School-Based SLPs, Struggles and Ethical Considerations

Published in the July 2024 issue of the ISHA Voice.

 By Christina (Tina) Panzl, co-chair of the Ethics Education Committee

I left the job I once loved. I left the job I had done for nine years, and the job that gave me my start as a speech-language pathologist. I left the job working for the school district I bought a house in, and the one where my children will go to school. It broke my heart. Turns out, the decision to resign from that position boiled down to one simple ethical principle: beneficence.

This past February, I sat in my first Ethics Education Committee meeting at the 2024 ISHA Convention and was asked what brought me to the committee. While I don’t remember what my exact answer was, I know I let out an audible sigh before I attempted to answer the question. So many feelings from the previous school year flooded over me.

My story parallels that of so many school-based SLPs. For me, feeling unsuccessful trying to improve a situation I could not change was one of the biggest factors that contributed to my burnout. However, the ethical “ick” I kept feeling when I voiced my concerns about what would happen to my students if nothing changed was the reason, I knew I had to leave the position.

Beneficence can be defined as actions that are done for the benefit of others, as well as those that produce good (Eadie & Charland, 2005). There were many years and countless moments as a school-based SLP in that role where I knew I was doing good for others - students, colleagues, parents, community members. Unfortunately, there were many external factors in that position that slowly chipped away at that belief. I no longer felt beneficent. 

School SLPs are frequently told to “do the best you can” despite not being given the time and resources needed to make meaningful change in our students’ lives. In an effort to be supportive of our fellow SLPs, we tell each other to give ourselves grace. It’s a great sentiment on a human level. However, as ASHA members who agree to abide by the Code of Ethics, is accepting a “you’re doing the best you can” attitude enough?

Let’s review Principle 1, Rule L from that ASHA Code of Ethics, which states, “Individuals who hold the Certificate of Clinical Competence shall use independent and evidence-based clinical judgment, keeping paramount the best interests of those being served” (ASHA, 2023). This principle feels like the core of who we are as SLPs. We take what we know to be the best course of action based on the evidence and our experience, and we use it to benefit our students, clients and patients.

How many school principals know that their speech-language pathologists agree to abide by the ASHA Code of Ethics? The responsibility to educate others on what you are professionally required to do while upholding these principles is ultimately yours, not the school district’s responsibility to just know. When having conversations to advocate for your needs so that you can support your students, remember to include information relating to evidence-based practice standards, current IEP goals and accommodations, and the educational eligibility your students fall under. Painting this picture for school administrators allows them to see how your struggles are ultimately affecting both the best interests of the students, as well as the legal responsibilities of the district.

What could this sound like when talking with school leaders and special education administration?

• “Due to my caseload, I am currently required to see kindergarten students in a group of five. It does not align with evidence-based practices to service students with this type of delay in a group this large. Large group sizes do not permit students to produce a sufficient number of sound trials and receive specific and corrective feedback regarding their accuracy. As a result of these constraints, this situation will not lead to meaningful improvement of their disability, requiring a longer duration of special education services.”

• “Based on my current workload, my schedule does not allow for time to properly train teachers and staff to support the use of Student X’s augmentative and alternative communication (AAC) device. I am concerned that this does not align with both staff and parent wishes, as well as what the team listed in his IEP accommodations and supports to support a free appropriate public education (FAPE). Without proper training and ongoing support, Student X is not able to make sufficient progress towards his annual goals and engage with additional students and staff members within the educational setting. I would like you to help me problem-solve what can be removed from my plate so I can help the district meet this need.”

• “Due to the lack of available therapy space for my position, I am currently seeing a second-grade student with an educational eligibility of hearing impairment in the hallway and within the classroom. The audiological findings and their accommodations and supports do not align with this practice, as they need a reduction in background noise. Students with communication needs, especially those who are hard of hearing, need a consistent and quiet space to participate in their therapy sessions. What options can we explore to be able to provide me a space that meets their needs?”

Weaving your ethical responsibility to do what is best for your students into conversations about the lack of resources or support you are receiving in the school setting is one way to advocate for your students and their needs. It allows administrators to see that you are not just complaining about your noisy shared classroom or your busy schedule, but rather that the district is not upholding the legal requirements of the student’s individualized education program for a student with a disability.

My idea of beneficence also includes advocacy for those who don’t even recognize they need it. We all know that the “squeaky wheel” parent is the one whose child receives the most special education “grease.” The students I lost sleep over were the ones that were coasting along, not making any significant progress, but had nobody speaking up for them. These students, in these less than ideal, but still legal, therapeutic conditions are the ones I kept fighting for.

Did I feel like an absolute failure as an SLP last year? Yes. Did I make the right move for me, both professionally and personally, leaving to go to a new district? Not a doubt in my mind. I feel beneficent again. The burnout I was feeling for the profession is gone. I have time to plan and implement meaningful and engaging sessions. I collaborate with my fellow SLPs and classroom teams on a weekly basis. I have time to train staff in order to support my students outside of my therapy room. I know I am making a difference and benefitting my students again. I can’t speak for all SLPs, but for me, feeling beneficent again was the cure to the burnout I was feeling.

Keep speaking up, colleagues. Stress that evidence-based practices aren’t able to be implemented given your current workload. Educate others on how you cannot facilitate the beneficial supports your students are legally entitled to. Share the responsibility for creating solutions. Explain your ethical and professional responsibilities. Advocate for those who aren’t aware they deserve better. Why? To quote a school leader I continued to respect throughout all the difficult moments, “because kids deserve it.”

References

American Speech-Language-Hearing Association. (2023). Code of ethics [Ethics]. Available from https://www.asha.org/policy/et2016-00342/.

Eadie, T. L., & Charland, L. C. (2005). Ethics in Speech-Language Pathology: Beyond the Codes and Canons. Journal of Speech-Language Pathology and Audiology, 9(1), 27–36.

Christina (Tina) Panzl is a school-based speech-language pathologist currently practicing in the Glenview/Northbrook area. Her areas of interest include childhood language, AAC, supervision and mentoring. Tina currently serves as the co-chair of the Ethics Education Committee.