Service delivery: Determining service time

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Working in a large school district, we read a lot of IEPs and talk with SLPs often about service delivery time and scheduling.

What do we see and hear most often? Students being served in 30-minute increments! 2×30 minutes per week (in the speech room) seems to be the most common choice. Of course, many students have more than 60 minutes per week or have an in-class session thrown in there. Many students in middle and high school may be seen once a week for the length of a period (stay tuned for our next post about an alternative service delivery model for adolescents-link).

But overwhelmingly, students who receive speech-language services for 60 minutes per week are seen in two 30-minute sessions, regardless of the type of communication disorder(s). Sometimes the justification can’t even be expressed – we’ve asked!

We’ve talked about getting out of the speech room (link) and provided some tools (link) for collaborating. But regardless of where you serve, the reason(s) for the amount of time and how it is broken down are just as important – and are determined on an individual basis. There is more than just 30 minutes!

45 minutes one time per week may be sufficient

What about 3×20 minutes/week?

90 minutes broken down into 2×45 instead of 3×30?

4 hours per month instead of 1 hour per week? Because one week may necessitate 90 minutes while another only 30!

There is a lot of talk about quick articulation drill sessions like Speedy Speech or 5 Minute Kids. These are amazing models for students with speech sound disorders.

Frequent and intensive therapy is definitely efficacious for apraxia of speech.

And students with language disorders and/or learning disabilities can absolutely benefit from extra practice with skills and strategies.


Do you have a parent who is anxious about a recommended reduction of service time? Is it the AMOUNT of time or the decrease in weekly consistency they are most worried about?

                3×30 => 2×30 can be a little frightening but…

                                3×30 => 3×20 may soften the blow

Scheduling is a beast involving so many factors but students’ needs are ultimately where it should begin!

We have found a few states with severity rating scales:

Maine, Tennessee, Arkansas, Virginia

But they don’t equate to specific service time recommendations – though there may be states or districts out there who have developed their own. However you determine service time recommendations, be sure they are individualized and incorporate team decision-making including the severity of the disorder(s), level of educational impact, and need for specialized instruction from the SLP!

How do you determine service time recommendations for your students?

Planning to co-teach?

In the previous post, we discussed getting out of the speech room and into the classroom. We touched on the various models of co-teaching (descriptions found in this printable) and encouraged school-based SLPs to give it a try!

In this post, we’d like to provide some suggestions on how to PLAN for this service delivery model. So keep reading for some tips and your free printable lesson plan template.

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But first, let’s talk about the benefit of this model for students with AND WITHOUT disabilities…

For students with disabilities, this model can effectively increase participation in class, achievement and test scores, social skills and self-esteem. It can increase teacher expectations and generalization of skills. And of course, it helps reduce the missing of class activities.

For students without disabilities, this model can provide exposure to varied instructional strategies and activities. It can also provide additional help to those at-risk with specific skills. It definitely helps increase tolerance of differences. And it absolutely DOES NOT impede their achievement.

So we know the models (or check out the free printable in our last post for a refresher), we know why it’s a good idea (for some, not all students), we’ve found a teaching partner to take it on with us…now how do we plan for it?

First, pick a time to plan together and decide what you will need to accomplish during this time.

Always have a back-up plan in case meeting face-to-face it is out of the question…because it will happen!

Some suggestions – a daily or weekly face-to-face check in and debriefing; a planning notebook; email; post-it notes; phone calls.

Any other thoughts or systems that have worked for you? Comment below!

During the planning session, SLP and teacher will want discuss the following:

Teacher’s role

  • discuss the curriculum content and objectives for the lesson including topics, concepts, activities, outcomes, and methods of instruction
  • discuss common problems in the content

SLP’s role

  • discuss accommodations/modifications, strategies needed for instruction, materials, and activities
  • discuss the specific IEP objectives to be targeted

Together you want to be sure to discuss the co-teaching approach you plan to use; keeping in mind that more than one may be used in any given lesson. Room arrangement is also very important including where your speech-language students will be for each part of the lesson.

