Districts are facing rising costs for speech therapists

Providing speech therapy services to students is an ever-evolving conundrum as nationwide staffing shortages drive up costs for school districts.

Shannon Richards, director of special education for the Moscow School District, takes 20 minutes to list all the creative ways she has filled open speech-language pathology positions — including teletherapy and hiring a candidate from out of state.

“In March, I knew I was down to one SLP, and that sent me into pure panic,” Richards said. “Many of these positions are advertised for a year and I receive two applications.”

SLPs provide a range of services, from treating speech delays in younger children to intensive therapy for nonverbal students.

These services are often part of a special education or individual education program (IEP), meaning schools are required to provide them regardless of how difficult it is to hire SLPs.

Of Moscow’s 301 children receiving special education services, 160 require SLP services.

The caseload for an SLP in Richard’s district is approximately 40 students each.

According to a survey by the American Speech-Language-Hearing Association earlier this year, 78.5% of school respondents said job openings for SLPs outnumbered job seekers.

Moscow school leaders recently increased SLP salaries, which could help the district better recruit and retain them.

Still, it’s difficult to retain SLPs in Moscow and other areas of northern Idaho because Washington and its higher wages are just a few miles away.

If Richards cannot fill her SLP positions and provide adequate services, she will have to work with a telehealth company, which will cost the district significantly more.

An SLP in Moscow typically earns between $50 and $60 per hour. But an online contractor generally costs $70 to $80 an hour, Richards said.

Support staff are also required to take children to and from teletherapy and often sit in the room and supervise them.

For this reason, telehealth services can cost twice what counties pay to employ an SLP directly.

Another complication: Idaho only has one SLP program, limiting options for those interested in the field.

“I think that works against us as well,” Richards said. “We as a state need more SLPs than our system produces.”

Idaho only has one SLP program

Idaho State University is the only college in Idaho to have a speech-language pathology program.

ISU offers its master’s degree program in Pocatello, Meridian and online, with a goal of having 15 people in person at each campus and 25 online students each year, said Alycia Cummings, associate professor and chair of the communication studies department.

Around 160 students take part in the program at any given time. That’s far more than other comparable programs, which admit about 20 students per cohort, Cummings noted.

While the program could grow to meet SLP needs, expanding too much could be problematic, Cummings said. It’s not just about pure numbers, but also about the quality of the graduates. If students are not prepared for the actual workload of being an SLP after graduation, they are less likely to stay in the profession, she said.

“Most people in ISU’s undergraduate and graduate programs have had experience with a speech-language pathologist in their own lives,” said Mary Van Donsel, who directs the undergraduate and post-baccalaureate programs.

“It’s not the first career people think of when they want to go into the medical field, such as: B. Doctor or nurse,” said Van Donsel. Even compared to other similar programs, such as occupational therapy or physical therapy, speech-language pathology is less well-known, she said.

ISU’s program often targets students who want to go into health care but aren’t sure exactly what they want to do, educating them about speech-language pathology, she said. That reach is key to meeting statewide needs, Van Donsel said.

“The scope of an SLP practice is huge,” said Clinic Director Amy Hardy.

SLPs in Idaho have difficulty finding mentors in schools

“It’s basically a birth to death,” she said.

Students complete clinical rotations in a variety of settings, from hospitals to nursing facilities to schools.

“Your initial thoughts can sometimes change,” Hardy said of students’ desired practice area.

But the positive thing is that there is a need everywhere, she said.

One problem for students considering working in schools is the lack of available mentors, Hardy said.

Students are required to work in a school as part of their internship, but it can be difficult to find a school place for their eight-week internship abroad, she said. Professionals are not paid to serve students, and given the high caseloads in most schools, it can be difficult to retain SLP students in schools for an extended period of time.

“A school SLP is very, very busy,” Cummings said.

SLPs are part of the IEP process and work with directors of special education and other disciplines. Not only do they have to provide therapy, but they also have to coordinate schedules and complete paperwork, she said.

The hiring battle continues: “It would be great to get an applicant,” said one administrator.

In Rathdrum, Lakeland Superintendent Lisa Arnold said they too are having difficulty hiring SLPs.

“They’re finding they can make more money online,” Arnold said. “This is not the ideal way to work with children who have difficulty learning.”

Arnold also cited the cost of hiring a teletherapist as an obstacle.

There is also a shortage at nearby Coeur d’Alene Public Schools, said Frank Maier, director of special education. They currently have 11 SLPs on staff and two virtual ones.

Despite the larger number of SLPs, Coeur d’Alene’s caseload is often high, particularly toward the end of the year when new student needs emerge. Maier said that in the end they often end up with a case number of 55.

“It would be great to get an applicant,” said Maier. “Pay is always a factor with these particular positions, they do so much and we do the best we can with the funding we get.”

Most of their SLPs are assigned to more than one school building, making travel time another costly issue.

However, having them in the building is invaluable, Maier said.

“I think much of their work is critical to the success of all students. I know some of our SLPs just walking down the halls to their room and listening to the kids talk,” Maier said. “They are always on the hunt. They have an eye on every student in this building.”