Schools Survey Report: SLP Caseload Characteristics Trends ... · Activities In 2014 and 2016, SLPs...

Schools Survey Report: SLP Caseload Characteristics Trends 1995–2016

Gail Brook, Surveys and Analysis American Speech-Language-Hearing Association November 15, 2016

Schools Survey Report: SLP Caseload Characteristics Trends, 1995–2016 Page 1 of 15

Contents

Introduction 2

Survey Report Highlights 2

Caseload Versus Workload Approach 3

Caseload Size 4

Caseload Size, by School Setting 4

Caseload Size, by State 4

Degree of Communication Impairment 4

Degree of Communication Impairment, by School

Setting

4

Areas of Intervention 5

Activities 5

Activities, by School Setting 5

MTSS/RtI 6

MTSS/RtI, by School Setting 6

Cultural and Linguistic Diversity 7

Survey Methodology and Response Rates 8

Suggested Citation 8

Additional Information 8

Questions? 8

Acknowledgment 8

Appendix 9

Schools Survey Report: SLP Caseload Characteristics Trends, 1995–2016 Page 2 of 15

Introduction

The American Speech-Language-Hearing Association (ASHA) conducted the 2016 Schools Survey to gather

information about professional issues related to school-based services. Results from this survey are presented

in a series of reports, including this report on speech-language pathologist (SLP) caseload characteristics

trends.

Findings from the 1995, 2000, 2004, 2006, 2008, 2010, 2012, and 2014 ASHA Schools Surveys and the

1995, 1997, and 2000 ASHA Omnibus Surveys are included in this report for comparative purposes.

Questions differ among surveys, so data on all topics are not available for all survey years.

Survey Report Highlights

From 2008 to 2016, most SLPs (79%–82%) indicated that a caseload approach, as opposed to a

workload approach, was used to determine the number of students they served.

From 1995 to 2016, overall, SLPs had a median monthly caseload size of about 50 (48 in 2016).

From 1995 to 2016, caseload size was lower in special day or residential schools (23–32) and in

preschools (30–41) than in other school settings.

SLPs in Ohio consistently had among the largest caseload sizes (55–61) from 2000 to 2016. SLPs in

New York consistently had among the smallest caseload sizes (31–50).

From 1995 to 2016, overall, nearly half (42%–49%) of the students on SLPs’ caseloads had

moderate impairments.

From 2004 to 2016, more than half (55%–71%) of the students on the caseloads of SLPs in special

day or residential schools had severe or profound impairments.

From 2000 to 2016, most SLPs (89%–97%) treated students with speech sound disorders; 80%–

91% of SLPs treated students with autism spectrum disorder.

From 2000 to 2016, caseloads typically included a higher number of students with speech sound

disorders than with other disorders. Numbers ranged from 18 to 24 students.

In 2014 and 2016, SLPs spent much of their time each week (18–19 hours) in pullout services to

students.

Overall, a smaller percentage of SLPs participated in multi-tiered system of supports (MTSS)/

response to intervention (RtI) or pre-referral in 2016 than in 2012 and 2014.

In 2014 and 2016, SLPs used a 5-point scale to rate how qualified they believe they are to address

cultural and linguistic influences on service delivery and outcomes. Nearly half (44%–46%) rated

themselves as 3—the middle score.

ASHA Schools Survey Report: SLP Caseload Characteristics Trends, 1995–2016 Page 3 of 15

Caseload Versus Workload Approach

As defined in the survey, a caseload approach is based on the number of students served; a workload

approach is based on all activities required and performed.

From 2008 to 2016, most SLPs (79%–82%) indicated that a caseload approach was used to determine the

number of students they served (see Figure 1).

Figure 1. Percentage of school-based SLPs who report that caseload and workload approaches are used

to determine the number of students they serve, by year.

Note. These data are from the 2008, 2010, 2012, 2014, and 2016 ASHA Schools Surveys. In 2008, analysis was limited to

clinicians employed full time; in 2010, 2012, 2014, and 2016, clinicians who were employed part time were also included. In

2008, 2010, 2012, and 2014, caseload and workload approaches (combined) was not included in the survey.

n = 1,733 (2008); n = 2,153 (2010); n = 2,149 (2012); n = 1,517 (2014); n = 1,566 (2016).

3.8%15.2%

20.7%

20.7%

17.9%

20.1%

80.9%

80.9%

79.3%

82.1%

79.9%

2016

2014

2012

2010

2008

Caseload approach

Workload approach

Caseload and workload

approaches


Caseload Size

From 1995 to 2016, SLPs had a median monthly caseload size of 50 (48 in 2000, 2014, and 2016; 47 in

2012; see Appendix Table 1). In other words, each SLP treated about 50 different students in a typical

month.

