I'm a male SLP working with young children, and I've struggled with feeling insecure about my masculinity for quite some time.

Sometimes I feel embarrassed telling people what I do for a living. Being in such a female-dominated profession, especially working with young children, has made me question how others perceive me as a man.

I've occasionally heard comments comparing my profession to more traditionally masculine careers, such as engineering or working in the trades, and although I know logically that my job doesn't determine my masculinity, it's still something that bothers me.

I actually have a pretty good work-life balance and make a comfortable living, so it's frustrating that I still struggle to feel proud of my career.

I've also been questioning what it even means to be masculine in this day and age. A lot of the qualities traditionally associated with masculinity, like strength, responsibility, and providing for others, are qualities anyone can have regardless of gender. Yet I still find myself comparing my career to traditionally masculine professions, and I struggle to separate those expectations from how I see myself.

I'm curious whether any other male SLPs have experienced similar feelings, particularly those working with younger populations. How have you dealt with these insecurities, and has your perspective changed over time?

I just wanted to share a positive perspective, since of course there are many things to be improved about our field. I work in early intervention, and I love everything about the schedule, the families I work with, and the job flexibility. It has been so refreshing having breaks in between each visit and I feel like those 15 to 30 minute resets in the car give me so much more energy. I don’t feel exhausted at the end of each day. I have a reasonable amount of paperwork, and I don’t end up bringing any work home. I also don’t need to plan thoroughly for sessions since they’re home visits and I’m just joining into their daily activities. I also feel like I get to have the biggest impact since I’m working directly with the families! I also set my own schedule, so I can have some shorter and some longer days if I want. I also love the interdisciplinary collaboration!

If you’re looking for a career change, I really recommend looking into early intervention!!

Please tell me what you think about either/both statements!

I just started with a kid who is 6 years old (autistic and CAS) and has been using an AAC device for 2 years. He has been in therapy for many years and from what I can hopefully assume, has been receiving a high level of modeling and AAC exploration throughout that time. I know that “random” AAC usage is babbling, good for exploration, and always meaningful, and I understand the argument of how we would never limit a non-AAC users words, so we shouldn’t with AAC users, but after two years of little progress in communication goals and very rare session/topic-related communication during our time together, I am feeling unsure of when these communication milestones will happen. For those that have long term experience with AAC users, is 2+ years normal before you see understanding of icon intent? Are there any other ways beside modeling without expectation that are helpful for intent and association? Is there such thing as too many AAC icons? They have the most icons I’ve ever seen on a device and sessions just go from one million icon page to the next. Any advice and help is appreciated.

Hi, I work in a general education high school where most of the students have had speech on their IEPs since early elementary school. Nearly all of their goals pertain to language skills. No articulation.

My students are expected to meet the demands of the general education curriculum. Most of them are in co teaching classrooms. Honestly, the teachers do a great job at differentiating instruction.

Most of my students have mandates of 2 times a week for 45 minutes in a group. I am not allowed to pull from specials meaning most of my kids end up being pulled out of social studies and science.

They are expected to make up the work that they miss because of being pulled from speech. They complain that they don’t want to be pulled from class because then they feel even more lost the next time they have that course, having missed instruction time.

Yes, these kids have language impairments. But honestly, their ICT classrooms do a great job at differentiating instruction.

So how is it in their best interest to be removed from these classes, to work on skills with me, and then return to class feeling confused about the content? Sometimes I feel like our roles in middle school/ high school don’t make sense.

Someone please explain.

Hi everyone!
I’m a new CF working in acute care, and one area I find myself struggling with is dysphagia management in patients who are on hospice, have palliative care consulted, or have advanced dementia.

Specifically, I’m referring to patients with severe oropharyngeal dysphagia where we may recommend NPO with consideration of alternative means of nutrition/hydration.

I understand the importance of quality of life, patient autonomy, and goals of care, especially in patients with advanced dementia or those approaching end of life. I’m also familiar with the evidence surrounding feeding tubes in advanced dementia, including that they don’t eliminate aspiration risk or necessarily improve survival or quality of life.

