A Model for Collaborative Service Delivery for Students With Language-Learning Disorders in the Public Schools
Committee on Language Learning Disorders
About this Document
This report was prepared by the members of the American Speech-Language-Hearing Association (ASHA) Committee on Language Learning Disorders: Bonnie Brinton, chair; Jack S. Damico; Lynn M. Flint-Shaw; Noma R. LeMoine; Joan D. Marttila; Patricia A. Prelock; Lynne E. Rowan; Brian B. Shulman; Donald F. Tibbits; and Stan Dublinske, ex officio. Teris K. Schery, 1988–1990 vice president for clinical affairs, was monitoring vice president. The report was received by the Executive Board in October 1990 (EB 158-90).
Speech-language pathologists have traditionally provided services within the public school setting using a variety of service delivery mechanisms. In the most common service delivery method, speech-language pathologists work independently as they pull students out of their regular classrooms for individual or small-group treatment sessions. However, recent emphasis on whole-language approaches to instruction, least restrictive educational settings, and better generalization of treatment results demands the consideration of alternative service delivery options for public school speech and language intervention. The purpose of this paper is to describe one alternative service delivery model for provision of services to children with language-learning impairments within the public school setting. The model is called collaborative service delivery, and it focuses on the role of the speech-language pathologist as a member of a transdisciplinary educational team.
In accordance with Public Law 94-142, speech-language pathologists working in the public schools act as part of an educational team designed to provide appropriate educational experiences for students with special needs. However, the nature and function of educational teams differ widely across school settings. For example, in some service delivery models, the speech-language pathologist serves as a member of a multidisciplinary team composed of educators and parents, each of whom works independently; there is little or no collaboration among team members (Peterson, 1987). In other service delivery models, the speech-language pathologist serves as a member of an interdisciplinary team whose members meet and discuss findings regarding each student. However, little collaboration beyond discussion typically occurs, as each team member assesses and treats students within the confines of his or her own discipline.
Collaborative service delivery differs essentially from multidisciplinary and interdisciplinary models in the purpose, the amount, and the effect of collaboration among team members. The collaborative service delivery model is considered a transdisciplinary approach because it represents an attempt to overcome the boundaries of individual disciplines. In the collaborative model, it is assumed that no one person or profession has an adequate knowledge base or sufficient expertise to execute all the functions (assessment, planning, and intervention) associated with providing educational services for students. Professionals, paraprofessionals, parents, and students communicate and collaborate with one another to make meaningful decisions and to provide appropriate and effective services (Woodruff & McGonigel, 1988). All team members are involved in planning and monitoring educational goals and procedures, although each team member's responsibility for the implementation of procedures may vary. Team members can be considered as sharing joint ownership and responsibility for intervention objectives. In the collaborative service delivery model, the speech-language pathologist serves as an integral member of the educational team and is involved in all levels of service provision, from planning of the overall educational program to direct implementation of specified treatment procedures.
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From the perspective of speech-language pathology, collaborative service delivery is designed to assess and treat communication impairments within natural settings and, on a more global level, to enhance the learning experiences of children with and without handicaps. Collaborative service delivery does not necessarily replace the services provided to students under traditional models. Rather, collaborative service delivery can supplement or extend the services that are provided in the isolated intervention context to the classroom, where students are expected to “play the school game” both on an academic performance level and on a social communication level. The collaborative service delivery model affords the speech-language pathologist the opportunity to (a) observe and assess how the student functions communicatively and socially in the regular classroom, (b) describe the student's communicative strengths and weaknesses in varied educational contexts, and (c) identify which curricular demands enhance or interfere with the student's ability to function communicatively, linguistically, and socially. The purposes of collaborative service delivery are as follows:
To enable professionals with diverse expertise and backgrounds to generate innovative solutions to mutually defined problems (Idol, Paolucci-Whitcomb, & Nevin, 1986).
To facilitate collaboration among the educators of preschool and school-age children in developing functional social communication skills within the classroom context (Frassinelli, Superior, & Meyers, 1983).
To meet and enhance the academic and language needs of students at all educational levels (Damico, 1987; Despain & Simon, 1987; Gerber, 1987; Simon, 1987; Stewart, 1987). Collaborative service delivery maximizes the effectiveness of services provided for students with developmental articulation/phonology and language impairments; cultural and linguistic differences; language-learning impairments; hearing impairments; and autism, mental retardation, and other developmental disabilities.
To stimulate speech and language patterns outside the traditional speech-language pathology service delivery context and to facilitate generalization of targeted skills.
