Caseload and Workload

Overview

This page focuses on caseload and workload issues specific to school-based speech-language pathologists (SLPs). Many of the topics discussed in this page are also relevant for professionals in a variety of other settings.

Caseload refers to the number of students with individualized education programs, individualized family service plans, and 504 plans served by school-based SLPs and other professionals through direct and/or indirect service delivery options. Caseloads can also be quantified in terms of the number of intervention sessions in a given time frame. In some school districts, caseloads may also include students who receive intervention and other services within general education, through multi-tiered systems of support, such as response to intervention, designed to help prevent future difficulties with speech, language learning, and literacy.

Workload refers to all activities required and performed by school-based SLPs. Workload includes the time spent providing face-to-face direct services to students as well as the time spent performing other activities necessary to support students’ education programs, implement best practices for school speech-language services, and ensure compliance with the Individuals with Disabilities Education Improvement Act of 2004 (IDEA, 2004) and other mandates, such as additional school duties (see ASHA’s Practice Portal page on Documentation in Schools).

Workload and caseload are not interchangeable terms. Caseload is only one part of the picture. An SLP may need to allocate significant time for additional important and necessary workload activities whenever a student is added to a caseload for direct services. The total number of workload activities required and performed by school-based SLPs should be considered when establishing caseloads. ASHA recommends taking a workload analysis approach to setting caseloads to ensure that students receive the services they need to support their educational programs (ASHA, 2002) and make adequate progress (Endrew v. Douglas County School District RE-1, 2017).

ASHA does not recommend a specific caseload number for the following reasons:

There is no research to support a specific caseload size.
The needs of students receiving speech-language services vary greatly, and a specific caseload number does not take into account this variation. For example, a caseload of 40 students with mild communication disorders could be manageable, whereas a caseload of 40 students with severe disabilities is not likely to support the provision of a free and appropriate public education.
A specific caseload number could be interpreted as a “minimum” number and, if the SLP’s caseload is below that number, then the SLP could be assigned additional duties or allocated to provide services to students in other buildings.

For these reasons, ASHA encourages assignment of SLPs based on workload rather than caseload. See ASHA’s A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in the School: Position Statement.

Key Issues

Caseload Characteristics

School-based SLPs provide services to students from at least five different groups:

School-age students whose primary disability under the Individuals with Disabilities Education Improvement Act of 2004 (IDEA) is speech or language impairment
School-age students identified under IDEA with primary disabilities other than speech-language impairment but who receive speech-language therapy as a related service
Students who qualify under Section 504 of the Rehabilitation Act of 1973 who may need accommodations, supports, or other services
Preschoolers who are eligible for speech-language services
Students who receive pre-referral intervention, including multi-tiered systems of support (MTSS; e.g., response to intervention [RTI]) and other services designed to help prevent future difficulties with language learning and literacy

According to the ASHA 2022 Schools Survey, the median monthly caseload size of ASHA-certified, school-based SLPs who were clinical service providers working full time was 48, with a median caseload range of 36–55, depending on U.S. region (ASHA, 2022).

Some states have established caseload guidelines for school SLPs, but others leave these determinations to local districts. Contact individual state departments of education for current information regarding caseload guidelines. See also ASHA’s State Caseload Chart [PDF].

Impact of Large Caseloads

While ASHA does not recommend a specific caseload number, large caseloads can have an extensive impact; the most notable areas are described below.

Student Outcomes

Students on smaller caseloads may make more measurable progress on functional communication measures than those on large caseloads (Schooling, 2003). These positive student outcomes may be less likely when SLPs have large caseloads and expanded responsibilities. For example, large caseloads may necessitate a shift from individual to group treatment and from smaller to larger group sizes, when such changes are not necessarily ideal for the student (Cirrin et al., 2003).

Student outcomes also depend on the SLP’s ability to provide services that integrate into the child’s curriculum. Large caseloads often limit the time available to become familiar with curriculum and standards (e.g., Common Core State Standards or other state standards) across all grade levels served. See Common Core State Standards Initiative (National Governors Association Center for Best Practices, Council of Chief State School Officers, 2010) and ASHA’s Common Core State Standards: A Resource for SLPs.

Service Delivery Options

Large caseloads may also limit service delivery options. In fact, caseload size, rather than student characteristics, frequently influences recommendations about program intensity and/or model of service delivery (Brandel, 2020; Brandel & Loeb, 2011). Larger caseloads may cause SLPs to use service models that are not appropriate for some students and that may affect the SLP’s ability to provide a free and appropriate public education (FAPE).

