So you want to be a Pediatric Speech Language Pathologist? Making Sense of (and Choosing) the Best Settings and Terms for You – Part Two of Two

(This article was adapted for ASHA from the the “PediaStaff New Graduate Guide” [PDF])

In my last article I reviewed some of the basic terminology that you need to know before starting your job search as a pediatric or school based SLP. We talked about ‘terms’ (‘direct hire’ vs. ‘contract’ and ‘travel’) as well as definitions of the different pediatric settings such as school-based, outpatient clinic, hospital or early intervention. The ‘term’ part isn’t too hard to decide if you sit down and make a list of your priorities. However, it is much more slippery for someone like me to suggest exactly which setting is best for you, because there are a variety of factors specific to your particular search that should have a far greater impact on your choice over just the setting. So we will chat more about those factors and other practical considerations, rather than the ‘pros and cons’ of each.

TERMS: Direct, Contract or Travel?

The advantages of direct hire placement often include opportunities for professional advancement. The size of the organization that you are joining will also determine whether and how quickly you can move into a supervisory role. Benefits may be better in a direct hire environment, especially with larger organizations. Generally school districts have excellent benefits; and although the pay is much lower for district employees vs. contracting, therapists with large families may find that the better benefits package outweighs the lower annual salary. Large hospital systems, as you might guess have better benefits than small privately run clinics, which might not offer any.

Travel or contract placement can be preferable for a therapist in several situations. For one, pay is generally much higher when contracting. If you are traveling in a state or city away from your permanent place of residence you may be eligible for tax-free per-diem to cover the costs of your housing and meals while working away from your primary residence. This can be a fantastic way of socking away some extra cash for later because the money that you are spending on your daily living is not taxed like it is when you are working at home. Traveling/contracting is also ideal if you are looking to explore new areas of the country for a while.

Depending on your personality, what your leadership potential is and the type of chemistry you are looking for will influence what type of direct hire position you should consider. Are you looking for a large team where you can share your experiences with peers on a daily basis and rise in the ranks to eventually manage, or are you looking for a tight knit group where you may have a chance to work with a wider variety of clients, with a range of populations and diagnoses.

Settings and the ‘Rest of the Story’!

So you say, “Ok, I understand the different terms. What can you tell me about the pros and cons of all of the different settings?” Well, for this one, the ‘devil is in the details.’ It is impossible to generalize (so I won’t even try) the advantages and disadvantages of one setting over another because every employment situation is going to be unique based on size, location, demographics of the client base, the clinical population, caseload, and most importantly the people who work there. The clinician with no roots and flexibility to move anywhere has the unique privilege of choosing his or her preferred setting in a vacuum, but most of us have to work within certain geographic parameters. If I live in a big city, I can’t work in a small country school house.

For most of us, it’s going to come down to the people. Do your homework. How often does the staff turnover? Are there long term employees you can talk to who can tell you why you should work there? What is the reputation of the company or organization? 99 times out of 100, the places that are ranked the best companies and organizations to work for get those rankings because of the people working there and the culture created by those people.

To be sure, there are also other practical considerations that will “trump” even the quality of the people. A new graduate in her Clinical Fellowship probably isn’t best served if she is working alone in home-health setting, even if the clinic with the contract is a wonderful employer. Better to work with babies in a hospital with someone who can mentor you first if you must work with babies.

On the travel/contract side, there are also practicalities that might fly in the face of what you might really want to do. The best candidate for a school-based, travel or contract position with peds is the SLP with his or her C’s. But just because you are experienced doesn’t mean the short-term jobs will be easy to find everywhere you might want to go. Competition for local short term pediatric positions can be fierce. Most hospitals, for example, will reward a current clinician who is working with adults in another part of their organization a temporary transfer to the pediatric unit before hiring someone from the outside. Additionally, would-be travelers to major cities must compete with local PRN pools. Short term openings in medical and home-based settings do exist, but the trick is finding the employer that will offer money for living and travel expenses. This is where working with a good agency that knows the ins and outs of the school and pediatrics market comes in.

And then, of course, there are the realities of being a new grad. If you are a new grad and need to complete your CFY you may be a bit more limited if you want to try contract or travel therapy, but the opportunities do exist if you know where to look. As you might imagine, it is fairly costly to bring on a CFY. So you will need to find an employer who a) will need you for the entire nine months; b) has the means and staff to supply you with supervision, and c) needs you badly enough to pay for your supervision despite the fact that they will essentially be training you to leave after the year is up. At PediaStaff, we place a large number of CFY’s in schools all over the country. The key is just knowing who has the critical need.

In Summary – Be Open Minded and Write it Down!

All this said, if you have a setting that you are particularly excited about, certainly check out all your options – but don’t get too emotionally attached to that choice, in case reality doesn’t jibe with your ideals for your ‘dream job.’ Sit down with pen and paper and answer questions that can help you prioritize which things will be most important to you. You might even call on a friend, loved one, or professional mentor to be a sounding board to help you answer questions like these:

  • How important are specifics about cash money and/or benefits?
  • Do you want to see the country or be closer to family and friends?
  • How much drive time or are you willing to have or are you willing to move across town?
  • How important are opportunities for advancement?
  • What is your ideal caseload size, population age and diagnosis?
  • What about the SLP staff? What is the quality of the supervision available if you need it? How about their experience and specialties?
  • Is it better to wait for a particular experience that I want later in my career in favor of something that needs to take higher priority in my current situation?

Remember too, much will depend on what job offers actually arrive on your table and whether you have the good fortune to have options. When you sit down and start to make your list of priorities, you will quickly realize that your choice will probably have a lot more to do with the people who are currently (and will be) in your life as well as the kinds of kids you want to treat, more than it will be about exactly what type of setting it is.

Happy searching and remember to stay relaxed and enjoy the journey!

Heidi Kay is one of the founding partners of PediaStaff and is the editor-in-chief of the PediaStaff New Graduate Guide [PDF], and the PediaStaff Blog, which delivers the latest news, articles, research updates, therapy ideas, and resources from the world of pediatric and school-based therapy. PediaStaff is a nationwide, niche oriented company focused on the placement and staffing of pediatric therapists including speech-language pathologists.