Since student assessment is important to both the teacher and SLP, you will want to be sure to talk about how this will take place for the lesson along with the specific supports needed for any given students.

Based on the lesson you’ve planned, don’t forget to outline the tasks you each will need to accomplish before, during and after the lesson. This includes material preparation, who will teach what, and who will assess what.

We have included a free 2-page lesson plan template that can help guide your planning session.

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Download it here

 

 

 

What are your go-to resources for planning for your co-teaching lessons?

 

Service delivery: Thinking outside the box (or therapy room)

Service delivery

Anyone else’s district seem hyper-focused on the least restrictive environment (LRE)? Sometimes it seems it is all we talk about for students receiving special education services. So much so that we move from too many students being served in a small group resource setting to too many being served (inappropriately) in a general education (or co-taught) setting. Come on, no one model is best for everyone. It is an Individualized Education Program/Plan, right?

So what about when it comes to speech-language services? Where are those students being served?

In our experience, we see that MOST are seen in the speech room – you know that closet with no windows. Pulled from reading…or science…or chorus…or art history to work on speech and/or language skills. Hopefully they know what skill(s) they are working on, why they come – hopefully they come! The skills may be embedded in a curricular context but how often is it based on the context of the class they just left? How often do they return to that class having missed out on the instruction entirely? Hmmm…hard to say. Depends on the student, on the goals, on the class, on the day, on the week, on the month…geez give us a break. We have large caseloads, are overloaded with paperwork, and have tons of additional duties and responsibilities!

One size does not fit all but maybe we should better look at each student individually. Where will their needs best be met? It may very well be that the speech room is THAT place! But what about those for whom it is not? What about the students who are better served in their classroom setting (be it a special education, general education, or co-taught environment)?

Being in the classroom is such a rewarding experience. Not only do you, as the SLP, get to see the fast-paced curriculum your students are learning (or struggling to keep up with) but you get to show off your knowledge. Let those teachers see how they can incorporate language, scaffolding, strategies all day long…to build those skills that your students lack even when you’re not there.

Maybe you pick one teacher or one grade level. Maybe you go in once a week or once a month. Maybe you plan a 10-minute mini lesson or maybe you support the instruction that is already occurring. Maybe you do station teaching or parallel teaching, or maybe you and the teacher plan an hour-long lesson to team teach together. After all, it’s not a one size fits all model – for the students or the teacher(s) or SLP(s).

Download your free printable here for descriptions of the various models of co-teaching: 

co-teach printable
!DOWNLOAD NOW!

Give it a try. Maybe, just maybe, you’ll LOVE it and want to do more. And maybe the students will get much more of what they need.

Co-teaching is only one way to switch up your service delivery. Come back and visit as we expand on the service delivery discussion in our next three posts. We’ll cover planning for co-teaching, determining service time and a different and fun model for adolescents.

Comment below and tell us how you think outside the box for service delivery…

The CF experience: Mentor and mentee growing together

Back to school time is rapidly approaching! Are you ready???

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So you’re starting your CF this school year.

Congratulations on completing (surviving?) a grueling graduate school adventure. We know you learned a lot, studied a lot, practiced A LOT. We’re here to tell you that you will fall back on that experience often as you start your career. But this CF experience will greatly shape you from this point on.

So make the most of it!

Not a CF or SLP-to-be? Keep reading for tips for CF mentors!

Your mentor is definitely observing you during direct treatment, possibly testing and hopefully supporting you in preparation of (and maybe at) your first staffings/meetings. Take advantage of this time with an experienced SLP. Make sure they provide you with feedback – preferably written – and use the constructive comments to keep growing.

Get your free feedback form here (and keep reading for additional freebies)!

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Implement your mentor’s suggestions, tweak them to meet your needs, share your thoughts on how it worked. Ask for advice on difficult cases or tasks.


To put it mildly, paperwork is abundant as a school-based SLP. Your mentor probably has some great tricks up her sleeve!

Have a group you can’t wrangle?

Ask her to observe and discuss some tips or strategies.

Have some goals you’re unsure how to target?