Caseload Size, by School Setting

Caseload size differed by school setting. From 1995 to 2016, caseload size was lower in special day or

residential schools and preschools than in other school settings (23–32 for special day or residential schools

and 30–41 for preschools; see Appendix Table 1).

Caseload Size, by State

Caseload size varied considerably by state. From 2000 to 2016, SLPs in California and Ohio consistently had

among the largest caseload sizes (55–60 and 55–61, respectively). SLPs in New York and Missouri

consistently had among the smallest caseload sizes (31–50 and 39–50, respectively; see Appendix Table 2).

Degree of Communication Impairment

From 1995 to 2016, overall, nearly half (42%–49%) of the students on SLPs’ caseloads had moderate

impairments; almost one third (26%–33%) had mild impairments; and about one quarter (18%–27%) had

severe or profound impairments (see Appendix Table 3).

Degree of Communication Impairment, by School Setting

From 2004 to 2016, more than half (55%–71%) of the students on the caseloads of SLPs in special day or

residential schools had severe or profound impairments. Percentages of students with severe or profound

impairments were considerably lower in other school settings: 28%–35% in preschools, 15%–22% in

elementary schools, 20%–31% in secondary schools, and 20%–33% in a combination of school settings.

(These data are not presented in any table.)


Areas of Intervention

SLPs served students in numerous areas of intervention. From 2000 to 2016, most SLPs (at least 89%)

treated students with speech sound disorders; at least 80% of SLPs treated students with autism spectrum

disorder (see Appendix Table 4).

From 2000 to 2016, SLPs’ caseloads included a high number of students with speech sound disorders.

(Numbers ranged from 18 to 24 students.) Caseloads also included a fairly high number of students with

reading and writing (literacy) difficulties. (Numbers ranged from 14 to 15 students; see Appendix Table 5).

Activities

In 2014 and 2016, SLPs spent much of their time each week (18–19 hours) in pullout services to students

(see Table 1).

Table 1. Number of hours per week that school-based SLPs spend on activities, by year.

# Hrs/wk

Activity 2014

(n ≥ 989)

2016

(n ≥ 1,033)

Direct intervention: Classroom-based/

integrated services 4.3 4.6

Direct intervention: Pullout 18.2 18.6

Services to section 504 students 0.2 0.2

Documentation/paperwork 6.5 6.5

Medicaid billing — 1.6

Other indirect activities 4.1 2.3

MTSS/RtI activities 1.0 1.1

Diagnostic evaluations (e.g., observation,

screening, scoring, analysis) 2.8 3.1

Technological support (e.g., hearing aids/

cochlear implants, augmentative and

alternative communication)

0.7 0.7

Supervision 0.6 0.6

Note. These data are from the 2014 and 2016 ASHA Schools Surveys. Dash indicates that the item was not included in the

survey. Analysis was limited to clinicians who were employed full-time; worked a maximum of 52 hours per week; and had a

caseload size of at least one student.

Activities, by School Setting

The amount of time spent on activities varied by school setting. In 2014 and 2016, SLPs in elementary

schools spent more time in pullout services per week (20 hours) than did SLPs in other school settings. SLPs

in special day or residential schools and preschools spent the least amount of time per week in pullout

services (14–16 hours). (These data are not presented in any table.)


MTSS/RtI

The percentage of SLPs with roles on MTSS/RtI or pre-referral teams dropped somewhat in 2016—after 4

years of steady increases (see Table 2).

Table 2. Percentage of school-based SLPs participating on MTSS/RtI or pre-referral teams, by role and

year.

%

Role 2010

(n = 2,198)

2012

(n = 2,202)

2014

(n = 1,517)

2016

(n = 1,597)

Conduct screenings 47.1 55.5 59.6 54.9

Provide consultation as a member of the

pre-referral teama 51.7 59.7 64.1 54.6

Provide direct services within general

education 31.9 35.3 40.9 30.4

Provide strategies to classroom teachers 52.0 55.8 60.8 58.2

Not applicable; I don’t participate in

MTSS/RtI or pre-referral 32.3 25.5 22.6 26.9

Note. These data are from the 2010, 2012, 2014, and 2016 ASHA Schools Surveys. aIn the 2010, 2012, and 2014 surveys,

this item was provide consultation.

