Are We Making Assumptions? Speech-Language Pathologists' Approaches to Identifying and Managing Caregiver Burden

Purpose: While research recognizes the importance of caregiver support, limited evidence exists about how speech-language pathologists (SLPs) translate this awareness into clinical practice. This study examined how SLPs identify and address caregiver burden in adults with communication disorders and/or dysphagia. Method: A cross-sectional survey was administered to 93 practicing SLPs treating adults with communication disorders and/or dysphagia. The survey examined demographics, clinical practices for identifying and addressing caregiver burden, and barriers to providing support. Descriptive statistics, Mann–Whitney U tests, Spearman's correlations, Fisher's exact test, and Kruskal–Wallis tests were performed. Thematic analysis examined open-ended responses about burden sources and management strategies. Results: Eighteen percent of SLPs reported “often” or “always” explicitly asking caregivers about burden, with only one participant using standardized methods. No significant differences emerged based on funding source or location. Mid- and late-career clinicians reported significantly higher frequencies of inquiring about sources of burden compared to early-career clinicians. SLPs reported addressing three primary sources of caregiver burden: psychosocial (48%), physical (31%), and financial (18%). Management strategies fell into five themes: making services accessible, providing culturally sensitive care, linking with community resources, referring to other professionals, and involving caregivers in therapy. Seventy percent of SLPs reported being unable to determine if their support alleviated caregiver burden. Conclusions: While SLPs demonstrate awareness of caregiver burden and many implement meaningful support strategies, few explicitly ask caregivers about specific sources of burden or follow up to evaluate whether their management strategies are effective. We discuss opportunities to help SLPs more systematically identify sources of caregiver burden.