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UMass Amherst COMM-DIS 416 - Service Delivery Models

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COMMDIS4161st Edition Lecture 12 Outline of Last Lecture I Individualized Family Service Plan IFSP II Early Intervention EI III Multidisciplinary EI Team IV Eligibility for EI V Areas of Development VI At risk Factors VII Eligibility for EI Continued VIII Possible EI Services Programs IX Case Example X Termination of EI XI Who Pays for EI XII Early Intervention Steps XIII Key Differences Between IFSP and IEP Outline of Current Lecture I 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 Model XI Summary XII Service Delivery Considerations XIII Challenges Current Lecture Service Delivery Models Consider frequency duration type of treatment individual basis one on one or group and location I 2008 ASHA Survey Most school based SLPs use traditional service methods group treatments outside the classroom once or twice a week for 30 minutes for most of their students Influenced by the clinician s caseload size and graduate training what you re comfortable with what you re trained to do Not much has changed since 1910 when school services first were provided o Early speech language treatment was provided in 30 minute group sessions outside of the classroom 2 or 3 times each week Duchan 2010 Given these findings are students needs driving treatment decisions as required by the individuals with Disabilities Education Improvement Act 2004 IDEIA provisions call for school teams to individualize services for students including service delivery decisions one on one separate room in classroom Why do SLPs overwhelmingly provide services to students once or twice a week for 20 to 30 minutes in groups o Is this schedule intense enough to result in significant gains o Unfortunately little research evidence can assist in answering this question o There is evidence that intensive language intervention can result in significant gains Gillam et al 2008 found significant gains in language skills when intervention was provided every weekday for six weeks for a 100 minutes each day Intervention was provided for a short intense period Yet only 2 of SLPs completing the survey reported ever using this type of intensive therapy II Questions What are other reasons that the pull out group model is used so commonly in the school o Easily distracted noise peer interaction o May disrupt the other kid s general education Do some goals require more intensity than others o Yes o Ex Articulation What are the reasons to conduct individual versus group intervention o Build off one another modeling o Feel more comfortable What factors affect group membership success i e how do I form successful groups o No right or wrong answer for this o Probably a good idea to use similar ages ability levels personality Why are clinicians not using classroom based intervention more frequently o Noise control o Embarrassment in front of peers III 2008 ASHA Survey Avoid routine treatment recommendations Make recommendations based on student characteristics Intensity place and type group individual IV Rationales for New Service Delivery Models Changing school populations Deficits impact on educational performance Focus on curriculum based learning Collaboration is essential Law requires services be provided in the LRE alternate models of service delivery rather than traditional pull out model Increasing numbers of students qualifying for services o Shortage of SLPs in many areas Case Load of students with an IEP that you re going to see screen assess Work Load all of caseload everything else you have to do in a day nonacademic responsibilities such as bus duty consulting with parents IEP meetings programming AAC devices report writing reviews assessment reports daily logs V Service Delivery Service delivery is a dynamic concept and changes as the needs of the students change No one service delivery model is to be used exclusively during intervention Unfortunately there is little research to guide school based SLPs in determining how often where and what type of service delivery model should be used when making recommendations to the student intervention team VI Service Delivery Models Direct Services Services provided directly to the students on your caseload therapy and evaluation o Pull out intervention individual or group intervention outside of classroom o Push in intervention individual or group intervention within the classroom and regular education curriculum Indirect Services These include but are not limited to meeting with teachers parents and other specialists developing treatment materials reviewing and writing IEP goals and completing paperwork o Collaborative Consultation training teachers and staff Flexible Services o 3 1 Model direct services provided for 3 weeks indirect services provided for 1 week VII Direct Services Pull out Intervention most commonly used model o Provide direct clinical services o Skills are modeled and reinforced o Regular or special education classrooms o Target a specific skill can group kids who have same type of deficit o Individual and or group comm Disorder e g language voice fluency artic etc Push in Intervention inclusion classroom based o Provide intervention to students with disabilities within the classroom o During a portion of the class you may work next to the child at his or desk for 10 min then include the child in a small group for practice and then observe the child as part of the class applying what he or she has learned o Encourage peer interactions with typical language models o Provide services in natural education environment o Integrate speech and language intervention within classroom curriculum VIII Indirect Services Collaborative Consultation Model o Educate the teachers o SLP offers information and guidance teacher is responsible for direct implementation shared responsibility Assist in adjusting the learning environment Modifying their instructional needs SLP can modify presentation of material and or scaffold response o Material is related to curriculum o Teacher may see this as more work IX Flexible Services 3 1 Model o Combination of direct and indirect intervention Direct service weeks provide direct intervention for 3 weeks Indirect service weeks communicate with classroom teachers about key strategies that would facilitate generalization for each student


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