MTSS/RtI, by School Setting

Participation in MTSS/RtI or pre-referral varied greatly by school setting. From 2010 to 2016, overall,

participation was most common in elementary schools and least common in special day or residential

schools. Fewer than one quarter (13%–24%) of SLPs in elementary schools indicated that they did not

participate in MTSS/RtI or pre-referral compared with about three-quarters (67%–85%) of SLPs in special

day or residential schools. (These data are not presented in any table.)


Cultural and Linguistic Diversity

In 2014 and 2016, SLPs were asked to use a 5-point scale (1 = not at all qualified, 5 = very qualified) to rate

how qualified they believe they are to address cultural and linguistic influences on service delivery and

outcomes. As displayed in Figure 2, overall, nearly half (44%–46%) rated themselves as 3—the middle

score.

Figure 2. Ratings for how qualified school-based SLPs believe they are to address cultural and linguistic

influences on service delivery and outcomes, by year.

Note. These data are from the 2014 and 2016 ASHA Schools Surveys.

n = 1,688 (2014); n = 1,689 (2016).

5.9% 3.7%

16.9%16.7%

44.1% 45.6%

24.5% 25.9%

8.6% 8.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2014 2016

5 (Very qualified)

4

3 (Midpoint)

2

1 (Not at all qualified)


Survey Methodology and Response Rates

The survey was mailed in February 2016 to a random sample of 4,000 ASHA-certified SLPs and 500 ASHA-

certified audiologists employed in school settings in the United States. Second and third mailings followed,

at approximately 3- or 4-week intervals, to individuals who had not responded to earlier mailings.

Of the total sample, eight had incorrect mailing addresses, 21 had retired, and 24 were ineligible for other

reasons, which left 4,447 possible respondents. The actual number of respondents was 2,108—a 47.4%

response rate.

Of the original 4,000 SLPs in the sample, eight had incorrect mailing addresses, 18 had retired, and 21 were

ineligible for other reasons, which left 3,953 possible respondents. The actual number of respondents was

1,894—a 47.9% response rate. The results presented in this report are based on responses from those 1,894

individuals.

Past ASHA Schools Survey response rates were as follows:

2000: 43.0%

2004: 69.7%

2006: 64.9%

2008: 64.0%

2010: 64.8% (overall); 65.5% (among SLPs)



Suggested Citation

American Speech-Language-Hearing Association. (2016). Schools survey report: Caseload characteristics

trends, 1995–2016. Available from www.asha.org.

Additional Information

Companion reports are available on the ASHA website at www.asha.org/research/memberdata/schoolssurvey/.

Visit the practice portal at www.asha.org/practice-portal/professional-issues/Caseload-and-Workload/ for related

information.

Questions?

For additional information regarding this report or school services generally, please contact Deborah Dixon,

director of school services, at [email protected] or 800-498-2071, ext. 5690. To learn more about how the

Association is working on behalf of school-based ASHA-certified members, visit www.asha.org/slp/schools/.

Acknowledgment

Without the generous cooperation of the members who participate in our surveys, ASHA could not fulfill its

mission to provide vital information about the professions and discipline to the Association membership and

public. Thank you!

http://www.asha.org/

http://www.asha.org/research/memberdata/schoolssurvey/

http://www.asha.org/practice-portal/professional-issues/Caseload-and-Workload/

mailto:[email protected]

http://www.asha.org/slp/schools/


Appendix


Appendix Table 1. Median monthly caseload size of SLPs, by school setting and year.

Size

Setting 1995

(n = 511)

1997

(n ≤ 594)

2000

(n ≤ 519)

2004

(n = 2,052)

2006

(n = 1,772)

2008

(n = 1,721)

2010

(n = 1,749)

2012

(n = 1,760)

2014

(n = 1,224)

2016

(n = 1,328)

Overalla 50 50 48 50 50 50 50 47 48 48

Special day or residential

school 32 30 23 25 27 28 28 25 24 30

Preschool 30 35 40 40 40 40 40 37 41 38

Elementary school 56 55 50 52 52 50 50 50 50 50

Secondary school (middle

school, junior high, or

senior high)

44 45 48 50 55 49 50 48 50 50

Combination of the above

school settings 60 55 48 50 55 50 50 50 52 45

Note. These data are from the 1995, 1997, and 2000 ASHA Omnibus Surveys and 2004, 2006, 2008, 2010, 2012, 2014, and 2016 ASHA Schools Surveys. Overall

includes respondents who did not indicate a school setting.


Appendix Table 2. Median monthly caseload size of school-based SLPs, by state and year.