However, I find myself struggling with how to navigate these situations as an SLP and where exactly our role begins and ends.

For example, if I evaluate a patient at bedside who demonstrates severe swallowing deficits, is not appropriate for an instrumental assessment, and I recommend NPO, what happens when the patient or family wants to continue PO intake for comfort? I understand the concept of comfort/pleasure feeding, but I feel like I don’t fully understand what that looks like in practice.

I guess my main questions are:
How do you approach NPO recommendations when a patient’s goals of care are focused on comfort rather than rehabilitation?

What does comfort/pleasure feeding actually look like? How do you determine consistencies, amounts, and precautions? At what point do you recommend or discuss this option?

How do you approach these situations in patients with advanced dementia, especially when alternative nutrition may not be appropriate?
Where do you draw the line between our role as SLPs, the medical team’s decisions, and the patient/family’s wishes?

How do you document your recommendations when a patient/family chooses to continue PO intake despite known aspiration risks?

I think my biggest struggle is wanting to make clinically appropriate, evidence-based recommendations while also recognizing that preventing aspiration isn’t always the primary goal, especially at the end of life. I feel like I understand these concepts in theory, but applying them in real clinical situations and navigating these conversations is much more challenging.

I’d really appreciate hearing how other acute care SLPs approach these situations, especially any advice or resources that helped you as a new clinician. Thank you!

The amount of Youtube in the schools is crazy. It seems like such a disservice to let students with autism be on YouTube multiple times per day when they will be on screens all waking hours outside of schools. People look at me like I’m crazy when I suggest we should try to facilitate other leisure skills that allow for the possibility of interaction. I feel like putting this on my door.

SLP in the schools here. I have a situation where I’ve taken over another therapist’s students while they’re out for FMLA for several weeks. I’ve worked with this therapist for years and they’re amazing, but as I’ve been seeing a few of their kids I’ve been running into an issue of not agreeing with their accuracy ratings for a couple of students .

For example a student who’s working on /sh/ and /ch/. Other therapist had them rated at 70-80%, but when I listen I still hear a distorted /s/ rather than a true /sh/. Asked a third teammate for an opinion and they say the /sh/ sounds fine.

I’d be worried it’s my hearing or something, but another student in the same group is also working on /sh/ and theirs actually does sound fine to me, no /s/ to be heard.

Anyone else experienced this? Should I be considering the distorted but still definitely slightly fronted sound as “good enough” if multiple others hear it that way? Am I the problem??

I see lots of IG and reddit posts about leading weekly whole group lessons in self-contained classes. Does anyone do this at the middle school level? What does it look like and what is the benefit of it?

Everything I've seen looks very similar to what my sped teachers are leading in their Lifeskills classes. It doesn't feel like the right way to spend time that could be used to prep materials for students actually on my caseload, but at the same time it feels like I'm supposed to be doing it because I hear about it so much.

Hello everyone, I’m not using my main account for privacy reasons but I’m really struggling and can use some advice. This is my third year working as a SLP, my second year working with preschoolers, and I’m having a really tough time dealing with all of the behaviors. I did my CF in an elementary school for children with complex communication needs, and decided to seek a different population despite liking AAC because I couldn’t handle all of the behaviors (ex. Headbutting, biting to the point where it broke skin multiple times, and scratching that left scars). Last year was my first year in my current position (I work with preschoolers in ICT classrooms at multiple sites), and I did struggle a bit with some students and had a really tough time but I thought it would be better this year since I had more experience and my materials from last year. But this year so far has been worse, and sometimes I really can’t tell the difference between the behaviors I saw in my CF and the behaviors I see now. I have students that hit, pinch, try to grab my clothing, throw materials off of the therapy table, and climb on top of their chairs/the table. And instead of it only being one or two students, it’s approximately maybe half of the students I see. I’ve tried reducing demands and focusing more on play therapy / incorporating visuals and aided language input, but I’m still having issues. Today I was legitimately afraid that a student would get hurt because she had difficulty remaining in her seat or even the therapy area, and I couldn’t really let her wander the room because it is borrowed and there are tons of other materials / computers that she will try to push off the tables. I usually sit next to the student and orient their chair so that they can’t get up and wander around easily, but she became so dysregulated that I just moved aside because I was afraid she was going to throw herself backwards off her chair. I’ve talked to my other SLP coworkers for advice, but I still feel like I’m just not cut out for preschool or the schools in general.

