An Open Letter: The Clinical Fellowship and Early Intervention

1 Apr

Even though I find myself irked on the regular, I continue to follow a few SLP boards on Facebook. Recently a graduate student (presumably) asked about doing her clinical fellowship in an early intervention setting. And I was really bothered by so many negative responses – most people seemed to feel that a CF would not get the support they needed in an EI position. So I wanted a chance to express my point of view as a fairly recent EI CF (without having to unsubscribe myself after posting on her question because notifications for days.)

Dear Clinical Fellow,

Pursuing a CF position in an early intervention setting (or really in ANY setting) is going to be hit or miss. Every single early intervention company runs things differently. Some agencies, you may make your own schedule and at other locations you may get your schedule handed to you. Some agencies may require that you build your own caseload (I don’t even know how you begin to do that so don’t ask me) while other companies may provide you with the referrals. At some agencies you may be an island – floating from house to house with nary an ECE or supervisor in sight. Other agencies may be about teamwork, collaboration, and cotreats like you wouldn’t believe. Some places you may not even have a center as a home base. Your center may be your car. You may have the opportunity to have flexible hours – make up kids as you go and as you please even at 7am or 7pm, and some places may be 9-5, Monday-Friday. Some agencies may not pay you if a client cancels or no shows, some agencies you may be salaried regardless. Some companies may offer reimbursement for travel, some companies may say “Put your mileage on your taxes and good luck to you!” Maybe you’ll have paid time off and sick time and insurance. Maybe you’ll be contracted and have nothing. — And that’s just some of the administrative stuff. Not to mention the variety within the actual clinical experiences.

There are pros and cons. As is the case with any setting. I had CF friends in preschools, elementary schools, schools for kids with special needs, acute care, TBI units, nursing homes, outpatient rehab – some had support and some didn’t. Some loved their CF. Some didn’t. I had friends whose CF supervisor worked in the same building as them and they STILL didn’t feel like they had someone supportive behind them. That’s the way the cookie crumbles boo boo.

I, got lucky. My CF was awesome and it was in early intervention. My supervisor was supportive, available, and knowledgeable. As for my coworkers I can say the same. I had so many amazing therapists that I got to collaborate with every single day. I was reimbursed for my travel. My paycheck did not rely on the attendance of my kiddos. I had a center where I could pop in for paperwork and printing and meetings etc, and I also had a work laptop to do paperwork in the car as needed. I worked a 8:30-4:30 schedule. My clients were scheduled for me, though I did have some autonomy as far as wiggling them around within that 40-hour-week framework. My CEUs were reimbursed. I had all the benefits of a normal employment position (thank goodness!) And while that was all great for me and suited my needs, maybe that isn’t the ideal setup for someone else.

Do I think I’m the exception? Possibly. But advocate for yourself – don’t just take the first EI position that pops up. Early intervention is a field that is growing and NEEDS YOU! Yes you, my CF-SLP friend. If we all listened to the nay-sayers who think a clinical fellowship isn’t appropriate for early intervention who would be doing early intervention? Everybody has to start somewhere, and trust me, even if you had the experience of a school or Head Start or acute care or WHATEVER you are still not going to have the EI experience under your belt until you get in there and do it. Honestly, if you think you want to do early intervention it’s probably better to do it now, and learn it fresh before you have any clinical preferences, than to develop habits and have to go back and relearn later – especially in regard to parent coaching.

When you’re interviewing, ask questions. Ask about caseloads. Ask about supervision style and opportunity. Ask about collaboration. If it feels like you aren’t going to get the support a CF needs, try a different agency. You have to ask the questions though. If you don’t ask, you won’t find out until it is too late. Yes, as a CF you need someone’s help. If you’re interviewing somewhere and it feels right you will know. If it feels wrong, you will know. I do encourage you to look for an early intervention agency that is going to back you up, and empower you, and keep their eyes on you. You do not want to be an island during your CF or you’ll end up on Facebook asking the same question everyone else has asked twenty times already. And you don’t have to be, but you need to know what to look for.


(Let me know if you have questions about CFs and EI – I’m happy to help if I can) NP: Ben Sollee

9 Responses to “An Open Letter: The Clinical Fellowship and Early Intervention”

  1. Katie April 1, 2015 at 6:42 pm #

    I actually think that the inquiring soon to be CF was me! I saw this link on twitter and thought “NO WAY!”. thanks for your insight and writing this!

    I was actually really disappointed when I read the comments, but after a while realized they don’t actually know me.. they don’t know that I looked into several companies, that I HAVE asked about supervision, etc. etc. there were a lot of comments I wanted to respond to but didn’t for my general tiredness towards long Facebook conversations/debates

    • weathersby April 1, 2015 at 6:50 pm #

      Ohmygosh! Haha I’m so glad this got to you! I was thinking about your post all day and I was just so cranky about all that negativity that came your way that I had to write this post. I have faith in your ability to be a CF in EI – you’ll have to keep us updated on what happens 🙂

      Also, you are totally right about online battles – not my jam either!

  2. Allison April 20, 2015 at 7:13 pm #

    As a soon-to-be CF applying for positions, this was great to read. I agree, I’ve heard a lot of negativity around CF’s taking EI positions. It’s on my list to apply to, and I’m a little less hesitant now 🙂

    • weathersby April 26, 2015 at 6:27 pm #

      I’m so glad! EI is so much fun and so rewarding

  3. Trina Heussner April 26, 2015 at 4:49 pm #

    I would like to know why you are so irked by the questions you mentioned in your first paragraph.

    • weathersby April 26, 2015 at 5:09 pm #

      It’s not really the specific questions because I’m glad people are asking questions, it’s just that it’s the same questions. I wish people would scroll. A lot of the time you’ll see people comment “We just talked about this, look for that post from three days ago.” But luckily people are still willing to answer the same questions over and over, especially the people trying to sell something…gives them lots of chances to post links to advertise.

  4. Ashlyn September 13, 2016 at 10:14 pm #

    I’m in the second week of my CF and I’m contracted through a home health/EI practice. One of the parts I’m having a hard time with is determining what I can count towards my CF hours. The sessions are only 30 minutes, but I also spend time doing paperwork in between some kiddos. Can I only count when I’m with the kiddos for that 80% of direct time? I feel like its going to take awhile to complete my CF if I can only count that time. Any insight would be greatly appreciated!

  5. CF December 15, 2016 at 7:02 am #

    I know this post was posted 2 years ago but I just wanted to say thank you for writing this and sharing it with fellow CFs who are doing EI. I am in a unique situation where I was coerced to do EI as the only option. Although I love the acute setting and geriatric population, I long for a center based location and not having to go from home to home. I thought about all the cons but you showed me the pros. I am excited. Thank you.

  6. Nikki Roble February 12, 2018 at 2:04 pm #

    Hi there! I am currently applying as a CF and was wondering if you can provide some questions that are typically asked in an interview! I’ve had many phone interviews with agencies for district positions, but have only had one interview for EI. I have one coming up and I am pretty nervous as it will take 2-3 hours and they will be asking me clinical questions.

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