To address the motivational needs of staff members by encouraging interaction among professionals, making maximal use of the professionals' strengths and expertise, and facilitating student progress.
To facilitate communicative functioning in an ecologically valid context.
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The team is the nucleus of the collaborative service delivery model. The team members work together closely to plan and implement each student's educational program. The team consists of the individuals who are involved in the student's education and may include the regular education teacher, the speech-language pathologist, the audiologist, the special education teacher, the psychologist, the parent(s), the student, and any other individuals who act as educational resources.
Collaborative teaming is a skill that requires time and effort to acquire. Members of a collaborative team must possess depth of experience within their own disciplines if they are to share their knowledge with other team members. At the same time, team members will extend their experience beyond their own disciplines as they learn from other members of the team. Close cooperation is essential to foster the integration of professional abilities (Woodruff & McGonigel, 1988). The notion of professional “turf” is inappropriate in the collaborative service delivery model. Professional boundaries are eased and blended as team members release some responsibilities that might traditionally be associated with their disciplines.
The roles of individual team members may be flexible with regard to the student's overall educational program. However, those roles should be carefully defined. For example, a services coordinator should be designated for each student. This person is a team member who oversees a specific student's programming and ensures that services are coordinated and implemented according to the plan devised by the team. In addition, a group leader should be identified to manage the team meetings and to monitor the activities of the entire group. Other roles may also be assigned to team members to best facilitate service delivery. It is important that the services coordinator and group leader roles rotate among the team members so that each professional shares the responsibility for the programming of individual students and for team management.
In collaborative service delivery, the team devises assessment and treatment goals and procedures. Responsibility for specific goals is assigned by the team to individual team members. Typically, one team member assumes primary responsibility for those goals that fit best within that individual's training and expertise. The team member with primary responsibility for a goal devises assessment and treatment procedures, usually with input from the team. Other team members may be assigned secondary responsibility for the goal and may carry out specified procedures as they interact with the student. The individual with primary responsibility for the goal monitors and documents the student's progress on that goal, although various team members may aid in data collection.
For example, the team might decide to assess a student's conversational responsiveness. The speech-language pathologist might assume primary responsibility for assessment and administer measures to probe such aspects of conversational responsiveness as the ability to provide conversational repair in response to clarification requests. Other team members might assume secondary responsibility and carry out assessment procedures that would involve inserting clarification requests into various types of discourse. The speech-language pathologist would collect, analyze, and synthesize the assessment information and present the results to the team. If the team decided to pursue conversational repair strategies as an intervention goal, the speech-language pathologist might retain primary responsibility for that goal and could design a number of treatment procedures to encourage the production of varied repair strategies in response to requests for clarification in academic activities. The speech-language pathologist might then implement certain procedures to facilitate the use of repair strategies during individual or small group activities. In turn, the regular classroom teacher might assume secondary responsibility for the goal, carrying out facilitation procedures during regular classroom activities. The parents might also assume secondary responsibility and carry out specific procedures that feature request-repair sequences during activities they conduct as they staff learning centers in the classroom as volunteers. They might also carry out specified procedures at home. The speech-language pathologist would track the various procedures and document the student's performance regularly. Thus the collaborative service delivery model allows all intervention goals to fit within the student's academic curriculum as designed by the team. Often, treatment procedures can be devised that focus on multiple goals simultaneously.
It should be emphasized that although the responsibility of team members may be described as primary or secondary, this does not imply differences in the relative value or extent of team members' commitment to particular objectives. On a collaborative team, members “perceive that they can achieve their goals if and only if other team members obtain theirs” (Nelson, in press, p. 9).
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The administrator is an integral member of the collaborative service delivery team. Without administrative support, collaborative service delivery cannot be implemented. To obtain such support, team members should communicate directly with administrators about the functions and purposes of collaborative service delivery. Administrators must understand that with collaborative service delivery, professionals can be more innovative in designing and implementing a total curriculum-based approach for each student's own academic and communicative levels of functioning. In addition, this service delivery model can be used to document the effectiveness of intervention in terms of outcomes relevant to the student's everyday life.
Administrators must be willing to provide meeting time for collaboration by all team members. Regular team meetings must be scheduled to plan and monitor each student's program. Typically, these meetings might occur monthly or bimonthly; however, the frequency of meetings required may vary as the student's needs change.
Even though collaborative service delivery could mean that team members work on the same intervention goals, it does not mean that the number of support staff working with students should be reduced. The diversity of expertise represented by professionals from multiple disciplines must be retained. Collaborative teaming is an efficient use of educational resources but not a method to reduce the amount or expense of special services provided to students. Collaborative service delivery may demand reduction in student caseloads or sites served by speech-language pathologists.