Talk it through.

This is what the CF experience is all about! To refine your skills under supervision, be supported as you implement all you’ve learned, and to begin the process of continued growth and learning as a SLP.

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Check out this free printable to help you keep track of all the experiences you and your mentor will share.

 

What are you hoping to gain from your CF experience?

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So you’re mentoring a CF this school year.

Whether it’s your first mentoring experience or you’ve done it many times before, it is an opportunity to grow your skills in various ways. You will learn about yourself – your strengths and weaknesses – and inspire a new SLP.

So make the most of it.

Not a CF mentor? Keep reading and save for when this great opportunity becomes available!

You’ll spend valuable time each month with your CF. You’ll observe therapy or testing, you’ll talk about strategies. You’ll provide constructive criticism and PRAISE. Remember how far these new SLPs have come. Think about how far you’ve come since you completed your CF experience. And take this opportunity to learn and grow even more.


Sometimes we get so caught up in our day-to-day (busy) lives as school-based SLPs that we get stuck in our ways. Step back and watch what that new SLP is doing – look at it as a type of continuing education for you. You may see this CF implement a strategy in a way you’ve never thought…or you may come up with these new ideas as you help her grow. Either way, it’s practically guaranteed that you will grow and discover new tricks. A new way to get a /r/, an innovative approach to curriculum-based instruction, an inventive material for comprehension…

Tackling a grouping issue you haven’t encountered before?

Talking through the challenges with your CF will enlighten you for when it inevitably happens to you.

Stuck in a rut of IEP goals?

Working with your CF to write and implement hers will no doubt give you new ideas for next time.

This is what mentoring is all about! Sharing what you know and admitting what you don’t. Working together to find the answers and growing together.

Check out our freebies for CF mentorship including a CF feedback form, checklist of experiences and log of activity/visitslog pic

What do you hope to gain as you mentor a CF?

 

 

Educational impact and school-based practice

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So there’s this three-pronged approach to determining special education eligibility in the school system…

  1. A student exhibits a disability
  2. The disability adversely affects educational performance
  3. Specially designed instruction (and/or related services) are required for the student to progress in the general education curriculum

So step one doesn’t seem to be too difficult. Standardized tests, criterion-referenced assessments and other formal and informal measures are available to SLPs for this purpose. Didn’t we all spend most of our graduate school class time studying the various communication processes and what constitutes them being ‘disordered’?

Step 2 – that’s another story we’ll come back to in a minute…

And step 3…well let’s just say that most SLPs want to help everyone. It’s kind of in our nature! But we cannot do it all. And we have to think about all of the expertise in a school building and what EACH are specially trained to do. If the student can’t get their needs met by other individuals on the team, perhaps they require your specialized instruction. But, let’s be honest, sometimes someone else can do it.


So back to step 2…what is adverse educational impact anyway?

Well, of course, it’s determined on an individual basis so there’s no formula for it. But it definitely includes academic and social-emotional performance.

The U.S. Department of Education, Office of Special Education Programs (OSEP) provided some clarification to ASHA in 2007 confirming that educational performance does not just refer to academics.

We’ve touched on the communication skills evident in the Common Core State Standards (see that post here). The skills addressed by an SLP are clearly required for so many of these skills – easy way to justify that educational impact? We’d say so.

And it’s fair to say that educational impact for language skills is WAY easier than articulation, voice or fluency skills…but not an impossible task at all. Sometimes getting the documentation from the teachers is the hardest part.

We know that even a single-sound articulation error MAY impact a person’s self-confidence and social-emotional well-being. It’s that word ‘MAY’ that we have to be extra careful using.

Unless you are one of those SLPs with a crystal ball,

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shouldn’t we consider if there is an impact AT THE TIME OF eligibility?

Is decreased intelligibility an educational impact? Sure…how do you determine progress in the curriculum if you can’t understand the individual?

Refusal to read aloud or participate in classroom discussion? Of course, if we can pinpoint that this is related to the communication disorder.

Does the student spell like they speak? Probably some good evidence that the student isn’t even discriminating.

