I have been a Speech Language Pathologist for 17 years. I am also the parent of two children with special needs who receive weekly speech pathology services from another SLP. In my career so far, I have had the privilege to work beside and learn from some amazing SLP's, both women and men. I have also had to work with SLP's who were, in my opinion, quite terrible. So how do you tell a good SLP from a bad SLP? It is not based on age (there are good SLPs who are young/old and bad SLP's who are young/old) and it is not based solely on experience either. Here's a few things that I look for when I receive/find/am looking for an SLP for my own two sons:
A good SLP usually exhibits most of these traits:
- Shows up on time so they can start the session on time.
- Is prepared.
- Uses various motivators for the session. They see it as their job to engage my child in the activities. You won't hear them saying "(your child) just wouldn't do anything today" but you might hear them say "I need to work on finding better motivators for your child". They feel the responsibility of how engaged your child was in the session falls on them, not your child.
- Is professional and drama free.
- Enjoys children and working with your child. Finds positive things about your child to share with you that you can both build on; even after a "hard" session.You would think that one would be obvious, but I once had a new SLP for the boys tell me the reasons she planned to never have children of her own, and all the reasons she didn't like kids. We didn't have her back...
- Is flexible and remembers she/he is there to provide you a service.
- Stays up to date on current therapy techniques by seeking out in-person learning opportunities.
- Knows what she doesn't know. There have been times when I have had a new client and I knew with extra training I would be able to stay ahead of my client and be able to provide a treatment with efficacy (good result), even though I did not have alot of experience with their diagnosis at the time of our first session. There were other times I was asked to see a client and after the first session with the parents I KNEW I was not the best therapist for that job. Speech pathology is a VAST field and it is just not possible to be truly versed in all the different therapies for all the different diagnoses. Even though there is a shortage of SLPs, If a new-to-you SLP tells you "I don't know enough about (diagnosis) to properly treat your child, they just did you a favor... ( and in my humble opinion, the areas of trachs, feeding, stuttering, cochlear implant, hearing loss, and augmentative communication all come to mind as areas when the therapist MUST have either good experience or excellent training (and still have a supervisor available to them if no experience) to adequately and safely provide therapy.
- will provide you with home program activities that you can do with your child until the next therapy session,because she knows that one hour of therapy once a week is not going to "fix" anything without parents doing the heavy lifting the other 6 days of the week. She lets you know at the beginning, the important role you play on your child's therapy team.
- Explains the "what" but also the "why" of what she is doing. For example: "we worked on blowing bubbles today so that (your child) can improve his lip rounding skills. We are doing this because lip rounding skills are necessary to make his /w/ sound correctly". There is a LOGICAL chain from the therapy activities she is doing to the end result wanting to be achieved.
- loves her job
- Starts sessions late or ends them early....habitually. Or cancels often. Progress cannot happen in therapy unless attendance to therapy is consistent.
- sees the session as just her job, not as her job to provide a service to you,and definitely not as a calling.
- lacks enthusiasm. Is there animation to her voice? is she actively trying to engage your child?
- does not seek out opportunities to improve her knowledge base or therapy techniques. I see this more often in older SLPS than younger. Some have done the same techniques for 20 years and call it experience. Whose to say that is the best technique for your child? If all the cont. ed is done online instead of seeking out opportunities to network and improve skills via in person trainings, that can (but not always) serve as a red flag.
- Cannot properly tell you the what or why of the activities she is doing in therapy (see #9 in the good SLP list above). I fired an SLP last year because every time I asked her what she was doing with the boys she said "play therapy". When I dug deeper for specifics, i.e what end results was she working on achieving with these play activities, she couldn't provide an answer because she simply didn't have a knowledge base. As it turns out, she was still working on her Masters Degree , i.e. still in school, but had been hired by the agency anyway due to the severe SLP shortage we have here. I don't mind a young SLP, I find they often make up in enthusiasm what they lack in experience; this therapist had neither.
- Does the same thing. every single session. without variation. "automatic pilot". Therapy is a dynamic process, not a static one.
- Is unable to see a child's negative behaviours as challenges within a diagnosis that she must find the way to overcome/resolve. It is the SLP's job to work through your child's behaviours to find what works for your child. That is what they are trained to do. They may need to have you be more involved in the session if behaviours are exceedingly difficult but telling you "little Johnny did "x" so we got nothing accomplished" is just so not okay.
- Offers no home program or ideas for you. She leaves and speech/lang. stops until the therapy session the following week.
- Doesn't know what she doesn't know because she/he is too busy thinking they know everything. As I write this one, two different therapists I worked with in my career come to mind. One was young and one was old. The young one knew EVERYTHING. She would volunteer for to perform evaluations and then when it was obvious she had no idea how to do them, I would get called off of another floor of the hospital to take over the evaluation, mid way through. This made everyone look bad. The older one would tell you black was white in order to not have to agree with a therapy technique you were suggesting. A good therapist wants what is best for the patient, and doesn't let their pride stand in the way of the patient getting it.
- May actually be a good SLP but is just suffering burn-out, or may be going through a temporary personal situation that is keeping them from being their best.
RE: Young SLP's. Some of the best SLP's my sons have ever had were rookies. Likewise, Some of the worst SLP's I've ever worked with were rookies. Look for a solid knowledge base (like a general practitioner...they may not have a specialization yet but still a good knowledge base) who is enthusiastic and willing to learn more about your particular child's diagnosis, speech device, etc. Are they willing to do continuing education or trainings? Do they have in enthusiasm (one "E") what they lack in the other "E" (experience)? If so, they are probably a "keeper". If they are lacking both the E's, best to keep looking for one that will be a better fit for your family.
RE: Older SLPs. Again, look for an SLP who is versed in the type of speech/language therapy your child needs, a willingness to learn (or at least not be afraid of) new technology, and an energy level that matches your child. Are they doing their cont. ed online or going out and learning about the latest treatments and techniques? You want to try and avoid an SLP who has been doing something the same way, wrong even, for 20 years and calling it experience.
Also, if there is a problem, the problem may be the time of day and not your therapist. I find that therapy with my boys works best when it is a good time of day for them and the SLP. The boys work best with therapists in the mornings usually, as they are less tired and anxious to "do their good work". My boys are also challenging therapy patients due to their diagnosis and behaviours, so I find that morning therapies, with an SLP who is not already tired from a day of seeing clients works best in that regard as well. When I was working full-time, I always tried to schedule my harder therapies at the beginning of the week when I was more fresh from a weekend of rest; scheduling my easier therapy clients towards the end of the week when I was apt to be more tired.
There is an extreme shortage of SLP's in some areas. You will have to decide, especially if you have been on a waiting list for a long time, if you think you really need a different SLP for your family, as that will probably mean being put back on the waiting list. When I start a new therapist with my boys, I always tell them, as the parent, "The boys have had lots of therapists over the years. I have found it works best to have you work with them for a month and then let us reconvene. Then you can tell me if you think you are a good fit for them and if our family is a good fit for you and vice versa". I find this allows both the parents and the therapists (OT, PT, and SLP) a gracious "out" if either party feels the boys therapy needs are not a good fit for their skill set (or patience set).
Most of the SLPs you are going to encounter love their job. Most of them are very good (you have to complete a Master's degree to be an SLP, unlike OT's and PT's which only require Bachelor's degrees) and most of them became pediatric SLP's in the first place because they love kids and want to serve families in a "giving' profession. I hope this post has given you some insight to some of the things to look for when your child is participating in speech therapy. I look forward to your comments. I also need to disclose that this post was written for information purposes only and does not, in any way, constitute the giving or recieving of medical advice.