If you have been working in special education services administration for any length of time, you have most likely experienced a therapist shortage in your district at one point or another. I have heard it over and over in my 25 years as a Speech-Language Pathologist, “We can never find enough therapists.” Or “Therapist shortages are a constant problem every year.” So, what can school district officials do about this ongoing issue? How can you keep the therapists currently employed with your district and attract more quality therapists? What internal changes can be made and how can we gage the risks we have of high turnover? Lastly, what other options are available?
Location, Location, Location
I know there are school districts in the USA who are fortunate and have never had difficulties attracting therapists. Many times, these districts are fortunate enough to be located near a major university that graduates therapists annually or the district is in a desirable location that attracts therapists. However, even places like Hawaii have a shortage of teachers and therapists. So much so that they have “Shortage Category Differential” which allows them to calculate the available salary based on the shortages in that position and increase the pay to hopefully attract more candidates due to the high cost of living in Hawaii.
Obviously, there is truly a shortage. The American Association for Employment in Education (AAEE) reported Speech Pathology had considerable shortages in eight out of ten regions and some shortages in the other two regions reported. (AAEE Educator Supply and Demand Report 2016-17) The US Department of Education and the National Center for Education Statistics, 2018, reported that there an estimated 6.7 million public school students in the United state currently receiving special education services through an IEP. (U.S. Department of Education & National Center for Education Statistics, 2018). With the need for related service professionals going up, and the continued shortages, it has become more critical and more difficult to find and retain quality therapy staff. Like all areas in education, therapists are having to work with higher and higher caseloads and/or additional responsibilities.
Compensation, Flexibility, Recognition
When recruiting therapists is it all about the money?
American Speech Language Pathology and Audiology (ASHA) asked members to indicate the three most important factors for accepting or staying in a job. Compensation/pay was in the top three, but flexibility was considered more important than compensation. The top three factors were the same for all settings:
- Flexibility to balance life and work
- Meaningfulness of job
Job flexibility can look as different from one person to the next as their choice of where they choose to work. Having the ability to work part-time, job sharing, the number of assigned locations the therapist is required to cover, caseload size, and student population served are a few examples. At a previous employer, I witnessed an example of job sharing that was terrific. One therapist was retiring after 25 years and another therapist was just married and getting ready to have a baby. The district worked it out for the next school year, that these two could job share a position so they would both remain in the district rather than losing them both to part-time positions elsewhere that would more readily meet their need for life/work balance.
Another example that always confused and frustrated me as a school therapist was random assignment of caseloads. I have seen therapists to a location with a population of students that another therapist had much more expertise in working with, but the therapists were not given the option of where they were assigned. Having open and consistent communication with the therapy staff about their assignments and their satisfaction with their assignment is critical to retaining therapy staff.
By keeping communication open about assignments and the options available, staff feel more in control of their position. Knowing their opinion is heard and considered goes a long way toward retention. Some may choose to stay right where they are, even though they don’t have the option to move to another assignment, simply because they were able to communicate openly about what their choices were to begin with.
Giving your staff trust and recognition are also extremely important. As a leader in my department early on in my career, I was taught the sandwich principle for any time I need to give corrective feedback. The principle technique is to praise followed by the corrective feedback followed by praise. The corrective feedback is sandwiched between two layers of praise. Here is a more in-depth discussion of this principle How to Give A Compliment Sandwich Feedback @ Right Attitudes: Ideas for Impact By using this simple technique in my interactions and emails, I have experience amazing interpersonal relationships with people who have and continue to work with and for me. Many times, when I have spoken to staff about assignments, I have heard, “I don’t mind where you assign me as long as I know you will be my lead therapist.”
The opportunity for growth and development give quality staff a way to reach their full potential. These opportunities can come with many different aspects. A therapist may be interested in a technique or new service delivery model that they can learn, become an expert providing, and then share with others in their department. It can be supervision or mentorship of newer staff members, giving them the opportunity to show others their skills and making connections with new staff members. Another option could be assistance with school committees in which they can help impact school policy or community interactions. To become a therapist, whether it’s a Speech-Language Pathologist, Occupational Therapist, School Psychologist, etc. these professionals all have advanced degrees and will be a valuable member to add to your teams and committees.
Don’t burn me out
On average, about 47 percent of speech language pathologists report staff shortages occurring in their schools, with the highest shortages in the nation’s western states, according to the National Coalition on Personnel Shortages in Special Education and Related Services. Solving the school therapist shortage from DA District Administration According to U.S. News and World Report, Speech-Language Pathologists reported stress levels above average in the work environment and complexities of the job’s responsibilities. US New Speech-Language Pathologist Reviews and Advice.
Caseload size matters. Having 60+ students on a caseload in 5 different school sites is difficult. I have done it. Going beyond those numbers is insane for a Speech Therapist at a school district. Therapists have expressed frustration to me about groups of 6-7 student at a time so that they can get all the students seen according to their IEPs. Groups of more than 3 students mean there isn’t enough time to provide adequate therapy and it is difficult for the students to make progress. Additionally, with such large caseloads, the therapists have difficulty collaborating with teachers and parents because they are too busy trying to get to all their students. That’s not to mention the times therapists are missed on invites to IEP meeting and 3-year reassessment meeting so they must do some fast paperwork. Which they do, because they truly care about the students and making sure their goals match their needs. Then add in transportation time for getting students to the therapy room or drive time between school sites and it becomes a recipe for a quick burn out.
The use of telepractice has been shown to be an effective way to alleviate therapist shortages. By choosing to add a telepractioner to your team, you can alleviate the caseload numbers for your on the ground therapists, thus reducing the risk of burnout.
In an article by Michelle K. Boisvert and Nerissa Hall, published in Perspectives of the ASHA Special Interest Groups, February 2019, “Telepractice, in conjunction with onsite services, can be a reliable and effective workload management method for school-based SLPs and other educators who travel to multiple schools. The use of telepractice does not supplant onsite services but rather supports school-based clinicians’ ability to maximize their time, efforts, and expertise in an effort to effectively manage their workload. The strategic use of technology enables service providers to deliver services, collaborate, and communicate with students and colleagues, regardless of their geographical location.” Telepractice for School-Based Speech and Language Services: A Workload Management Strategy
Many studies have been done that support the use of telepractice. In an article at District Administration that was quoted earlier, “Studies appear to back up the student results that districts using telepractice are seeing. Researchers at Kent State and Bowling Green State universities studied 13 rural Ohio K6 students with speech sound disorders and found they demonstrated a greater mastery of speech sounds when they did telepractice therapy.
Researchers found that 84 percent of students mastered IEP speech sound goals through telepractice, compared to 47 percent of students who achieved mastery through in-person therapies. The study, “A Pilot Exploration of Speech Sound Disorder Intervention Delivered by Telehealth to School-Age Children,” was published in the International Journal of Telerehabilitation, a research journal that covers rehabilitation programs using online communication.” Solving the school therapist shortage from DA District Administration
Nobody should have to experience therapist shortages. By choosing to add telepractice services you are eliminating these shortages for your district and reducing the risk of losing the great therapists you already have. Partner with Lighthouse Therapy to help you find the therapists you need. No more stress, no more worry, no more due process risks from lack of therapy services.