How are yall getting through stories??

Im at a new school this year, elementary school k-4 , and im trying to do literacy based sessions, and i have a lot of kids with adhd and asd, and i feel like they really can’t keep their attention on the story for more than a minute. Ive tried using puppets, and using fun voices, and story props, and accompanying craft etc, but I feel like I really can’t capture their attention. But I also feel like these students are too advanced for adapted books and for just doing play based sessions

So how do yall do it? How do you read a story ?

Videos would be appreciated 😅

Look, I’m aware of the discussions regarding cognitive referencing. I try my best to be neurodiversity affirming and I my typical m.o. is to “do the right thing.” My leads give little guidance in these situations and it is frustrating when you, the SLP, aren’t really clear on what is expected of you. I’m trying to present the details and my experience clearly, so please don’t play the “tone police.”

I have two 8th graders on “support,” one who came to me that way in and one who I put on when they transferred because he had reasonable functional communication and was able to do things like define unfamiliar words in context, describe, compare, and interpret figurative language with a little bit of prompting. Parents are frustrated because the second is failing. Now demanding that he “be put back in speech,” while, at the same time the child receives inclusion services for most classes and-this year they took away their resource block for an elective (that he is not participating in btw).

Both students are working with an IQ of around 70, not working anywhere near grade level (and haven’t been), and are eligible under autism. I screened “annoyed parent kid” again just to get an update. Strengths were the same. However, he could not make sense of the word “opposite” no matter the ways I described it, nor tell me the meaning of a familiar word when it was modified by an affix despite the fact that the word, the affix, and the meaning were written down, labeled, on a plain sheet of paper with multiple prompt to put the two ideas together…after already doing an example. You know, the kind of who seems to try and guess/figure something out when it is right in front of them no matter how you phrase the directions. The teachers have the same experience when attempting to work with them on most concepts.
This is where I want to throw my hands up, because I never know what to say or where to go with them. To me, it isn’t “just language” but a struggle with abstract concepts (right?)The cognition and functional aspect gets to be a point of reference for the rest of the related services team so why don’t we get to do it, too?

In support I try to check on progress towards IEP goals, towards mastery of standards, and communication concerns.
I have attempted to provide the inclusion teachers with targeted materials related to goals. Not many are keen to collaborate as they are stretched thin. But like, I’m trying?

A true communication disorder.

Not a learning disability, ADHD, level 1 ASD, or dyslexia.

I actually have older students labeled ID that I would not qualify, I would place them in a functional skills classroom, not be working on syntax and /r/ in structured drill tx. Does it really matter if they can use story grammar marker if by 5th grade they can't read sight words and have sufficient conversational skills? How is that functional for them? I love these kids but I think if I got straight to the point from a clinical perspective, I would not be left with much of a caseload.

I'm just not sure what we can really remediate anymore.

I've recently switched over to a high school where a lot of the students are working on pragmatics and perspective taking. One of the school psych mentioned the previous SLP would often show videos or clips of tv shows as a jumping off point for sessions. does anyone know any good shows or videos to take clips from where people frequently misunderstand each other or otherwise that might be good for pragmatics focused sessions?

Hi! I was wondering if anyone had any executive functioning tasks, activities or worksheets in Spanish? It would be super helpful! I’m having a hard time sourcing some online.

The upcoming CPT changes have me curious.

