r/slp

The Ocean Friends AI system has been peddling themselves to private practices without following through on their borderline magical promises. I’ve given it a good 6 months to try and prove that they can fix the NONSTOP bugs, errors, AI slop, harmful AI therapy recommendations you can’t fully turn off, parent communication clunkiness, etc. Our clinic is actually in a full uproar over how bad this has been. For reference, I’ve worked with two other common EMRs, and this has to be the worst experience I’ve had with the most over promising and underperforming. We are in non-stop meetings with them for new errors and bugs each week. The notification system for when you have a progress note or a re-eval due is endlessly buggy and your whole schedule will just show up as due randomly. Parent messages texted to the clinic are NOT defaulted to private and are viewable to every team member. Notifications are bugged and don’t show up when parents self-check in. I can’t tell you how many things go wrong each week. We have like 50 email chains about it.

The biggest thing is they will promise you ALL your documents from your EMR will be transferred automatically to Ocean Friends after 1 month of overlap. BULL! We’ve been trying to get them over for 6 months. It took 4.5 for them to transfer, but they are all UNNAMED random letters and numbers. Finding an old eval is a nightmare. They’ll blame this on the old EMR btw, saying it’s not a “smart” system so they can’t use it to get the document’s titles or types automatically after saying it can. They auto-download to your computer if you open the documents tab on a patient profile and it overloads your computer immediately. We have had to keep our old profiles in our old EMR active this whole time to be able to manage the “transition” that has lasted nearly half a year now.

Please, if you are a clinic owner looking for something better than what you have, do NOT just take these people at their word. We are fighting for our lives over here to get documentation done well with all of the incessant glitching.

Don’t even get me started on the way it actually allows AI to MAKE THERAPEUTIC SUGGESTIONS AS A DEFAULT. You have to actually turn that OFF by contacting your representative directly. Trust me, the AI documentation is not a plus. If you actually read the stuff it writes for you, it is genuinely ridiculous. EVERY discharge note you write will default to say that the child has plateaued, and no longer requires treatment.

The worst thing is any time you complain about the AI being harmful, wrong, non-sensical, or over-bearing, the team responses that you need to “train” it over time to be better. How about you make sure code and test your product before you sell it as a magic fix?

Everyone at my clinic is pissed. No one likes it, admin is scrambling every week to try and get something fixed, it has created such a cloud over our team and I’m tired of seeing clinics believe all their marketing and then dealing with all of this shit later.

Allegedly :)

I’m super burnt out on my outpatient peds job. My productivity has grown considerably and my pay has not. I’ve been denied a raise and schedule adjustment. The families I work with right now are incredibly high needs, I am essentially a case manager for many of them- getting them the resources they need and coordinating with other agencies. There’s zero opportunity in my company for growth, continuing ed, or leadership.

I’m considering a swap to a local contract company that lets you build your schedule with their many contracts. The compensation is attractive and they have tracts to become a supervisor. I know school contracting isn’t the best ever, but I’m genuinely considering a swap out of SLP with how much I’m hating my current job. I figure maybe I’ll try something new and make more money doing before I swap completely out. Thoughts? Does anyone have experience with this kind of transition ?

My pt (11 y/o m) has Down syndrome. Very low tone and it significantly impacts his speech. His goals involve producing multisyllabic words, using final consonants, utilizing appropriate pronouns, and producing appropriate plurals.

Any advice on what to do to target these goals/where to start? TIA!

Hi everyone! Any guidance is very much appreciated!
I graduated from an out-of-state university and applied for my preliminary SLP credential with the CTC, which can take upwards of 50 days. I have my RPE license in hand and was verbally offered a CF position in the Los Angeles area. I am worried that my preliminary credential will not be processed by the time students come to campus. Has anybody been in this situation before? Will the school district rescind the offer due to this? Or will they provide some sort of waiver?

My 2 year old currently receives private speech therapy. He had the same SLP from the time he was 9 months old (starting with feeding therapy and later transitioning to speech therapy) until last month. She left to stay home with her baby. He made steady progress with her, she always gave us activities to work on at home, and she advocated for him every step of the way.