Collaboration and Interprofessional Practice

Students may benefit from classroom-based models in which the SLP and the classroom teacher co-teach language lessons (e.g., Gillam et al., 2014). Large caseloads, however, limit the time available to the SLP for collaboration with teachers and other professionals (Green et al., 2019). See ASHA’s resources on interprofessional education/interprofessional practice (IPE/IPP).

Large caseloads influence an SLP’s ability to provide equitable services for linguistically diverse students. Multilingual students require multilingual assessment and/or intervention. Appropriate services may require collaboration with interpreters and translators, per IDEA legislation. See ASHA’s Practice Portal page on Bilingual Service Delivery and Collaborating With Interpreters, Transliterators, and Translators.

Additional Areas of Impact

Large caseloads also have an impact on the following:

Recruitment and retention
- Large caseloads are associated with difficulties recruiting qualified SLPs in the schools (Katz et al., 2010; Woltmann & Camron, 2009) and may factor into higher SLP attrition rates in some school districts. Unmanageable workloads from large caseloads may also contribute to occupational stress and burnout (Marante et al., 2023).
Supervision and training
- Larger caseloads limit the time available to adequately train and supervise student clinicians, clinical fellows (CFs), and support personnel (e.g., speech-language pathology assistants [SLPAs], classroom aides).
Professional development and leadership opportunities
Paperwork requirements for third-party billing (Medicaid)
- Larger caseloads result in increased paperwork requirements for billing.

Additionally, large caseloads may impact an SLP’s ability to provide effective, evidence-based services; be able to make up missed sessions; and address all student goals. This can cause ethical concerns or potentially lead to litigation. For further information, see ASHA’s Code of Ethics and ASHA’s resource on missed speech-language sessions in schools.

Factors Affecting Workload

ASHA’s Schools Surveys indicate that the average number of students on speech-language caseloads has remained relatively unchanged over the past decade, whereas the roles and related responsibilities of the school-based SLP, which affect workload, have increased dramatically.

Factors that may lead to increased workloads include the following:

Students with multiple diagnosed disabilities and complex communication disorders—necessitating intensive, long-term interventions.
SLPs familiarizing themselves with norms and rules for language(s) and dialects and the impact on communication.
Need for collaboration in planning and providing services, as students frequently receive services from a variety of providers.
Extra labor that SLPs from underrepresented groups may experience as cultural brokers and/or as bilingual service providers.
Mandates requiring SLPs to provide services in the least restrictive environment (LRE) and focus on state standards of compliance. This results in additional planning, collaboration, and service delivery time.
Responsibilities in facilitating literacy for children and adolescents.
Programming and maintenance of augmentative and alternative communication (AAC) systems.
Reporting requirements (including progress reporting) and attending student-centered meetings (both individualized education program [IEP] and non-IEP) with general education teachers and parents.
Mandated staff development, “other assigned duties” in the building (e.g., bus duty), mentoring new SLP staff, and supervising CFs.
Accountability mandates involving additional documentation and paperwork (e.g., third-party billing).
Additional responsibilities related to supporting students in MTSS (e.g., RTI).

Workload Approach

All workload activities required and performed by school-based SLPs must be taken into account when setting appropriate caseload standards. Given the expanding roles and responsibilities of school-based SLPs, it is important to consider a shift in thinking from caseload to workload. A workload approach is a better representation of the sum of SLP duties and responsibilities toward service provision than a caseload approach (ASHA, 2002). Such a shift is consistent with the intent of IDEA and best practices in school speech-language pathology to ensure the delivery of appropriate services to students with disabilities.

Use of a workload model is foundational to

providing high-quality services that promote positive student outcomes in the child’s LRE;
engaging in collaborative, interprofessional practices;
delivering services with a full service delivery continuum;
providing FAPE and maintaining compliance with state and federal regulations;
ensuring that the student has access to—and benefits from—accommodations and modifications; and
increasing recruitment and retention of SLPs.

Workload Analysis

A workload analysis may be helpful when advocating for a workload approach and establishing an appropriate caseload. This allows education agencies to consider the time available in the SLP’s schedule when determining the number of children to assign to each SLP.

Steps in Conducting a Workload Analysis

Step 1: Document current roles and responsibilities.

SLPs may make a list of all roles, responsibilities, and activities necessary for providing services in their specific school settings and then sort these activities into the categories below. The roles and responsibilities of school-based SLPs can be organized into four categories, as follows:

Direct services to students
Indirect services that support students’ educational programs
Indirect activities that support students in the LRE and in the general education curriculum
Activities that support compliance with federal, state, and local mandates

Sample roles and responsibilities, organized by activity cluster, include the following.