What about teasing? It absolutely happens…but we’d venture to say that not every student is teased and those that do experience it are not always bothered by it. Shouldn’t part of the evaluation process include how the students themselves feel about their own speech?

There can be this mindset that the educational model neglects students with communication disorders unless they are failing academically. But there is so much more to success in school than just academics.

What does adverse educational impact mean to you?

TV for the win…

tv for the win photoSummer vacation…aaaahhhh! What every school-based SLP waits for ALL year, right? Spending time traveling? Just sitting in front of the TV? Well-deserved time off no matter how you spend it!

But think of all the inspiration you can gain just from watching TV…

I mean does EVERY Looney Tunes character have a speech disorder? And I have yet to watch a newscast without finding something off – a voice, a weird sentence structure, or that tongue sneaking out!

So many TV shows with kids with special needs, someone definitely on the spectrum, and this new show ‘Speechless’ coming soon. Can’t wait for that one!

My favorite part of watching TV these days, though? The commercials! We don’t watch them as much these days with DVR and fast forward, but what a hidden gem!

Google ‘using commercials in speech therapy’ and there are so many great ideas! Especially when it comes to targeting social language skills. Love it!

My favorite right now…a State Farm commercial called ‘Jacked Up’

A girl expresses her excitement over a new car; a man expresses his anger and frustration over his car damage…and they both use the EXACT same words, phrases and sentences to do so.

What can be learned from this short and sweet ad, besides what an insurance company can do for you?

Nonverbal cues

                     Tone of voice and prosody

                                                       Perspective-taking

                                                                                       Making an inference

                                                                                                                        Understanding emotions

The opportunities are ENDLESS!

Video modeling is highly discussed as a tool for teaching social language. Social Skill Builder is one of the many websites and companies that highlights this and provides an overview of the research behind it.

But it is also so much fun*!

(*just be sure you preview the material to make sure it is appropriate for the grade/age level!)

How does watching TV inspire you as a SLP? Share below!

The ABCs of /s/ and /z/

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We all know that there are various reports, research, and information regarding the age of acquisition of speech sounds. How in the world do we decide which ones to use for determining if a student has an articulation disorder? Are you at the mercy of your school system and the age norms they have decided to use?

We have searched many resources and found The Iowa Articulation Norms Project and its Nebraska Replication to be a very helpful read.

When it comes to /s z/, this article raises some great points. Believe it or not, the projects found that acquisition curves for /s z/ did not reach 90% criterion until age 9! Considering that these sounds are so common in English, do we really want to wait that long?

The researchers identified that 80% of responses were adequate by age 7 with slow growth after that. We love the recommendations they provide to look at /s z/ at age 7 with some additional considerations.

To wait or not to wait, that is the question

If a 7-year-old uses an acceptable production of /s z/ in any context (including clusters), it may be best to delay intervention. We should also consider if the child is stimulable for any acceptable production or if they are still waiting on those two front teeth for Christmas! Check again for these same factors at age 8 and again at age 9…but by then we should intervene for sure if errors in production (and educational impact) are still evident.

Speaking of educational impact…

Us school-based SLPs ALWAYS have to consider educational impact. More often than not, with articulation, this is especially evident in the social context. There can definitely be justification to start earlier based on documentation of impact on educational performance!

Too late for lateralizations?

Lateralized productions are not likely to improve with age without intervention. Therefore these should not be considered developmental errors. Early intervention can be considered (as early as preschool) given that the child demonstrates a response to treatment and does not appear to be improving on their own.

Our favorite reference: Smit, A. B., Hand, L., Freilinger, J. J., Bernthal, J. E. & Bird, A. (1990). The Iowa articulation norms project and its Nebraska replication. Journal of Speech and Hearing Disorders, 779-798

Elissa’s personal perspective

You know you’re an SLP mom when you shudder at your two year old’s dentalized /s z/. And you try SOOOO hard not to help her fix it! Then at age 3 it hasn’t changed AT ALL…what’s a mom to do?!?!

So you provide models, show her in the mirror where her tongue goes…

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She’s only 3!

