Survey 001: Strengths and Weaknesses of the Profession

Who took the survey:

Professional status:

• 90% speech-language pathologist (SLP)
• 6% clinical fellow (CF)
• 1% student 1% SLPA
• 1% other
• <1% audiologist

See how these numbers compare to ASHA’s data on SLPs by setting

Setting:

• 40.9% education
• 28.9% healthcare
• 14.9% private practice
• 4.9% college/univerisity
• 4% business owner
• 6.3% other
• .1% prefer not to say

The profession of speech-language pathology is predominantly white (91.3%). Respondents overwhelmingly considered this racial distribution to be a weakness of the profession, with older respondents and those who self-identified as white skewing less toward weakness.

In fact, of all the questions in the survey, this was the question with the most people rating it as a “significant weakness,” and for that reason, we’re covering it as our first topic.

Below is an overview of participant profiles and demographic characteristics examined, to see what may be skewing the data.

Quotes from survey respondents

“People who hold positions of power in our field and in SLP programs are biased. There are not enough folks in higher education to properly represent the diversity needed in our field. The folks in supervisory roles have yet to dismantle their own implicit biases, and they pass that onto clinicians of color. It feels as if the system is so broken. I am a new grad, and after going through so much academic trauma from a top-rated program in the nation, I am in intense therapy to recover. I am just trying to keep my head above the water. I thought I was the one of the few people who’ve experienced this, but I’ve connected with other clinicians of color who have a SHARED lived experience that I have. How do we expect to have clinicians of color join our field, put them through trauma, and expect them to thrive when the advertisement does not match the expectation?”

“Low pay, poor advocacy from ASHA, lots of scam and unscrupulous business practices in private clinics, universities have an implicit bias with their hiring of professors (white women) as well as admittance of the students (white women) which leads to racist and harmful practices towards students of other races and genders.”

“ASHA does not seem to take the need for greater diversity seriously and seems to do quite a bit to gatekeep.”

“BIAS!! Constant talk of needing more diversity with no real solutions.”

“Obviously the whiteness is an issue.”

“Lack of diversity, lack of appreciation/respect for clinicians who come from diverse backgrounds, bilingual clinicians expected to do double the work with no additional pay, this field is extremely classist and lacks diversity and cultural responsiveness”

“The main weakness right now is the field focusing on equity and diversity over competence. It’s turning me off and making me want to not be a member of ASHA. We need to go back to focusing on competence.”

“ASHA has demonstrated poor ability to follow through on their mission statements, and to make statements and take a stand on issues that matter. They have been tone deaf and wishy-washy at best, and persecutory and concealing at worst. We have a lot of work to do to honor and increase diversity in all areas (race, gender, sexuality, ability and other-ability, and more). We need to promote the field as an option for young people thinking about careers, so that we can increase diversity and serve our diverse populations better.” 

“Gender, race, and cultural homogeneity (are weaknesses in our field)–with those with the most power in the field usually being older whites women with higher SES”

“Universities have an implicit bias with their hiring of professors (white women) as well as admittance of the students (white women) which leads to racist and harmful practices towards students of other races and genders.” 

“Our diversity as a field is a significant weakness, especially for those of us working in the schools. The lack of clear guidelines from ASHA on inclusivity and how to accommodate for diversity in assessment of people of other races/cultures/dialects is upsetting.” 

“Lack of diversity amongst the clinicians, lack of cultural awareness, lack of transparency from ASHA, lack of efforts for diversifying from ASHA, nepotism within the field. It’s a very long list and this is a very small space.” 

.97% of our sample are female (typed in female, woman, or F)

Full data set:

• 6382 female
• 126 male
• 37 nonbinary
• 5 agender
• 5 trans
• 3 genderfluid
• 2 genderqueer

Note that the categories include implied synonyms– e.g. female category also includes people who typed in “woman.”

Most respondents think lack of gender diversity in our field is a mild to significant weakness. As we continue to release data over the upcoming weeks, you’ll find that while people definitely think gender diversity is a weakness of our field, it doesn’t have as high of numbers of people rating it a moderate to significant weakness as some of the other questions do. 

Notably, more people thought that being 95.6% female was less of an issue than being 91.3% white.

