A long time ago, in a setting not too, too far away…
After graduate school, I knew I would be a school-based speech-language pathologist. With the letters M.S. after my name, a bag filled with speech and language therapy goodness and a firm grasp on the ins-and-outs of working in a school, I was ready to tackle my profession. During my first year, the Schedule of Services page on the paperwork was easy to fill out. It was always 30 minutes, twice a week. Once in a blue moon, I would see a student once a week.
No one told me that I was caught in a pattern of service delivery for my students! To be honest, the combination of words “pattern-of-service-delivery” had no significance to me.
I would like to think that experience and knowledge made me change my ways. Rather, it was another SLP asking me why I used the aforementioned schedule. I did not have a good answer. It was the 2004-2005 school year, and I was going to start an intensive service delivery program for 3-5 year olds working on phonological patterns, articulation and expressive language. The data obtained from the Preschool Articulation and Language Services (PALS) program, an intensive model, in McKinney, TX, demonstrated students receiving approximately 2-4 hours of weekly, literacy-based therapy (also incorporating Barbara Hodson’s cycles approach) resulted in students graduating from speech services faster. The best part, their scores on reading assessments in Kindergarten were at or above peers who did not require speech and language services. So, students made quicker progress, and they did better in their general education classrooms? This is surely a win-win.
Let’s look at the research
In 2010, Gillam and Loeb reported four components of language intervention were associated with successful language outcomes: Intensity, Active Attention, Feedback and Rewards. Specifically, the study demonstrated that a 6-week intensive service delivery model showed 5x the gains as a traditional 2-year service delivery model (Gillam & Loeb, 2010). Recent studies found intensity as a consistent factor that contributed to increased language outcomes.
Now, I know what you are asking yourself. Can I do this as a living, breathing SLP who actually works in the schools? We are here to let you know that another school district has already done the work for you. Special Education director Keith Schneider made this happen during the 2012-2013 school year at Jarrell Elementary. With the great brain and passion of SLP Mary Jo Lytton, the powerhouse team tackled intensive service delivery. Here is where Dr. Ronald Gillam makes his second appearance in this post. Mary Jo used Dr. Gillam’s SKILL program (www.usuworks.usu.edu). Supporting Knowledge in Language and Literacy (SKILL) is a step-by-step guide designed to improve language skills that are aligned with the core curricular standards. This program not only tackles story grammar components, but it also addresses ways to elaborate language and writing. After seeing students daily for nine weeks, results on the Test of Narrative Language increased, on average, by 18 standard score points. Teachers reported seeing improved self-esteem in the classroom and measurable differences on reading scores.
Take a look at this pre- and post- story writing sample:
By seeing students every day, Mary Jo was able to address speech and language skills that made a direct impact in the classroom.
Scheduling may be a concern you have regarding this model. Here is what Mary Jo’s schedule looked like:
- 8:05-8:35 3rd and 4th grader
- 8:50-9:35 1st grade
- 9:45-10:30 Pre-Kindergarten
- 10:40-11:10 4th grade
- 2:05-2:50 Kindergarten
Brenden’s language, confidence and behavior has improved within this model.
How to try this out yourself
We also did some leg work for you. If you have a caseload of 50 students across two campuses, you could also go with this schedule:
Intensity: Students will receive 8 hours of therapy every six weeks
Alternating schedule: 3 groups of 16 students (1,2,3)
Each group will have a rotating schedule (a, b, c, d, e)
Group are rotated through two week cycles along with alternating daily schedule
Another possibility would be to see one campus for one grading period and then seeing the other campus for the next grading period. Gasp! I understand this goes against what we systemically have in place in the schools; nonetheless, the results show that with an intensive service delivery model we can improve student scores immensely, and, ultimately, graduate them from speech and language services quicker. That is our goal. We want our students to be in the general education curriculum and have the speech and language skills to function in their classrooms. Intensive Service Delivery may, in essence, be the light saber needed to provide more effective and efficient therapy services.
- Gillam et.al (2008) , Loeb et. al. (2009), Tomblin, (2007), Gillam and Loeb (2010)
- Lytton, M., Palafox, P., Schneider, K. (2013) Jarrell Elementary: Making an Impact on Student Progress [Handouts]. Retrieved from Texas Council of Administrators of Special Education Interactive.