10 Problem Solving and Decision Making Skills Every Speech Therapist Needs To Know (no one teaches you)

This post is about problem solving and decision making skills

As speech therapists, we're not just teaching communication—we're constantly making clinical decisions and solving complex problems. Whether you're a new grad or a seasoned clinician, sharpening these skills can transform your practice.

Here's what you need to know:

1. Assessment Is Your Foundation

Before jumping to solutions, gather comprehensive data. A client who stutters might also have anxiety, a family dynamic that needs addressing, or a learning difference affecting their progress. (don't be afraid to call upon other professionals for their expertise)

Practical tip: Create a mental checklist for each evaluation. Ask yourself: What am I seeing? What am I missing? What does the research say? What does the client/family say?

2. Pattern Recognition Develops With Experience

You'll start noticing patterns across clients, common family concerns, predictable plateaus. This pattern recognition speeds up your problem-solving dramatically.

Example: After seeing client's with aphasia you learn that giving a combination of a phonemic and fill-in-the-blank cue helps with word recall.

3. Not Every Problem Needs Solving

If your client is having difficulty with intelligibility but also had dental work, stop and pause.

Ask yourself: Is this problem solvable right now? Will intervention now make a meaningful difference? Is this due to a medical/orthodontic issue?

4. Collaborate for Better Decisions

The best solutions often come from teamwork. Consult with OTs about sensory issues, psychologists about anxiety issues, or caregivers about what's actually feasible at home.

Practical example: A client struggling with carryover? Loop in the caregiver to reinforce your word recall strategies at home.

5. Evidence-Based Practice Isn't Just a Buzzword

When facing tough decisions, lean on research. But remember: evidence-based practice = research + clinical expertise + client preferences. All three matter.

Action step: Can't decide between two treatment approaches? Spend 20 minutes reviewing recent studies. Often the answer becomes clearer.

6. Flexibility Is Your Superpower

That perfectly planned cognitive session? Your client might be having a bad day. Rigid adherence to your plan isn't problem-solving.

Real scenario: Your client left their speech binder at home. Switch gears to something digital. You're still targeting their goals, just differently.

7. Define the REAL Problem (problem solving and decision making skills at their finest!)

The client says they are not able to speak properly. Anxiety? Hearing loss? Motor planning difficulties?

Problem-solving framework:

• What do they say the problem is?

• What do I observe the problem to be?

• What does testing reveal?

• What's the root cause versus the symptom?

8. Small Decisions Add Up

Every session involves micro-decisions: when to cue, when to wait, whether to push harder or ease up, how to respond to a behavior. These small choices compound over time.

Practice awareness: After sessions, reflect on 2-3 decisions you made. What worked? What would you change? This builds your decision-making muscles.

9. Document Your Reasoning

Write down WHY you made clinical decisions. "Reduced therapy frequency to twice monthly because client achieved 80% accuracy across three settings and family can implement home program independently."

Why this matters: When progress stalls or questions arise later, you'll remember your rationale. It also protects you professionally and helps you learn from outcomes.

10. Trust Your Gut (But Verify It)

Your clinical intuition matters. If something feels off about a diagnosis or treatment approach, pause and investigate. But also challenge your assumptions with data.

Example: Trust that instinct enough to do deeper assessment, watch for characteristic signs, and adjust your approach accordingly.

Bonus Insight: Learn From Every Client

Every success and every setback teaches you something. The client who made zero progress with your standard approach? They forced you to innovate. The client who soared? Analyze what you did right so you can replicate it.

Remember: Problem solving and decision making in speech therapy isn't about being perfect. It's about being thoughtful, flexible, and continuously learning. The more challenges you face, the sharper these skills become.

Thank you for reading this post about problem solving and decision making skills