‘We’re Everywhere Now’: How a Speech Language Pathologist Has Seen Her Work Evolve

Debi Ryan insists that bad days are few and far between in her line of work as a school-based speech language pathologist.

The good days, she says, are abundant — thanks in great part to her ongoing enthusiasm for and belief in the power of communication in the lives of children and adults.

She calls her job “soul-filling,” and she has anecdotes to back it up.

Ryan has worked in a public school setting for about two decades, following a stint in the medical track of speech language pathology.

Over the years, she says, public awareness of her role has improved. When she started out, few people knew what her work entailed. Today, though, many know not only what a speech language pathologist does, but often, they know a loved one who has been helped by one too.

“When I was in school,” Ryan recalled, “we had one speech pathologist. No one really even knew who she was. The kids would go to her in her special little office and come back with a sticker. She wasn't involved in the day-to-day educational interventions like we are.”

Ryan is part of a team of 26 speech language pathologists at Huntley Community School District 158 in Algonquin, Illinois, which serves around 8,000 students.

“We're everywhere now,” she says of those in the profession. “You can't separate what we do from a student's academic success.”

In our Role Call series, we meet and feature staff who are integral to their school community but not always visible. For this installment, we spoke with Debi Ryan.

The following interview has been lightly edited and condensed.

EdSurge: How did you get here? What brought you to the role that you're in today?

Debi Ryan: It's a great story. I love this story. I am a proud Northern Illinois University graduate, both undergrad and graduate. Go Huskies! Originally I entered the university as an accounting major — which, for anyone who knows me, that's pretty hard to believe — and NIU was known for their business school. So I embraced that and thought that would be the perfect path until I took some accounting classes and realized that really wasn't my chosen path. I was talking to many people at that time, and I had a sorority sister in this program called communicative disorders, and that was completely foreign to me. I had no idea what it was, but the more I spoke with her and asked her questions, I thought, ‘That sounds pretty cool.’

So I took an introduction to communicative disorders class, and I fell in love with it. I embraced it. I continued on to my graduate degree at NIU. It was not an easy decision to make, because as a speech language pathologist, you have to get your master's. So that's a commitment of two very extensive, stressful years. But I have no regrets. I am one of those lucky individuals that loves her profession.

Upon graduation from graduate school, I went into the medical track of speech language pathology. As a licensed speech language pathologist, we can work in multiple settings, medically based or educationally based. So I started my career working in a hospital in acute care and adult rehabilitation. I eventually transitioned to pediatrics in the form of outpatient clinics. Then, as the years unfolded, I was blessed to have three beautiful daughters, and with them coming into my world and them starting school, I decided to transition into the educational setting to match their calendars and have better work-life balance. And I've been here ever since and absolutely love it.

What does it look like for you to have been in a pediatric outpatient setting versus in a school?

It's interesting. In the medical setting, you get more parent contact because they're the ones bringing the patient to the clinic, whereas in the schools, you get more interdisciplinary contact and less with the parents. That has to be more intentional through emails, meetings, IEPs, things of that nature.

The goals are also unique in the public school system. There has to be academic impact in order to qualify for speech language pathology services. So we have to show that any need that we identify is impacting a student’s academic success. Whereas in the medical side, we're looking more at medical necessity. So we may generate our paperwork differently, our goals may look somewhat different. But all that to say, there's actually wonderful collaboration oftentimes between the educational setting and the medical setting to really treat the child as a whole as much as we can.

When people outside of school ask you what you do, how do you describe your work?

I actually love this question so much because I've been in this profession for decades, and this has changed dramatically over the years. When I first started in this field and someone would ask what I do, I would say speech language pathologist. And typically the response was, ‘Oh, you help students with their R sounds or their S sounds.’ And that was the extent that people really understood. But our scope of practice, as a speech language pathologist, is vast. It is huge and wide what we work with, and to condense that into a one-minute summary to describe to someone was never an easy task.

However, nowadays it's different. It has been so exciting to say what I do, and people now either know someone in the field or they've had a loved one who's been supported by a speech language pathologist. So they at least know one area that we work with. Now it's a much easier task for me to describe to them what I do.

And then my role in my district is very specific. I work with students who use augmentative and alternative communication. So the way I describe it to people who maybe have never heard of that is I help students who are unable to use their mouth to communicate. And sometimes we have to use devices in various forms that have voice output to communicate for them. But we also work on the entire gamut of communication modalities, such as using word approximations, the tone of their voice, gestures, contextual cues in the room, or these augmentative communication devices.

Can you share more of what speech language pathologists do beyond helping with the ‘R’ and ‘S’ sounds?

So what I referenced with the R and the S sounds is what we would call articulation, or the actual speech sound. In addition to that, language is a huge chunk of our scope of practice: expressive language (or how an individual communicates to another individual), receptive language (how they can absorb information that they hear or read from other people coming at them), the voice (the way your voice sounds, the quality of your voice), fluency (or what people might hear as stuttering). There are gender-affirming roles that are recently evolving, on helping people through transitions. Feeding and swallowing is a huge one that a lot of people are unfamiliar with, but we work on that. Even in the public school system, we have a feeding and swallowing team that helps us develop feeding plans so students are safe in their educational setting.

What does a hard day look like in your role?

Well, I don't have many of them — I'm happy to share that. But I would say when I look back on my years in the public school system, my hardest days are by far the days when my students are escalated to such a degree that they are in what we would call ‘crisis.’ We have a crisis team. We have different tiers of crisis, level three being potential and/or actual physical harm to themselves or other individuals in the school. As part of this crisis team, we have walkie talkies and we are always on alert, ready to respond. That can make for a challenging day for many reasons. It's obviously a horrible experience for the student and we all know that, but it also is very emotional for the team members, myself included, that support.