The most notable demographic skewing the data in this question is gender. Of the 120 people who reported male in the survey, 17% said it’s a mild weakness, 27% said moderate weakness, 47% said it’s a significant weakness, and 9% said it’s not important or other. That is, more males rated this as a “significant weakness” of the field compared to the cohort.

Quote from survey respondents:

Given the relatively high education requirement (masters), for the relatively low return (low salary- I make $61K in healthcare), it seems to me that this discrepancy would make it hard to increase diversity of socioeconomic status. 

The continued ableism and audism our field continues to demonstrate, the mental trauma that we leave on patients!  The a weakness would be that our profession needs more SLPs of diverse backgrounds! But!!!!!! It is not accesible as those Students tend to be first gen and from a low socioeconomic status. Going to a master program to re-take the clases already taken in undergrad is ridiculous! Also becoming an SLPA the field makes it so difficult! No wonder why there are not enough SLPs and not enough SLPs of color 

We have to infiltrate ASHA in order to unionize. A weakness in our field is that most SLPs/auds come from affluent backgrounds and are unaffected by socioeconomic income gaps. As Medicare and public funding for schools decline, our labor conditions will worsen. I hope the focus remains on fair labor and safe working conditions. 

Of all the questions’ data (we’re about halfway through them all!) there were two questions that yielded the strongest skewed “weakness” responses of any of the questions: 

• racial and ethnic diversity
• stress

The overwhelming majority of people in our field think that an above average stress level is a “significant weakness” of our profession.

We examined participant demographics closely, and found that age didn’t seem to matter much– even the more seasoned SLPs in our field rated this as a significant problem. Groups that tended to rate this as a “significant weakness” in lower numbers included: SLPDs, PhDs, and men.

Men also rated stress as a “significant weakness” in lower numbers 

• DATA: 65% of men rated it a significant weakness, 24% of men rated it a moderate weakness, and 11% rated it a mild weakness or lower.

Quotes from respondents:

Of note: The word “caseload” was mentioned 424 times in the open comment section.

Ableism, “saviorism,” lack of representation/support for disabled and ND SLPs, not enough advocacy/pushback on absurd productivity requirements and caseload sizes, general PR problems.

Caseloads are too large. Productivity requirements too high to provide quality therapy.

A lack of support for caseload management and caring for SLP’s quality of life. Our salaries are poor compared t the amount of work we’re required to do. I work nights and weekends without additional pay.

Absolutely that the caseloads, especially in the school setting, are unacceptable. ASHA needs to do more for SLPs and our field to advocate and demand for more reasonable caseload sizes and work load.

Addressing the exploding caseload numbers and paperwork demands in the schools. The workload approach that ASHA recommends is not accepted by school administrators, the school environment for SLP’s is highly stressful and many therapists are burnt out.

Advocacy for manageable & ethical caseloads across settings!!!!

Advocating for school based slps who often have to give up their personal time for required professional meetings (ie, after school IEP mtgs), and high caseload expectations

Already stayed the stress level is high and we are expected to be an expert in so many aspects of our job including AAC. Not enough hours in the day to do all we need to do at the public school. We are also expected to maintain out caseload cap (55in my district) when we have students with AAC needs.

ASHA has yet to eliminate the ; from the Medicare rules which binds SLP to PT. It has also not addressed the # of kiddos that we can have on caseload in the schools.

ASHA’s advocacy for school SLPs is a significant weakness right now. School SLPs are DROWNING and BURNING OUT. ASHA needs to advocate for a weighted caseload vs. just a number. We all know that having a student with an AAC device, or a student with significant autism, etc. add more to the SLP’s workload than a single sound error child. Pay for SLPs in the schools is also a significant weakness. It is very frustrating to work alongside a COTA who has less education and training and he/she makes more than I do with 27 years of experience!

Of all the topics we asked about, this is the only question that had an overwhelming strength trend. Meaning– most of you thought collegiality is a strength of our field! 

Groups that differed from each other in response rates were white vs non-white SLPs and SLPs by setting. With non-white and healthcare SLPs rating collegiality as a weakness of the profession in higher numbers; and white and school-based SLPs rating collegiality as a strength of our profession in higher numbers.