Our new SLP just graduated last month. We’ve seen her four times, and honestly I’m struggling with how things are going. During multiple sessions, she has told me she isn’t sure how to help him because he’s so young and has had to ask her coworkers for guidance. During one session, she even turned on Ms. Rachel on her laptop. Unlike our previous therapist, she hasn’t given us any home strategies or exercises to work on between appointments, and I haven’t noticed any progress so far. She gets out multiple toys when he can really only focus on one at a time.

I also explained to her that private speech therapy is becoming financially difficult for us. We pay about $100 per session, and weekly appointments just aren’t sustainable right now. I told her we were considering enrolling him in our state’s early intervention program and then supplementing that with private speech twice a month. At the following visit, she told me she didn’t think that was a good idea because he’ll only qualify for the state program until he turns 3 and recommended that we continue weekly private sessions, even after I had already explained that we simply can’t afford it more than twice a month, our deductible is so high we will never meet it, and it has left us with paying $100 upfront every session.

One thing that has also been bothering me is how the conversations about cost have gone. When I told her that therapy was becoming too expensive for us, she responded sympathetically, but I wasn’t looking for sympathy, I was trying to explain that we genuinely cannot afford weekly sessions. I was hoping that would lead to a discussion about practical things we could do at home between visits if we had to reduce the frequency of private therapy.
Instead, it seems like a lot of our sessions involve her getting on the laptop and giving us paperwork, such as information about preschool enrollment, even though my son just turned 2. Our previous SLP never focused on those things. She spent our sessions teaching us strategies we could use at home and tailoring everything to his immediate communication needs, which is what I was hoping for with the new one.

At this point, would you recommend asking for a different SLP, having an honest conversation with her first, or maybe speaking with owner of the private practice? I’d really value input from experienced SLPs.

Hi all, I studied a small part of linguistics, so I don‘t know how to approach this.
Can someone tell me if there is a word for the phenomenon of mixing up letters in a single word when writing?
For example, writing prttye instead of pretty.

I‘m trying to look it up, but damn it‘s hard. I don‘t know what to search for or who‘s field of research that even is. :‘-)
Found some somewhat similar things that belong to the field of speech pathology, that lead me here.

Hello!

I am looking for some salary transparency as were told all these lies in grad school (high rates). The reality is low, I was slapped with a 20 hr rate and, I found that insulating (Texas).

Hello,

I work in a fairly large inpatient rehab facility. We recently lost our DOR and have an interim one. Admin has narrowed it down to the last (2-3?) permanent DOR candidates and as part of the interview process they go through, therapy gets to speak with/interview them. One person from PT/OT/ST is going to each interview and I was asked to be the SLP to attend. I need help coming up with questions. I asked the other 3 SLPs if there is anything they would like me to bring up but it was crickets.

So far I plan to ask about management style and what the candidates' preferred method to allocate resources across disciplines is (replacing old equipment, what generates the most revenue, etc.). I don't know quite how to better phrase "How do you avoid favoritism?"
I am wondering how they plan to support the SLPs goals (we recently got the green light for FEES but it took years and was only given the go because an acute care therapist started and pushed hard for all of us in both acute and rehab) so I would like to ask about their participation in that ongoing project (training in this case). Im bad at phrasing these thoughts 😅

I have been trying to think of what I disliked/disagreed with when reflecting on the previous permanent DOR. However, I am coming up short. He was a very laid back, friendly man who did not micromanage. This biggest issue was playing favorites and he did attempt to be subtle about it (our interim DOR does not know the meaning of subtlety). Therapists report to the therapy leads and the therapy manager, not the DOR at this facility.

So my question is what would any SLPs here ask a potential DOR?

TLDR: I'm helping interview a DOR candidate for IPR. What are some questions you would ask?

I’m a CF in a hospital pediatric outpatient clinic and doing tons of evals right now to build my caseload. I find where I’m most unsure is the “soft skills” part of doing an eval. How do you generally structure evals for preschoolers? Start with play to build rapport and then transition to the eval? What is the kid doing while you’re talking to caregivers to get a history, etc?

Any tips and tricks for warming up shy kids? Or for transitioning to the standardized eval?

Recently completed my CF at the schools and I will be returning this year with my Cs.

