The Practical SLP:
Middle School
A Guide to the roles and
responsibilities of the Middle
School Speech Language
Pathologist
Forward
The following power point is based almost solely on my 20 years of experience as a Speech
Language Pathologist. I have spent the last 11 years working as a Middle School Speech Language
Pathologist. I know what my role is in my student’s education. However, I never felt the
administration, teachers, support staff and parents understood what I do. In some school
systems, the speech language pathologist is just considered an articulation expert. We are much
more than that. Parents and professionals often view us as the “speech teacher”. I have to admit
that I have perpetuated this by referring to my self as the “speech teacher” (a throw back from
my preschool days) or telling the kids it is “time for speech”. Our own professional group has
given us a confusing name “Speech Language Pathologist”. Often shortened to Speech Pathologist.
A pathologist that does therapy. The only pathologist most people know is a medical examiner.
Our official title change actually occurred during my career. It is no wonder that there is often
confusion as to what is the role of the speech language pathologist, the name alone is semantically
confusing. Fortunately, teachers and parents usually only have to sit through one team meeting
with us to realize we are not just experts in articulation but in language and communication as
well.
In my community, the first wave of integrated preschoolers graduated from high school, class
of 2004. These students were successfully integrated into their local public school through out
their school career. This happened in schools all over the country. Specialized programs and
special education services increased drastically within the public school system during that time.
The public school speech language pathologist’s caseloads grew and evolved to accommodate these
students. A public school therapist was no longer working on only vocabulary, grammar and
articulation. These students varied in their needs from mild language learning disabilities to
severe physical and mental impairments. Along with this trend in public education, parents
awareness of their children's special needs and their power to advocate for them grew. Both
these factors effected the growth of the Speech Language Pathologists caseload.
 forward cont.
We all know that middle school is a time of transition for students. Expectations for the older
student increase and school becomes more challenging. This is no different with
language/learning disabled students. By middle school most goals and objectives written by a
speech language pathologist will focus on higher-level language needs not just articulation or
When referring to language needs at the
middle school level we are talking about teaching the skills
needed to make students proficient listeners, speakers,
writers, communicators and social beings.
basic grammatical usage.
I hope you find this power point helpful and informative.
Teresa Sadowski MA/SLP-ccc
AKA The Speech Teacher
What does the Middle School
Speech Language Pathologist Do?
This power point will help to answer the following questions
 What are the common areas of language the speech pathologist
addresses?
 What does the typical middle school speech and language caseload
look like?
 What does the typical middle school speech and language student
look like?
 What is the best way to service the middle school speech and
language student? In class or pull out
 How does a student qualify to receive speech and language
therapy?
 Does the middle school speech pathologist address articulation?
 When is a student ready to be discharged from therapy?
 When should a student be referred for a Speech and Language
evaluation?
Some of the common areas of language
the Speech Language Pathologist might
address at the Middle School level are:
auditory perceptual abilities (memory, comprehension etc..)
organization of language
understanding of word relationships
awareness and understanding of language needs
higher-level vocabulary
word retrieval
understanding of ambiguous language
understanding of figurative language
pragmatic/social speech skills
expanding language
problem solving, reasoning, drawing conclusions and making
inferences
 language difficulties due to hearing impairment
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The Typical Middle School Caseload
 Middle School caseloads have shown significant
growth in the past several years. Every school
system tends to deliver special need services
differently depending on their population.
Because of this, the speech language
pathologist’s caseloads can be extremely
diverse. Severely disabled students may be in a
separate program either within the public school
setting or in a separate facility. Those students
have extremely unique needs, which requires
even more of the speech pathologist’s time and
expertise.
Most Middle School Students on the
speech pathologists caseload will fall
into two specific categories
Language learning disabled students
Students with social pragmatic needs
Or a combination of both
The typical student on the Middle
School Speech and Language caseload
will probably:
 have a history of a language/learning disability from
early on
 be integrated into the regular classroom setting for
most of the day
 have received speech and language therapy through
out grade school
 require additional support by either a special needs
teacher or a teaching assistant through out the day.
 require other special services such as counseling
 demonstrate other academic and learning needs
How are Speech and Language
Services Delivered
There is no ideal service model at the
middle school level. The way the Middle
School Speech Language Pathologist
services students is extremely dependent
on the type of special needs program the
school provides, the type and size of the
caseload, individual student needs and
the therapist’s personal philosophy.
Servicing Students within the
Classroom Setting
Many speech language pathologists and scholars will insist that the curriculum
based co-teaching model is the only way to service middle school students
efficiently
 Cons
 Pros
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Curriculum based
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Working on class work relevant to the
student.
