not take it. It has been a conversation before, and she absolutely rejected it immediately. Even when I came with reasons of how this could be beneficial at this point, I’m debating of just completely letting her go. Has anybody else dealt with this?

Hi everyone!

I work home health and don’t have a whole lot of SLP community and also still new to the field.

I have a 22 y.o client with Down syndrome and autism.

Dad states Bobby (fake name) used to be fully verbal up to 4 years ago. Making it when he was 18. He said that he started to slowly loose his sentences. Then phrases and now words. Dad feels it’s due to the pandemic and being isolated. Absolutely possibly I’m not dismissing that. Dad wants his son to go back to speaking fully sentences and back how he was. Bobby currently has an AAC device as his last SLP mentioned that AAC can elicit words phrases and sentences. Dad wasn’t thrilled and says it’s not going to work. I tried to give dad resources that support this. They’re not using his aac at home. I know because it’s never charged.

Dad feels that with the correct amount of therapy and support he will gain those skills back.

sure.

I had a client previously with Down syndrome regression disorder where her language never came back and she was 44. So I’m wondering if this is the same case.

I’m not saying that if he does have this regression we should just give up absolutely not. My job is still to carry out the therapy and give this client every possible way to communicate that works for him. But I’d like to hear others experience? Did you have success? Was it temporary? What do you tell the parents?