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Collaborative service delivery is designed to enhance the interaction among professionals and the coordination of the services provided to students. When determining the plan of action for each student, it is important not to fragment the student's skills and abilities according to different professional interests and expertise, but rather to maintain a transdisciplinary approach. In collaborative service delivery, professionals meet to determine together what the major concerns are regarding a specific student and how best to approach these concerns in remediation. In approaching evaluation, the collaborative team should determine the assessment goals (i.e., “What do we want to know?”), select the most appropriate assessment procedures to evaluate the student, target the most important contexts to sample, and determine who will conduct the various data collection and analysis procedures. Once the evaluation has been completed, the collaborative team determines the most appropriate placement and jointly constructs the student's Individualized Education Program. At this time, the appropriate procedures, intervention contexts, and intervention agents are determined. It is also necessary to determine who will have the primary and secondary responsibility for fulfilling the objectives. No one individual should ever be solely responsible for an objective. Collaboration requires a sharing of responsibility.
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Speech and language assessment involves detailed description of behaviors to determine whether an individual has a communication problem that warrants remediation. The focus of assessment is typically on actual communicative tasks. During the assessment process, the evaluators ask how effectively the individual uses language in a variety of contexts. The collaborative model aids the assessment process in several ways. First, because various professionals are involved in assessment, they can observe and analyze a wide range of tasks and skills. This enables greater sampling of behaviors. Second, collaborative assessment can evaluate the student's behavior on real communicative tasks rather than probing splinter skills that are only tangentially related to communication. On a collaborative team, various professionals who are pivotal in the student's environment can determine which interactive skills are important and can describe the student's success in using these skills. Collaboration increases the linguistic realism of assessment (Crystal, 1982; Milroy & Milroy, 1985). Third, rather than using artificial tasks in contrived situations to determine a student's communicative ability, collaborative assessment encourages data collection in real and natural communicative contexts. This tends to increase the authenticity of the assessment (Muma, 1978; Seliger, 1982; Shohamy & Reves, 1985). Finally, collaborative assessment encourages data collection and analysis from multiple perspectives. Not only the speech-language pathologist is involved, but so are the appropriate teachers, the parents, and even the student. For example, the teacher will be able to comment on the student's ability to handle language in the classroom at all times rather than just during the times when the speech-language pathologist observes. Similarly, the student's parents may lend a different—but valid—interpretation on why their child does not perform well on certain tasks and provide insight concerning the student's ability to establish social interactions in the neighborhood. This triangulation of assessment data increases the validity of the evaluation process (Cheng, 1990; Damico, 1990; Ripich & Spinelli, 1985).
For successful collaborative assessment, the evaluation goals, methods, and results must be accessible and comprehensible to all team members. All assessment results are shared and discussed by the team before intervention goals are selected. With regard to speech and language evaluation, the burden for planning, justifying, and explaining communicative assessment should lie primarily with the speech-language pathologist. However, the responsibility for conducting the assessment is never the speech-language pathologist's alone.
Formal and informal testing procedures may be selected if they are appropriate to the needs determined by the team. Some approaches that lend themselves well to assessment in a collaborative framework include the following:
Baseline data collection methods. These methods involve the use of formal and informal probes and counting procedures that allow the team to closely scrutinize specific behaviors that are significant to the academic needs of the student. For example, if it is suspected that the student has difficulty with linguistic abstraction, specific procedures may be used to obtain baseline information on this behavior (Blank & Franklin, 1980). A number of procedures are available to collect such baseline data on a variety of behaviors in several contexts (Cloud, 1990; Connell, 1986; Fey, 1986; Larson & McKinley, 1987; Loban, 1976; Miller, 1981; Simon, 1984, 1989).
Direct observational procedures. A number of direct observational tools, checklists, and protocols are available to determine what types of problems are present in various contexts. Some of these tools allow for general descriptions of classroom communication that can later be analyzed for specific problem areas (N. W. Nelson, 1985; Rice, Sell, & Hadley, 1990; Simon, 1989). Other tools are designed to focus on specific behaviors that are important to the communicative process (Creaghead & Tattershall, 1985; Prutting & Kirchner, 1987; Shulman, 1985). In each instance, however, direct observation and directed behavioral coding are necessary to help structure a description of behavioral, academic, communicative, and social performance.