Size

State 2000

(n = 2,067)

2004

(n = 2,067)

2006

(n = 1,742)

2008

(n = 1,707)

2010

(n = 1,785)

2012

(n = 1,760)

2014

(n = 1,224)

2016

(n = 1,328)

Alabama 50 — 50 — — — — —

Alaska 55 — — — 49 — — —

Arizona 55 54 55 57 60 57 — —

Arkansas 48 40 41 40 40 42 — —

California 60 58 58 55 55 55 55 55

Colorado 60 48 — 48 — 55 — —

Connecticut 47 42 40 37 40 32 — 35

Delaware — — 50 55 54 — — —

District of Columbia — — — — — — — —

Florida 64 72 65 46 65 59 60 64

Georgia 55 50 46 43 46 45 52 42

Hawaii 50 — 35 40 40 — — —

Idaho 60 — 57 61 58 — — —

Illinois 60 50 55 50 50 48 49 50

Indiana 75 74 78 75 80 72 — —

Iowa 45 50 49 55 50 — — —

Kansas 47 47 — 46 45 — — —

Kentucky 62 63 60 65 59 52 — 60

Louisiana 48 50 — 45 46 45 — —

Maine 45 — — — 30 — — —

Maryland 60 50 52 45 43 45 47 45

Massachusetts 50 45 40 40 43 42 41 40

Michigan 55 57 57 55 60 55 58 50

Minnesota 40 42 45 45 42 43 — 36

Mississippi 58 55 55 50 45 — — —

Missouri 50 45 42 48 45 39 40 40 (Table continues)


Appendix Table 2. Continued

Size

State 2000

(n = 2,067)

2004

(n = 2,067)

2006

(n = 1,742)

2008

(n = 1,707)

2010

(n = 1,785)

2012

(n = 1,760)

2014

(n = 1,224)

2016

(n = 1,328)

Montana 50 — 45 43 45 — — —

Nebraska 50 — 54 53 55 — — —

New Hampshire 40 — — — 31 — — —

New Jersey 55 48 46 42 40 40 40 40

New Mexico 44 35 40 35 45 — — —

New York 50 35 40 40 32 32 35 31

Nevada 60 — 55 — 60 — — —

North Carolina 55 45 56 50 47 43 46 48

North Dakota 32 — 32 33 35 — — —

Ohio 60 55 60 60 61 60 57 55

Oklahoma 55 52 54 55 50 50 — —

Oregon 56 — 60 — 50 — — —

Pennsylvania 60 60 53 53 60 50 50 50

Rhode Island 55 — — — — — — —

South Carolina 60 58 55 — 48 50 — —

South Dakota — — 49 40 — — — —

Tennessee 59 — 61 57 60 — — —

Texas 60 55 55 50 50 50 50 51

Utah 61 — — 65 60 — — —

Vermont 40 — 30 — 31 — — —

Virginia 55 55 55 55 56 53 55 55

Washington 57 50 51 52 53 — — —

West Virginia 50 — 50 50 49 — — —

Wisconsin 37 38 40 40 38 40 — 40

Wyoming 47 — 50 45 — — — —

Note. These data are from the 2000, 2004, 2006, 2008, 2010, 2012, 2014, and 2016 ASHA Schools Surveys. The table contains median caseload sizes for states

where 25 or more SLPs responded to the survey.


Appendix Table 3. Mean percentage of students on school-based SLPs’ monthly caseloads, by degree of communication impairment and year.

%

Degree of

impairment

1995

(n ≥ 883)

2000

(n = 1,931)

2004

(n = 2,099)

2006

(n = 1,667)

2008

(n = 1,578)

2010

(n = 1,661)

2012

(n = 1,665)

2014

(n = 1,180)

2016

(n = 1,283)

Severe/profound

impairment 21.0 18.0 20.0 20.6 21.3 21.9 23.5 26.0 27.2

Moderate impairment 49.0 49.0 44.3 45.1 44.9 41.8 43.8 44.0 43.1

Mild impairment 26.0 28.0 30.3 29.5 29.1 31.0 32.7 30.0 29.7

No impairment 4.0 5.0 5.4 4.8 — — — — —

Not IEP, RtI, or 504a — — — — 4.7 5.3 — — —

Note. These data are from the 1995, 2000, 2004, 2006, 2008, 2010, 2012, 2014, and 2016 ASHA Schools Surveys. a“Not IEP, RtI, or 504” = Not Individualized Education

Program (IEP), response to intervention (RtI), or Section 504 of the Rehabilitation Act of 1973. Respondents used their state’s or school district’s definition of degree of

communication impairment. Dash indicates that the item was not included in the survey.


