Why Speech-Language Pathologists Are Quietly Becoming Executive Function Coaches
- Sean G. McCormick
- Jul 21
- 9 min read
Table of Contents
If you're a speech-language pathologist who is tired of prior authorizations, denied claims, and being paid a fraction of what your session is worth, you're not imagining the problem and you're not alone.
A growing number of SLPs are adding executive function coaching to their practice, or replacing clinical work with it entirely, because it lets them work directly with the clients who need them most, at rates they set themselves, with no insurance company standing between the two of you.
For example, EFCA graduate, Robyn Dalberg, was an SLP and school leader who got certified as an executive function coach and now runs her own EF coaching practice where she helps students move from frustration and avoidance toward more clarity, confidence, and follow through.
This isn't a theoretical trend.
It's showing up, week after week, in conversations with SLPs who are done asking permission to help people.
The Insurance Model Was Never Built for the Work You Actually Want to Do
Speech-language pathology is a demanding, clinically rigorous field, and the U.S. Bureau of Labor Statistics projects strong continued demand for it.
But demand for the profession and sustainability inside the profession are two different things.
Reimbursement pressure on therapy services has been well documented industry-wide, and SLPs feel it directly:
shrinking fee schedules
prior authorization requirements
documentation burdens that eat into actual client time
and payment rates that don't reflect the expertise required to earn a license in the first place
None of that is a reflection of your skill.
It's a structural problem with how the system pays for care.
What I hear on call after call is some version of the same sentence:
"I love the clinical work. I'm exhausted by everything wrapped around it."
What This Actually Looks Like for Real SLPs
Strip away the identifying details and the pattern is remarkably consistent across SLPs at very different career stages.
One SLP with nearly three decades of experience in public schools, now working remotely for health reasons, wanted a sustainable way to keep serving students — including the ones who "age out" of school-based services the moment they turn 22, right when many of them need executive function support the most.
She wasn't looking to leave speech pathology.
She was looking for a second stream of income she could run from home, on her own schedule, without the licensing constraints that come with practicing across state lines.
Another SLP spent over a decade at a private nonprofit before stepping away.
The reason wasn't burnout in the clinical sense — it was watching a system with no real curriculum and no accountability fail the kids in it, and realizing she could build something better on her own terms, directly with families, without waiting on a board that wouldn't listen.
A third SLP, based in a small Montana practice, wanted to diversify her caseload without adding more insurance paperwork to her plate.
Her plan wasn't dramatic: build a referral network, start with a handful of private-pay clients, and let the practice grow at a pace her existing caseload could support.
Different starting points. Same underlying decision: stop waiting for the system to change, and build a direct relationship with clients instead.
Why Speech-Language Pathologists Are a Natural Fit for Executive Function Coaching
This isn't a random career pivot.
SLPs already do a version of executive function work every day — they just don't get to bill for it as such.
Executive function — planning, working memory, task initiation, self-monitoring, flexible thinking — is deeply intertwined with language processing, pragmatics, and the social-cognitive work SLPs are trained in.
An SLP who has spent years helping a student sequence their thoughts to speak in complete sentences already understands, at a practical level, how to help that same student sequence the steps of a homework assignment or a college application.
The clinical instincts transfer.
What's usually missing isn't the skill — it's the business model to charge appropriately for it outside the insurance system, and the framework to market it as a distinct, valuable service.
That's where the Certification Program can help.
The Direct-Pay Model, in Plain Numbers
This is usually the part of the conversation that changes the tone from "interesting idea" to "let's talk specifics."
Clinical, insurance-based hourly rates for licensed therapy professionals commonly land in a fairly narrow, insurance-dictated band — and that band is set by the payer, not by you.
Executive function coaching operates on a completely different model: you set a flat rate for a defined package of sessions, you get paid directly by the family, and there's no claim to submit, no authorization to wait on, and no reimbursement to chase down three months later.
Coaching rates typically run well above what insurance reimburses for a comparable clinical hour — and unlike clinical billing, they don't shrink from one payer's fee schedule update to the next.
You decide the price.
You decide the packages.
You decide whether a client is a good fit before you ever start working together.
In our 2026 EF Coaching Industry Report, we found that our graduates charge an average of $100-$149 per session, and top earning coaches (working full-time) charge $250+ per session, earning $10,000+ per month!
For an SLP already carrying a full clinical caseload, that's often the appeal of starting with just a handful of coaching clients on the side: five clients at a flat per-session rate can add real, dependable monthly income without requiring a single hour of insurance paperwork.
What About Licensing and Liability?
This is the question every serious SLP asks, and it deserves a direct answer rather than a vague one.
Executive function coaching is a distinct profession from speech-language pathology.
