When speech-language pathologists in the Portland (OR) Public Schools embarked on a mission in 2001 to reshape their service delivery model, they hoped to create a better working environment, increase consultative time with teachers and parents, and ultimately enhance services to students. They now have a service delivery model that meets all those goals and more-it also makes the Portland Public Schools a very attractive place to work.
During the 2001-2002 school year, SLPs in the Portland Public Schools participated in a district-wide pilot of a "3:1 model" for service delivery. With the model, three weeks out of each month are designated for direct intervention with students, and one week is set aside for indirect services, such as meeting with teachers, parents, and other specialists; developing treatment materials; and completing paperwork. The model is exactly the kind of new approach that ASHA has been officially advocating since the 2002 adoption of its policy documents on "A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in the Schools."
"With this service delivery model, we sought to do a better job reaching out to other specialists, parents, and general education to align with No Child Left Behind," says SLP Sharon Soliday, who serves as a liaison between clinicians and administration as the SLP technical assistant for Portland Public Schools. "We also wanted to meet the new demands of the reauthorized Individuals with Disabilities Education Act [IDEA] for us to align with curriculum. In the past, we never had time to meet with teachers, know what's coming up in a curriculum, or be able to consult with teachers about students' needs in the classroom."
Following the successful pilot year, the Portland Public Schools administration approved permanent implementation of the model beginning with the 2002-2003 school year. Now in its third year, the 3:1 model continues to be a success for students, clinicians, teachers, families, and the district.
The Pilot Project
Like so many clinicians across the nation, SLPs in the Portland Public Schools faced large caseloads-and not enough time in the workday to juggle direct intervention to their students and the many related indirect activities. When a newly hired SLP spoke of a 3:1 service delivery model used by some clinicians in her previous district in Wisconsin, the Portland SLPs began exploring the idea of adopting such a model in their district.
As the liaison between clinicians and the district, Soliday developed a proposal to pilot such a service delivery model and presented it to district administration. The proposal addressed the need to support students in the general education classroom, the value and purpose of consultation with teachers, and the effects of caseload size and service delivery models. It also included SLPs' testimonials on the benefits of a scheduled consultation week, a draft checklist for documenting the use of their time during the consultative weeks, a sample calendar, and a list of clinicians committed to following the model and providing accountability data during the pilot year.
The district approved the pilot project and implemented it in the fall of 2001.
According to Soliday, results of the 2001-2002 pilot project included:
- significant reductions in speech-language pathology work being completed at home at the district's expense
- significant increase in billings for third-party Medicaid reimbursement, generating money for the district
- fewer student service cancellations, improving compliance
- increase in consultation to teachers and parents, improving quality
- better morale among SLPs
- improved ability of SLPs to integrate speech and language goals with classroom curriculum, as mandated by IDEA
Soliday reports that, while data collection during the pilot did not track student results over time, anecdotal data indicate strong student benefits. "Our increased consultation with general education can only lead to improved, seamless services," she says. "The next logical step in data collection would be assessing student progress and teacher/parent satisfaction over time."
Maintaining the Model
After the successful pilot project, the district permanently adopted the 3:1 model for SLPs in the fall of 2002. Soliday says the model continues to be a success, providing more time to meet with teachers and parents, better compliance with federal education laws, and enhanced recruitment and retention.
"It helps to spend time in classrooms supporting teachers directly. We have not had complaints from administrators-in fact, I believe we are a more visible force in the building," she says. "Many clinicians have become significantly involved in building literacy and reading programs, screening classes they never had time to reach out to before, and introducing new curriculum ideas to teachers."
Soliday, for example, while practicing at the high school level, was able to co-teach a unit highlighting hearing loss prevention. Some students were able to visit the local university's graduate speech and hearing clinic. While she appreciated such an "extra," Soliday said the real benefit was observing students and modeling teaching strategies "for students I typically saw independently. Without a consultative week built into our calendar, I never would have had such an opportunity."
Soliday describes ASHA's workload policy documents as "very helpful as we've shifted our entire way of thinking about our jobs. Only a few years ago we were working to keep folks at a caseload of 50 or fewer. Now, we look at all the responsibilities within our practice, and good advocacy has shifted administration's thinking as well.
"After all, your five students with articulation needs are a different demand on your time than the five students with autism. Our service paradigms should reflect the flexibility we need."
Soliday adds that the 3:1 model also has served as an effective recruitment tool. "As elsewhere, the demand for SLPs is high, and districts are competitive," she says. "However, our student interns quickly figure out the benefits of working in our district and word spreads fast. We're never at a loss for SLPs interested in working for Portland Public Schools."
Spreading the Word
Soliday and her colleagues are sharing their success with others in Oregon, as well as other states. "Word has spread on the success and effectiveness of our service model. Several districts in Oregon have or are considering implementing the same service model. I have presented to SLPs in other areas on the model, and in some cases have followed up with training on how SLPs can support general education curriculum," she says.
"The need for practical information on how to make a difference outside of the speech room is greater than ever before. Many SLPs are not comfortable reaching out to general education. Now, the walls are dissolving and we have more to bring to the table than most realize.
"Although our training may not reflect general education practice, we understand how language skills are related to thinking. And that's what we want for our students more than anything-to be better thinkers. The 3:1 model allows us to make that difference."
For more information on the 3:1 model, contact Soliday at email@example.com. To access ASHA's workload policy documents, visit ASHA's Schools Related Resources page or call the Action Center at 800-498-2071.