Speech Therapy at School: Inside or Outside the Classroom?

Two models of delivery, collaborative and pull-out, help make speech therapy an enriching, rather than disruptive, part of the school day. The following information illustrates how each model best serves the unique needs of students.

Students who need speech therapy exhibit a variety of speech difficulties and challenges. These can include articulation, understanding questions and directions, vocabulary development, sentence structure and grammatical understanding, expression of wants and needs as well as thoughts and ideas, and social communications. The primary role of the school’s speech language pathologist (SLP) is to identify the student’s speech and language needs and design a therapy program to address those needs. Factors considered when determining need are age, cultural background, type of learning difference, social skills, overall academic performance, family and teacher concerns, and the student’s own attitudes towards remediation.

The collaborative model, also known as inclusion, works primarily within the student’s natural academic environment. The SLP examines how the student communicates and socializes in the regular classroom to understand the student’s strengths and weaknesses in various educational contexts. The general education teacher and the SLP work together on classroom activities and discuss strategies and techniques for academic instruction.

The collaborative model is the least disruptive to a student’s typical school day. The collaborative model best serves children who:

• have met their articulation, expressive and/or receptive goals in a one-on-one setting and now need to practice those skills in the classroom.
• are working exclusively on pragmatic language goals and need practice with peers and adults in a functional setting.
• are working on goals that require a larger group for practice such as listening and communicating during circle time or in a discussion group.
• need general monitoring from an SLP after meeting goals and while being “phased out” of speech therapy.

The pull-out model is a good choice for students with more severe speech issues that require more intensive interventions. Students receive therapy outside the classroom (pull-out) in small groups or one-on-one with the speech therapist. This mode of therapy allows for direct instruction and the use of sound placement models which are not practical for use in the regular classroom. The SLP makes recommendations to the general education teacher to provide reinforcement in the classroom of what the student learns in therapy.

The pull-out model best serves children who:

• are initially identified for articulation issues and need one-on-one drill and practice work.
• would be easily distracted in a classroom setting.
• have auditory processing issues and need a quiet setting to help them learn.
• need oral motor work with a therapist who manipulates the mouth, lips and face.
• achieve their best focus through sitting on the floor or in motion.
• may be easily embarrassed to have extra adult attention in the classroom setting.

With a student’s best interests as the priority, a speech therapy program within the school setting has many advantages. Whether it takes place inside or outside the regular classroom, the therapy should minimize disruption to a child’s daily routine. The effective coordination between classroom teacher, SLP and parents ensures that speech therapy enriches a child’s school day while meeting his unique speech and language needs.

Our appreciation to Wendy Ames, M.A., CCC-SLP, Sagamore Hills Elementary and Danielle Moore, M.S. Ed., CCCSLP, owner of The Language Group for their contribution to this article.

2 Comments »

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1. In comparing the progress made by students in either pull-out or collaborative modes, which group makes more progress in the same given amount of time?

   I am a doctoral student writing on the effects of clinical school social work psychotherapeutic intervention in the classroom as measured by student academic achievement on State-standardized testing. I am thinking of having tier 1, 2 & 3 students in class together and working individually with each student in need of any intervention and doing some whole class interventions as well. Would you think that Tier 1 students who be better served in class or in the SSW’s office?
   I’d like to have your opinions related to speech therapy and to providing mental health services in class for all students, or would you have me think about revising my model for Tier 1 students.

   Thank you for your reply and any references in the professional literature that you would suggest I read.

   Harry Kuhn
   105 Firth Street, South Plainfield, NJ 07080-3721
   hkuhn1@aol.com

   Comment by Harry Kuhn — August 31, 2010 #

2. In my 30-year career as a school social worker on a child study team, I had the greatest professional admiration for speech language specialists who adapted their mode of practice to the actual needs of their students in speech therapy. They were the vanguard in legitimating the provision of related services in the classroom, when appropriate for the individual student’s speech and language development. My own model of applied school social work theory and clinical practice is indebted to my colleagues in the field of speech therapy. Pulling children out of the classroom for services which otherwise could be delivered in the classroom setting is a pretentious fabrication of the mistique of clinical practice in schools. School psychologists and guidance counselor rely on the privacy of their offices to bolster their image as experts extraordinaire. School social workers with clinical training and expertise prefer to approach student needs through on-site, in the classroom, collaboration with the teacher. Pulling students out of class seriously disrupts the flow of instruction and the academic achievement of those students who sit in an office rather than in their classroom.

   Comment by Harry Kuhn, MA, MSW, LCSW, BCD-E, ACSW, DCSW, QCSW — October 12, 2010 #

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