Questions to Ask a Speech Pathologist While Shadowing
For a student or career changer spending observation hours with a speech-language pathologist. These questions cover the clinical reasoning behind what you are watching, the parts of the job that happen outside sessions, and what the training and the pay actually look like.
The questions
Open any question for the note
What should I do and not do while I'm here today?
Why ask it
Ask this before anything else, since expectations differ by setting: some clinicians want you silent, others want you handing over materials or taking data. Getting it clear at the start prevents a mistake in front of a client.
What was the referral question for the client we just saw?
Why ask it
Knowing what the clinician was asked to answer turns an opaque session into something you can follow. It also shows how often the referral reason and the real problem differ.
Why did you choose that activity rather than something else?
Why ask it
The reasoning behind a specific task is the whole skill, and it is invisible to an observer watching what looks like play or conversation. Ask about a single moment rather than the session in general.
How many practice trials were you aiming for in that session?
Why ask it
Dosage is a real variable in speech therapy, and the number a clinician targets per session will surprise most students. It also explains why sessions sometimes look repetitive.
What cue did you use there, and what would you do if it stopped working?
Why ask it
Hierarchies of cueing and fading are central to practice and hard to see unless someone names them. The fallback plan tells you how the clinician thinks about levels of support.
How did you decide where to start with this client's goals?
Why ask it
Target selection follows principles such as stimulability, functional impact or what unlocks other skills, rather than working through a list in order. This is the question that most changes how students see a caseload.
How is progress on that goal measured, and where does the data go?
Why ask it
Trial-by-trial accuracy, rating scales and probe sessions each have different uses, and the documentation requirement drives much of the workload. Ask to see a data sheet if privacy allows.
What does your caseload look like in numbers?
Why ask it
Caseload size differs enormously between schools, hospitals and private practice, and it determines session length and preparation time. This is a concrete figure worth collecting from every clinician you shadow.
How much of your week is direct treatment versus everything else?
Why ask it
Documentation, meetings, report writing, billing and travel often take more time than sessions, and students consistently underestimate it. Ask what the paperwork is like at the end of a school term or a hospital month.
What does a session look like when it goes badly?
Why ask it
Refusal, illness, a bad day at school and equipment failure are routine, and how a clinician salvages the time is genuinely instructive. You will rarely see this on a scheduled observation day.
How do you handle a family that disagrees with your recommendation?
Why ask it
Disagreement over dosage, discharge or whether therapy is needed at all is common, and the strategies are specific. This is also where the counselling side of the role becomes visible.
How much of the job is coaching the people around the client?
Why ask it
Parent coaching, teacher consultation and nursing handover are often where the actual change happens rather than in the therapy room. Clinicians tend to have strong views on this.
Which populations do you work with that you weren't trained for?
Why ask it
Graduate programmes cannot cover the whole scope, so most clinicians have learned dysphagia, AAC or voice on the job. Their answer tells you what to seek out in your own placements.
How do you decide when someone is finished with therapy?
Why ask it
Discharge criteria vary by setting, funding and clinician, and are one of the hardest judgments in the field. Ask about a case where they discharged sooner than the family wanted.
What ethical situation have you had to think hardest about?
Why ask it
Real dilemmas in this field involve billing pressure, caseload caps, working outside competence, and disagreement with a team about a patient's safety. Ask for the shape of the problem rather than identifying details.
What do you wish your graduate programme had covered?
Why ask it
The consistent gaps students hear about are documentation, dysphagia confidence, difficult conversations and time management. Collecting these across several clinicians tells you what to prepare for yourself.
How did you choose this setting, and would you move?
Why ask it
Pay, autonomy, caseload and paperwork differ sharply between schools, hospitals, skilled nursing and private practice. Someone who has worked in two can compare them directly, which is worth more than any careers page.
What does the pay look like here, and how does it compare to other settings?
Why ask it
Students often reach the end of an expensive programme without a clear picture of earnings by setting, and clinicians are usually willing to talk in ranges. Ask about student loan reality as well as salary.
What keeps you in this profession?
Why ask it
Asked after a full day of observing, this gets a more grounded answer than at the outset. Listen for whether it is the clinical puzzle, the relationships or the schedule, since that tells you what kind of person fits.
What should I be doing in the next year to prepare?
Why ask it
Concrete answers usually involve specific coursework, observation hours in a second setting, or a technician or aide job. Ask them to name one thing rather than give general encouragement.
Making Observation Hours Count
Practical guidance for the conversation itself
Before You Arrive
Sort the Paperwork Early
Many settings require confidentiality agreements, a background check, immunisation records or a formal observation form signed by your programme. Chasing this on the day costs you the visit.
Ask What to Wear and When to Arrive
A hospital, a school and a private clinic have different dress and access expectations, and arriving with a badge or at reception on time matters. Confirm where to park and who to ask for.
Bring Paper, Not a Phone
Note taking on a phone looks like texting and can appear to be recording in a clinical space. A small notebook with your questions already written is better.
Learn the Setting's Vocabulary
Reading up on IEPs for a school or on dysphagia terminology for a hospital lets you follow what you see. It also means your questions can be about reasoning rather than definitions.
How to Use the Day
Save Questions for the Gaps
- 1Note the moment and the time, then ask between sessions
- 2Ask about one specific decision rather than the session overall
- 3Keep a running list for the end of the day
- 4Ask what you should read to understand what you saw
If You Shadow More Than One Setting
- 1Compare caseload size and session length across settings
- 2Compare how much time goes to documentation
- 3Compare who else is on the team
- 4Ask each clinician what they would not go back to
Afterwards
- 1Write up what you saw the same evening, while the detail is fresh
- 2Send a short thank you naming something specific you learned
- 3Ask whether you may contact them with a question later
- 4Log your hours in the format your programme requires
Common Pitfalls
Asking Questions in Front of the Client
Even a quiet question changes the session and can be distressing for a family. Wait for the gap, and if there is no gap, wait for the end of the day.
Recording or Photographing Anything
This is a confidentiality breach in almost every setting and can end your placement. Assume no photographs, no video and no audio unless someone explicitly instructs otherwise.
Talking About What You Saw Afterwards
Details shared with classmates or online can identify a client even without a name. Keep your written reflection free of identifying information too.
Only Observing the Sessions
The realities that make people leave the profession are in the documentation, the meetings and the caseload, not in the therapy room. Ask to see the unglamorous parts.
Offering Clinical Input
Suggesting an activity or correcting a client oversteps your role as an observer, however well intended. Save your ideas for the debrief and frame them as questions.