Workload vs. Caseload In the School Setting…Can It Be Done?

So, if you’ve had a chance to browse through this month’s ASHA leader (with all that spare time you have after treatment planning, room prep, professional development training meetings, etc), you’ll have noticed that there is a TON of emphasis placed on workload vs caseload for the school-based SLPs.  I don’t currently work in the schools, but I have in the past, so this topic has me intrigued.  When I worked in the schools, I had a full caseload, but it was not the largest caseload in my district by far.  My caseload ranged from 50-55 students during my time in the schools, but I had friends in my district who were pushing 90!  I know there are some of you out there in the same boat, and I have a feeling that things will only get worse in the future, not better.  But, ASHA seems to think that using a workload model can help school-based SLPs solve the issue of overload.  This is by no means a comprehensive list, but here are some of the ideas the ASHA Leader gave for running a workload model:

  • Push-into classrooms as opposed to pull-out
  • Schedule rotating Time Blocks rather than keeping the same schedule week after week
  • Use a 3:1 ratio of treatment to indirect services.  Indirect services include planning, paperwork, meetings, collaboration, etc.
  • Schedule blocks of time for RTI services

ASHA provides further info/ideas concerning implementing a workload on their Practice Portal Caseload/Workload Section.

I have been concerned about the issue of caseload vs. workload for a long time.  In fact, I was an intern in a school in the district I later ended up working for when I first heard about the idea of a workload.  I actually discussed the idea of workload vs. caseload with my district supervisor, and specifically asked about the possibility of using a 3:1 model, but the idea was immediately struck down.  To be fair, I don’t think it was my supervisor who didn’t like/want the change, but rather I think there are people higher in the district and state levels who resist the idea of a workload model.  Regardless, I wasn’t allowed to use the approach.

So, my question to all of you is: Is it really possible to make the change from a caseload to a workload model?  If so, how?  Is there anyone out there who has implemented one or more changes to make this possible?  How did you do it, and were you successful?  I’m also interested to hear from any of you out there who have consistently used a push-in model.  What did therapy look like, and how affective was it for your students?  The only push-in that I have experience with is with my Special Education Kindergarten class.  It was a small group Kindergarten class and 75% of the children in the class were on my caseload.  I taught a 20-minute lesson once a week, and worked on generalization of the students’ goals.  I then pulled the children out for more intensive intervention once a week.  The system worked really well, and I loved it.  But, it was also a fairly easy system to create.  I don’t think most SLPs have that kind of classroom set-up on their caseload, and I’m interested to hear how you do push-in.  If there is anyone out there with a lot of experience in this area, I would love for you to guest post about it on my blog.  Just email me, and we can discuss the details!  I’m excited to hear all of your ideas and experiences!

Until next time,

Aersta Acerson
A Utah Speech Therapist
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