Recently, SL3 was mentioned in The Snow Report, a blog written by Pamela Snow, an Australian SLP and Associate Professor at Monash University. Dr. Snow read our recent post on "push-in" services. She described her concern that when SLPs overly focus on services within Tier 1 and Tier 2 that the therapeutic focus within Tier 3 is lost. An excerpt of her post is below:
"....classrooms are educational, not therapeutic environments, and teachers (or indeed teaching assistants) cannot be expected to provide the kinds of specialized, individually-tailored intervention that children with significant language difficulties need, in order for them to engage with the curriculum and form social connections with peers. If SLTs (SLPs in Australia and the USA) are operating more at Tier 1 in a Response to Intervention (RTI) framework, with occasional Tier 2 work and virtually no Tier 3 interventions, this has serious implications for (a) the extent to which such children have their educational trajectories altered, and (b) the development and maintenance of professional SLP skills in ameliorating complex expressive and receptive language disorders in young children. "
At SL3, we believe that Response to Intervention works precisely because it allows SLPs to focus more attention on students with the most severe needs. While Tier 1 and Tier 2 services are an important part of our role, we still focus the majority of our time providing Tier 3 and Special Education Services. So, how does this work?
Below is a breakdown of how we have divided our time as SLPs.
As you can see, 65% of our workload is always spent working directly with students who have IEPs. Some of this time is spent doing "push-in" service, while some of this time is spent doing "pull-out." The setting of the therapy depends on the need of the student. Some students need support communicating either orally or in writing using academic, classroom based materials. Other students need a quiet setting with alternative curriculum in order to improve their communication. Regardless of the setting, this time is spent providing individualized instruction that focuses on students' IEP goals.
We spend another 10% of our workload in consultation. Consultation includes discussing strategies for IEP students as well as joint-planning. If students receive push-in services, teachers and SLPs need to jointly plan in order to ensure that instruction is therapy tailored to individual needs. Students with more severe needs still often receive pull-out services. These students already have difficulty generalizing learning across settings. Therefore, it's key that professionals share ideas and strategies to create an instructional bridge.
5% of our time is spent in screenings. Since the Kindergarten Language Benchmark Assessment (KLBA) replaced all teacher referrals in kindergarten, the bulk of this time happens over three weeks, one each in the fall, winter, and spring. This screening happens concurrently with other school-wide RTI testing such as Aimsweb or DIBELS. One goal of the KLBA is to monitor benchmark data across testing points to ensure that ALL students are improving in their language skills, not just those identified as SLI.
Finally, 5% of our workload is dedicated to Tier 1 & Tier 2 instruction. We have successfully used a mini-lesson model at Tier 1 as described here. For Tier 2 services, we recommend that SLPs advocate for other school personnel to directly lead these interventions, so that we can keep our main focus on Tier 3 students. Some school-based SLPs that we have spoken with have tried training teachers to lead SLP-planned language activities. However, this becomes time-intensive for both the teachers and SLPs. It also often results in a haphazard focus of instructional activities. To solve these problems, we currently recommend that schools use the direct instruction program called Language for Learning (McGraw Hill). Language for Learning is a research backed program that can be delivered by any trained school personnel. It also includes progress monitoring tools that correspond to the program. We recommend that the Tier 2 instructor monitor progress at the completion of every 10th lesson (approximately every 2 weeks). Each month, the RTI team, including the SLP, Tier 2 instructor, grade level teachers, and school psychologist, meet to review the data. If a student is not making gains as demonstrated by lack of growth across 2 data points, then a Tier 3 discussion, including a possibility of full-scale assessment, is warranted.
Dr. Snow concludes her blog post with the following:
"I am absolutely for SLPs and teachers working collaboratively at Tier 1, sharing knowledge, both of theory of individual children. At Tiers 2 and 3, however, SLPs need to be able to offer targeted services to children whose language needs will never be met in the mainstream classroom."
We absolutely agree!
By using a Response to Intervention approach to language services, all professionals within the school are now responsible for ensuring that students grow in their language skills. The SLP acts as a Tier 1 strategy coach, data facilitator, and mentor for Tier 2 support personnel. By doing these things, more students will have their needs met in Tier 1 and Tier 2 supports. This allows SLPs to provide more individualized attention to the students with the most severe needs.