There is no legal governing body for executive function coaching, and there is no legally required certification to practice as an EF coach — which is precisely why the professionals who take it seriously build real credibility through structured training, a documented methodology, and a track record of client outcomes, rather than assuming the title alone carries weight.
For SLPs specifically, the cleanest approach is to keep the two practices separate: your clinical caseload continues to operate under your SLP license and your state's scope-of-practice rules, while your EF coaching work operates as its own service, under its own name, with its own intake process and its own agreements.
Coaches who do this well typically use a simple, separate website or landing page and a distinct set of client documents, so there's no ambiguity for clients — or for your liability coverage — about which relationship they're in.
Where SLPs Get Stuck (and What Actually Fixes It)
Almost none of the SLPs I talk to are stuck on whether they can help clients with executive function challenges.
They already know they can.
What stalls them is everything around the clinical skill:
how to price a package
how to run a discovery call that ends in a "yes" instead of a "let me think about it"
how to build a simple website
how to stay HIPAA/FERPA-conscious with digital documentation outside a clinical setting
and how to find the first five clients without an existing referral pipeline
That gap — between clinical competence and business readiness — is the entire reason a structured certification path like our EF Coach Certification Course exists in the first place.
It's not there to teach an SLP how to understand executive function.
It's there to teach the business of coaching:
how to run the sales conversation
how to price and package sessions
how to build a basic online presence
and how to convert a first conversation into a first paying client
If you are an SLP exploring executive function coaching, your next step is to apply for certification to get a 15-minute coaching session with me where we can talk through your goals and how the certification course might help you get there.
If you're wanting more details on how to become an executive function coach, watch this video👇
A Note on the Aging-Out Problem
One thread worth naming on its own: a striking number of SLPs are drawn to this work because of what happens to their students at 18, or 22, or the day the IEP ends.
The scaffolding disappears overnight, right as the executive function demands of adult life — managing a class schedule, holding a job, living independently — spike dramatically.
Families of these young adults are actively looking for support, and they are often willing to pay directly for it because insurance rarely covers anything that isn't classified as medically necessary therapy.
For SLPs who've spent a career caring about what happens to a student after graduation, this is frequently the moment the pivot starts to feel less like a career change and more like an extension of the work they were already doing.
The Bottom Line
SLPs already have many of the skills needed to become effective executive function coaches.
The bigger challenge is learning how to package those skills, find clients, set sustainable rates, and build a practice outside the insurance system.
Executive function coaching can give you more control over your schedule, income, and the clients you serve.
Your next step is to apply for certification so we can talk and explore whether the program is the right fit for your goals.
Hope this helps! 🤙🏻
FAQs
Can a speech-language pathologist become an executive function coach?
Yes. SLPs bring directly transferable skills — understanding of executive function's role in language and learning, experience with individualized goal-setting, and comfort working with students, adults, and families. Most SLPs who make this move keep their clinical license and practice, and add EF coaching as a separate, private-pay service.
Do you need a special license to be an executive function coach?
No. There is no legal governing body for executive function coaching and no legally required certification to work as one. That makes structured training and a credible, documented process especially important for building trust with clients and referral sources.
How much do executive function coaches charge compared to insurance-based therapy sessions?
Coaching is typically priced as a flat-rate package rather than a per-session insurance claim, and rates are usually set well above standard insurance reimbursement for a comparable clinical hour, since there's no payer fee schedule dictating the number.
Should an SLP keep coaching and clinical work separate?
Generally, yes. Keeping EF coaching under its own name, website, and client agreements — separate from your SLP license and scope of practice — is the cleanest way to avoid overlap or liability confusion between the two services.
Why are SLPs specifically drawn to executive function coaching right now?
Two reasons come up constantly: frustration with insurance billing, prior authorizations, and shrinking reimbursement, and a desire to keep helping clients — especially those aging out of school-based services — in a way that doesn't depend on medical necessity criteria.
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About Me
Hey! I'm Sean 👋
I'm a former public school special education teacher who realized that executive function skills are more important than knowing when George Washington crossed the Potomac.
Since then, I've made it my mission to teach anyone who will listen about how to develop these key life skills.
In 2020, I founded Executive Function Specialists to ensure all students with ADHD and Autism have access to high-quality online executive function coaching services. We offer online EF coaching and courses to help students and families.
Realizing I could only reach so many people through coaching, in 2021 I started the Executive Function Coaching Academy which trains schools, educators, and individuals to learn the key strategies to improve executive function skills for students.
In 2023, I co-founded of UpSkill Specialists, to provide neurodivergent adults with high-quality executive function coaching services.
When not pursuing my passions through work, I love spending time with my family, getting exercise, and expanding my brain through reading. You can connect with me on LinkedIn.