Discourse sampling procedures. These widely used approaches allow a professional, paraprofessional, or parent to audio-record, transcribe, and make available for analysis a variety of communicative behaviors. Specific discussions are available on how to collect communicative samples (Barrie-Blackley, Musselwhite, & Rogister, 1978; Miller, 1981; Stickler, 1987), and a number of analysis procedures are available. These procedures range from narrative analysis (Applebee, 1978; Brown, Anderson, Shillcock, & Yule, 1984; Hedberg & Stoel-Gammon, 1986; Johnston, 1982; Westby, Van Dongen, & Maggart, 1989) to the analysis of various aspects of conversational interaction (Bloom & Lahey, 1978; Brinton & Fujiki, 1989; Crystal, 1982; Damico, 1985; Kamhi & Johnston, 1982; Miller & Chapman, 1983; Muma, 1978; Stickler, 1987). Although the speech-language pathologist may be ultimately responsible for data analysis, collaboration with the other team members will mean greater validity and accuracy of data collection and interpretation.
Contextual analysis. In addition to sampling and describing a student's behavior, a number of tools and procedures have been designed to describe the contexts within which the student interacts. Some of these procedures focus on the classroom environment (Gruenewald & Pollack, 1984; Larson & McKinley, 1987; N. W. Nelson, 1985; Ortiz, 1988), and some focus more on the student's home environment (Gallagher, 1983; Peck, 1989). In either case, however, these procedures are appropriately implemented by assessment personnel, teachers, aides, or other paraprofessionals, and they provide valuable insight on the impact of contextual factors.
Curriculum-based assessment. This classroom assessment technique employs probes, protocols, and direct assessment to determine what the language demands of the curriculum are and how well the student can handle those demands. The evaluator describes the actual curriculum, the potential environmental factors at work (e.g., scheduling, teaching strategies), the task expectations placed on the student, and how and when the student experiences difficulties. As Nelson (1989) and Tucker (1985) have discussed, this assessment approach is well suited for collaborative assessment.
Interviewing. Obtaining information from the student and the student's parents, teachers, or peers in an interview format is another collaborative assessment procedure (Cloud, 1990; Holtzman & Wilkinson, 1990). Interviews allow the team to obtain information from the perspectives of others in the student's environment and result in greater validity of test interpretation (Westby, 1990).
Ethnographic approaches. To aid in obtaining assessment information from multiple perspectives and through a rich and detailed description of the student's communicative ability, an ethnographic approach to assessment is valuable (Kayser, 1987; Omark, 1981; Ripich & Spinelli, 1985). An ethnographic approach provides a way to view the classroom as a special kind of culture, which can be viewed from various perspectives. An ethnographic approach specifically addresses the effects that various contextual variables might play in the development of the student's communicative abilities and strategies and it enables a wider interpretation of the data. Such information is particularly beneficial for addressing the needs of culturally and linguistically diverse populations (Cheng, 1990).
Regardless of the assessment methods used, data collection should occur across different contexts and the data should be analyzed from various perspectives. Collaborative service delivery ensures more balanced and typically more valid assessment results.
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In collaborative service delivery, after the assessment process determines the student's academic needs, the transdisciplinary team develops treatment goals to address those needs. The team also designates intervention procedures, contexts of intervention, and primary and secondary intervention agents to carry out those goals. Collaboration allows the use of clinical methods that may not be feasible within other service delivery models. Procedures to improve speech and language can be carried out within genuine communicative contexts. In addition, collaborative effort greatly increases the time spent on treatment and the support provided to the student: Speech and language intervention need not occur only within the time constraints of a service schedule, and the speech-language pathologist need not be the sole intervention agent. Procedures and activities such as modeling, demonstrating, informing, instructing, role playing, and group problem solving can be carried out within varied genuine communicative contexts (Brinton & Fujiki, 1989; Damico, 1987; Marvin, 1987; Miller, 1989).
Some intervention approaches that may be difficult to employ in traditional service delivery models but that are well suited to collaborative service delivery include the following:
Joint text/curriculum review and modification. This approach allows the team to determine how best to select, develop, or adapt the targeted student's academic material in a way that is linguistically relevant to the student's needs (Norris, 1988).
Modified time sharing in treatment contexts. With this approach, team members share and exchange duties within the classroom. This approach offers each intervention agent an opportunity to learn more about effective intervention practices and more time to work with the targeted student. For example, if team members cover some classroom responsibilities, the teacher may devote more time to direct interaction with a student (Gerber, 1987; Simon, 1987). This allows greater flexibility and more individualized and informed intervention in the classroom and other contexts.
Positive and empowering learning environments. In any intervention activities, it is important to establish a positive learning environment (Cummins, 1989). In collaborative service delivery, an environment can be structured to focus on the student's strengths and, at the same time, provide a positive and nurturing context within which optimal learning may occur. This environment should focus on building the student's self-esteem as a learner and communicator and should use appropriate collaborative intervention strategies to address the student's less effective responses to previous failure (Sinclair & Ghory, 1987).