During my CF, I was extremely stressed and anxious because of parents. I don’t know why but I had so many difficult and complex cases that other CFs wouldn’t normally get, and that resulted in a lot of parents who are overly concerned, mad, disappointed, etc.

These parents cause me so much anxiety to the point where I am always in a fight or flight mode, and my nervous system is going crazy. I am sweating profusely during meetings (like sweating to the point where the staff have asked me to step out and freshen up), stuttering, and etc.

Then I dread going to work and even seeing the student, it causes so much depression and anxiety in me I don’t even know where to start.

A lot of people say things in the nuance that we have to try “understanding” these parents because it is their child and I do understand that, but I am also a person too and this is so stressful and hard for me.

I’ve tried almost everything… mediation, working out, taking a walk, talking to a supervisor, nothing helps. The only thing that helps me is these situations not happening at all. But obviously that isn’t possible.

What do you do to remedy situations like this?

I already feel dread thinking about going back

Hello, im looking for a SLP to help supervise me so I may become an SLPA. Ive been struggling withj trying to find an SLP. I have contacted Widener, no response, personally emailed 10-15 SLPs in my area, only got one response. I've called places and got nothing. Now, I dont know if it has anything to do with this, but I am a black man, and I've noticed their are little to no black people doing Speech Therapy, and even less men doing it. I'm starting to get worried because of it. I thought it would be a great career to breakthrough in. But Im starting to feel like the SLPs take one look at my LinkedIn, or email PFP, and don't want to help. I would love for someone to help me here, I'm not sure what to do. I am going to get my Masters starting next year, so I'm scared cause idk if I even should go do that with the way im struggling now.

Any other tired, pregnant SLPs out there? Doing this job while pregnant is starting to feel like cruel and unusual punishment! I work in pediatric home health and between the heat, home environments, and energetic kids I’m on my last leg! I’m falling behind on notes because by the time I get home I have 0 energy. Any tips on how to help power through these next few months?

I’ve been working as a medical-based SLP (ie: SNF, outpatient, home care) for the past 10 years. I work exclusively with seniors. Like most people, I’ve had second thoughts about entering this field for many reasons, but the availability of work was never one of them. Lately, the number of job postings for SLP’s in this setting has bottomed out, and advertise wages are actually decreasing.

About 2 years ago, I left a FT director job at a SNF/outpatient to pursue PRN work, because the hourly rate at the SNF wasn’t paying my bills. For context, I’m a single coparent with 2 elementary-aged kids.

Now, for nearly 2 years, I’ve had no difficulty finding work. The pay has varied, but I’ve always been able to pay my bills and rent.

I currently work for 2 home care agencies, and 2 “senior living” agencies. Home care referrals are getting hard to come by, I’m being forced to cover larger areas for no extra compensation, and yesterday one of my Senior Living companies let me know that they’re planning to replace me with a part-timer to “save money”, even though the pay is already low. I didn’t expect to be competing for mid-pay work for somebody willing to do it cheaper.

I’m genuinely concerned that supply of labor is outstripping demand. I think it’s a combination of Medicare cuts, the increasing encroachment of insurance companies dictating access to therapy, and new grads desperate for work, who will take literally any job (and they have all my sympathy). Employers are also enforcing much stricter policies on things like documentation timeliness and productivity, which is adding to the stress of an already-draining job where I treat sick seniors for 7-8 hours a day and try to show up as the best clinician I can be.

I’m just feeling so stressed, so overwhelmed, so pessimistic about the future. Am I alone in this, or are other people noticing these trends?

(This isn’t my main Reddit account, as this post is kind of a vent.)

I’m still a grad student and this is my second external placement. I love this setting and the child-led, neurodiversity-affirming approach, and my supervisor is really supportive. I can see her taking the effort and time to really try to support me. The thing I’ve been struggling with is adding music to the session. A lot of children on our caseload can sing and recite lyrics but cannot use speech or aac to request yet. My supervisor sings a lot and I feel like it is a great way to connect with the kids, develop joint attention skills, and encourage communication. The problem is that I can not really sing 💀 I love art and literature but for some reasons music has never been my interest, and I feel really uncomfortable singing in front of people. I am an introvert and a pretty reserved person, I do feel like this setting has brought me out of the shell a lot, and I am feeling more confident talking to parents and teachers. But thinking about singing just makes me really anxious. Just curious is it possible to be a good clinician without being able to sing? Any advice would be greatly appreciated! I just kind of feel stuck at the moment. Maybe it is just another thing I can learn and do, and maybe there is another way to do it?

