The Invisible Cause of Burnout

Whether working in a school or consulting to one, there is one message echoed by service providers across every building I walk into: there is not enough time in the day.

It is true. Our time is valuable, limited, and legally mandated.

As a consultant, I have reviewed thousands of IEPs, including service delivery grids and goals, and I have interviewed hundreds of providers and school administrators. A theme started to emerge slowly, and then so blatantly that I could no longer unsee it.

Our misunderstanding of indirect services drains our time, and the boundary around them is often nonexistent.

Let me explain what I mean through a case study, using fictitious names and altered details, but based on a true person.

A talented speech therapist confided in me about how burned out she felt. Her student had significant needs and was in a room learning through DTT. She saw the student three times a week for thirty minutes outside the classroom and had 120 total minutes of consultation time on the grid each month, divided between her, the BCBA, and parent training. She was updating AAC devices regularly, responding to behaviors, creating materials, and planning for all of her students. She didn't feel like she had enough time, and the two hours per month, per student, was catching up. She didn't feel as if she was making progress within her sessions, and she didn't feel like she was making a difference anymore, even though she poured notable energy into her students.

She is not the exception. This is often the rule when it comes to school-based related services.

In fact, low retention among school-based SLPs is a recognized and growing problem, with workload manageability, role ambiguity, and limited time for paperwork and lesson planning identified as key drivers (Marante, Hall-Mills, & Farquharson, 2023). The same study found that many SLPs report planning to leave their school positions within three years specifically because of stress and burnout. ASHA's 2024 Schools Survey backs this up: the median actual caseload size is 50 students, while the median manageable caseload SLPs identify is 40, and a meaningful share of clinicians report regularly working more than the standard work week to keep up.

The misconception

A-grid services have come to mean one thing in practice: a meeting separate from students in which two or more people meet to talk.

These meetings rarely function like their general education counterparts, where teams review data or common-plan from a shared assessment. Special education consult meetings are typically a place to discuss problems that arise with certain students. They depend on the relationship between the people in the room, and they rarely have an end date or a data-backed method to demonstrate that the consultation is producing meaningful student progress.

What happens as a result is that providers must make up time elsewhere to do the other part of their job that is also indirect: planning sessions, taking and interpreting data, creating materials, observing students in various settings, observing teachers to ensure accommodations are used as written, coaching staff in the moment, emailing parents, and coordinating with outside providers.

This invisible work is substantial. ASHA explicitly names these activities as core indirect work: the design, maintenance, programming, and staff training for augmentative communication systems are vital work activities if students are to learn to communicate across school and other environments. The 2024 ASHA Schools Survey suggests that the median school-based SLP spends roughly a quarter to a third of the work week on paperwork and other non-direct activities — and that's before AAC programming, coaching, and material creation are layered on top.

This is the invisible cause of burnout. When consultation is viewed and carried out only as meetings, and those meetings do not center measurable outcomes and action plans, valuable time is consumed that could have directly supported student progress.

Why this also threatens our job security

The invisible work also impacts our advocacy. When we don't accurately report indirect time on our service delivery grid, then everything we do beyond the grid is just that… extra. It is hard to walk into a conversation with administrators and ask for more FTE when we are choosing not to reflect the amount of time we actually need to spend with each student, and are actively choosing to use the indirect minutes we do have on meetings away from students.

When an SLP has zero consultation minutes on the grid, that reads to me like the SLP is doing nothing indirect for that student. But that's not actually possible. ASHA's own implementation guidance is clear: SLPs should consider all of the time that they spend on behalf of students and should make certain that this time is reflected in service plans and IEPs.

Consider what counts:

• Annual meetings, progress meetings, evaluation meetings. Indirect minutes.
• Writing a student's IEP or progress notes. Indirect minutes.
• Prepping for that student's sessions. Indirect minutes.
• Meeting to help scaffold a lesson for a teacher. Indirect minutes.
• Programming a new core word set onto an AAC device. Indirect minutes.

All of these minutes are indirect services tied to a student's success. When we conflate A-grid with consultation meetings only, we then spend extra time discussing problems that aren't rooted in solutions, and we erase the rest of the indirect work from view entirely.

My solution

If you believe a team consultation away from a student is needed, attach a shared goal to it. Plan a scope and sequence with learning objectives that build capacity. Each provider shares their data and outcomes (this could be done asynchronously too). Parent training should be tied to a specific goal that supports in-school success, so we know when we have reached our outcome and can fade out.

Have your IEPs reflect your time.If a student requires more indirect time to prepare — like updated AAC devices — document that time in the service delivery grid and specify it in additional information. Count those minutes. What happens if you don't update the device? The student does not have the language available to access their day. That is not extra. That isthe work, and if the answer to “What if I didn't do this?” is “My student doesn't make progress,” then it deserves to be represented in the service delivery grid.

Speak up. If you have a team consult that is not grounded in data sharing, goals, or an outcome, propose changing it. Look at your IEP. Does it specify that the consult must be the whole group and must be away from the student, or could you do something else? Such as observe in the classroom, share data asynchronously, or co-treat for the sake of learning from one another. If the IEP language requires a specific format, talk to your team about updating it.

The pattern is clear. We create our service delivery plan without reflecting the work we actually put in. We do it the way it has always been done. Then we feel burnt out, because there are only so many hours in the day.

The good news: we are all capable of learning and growing.

It's time to team up and start working toward our shared goal: student success.