Appendix Table 4. Percentage of school-based SLPs treating students, by area of intervention and year.

%

Area 2000

(n = 809)

2004

(n = 2,051)

2006

(n = 1,769)

2008

(n = 1,718)

2010

(n = 1,747)

2012

(n = 1,760)

2014

(n = 1,224)

2016

(n = 1,328)

Auditory processing disorder — 66.9 60.8 54.4 47.4 57.7 45.5 37.0

Autism spectrum disordera 83.0 80.2 84.4 84.1 88.0 90.3 89.8 91.3

Childhood apraxia of speech — 60.2 56.3 57.5 58.8 56.9 62.9 63.4

Cognitive communication

disorders — 51.5 — — — — 60.8 60.1

Dysphagia (swallowing/feeding

disorders) 21.0 12.3 10.2 9.3 9.4 11.4 13.9 10.5

Fluency disorders 80.0 70.2 68.5 67.2 66.9 66.5 67.6 68.6

Hearing lossb 66.0 48.6 48.1 43.8 46.4 45.4 50.5 46.4

Language disorders: Pragmatics/

social communication — 76.2 76.6 75.3 81.0 83.0 89.1 89.5

Language disorders: Semantics,

morphology, syntax — — — — — — 92.2 90.8

Nonverbal, augmentative and

alternative communication 62.0 48.9 50.4 45.0 53.2 48.8 54.9 55.1

Reading and writing (literacy)

difficulties — 39.7 36.6 32.3 32.3 29.6 35.8 33.0

Selective mutism — — — — 16.1 16.7 18.3 17.6

Speech sound disordersc 97.0 93.4 91.1 94.2 91.6 92.6 92.7 88.7

Traumatic brain injury — 19.3 18.0 14.2 16.9 17.4 0.2 17.1

Voice or resonance disorders — 31.5 28.5 23.9 23.3 22.1 22.0 17.5

Note. These data are from the 2000 ASHA Omnibus Survey and 2004, 2006, 2008, 2010, 2012, 2014, and 2016 ASHA Schools Surveys. aFrom 2000 to 2008, this item

was Autism/pervasive developmental disorder; from 2010 to 2012, it was Autism spectrum disorders, including pervasive developmental disorder and Asperger’s. bFrom

2000 to 2012, this item was hearing disorders. cFrom 2000 to 2014, this item was articulation/phonological disorders. Dash indicates that the item was not included in the

survey.


Appendix Table 5. Average number of students on school-based SLPs’ caseloads, by area of intervention and year.

#

Area 2000

(n varies)

2004

(n varies)

2006

(n varies)

2008

(n varies)

2010

(n varies)

2012

(n varies)

2014

(n varies)

2016

(n varies)

Auditory processing disorder — 9 9 8 7 10 7 6

Autism spectrum disordera 4 5 6 7 8 8 9 10

Childhood apraxia of speech — 3 3 3 3 3 3 3

Cognitive communication disorders — — — — — — 10 10

Dysphagia (swallowing/feeding

disorders) 3 3 4 3 3 3 3 2

Fluency disorders 3 3 3 2 2 3 3 3

Hearing lossb 3 3 3 3 3 3 3 3

Language disorders: Pragmatics/social

communication — 8 8 8 8 10 11 12

Language disorders: Semantics,

morphology, syntax — — — — — — 22 22

Nonverbal, augmentative and alternative

communication 5 5 5 4 5 4 5 5

Reading and writing (literacy) difficulties — 14 15 15 14 14 15 15

Selective mutism — — — — 1 1 1 1

Speech sound disordersc 24 23 23 22 21 19 21 18

Traumatic brain injury — 2 2 1 2 1 1 2

Voice or resonance disorders — 2 2 2 2 2 2 1

Note. These data are from the 2000 ASHA Omnibus Survey and 2004, 2006, 2008, 2010, 2012, 2014, and 2016 ASHA Schools Surveys. aFrom 2000 to 2008, this item

was Autism/pervasive developmental disorder; from 2010–2012, it was Autism spectrum disorders, including pervasive developmental disorder and Asperger’s. bFrom

2000 to 2012, this item was hearing disorders. cFrom 2000 to 2014, this item was articulation/phonological disorders. The numbers included in this table were provided

by respondents who do treat students in the areas of intervention listed. The n values vary widely because respondents did not treat students in all areas. Dash indicates

that the item was not included in the survey.

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