This set of data covers four questions. And for that reason, only some of it is in this Instagram post! Make sure to visit slpdatainitiative.com for the rest, to observe trends like:

• 83% of people think our salaries in general are a weakness; 11% find it a strength.
• People were approximately 10% more likely to rate a salary question as a significant weakness when it’s their own salary– meaning, healthcare SLPs rating healthcare salaries, University professors rating University salaries, etc.
• Across all respondents, SLPs in general tend to think the lowest-paid annual setting (school-based SLPs) are a moderate to significant weakness in higher numbers.
• Non-white people labeled all three salary questions as a “significant weakness” more often than white people; whereas white people labeled it a “mild weakness” in higher numbers.

Quotes from respondents (copied verbatim):

Concerning salary: In an educative cooperative, monies to pay salaries comes from school districts’ special ed. funds so there is no money for salaries.

SALARY. An appropriate salary for our level of education in this economic climate should be easily more than 100k a year. Caseloads are far too big and schools can’t find enough SLPs partially because why would anyone stay in this profession to make little money for a whole lot of stress.

Salary/hourly rates are not commensurate to amount of money invested in graduate degree.

We are not compensated for the work we are doing. There is no reason that OT and PT in the medical setting should be making more than we do. I should not be able to be a manager at Taco Bell with no experience and make more than what I do in a hospital with a masters degree. The cost of grad school is too high. I got a raise of 1.50 an hour for the first time in 8 years while OT got a 3 dollar raise and PT 3.75 it’s ridiculous. We need advocacy and awareness and to be compensated for the work we do. The absolute price gouging of a masters degree. The absolute inability of ASHA to ever have a clinician focused assistance while they condemn some so publically but have others with multiple complaints against their license never touched. ASHA charges astronomical amounts and we are beholden to them to have our ccc. PT and OT don’t have near the dies we play and they don’t pay them as often- they also gain access to research with their dues while ours are gate kept for more money. The disparity between what Asha workers make and what a clinician makes is a scam.

We make very little money in the educational system. Paid as a teacher but wants us to bill as a medical professional, and restrict eligibility to educational relevance.

Employment in our field has been increasingly overtaken by rehab companies and contract companies that typically do not pay the SLPs fair wages or adequate benefits. These greedy companies are making significant money off the SLPs by demanding high productivity rates while providing horrible benefits. The majority of teletherapy companies are paying the SLPs on a 1099. These educational teletherapy companies are insistent on the SLPs scheduling group sessions resulting in SLPs having high caseloads but often are only paid for four or five hours of work per day. The educational contract companies often do not pay comparable wages or benefits that the school districts they are contracted with provide to their teachers. I am sad for the direction this field is headed. Productivity rates and 1099 pay has both escalated in the last 10-15 years. There are quality school districts and medical providers that continue to pay well and treat employees professionally but many SLPs do not have access to employment with these companies. I do not know what the answer is but I do know that in my geographic area, there are not enough job choices for SLPs resulting in many SLPs taking teletherapy jobs out of necessity.

For the amount of money that is paid being a ASHA CCC holder is a joke. ASHA does not advocate for our best interests as a professional body. Honestly where does the money go? We are at the body of the totem pole on when it comes to respect as a therapeutic profession.

Give a majority femal profession we are allowing ourselves to be overworked and underpaid and ASHA just takes out money and provides us with Nothing. Why are SPS being paid less by insurance companies than other fields that provide TX?

I don’t make enough money to justify how much student loan debt it took to get me here.

Lack of ASHA standing up to protect SLPs from money hungry companies who only seek to bill Medicare and are not patient-centered.

Lack of diversity, Low salary for the amount of schooling, no advocacy for better working conditions, no unions, absolute ridiculous amount of paperwork in the schools keeping us from actually doing our jobs of helping kids, little public understanding of what we do, difficult to access research without paying a lot of money, large caseloads.

Large amount of time and money required for school with inadequate pay.

Salary, ASHA does not do anything to help the profession but takes so much money every year, extreme caseloads, no advocacy from ASHA, ASHA does not seem to care about service providers in the schools, low salary growth during a time of historic inflation.

We had three questions on education, covering both graduate education and practice education (continuing ed).

You’ll see a fair amount of variability in the graphs, above. There were also two notable trends we pulled out in cross-tabs analyses:

• 10% more non-white people (compared to white) thought that the CAA’s ability to follow through with ensuring graduate education excellence was a weakness in our field.
• Very different trends on strength vs weakness determinations per degree type, with more PhDs labeling “Excellence in graduate education” a strength, and more MA/MS  and SLPDs labeling it a weakness.