Improving Oral Language Skills in the General Education Setting Using Interprofessional Practice

March 17, 2016

Pattan Presenter: Deborah Dixon, M.A. CCC-SLP

Attendees: Christina Owens, Vanessa James, Natalie Greenholt, Bethanie Freeman

Ms. Dixon presented the importance of using interprofessional teams as best practice to support students in the school setting. These groups must meet certain levels of competency to be effective. Some areas of competency include:

  • Values and ethics-for example, embracing cultural diversity and individual differences within the interprofessional team
  • Roles and responsibilities – for example, communicating roles and responsibilities clearly to students, families and professionals.  We do this with students and families, but need the opportunity to communicate about the role of SLPs to the broader district community (i.e. School Board presentation)
  • Interprofessional communication-for example, providing communication tools/technologies to enhance team function
  • Teams and teamwork- for example, integrate the knowledge and experience of other professionals appropriate to the needs of the student

In discussing these competencies as a district team, we identified the need for improved infrastructure to allow SLPs to be part of forums in which student progress is assessed (student concern meetings, evaluation review meetings, reading data meetings and team meetings) as appropriate.  Often decisions are made regarding students who receive speech/language support, without input from the SLP or without the SLPs knowledge that a meeting is being held.

Another area of discussion by Ms. Dixon, as related to Multi-tiered Systems of Support (MTTS) and  RTI, was  the relationship between data analysis and instructional knowledge.  Often data is analyzed among a team, without the necessary team members present. For example, if there are significant sensory or motor concerns the occupational therapist should be part of the discussion. Another example is that there should be a close affiliation between analysis of a student’s reading progress and his/her speech and language development.  Through the lens of speech and language and learning, SLPs can also contribute to PSSA score analysis for those students who are consistently have Basic scores.

Ms. Dixon then focused on the 3 tiers of support in RTI, providing examples of SLP support within the classroom.

  • In Tier 1, the SLP can analyze classroom communication expectations and recommend adaptations. This is particularly helpful in helping teachers support students who have a variety of listening challenges. The SLP can also identify factors that are contributing to a child’s oral and written language difficulties. (i.e. Sequencing deficits, syntax error override, etc). The SLP can also train teachers and paraeducators to facilitate oral language development.
  •  In Tier 2, the SLP can provide short-term instruction in the classroom w/ small groups to address specific skill deficits. For example, the SLP may be part of guided reading instruction to help provide more specified instruction with compare and contrast for those students who have associative deficits.  When observing a student working in reading comprehension, SLPs can often quickly identify missing prerequisite language skills which are interfering with the student’s general comprehension abilities.  The SLP can also provide ways in which the teacher can provide practice and feedback for the child.
  • In Tier 3, the SLP can help provide more intensive and frequent individualized instruction and, in turn, conduct more frequent and focused progress monitoring. Areas in which the SLP is skilled to provide the team with relevant information include, but are not limited to:
    • Categorical semantic deficits
    • Syntax and grammatical deficits
    • Information processing deficits
    • Hearing deficits
    • Language load of instruction all and curricular requirements
    • Milestone deficits for phonemic and language skills
    • Systemic patterns

Following this portion of the presentation, we had opportunity to discuss one skill that is commonly in need of specialized instruction and determine Tier 1, 2 and 3 strategies for that skill.

Ms. Dixon outlined the following foundations necessary for SLPs to participate in oral language facilitation:

  • Appropriate workload (not just the number of students on caseload)
  • Administrative support and teacher acceptance
  • Access to curricular materials
  • Dynamic service delivery
  • Strong collaboration skills and time to collaborate
  • Knowledge of treatment and assessment of oral language and the state standards

One of the major benefits of classroom based speech service and collaboration is that it helps students generalize communication skills and impact academic progress.  There are several models of classroom collaboration models:

  • Complimentary teaching-classroom teacher is primary instructor and the SLP assists students when they encounter difficulty
  • Station teaching – classroom teacher and SLP each teach a group of students and then the groups switch
  • Parallel teaching – students are divided into two groups with SLP modifying instruction for the one group
  • Reteaching – classroom teacher presents material while the SLP reteaches
  • Supportive teaching – SLP pre-teaches a skill to a student individually, then the SLP teaches skill in second session in classroom with classroom teacher present. Then, if necessary, the SLP may work with student individually for clarification or test accommodation.
  • Team teaching -teacher and SLP teach lesson with each addressing area of expertise
  • Consultation – SLP analyzes, adapts, modifies materials outside the classroom and observes in the classroom and meets with teachers to monitor progress.

Data collection should also be completed collaboratively.  Methods of data collection for SLPs, both in and out of the classroom, include technology, audio, video, scripting and templates.  Collaborative data should not just be numbers, but should also be compiled by instructional settings such as whole class lessons, co-teaching, learning centers, and routine daily activities.

Ms. Dixon shared a number of great points that would be beneficial to our district. Time, education, and planning would be crucial to providing services in this manner.

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Managing Cluttering in the School-Age Child: From Diagnosis to Carryover

PaTTAN continues to provide school-based speech therapists with opportunities to receive continued education units related to our direct field.  Today we were able to hear Kathleen Scaler Scott, a Board Recognized Fluency Specialist and Speech Language Pathologist.  She spoke on a topic of study that is often overlooked, Cluttering.  The current definition for this disorder is as follows: “a fluency disorder wherein segments of conversation in the speaker’s native language typically are perceived as too fast overall, too irregular, or both. The segments of rapid and/or irregular speech rate must further be accompanied by one or more of the following: (a) excessive “normal” disfluencies; (b) excessive collapsing or deletion of syllables; and/or (c) abnormal pauses, syllable stress, or speech rhythm.”  This disorder is often misdiagnosed in our culture, as those affected may demonstrate articulation errors, stuttering, word finding issues, and other symptoms.  The presenter shared proper assessment techniques, differential diagnosis information, case studies, treatment options, and ideas for carryover.  Some of these include practicing pausing in speech, learning self-regulation, alternating rates of speech to learn to control moments of cluttering, and watching others (friends, adults, television shows) for signs of communication breakdown and identifying how to fix the breakdown.  Kathleen Scaler Scott provided attendees with new research and information to take back into the classroom to provide proper services to this often overlooked population.

Chris Owens and Bethanie Freeman

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