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Scheduling may be easier if several
children can be serviced at one time
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Can work on developing compensation
techniques within the classroom setting.
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During the course of a class there are fewer
opportunities to interact, in a therapeutic
manner with your student.
The co-teaching model requires significant
planning time with the classroom teacher and
a significant amount of time servicing the
student within the classroom setting. Unless
this is a full time proposition it is almost
impossible to co-teach effectively.
SLP’s who attempt co-teaching as an
alternative to direct therapy often fall into
the trap of becoming a “glorified teaching
assistant” rather that a therapist
May end up working on getting through class
work rather than focusing on goals
The last thing most middle schoolers want is
another adult hanging around them making
them feel different
Servicing Students with the
Traditional Pull out Model.
I prefer this model. A few other therapists and scholars also think this way.
 Pros
 The pull out method provides the
therapist a good chunk of time to
work directly on a specific language
skill
 With a little planning class work and
selected vocabulary can still be
worked on
 Small group settings can provide
structured social interactions for
students who need it
 Students are more likely to work on
improving specific weak skills if
they are in a private or semi-private
setting
 Work on specific skill development
has a better chance of transferring
to other settings.
 Cons
 Scheduling can be a nightmare. If
they are taken out of core classes
they might miss too much work. It is
very difficult for special needs
students to catch up on their work.
Coming out of small group settings,
specialists (art, gym, music etc) or
support periods may be a little easier.
However, specialists classes are fun,
provide a little relief from academics
and provide opportunities for social
interaction.
 Some students do not want to be
pulled out of class for any reason.
How does a Student Qualify to
Receive Direct Speech and Language
Services?
 Most schools systems require the student to go through a
pre-referral process to determine if specialized testing is
necessary.
 Speech and language testing is completed focusing on the
specific area of need and general receptive/expressive language
abilities.
 Testing will determine if the student exhibits a language based
learning disability.
 Other factors taken into account when determining a language
based disability include: classroom performance, other areas of
need and manner of performance during testing.
 Whether or not a student receives direct services is a team
decision with specific recommendations from the Speech
Language Pathologist.
Very few Middle School students
receive direct articulation therapy
 By middle school most articulation issues a student may have been
remediate
 A few students may continue to have difficulty with later developing
sounds such as s,z, and r. These are very difficult sounds to
remediate, especially for young children.
 Some children will present with a history of severe oral motor
dyspraxia and may continue to require specialized therapy.
 Many children are going through extensive orthodontia and articulation
therapy may be counter productive.
 To successfully remediate articulation at the middle school level the
student must be invested in therapy.
 Another consideration is whether or not articulation is effecting the
child’s classroom performance.
 Students who present with intelligibility issues to the extent that it
interferes with academic or social development may be candidates for
continued articulation therapy.
Discharge Criteria
A student should be discharged from Speech and Language
therapy when…..
 age level goals have been met
 evaluation results indicate that the student is within the average
range of functioning.
 the student has developed compensatory skills that are functional
in the deficit areas.
 the students deficit areas can be managed through classroom
modifications.
 the student has shown little or no response or gains from direct
speech and language therapy for the past school year
 the student has plateaued in the areas of development related to
speech and language treatment.
 a parent requests that speech and language services be
terminated.
 the students disorder is not considered amenable to remediation
at this time
 attendance is an issue
 the team decides that it would be in the child's best interest to
discontinue direct services.
When Should a Student be Referred
for a Speech and Language Evaluation?
 Most schools have a pre-referral process to determine if a speech and
language evaluation is warranted
 At the middle school level a student should be recommended for the
pre-referral process if concerns are raised in any of the following
speech and language areas.
 Trouble following directions
 Trouble understanding new concepts
 Hearing acuity
 Poor vocabulary skills
 Difficulty organizing language
 Using inappropriate word order or grammar
 Difficulty staying on topic
 Difficulty understanding simple word relationships
 Has a hard time understanding jokes
 Inability to reason
 Has difficulty interacting with peers or adults
If you have any questions or
concerns about a students speech or
language abilities…………Just Ask!
 It has been my experience that Speech Language Pathologists
love to talk and talk about what they do! So ask away.
 We also love to give our opinion.
 Seriously……… The Speech Language Pathologist can also offer
support to the general education curriculum as a consult
whenever necessary.
 The Speech Language Pathologists works with kids in a
therapeutic manner to remediate speech and language issues.
 The Speech Language Pathologist may offer suggestions from a
different perspective.
 I am always happy to help colleagues and parents by offering
any assistance around speech and language issues. So are most
Speech Language Pathologists.