Hello! Looking into possibly working in Ireland. Are there any SLPs from Ireland here?

Would love to get first-hand insights.

Like:

How is the workload?
Do you have good work-life balance?
Is the pay good enough to support a small family? Maybe buy a house eventually?
How satisfied are you overall with your career there?

Many thanks!

Seeking advice from more seasoned folks as an SLP who is early in her career. How do you come back from an objectively crappy session? I felt like such a dunce at my session this afternoon: dropped my clip board flat on the floor, spilling papers everywhere and spooking the child. Then the voice output for the device I was trying to model with family wasn’t working despite all my trouble shooting.

This was only my third time meeting this family, so rapport isn’t there to really expect a lot of grace. This parent was still kind to me, I could tell she was a bit put off and annoyed by my chaos. I wasn’t able to loan the device to family to trial between sessions, which made me feel even worse. It’s been a few hours now and I can’t stop thinking about all the ways I screwed up.

Any words of wisdom or advice would be helpful. I know we won’t always perform perfectly in visits, but my performance today was particularly subpar. I’m afraid that this initial impression will color my relationship with this family.

Had a parent recently tell me “I feel like my child has gotten lazy. He’s not non-verbal. He can speak. But now that he has access to the device he chooses to use that. I don’t want that, I want him to build on his verbal abilities.”

Hello! I have a 2nd grade student in the schools who I am assessing. She displays an interdental lisp for /s, z/. /sh, ch/ sounds lispy at times, as well.

This student has a high/narrow palate and history of prolonged pacifier use. I suspect she has tongue thrust but I’m not experienced enough in this area to say.

She is highly intelligible and there are no social impacts, so I will be exiting her. However, I do have some questions -

1. Thoughts on remediating an interdental lisp if a student DOES have tongue thrust? I’ve heard that it can be done, but to me it sounds counterproductive.

2. Outside referrals - would you refer to orthodontist (for palate) and myofunctional therapist for suspected tongue thirst? Am I missing anything?

TIA!

Hi everyone! I’m doing a lot of babysitting right now as I build my caseload at my new private practice job. A mom I frequently babysit for (she has a 5 yo boy with ASD and two younger daughters) told me she thinks I should become an “SLP nanny” meaning doing full time nannying/babysitting while being an SLP and implementing speech therapy! It actually intrigued me! Just something to think about but is this an actual thing/ what are the ethics with it? She may have been kidding but the idea wasn’t bad!

Hi everyone, I would just like to rant and also get some advice if possible. I am thinking of giving my 2 weeks notice after only working at my CF little over a week. It is currently in a pediatric clinic. I feel super misled by them, but I'm not sure if I am overreacting. When I was getting hired, I was told I would be starting out 3 full days a week, since they wanted to ease me into a full caseload and I thought that sounded very thoughtful, and I agreed! My first week, I did training for about 2 hours, and then only had 2 evaluations (2 tx sessions cancelled on me). This week, I have a total of 9 sessions (1 hour each), and tomorrow I literally have to drive over 30 minutes (each way) to see one kid in the clinic which is ridiculous! I know that a CF is going to be difficult no matter what, but there are other inconsistencies in what they have told me vs what actually has ended up happening. I just have this gut feeling in my stomach that tells me this place isn't right for me. I figure the sooner I leave, the easier so I don't waste more time getting more hours that don't count. I am only paid by treatment hour (documentation time isn't paid either), so I am literally barely getting an income, and I feel like it won't increase to the amount I need anytime soon. Any advice is appreciated.

Some people on this sub were telling me it is not possible to go to WGU and get a bachelors degree and then become an SLP after. Wanted to confirm that it is very possible ! Please someone explain why this is a bad thing when it’s an accredited school ? The only difference is you go at your own pace . You still have professors , tests and studying . You can fail and not pass so I’m a little confused ? I’m a sahm and so this schedule and the amount of money works best for me . If it’s accredited and grad schools accept it what is the issue ? EDITED more important info in the comments