COMMDIS416 1st Edition Lecture 13Outline of Last LectureI. 2008 ASHA Survey II. Questions III. 2008 ASHA Survey IV. Rationales for New Service Delivery Models V. Service Delivery VI. Service Delivery Models VII. Direct Services VIII. Indirect Services IX. Flexible Services X. Factors Affecting Choice of Service Delivery ModelXI. SummaryXII. Service Delivery ConsiderationsXIII. Challenges Outline of Current Lecture (Continuation of Lecture 14) -XIV. PAC Model XV. PAC Model based on 3 PremisesXVI. Premise One-Characteristics of Good Service Delivery XVII. Premise Two-Service Delivery Must Be Creative and Flexible XVIII. Premise Three-The Provider, Activity, and Contexts Must be Clearly DefinedXIX. Example PAC(Beginning of Lecture 15) -I. Caseload vs. Workload II. Impact of Large Caseloads III. Workload IV. Workload Analysis V. Approaches to Managing Existing Workloads VI. Scheduling Strategies VII. Massed vs. Distributed Practice VIII. Scheduling 101 Current Lecture(Continuation of Lecture 14) – XIV. PAC Model PACs: A Framework for determining appropriate service delivery options  Consider the unique combination of providers, activities, and contexts (PACs) necessary to meet the specific needs of each individual with a communication disorder.  Used by planning teams to devise treatment plans Helps clarify the roles of teachers, parents, and related service professionals in service delivery process Can be used at beginning to plan goals and direction of treatment or later on to refine/expand treatment optionsE.g. “Classroom-based” interventiono Specifics of the intervention are NOT clear:  Classroom-based materials Collaboration with the teacher Small group in classroom setting Language-based lesson to entire classXV. PAC Mode based on 3 Premises- The PAC Model is based on three premises:1) There are essential characteristics that define good service delivery- Efficacy, Coordination, Continuity, Participation, Economy2) Service delivery must be creative and flexible3) The provider, activity, and context must be clearly specified in the planXVI. Premise One-Characteristics of Good Service Delivery 1. Does the service make a difference to the child? 2. When multiple professional services are provided to the same individual, are all services coordinated and working toward the same end? 3. Is there an uninterrupted sequence of services? 4. Are the individual’s wishes, motivations, and interests considered by incorporating the individual and family members in the decision making process? 5. Are the time, energy, funding, and other resources used most efficiently to accomplish the goals? XVII. Premise Two-Service Delivery Must Be Creative and Flexible  Various key aspects of the service delivery must be manipulated to meet the student’s unique needs.The aspects that can be tailored include:1. The type of service provided2. The amount of contact time the SLP actually spends with the student3. The location for providing services4. The provider who delivers the services5. Individual vs. group servicesXVIII. Premise Three-The Provider, Activity, and Contexts Must be Clearly Defined- Providers-communication partners that can foster meaningful change in a student’s communication and performance o Eliciting, modifying, and reinforcing responseso May change over time as the intervention needs/goals change - Activities-tasks that comprise the total case management for clients with communicationdisorders o Planning, assessing, treating, and monitoring client outcomes - Contexts-the situations, conditions, environments, and interactions where communication is required o E.g., recess, lunchroom (not always academic) o Ask yourself: “Where are we trying to foster “functional communication”? XIX. Example PAC- GOAL: R will use an augmentative communication device to communicate during classroom activities and daily activities at home to request info or comment to teach parents and peers - CRITERIA: requires or comment at least 3 time per day - EVALUATION: teacher will observe R during small group activities and document incidents of request and comment on a chart **(Beginning of Lecture 15) - <<Workload Analysis and Scheduling>> **Need 30 hours of Continuing Education every 3 years !. Caseload vs. Workload - The total number of workload activities required and performed by school-based SLPs should be taken into account when establishing caseloads - Some states have established maximum caseload guidelines for school SLPs, but others leave these determinations to local districts: http://www.speechville.com/advocacy-depot/caseloads-state.html- ASHA does NOT recommend a maximum caseload number, but recommends taking a workload analysis approach to setting caseloads to ensure that students receive the services they need to support their educational programs - In MA, most school districts take a “Caseload” approach o MA does NOT impose a MAXIMUM Caseload II. Impact of Large Caseloads - Minimize opportunity for individualized interventiono Shift from individual to group services - Larger groups sizes o Smaller groups: students tend to verbalize and/or communicate more in small group settings (Schooling, 2000, 2003)- Caseload size, rather than student characteristics, influences recommendations regarding program intensity and/or model of service delivery - SLP recruitment and retention - Integration of curriculumo Become familiar with curriculum goals/standards across grade levels - Reduce time for planning and prep - Impacts opportunity to collaborate with teachers - Limits time to train/supervise- IEP meetings/Due process hearings - Documentation/paperwork requirements for Tx and third-party billing - Limit time available for participating in professional growth and leadership activitiesIII. Workload - Given the expanding roles and responsibilities of school-based SLPs and the impact of larger caseloads on service delivery options and student outcomes, it is imperative that there be a conceptual shift form “caseload” to “workload” - TAKING A WORKLOAD APPROAH: Mike Maykish o “I have been in the Brunswick County, North Carolina Schools for the past 2 years, and we use the workload approach. I feel as though most school-based SLPs, both in and out of our district, would consider themselves "very busy." Theworkload calculator helps individual SLPs to quantify their "busy-ness" in a meaningful way. This has led to several positive changes. It