I can speak to the students that I work with that I get the calls for, and a lot of times it is because they're unable to communicate functionally. There are sensory needs that cause dysregulation. There are antecedents that we don't know about. Maybe that student had a really rough night the night before, or there was turmoil in the home, or they're wearing a shirt that is itching them. We oftentimes don't know what the cause is, and it can change from day to day, from moment to moment.

Luckily, I'm part of a just remarkable team and district, so I do feel support when we can debrief and work through all of that and problem solve for future situations. But more importantly, when I really think about that from the lens of a speech language pathologist, I am a true believer in the quote, ‘All behavior is communication.’ So specifically in my role, where my students have so much trouble with communication, especially verbally, I know they are communicating in the only way that they know how and it's my job to teach them a more functional — or what we would call conventional — means of communicating, even those big, huge, overwhelming functional communication needs. Those are my hard days. Those are my hard days when that happens.

What does a really good day look like in your role?

This one's easy. Most of my days are really good days. I love my job. I love my students. I love my teammates. I'm grateful to work in this amazing school district, but I can tell you a good day for me — and this happens a lot — is getting those success stories of when a student communicates anything.

Just yesterday, I received an email from one of the teachers that I work with, and she was telling me how one of our students who uses an AAC (augmentative and alternative communication) device — he can speak, but it’s very unintelligible — he was on a carpet, and they were doing a whole group literacy activity, and he was becoming very agitated with a classroom peer who kept invading his personal space and laying on him. So this student, this lovable little boy, got his AAC system and communicated, asking his peer to move away, and sharing that he was feeling frustrated.

So the teacher sent me an email. It was a big party. I mean, we celebrate. It might not sound like a big deal to somebody else, but this same student in the past would have hit that peer to push him away. So the fact that he initiated, independently, this functional, socially appropriate communication is such a huge win. We emailed Mom. She was thrilled. We celebrated with popcorn for the student so he understood the power of that.

Those types of stories happen to me every week. And because I'm the AAC facilitator for our district, I get those stories coming from other therapists all the time. So it is soul-filling for me, just given my passion for this job, it fuels me.

What is an unexpected way that your role shapes the day for kids?

I can't cite where I've heard this, but I do know that people have been asked, if you could lose a skill or function as a human, and you had to choose between losses such as the ability to walk or to see or to communicate, respondents said it would be the most devastating to lose their ability to communicate. And that's what we're working with — students who are either unable to communicate, or they can communicate, but it's very ineffective, not sufficient and requires a lot of questioning and is a daily struggle. I'm even referencing some of our students that are lacking intelligibility because of their speech impairment or they have a word retrieval deficit where every time they're trying to find a word, they're getting that tip-of-the-tongue sensation and it's a struggle for them every day.

So I don't know if that's unexpected, but maybe people — the general public — don't understand that that's a profound impact on these students we work with in our profession. Sometimes they lose that ability from a stroke or a traumatic brain injury, and it's profoundly, endlessly impactful.

What do you wish you could change about your school or the education system today?

I am extremely blessed to work in a supportive, innovative, student-focused environment at my school district. But I will say globally, when I really think of this from a big-picture perspective, three big things come to mind.

First, I do understand that rules, regulations and accountability are all necessary. I appreciate that. But I also will say the paperwork demands are burdensome. The amount of time that we spend literally on paperwork, writing evaluations, completing IEPs and documentation is impactful in our workload and, I would say, compromises time that we can spend with students and with coworkers and fellow educators to consult and collaborate for the benefit of the students.

The second one is embracing a workload model. I don't know if you've heard that term, but it's been a huge initiative in the world of speech pathology — workload versus caseload. Caseload would be how many students you have that have IEPs. That's what your caseload is. Workload encompasses all of the demands that we have. Our district, we are moving in the workload direction. We have made huge strides. That's part of the reason we have grown as a department. But I don't think that that is equitable among districts, even within my own state or across states. I think every state has their own rules and laws that they abide by for how a speech pathologist works in the schools. It would be great to have a more uniform approach to that to ensure equity and consistency of services countrywide.

And then third, I think we could solve a lot of issues by improving retention and recruitment of speech language pathologists in the school systems, but also educational professionals in general. I genuinely feel it would be profoundly impactful if we could see educators compensated accordingly, given the impact that we have on, basically, the future — the children. I would love to see us held to the same level of esteem as, let's say, lawyers or doctors. It's just not how it is right now. And I think that impacts recruitment and retention.

Your role gives you unique access and insight to today's youth. What's one thing you've learned about young people through your work?

When you asked me that question, a word that comes to mind immediately is acceptance. I will say that one of our goals in speech language pathology is facilitating successful relationships and interactions between students that have special needs and students who don't. So neurodiversity and neurodivergent versus neurotypical, trying to bridge those gaps. That's always our goal. And for my students, in particular — as I mentioned, many of my students are what we would call a high-need, low-incidence population — we want them merged with their general education, neurotypical peers as much as we can. Our district is always striving toward meaningful inclusion, my students included. So part of that process is going into the gen ed classroom at any time that we can. And those moments, when I watch these children — I'm thinking of a third grade class right now — embracing neurodivergency and accepting it, and the flexibility and the patience and just general compassion is consistent. They're just this beautiful bundle of accepting little humans.