Naturalistic intervention strategies. Consistent with the pragmatics movement in applied linguistics (Oller & Richard-Amato, 1983), the whole language movement in reading (Goodman, 1986; Smith, 1982), and the sheltered instruction approach in bilingual education (Parker, 1985), naturalistic approaches to intervention should be used. Such approaches typically involve using “good teaching practices” (Graves, 1983; Mohan, 1986; Norris & Damico, in press; Oller, 1983; Willig & Ortiz, 1990) from a developmental perspective in a meaningful and goal-oriented context (Brinton & Fujiki, 1989; Fey, 1986). In collaborative service delivery, teaching strategies are child-directed and focus on real communicative strategies in actual interactive contexts.
Mediational techniques and scaffolding strategies. As has been noted by Vygotsky (1978), Bruner (1983), and K. Nelson (1985), mediational techniques such as scaffolding provide an effective approach to enhancing communicative development. In scaffolding, the intervention agent provides challenging input in a way that is buttressed by some supportive technique (e.g., simplification, contextual cuing). The students are presented with demanding information in such a manner that it expands their abilities (Feurestein et al., 1988; Krashen, 1982). Collaborative service delivery encourages the use of mediational techniques such as scaffolding in a variety of communicative contexts.
Peer tutoring. To increase the amount of support and the time devoted to intervention, the use of peers as tutors can be beneficial (Buehler & Meltesen, 1983). With this technique, other students act as intervention agents, typically in natural settings, during those times when the professionals or paraprofessionals are not working directly with the targeted student. Once chosen, student peers are provided with some simple but effective strategies for providing support in academic and social contexts. It is important that the targeted student also act as tutor to other students on some tasks. This practice builds self-esteem and fosters constructive peer interaction (Greenwood, Delquadri, & Hall, 1984).
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Accountability requires that educators be responsible for ensuring that appropriate educational programs are provided to meet the individual needs of students. Accountability for special educational services is an issue whose importance looms ever greater as educational costs rise and expenditures are scrutinized. The general efficacy of special educational programs must be demonstrated to ensure continuing support for them. The efficacy of intervention programs can be verified by illustrating student levels of functioning and documenting student progress toward educational goals over time. Collaborative service delivery is well suited to demonstrating the effectiveness of general programs by documenting and summarizing the progress shown by individual students.
Collaborative service delivery also encourages accountability for the efficacy of individual student programs. Documentation of progress is an integral part of each student's plan as specific areas of student performance (e.g., speech intelligibility, reading, writing, spelling) are evaluated with regard to overall functioning in the academic setting. Toward this end, behaviors targeted for intervention can be observed in natural contexts.
In collaborative service delivery, the team devises procedures to assess and document student progress at the same time as it establishes intervention goals. The team also assigns responsibility for completing the necessary paperwork. The individual with primary responsibility for implementation of the goal is usually responsible for documenting the progress as well. This individual specifies methods to collect and analyze data on student behaviors, with input from the team. Several team members may be involved in data collection, but the individual with primary responsibility for the goal analyzes the data collected and synthesizes the available information. All team members are regularly apprised of student progress on specific goals. Procedures and targets can be modified by the team as the student's needs change.
Collaborative service delivery permits the use of a variety of methods to assess progress. Targeted behaviors can be observed in structured tasks or in natural contexts. Generalization of targeted behaviors to novel contexts within the classroom can be observed. Any effects of student progress on other academic skills can also be documented.
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Collaborative service delivery can augment traditional methods for serving students with language- learning disorders in the public schools. In collaborative service delivery, the speech-language pathologist is an integral member of a transdisciplinary team consisting of educators, parents, and the student. Team members collaborate to formulate a single educational program. for each student. The team devises all treatment goals, assessment methods, intervention procedures, and documentation systems to enhance the student's academic and social functioning in the school environment. All team members are aware of the student's entire curriculum, and team members typically share responsibility for specific educational goals. Most special services, as well as regular instruction, take place within the classroom.
Administrative support is crucial to the implementation of collaborative service delivery. Effective collaboration requires that team members be allotted time to meet outside of their classroom duties. In addition, cooperation among team members is essential. Potential team members must be willing to pool their expertise and abandon notions of professional “turf.” The implementation of collaborative service delivery may require some adjustment in the way speech-language pathologists and other educators perceive their roles in public school settings. However, this service delivery model holds great promise for providing services to maximize the functional potential of students with language-learning disorders.
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