5 Challenges of Switching from a Geriatric to Pediatric CFY Mid-Year

December 1, 2025

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Making a mid-CFY transition from geriatrics to pediatrics is no small adjustment. Just when you’ve found your rhythm working with older adults, you’re suddenly in a world of tiny voices, endless energy, and play-based therapy. While both settings require strong clinical skills, the shift from compensating for decline to fostering development can feel like starting from scratch. From relearning assessments to keeping up with high-energy sessions, here are five of the biggest challenges you might face—and why the experience will ultimately make you a better clinician.

1. Rewiring Your Brain

Geriatrics is about compensating for decline , while pediatrics is all about building skills . Shifting from cognitive therapy and dysphagia to articulation and language development requires a complete mindset reset.

2. Keeping Up with Energy Levels

Geriatric therapy is structured and calm—pediatrics? Nonstop movement. Expect wiggly kids, play-based sessions, and a new appreciation for coffee.

3. Learning New Assessments & Goals

Swapping bedside swallow evals for articulation tests and MLU tracking is overwhelming. Different tools, different therapy approaches, and a lot more toys.

4. Navigating Parent Involvement

Instead of working with nurses and OTs, you’re guiding parents—some eager, some disengaged. Balancing education, trust, and realistic expectations is key.

5. Starting Over (Again)

Just when you feel confident, everything changes —paperwork, therapy materials, and IEP lingo. The learning curve is steep, but your clinical skills transfer.

Mid-CFY switches are tough, but they push you to grow in unexpected ways. Staying flexible means accepting that what worked yesterday might not work today, and that’s okay. Embracing the chaos helps you see that progress doesn’t always look structured—sometimes it’s hidden in messy, playful moments. And above all, play is therapy—kids learn best when they’re engaged, so leaning into fun makes sessions more effective. While the transition is challenging, it builds adaptability, creativity, and a new appreciation for the little victories.

Madison Wood, M.S., CCC-SLP

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