Direct services to students

Evaluate students for eligibility for special education
Identify students with speech and language impairment
Provide direct intervention to students
Provide direct services to students within the confines of MTSS (e.g., RTI)
Reevaluate students to determine whether continued services are needed

Indirect services that support students’ educational programs

Analyze demands of the curriculum and its effects on students
Consult and coordinate with students’ families and caregivers regarding the student’s needs (e.g., neurodivergence considerations)
Contribute to the development of IEPs, individualized family service plans, and 504 plans
Monitor the implementation of IEP modifications
Implement the use of AAC systems
- Update and train staff in the use of AAC materials and devices
Design curriculum modifications
Provide professional development and workshops for school staff and parents
Provide training and oversight to SLPAs and other therapy extenders

Indirect activities that support students in the LRE and in the general education curriculum

Consult with teachers to support students’ acquisition of the curriculum
Engage in interprofessional practice for education planning and communication activities (see ASHA’s resources on interprofessional education/interprofessional practice [IPE/IPP])
Design and engage in pre-referral intervention activities (e.g., MTSS, RTI)
Design/recommend adaptations to curriculum and delivery of instruction
Observe students in classrooms
Consult with outside entities
Become familiar with Common Core State Standards or other state standards and with the implementation of these standards
Collaborate with interpreters and research unfamiliar language(s) and dialects

Activities that support compliance with federal, state, and local mandates

Collect and report student performance data
Complete compliance paperwork
Document third-party (Medicaid) billing activities
Supervise SLPAs, teacher aides, interns, and CFs
Write student evaluation reports
Participate in IEP/504 meetings
Participate in professional development activities

Step 2: Analyze the current workload relative to the needs of students receiving services. Review current service delivery to ensure that models support adequate progress and address the changing needs of students. In this review,

identify services, settings, group size, and tasks necessary to meet each student’s individual needs and IEP goals;
determine the time it takes for each student-related service and activity (per school day, week, or month) and the time available for these activities; and
determine the SLP’s caseload maximum—this will be reached when all available time slots are filled. This maximum number will vary across settings and will be a function of the needs of the specific students on the caseload.

Step 3: Determine if the workload is balanced.

When all time slots are filled but required activities or student services remain unscheduled, an imbalance exists between the SLP’s assigned workload and the amount of time available to fulfill those responsibilities.

To address this imbalance,

make a list of services and activities required for full implementation of IDEA and best practices that cannot be completed given current workload conditions and
objectively assess how the local education agency might address these unmet needs.

Step 4: Collaborate with SLPs, teachers, administrators, union representatives, parents, and other service providers to address workload issues.

The use of multiple advocacy strategies and partnerships is often necessary to influence workload and caseload issues within state and local education agencies. If the current service delivery is not sufficient to produce appropriate progress, suggest options to enhance services.

ASHA has developed a variety of resource materials that can strengthen local SLP advocacy efforts. Working for Change: A Guide for Speech-Language Pathologists and Audiologists in Schools [PDF] outlines several strategies for collaborating with teachers’ unions and local and state education agencies to improve working conditions.

Approaches to Managing Existing Workload

Administrative Solutions

School districts have implemented a variety of administrative solutions to assist SLPs in managing their existing workloads.

Scheduling Strategies

Scheduling is clearly noted on the IEP. SLPs ensure that scheduling decisions are individualized and that parents, caregivers, and educators understand the strategy or strategies selected. Although federal regulations allow for significant flexibility in designating frequency of service on the IEP, local and state jurisdictions may operate differently. It is helpful to write the amount of SLP services into the IEP as a quarterly, semester-based, or annual amount of time to allow for some flexibility.

3:1 model: Services are provided on a typical schedule for 3 weeks, followed by 1 week with more flexible scheduling to provide a variety of direct and indirect services.
Cyclical schedule (e.g., block scheduling): Direct services are provided for a specified period of time followed by a similar period of time devoted to indirect services (e.g., 9 weeks of direct intervention followed by 9 weeks of indirect services).
Flex schedule: The frequency, amount, and type of services vary on the basis of student progress toward IEP goals or changing classroom demands.
Receding schedule: Initial service involves intense amounts of direct services, which are then reduced over time on the basis of student progress.
Weekly schedule: Direct services are provided on a weekly basis (e.g., two 30-min sessions per week).

Service Delivery Models

SLPs choose service delivery models that afford the most flexible and efficient delivery of services, while ensuring FAPE, according to IDEA. See ASHA’s resource on school-based service delivery in speech-language pathology.

Focus on Eligibility Criteria

Appropriate and consistent identification of children who qualify for speech and language services will help prevent over-identification that unnecessarily expands caseload and workload. See ASHA’s resource on eligibility and dismissal in schools for information and guidance on eligibility, dismissal, adverse effect on educational performance, and cognitive referencing, as well as examples of eligibility guidelines from various states. Many states have also developed guidelines, so check with your state department of education.