By age 4 she is stimulable (mom breathes audible sigh of relief). Maybe she won’t need speech…

So now she’s 5 (5 ½ if you ask her) and ALL BY HERSELF she produces the most beautiful /s/ and /z/…well, most of the time. Sure she slips now and then but come on…she’s only 5!

It will all be ok!

What age norms do you utilize for /s z/?

Image courtesy of fantasista at FreeDigitalPhotos.net

School’s out for summer…

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Image courtesy of Stuart Miles at FreeDigitalPhotos.net

Most, if not all, of us school-based SLPs are in the midst of summer break. A time to relax, get refreshed, and spend much-needed time with friends and family. And probably do some work – whether you see private clients, do testing or Extended School Year with your school system, or prep for the upcoming school year. It may be just as important to reflect back on all of the hard work you achieved during the school year.

How many IEP meetings were you part of? How many did you schedule? How many were you not invited to (or maybe at the last minute) but somehow managed to get your part completed in time (and figure out a way to attend)?

Did you evaluate more than 20 kids this year? Did you change your schedule once a month, once a week, once a day? Did you have to pack up and move to a new space? Did you have a space?

Were you bombarded with advocates or attorneys? Were you constantly forced to justify your role, decisions, value to a parent, teacher, administrator?

You are a school-based SLP. You fight for students everyday – the ones you work with now and the ones you know need your help. You are passionate about what you do and how you do it. You deserve a break!

So how are you spending your summer?

How do YOU conquer the core?

As SLPs working in the school system, we are charged with supporting the curriculum and standards. According to ASHA’s Roles and Responsibilities of Speech-Language Pathologists in Schools, SLPs level of expertise in the area of language allows us to aid in the linguistic and metalinguistic foundations of learning the curriculum.  These SLP roles must be created with a workload approach in mind and take into consideration the roles of all other educators and the range of student programs and services.

Ok, so what does that really mean for us? I mean, have you looked at the Common Core State Standards (CCSS)? There are a lot of standards! There is a lot of overlap across grade levels with maybe one slight change in wording! There are a lot of assumptions made that students will come into their respective grade level with underlying skills. And don’t get us started on the developmental appropriateness of some of these standards.

Have you considered the amount of language skills required to even begin to learn, let alone master, some of these standards? Wow! It’s truly unbelievable. Imagine if you went through all the standards and pulled the ones that require foundations of language…and identified the specific language skills necessary. Here’s a secret (ssshhhh!) – we’ve done much of that work for you for CCSS and a selection of Early Learning Standards for preschoolers. You can find it all in the recently published book IEP Goal Writing for Speech-Language Pathologists: Utilizing the State Standards. You can find the book and sample pages at Plural Publishing Inc.

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Let’s consider a fourth grade reading informational standard (CCSS 4RI3):  Explain events, procedures, ideas, or concepts in a historical, scientific, or technical text, including what happened and why, based on specific information in the text.

Can you identify any prerequisite language skills that a student must have in order to work toward this standard?

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Image courtesy of hyena reality at FreeDigitalPhotos.net

I think it’s fair to say that in order to explain anything a student needs to possess some describing skills…would you agree?

What about being able to identify the main idea and supporting details? Would they need these skills in order to figure out what happened and why using information from the text?

Sound like some skills you work on daily with any of your language impaired students? Maybe you didn’t even know this standard existed! But you’ve been supporting the standards the whole time, haven’t you?

In addition, every language skill has its own set of prerequisite skills (we’ll talk more about that topic in another post!).

We as SLPs have always known language was the foundation of all learning but there is no limitation of proof when you dive into those CCSS (or any state standards you may be using).

Do you as the SLP teach the standards? Nah, let’s leave that job to the teachers!

Do you as the SLP support the standards, Heck yea! And more often than not you do it without even thinking about it during every session.

Does anyone ever question how or if you support the curriculum and standards? How do you justify the goals you write and the lessons you create (or download from Teachers Pay Teachers)?

It’s not that hard to do!

Comment below and tell us, how do you conquer the core?