I do home care and with the east coast heat wave, i’m discovering a lot of homes don’t have AC or aren’t turning it on. I bring a personal fan but it’s not enough. What do you all do?

Obviously Boho Speechie... and after checking her IG, it seems she also believes that her acupuncturist could tell the sex of her fetus just by feeling her pulse. 🤦 Pseudoscience begets pseudoscience, it seems...

Now I see Rachel Dorsey, even though she isn't outright supporting S2C, is interacting with accounts like Reach Every Voice and I-ASC Spelling.

And not an influencer, but Barry Prizant believes S2C is authentic for some people...

It's so, so disappointing. Are there other popular influencer-SLPs getting into S2C/RPM?

anyone have any experience working for this company in NYC?

I primarily work peds, but do some SNF PRN work. I had a pretty consistent gig due to a job vacancy, but the facility hired someone in Feb and didn't need me as frequently. I started a new PRN about a month ago and I kind of hate it.

It's a big rehab company with all kinds of branches and the branch my job is under supplies therapists to a VERY small (40 bed, not full) privately owned ALF/SNF in a rural area. I was told an SLP had been going between two buildings for about 6 weeks, but they would have her stop once I came on. I thought it would be a couple consistent hours a week if I needed it, which I do.

Well... turns out the expectation is that I travel there at roughly the same time at least 3 days a week and manage everything, no matter the caseload, big or small. It's not close either, but that part is on me. Anyway, the SLP mentioned to me was the FIRST SLP TO WORK IN THE BUILDING and that was only 6 weeks before I started. They have no SLP related systems in place because they have only been able to get OT in the building. No tests, no materials, no nothing. I was given a quarter of an old bottle of powder thickener & a prayer. With previous PRN positions, no matter what they needed, I could say yes/no to whatever I wanted but I drive to this place to fulfill anything from 0.5 to 8 treatment hours. If 5x a week sessions were indicated, I would be expected to come more often. I don't have access to thickener, straws, tongue depressors, nothing. I am not equipped to or interested in building them something from nothing as a PRN with 90% productivity expectations. I'm not doing in-services or educating building admin on why an SLP would need access to thickened liquids. I have never had a PRN position like this. I'm used to coming in on an odd weekend to cover a vacation or afternoon to cover a call out. I enjoy that, not being the sole provider in a place with no resources.

I feel guilty for wanting to leave because it's a poor, rural area and the residents are so sweet. I do need the money and will be hurting without it, but a PRN position should not be compelling me write a long ass reddit post. In hindsight, I feel like I should've realized what I was getting into but it didn't click until about week 2. I know the answer, but what would you do? Is PRN like this and I just didn't know?

TLDR; I want to quit my PRN position after a month because "as needed" was actually being needed multiple times a week, every week with no resources.

I posted on here asking for advice about this situation a few months ago, but it’s still ongoing. I need some advice because I’m starting to feel really hopeless.

Basically before my last year of grad school I signed a contract with a well known contracting company in my area. They gave me a scholarship in exchange for an agreement to work with them for one year during my CFY. It’s their responsibility to place me within a school and I’ve been asking them since April for updates. I’ve gotten periodic updates but only after emailing my recruiter two or more times. The communication has been sparse and I have not felt supported or like they were treating placing me within the urgency they should. Now it’s July, most positions are filled or filling up, I’ve reached out to my network with no luck so far. If I choose to terminate the contract, to my understanding, I have to pay back the entire balance of the scholarship, which would deplete most of my savings. In the meantime, how long can I just sit and wait for them to find me something and not respond to my emails? I feel like I need to get out of this, but I’m not sure how. If they can find me something in the next two weeks, fine, if not, I’m going to have to pay these thousands of dollars back. I’m so unbelievably frustrated that I’ve wasted months I could have used to find a job waiting for them to find me something only for them not to be able to do anything for me. I’m at a loss. Any advice welcome. Thanks for reading all of this.