Make It Work: Steps to Save Our Sanity We've all heard the benefits of moving services into the classroom. But how, practically, do we do it? Make It Work
Make It Work  |   August 01, 2013
Make It Work: Steps to Save Our Sanity
Author Notes
  • Kathy Clapsaddle, MS, CCC-SLP is the Austin director for THERAPY 2000, a provider of home-based pediatric therapy services. She has been a public school SLP, a university instructor, and a specialist in speech-language pathology for the Region 13 Education Service Center. She is an affiliate of ASHA Special Interest Group 11, Administration and Supervision.
  • Phuong Palafox, MS, CCC-SLP is a bilingual SLP who has worked in public schools and is now the speech-language pathology and autism specialist at the Region 13 Education Service Center in Austin, Texas. She is an affiliate of SIG 16, School-Based Issues.
Article Information
School-Based Settings / Make It Work
Make It Work   |   August 01, 2013
Make It Work: Steps to Save Our Sanity
The ASHA Leader, August 2013, Vol. 18, 26-27. doi:10.1044/leader.MIW.18082013.26
The ASHA Leader, August 2013, Vol. 18, 26-27. doi:10.1044/leader.MIW.18082013.26
"I just don't know how to do it all."
We often hear this from our SLP colleagues as they juggle an ever-increasing workload. And as long as SLPs continue providing most services in a pull-out setting, the workload problems will continue. For our own self-preservation, we need to think more creatively about service-delivery methods (see "School Matters: Thinking Beyond Caseload," "Time Block After Time Block," and "SIGnatures: Push-In Services: Making the 'Impossible' Possible").
Certainly, pull-out services are effective for some students, but they should be used on a finite timeline. More broadly, we need to align our services to the general education curriculum, providing more "push-in" services in the classroom.
Why push in? Bottom line: It helps us work more efficiently and effectively. We can have a greater impact on our students' skills with the same amount of our time. Classroom-based services allow us to:
Maximize our impact. Teachers have 28 percent of our student's waking time (1,260 hours) in a year. Traditional methods give SLPs approximately 30 hours annually. Let's build capacity by helping teachers to use strategies all day to make a lasting impact.
Promote generalization. Let's face it—children with disabilities aren't the best at generalizing a skill to a new setting. But when we provide intervention using classroom content in the students' natural setting, and consistent strategies are carried over throughout the day, our students use the skills they've learned when they really need them, not just in the therapy room.
Provide strategies for students receiving response-to-intervention. When we are in the classroom, we can provide intervention for at-risk students so they will not become a student on our caseload with an individualized education program. 
Build rapport and community with teachers. Our relationships with teachers improve dramatically when they feel like we are "one of them," rather than the "speech lady" who pulls their students out during instruction. And when they understood and respected us, they were much more likely to be listening and learning during classroom intervention rather than using the time to check e-mail.
And most important, we initiate change in our students that teachers can see in the classroom every day, rather than the incremental change that we see in our data charts in the therapy room.  As one first-grade teacher said, "I've had students pulled for speech. [But] with this model, I saw the most improvement I've seen."
So how do we make this change?
  • First, we have to create time to do it. We recommend using a 3:1 service delivery model that gives you time to ask about the classroom needs for your students and make collaborative plans to address them. 

  • We don't have to change the world in one day. Start with one teacher—the one you eat lunch with or chat with in the hall—in one classroom. Word spreads quickly. Both of us started in one classroom and quickly expanded to all classes in the grade level.

  • We need to focus intervention on what children need to do in the classroom. Literacy is most critical to classroom success, and although SLPs should not be reading teachers, we know that language skills are foundational to reading and writing. If we can help children understand what they read, teachers are much more interested in having us in the classroom.

The shared reading framework, therefore—with its before, during and after reading structure—can be a successful frame on which to design classroom-based language intervention. There are several advantages to this framework:
  • As children become more competent in their language skills, the purpose for reading and the strategies we teach can become more complex. And we can address everything from story grammar to pronouns to writing using this flexible framework.

  • It is adaptable for children at multiple ability levels. Literacy is a life skill, and sharing a book is a meaningful reason to communicate. The framework can remain the same, but the reason for reading can change based on the ability and needs of the student and the classroom.

  • It creates a common language for teachers and SLPs to use in designing intervention.  When we speak the language of the classroom, teachers are more likely to take our strategies and use them throughout the day, rather than relegating those strategies to "speech time."

We also need to rethink what we consider "classroom-based intervention." If the thought of teaching a whole class of first-graders makes you shiver, your classroom intervention could be teaching a center, a literacy workstation or a small group within the class. And for students who need more individual support, consider the use of "therapy bursts"—short, intensive sessions in which you can drill on speech sounds, prime for classroom vocabulary, or prepare students for the classroom-based instruction—outside of the classroom setting. That "burst" of time may give your student with a language impairment the background knowledge he needs to shine in the class.
Finally, share your successes with colleagues, teachers and administrators. Sometimes, we are our own worst enemy because no one understands why we're on a campus or what we do. Let them know!
How to Push In

Here are some resources to get you started on plugging in your services in the classroom, including some videos of SLPs in action.

Inclusion for students with autism spectrum disorder—"The Path to Inclusion," The ASHA Leader, April 27, 2010.

Articles on inclusion for students with disabilities from Language, Speech, and Hearing Services in Schools—"Collaboration and Inclusion: Multiple Perspectives, One Focus."

Life skills lessonshow to address social skills, language comprehension and expression, choice-making and emotional regulation.

Implementing inclusive, literacy-based language therapy in the first-grade classroom—"Bilingual AND Inclusive AND Literacy-Based Language Therapy! Oh my!".

Shared reading strategies: "Shared Reading Opportunities for Direct Literacy Instruction."

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August 2013
Volume 18, Issue 8