Monday, 8 December 2014

The Speech Language Pathologist-Teacher Tango


Image source: http://www.freedigitalphotos.net/ 

Because of my interest in the language-literacy nexus and school success, I was very interested to read the following in a recent post on the Speech Language Literacy Lab blog: 

Service delivery models have changed substantially over the last few years. While small pull-out groups are appropriate in many situations, keeping students in their classrooms is more of a priority than it has been in the past. As SLPs, we are often told by administrators that we should be "pushing-in" to general education, and providing services in the classroom. 

This post called to mind some thought-provoking conversations I had with various UK colleagues during my recent visit there. Professor Courtenay Norbury (Royal Holloway, London) was lamenting the fact that Speech Language Therapists in the UK are increasingly providing a secondary consultation service to teachers and classrooms, spending very little time working 1:1 with those children whose poor language skills pose serious and imminent threats to school success, both academically and socially. Courtenay and I discussed the fact that classrooms are educational, not therapeutic environments, and teachers (or indeed teaching assistants) cannot be expected to provide the kinds of specialised, 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. Courtenay observed that a consultation-only model is a sure-fire route to redundancy of the specialist knowledge and skills that sit within the SLP profession.

Some commentators have referred to SLPs providing their 1:1 services to children in "homeopathic doses" -  a charge that most clinicians would recoil from, yet it is hard to argue the other corner if a sufficient intervention frequency and intensity cannot be demonstrated. It will also be difficult to establish the efficacy of SLP interventions if they are conducted in ways that promote classic Type II errors, if not statistically, then certainly in the minds of administrators and policy makers. Remember the dinosaurs?

The other conversation that stands out for me in relation to SLPs and teachers working together on the issue of early literacy instruction is the one I had with Professor Bill Wells at the University of Sheffield. When I commented during a presentation that teachers have, in recent years, received uneven pre-service preparation on the linguistic basis of the transition to literacy, Bill rightly asked me whether I thought SLPs learn enough about how reading should be taught during their pre-service education. While I can't call on any empirical data to answer this question, my guess is that an audit of SLP curricula would reveal similar gaps and unevenness to that which has been reported in teaching curricula concerning linguistic precursors to reading.

So - if we are wanting SLPs and teachers to meet in the middle, then it really will take two to tango.

Dancing Tango

Faculties of Education need to ramp up their curricula with respect to linguistic precursors to literacy (vocab., phonemic awareness, narratives, syntactic complexity and so on) and Speech Language Pathology curricula are going to need to cover historical, epistemological, and pedagogical approaches to reading instruction. If this isn't done, too much time will be lost in trying to deal with turf issues and find a common language between professions. If it is done, however, the children who really need them might have better chances of receiving those Tier 2 and 3 services that genuinely impact on their language, academic, and social struggles.

I am absolutely all for SLPs and teachers working collaboratively at Tier 1, sharing knowledge, both of theory and of individual children. At Tiers 2 and 3, however, SLPs need to be able to offer targetted services to children whose language needs will never be met in the context of the mainstream classroom. Advocacy for this needs to come both from the education sector and from SLP/SLT peak bodies. Failure to do so will "dumb down" the skill-base of the SLP profession and will entrench developmental disadvantage for those children whose language skills are not adequate to meet the rapidly changing academic and social demands of the classroom.


Image source: http://www.freedigitalphotos.net/ 


(C) Pamela Snow 2014

7 comments:

  1. Hi Pamela! Jen Preschern here, co-founder of Speech Language Literacy Lab and author of the blog you reference here. I found your link as I was scanning referrers to my page. (I believe) we've developed a good RTI language system. Our RTI system does make SLPs part consultants and part over-seers of Tier 2 date. However, if the model is implemented with integrity, then it also allows SLPs to really focus on children who truly need Tier 3. Here's an overview: http://www.sl3lab.com/#/rti-for-language-process-using-the-klba/ We're always looking for researchers to use our KLBA (and soon to be released Pre-K version) as part of their research/publications. If you're interested in learning more, please email me at jenpreschern@gmail.com All the best! Jen

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  2. Hi Jen
    Many thanks for your comment. I will look at the link you've provided with much interest. Please be assured that this post is not a criticism of your model - it literally just got me thinking about some of the conversations I had about this while I was away recently. I like your notion of "push in" alongside "pull out" and it's pleasing to see the changes that are occurring at Tier 1. However I think most clinicians in Australia would say that we currently under-do Tier 3.
    Warm wishes
    Pam

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  3. Hi Pam,
    Some children still need a pull-out model. It really depends on their needs. My partner and I are in the process of drafting up a blog in response to your blog :) We'll post a link back here once it's done.

    It's always great to share ideas especially across the ocean!

    Jen

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  4. Terrific! Thanks Jen, I'll look forward to it. Where are you based?
    cheers

    Pam

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  5. Hi Pamela- Here is our blog http://www.sl3lab.com/new-blog/2014/12/11/with-rti-you-really-can-have-it-all Speech Language Literacy Lab is based out of Chicago. However, I am actually living this year in Linz, Austria. My husband's work moved us here temporarily. I've been contract working within a publically financed international school here. Austria is quite behind in terms of special education services (basically, there are none in regular education schools). I've been bringing in the idea of early assessments/interventions to prevent dyslexia. It's been quite fun.

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  6. Hi Jen
    Thanks for your response blog post. I think we might be in furious agreement :)
    I hope you enjoy Austria - it must be beautiful at this time of year.
    Warm wishes
    Pam

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  7. Happy Holidays to you too! Jen

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