Purpose To date, few studies have examined school-based pediatric feeding and swallowing practices across the United States. This study aims to (a) identify barriers to feeding and swallowing service provision in an educational setting and (b) identify the types of service suggested by school-based speech-language pathologists in response to a fictional case study. Method School-based speech-language pathologists and clinical fellows were invited to participate in a 15-min web-based survey. The survey questions addressed demographic and vocational information and perceived barriers to service provision. Survey respondents were also asked to develop a treatment plan in response to a fictional case study. In total, 200 anonymous survey responses were coded and analyzed using qualitative analysis methods. Results A number of barriers to practice were identified, which include academic and/or clinical preparedness and concerns related to the educational relevance of service. Analysis of the case study results indicated a wide range of treatment plans. The most common type of direct intervention suggested was an oral motor exercise regime, followed by diet modifications, and the implementation of safe swallow strategies. Conclusions Information gained in this study may be used to support policies and protocols related to the assessment and treatment of pediatric feeding and swallowing impairment in school settings.