EDU Healthcare Opportunities

Interview with Kathleen Whitmire, Ph.D., Director of School Services, ASHA

June 6, 2005

Beck:Hi Kathleen. Thanks for your time this morning.Whitmire:Hi Doug. Nice to be with you, thanks for the invitation.Beck:Kathleen, before we get to the topic at hand, would you please review a little bit about your professional positions, for the readers who may not be familiar with you?Whitmire:Su
Beck:Hi Kathleen. Thanks for your time this morning.

Whitmire:Hi Doug. Nice to be with you, thanks for the invitation.

Beck:Kathleen, before we get to the topic at hand, would you please review a little bit about your professional positions, for the readers who may not be familiar with you?

Whitmire:Sure, Doug. I was a school-based SLP for 14 years, working with students between ages 12 and 21 years. After that, I spent 7 years as a clinic supervisor and lecturer at Syracuse University. Then I went to the College of St. Rose in Albany, New York as an assistant professor and the department chair.

Beck:And where and when did you get your doctorate?

Whitmire:I earned two master's degrees and my PhD at the University of Rochester, and I finished in 1994.

Beck:Thanks Kathleen. What was your dissertation on?

Whitmire:It was about adults who stutter, and their perceptions and beliefs about how others viewed them. However, right up to the point where I had to choose a topic, I was involved with children and learning disabilities.

Beck:Thanks Kathleen. If I were an SLP, I would've done the same thing! Stuttering has always fascinated me, and I still think it is still terrifically elusive. OK then, moving to the topic of the day...what can you tell me about the rather large "SLP caseloads" in the schools? Many of the SLPs I speak with tell me that is a terrifically significant issue for them.

Whitmire:You're exactly right. ASHA has collected data from surveys and focus groups for many years on this topic, and ASHA members who work in the schools have consistently indicated that caseload is one of their greatest concerns. An ASHA policy document was approved in 1993 that recommended a maximum caseload of 40 students in ideal situations. But data throughout the '90s indicated that the caseloads averaged 50 or more, and some ASHA members reported more than 100 children in their school practice. So about 3 years ago we assembled an ad hoc committee to address caseload size. That ad hoc committee developed a position statement, guidelines and a technical report on a "workload" approach to establishing caseload standards. The committee realized that setting a maximum number of cases was not in the best interest of our members or the students they serve. Often the maximum number was misconstrued as the workplace minimum. Also, it didn't reflect all of the many activities that SLPs engage in both with and on behalf of students in order to meet student needs, provide accepted standards of practice, meet federal and state mandates, and complete administrative duties. So, rather than addressing the number of students on a caseload, the ad hoc committee addressed workload. They looked at the individual needs of the students, the direct and indirect services needed to support those children, working conditions and other related factors. In other words, if you have 20 complicated kids, that could be a full caseload, and then again, someone might have 45 simple cases, and in a given situation, that too, could be an acceptable caseload.

Beck:I like the idea of addressing workload, because that's the reality the children, the teachers and the SLPs have to deal with.

Whitmire:Right, there are many factors that determine a reasonable caseload for an SLP. This workload approach to determining caseloads is clearly explained in documents and resources that are available on the ASHA website. I urge readers to obtain them; they're free and they are fantastic. We'll hyperlink to them at the end of this interview, if that's OK?

Beck:Yes, absolutely.

Whitmire:In addition to preparing these excellent policy documents, the ad hoc committee wanted to help members implement these changes, so they did a number of things. They gave presentations at three ASHA school conferences and three ASHA conventions, conducted a telephone seminar with web activities, and developed an implementation guide with a CD Rom that includes worksheets and an EXCEL spreadsheet. These tools can be used by SLPs to determine and document direct services, indirect services and administrative duties - in other words, the full range of activities that they engage in both with and on behalf of students. In addition, committee members trained a cadre of ASHA members to help with the many requests for presentations at the state and local levels They've worked very hard on spreading the word about this change in thinking from caseload to workload.

Beck:Have you seen an impact since making these tools available?

Whitmire:Yes. Since we've been providing these resources and tools, we've seen some encouraging changes. Members are reporting successes such as increases in staff positions, modifications to IEPs in order to include the full range of services provided to students, schedules that reflect activities both with and on behalf of students, references to workload in local teacher contracts as well as state guidelines, and even salary supplements to SLPs based on the documentation of their full workloads. One district (Portland, Oregon) even reported the elimination of persistent vacancies in the speech-language staff based on improved working conditions through the use of scheduling that allows for both direct and indirect services to students. These successes are all listed in a local workload activity table on ASHA's web site which we can list at the end of this article. The table includes contact information for SLPs who have implemented the workload approach, so interested readers can contact them for more information.

Beck:Very good. So in essence, members got the administrators away from the caseload model and refocused them on workload issues?

Whitmire:Yes. That's a good way to think of it.

Beck:And frankly, developments in caseloads and workloads may have even greater importance than meets the eye, as so many SLPs work in the schools.

Whitmire:Yes, that's correct. We have about 56 thousand ASHA SLPs working in the schools, so that's a significant number of professionals providing needed services to students. Also, we know that large caseloads impede student success, limit service delivery options, increase burnout, and are a significant factor in attrition. So rethinking caseload as workload is a critical component in student success, quality of services, and recruitment and retention of qualified personnel.

Beck:This all makes perfect sense to me and I am honored that you've shared this information with us today.

Whitmire:Thanks Doug. I am happy to work with you and I appreciate the opportunity to get the word out about our workload approach.


For more information on WORKLOAD issues visit

Local District Workload Chart

School Services Team

Workload Position Statement

Workload Technical Report

Workload Guidelines