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School-based speech-language pathologists (SLPs) are increasingly confronted with opportunities to use screen-based devices. In order to fully investigate how technology impacts therapeutic efficacy, it is imperative to first understand how and why SLPs utilize technology. This study explores: (a) the frequency with which SLPs use eight types of screen-based devices during direct intervention; (b) how student and SLP characteristics impact device use; and (c) the clinical rationales supporting device use. Using a self-administered, online questionnaire, 261 SLPs reported that technology use contributes to perceptions of increased clinical effectiveness. Results indicate tablets are the most frequently used device; however, student age, specific communication disorders, and service delivery model significantly impact the type and frequency of device use. Furthermore, academic materials and traditional activities continue to be the predominant format of intervention activities. Findings provide insight into how SLPs balance the allure of screen-based devices with student needs, professional characteristics, and the educational environment.