Advocacy

An SLP, a group of SLPs, or state associations must consider many factors before launching an advocacy effort. SLPs can review ASHA’s School Advocacy Resources and Member Advocacy Guide before starting an advocacy effort, such as advocating for a workload model in their school district or state.

Resources

ASHA Resources

Other Resources

This list of resources is not exhaustive, and the inclusion of any specific resource does not imply endorsement from ASHA.

References

American Speech-Language-Hearing Association. (2002). A workload analysis approach for establishing speech-language caseload standards in the school [Position statement]. https://www.asha.org/policy/

American Speech-Language-Hearing Association. (2022). 2022 Schools Survey: SLP caseload and workload characteristics. https://www.asha.org/siteassets/surveys/2022-schools-survey-slp-caseload.pdf [PDF]

Brandel, J. (2020). Speech-language pathology services in the schools: A follow-up 9 years later. Language, Speech, and Hearing Services in Schools, 51(4), 1037–1048. https://doi.org/10.1044/2020_LSHSS-19-00108

Brandel, J., & Loeb, D. F. (2011). Program intensity and service delivery models in the schools: SLP survey results. Language, Speech, and Hearing Services in Schools, 42(4), 461–490. https://doi.org/10.1044/0161-1461(2011/10-0019

Cirrin, F., Bird, A., Biehl, L., Disney, S., Estomin, E., Rudebusch, J., Schraeder, T., & Whitmire, K. (2003). Speech-language caseloads in the schools: A workload analysis approach to setting caseload standards. Seminars in Speech and Language, 24(3), 155–180. https://doi.org/10.1055/s-2003-42823

Endrew v. Douglas County School District RE-1, 580 U.S. (2017). https://www.supremecourt.gov/opinions/16pdf/15-827_0pm1.pdf [PDF]

Gillam, S. L., Olszewski, A., Fargo, J., & Gillam, R. B. (2014). Classroom-based narrative and vocabulary instruction: Results of an early-stage, nonrandomized comparison study. Language, Speech, and Hearing Services in Schools, 45(3), 204–219. https://doi.org/10.1044/2014_LSHSS-13-0008

Green, L., Chance, P., & Stockholm, M. (2019). Implementation and perceptions of classroom-based service delivery: A survey of public school clinicians. Language, Speech, and Hearing Services in Schools, 50(4), 656–672. https://doi.org/10.1044/2019_LSHSS-18-0101

Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. § 1400 et seq. (2004).

Katz, L. A., Maag, A., Fallon, K. A., Blenkarn, K., & Smith, M. K. (2010). What makes a caseload (un)manageable? School-based speech-language pathologists speak. Language, Speech, and Hearing Services in Schools, 41(2), 139–151. https://doi.org/10.1044/0161-1461(2009/08-0090)

Marante, L., Hall-Mills, S., & Farquharson, K. (2023). School-based speech-language pathologists’ stress and burnout: A cross-sectional survey at the height of the COVID-19 pandemic. Language, Speech, and Hearing Services in Schools, 54(2), 456–471. https://doi.org/10.1044/2022_LSHSS-22-00047

National Governors Association Center for Best Practices, Council of Chief State School Officers. (2010). Common Core State Standards Initiative. https://www.corestandards.org/

Rehabilitation Act of 1973, 29 U.S.C. § 701 et seq. (1973).

Schooling, T. L. (2003). Lessons from the National Outcomes Measurement System (NOMS). Seminars in Speech and Language, 24(3), 245–256. https://doi.org/10.1055/s-2003-42827

Woltmann, J., & Camron, S. C. (2009). Use of workload analysis for caseload establishment in the recruitment and retention of school-based speech-language pathologists. Journal of Disability Policy Studies, 20(3), 178–183. https://doi.org/10.1177/1044207309343427

About This Content

Acknowledgments

Content for ASHA’s Practice Portal is developed and updated through a comprehensive process that includes multiple rounds of subject matter expert input and review. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Caseload and Workload page:

In addition, ASHA thanks the members of the Ad Hoc Committee on Caseload Size whose work was foundational to the development of this content. Members of the committee were co-chairs Frank Cirrin and Ann Bird, Larry Biehl, Sally Disney, Ellen Estomin, Judy Rudebusch, Trici Shraeder, and Kathleen Whitmire (ex officio). Alex Johnson, vice president for professional practices in speech-language pathology, provided guidance.

Citing Practice Portal Pages

The recommended citation for this Practice Portal page is:

American Speech-Language-Hearing Association. (n.d.). Caseload and workload [Practice portal]. https://www.asha.org/practice-portal/professional-issues/Caseload-and-Workload/

Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting.