Reimagining School SLP: Collaboration, Tiers, And Sustainability

We trace a path from isolated pull-out therapy to a collaborative, tiered model that centres students and restores SLP sustainability. Through stories, strategies, and systems thinking, we show how shifting from caseload to workload builds capacity and real classroom impact.

• redefining the SLP role from expert to partner
• limits of pull-out therapy and missed authentic language
• practical collaboration moves that stick in classrooms
• MTSS tiers for universal, targeted, and intensive support
• workload weighting and honest scheduling
• collaborative referral pathways and “not yet” as a plan
• valuing prevention, coaching, and capacity building
• small steps to begin culture change and reduce burnout

Follow my podcast
You will hear inspirational and informative interviews
I will share exciting ways of thinking
I will guide you towards a more sensible, fun, creative and collaborative way of working

https://sarahdowlingschoolslpcoaching.com

Music: Daniel Chui

Transcript

From Expert To Partner

The Pull-Out Problem

Learning Collaboration In Real Schools

Finding A Tiered, Workload Model

Why Workload And Tiers Matter

Barriers, Permission, And Language For Change

Invitation And Next Steps

Sarah 0:02

Welcome to the Aligned SLP, a radical reimagining of school practice. I'm Sarah Dowling, and if you've ever felt like a clinical island in the middle of an educational ocean, you're in the right place. If you felt like you're working in two incompatible systems at once, if you feel in your gut that there's a better way, if you're drowning in referrals and wondering if you can survive your job, you're in the right place. This podcast is for school-based SLPs who are ready to challenge the invisible rules of our profession and the history that has trapped us. What if we stopped trying to be the experts and started being the partners? What if we ditched the caseload for a workload that actually lets us breathe? We're going to explore collaborative practice, multi-tiered systems of support, the difference between need and caseload, the 21st century ways of being, and how to make this work sustainable without sacrificing your soul. In this space, we'll reclaim your joy as a professional aligned with the education world. Let's get started. I remember a day in northern England. I was leaning over, talking with the young girl I was doing some speech language therapy work with, and I remember hearing beyond the wall the teacher and the other children playing, laughing, dressing up as characters, and I was there one on one with a student, and she was seeing some progress, but I knew that the environment I was creating, where we were doing one on one work and kind of just providing some clinical and medical advice for the teachers wasn't truly facilitating the best results that I'd always truly hoped for as a speech and language therapist. And I felt completely isolated. Not just me, the child was isolated too. We were in our own little bubble, removed from all those rich communication opportunities happening just beyond the wall. And I felt completely uncomfortable with this sinking feeling that what I was doing wasn't really working. I was missing all those authentic communication moments, the story time, the negotiations, the turn taking, the language happening in the classroom. I was watching them from the outside. I was trained in the medical model. Pull the kid out, do the therapy, report back to the teacher. That's how it was supposed to work. But something inside me was screaming that this wasn't right. So I had this growing desire to create an environment where students weren't isolated from their learning context, where speech and language support wasn't something that happened over there in the therapy room, but something that was woven into the fabric of the classroom, or at least supported it. And I remember wanting to work more closely with the teachers to support our students. And that discomfort, that feeling of being in the wrong place, doing the wrong thing, became the catalyst. I decided I couldn't stay in that environment. I had to find a place where I could work differently. So I moved into a role at a different specialist school, and honestly, it was like doing a master's degree in school based practice. I was there for six and a half years, and it completely transformed how I worked. In this new environment, I had the most amazing colleagues and a speech and language therapist, an educational assistant, and a teacher in every classroom. Doesn't that sound like the dream setup? And in many ways it was, but even there we had to constantly navigate the tension between the curriculum and the communication needs. The curriculum was everything. Our speech and language work had to ride on the back of it. And that's where I learned to truly collaborate, not in a perfect, friction free environment, but in a real one. I learned to observe and ask teachers how they worked before I ever suggested anything. I learned to add one thing to what they were already doing, not take over their curriculum plans. I learned to frame everything as an offer, a conversation, not a directive. We even did some joint curriculum planning. Each teacher, SLT, and assistant colleague had taught me new ways of working. I experienced difficulties that made me vow never to work like that. By the time I left, that co-creation, experimentation, and discussion had opened my mind and heart up to the way forward. Working in collaboration with teachers was the key to delivering excellent speech, language, and communication outcomes and services in schools. I kept on learning in the UK, and then later in my career I moved to Canada, to Prince George, British Columbia. I had found a district that had already built an excellent system, a tiered, problem-solving collaborative model. And it continued to develop into a weighted workload approach within a multi-tiered system of support framework. And I continued to evolve and develop with it. So over those years I pushed the boundaries of what was possible. I saw SLPs who were busy but weren't drowning. I saw schools where teachers saw us as partners, not a pull-out service. I saw students getting support at the right tier, at the right time. We shared responsibility. It wasn't perfect. I wasn't perfect, but it made so much more sense. I'd rather fight for change in this system in which I could see a positive future. And I received feedback like this from my colleague Andrew, who said in his speech at my retirement, Whenever I think of a challenging situation that I had involving a student with autism or complex behavioral diagnosis or speech, I see Sarah right there beside me. Sarah was always there to lend a collaborative ear and a sensible and thoughtful interpretation and way forward that always put the student first, being knowledgeable, kind, and steadfast in her resolve to provide service for her clients and to build capacity for others to take a similar approach. And some of the ways that Sarah will leave a lasting impression on those she has worked with, students and staff alike. So hey, I want you to get compliments like that too. So here's what I learned and what I want to share with you that the workload approach, built on collaboration, shared responsibility, and a tiered support within a multi-tiered system of support framework is the most effective way to create a sustainable, impactful, school-based speech language pathology service. It's not just about counting students differently, it's about fundamentally shifting how we see our role. So from an isolated service provider to a collaborative partner, from measuring our worth with high caseload numbers to recognizing the full scope of our contribution, such as tier one classroom prevention, tier two coaching, tier three direct support, and collaboration, capacity building. When we make referral decisions collaboratively with school teams, not yet becomes a clinical judgment, not a rejection. And when we weight students by complexity, we're honest about the reality of our work. When we value all our professional activities, not just direct therapy, we reclaim our sustainability. And this isn't about working harder, it's about working smarter. And it's more aligned with how humans actually learn and how schools actually function. So why does this matter to you right now? Well, because I know many of you are sitting where I was. You're drowning in referrals, you're making prioritization decisions alone and carrying all the guilt when you have to say no. You're working in a model that treats every student the same, regardless of complexity. You're burning out, trying to be everything to everyone, and you know, just like I knew, that there has to be a better way. The barriers you're facing aren't about your competency. They're about systems. They're about having permission to work differently. They're about having the frameworks and language to advocate for a sustainable model. That's why the ideas I will share are crucial because they give you a way forward. They give you a framework for shifting from caseload to workload thinking. They give you the tools to build collaborative referral processes. They give you permission to value tier one and tier two work as legitimate SLP practice. And most importantly, these ideas allow you to breathe again, to love your job again, to feel like a valued partner instead of an isolated service provider barely keeping their head above water. So here's my invitation to you. Follow my podcast. You will hear inspirational and informative interviews. I will share exciting ways of thinking. I will guide you towards a more sensible, fun, creative and collaborative way of working. You don't need to change everything overnight, you just need to start somewhere. Because the journey from isolation to collaboration, from burnout to sustainability, from being overwhelmed to feeling aligned, it starts with just hope opening your mind and heart to a new way of working. So, I'll see you in the next episode.